The URL can be used to link to this page

Browse Search

Home My WebLink About20001537 RESOLUTION RE: APPROVE SIX NOTIFICATION OF FINANCIAL ASSISTANCE AWARDS FOR CORE SERVICES FUNDS AND AUTHORIZE CHAIR TO SIGN -ACKERMAN AND ASSOCIATES, P.C. WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with six Notification of Financial Assistance Awards 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 Ackerman and Associates, P.C., commencing June 1, 2000, and ending May 31, 2001, with further terms and conditions being as stated in said awards, and WHEREAS, after review, the Board deems it advisable to approve said awards, copies of which are 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 six Notification of Financial Assistance Awards 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 Ackerman and Associates, P.C., be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said awards. 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 cif, ATTEST: r % iiic,��`N/� l�'. '�+ �1! './, � !i- • i ' -- arbara J. Kirkmeyer, Chair Weld County Clerk to the): IS • XCUSED J. GRile, Pro-Tem Deputy Clerk to the Boar. tl /, .7 r . E. Baxter APPROVED AS TO FO -- �� Dale K. Hall 74-z-7 Attor ey EXCUSED Glenn Vaad 2000-1537 C ,' 5.5 cker,Mai� his= ,`(L/e SS0027 DEPARTMENT OF SOCIAL SERVICES P 8Ox.A GREELkcY,GO 80632 Administration and Public Assistance(910)352-1561 eili'live COLORADO MEMORANDUM • TO: Barbara Kirkmeyer, Chair Date: June 15, 2000 Board of County Commissioners 1 FR: Judy Griego, Director J d tab Weld County Departmer f S al Se ces RE: PY 2000-2001 Notification of Financial Assistance Awards (NOFAA) under Core Services Funds Enclosed for Board approval are the PY 2000-2001 Notifications of Financial Assistance Awards (NOFAA) for Families, Youth, and Children Commission (FYC) Core Service s Funds, which are for the period ofJune 1, 2000, through May 31, 2001. The Families, Youth and Children Commission (FYC) reviewed proposals under a Request for Proposal process and are recommending approval of these bids. 1. Ackerman and Associates. P.C. A. Option B, Home Based Intensive. A maximum of 60 families for an average of three hours per week of in-home services for a 20-week perind. The average length of stay will be 60 hours. Rate $99.50/hour unit of service. B. Intensive Family Therapy 1. Mediated Family Conflict Resolution: A maximum of two farnili e,v per month (24 per year) with 6 hours of face-to face meetings her family. Services can assist the family in finding behavioral solutions to the existing conflict, not sexual abuse conflicts. Rat(' is $99.50/hour. Page 1 of4 MEMORANDUM TO BARBARA KIRKMEYER, CHAIR WELD COUNTY BOARD OF COMMISSION RE: CORE SERVICE NOFAA FY 2000-2001 2. Short-term Goal Achievement Program: A maximum of 14 Tumuli?, per month with approximately 20 hours of face-to face meetings per month with one therapist present. Rate is $99.50/hour 3. Family Group Decision Making: A maximum of four families prr month (48 per year) involving the nuclear family, professionals involved in the case, and with individual members of the extende 1 family. Rate is $2,000 per family group conference. C. Sex Abuse Treatment.Projected maximum total per year is estimated at 36 families, three families per month, the average monthly capacity is I: families, the maximum stay is 46 sessions over a 12-month period. Gron v treatment provided at one-half the hourly rate. Rate is $99 50/hour. D. Foster Parent Consultation. Group training for a maximum of 12 participants with an average of five participants per group. Telephone consultations for crisis management available for a maximum of one-ha f hour per call. This program anticipates serving 40 family units. The program 's capacity is able 10 serve more than these 40 families. Rate Is $90 an hour. 2. Alternative Homes for Youth • A. Intensive Family Therapy. Multisystemic Therapy (MST): A maximum (PI 36 clients for an average of 20 weeks, with an average of 5.9 hours per week of family preservation services. The program will serve both mah and females from ages of 12 to 18, with a primary caretaker. Appropria r c youth will have one or more issues involving delinquency, drug and alcohol,family conflict, school issues, or mental health concerns. Rate i; $76.01/hour. B. Day Treatment. A maximum monthly of 14 youth (12-18 years of age)per year, five-eight hours of site-based services per day, 40 hours per week or 24 weeks. Rate is $1,490.41/month. 3. Child Advocacy Resource and Referral A. Lifeskills . Parent Advocate Program: This program is a very intensive how based intervention program. Each family would he provided wan two to 50 hours per month of life skills training. Approximate() 165 clients in the 12-month program, 40-50 total family units, families per month, 4-5 hours per week, average stay is 25 week Rate is $42.46/hour. Pagel2 of 4 MEMORANDUM TO BARBARA KIRKMEYER, CHAIR WELD COUNTY BOARD OF COMMISSION RE: CORE SERVICE NOFAA FY 2000-2001 2. Visitation Program: A maximum of 20 families per month, or an approximate total of 90 clients per year. The average stay in the program is 20 weeks, average hours per week is one hour for exchanges, 3-4 hours for visits. Rate is $32.23/hour. 4. Island Grove Regional Treatment Center A. Intensive Family Therapy. A maximum of 60 families a year, 14 units active at any one time, with an estimated average stay in intensive dies amp of 25 weeks (in-home or in-clinic), an average of one-two contacts per week of three clock hours of contact. Rate is $98.75/hour. B. Sex Abuse Treatment Stage 1 of the program will serve an estimated 3t, families per year; Stage 2, 32 families; Stage 3, 10 families. Recommendation is 18 months involvement with all tracks o/'the program an average offour hours per week. Rate chart. 5. Lutheran Family Services A. Option B, Home Based Services. A maximum number of 40 families wi/r children 0-18 years, a maximum of ten families at any given time. Rate is $103/hour. B. Intensive Family Therapy 1. Group Services: A minimum offour families and a maximum of Ian participants per group that is presented in six weekly two-hour sessions. Rate is $150 per direct contact hour. 2. Family Group Decision Making: One or two clinicians will participate in the Family Group Decision Making depending on the needs of the family. A Bilingual/Bicultural Clinician is currently employed. Rate per Family Group Conference is $1,(560 C. Foster Parent Consultation. Foster Parent Support groups, birth child support groups and training groups (parent and/or child.) Hourly rater; $103.00. 6. The Greeley Dream Team A. Lifeskills. A maximum of 2.5 families per year for three hours per week for 24 weeks. Parents would he required to participate in three progran s- Supervised Visitation, Parent Support Group, and Adult Education/Lifeskills. Rate is $38.69/hour. Page 3 of 4 MEMORANDUM TO BARBARA KIRKMEYER, CHAIR WELD COUNTY BOARD OF COMMISSION RE: CORE SERVICE NOFAA FY 2000-2001 7. Mediation Communication Training, Inc. A. Intensive Family Therapy. A maximum of 15 families served yeardy, for i,p to four hours of service per family. Services for pre D&N pleas, determining treatment plans, addressing communication and/or termination of parental rights issues. Rate is $150.60/hour. 8. North Colorado Medical Center, PsychCare, Youth Passages A. Intensive Family Therapy. A maximum of 60 clients under the age of IS for two to four hours of brief solution-based therapy per week per famihi at an average of 8 to 10 weeks. Home visits will be considered on a case by-ease basis. Rate is $83.25/hour. B. Day Treatment. Ninety-six adolescents (10-18 years)per year, eight monthly average capacity, 40 hours weekly for 12-20 weeks. Rate is $18.72/hour. 9. North Range Behavioral Health, Inc. A. Day Treatment. Littler Center, A maximum of 18 children yearly, eight monthly average capacity, 29.5 hours weekly for 36-52 weeks. Rate is S1,510.00/month. 10. Weld County Department of Public Health and Environment A. Lifeskills. A maximum of 16 families served for six to eight months (24 o' 32 weeks), average of one to two hours per week. Rate is $104.15/hour. 11. Weld County Youth Alternatives dba Partners A. Lifeskills. A maximum of 18 families in short-term intervention with children ages 8-18, average of 10 hours per week Or 24 weeks. Rate is $16.50/hour. 12. Weld County Department of Social Services A. Sex Abuse Treatment.Depending on the gravity of the presenting issur.s• there will be variability as to how much contact is required on a weekly basis. Program capacity and the total number of clients to he served wit be flexible. Provider rate. If you have any questions, please telephone me at extension 6510. of Page 4 of 4 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 FY00-PAC-2001 Revision (RFP-FYC-(00010) Contract Award Period Name and Address of Contractor Beginning 06/01/2000 and Ackerman and Associates, P.C. Ending 05/31/2001 Option B —Home Based Intensive 1750 25th Avenue, Suite 101 Greeley, CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Finarcial Assistance Improve both individual and family functioning Award is based upon your Request for Proposal (REP). through in-home services. Service to a maximum The RFP specifies the scope of services and conditions of 60 families. The service offers a range, on of award. Except where it is in conflic with this avenge, of three hours per week of in-home NOFAA in which case the NOFAA governs. the RF1' services for a 20-week period. The average length upon which this award is based is an integral part of the of stay will be 60 hours. action. Special conditions Cost Per Unit of Service 1) Reimbursement for the Unit of Services wi II be based Hourly Pate Per $ 99.50 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 lace to face contact with the child and/or family, as evdenced by client-signed verification form, and as spec[lied in the unit of cost computation. 3) Unit of service costs cannot exceed the hourly, and yearly cost per child and/or family. 4) Rates will only be remitted on cases open with, and Enclosures: referrals made by the Weld County Department of X Signed RFP:Exhibit A Social Services. X Supplemental Narrative to RFP: Exhibit B 5) Requests for payment must be an original and submitted X_Recommendation(s) to the Weld County Department of Social `services by the end of the 25th calendar day following the end oI the _Conditions of Approval month of service. The provider must submit requests for payment on forms approved by Wt Id County Department of Social Services. Approvals: Program Official: t ' By 1, Ah,w Cti By l ( - arbara J Kirkmeyer, Chair Judy Grieg Directo Board of Weld County Commissioners Wel ' oun epartment of Social Services Date: O4.-.?G -2oc Date: 2000 1537 SIGNED RFP EXHIBIT A INVITATION TO BID DATE:February 28, 2000 BID NO: RFP-FYC-00010 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-00010) for:Family Preservation Program--Home Based Intensive Family Intervention Program Family Issues Cash Fund or Family Preservation Program 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 competing applications will be accepted for approved vendors pursuant to the Board of Weld County Commissioners' authority under the Statewide Family Preservation Program (C.R.S. 26-5.5-101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement (C.R.S. 26-5.3-101). The Families, Youth and Children Commission wishes to approve services targeted to run from June 1, 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 Home Based Intensive Family Intervention Program is a family strength focused home-based services to families in crisis which are time limited, phased in intensity, and produce positive change which protects children, prevents or ends placement, and preserves families. This program announcement consists of five parts, as follows: PART A...Administrative Information PART D...Bidder Response Format PART B ..Background, Overview and Goals PART E...Bid Evaluation Process PART C ..Statement of Work Delivery Date ._ ? C) (After receipt of order) BID ST BE SIGNED IN INK � C Nmeh€ \ A inc) TYPED OR PRINTED SIGNATURE VENDOR l l (/t'z r SSoua - C•� „. „ G,s,x--A , _ �rk (Name) Han wri en Signature By Authorized Officer or Agent of Vender ADDRESS l I STh? Sff` 4 Uwe- TITLE' L 1Vl1C\C�1 �t i, rrte Icy Co en,3Y DATE 3 _ z G — C2.) CD) PHONE 14 '1W — 3S3 - 3.373 The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 31 RFP-FYC-99010 Attached A HOME BASED INTENSIVE FAMILY INTERVENTION 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-00010 NAME OF AGENCY: ft c Ice on.o,,., c. or Ass p a _mac C . ADDRESS: / )517 i S 7-1-. iQ vim, 114 /O/ G i-e e / evo PHONE:L 2') - 3 3 23 n CONTACT PERSON: T/ce S� t- �Pl/r Eel- D TITLE: PS/ G /Lc 151-- ) DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Home Based Intensive Family Intervention Program is a family strength focused home-based services to families in crisis which are time limited.phased intensity. and produce positive change which protects children.prevents or ends placement.and preserves families, 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1.2000 Start End May 31.2001/] End �Q G TITLE OF PROJECT: AG."-C �/r�i /To/ m Aa-5`'�L Of t-70.-1- "' , ?p_0/00 - Name an SignAture of Person Preparing Document Date \\U �1'Si- ® M( cNkl -S/coo/GV -- Name and S atu e 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 1999-2000 to Program Fund year 2000-2001. Indicate No Change from FY 1999-2000 _k" Project Description /nine/ c-A - �7 Target/Eligibility Populations ✓ �! Types of services Provided /Measurable Outcomes _ ✓ Service Objectives __i,/ Workload Standards ✓ Staff Qualifications /n .t • _g,/ Unit of Service Rate Computation e'C Program Capacity per Month ✓ Certificate of Insurance Pace 25 of 31 RFP-FYC-99010 Attached A & ermo". /10 e 11 k Othon . Oro u,-r. Date of Meeting(s)with Social Services Division Supervisor: -:_)t _ —0 0 Com ents lry SSD Supervisor: i,t(Pr-' ('I �/ A C t (fc fri, `L _ _ ;L'( � .�� (� A P7/ -ILL Art k L(rLL( e ((/l .f < / r ` /s l- i ' An tit-et. L LP e- 3 - g - vo Name and Signature of SSD Supervisor Date - LJ Page 26 of 31 RFP-FYC-99010 Attached A Program Category Home Baf ed Intensive Family Intervention Program Bid Category _ Project Title 14 lr -,(S Hon-. e tt cc s ect 0/'h� Vendor /9� �.rot -- O.)--1_ As C Cz-lc - PG PROJECT DESCRIPTION Provide a brief one-page description of the project. II. TARGET/ELIGIBILITY POPULATIONS Provide a one page brief description of the proposed target/eligibility populations. At a minimum your description must address: A. Total number of clients to be served. B. Total individual clients 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. Sub-total of Individuals who will have access to 24 hour service. G. The monthly maximum program capacity. H. The monthly average capacity. I. Average stay in the program (weeks). J. Average hours per week in the program. III. TYPE OF SERVICES TO BE PROVIDED 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. Therapeutic Services - includes re-parenting, family therapy, support groups, problem solving, communication skills, parent-child conflict management, etc. B. Concrete Services - means concentrated assistance in the development and enhancement of parenting skills, stress reduction, problem solving, hands-on parenting, budget management.. recreational activities, etc. C. Collateral Services - teaching families to work with other community agencies such as drug and alcohol, health care,job training, information and referral, advocacy, etc. L.. Crisis Intervention Services - including in-home counseling and other intervention; available on a 24-hour basis. Provide your quantitative measures as they directly relate to each service. At a minimum, include a number to be served in each service component. Describe your internal process to assure that FYC resources will not supplant existing and available services in the community; e.g. mental health capitation services, ADAD and professional services otherwise funded. Page 27 of 31 ��., .... RFP-FYC-99010 Attached A IV. MEASURABLE OUTCOMES Provide a two-page description of your expected measurable outcomes of the project. Address the following measurable outcomes: A. Child remains in home at time case is closed. B. Improvements in parental competency,parent/child conflict management and household management competency as measured by pre and post placement functional tests. C. Children who are currently in their own home will remain in their own home 12 months after the completion of Home Based Intensive Family Intervention family preservation services. D. Children currently in long-term placement who are provided reunification Home Based Intensive Family Intervention services will return to their own home and not reenter out-of- home placement 12 months after completion of Home Based Intensive Family Intervention services. E. Families who receive either family preservation or reunification services will not have a substantiated abuse or neglect 12 months after completion of Home Based Intensive Family Intervention services. F, Cases which receive either family preservation or reunification services by Home Based Intensive Family Intervention will measure"LOW" on the risk assessment devise at service closure. 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 Family Conflict Management - Mediation and counseling designed to resolve conflicts and disagreements between parents and their children contributing to child maltreatment, running away and other status offenses. B. Improve Parental Competency- capacity of parents to maintain sound relationship;with their children and provide care, nutrition, hygiene, discipline, protection, instructions, and supervision. C. Improve Household Management Competency-. capacity of parents to provide a safe household environment for their children through competent household cleaning and maintenance, budgeting and purchasing. D. Improve Ability to Access Resources - services shall assist parents in learning to obtain help from other sources in the community and within the local, state, and federal governments. Describe the methods you will use to measure, evaluate, and monitor each service objective. Page 28 of 31 • RFP-FYC-99010 Attached A VI. WORKLOAD STANDARDS Provide a one page description of the project's work load standards and quantitative measures Address, at a minimum, the following areas: A. Number of hours per day, week or month. (Minimum intensity of 3 hours per week per family.) B. Number of individuals providing the services. C. Maximum caseload per worker. (Minimum family caseload of 8-10.) 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 who are providing direct services have the minimum qualifications in education and experience? Describe. B. Total number of staff available for the project. C, Will your staff have received mandated new caseworker training? D. Will your staff have knowledge in risk assessment? E. Will your staff have completed the required State Home Based Intensive Family Services training component? Page 29 of 31 Project Description, 2000 - 2001 Option B Home Based Services Overview: Ackerman and Associates, P.C. proposes to continue to deliver an Option B intensive Home Based program. We have had a very successful first four years of operation. To date we have treated approximately 160 cases in Weld County. The proposal presented here incorporates our combined experiences. Target families are either facing imminent out of home placement or the family has a member who has returned from foster placement. These services are designed to help maintain placement at home or to help reunification succeed. Modifications have been made in this proposal to time limit the delivery of services to one sixty hour cycle with a mechanism to continue therapy in this model for an additional cycle only in very clearly defined circumstances. Entry into the program would involve construction of clearly defined and measurable goals for the family to achieve during the Option B program. Such goal construction would be completed and accepted by the client (as a signed "purpose of the program" for their family) by the end of ten hours of client contact Review of these goals with the client will occur at 30 and 45 hours of treatment. Treatment will be continued after thirty hours only if progress is being made. s1Iome: We propose to continue to provide home-based services in Weld County that : 1. are strongly based in the principles of bilingual/ bicultural treatment, 2. are based upon a nationally recognized model for home-based family preservation, 3. continue to be promptly responsive to the needs of Social Services for feedback on the enrollment of families and the progress of families in the home-based treatment process, 4. continue to be effective at preventing placement of referred children, 5. place the needs of the child first and is consistent within that mandate while simultaneously being valued and appreciated by caseworkers, social services supervisors and the families that are being served, 6. conform to good management practices and are both cost effective and cost contained as set forth in the practice standards stated in the overview above and further in the project design below. Our target for prevention of placement for the past year was 85% which means of the projected up to 60 families in our program, no more than nine families should have to 1 ultimately receive placement during the program period. pet= Implementation of our program in Weld County has been quite successful in the last four years. This proposal incorporates changes and adaptations to this model as we have implemented it since 1996. We have also incorporated a number of mechanisms for 1) cost containment and 2) to limit renewals of clients beyond sixty hours of service. We believe this program should be time limited and results oriented in the delivery of services. The goal for 2000-2001 for the program is to tighten service delivery standards as follows: 1. To have 70% or more of clients referred need no more than sixty total hours of service. Those who continue will do so only because this is the most cost effective alternative available 2. A mid point review at 30 hours into the initial program will be conducted. The aim of this review is to identify families who have reached appropriate treatment goals who can either 1) stop or 2) who can step down to a more supportive or maintenance level of treatment. This "step-down" level will be delivered less often for the remainder of the program. Those who have entered a maintenance phase will have a review at 45 hours of treatment. Those who, at the 30 hour review, appear to have had a clinically insignificant level of progress on their case plan will be referred back to Social Services. 3. Of the remaining 30% or less who we anticipate will need more than sixty hours of treatment, two out of three will complete treatment for the episode they were referred for in 30 additional hours or less. Specifically, continuation would be in increments of 15 hours and a thorough review by the clinician and the caseworker would be documented. A decision would be made by this team at sixty and seventy five hours if further treatment is needed prior to proceeding into the next 15 hour segment. 4. All families who need more than 60 hours of treatment will either be: * referred to a specific life skills program, * referred to short term intervention programs such as GAP to finalize treatment, * stepped down to a maintenance mode of treatment in a home based renewal either once every two weeks or once a month or * referred back to social services for determination of future action if progress in our determination has been inadequate. 2 QYher Considerations: The strength of our staff in this project, in experience, in bilingual/bicultural service delivery and in the delivery of home-based services to over one hundred client families are considerations we think are important for the reviewers of this proposal. Nicole Warnygora, MA, Licensed Professional Counselor and Doctoral Candidate in School Psychology, has extensive experience in work with children from extremely disturbed backgrounds and a year of hands-on experience with our home based program. Dr. Sherri Malloy, Licensed Psychologist, was formerly director of the Children's team of the Boulder Mental Health Center and has a year and a half experience in Home Based Option B Program delivery with us here in Weld County. Emily Jaramillo -Bansberg, MA is a bilingual psychotherapist provider from the Greeley community with a master's degree in counseling. She also self-identifies as Hispanic. She has worked in the Family Recovery Center and in educational support for minority students at UNC as well as in private practice, including work for Home Based clients in the past year. Dr. Joyce Ackerman, Licensed Psychologist, is director of Ackerman and Associates and clinical supervisor of the program. Other staff are listed later in this proposal. We seek to continue to be on the list of approved vendors for the provision of these services. Target/Eligibility Populations A Total number of clients to be served . Five families per month times twelve months equals sixty families per year. If we assume a family size of six, two adults and four children, then the total client pool to be served is 360 individuals. That number includes at least 60 individuals who face either imminent out of home placement or who need reunification services. B. Distribution of clients. Total number of clients we will serve is approximately 360 as calculated above. Our experience suggests we would expect approximately 120 of these to be adult members of the family and approximately 240 to be minors. The age distribution of the index case children would tend toward the younger children based on our experience with home-based intensive therapy. We estimate that about one third of the index children would be older than ten with an average age of about 14 and about two thirds would be under ten. The older group would most likely be teenagers in conflict with their family. The younger group will consist of children of no particularly predictable age whose parents are in conflict usually in relation to instability in the marriage. 3 C. Families Served,We would anticipate serving up to 60 family units. D. Sub total who will receive bicultural/bilingual services. As stated above, Emily Jaramillo-Bansberg is a master's level counselor (who is also Hispanic) who can provide services in Spanish or English. She will serve one third of the projected caseload. This represents a maximum of 20 families. Thus, one third of the projected total will be able to be conducted bilingually. All of the services provided (for a maximum of 60 families) will be done in a manner which is sensitive to the culture of origin of the family. E. We can provide services in South County and have done so in the last year. We anticipate that up to one third of the projected case load or 20 families may reside in the South County Area. F._Accessibility. All providers of Ackerman and Associates are accessible through a 24 hour answering service, cell phone and pager system. On weekends, our 24 hour access reaches the provider on call who is always a licensed Mental Health Provider. These providers are Laurence Kerrigan, Susan Bromley, Sherri Malloy, Joyce Ackerman, Karen Bender M.S. L.P.C. and Nicole Warnygora M.A., L.P.C. G. Maximum per month. The program maximum is five families accepted into the program per month. H. The monthly average capacity is two to five families per month. I. The average stay in the program is three hours per week over an average of a twenty week period, (sixty hours). For some families the sixty hours of treatment may be delivered over a longer or shorter period with more services delivered early in the program and less per week toward the end of the treatment. This is a design where services are more intense during a crisis and decrease gradually as clinically appropriate. The average length of stay will be sixty hours. Specific restrictions on the average stay in the program are described in the design section of this proposal. Types of Services Provided We will provide the following services to all families in the program. Specific details which further define these services are in the section of this bid called service objectives. Our model is summarized below: We are using the following strategies to increase effectiveness with families: 1. An immediate initial response to the crisis is made because people who are 4 in crisis are often more motivated to change. This has proven to be an excellent opportunity for client/therapist bonding. 2. The therapist focuses on the family's presenting problem. This increases the client's motivation to work on that problem. Clients are perceived in this model as having the best information about themselves and their lives. Everyone has strengths, skills and unique cultural experiences. Recognition of these experiences and respect for the family usually lead to positive working relationships. From this working relationship a scope of work to be achieved over the sixty hours or less of treatment is formulated and signed off by the therapist and the client(s). This becomes the case management plan and will be completed before the completion of the tenth hour of therapy. 3. Services are provided in the client's natural environment as much as possible to increase accurate assessment, therapist credibility with the client, and the probability the client will incorporate the material they learn into daily family activities. Some services and group work will be available in the office setting. 4. The practice is available on a 24 hour basis to address client concerns Such access increases the ability to monitor for potentially dangerous situations and provide immediate assistance in crisis situations. 5. Home Based Services uses skills-based intervention to empower the client to handle life situations without the help of others. This also lessens the need for ongoing long term intervention. 6. Specific review of use of services will be conducted at 30 and 45 hours of treatment. The client will participate in these reviews as a requirement for the continuation of services. A Therapeutic Services: We will provide the following services and document the delivery of these services using an individualized treatment plan for each family. Progress on this treatment plan will be reported to the caseworker on a monthly basis. The family treatment plan will be developed during the first thirty days of contact and as early as clinically appropriate but not later than hour ten of treatment. The plan will address the concerns identified by the WCDSS caseworker who fills out the family referral form as well as those raised through a clinical assessment of the family by the therapist, either Nicole Warnygora, M.A., L.P.C. or Emily Jaramillo-Bansberg M A. or Sherri Malloy, Ph.D. Clinically appropriate intervention strategies will be chosen by the therapist working with the family. Inherent in these modalities is the need to show progress on the goals stated in the case treatment plan. 5 In most families served by this program a selection of the following modalities will be utilized based on the individualized list of identified family needs: 1. Re-parenting including emotional support to address those issues related to the parents' family of origin, and parenting role models. 2. Family therapy to address structural and issue related difficulties the family is experiencing. 3. Support Groups to address couples' communication, alcohol and drug issues and other issues as identified. 4. Problem solving and negotiation skills to enhance the client's interpersonal effectiveness in implementing change. 5. Communications skills to enhance general aspects of interpersonal effectiveness. 6. Parent child conflict management skills to enhance the parent's ability to set effective limits for the child in a nurturing manner. Note that while the modalities outlined are general and may not apply to all families in all cases, the choice of clinical mode of treatment will be determined by the desire to produce documentable change over the period of treatment in relation to the specific problem for which the family has come to the attention of the Social Services System. There is obviously a tension between general improvement for the family unit and specific improvement in current behaviors and likely patterns of behavior that are detrimental to child safety. This tension needs to be reflected in the case plan and therapy must focus on achieving child safety and family improvement sufficient to protect the child within the treatment time limits in this program. B. Other Services: In addition to the therapeutic interventions described above, client families must be able to apply those concepts and skills to their own specific needs and experiences. They must be able to put these ideals into practice in their own family in order to protect their children. Their ability to do so is what we term concrete skills acquisition. We use the term concrete skills acquisition to describe the incorporation of behavioral management practices into the daily life of the family. This is distinct from the functional aspects of concrete services which are described later. Progress in this area and in other aspects of treatment will be documented in the family treatment chart. Behavioral Components of Concrete Services: Specific aspects of the family behavior where concrete skill acquisition is 6 documentable and usually necessary for family success to either prevent placement or retain a child who has been returned to the home include: 1. Development/enhancement and maintenance of parenting skills including nurturing, limit setting and appropriate child management. 2. Stress Reduction and Anger Management Skills. 3. Communications , problem solving and negotiation skills to enhance interpersonal effectiveness. 4. Practice in hands on parenting skills using a coaching model to provide feedback, reinforcement and clarification as to appropriate child management skills. 5. Money management including budgeting and resource acquisition. 6. Other activities of daily living including recreational activities related to enhancing family development, spiritual support, community involvement and maintenance of physical and emotional well being. Functional Aspects of Concrete Services In addition to helping clients learn and use concrete behavioral skills as described above, many client families need what we term functional concrete skills. These are skills at meeting the physical needs of daily living. By providing a forum for the client to determine how to improve access to the basic needs of daily living, the therapist helps the family obtain and plan for basic support for itself. When a family's basic needs for food, shelter and safety are met, they are better able to focus on acquisition of skills and on emotional recovery. We will seek to help families identify resources so that they can meet basic needs from the list below from within the income available to them. This allows the family to prioritize within the following categories as needed on a case by case basis. It is not anticipated that all familes will need all of these areas of service: Transportation _ Housework/cleaning Financial assistance Child care/babysitting -- Clothing — Legal aid Housing -- Utility benefits or services Food Medical/dental services -- Client employment Furniture/household goods Toys/recreational equipment C. Collateral Services: Collateral services involve connecting the family with the services they need in the community. Such services may include: • Drug and Alcohol Services. Such services are available on an outpatient basis through Ackerman and Associates, P.C. within the services we propose here for mild 7 to moderate levels of problems with addictions. Referrals to other alcohol and drug treatment programs including Island Grove and Family Recovery Center are available as well. • Health Care Referrals are also routinely available in our practice. Referrals to Sunrise Health Center and The Family Residency program are also available. • Job training referrals are available through the Job Services and through Vocational Rehabilitation. Case management is an important role for the providers of the home-based services in that our providers will help the family access services they need. D. Crisis intervention: Twenty four hour access is assured for the families to reach the providers. We have secretarial and office staff support 9-5 Monday through Friday at Ackerman and Associates, P.C. We maintain a twenty four hour, 365 day a year access system through our answering service. All providers can be reached through pagers by the answering service. In-home services for crisis intervention are available through this on call system. The Home Based specialists are on call during the week nights and on weekends we have a rotating call system within the providers of Ackerman and Associates. Measurable Outcomes Measurable outcomes are of two varieties. One type is termed formative outcomes and the other type is called summative outcomes. Formative outcomes measure how the program is proceeding while the treatment takes place. Summative outcomes are the results of the treatment. In terms of formative measures we have the following: 1. Did the family accept the referral from their caseworker? 2. Did we accept the family to our program? 3. Is the family making progress with the treatment plan for each component as outlined in the service objectives? 4. Has the family followed through with recommendations and referrals during the course of treatment? Summative outcomes: Over the duration of the six month treatment, we determine the following information. Is the child still in the home? How well are the changes from treatment persisting? This measures if family behavior is different compared to their behavior before treatment. Specific summative outcomes are listed below. 8 A 'The child receiving services does not go into placement and remains at home at the time the case is closed. This will be measured by recording the status of the child at the time the case is closed. B. Improvement in Parental competency and parent child conflict management will be measured by pre and post clinical assessment. A narrative which we term the monthly summary of pre and post treatment family conditions will be constructed based on a review of the treatment on a month to month basis and when the case is closed. This narrative will document the therapist's judgment of changes in parental competency compared to baseline. Failure to make progress will be discussed with the client at the 30 and 45 hour review sessions. C. Children will remain in the home twelve months after the case is closed. This criterion can be measured at the twelve month follow up contact by the caseworker. D. Children who were reunified will still be in the home twelve months after the case is closed . This criterion can be measured at the twelve month follow up contact by the caseworker. E. Treated families will not have a substantiated abuse or neglect twelve months after the case is closed. This information can be obtained by checking with the referring caseworker at Social Services at the same time as points C and D above are assessed. F. Families will be rated "low" on the risk assessment device at closure of the case. The providers will rate the family at the time of case closure on: 1. adherence and success with the treatment plan, 2. pre/post changes as documented in the discharge summary 3. clinical impression of future success. As well, other rating instruments in use by social services for monitoring home-based programs will be completed as requested. Service objectives We have the following service objectives: A. Improvement of family conflict management. The program is specifically designed to resolve conflicts that either precipitated the likely imminent placement of the child or which prevent the reunification of the child with the family. The initial goal of services is to assist the family in finding behavioral solutions to the existing conflict. Each provider is skilled in family systems work by experience and training. Other 9 aspects of conflict management include the following areas: Parent child conflict clarification Problem solving skills Negotiation Skills Communication Skills Multifamily Communications Group B. Improved parental competency in this treatment model centers on the parents developing more age appropriate strategies. In dealing with conflicts with their child especially with teenagers, the areas of discipline, protection, instruction and supervision seem most responsive to improvement. With younger children the treatment gives the parents the opportunity in their own home to practice and to clarify the roles each parent expects of the other and what is expected of the child. This model of home-based care is able to improve parental performance based on the experience that this staff brings to this proposal. Some examples of these service objective include delivery of services in the following skill areas ( although not all families will need all skills improved or work on all topics.) The areas in need of delivery for a specific family would be determined by their specific case plan. Some parenting skills include: Schedule of reinforcement _ Active listening skills Charting behaviors -- Using "I" statements Natural/logical consequences Problem-solving strategies -- Time out Coaching and Modeling good parenting practices Emotional skills include: Anger management -- Use of crisis plans Depression management Anxiety/confusion management Self-criticism reduction Building self-esteem _ Relaxation Handling frustration Tracking emotions Impulse management Interpersonal Skills include: Social skills Appropriate sexual behavior Problem-solving Negotiation skills Giving/accepting feedback Assertiveness skills include: differing aggressive v. assertive being fair respecting others and self 10 Other Intervention Topics that may be useful for family practice: Use of a journal -- Coordinating treatment plans Encouraging/building hope Setting treatment goals/objective Providing reinforcers Doing homework Counseling Relationship building _ De-escalating — Clarifying family roles -- Values clarification Coping with change -- Providing support/understanding Learning child/adolescent development Establishing structure/routine Clarifying problem behaviors Establishing family rules Defusing crises Role playing Reframing Managing money Pursuing leisure activities Managing time _ Job hunting/interviewing Identify strengths Practicing parenting skills C. Improve household safety. One aspect of the treatment plan is associated with maintaining a safe household environment, and in some families adequately cleaned and maintained and stocked with food and supplies. Service objectives assisting it the acquisition of the following areas as appropriate to the needs of a family might include Transportation _ Housework/cleaning Financial assistance Child care/babysitting -- Clothing Housing _ Utility benefits or services Food _ Medical/dental services Client employment Furniture/household goods D. The program will provide access to needed services as documented in the treatment plan for each family. Specific types of referrals may include the following Referral to counseling _ Working with schools — Referral to drug/alcohol program _ Referral to social services Using support groups Implementing court orders Negotiating with utility companies _ Coordinating with diversion/probation Recognizing potential suicide -- Coping with domestic violence Risk assessment Workload Standards A. The program has a capacity of five families per month with an average of two to five families per month. The families will receive an average of three hours per week for twenty weeks with a maximum length of service being five months and a maximum number of hours per family being sixty. All families will be treated within this 11 framework regardless of the family composition. B. We have three providers for this program who will be home based specialists. They are Nicole Warnygora, Emily Jaramillo -Bansberg and Sherri Malloy Gonzales Nicole Warnygora, M.A., L.P.C. is also a doctoral student in School Psychology at UINC. She has extensive experience with severely disturbed children including day treatment program experience. She has been providing Option B services over the past year. Emily Jaramillo-Bansberg, M.A. received her masters in agency counseling from UNC. Prior to joining Ackerman and Associates, she had a wide range of work in mental health including treatment for alcoholic patients and support of minority college students. She is fluent in Spanish. Her undergraduate major was in Criminal Justice and Sociology. Sherri Malloy, Ph.D. is a Licensed Psychologist specializing in children. She was director of the Children's Team at the Boulder Mental Health Center. She has worked in home based delivery in Weld County during the past two years. All of our staff are highly regarded by the caseworkers based on feedback we have received from supervisors. The three psychologists who complete the staff of Ackerman and Associates serve as back up and support for the Home Based Specialists and are available on call to assist them as well as to consult on intervention strategies on an anonymous case presentation basis. The psychologists are Joyce Ackerman, Ed.D., Laurence Kerrigan, Ph.D., and Susan Bromley, Psy.D., Karen Bender, M.A. Licensed Professional Counselor has extensive experience in treating adults for domestic violence and in the treatment of adults who have suffered sexual abuse. Other providers may be added at a later time. C. Of the up to 60 families the caseload is projected at twenty families with each provider. D. The modality of treatment is home-based care using our adaptation of the home builders model. As well, referral and group treatment and support will be offered as described above. E. Hours/weeks The total number of therapist hours is 60 per family over six months or a total for the budget calculation of 3600 per year based on our projected average. Maximum capacity is the same as this level. The hourly fee is requested at $99.50 as documented in the rate calculation section. F. Staff There are three individual providers supported by two office professionals in the practice. There are also three psychologists and another licensed professional 12 counselor who provide on call support and back up services. G. Supervisor - This contract would be supervised and clinically managed by Joyce Shohet Ackerman, Ed.D. who would monitor the project for compliance. The maximum caseload for the supervisor is five families per month. H. Insurance - Ackerman and Associates, P.C. carries one million three million liability coverage for professional liability on the corporation and its associates and each associate also carries the same level of coverage individually. In addition, Ackerman and Associates, P.C. carries a general liability policy related to accident or injury on our premises through Farmer's insurance. Staff Qualifications A. All staff members who will be Home Based Specialists exceed the minimum qualifications needed for this project in both education and experience as described above. B. Staff available for the project consist of the three Home Based specialists and three licensed psychologists and a Licensed Professional Counselor. C. Current Mandated Training: Emily Jaramillo-Bansberg, Nicole Warnygora and Sherri Malloy Gonzales all trained under supervision in this model with an individual who was a supervisor in Home Based Programs at that time. All of the above are trained at the masters degree or higher as mental health professionals. D. All of the Home Based specialists and all the psychologists have knowledge of risk assessment and are skilled in the application of that knowledge especially in reflation to the assessment of risk of harm to self or others. E. Will staff have required state home based training?. We have operated for the past four years without additional training beyond that described in paragraph C above. Unit of service rate computation We have calculated the unit of service rate based on the instructions. We used 1999 data for our agency. Using overall figures for the agency we arrived at a figure of$99.50 per contact hour. Group rates are billed at one half this rate per hour. The profit for Ackerman and Associates for all programs was 2.9% of gross revenues in 1999. 13 The volume of services for the home based program has been substantial and we anticipate it being maintained based on the success and popularity of the program with both families and caseworkers. As well the modifications put into place in the design section should increase its cost efficiency. The proposed cost is $99.50 per face to face contact hour. This is consistent with our operating fees for face to face therapy hour as allowed in other protocols we do with WCDSS and provides essentially the same provider fees of approximately $60.00 per contact hour consistent with the goals we set for all contractual relationships for providers. Budget Justification PAC money is tracked through a computer data base system called MediMac which we have used for the past 48 months. The system allows us to track payments by client and by source of payment and any payment through the PAC will be tracked in this manner. No special issues are present related to project audit to our knowledge. Ackerman and Associates mediation program was audited in a random audit (conducted by Anderson and Whitney) after its first year of operation with no deficiencies. Audit of the program will be conducted on a yearly basis. Ackerman and Associates, P.C. is a type S professional for profit corporation and not a 501.c.3. Specific standards of responsibility for the 2000 -2001 year have been addressed in the body of the proposal. 14 ,n] O RFP-FYC$4010 Attached A VIII. COMPUTATION OF DIRECT SERVICE RATE This form is to be used to provide detailed explanation of the hourly rate your organization will charge the Core Services Program for the services offered in this Request for Proposal. This rate may only be used to bill the Weld County Department of Social Services for direct, face-to-face services provided to clients referred for these services by the Department. Requests for payment based on units of service such as telephone calls, no shows, travel time, mileage reimbursement, preparation, documentation, and other costs not involving direct face-to-face services will not be honored. Likewise, billings must be for hours of direct service to the client, regardless of the number of staff involved in providing those services. Therefore, it is imperative that this rate be sufficient to cover all costs associated with this client, regardless of the number of staff involved in providing these services. (Explanations for these Lines are Provided on the Following Page) Total Hours of Direct Service per Client 620 Hours [A] Total Clients to be Served (✓/� O Clients [B] Total Hours of Direct Service for Year _ 3 &O O Hours [C] (Line [A] Multiplied by Line [B]Cost per Hour of Direct Services $ 1J /,►Iy 6, 7 o Per Hour [DI F,1/90-- Total Direct Service Costs 'q` [HI (Line [C] Multiplied by Line [DI ) p y gO Administration Costs Allocable to Program $ / [FI (��( yyo Overhead Costs Allocable to Program $ [G] Total Cost, Direct and Allocated, of Program$ .? / /i IOC [HI Line [E] Plus Line [F] Plus Line [G] ) Anticipated Profits Contributed by this Program $ /ç0 [1] Total Costs and Profits to be Covered by this Program(Line [H] Plus Line [I] ) $ 2.5-8 ° [J] NA. ✓ Total Hours of Direct Service for Year ' 0 [1K] (Must Equal Line [C] ) Rate per Hour of Direct, Face-to-Face Service to be Charged to Weld County Department of ,-'i: - Social Services $ [1] Page 30 of 31 • CIS' ]RFP-FYC, $010 Attached A Day Treatment Programs Only: ^ Direct Service House Per Client Per Month AM [N NA .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 tco 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 ES 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 on:y, this line represents the estimated number of hours per month your organization wlll 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 31 of 31 Branch B/A Producer# Issue Date Renewal/Rephicement No. 32 A 0002360 04/27/1999 RENEWAL PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. _ Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2032570 1. NAMED INSURED: ACKERMAN AND ASSOCIATES PC ADDRESS 1750 25TH AVENUE (Number & Street, Town, GREELEY CO 80631 County, State & Zip No.) 2. POLICY PERIOD: From 05/01/1999 'To 05/01/2000 (12:01 A.M. Standard Time At Location Of Designated Premises) 3. COVERAGE: LIMITS OF LIABILITY PZE"vMIU\l Professional Liability $1 ,000,000 $3,000,000 51 ,686.00 each Incident Aggregate 4. BUSINESS OF THE INSURED: Psychology 5. THE NAMED INSURED IS: Sole Proprietor (including Independent Contractors) ( ) Partnership (X ) Corporation OTHER: 6. This policy shall only apply to incidents which happen on or after: a) the policy effe:ti‘e date shown on the Declarations; or b) the effective date of the earliest claims-made polio v issued by the Company to which this policy is a renewal; or c) the date specified in any endorsement hereto. 05/01/1992 7. This policy is made and accepted subject to the printed conditions of this policy together with the provisions, stipulations and agreements contained in the following form(s) or endor.emenUsl- PLJ-2008 ( 10/94 ) POE-8004 PLE-2167 PLE-2081 P0N-2003 PLE-8036 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel Office Address: 1776 West Lakes Parkway Town and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 IMEMOMMEMME INTERSTATE IN>URANC.E MMOMMEMENNI CNUUP PLP-2012 (06/93) (Elec.) Ec _asN Branch BiA Producer # Issue Date Renewal/Rep,ac( men; 32 A 0002360 05/05/1999 DJPL : :ATE PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2050203 1. NAMED INSURED: SUSAN PL0CK BROMLEY PSYD ADDRESS 1621 13TH AVENUE (Number & Street, Town, GREELEY CO 80631 County, State & Zip No.) 2. POLICY PERIOD: From 04/01/1999 To 04/01/2000 (12:01 A.M. Standard Time At Location Of Designated Pre nis-:,) 3. COVERAGE: LIMITS OF LIABILITY RI .�11C�.1 Professional Liability $1 ,000,000 $3,000,000 each Incident Aggregate BUSINESS OF THE INSURED: Psychology 5. THE NAMED INSURED IS: ( X ) Sole Proprietor (including Independent Contractors) ( ) Partnership ( ) Corpora ,,rr_ ) OTHER: 6. This policy shall only apply to incidents which happen on or after: a) the policy erfect.,e dare shown on the Declarations: or b) the effective date of the earliest claims-made po i•:v issued by the Company to which this policy is a renewal; or c) the date specified i:i en" endorsement hereto. 04/05/1996 This policy is made and accepted subject to the printed conditions of this policy toleth,2 mirth the provisions, stipulations and agreements contained in the following form(s) or e ido Hemenn,i: PLJ-2008 ( 10/94 ) POE - 8004 PLE-2167 PLE -20(31 P0N - 2003 PLE -8035 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel Office Address: 1776 West Lakes Parkway Town and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 mmisommEmw INTERSTATE INSURANCE GROUP IIIMMEMMEMMI PLP-2O1'_ (0693) (Elec.) e7 LAsea. Issue Date: 01/06/00 <4The Reciprocal PROFESSIONAL LIABILITY OCCURRENCE ≥> Alliance INSURANCE POLICY FOR Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN DEVELOPMENT PRACTITIONERS ACA Insurance Trust,Inc. 5999 Stevenson Avenue ACA uswrat`i Policy Number: CL10073400 Administered by: Alexandria,VA 223043300 TRUST Tel Freer 1.8003476847 x284 ITEM DECLARATIONS INDIVIDUAL POLICY 1. NAMED INSURED: Norma Karen Bender 2. AO)RESS: 1104 Twin Peaks Circle Longmont , CO 80503-2170 3. PO".ICY PERIOD: From: 02/04/00 To: 02/04/01 12:01 A.M.Standard Time et Location of Designated Premises 4. The insurance afforded is only with respect to such of the following types of insurance as indicated by specific premium charge or charges: COVERAGE PREMIUM A. PROFESSIONAL LIABILITY S 290 . 00 B. GENERAL LIABILITY S 0 . 00 TOTAL PREMIUM: S 290 . 00 5. LIMITS OF LIABILITY: $1, 000 , 000 each Incident or each Occurrence $3 , 000 , 000 in the Aggregate 6. THE NAMED INSURED IS: Sole Proprietor(incl. Individual) Partnership Corporation X Other(refer to Item 7 below) 7. BUSINESS OF THE NAMED INSURED: Part-Time Self-Employed (Rating Category) Counselor/Human Development Professional 8. This policy is made and accepted subject to the printed conditions of this policy together with the provisions,stipulations and agreements contained in the following forms) or endorsement(s): CPL.0004.0199 CPL•0005•0199 CPL•0006.1199 NOTICE THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF TEE INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE FOR YOUR RISK RETENTION GROUP. CPL.00D5.G199.00 EXECUTIVE RISK SPECIALTY CO. THIS IS A CLAIMS MADE POLICY-PLEASE READ CAREFULLY 12/03/99 - A PSYCHCLCGISTS PRCFESSIONAL LI4EILITY POLICY *44 RENEWAL »• NOTICE A LOWER LIMIT OF LIABILITY APPLIES TO JUDGMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS OF S=FU.4. MISCONDUCT(SEE THE SPECIAL PROVISION'SEXUAL MISCONDUCT'IN THE POLICY). DECLARATIONS POLICY NO: 801-0005006 ACCOUNT NO: CC-KERL17'_-0 0099745E ITEM 1. ial NAME AND ADDRESS OF INSURED. ITEM 1. (b)ADDITIONAL NAMED INSUREDS. LAURENCE P. KEFRIGAN• PH.D. 1750 25TH AVE. SUITE •IOI GREiELEY. CO 80631 TYPEOFORG: INDIVIDUAL ITEM 2. ADDITIONAL INSUREDS. ITEM 3 POLICY PERIOD: FROM- 12/01/99 TO: 12/01/00 12.01 A.M. STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN. ITEM 4. _IMITS OF LIABILITY. • .000000 EACH WRONGFUL ACT OR SERIES OF CONT1HUC JS. RE IE<' H (a) $ 1 OR INTERRELATED WRONGFUL ACTS OR 0 6:131F 8 ENCE b) $ 5.000 DEFENSE REIMBURSEMENT (c) $ 3.000 .000 AGGREGATE ITEM 5 PREMIUM SCHEDULE. ANNUAL PREN'IUM CLASSIFICATION NUMBER RATE - - II 1ST PSYCHOLCOIST 1 1254.00 1,254.00 j DEFENSE LIMIT .00 I SUFFLUS LINES TAX 1 37.62 INSFECTICN FEE 1 � 2051 II 12/01/91 TOTAL PREMIUM. 1 .2'+4. 1 33 ITEM 6 RETROACTIVE DATE --- - ITEM ' EXTENDED REPORTING PERIOD 2 .265 .24 ADDIT.ONAL PREMIUM (If exercised)) $ -- ---- ITEM 8 POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY. ___ 322138 (7/95 ED. ) 822137 AUTHORIZED C0MPANYREPRESEI iTATi THIS IS NOT A BILL. PREMIUM HAS BEEN PAID. Branch B.A Producer# Issue Date Renewal Renloc) ment No. : 2 A 0002360 03/02/1999 RENE4AL -- PSYCHOLOGISTS PROFESSIONAL LIABILITY •• CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. ' Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2055185 1. NAMED INSURED: SHERRI MALLOY PHD ADDRESS 24 ALLES DRIVE ( Number & Street, Town, GREELEY CO 80631 Counts , State L Zip No.) 2. POLICY PERIOD: From 04/01/1999 To 04/01/2000 (12:01 A.M. Standard Time At Location Of Designated Premis--) • 3. COVERAGE: LIMITS OF LIABILITY RLVIL `.1 Professional Liability S1 ,000,000 $3 , 000,000 595 , 0 each Incident Aggregate BUSINESS OF THE INSURED: Psychology 5, THE NAMED INSURED IS: X ) Sole Proprietor (including Independent Contractors) ( ) Partnership ( ) Cu I cr.r.. , OTHER: This policy shall only apply to incidents which happen on or after: a) the police etteft .c date shown on the Declarations; or 0) the effective date of the earliest claim;-mad pa i :e issued bs the Company to which this policy is a renewal; or c) the date specified in u n endorsement hereto. 04/01/1998 -, This police is made and accepted subject to the printed conditions of this police tareth - Aii the provisions, stipulations and agreements contained in the following form(s) or end° em.: i1 . P _0 -2008 ( 10/94 ) POE -8004 PLE -2167 PLE - 208 '1 PM- 2003 PLE -8035 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO. ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke-Van Orsdel, Incorporated Office Address: 1776 West Lakes Parkwas Town and State: West Des Moines. IA, 50398 Toll-tree Number: I-800-852-9987 INTERSTATE NSURANCE GROLP PI.P-2':i e3693) IElec.) EVEREST NATIONAL INSURANCE COMPANY MENTAL HEALTH PRACTITIONER'S PROFESSIONAL LIABILITY POLICY DECLARATIONS Renewal of No. NOTICE: A SUB-LIMIT OF LIABILITY APPLIES TO "CLAIMS" ARISING OUT OF "SEXUAL MISCONDUCT". POLICY NO. 2200009922-991 ITEM 1 NAME AND ADDRESS OF INSURED: SEND ALL INQUIRIES TO: Nicole Ray Warnygora ROCKPORT INSURANCE ASSOCIATES 1 800 Angelo Court PROGRAM ADMINISTRATOR Fort Collins, CO 80528 P 0 BOX 1809 ROCKPORT, TX 78381-1809 1-800-423-5344 ITEM 2 ADDITIONAL INSUREDS: NONE ITEM 3 DESCRIPTION OF BUSINESS: MENTAL HEALTH PRACTITIONER(S) ITEM 4, POLICY PERIOD: FROM 05/20/1999 TO 05/20/2000 12:01 am STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED HERB.IN ITEM 5 LIMITS OF LIABILITY: S 1 ,000,000 EACH WRONGFUL ACT OR EACH OCCURRENCE SUE JEC ' TO ,, $25,000 SUB-LIMIT OF LIABILITY FOR ALL "WRONGFUL 7-CTJ" INVOLVING "SEXUAL MISCONDUCT". S 3,000,000 AGGREGATE ITEM 6 PREMIUM SCHEDULE: CLASSIFICATION NUMBER RATE ANNUAL PREMIUM CATEGORY M2 1 263.00 S 263.00 TOTAL PREMIUM S 263.00 ITEM 7 POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY: 190.00 0195, 189.00 0195, EEO 25 501 12 98, 193.00 0195,194.00 0195 May 21 , 1999 f� �JGL r g,/L AUTHORIZED COMPANY REPRESENTA "NE 189 00 0195 C Everest National Insurance Company, 1995 MEMORANDUM OF INSURANCE Date Issued 11/03/1999 Memorandum Holder This memorandum is issued as a matter ACKERMAN & ASSOCIATES ATTN DONNA of information only and confers no SUITE 101 rights upon the holder. This 1750 25 AVENUE memorandum does not amend, extend GREELEY CO 80634 or alter the coverages afforded by the Certificate listed below. Company Affording Coverage Producer Chicago Insurance Company Kirke Van Orsdel -- 1776 West Lakes Parkway Covered Person (Status) caner West Des Moines, Iowa 50398 EMILY L JARAMILLO-BANSBERG MA --x--- hmployte This is to certify that the Certificate listed below has been issued to the insured named herein fat the policy period indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this memorandum may be issued or may pertain, the insurance afforded by the Certificate described herein is subject to all the terms, exclusions and conditions of such Certificate. The limits shown may have been reduced by paid claims. Certificate Type of Insurance Number Effective Date Expiration Date Limtts Professional Liability each incident 1 ,000, 000 or occurrence Occurrence 80M-4003488 11/01/1999 11/01/2000 3 ,000,000 in the aggregate each incident General Liability or occurrence Occurrence in the aggregate Should the above described Certificate be canceled Insured before the expiration date thereof, the issuing company w 11 endeavor to mail written notice to the named Memorandum Holder, but failure to mail such EMILY L JARAMILLO-BANSBERG Mn notice shall impose no obligation or liabilty of any 183 50 AVENUE PLACE kind upon the company, its agents or representatives. GREELEY CO 80634 Authorized R epresentative: .1rtA•4. 0, e dCsaer, TRUCK INSURANCE EXCHANGE Q FARMERS INSURANCE EXCHANGE FIRE INSURANCE EXCHANGE ^.xrn F MEMBERS o1 FARMERS INSURANCE GROUP OF COMPANIESHOME OFFICE:4680 WILSHIRE BLVD..LOS ANGELES,CALIFORNIA 90010DR JOYCE SHOHET ACRERMAN PC Pd Count . 1750 25TH AVE SUITE 101Prematic Acct No. 07-04-362 04576-38-07 GREELEY CO 80631 Agent Policy Number Type of The named insured is an individual unless otherwise stated: ElPartnership ® Corp. Business OFFICE ❑ Joint Venture Ul Organization(Other than Partnership or Joint Venture) 2. Policy Period from 07/01/99 (not prior to time applied for) to 07/01/00 12:01 a.m.Standard Time. If this policy replaces other coverages that end at noon standard time on the same day this policy begins,this policy will not take effect until the other coverage ends. This policy will continue for successive policy periods at follows: If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums,rules and forms then in effect. 3. Insured location same as mailing address unless otherwise stated: 1750 25TH AVE SUITE 101 GREELEY CO 80631 4. Mortgage Holders Loan# Loan# 5. Premium$ 492.00 0 "X"if Mortgage Holder Pays 6. Policy Forms and Endorsements attached at Inception: E0079-ED1 2521551290 565310-ED2 S0700-ED3 E6036-EDI E4168-ED1 E4004-ED1 E4216-ED1 E3026-ED1 7. We provide insurance on for those coverages Indicated . a s. ilia limit or . an DU — COVERAGES LIMITS OF INSURANCE DEDUCTIBLE A-Building $ SECTION 1 B-Business Personal Property $250 apples unless other 50,000 o°tlon Indicated,D an® C-Loss of Income(Not exceeding 12 consecutive months) ACTUAL n11005500 Lit_ Property LOSS SUSTAINED NONE OPTIONAL COVERAGES and Swimming Pool/Fences and Walkways $ Loss of hj Building Glass(Blanket) Above detluc- income I Outdoor Sign Coverage REPLACEMENT COST unleappler 100 Valuable Papers(In addition to$1000 included.) $ 100 unless , $ option Inch• ❑ Earthquake Damage catetl ee Coverages s SECTION II D-Business Liability-Including Products and Completed A,B,8 C of the applicable ins. limit. Operations.(Annual aggregate applies for all occurrences LIMITS AF gregate) during the policy period.) (Annual Aggregate) Liability I E-Fire Legal Liability$75,000 Included unless other option indicated by an ® $ 1,000,000 and 0$100,000 0$150,000 each occurrence(Subject to the annual aggreagate shown for Coy. D) Medicals F-Medical Payments to Others(Subject to the annual aggregate shown for Coverage D.) $5,000 each person Limit of Liability ❑Professional Llablli see attached endorsementAggregate(Annual ®I-V COVERED SECTION III Agreement I-Employee Dishonesty DEDUCTIBLE Agreement II-Broad Form Money and Securities-Inside $5,000 NONE Agreement III-Broad Form Money and Securities-Outside $1,000 $250 _ --1 Crime Agreement IV-Medical Payments $50 000 $250 ON — Agreement V-Forgery or Alterations $2,5 each person NONE $2,500 NONE --1, 565208 2-82 2ND EDITION Countersigned Authorized Representative JOYCE SHOHET ACKERMAN, ED.D. 1750 25th Avenue, Suite 101 Greeley, Colorado 80634 Phone: 353-3373 PERSONAL DATA SHEET Date of Birth: August 3, 1950 Health: Excellent Married, two children CERTIFICATION/LICENSURE Licensed Clinical Psychologist, State of Colorado since 1984 Listed in National Register of Health Service Providers in Psychology since 1986 Staff Privileges, North Colorado Medical Center, Greeley, Colorado since 1985 Certified Teacher (K-12) for Emotionally Disturbed, Learning Disabled and retarded. Certified Teacher, Elementary Level PROFESSIONAL MEMBERSHIP American Psychological Association Colorado Psychological Association Colorado Psychological Association- elected board member 1986-1989 HONORS President's Award - Colorado Psychological Association, 1989 EDUCATION 1978 - 1981 Ed.D. in Counseling Psychology University of Northern Colorado December 1981 graduate 1972 - 1974 M.S. in Education (E.D./L.D.) Lesley College, Cambridge, Massachusetts August 1974 graduate 1968 - 1971 B.S. in Special Education and Elementary Education with a minor in psychology Boston University, Boston, Massachusetts December 1971 graduate PROFESSIONAL EXPERIENCE 1981 - PRESENT Clinician in private practice in Northern Colorado. Among responsibilities are: Diagnosis, therapeutic intervention and referral for adults, families, children and groups. Primary areas are: anxiety disorders, mood disorders and adjustment disorders. Typical problems include: trauma, physical abuse, job stress. Orientation used-primarily cognitive- behavioral therapy. Also, developing, organizing and presenting workshops and consultative programs to community, schools, organizations and agencies. Approximately 30 hours per week. 1986 - Present Consulting psychologist on interdisciplinary team for in-patient rehabilitation program. Progressive Care Rehabilitation Center, Greeley, Colorado. Medical Director Dr. Judith Vaughan, Neurologist. Adults with traumatic injuries-Primary problems are: psychological aspects of physical rehabilitation, grief counseling, and brief group counseling using cognitive-behavioral goa oriented therapy. Approximately 10 - 15 hours per week. 1989 - 1992 Head Injury Treatment Team North Colorado Medical Center, Greeley. Approximately 5 hours per week. Team coordinator - Dr. John McVicker, Neurosurgeon. 1986 - 1989 Consulting Psychologist for Family Recovery Center (in-patient substance abuse/chemical dependency program), North Colorado Medical Center, Greeley, Colorado. Coordinator Ruth Wick R.N. Approximately 5 hours per week. 19136 - 1989 Provider and Coordinator for Mental Health Services in Northern Colorado for Peak Health Care (HMO). Peak mental health services utilized a three session model for initial services followed by referral. Activities included coordination of Psychological and Psychiatric Services for approximately the last two years of the contract. Peak was purchased From Lincoln National by Biodyne in late 1989. Peak Supervisor - Elaine Taylor Approximately 10 hrs./week. 1983 - 1986 Psychologist subcontractor for a Vietnam Veteran's Counseling Program funded by the Veteran's Administration. Principal Contractor Dr. Robert Stewart 1980 - 1987 Part time faculty member with responsibilities for classes, workshops and community programs in parenting skills. Family/Life Education Program Aims Community College, Greeley, Colorado August 1980 Clinical Internship on Children's Team of to Community Mental Health Center. Responsibilities August 1981 included: consultation to schools and community programs; therapy for children and families; and assessment of diverse mental health programs. Assistant program Evaluator-Developed evaluation tools to determine cross-cultural perceptions of expectations and satisfaction with services. Supervisors - Dr. Joan Gillespie and Dr. Laurence P. Kerrigan. Weld Mental Health Center, Greeley, Colorado (Full time). Adults, Adolescents, Families. Primary areas anxiety disorders, mood disorders and adjustment disorders. Typical problems included: trauma, physical abuse substance abuse, job stress. Orientation used- Primarily cognitive-behavioral therapy. 1980 Group Facilitator-Regional and National Conferences in cross-cultural community needs. Flagstaff, Arizona - Colorado Springs, Colorado August 1975 Chairperson of the Department of Education and to Behavioral Science at an accredited, Indian controlled July 1978 community college on the Navajo Reservation. Administration responsibilities included: Supervision and evaluation of faculty; budget preparation and management; curriculum development and integration of Navajo culture; personnel recruitment and selection; class scheduling and program development. Also, faculty member with academic responsibilities for instruction in Psychology, Child Development and Counseling courses, advising and counseling students. Navajo Community College, Tsaile, Arizona (Full time) September 1974 Education Specialist and counselor at an Indian to controlled primary and secondary school on the August 1975 Navajo Reservation. Coordinated community resource program which included: Counseling, Student assessment, prescriptive programming, , staff development and curriculum. Also, adjunct faculty for the University of New Mexico and for Navajo Community College at the Rough Rock Demonstration school, Rough Rock, Arizona. (Full time) September 1972 Designed and coordinated Learning Center Program to for Dedham Public Schools. A program and crisis June 1974 intervention center for emotionally disturbed children. Responsibilities included: Diagnostic prescriptive programming, counseling, supervision and training of aides, tutors and volunteers, and consultation with regular classroom teachers. Also organized group and individual meetings with parents. Also, adjunct faculty for Curry College assisting in in-service instruction for Dedham School System employees. Dedham Public Schools, Dedham, Mass. (Full time) February 1972 Learning Disabilities Specialist. Consultation to staff, to prescriptive programming and teaching school age June 1972 children. Somerville Public Schools, Somerville, Mass. (Full time) Summer 1971 Chosen as state mental health intern. coordinated Tutoring Center for emotionally disturbed children. Responsible for: tutoring children, supervising aides, (high school dropouts) and consulting with psychiatric staff. Somerville Mental Health Clinic, Somerville, Mass. WORKSHOPS AND SPECIAL TRAINING 1993 - August Hospital Practice for Psychologists APA National Convention in Toronto, Canada- "Psychology and National Health Reform", "National Health Insurance: Policy Considerations, Benefit Designs, and Economic Realities", and "Marketing: Psychology's Key to National Health Reform. 1993 "Using the New MMPI-2 and MMPI-A" Mountain Crest Hospital, Denver, Colorado. 1993 Disaster Relief Training. Alan Keck, through Colorado Psychological Association, Denver, Colorado. 1992 - Fall Short Term Therapy. Bernard Bloom, University of Northern Colorado, Greeley, Colorado. 1990 - Fall National Cognitive Rehabilitation Conference, Richmond, Virginia. 1990 - Summer Post graduate training: 1. Adult Neuropsychological Method based on Lezak Neuropsychological assessment, 1983. 2. Child Neuropsychology, Dr. Hynd. 3. Child Neuropsychological Methods. 1989 Provider of Neuropsychological evaluations for Vocational Rehabilitation, Greeley, Colorado. 1988 Cognitive Rehabilitation Training Program, Dr. Sena, Ph.D., Colorado Springs, Colorado. 1988 - Present Psychologist - Head Injury Treatment Team at North Colorado Medical Center, Greeley, Colorado. 1987 Halstead Reitan Neuropsychological Assessment Training. Ralph Reitan, Ph.D., Washington, D.C. Summer 1986 Albert Einstein School of Medicine, Workshop on Adolescent Therapy, Cape Cod, Mass. 1985 to present North Colorado Interdisciplinary Team of Child Custody Member and participant. Fall 1985 Interdisciplinary Workshop on Child Custody, Keystone, Colorado. Summer 1984 Workshop in Clinical Use of Hypnosis, Boston, Mass. Winter 1983 Workshop on In-patient Programs for Service Related Disorders, Cheyenne Veterans Administration Hospital, Fall 1983 Veteran's Administration Workshop on Post Traumatic Stress Syndrome, Denver Veteran's Center. Fall 1981 Post-Doctoral Supervised Candidate for Licensure to (psychology) under Gale R. Giebler, Ph.D. Licensed Winter 1984 Psychologist and Susan Spilman, Ph.D., Licensed Psychologist. 1980 - 1981 Intern-Weld County Sexual Abuse Team, Greeley, Colo. Summer 1981 Independent Study of Child Sexual Abuse, University of Northern Colorado. Spring 1981 Interdisciplinary Workshop on Assessment of Sexual Assault, Boulder Social Services. Summer 1979 Biofeedback Training related to labor and delivery. Summer 1974 Participant in Institute on Obstacles to Learning. Joint Symposium between McLean psychiatric Hospital, Harvard University and Lesley Graduate School. Cambridge, Massachusetts. Summer 1973 Kennedy Memorial Hospital, Boston, Massachusetts. Participant, Summer Aphasia Institute. PUBLICATIONS Ackerman A., Ackerman J.S., Kelley K, Hale K. Family Planning Attitudes of Traditional and Acculturated Navajo Indians. Key Issues in Population and Food Policy. University Press of America, pp. 178-171 (1979). Ackerman, J.S., Client Expectations and Satisfaction with Community Mental Health Center Services: A Cross-Cultural Analysis Between Hispanics and Anqlos. Published Doctoral Dissertation, University of Northern Colorado copyright 1981. FACULTY VITA May 1999 NAME: BROMLEY, Susan Plock SOCIAL SECURITY NUMBER: 483-50-9243 POSITION: Associate Professor of Psychology Department of Psychology College of Arts and Sciences University of Northern Colorado Greeley, CO 80639 HOME ADDRESS: 1621 13th Avenue Greeley, CO 80631 TELEPHONE: Office: (303) 351-2236 Home: (303) 352-8750 EMAIL:sbromley@bentley.unco.edu EDUCATION: Years Pegree Institution Area of Study 1983 PsyD University of Denver Clinical Psychology School of Professional Psychology Denver. Colorado 1968 MSSA Case Western Reserve University Casework (MSW) School of Applied Social Sciences Cleveland, Ohio 1965 BA Mt. Holyoke College Economics/Sociology South Hadley. Massachusetts WORK EXPERIENCE --Professional.t cademi c: Year(sI Institution/Organization Position Responsibilities 1996-Pres University of Northern Colorado Assoc.Professor Psychology Teaching/Research 1985-96 University of Northern Colorado Asst. Professor Psychology Teaching/Research 1983-84 University of Northern Colorado Asst. Professor Psychology Teaching WORK EXPERIENCE --Professional NonAcademie. Yeartsl Institution/Organization Position Responsibilities 1996-present Ackerman and Associates Psychologist Clinical 1984-85 Kaiser Permanente Psychotherapist Clinical Lakewood. Colorado 079-80 Bethesda Mental Health Center Psychology Intern Clinical/ Denver. Colorado Administrative 1968-79 Denver General Hospital Clinical Social Worker! Clinical/ Denver. Colorado Supervisor Administrative AREA OF SPECIALIZATION: Behavioral Medicine/Pain Management/Clinical Hypnosis RESEARCH AREAS/INTERESTS: Hypnosis/Pain Assessment and Management/Women's Issues/Teaching Methods PROFESSIONAL ACTIVITIES: Colorado Licensure: Psychology License#1086 PUBLICATIONS --Professional/Juried Musgrave-Marquart,D.,Bromley, S.P. &Dailey,M.B. (1997)"Personality, academic attribution, and suhstance abuse as predictors of academic achievement in college students". Journal of Social Behavior and Personality, J—'(2) 501-511. Karlin, N.J. and Bromley, S.P. (1996). Differences in caregivers of demented and lucid chronically ill family members. Journal of Alzheimer's Disease and Related Disorders and Research Retzlaff, P. and Bromley, S. (1994). Counseling personality disorders. In Ronch, LL., VanOrnum, W. & Stillwell. N C. (Eds)The counseling sourcebook' A practical reference on contemporary issues. New York: Crossroad Publishing group pp.466-474. Bromley, S. and Hewitt, P. (1992). Fatal attraction:The sinister side of women's conflict about career and family. Journal of Popular Culture. 26(3), pp. 17-24. Retzlaff, P. and Bromley, S. (1991). "A Multi-Test Alcoholic Taxonomy: Canonical Coefficient Clusters". Journal of Clinical Psychology, 47(2), pp. 299-309. Bromley, S.P. (1985). "Treatment of Pain: Theory and Research" in Zahourek, R. (Ed.). Clinical Hvprg&s and Therapeutic Suggestion. New York: Grupe and Stratton. Reprinted in Zahourek,R. (Ed.) (1990). New York: Bruner/Mazel, Inc., pp. 77-98.. PROFESSIONAL PRESENTATIONS --furled. Nickisson, J.W. and Bromley, S.P. (1999)"Hypnosis: Attitudes,knowledge and experience among psychology and nursing students'. Accepted for a paper presentation at the American Psychological Association Convention, Boston (August) Campbell, J. S ,Titus, 1. and Bromley S. P. (1998). "Neuroanatomy teaching technique for introductory pychology students. Poster presented at the joint WPA/RMPA convention, Albuquerque, NM. (April) Bromley. S. (1997) (Chair)`Linking through honors programs: The cross-discipline course). Paper presentation as pan of a symposium titled"Creating links between psychology and other disciplines"., American Psychological Association Convention, Chicago. (August) Bromley, S. , Gilliam D., &Johnson, T. (1995). "Assessment of student created tests as an evaluation method". Poster presented at the American Psychological Association Convention, New York City. (August) Bromley, S. (1994). "Student created tests as an evaluation method". Poster presented at 16th Annual N;tional Institute on the Teaching of Psychology. St. Petersburg, Florida. Karlin, N. and Bromley. S. (1992). " Similarities and differences for caregivers of demented and lucid citron ically ill". Poster presented at the Rocky Mountain Psychology Association Convention, Boise, Idaho_ (April) Montoya, K.J. and Bromley, S. ( Chair) (1992). " Changes in undergraduate counseling styles in an introductory counseling theories course". Paper presented at the Rocky Mountain Psychology Association Convention Boise. Idaho(April) Bromley, S. (1992). "Connected learning methods to faciliate research understanding". Paper presentation as part of panel titled, `Teaching techniques in the social sciences", Western Social Science Association Convention, Denver, Colorado. (April) Bromley, S., Ramirez, S., and McCoy, J. (1991). " Impact of a health psychology course on student health beliefs". Poster presented at the Rocky Mountain Psychology Association Convention,Denver, Colorado. (April) Karlin, N. and Bromley, S. (1991). " Support,burden and affect among caregiver of dementia and nondementi.i patients". Poster presented at the American Psychology Association, San Francisco, California. (August) Bosley, G. and Bromley, S. (1990). Post death ritual in a Colorado community. Paper presentation at the 4mencan Psychology Association, San Francisco, California. (August) Bromley, S. (1990). "Husbands at Childbirth: Who Does It Help?" Paper presentation at Far West Popular Culture Association, Las Vegas, Nevada (January). Hewitt. P. and Bromley S. (1989). "Images of Work and Intimacy in'Turning Point'and'Fatal Attraction" Paper presentation National Convention of Popular Culture Association and American Culture Association, St. Louis. Missouri. (Session Chair) Retzlaft;P. and Bromley, S. (1989). "The Basic Personality Inventory: Alcoh Sub-Group Identification". Poster Session at the Joint Convention of the Rock Mountain Psychological Association and Western Psychological Association Reno. Nevada. Bromley, S. (1988). "Our Culture Affects Our Pain." Paper presentation,National Convention of Popular Culture Association and American Culture Association,New Orleans,LA. (March). Bromley, S. (1987). "Husband-Assisted Autohypnosis for Labor and Delivery: A Clinical Model". Paper presented at Rocky Mountain Psychological Association,Albuquerque,New Mexico(April). Bromley, S. and Loy, P. (1987). "Politics of PMS". Paper presentation Association of Women Psychologists, Denver, Colorado (March). PROFESSIONAL PRESENTATIONS --Invited: Strongin. D. & Bromley, S. (1999). Student and faculty reactions to the introduction of a graduate ethics course In Miller, R. (Chair)Ethics in college teaching. Symposium conducted at the Rocky Mountain Psychological Association. Ft. Collins, CO(April) Bromley, S. (1999). Issues of religion and spirituality with therapists and clients. In S. Bromley(Chair) Religion and spirituality in research, practice and the classroom. Symposium conducted at the Rocky Mountain Psychological Association, Ft. Collins, Co(April) Bromley, S. (1998)Hypnosis, psychology and managed care_ In S. Bromley (Chair) Complementary, nomradruonal and indigenous healing practices. Symposium conducted at the combined meetings of the Western and Rack: Mountain Psychological Associations, Albuquerque. (April) Bromley, S. (1998). Complementary healing methods: A psychological and artistic exploration. In L Wickertgren (Chair). Interdisciplinary courses involving psychology: A sampler. Symposium conducted at the combined meetings of the Western and Rocky Mountain Psychological Associations, Albuquerque. (April) Handelsman,M.M., Bromley. S.P.& Davis, S.F. (1995). "Clinical Psychologist, Counseling Psychologist Clinical Social Workder, or Psychology Professor: Which Degree is Right for Me?"Psi Chi invited panel presentation Rocks Mountain Psychological Association. Boulder, CO(April). Bromley, S. (Co-Chair), Seibert, P. (Co-Chair), Knuckey,D.. Bohlin, M.,Zaweski, C., Watson, D., Hammon, D., West, K. &Robins, J. (1994). "Training the Teaching Assistant" Invited Panel Presentation , Rocky Mountain Psychological Association,Las Vegas, Nevada(April) Bromley, S. (1993). "Hypnosis in Dentistry'." Presentation at Monthly Meeting of Weld County Dentists Association, Greeley, Colorado(February). Bromley, S. (1993). "Learning about the author as a way to understand research." Presentation at "Teaching Take Out", CTUP Special Event. WPA/RMPA Convention,Phoenix, Arizona(April). Allen, M. and Bromley, S. (1993). Co-Chairs Two CTUP Special Event Sessions, "Teaching Take Out: Experiences in Collaborative Learning", Western Psychological Association/Rocky Mountain Psychological Association Convention, Phoenix, Arizona (April). Bromley, S. (1993). Chair, Invited Symposium, "Psychological and Social Perspectives on Male Violence Against Women", Western Psychological Association/Rocky Mountain Psychological Association Convention, Phoenic Arizona(April). Fromley, S. (1992). "Enhancement of student research and writing skills in any course". CTUP Workshop presented at the Rocky Mountain Psychology Association Convention,Boise, Idaho. (April) Bromley, S. and Karlin, N. (1992). "General and health locus of control of adult caregivers". Poster session at the UNC Research Forum, Greeley, Colorado. Bromley, S. (1992). Panel member in Mental Health Symposia for Victim Compensation Convention as pan •if the Colorado Organization for Victim Assistance Conference. (Estes Park/October) Bolocofski,Bromley, Foster and Mean(1988). "Hypnosis:Research and Clinical Perspectives," symposium presentation. Colorado Psychological Association, Greeley(March). Bromley, S. (1986). "Pain: A Psychological Event". Presentor-20th Annual Emotional Crisis Workshop, University of Northern Colorado, Greeley, Colorado(July). I ECTURES--Invited: Bromley, S. (1998)"Psychological methods of pain control" Invited lecture for the annual meeting of the Weld County Arthritis Society. Bromley, S. (1998). "Hypnosis for pain control of arthritis" Invited lecture for"Brown Bag" lunch series sponsored by the Greeley Medical Clinic. Bromley, S. (1998)"Headache Control -Psychological Methods". Invited lecture as part of a seminar titled "roping with headache". Sponsored by the Greeley Medical Clinic. Bromley, S. & Ackerman J. (1998). "What to do to handle burnout" A workshop conducted for foster parents working with Weld County Social Services. Bromley, S. (1995). Keynote speaker for Golden Key Honor Society Induction Ceremony, University of C)lorido. Boulder. Co. (November) Bromley, S. (1992). Keynote speaker for Sophomore Honor Society Induction Ceremony. Bromley. S. (1991)Featured speaker. UNC Acadmic Honors Convocation. (April) Bromley-, S. (1991)_ Banquet speaker Emotional Crisis Workshop, Greeley, Colorado. (July) 4 GRANTS: Bromley, S ( 1994)Honors Grant($500)to attend research training at the Society for Clinical Hypnosis meeting. San Francisco(October) BromIcy, S. (1994). Research and Publications award of$1500.00. "Assessment protocols to measure tl.c efficacy of hypnotic treatment for injured workers. Karlin, N. and Bromley, S. (1990). Research and Publications award of$2,4440.00. "Control, support, burden and affect differences among dementia and non-dementia caregivers". BOOK /GRANT REVIEWS: Grant review for Boise State Department of Education(1995) Review of Santrock, J. (1991). The science of mind and behavior. W.C. Brown and Benchmark. Review of McKee. P. Ze Them. J. (1993). Real life; Ten stories of aging. University of Colorado Press. PROFESSIONAL CONSULTATION/PRACTICE: Years) Institution/Organization Role l 996-presnt Ackerman and Associates Clinical Psychologist 1988 Bonne' Good Samaritan Center Pain Management Consultant and Trainer 1984-85 Denver Metropolitan Dental Care Consultant in Pain Management 1984 Iowa Association of Registered Physical Therapists Hypnosis for Pain Management Consultant And Teacher PROFESSIONAL ASSOCIATION PARTICIPATION: Membershio 1986-present Rocky-Mountain Psychological Association 1988-present American Psychological Association(Divisions 2, 30, 35) 1989-present Greeley Area Mental Health Network 1987-88 Association of Women in Psychology 1980-89 Colorado Psychological Association 1988 CPA Program Committee Member for Spring Meeting--Greeley Coordinator SERVICE: EXTERNAL: NATIONAL SERVICE: 1994-present Rocky Mountain Coordinator-American Psychological Association,Division 2-Teach ng of Psychology I ) 2-94 Co-Chair, Rocky Mountain Region Council of Teachers of Undergraduate Psychology (CTLPI 1991-94 Mountain States Regional Academic Coordinator, Golden Key National Honor Society REGIONAL/STATE SERVICE: 1099 -Moderator for Stanley G. Hall Lecturer-Viney, W. (1999). A larger canopy for psychology: Unifying themes and pragmatic empiricism. Presented at the Rocky Mountain Psychological Association Convention, Pt Collins. CO(April) 1089-present Rocky Mountain Psychology Association 1998-1999 Ex-Officio Board Member As Division 2 Coordinator 1992-1998 Board Member 1995- 1998 Elected Chair, Groups Under-Represented in Psychology Committee 1992-94 Co-Chair, Groups Under-Represented in Psychology Committee 1991 Coordinator of Student Volunteers, RMPA Convention, Denver,Colorado S 1995 Psychology Chair-CCHE Faculty to Faculty Conference (October) COMMUNITY SERVICE 1998 Member, Weld County Medical Society Commitee on Alternative and Complementary Healing 1997-1998 UNC Loaned Executive -United Way of Weld County 1991- 1996 Board Member, 19th Judicial District Victim Compensation Board 1995-96 Chair 1990-93 Board Member, Weld County Area Agency on Aging 1992-93 Chair 1991-92 Vice-Chair 1986-Present Exam Supervisor-American Institute for Property and Liability Underwriters/Insurance Institute of America 1987-present Clinical Psychologist-pro-bono work with individual clients and community training IN 1 ERN AL• DEPARTMENTAL: 1993-present Member, Department Executive Committee 1985-88. 1995-present Co-Advisor Psi Chi National Honor Society 1996-1999 Guest lecturer for Psi Chi Grad Night on getting into clinicallcounseling grad programs 1929-91,93, 95-present Department Representative, CCHE Faculty to Faculty Conference 1987- 94 Department Representative to graduation ceremonies 1986-94 Library Representative 1983. 86 89, 90-93,97,98 Member, Faculty Search and Screen Committee 1990-92 Member,Psychology Department Undergraduate Committee (Chair 1992) 1987-88 Co-Coordinator Semester Conversion Committee COLLEGE: 1992.93,96,97 Member of faculty invited to teach in the Cluster Program 1990-93 Graduation Marshall, Arts& Sciences 1988-89 Member, Arts and Sciences Teacher Education Conunittee 1986-89 Chair, Interdisciplinary Committee to develop and revise Human Development Major in the College of Arts and Sciences and Psychology Department UNIVERSITY. 1992-94 1996-Present Member-Research and Publications Board 1993-94 Chair-Elect 1')88-present Founding Co-Advisor, Golden Key Honor Society 1992-95 Member-UNC Women's Commission 1992-94 Co-Chair- Assessment Task Force 1989-90 Faculty Representative. Student Fee Allocation Committee 1986-89 Mcmbcr, Faculty Senate 1988-89 Secretary 1987-88 Vice-Chair 1986-87 At-Large Member. Executive Committee 1986-89 Member, Academic Policies Committee 1986-87 Member, Elections Committee 1988 Representative, Western States Faculty Leadership Conference, Reno. 1988 Senate Representative. Statewide Commission Advisory Committee 1988 Advisor. In-Touch Helplinc 1985-86 Volunteer Therapist, UNC Counseling Center GRADUATE STUDENT COMMITTEES--Doctoral: 1998 Committee Member, Shu-Shin Lu,Professional Psychology 1997-prsnt Committee Member, Christine Rogers,Professional Psychology 1995-1997 Committee Member,Lisa Ing, Special Education I 994-pres Committee Member, Marla Gallagher,Educational Psychology 1993 Committee Member, Hsiu-Lan Ma, Science Ed. -Oral Comprehensives 1993 Committee Member, Jerry Buford, School Psychology, "Treatment of depressive symptoms early adolescents". 1993-1998 Committee Member, Pat Flanagan, CSPA ,Orals, "A comparison of attitudes and practices )f teaching faculty regarding student academic dishonesty at a two year and four year instil utio i' 1991 Committee Member, Mike Propriano, School Psychology 1990-94 Committee Member, Paul Lantz, School Psychology, 1989 Committee Member. Mike Peters, Vocational Rehabilitation _"The Effectiveness of Vocational Evaluation for Various Disabling Conditions 1987 Committee Member, Ane Marie Kajenckii, English, "The Concept of Free Association •n V'ri,inia Woolf s The Waves" 1986 Committee Member, Fuming Liao,Mechanical Kinesiology, "Development and Validat on of a Method for Providing Immediate Feedback Information on Speed and Angle of Release n Shotputting" GRADUATE STUDENT COMMITTEES -- tfasters 1998 Vanessa Ewing. Committee Member 1997 Stephanie Blasi, Committee Member 1997 John Nickisson. Chair 1994 David Watson, Committee Member 1994 Tiernan McIlwaine. Committee Member 1994 Jerrod McCoy, Committee Member 1993 Sheldine Runyan. Committee Member 1993 Sue Cole, Committee Chair, "Influences on Occupational Goals of Selected Male and Female College Students". 990 Jerry Benner, Committee Member 1990 Kurtis Armstrong, Committee Member."Attitudinal Consequences of Pre-Employment and Rr,ndom Employee Drug Testing" 1989 Michelle Hozer. Committee Member 1089 Anne Schnittgnmd, Committee Chair, " Age and Electrothermal Biofeedback Training". 1988 Chem Hockett, Committee Member, "The Effects of Turnover on Those Who Remain in an Organization" 1988 Tony Ambrosio. Committee Member. "The Belief in a Just-World and the AIDS Epidemic' Predictors of Attitudes Towards Individuals with AIDS" 1988 Steve Foster, Committee Chair, "Hypnotic Susceptibility As a Function of Locus of Control and Director Indirect Inductional Deepening and Suggestion Style" 1988 Lisa Dillon, Committee Chair, "Cognitive-Behavioral Approach to the Treatment of Elderly Rheumatoid Arthritis Subjects" 1987 Deanna Holmes, Committee Member 1987 Darlene*Told, Committee Member, "Reading and Writing Assessment Tests as Predictors of Success in the Basic Peace officer Academy at Aims Community College" 1987 Dan May, Committee Member 1986 Jeff Schiels, Committee Member, "The Reformulated Hypothesis: Is Its dominator of Learned Helplessness Literature Justifiable?" 1986 Linda Coulthard-Morris. Committee Member. "Biofeedback of Cortical Slow Wave Potentials. Hand'Temperature and Muscle Tension in Normal and Attention Deficit Disorder with Hyperactivity Children" TEACHING: Honors Activities' 1999 UNC Research Day, Faculty Panel Coordinator, " Complementary Healing Methods" 1999 Thesis Coordinator-Kristin Pietryzick, Jennifer Kimberling, Cristine Dickey 1997 Thesis Co-Advisor Kelly Kinser 1997 Honors Connection Course development-Alternative Healing Methods 1996-pres Honors Co-Coordinator,Psychology Department 1989-94 Honors Coordinator, Psychology Department 1994 Thesis Co-Advisor, Diane Musgrave,"The Relationships Among Personality Traits, Alcohol, Caffeine. and Nicotine Consumption, and Academic Performance in College Students" 1994 UNC Resent Day, Faculty Panel Coordinator,"Hypnosis: Theory and Research" 1993 UNC Research Day, Faculty Panel Coordinator, "Non-traditional Theories of Therapy Serving Women and Minorities". 1993 Thesis Co-Advisor Linda Norman, "Clozapine and Event Related Brain Potentials in Schizophrenics" 1992 Thesis Advisor, Deborah Knuckey, "The Effect of Touch on AffectAmong Strangers Under Mildly Stressful Conditions" 1992 UNC Research Day, Faculty Panel Coordinator 1992 UNC Research Day, Faculty Panel Coordinator(2 student panels)"Sex Roles and Psychology", The Power of Social Influence 1989 Thesis Advisor, Geri Bosley, "Post Death Ritual in a Small Colorado Community" 1988 Thesis Advisor, Pam Clasen. "The Use of Relaxation and Imagery Techniques in Pain Management" 1989 Honors Connection Course Development courses Taught' (1-4 Scale with 1 as Highest) (*1-5 Scale with 5 as highest) DATE COURSE TITLE HRS ENR AVG.RATING W 198 8 PSY 101 IntroSeminar Psychology 1 43 - W 1987 PSY 101 IntroScminar Psychology 1 16 1.12 W 1986 PSY 101 IntroSeminar Psychology 1 32 1.24 F 1997 PSY 120 Principles of Psychology 4 107 3.76 F 1996 PSY 120 Principles of Psychology 4 139 F 1991 PSY 120 Principles of Psychology 4 119 1.64 F 19911 PSY 120 Principles of Psychology 4 161 167 F 1983 PSY 170 General Psychology 3 42 --- Sp 1984 PSY 121 Intro to Psychology 1 4 40 ---- Sum 1988 PSY 230 Human Growth &Development 5 55 _-- Sp 1988 PSY 230 Human Growth &Development 5 60 1.58 W 1988 PSY 210 Human Growth &Development 5 90 1 18 F 1987 PSY 230 Human Growth &Development 5 45 1.54 W 1987 PSY 230 Human Growth & Development 5 75 1 54 Sp 1987 PSY 230 Human Growth &Development 5 90 -- Sum 1986 PSY 230 Human Growth &Development 5 47 -- F 1986 PSY 210 Human Growth &Development 5 80 1.36 W 1986 PSY 230 Human Growth & Development 5 80 1.42 W 1986 PSY 230 Human Growth &Development 5 52 1.27 F 1985 PSY 230 Human Growth &Development 5 56 1.53 F 1985 PSY 210 Human Growth &Development 5 85 1.56 Sp 1984 PSY 265 Social Psychology 3 26 ---- W 1984 PSY 265 Social Psychology 3 23 ---- Sp 1998 PSY 323 Health Psychology 3 40 4 11 F 1998 PSY 323 Health Psychology 3 39 4.08 Sp 1997 PSY 321 Health Psychology 3 44 4.37 c F 1995 PSY 323 Health Psychology 3 47 Sp 1994 PSY 323 Health Psychology 3 41 1.69 F 1992 PSY 323 Health Psychology 3 49 Sp 1992 PSY 423 Health Psychology 3 42 1.69 F 1990 PSY 423 Health Psychology 3 1.66 F 1988 PSY 423 Health Psychology 3 35 136 Sp 1986 PSY 330 Child& Adolescent Psych 3 27 1 4 Sp 1993 PSY 331 Maturity& Aging 3 40 Sp 1991 PSY 331 Maturity & Aging 3 46 1 62 F 1989 PSY 331 Maturity & Aging 3 23 1.45 F 1988 PSY 331 Maturity & Aging 3 27 1.40 Sp 1988 PSY 430 Maturity& Aging 3 44 1.58 Sp 1987 PSY 430 Maturity& Aging 3 34 -- Sp 1986 PSY 430 Maturity& Aging 3 36 1.52 F 1998 PSY 455 Abnormal Psychology 3 49 4.24 Sp 1997 PSY 455 Abnormal Psychology 3 49 4.03 F 1995 PSY 455 Abnormal Psychology 3 32 Sp 1993 PSY 355 Abnormal Psychology 3 37 So 1992 PSY 355 Abnormal Psychology 3 42 126 Sp 1991 PSY 355 Abnormal Psychology 3 37 1.37 F 1990 PSY 355 Abnormal Psychology 3 1 46 Su 1990 PSY 355 Abnormal Psychology 3 31 Sin 1990 PSY 355 Abnormal Psychology 3 37 1.38 Sp 1990 PSY 355 Abnormal Psychology 3 42 1.53 Sao 1989 PSY 355 Abnormal Psychology 3 78 1.51 Sp 1986 PSY 358 Abnormal Psychology 3 41 1.54 W 1984 PSY 358 Abnormal Psychology 3 31 Su 1998 PSY 350 Theories of Personality 20 4.10 Su 1990 PSY 357 Theories of Personality 3 21 1.45 W 1988 PSY 357 Theories of Personality 3 40 1.57 F 1987 PSY 357 Theories of Personality 3 55 138 W 1987 PSY 357 Theories of Personality - 37 1.33 F 1986 PSY 357 Theories of Personality 3 54 -- F 1983 PSY 357 Theories of Personality 7 51 F 1998 PSY 407 Intro to Counseling Theories 3 20 4 31 Sp 1998 PSY 407 Intro to Counseling Theories 3 20 4 42 F 1997 PSY 407 Intro to Counseling Theories 3 15 4.71 F 1996 PSY 407 Intro to Counseling Theories 19 F 1995 PSY 407 Intro to Counseling Theories 3 19 Sp 1994 PSY 407 Intro to Counseling Theories F 1993 PSY 407 Intro to Counseling Theories 3 24 1 32 Sp 1993 PSY 407 Intro to Counseling Theories 3 22 F 1992 PSY 407 Intro to Counseling Theories 3 25 1.18 Sp 1992 PSY 407 Intro to Counseling Theories 3 22 1.21 F 1991 PSY 407 Intro to Counseling Theories 3 44 1.26 Sp 1991 PSY 407 Intro to Counseling Theories 3 33 1.21 F 1990 PSY 407 Intro to Counseling Theories 3 Sp 1990 PSY 407 Intro to Counseling Theories 3 16 1 12 F 1989 PSY 407 Intro to Counseling Theories 3 24 1.20 Sp 1989 PSY 407 Intro to Counseling Theories 18 1.31 F 1987 PSY 407 Intro to Counseling Theories _ 26 121 F 1986 PSY 407 Intro to Counseling Theories 2 41 1.57 Sum 1987 PSY 499 Psychology of Sex Roles 3 16 1.18 Sum 1989 PST 508 Emotional Crisis Workshop 1-2 39 *** "Frontiers of Mental Health And Education" Sum 1988 PSY 508 Emotional Crisis Workshop 2-3 63 "Mind/Body Interactions" Sum 1987 PSY 508 Emotional Crisis Workshop 2-3 106 "Relationships" Sum 1991 PSY 595 Health Psychology 3 15 1998 PSY 620 Assessment & Interviewing 2 9 4.31 1992 PSY 620 Assessment &Interviewing 2 12 1.66 F 1990 PSY 620 Assessment& Interviewing 2 1.02 1988 PSY 620 Issues in Behavioral Medicine 3 5 2.08 = 1997 PSY 621 Practicum College Teaching 2 10 4.77 P 1996 PSY 621 Practicum College Teaching 2 10 1993 PSY 621 Practicum College Teaching 2 13 1 45 P 1992 PSY 621 Practicum College Teaching 2 13 1,1' 1984 PPSY 670 Tests and Measurements 3 20 Sp 1997 HON 200 Honors Connections Seminar: Alternative Healing Methods 2 20 3.67 of 4 Sp 1989 HON 200 Honors Connection Seminar II: 2 9 *•� "Love" Sum 1986 Elderhostel "Dream On" NC (25) Sum 1987 Elderhostel "Mind/Body Interactions" NC 19 s++ Courses Developed: 1997 HON 200. Alternative Healing Methods 991- PSY 595,Issues in Health Psychology, Sumer [989- 23rd Annual Emotional Crisis Workshop. Frontiers of Mental Health and Education. Summer 988- PSY 620, Assessment in Behavioral Medicine, Fall (Revised Spring 1998) 988- PSY 423. Health Psychology. Fall 988- 22nd Annual Emotional Crisis Workshop, Mind/Body Interactions, Summer 987- 21st Annual Emotional Crisis Workshop, Relationships. Summer 1987- Mind/Body Interactions - Elderhostel Program, Summer •987- PSY 499. Psychology of Sex Roles - Summer 1986- Dream On -Elderhostel, Summer Directed Studies; Graduate. 1995- Cynthia Holley. Hypnosis 1994 - Tam Johnson, Hypnosis Theory and Practice 1994 - Marla Gallagher. Sociometric Processes !994 - Marla Gallagher, Cluster Development in Intro Psychology Classes 199? - Bruce Holoman. Hypnosis Research and Practice 1988 - Paul Jantz, Hypnosis for Pain With Children 1988 - Lori Kochevar. Women as Leaders 1988 - Jcrri Israel, Alan Shaw, Issues in Health Psychology 1988 - Steve Foster. Michele Hozer. Teaching Apprenticeship 1987 - Tony Ambrosio, Hypnosis Models 1986 - Candy Disch. Psychological Testing t'ndcrgraduatc: 1998 Jennifer Altman - Exercise and Psychology 1996- Kindra Sanchez-Biracial Identity 1996 - Jenna Weatherbee -Pain Coping Styles 1995- Allison Ellis - Psychological Theories in Business Management 1005 - Holli Elrick. Counseling and the Hearing-Impaired Child 1994 - Lewis Garza. Etiology of Schizophrenia In 1994 - Suzanne Bodetko, Autogenic Training 1994 - Rebecca Furstenberg, Impact of Alzheimer's Disease on Families 1994 - Bonnie Sarton,Hypervigilence in Youth(Hon 351) 1993 - Mary Jo Hamilton.Hypnosis Theory 1994 - Greg Schooley,Forgiveness as a Therapy Tool 1993 - Jason DeBueno. Youth Advocacy 1993 - Kelley Ferguson-Women in Psychology 1993 - David Rosenberg -Offender Programs 1992 - Robin Trostel, Analysis of Learning Styles 1992 - Robin Trostel,Health Locus of Control 1992 - Roberta Inman,Family Violence and Lesbians(Hon 351) 1991 - Mark Kahl,Back Pain 1991 - Tracy Moulton,Treatment of Sexual Abuse 1991 - Alice McPherson. African American Women and Higher Education 1991 - Jody Hurner,Hypnosis: Theory and Practice 1990 - Jimmie Berg, Women's Learning Styles 1989 - Elary Violett, Cognition and Pain Management 1989 - Geri Bosley. Chris Snodgrass,Bev Foster, Elary Violett, Issues in Personality 1989 - Penny Vaughn, Female Pioneers in Social Work 1989 - Lori Peterson, Pain and the Elderly 1988 - Peer Training for Hotline Service 1987- Tracy Boh. Issues in Child Abuse 1987 - Julie Stoddard, Grief and Divorce 1987 - Eric Bouch. Hypnosis Models 1987 - Mike Lesser, Assessment in Sport Psychology (986 - Lynne Sheffield, Childhood and Loss 1986 - Jennifer March, Adolescence Practica 998- Andrea Lamb-Hypnosis and golf performance 998- Rebecca Varoula- Women's Place L998: Greeley Medical Clinic -Gay Lemons, Renae Smith 1.998- Ackerman and Associates-Amy Munnel, Kristin Pietrzyk, Jennifer Kimberling, Greg Pedersen 1997- Greeley Medical Clinic-Lori Darst, Barbara Glode, Ann Marie McCullen, Jeff Titus 1993 - Greg Schooley,Breavement Research 1993 - Di Smice, Women's Commission 1992 - Mary Jo Hamilton,Hypnosis Research 1992 - Carol Sexton. Psychology Testing 1992 - Lisa Schlott.Learning Styles PROFESSIONAL DEVELOPMENT ACTIVITIES: Workshops. Clinics. Symposia Conferences: (Excluding Conferences as a Presentor) 1999- EMDR training and Level 1 certification 1998 Qualitative research lecture series-UNC 1998- Lewis M. Taman Western Regional Teacher's Conference sponsored by APA Division2 in cenjt.nctu m with the WPA/RMPA joint convention. 1998- "Spirituality and health in counseling", CAHEC Workshop, Greeley 1998- `Divorce Bursting: Solution oriented brief therapy with couples". Colorado Assoc. Marriage and F ami'‘ 1997 - Health Maintenance - Legal and Ethical Issues 1997- Body and Soul: Healing in the 90's 1996- Celebrating our Essence: Women's Health and Spirituality 1995 - International Society for Clinical and Experimental Hypnosis -Research Workshop. San Francisco.( A (30 more hours toward certification) 1989 - "Minding the Body. Mending the Mind". CAHEC Workshop. Ft. Collins 11 1988 - "Demystifying Publishing". CAHEC Workshop, NCMC. Greeley 1985 - "Attentional Deficit Disorders in Children",Meichenbaurn, Denver 1980 - International Society for Clinical and Experimental Hypnosis -30 certification hours.Denver Numerous other workshops on Parent Loss, Child Abuse, Grantsmanship, Short-Term Treatment, Supen Lsion, Pain Management. Medical Terminology. Depression. Personality Disorders Courses Taken Credit. 1994- EPRE 603 -Analysis of Variance 1993 - EPRE 602-Elements of Statistics 1990- EPRE 700 -Advanced Research Methods ( rifling Education Credit 1976 - C.U. Medical School -Medical Ethics 1972 - C.U. School of Nursing -Hypnosis(10 weeks) 1969 - University of Chicago-Kubler-Ross.Death and Dying HONORS AND AWARDS: 1998- Distinguished Service Award-Rocky Mouintain Psychological Association 1998- Arts and Sciences Teacher of the Year Award-one of thre in Social Sciences 1998- "Wonderful Outstanding Woman" Award-Highlighted in October newsletter-Women's Resource Center 1993 - Commencement Banner Carrier. Arts and Sciences 1993, 91,89, 88 - Mortar Board Favorite Professor 1992 - Sudent Representative Council University Professor of the Year 1992 - Student Representative Council University Advisor of the Year 089 - Arts and Sciences Achievement Award 1988 - Honors Advisor of the Year 1984 - Psi Chi. University of Northern Colorado Chapter 1982-83 - Writing Associateship-Rocky Mountain Women's Institute BED. F=it ::CC-651-9E•14 - . I 9/28/99 CURRICULUM VITAE N. Karen Bender, MA, LPC 1104 Twin Peaks Circle Longmont, Colorado 80503 Phone: 303-678-8940 BUSINESS ADDRESS: 2919 W. 17th Ave.. Suite 214 Longmont. Colorado 80503 Phone: 303-678-0268 MARRIED: Brice J. Bender, MD, Aprl 26, 1974 CHILDREN: Sara C. Bender, born 3/13/79 and Melissa K. Bender. born 9/8/80 EDUCATION: Bachelor of Arts, Chemistry University of Colorado at Denver, 1977 Master of Arts in Agency Counseling, Emphasis in Marriage and Family University of Northern Colorado, 1993 Externship: Mental Health Center of Boulder County, Longmont Branch, Community Support Services Team, Sept. '92 to June '93 Currently enrolled in Professional Psychology Doctoral Program University of Northern Colorado (course work nearly completed) WORK EXPERIENCE: Feb. '94 to present: Private practice, Individual adult clients and coupies, Longmont. Fall '95 Counselor and presenter in multidisciplinary PMS program. 'Longmont Clinic. March '95 to May '96: Domestic Violence Counselor, Longmont Coalition for Women in Crisis, Individual adult clients; women's groups: domestic violence curriculum, support. and parenting. June '93 to Sept. '93: Therapist, Mental Health Center of Boulder County, Longmont Branch, Women's Issues Group. Sept. '84-Dec. '86: Cardiopulmonary Technologist, part-time Longmont United Hospital, 1950 W. Mountain View Ave., Longmont, Colorado 80501. June '79-April '82: Supervisor, Pulmonary Laboratory, Presbyterian/St. Luke's Medicai Center. 601 E. 19th Ave., Denver, CO 80203 Jan. '76-June '79: Supervisor, Pulmonary Laboratory, St. Joseph Hospital, 1835 Franklin St., Denver, CO 80206 1975-1979 Clinical Instructor, Front Range Community College, 3645 W. 112th Ave.. Westminster, CO 80030. VOLUNTEER EXPERIENCE Sept. '98 to Sept. '99: Doctoral Student Representative. Division of Professional Psychology. University of Northern Colorado. Sept '94 to Mar. '95: Volunteer therapist: Longmont Coalition for Women in Crisis. Individuals and groups: domestic violence curriculum and parenting. Jan. '94 to July '95: Volunteer therapist: St. Vrain Valley Child Development Council, Inc., Head Start Program. Individuals, families, parent support groups that include parenting curriculum. June '93 to Aug. '93: Volunteer Co-therapist: Mental Health Center of Boulder County. Drug Treatment Team, Women's Group: History of Sexual and Drug Abuse. Co-therapist: Lisa Franseen. June '93 to July '93: Volunteer Co-therapist: Mental Health Center of Boulder County, Longmont Branch. Children's group: Attention Deficit Disorder. Co- therapists: John Fallon, MSW, and John Garson, Ph.D. Nov. '91 to May '92 Volunteer individual counselor: University of Northern Colorado Counseling Center Feb. 1991 to Feb. 1992: Master's Student Representative. Division of Professional Psychology, University of Northern Colorado. Sept. '91 to Oct. '91: Volunteer Counselor A Woman's Place, Greeley, Co 1990 to 1992: Sch6arship Committee for American Association of University Women. 1990-1991: Member Board of Directors for Longmont Coalition for Women in Crisis. PROFESSIONAL ORGANIZATIONS: Co-chairman, Public Relations. Information and Education Committee, Child and Family Advocacy Team (Boulder County Child Sexual Abuse Task Force), June '95 to August '97 Facilitator, Longmont Study Group, Colorado Society for the Study of Dissociation, May '95 to August '97. z 1:. _c _- 11:LJc BF BEN F=i, 303-651-5514 Member: American Counseling Association, Colorado Counseling Association, and Eating Disorders Professionals of Colorado. Associate Member: American Psychological Association. PUBLICATIONS: N. Karen Estrldge Bender Slonim, N. B., & Estridge, N. K. (1969). Ozone —An underestimated environmental hazard. Journal of Environmental Health, 31, 577. Slonim, N. B., & Estridge, N. K. (1970). The acid-base surface --- A 3- dimensional visual model. Rocky Mountain Medical Journal. 57, 59. Slonim, N. B., & Estridge, N. K. (1970). Carbon dioxide --- Environmental health aspects. Journal Of Environmental Health, 33,171. Slonim, N. B., & Estridge, N. K. (1970). The acid-base surface: A three- dimensional visual model for analysis of acid-base information. Journal of Medical Education. 45, 828. Slonim, N.B., & Estridge, N. K. (1971). Carbon dioxide ---Environmental health aspects. In T. J. DeKornfeld (Ed.). $elected papers in inhalation therapy. Flushing, NY: Medical Examination PublisRing, Co.. Inc. Slonim, N. B., & Bender, N. K. (1974). Responses to carbon dioxide containing atmospheres. In N. B. Slonim (Ed.). Environmental physiology. St. Louis: The C. V. Mosby Co. Slonim, N. B., & Bender, N. K. (1976). A tabular history: Cardiopulmonary technology as a profession. CVP, The Journal of Cardiovascular and Pulmonary Technology , 4, 31. Bender. N. K. (1977). Relevant respiratory Johysiology. The post-surgical patient, Spirometry. In V. Archuleta, O. B. Plummer, and K. D. Hopkins, A demonstration model for the proiect"Training nurses to improve patient education Boulder, Colo.: Western Interstate Commission for Higher Education. Bender, N. K. (1988). Future trends in education, SVVEA Bridge, 3, 5. (St. Vrain Valley Education Association) PRESENTATIONS: Fall '95: Co-presenter with Haven Howell, M.D., multidisciplinary PMS program, Longmont Clinic. October '98: Co-presenter with Sean O'Halloran and Christine Rogers: A Roundtable discussion entitled: "Facing our Clients' Trauma: Implications foi Counselors in Training," at Rocky Mountain Association for Counselor Educat on and Supervision. 1 RESUME Emily L. Jaramillo-Bansberg 183 50th Avenue Place Greeley,Colorado 80634 (970) 353-1388 Office Telephone: (970) 351-2417/Email: ejaramil@che.unco.edu EDUCATION • Master of Arts: Psychology/Counseling, University of Northern Colorado,Greeley, CO • Graduate Fellowship Study: Rutgers State University of New Jersey, Newark, NJ • Bachelor of Arts: Sociology, University of Northern Colorado, Greeley, CO EMPLOYMENT Associate Director The Center for Human Enrichment University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 August 1997-Present Ensure efficient administration of the Student Support Services TRIO project which includes curricu.um and instruction, technology, advising, and tutoring. Review the non-competing continuation and annual pertormanc e reports. Assist with the provision of professional opportunities for Center employees. Oversee the state funded Bridging Opportunities Program that focuses on recruiting incoming freshmen and transfer sti!bents into the Center for Human Enrichment. Direct the Ronald E. McNair Postbaccalaureate Achievement Pi egram (see below). Director Ronald E.McNair Postbaccalaureate Achievement Program University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 March 1996-Current Direct all efforts to ensure efficient administration of the McNair federal TRIO grant. Co-author I J.S. Department of Education McNair proposal. Responsible for the compilation, analyzation,and subrr ission of Non-Competing Continuation and Annual Performance Reports to the Department of Education. Mo Mop- projects federal and matching budgets, supervise and train staff members, and plan, develop, and o irec t all student scholar activities. Collaborate with campus departments in order to exceed program object yes Responsible for coordinating, editing, and publishing the UNC McNair Scholars Journal. Identity, I ccncit, and select program scholars. Ensure the completion of scholars' academic research projects. Provide aca( emu advising and guidance to McNair scholars. Direct the academic year research seminar series, the r '-idential Summer Research Internship, and other scholarly activities that prepare scholars for doctoral stud,' Coordinate research and scholarly activities between faculty mentors and McNair scholars. Counselor/Assistant Director Ronald E. McNair Postbaccalaureate Achievement Program University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 October 1995 -February 1996 Assisted in the implementation of the McNair program (funded October 1995). Facilitated the rein itment and select on of McNair scholars. Compiled and submitted federal reports. Informed and collaborated with campus offices and departments. Implemented an academic workshop series based on student needs. Provided academic advisement and guidance to McNair scholars. Assistant Coordinator,Academic Advising Student Support Services University of Northern Colorado,Center for Human Enrichment,Greeley, CO January 1995-August 1995 Provided academic advisement and guidance to federal TRIO Student Support Service participants Maintained student record database. Assisted with the compilation of federal reports. Served as liaison to the athletic department and the financial aid office. Assisted in the supervision of peer advisors. Pro-.id(d technological assistance within the program. Assistant Coordinator,Macintosh Computer Laboratory Student Support Services University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 August 1994-December 1994 Supervised, scheduled, evaluated, and trained lab employees. Provided technical assistance and advisement to federal TRIO Student Support Service participants in a learning environment. Maintained and ordered consumable computer supplies. Evaluated and ordered computer software and hardware. RELATED EXPERIENCE Admissions Office Assistant University of Northern Colorado, Admissions Office, Greeley, CO December 1985-December 1988 Assisted in the daily operations of the UNC Admissions Office. Received and reviewed applicat:iors and distributed accordingly. Filed, typed, and performed data-entry on all incoming freshman, transfer re-entry, and non-traditional students. Trained and supervised co-workstudy employees on office procedures, 1-'ERPA, and the CCHE Index system. Provided general information to incoming students and parents. Co-Instructor University of Northern Colorado, Center for Human Enrichment CSPA 359: Paraprofessionals in Student Affairs, Academic Peer Advisors Co--facilitated the instruction for training of peer advisors who advised Student Support Service participants at the Center for Human Enrichment. Coordinated curriculum and instruction for pre-service and on-going training for a staff of fifteen peer advisors. Counselor Intern North Colorado Medical Center, Family Recovery Center, Greeley, CO January 1996-July 1996 Facilitated psychotherapy counseling groups and individual counseling for chemically dependent and eating disorder patients. Performed case management from admission to discharge. Presented psycho-edu i tional information to patients, family members, and staff. Designed a portfolio brochure distributed to health are and managed care providers. Clinical Care Assistant Weld Mental Health Center, Greeley, CO September 1994- February 1995 Monitored and supervised the daily activities of chronically mentally ill patients in a learning/self- development environment. Facilitated group and individual counseling sessions. Coordinated patien- recreational activities. Prepared written and oral reports. Correction Technician The Restitution Center, Greeley, CO February 1989- February 1990 Conducted informal counseling with non-violent felony offenders in a residential setting. Responsible for the supervision of clients. Distributed client medications as prescribed. Performed searches and confiscab.•d contraband. Prepared written and oral reports. Instructed clients on self-development and new life approaches as alternative methods of coping. PRESENTATIONS • Moderator: "Research & Policy Affecting the Education of the Mexican Child in the 21st Century," University of Northern Colorado. • Moderator: Second Annual McNair Scholars Research Symposium and Graduate Education Conference. • Panelist: Minority Students in Graduate School, Colorado State University. • Presenter: Financing a Graduate Education, Applying to Graduate School, Cultural Sensitivity and Awareness, Hispanic Women in Higher Education,Introduction to the Internet,and Communicate ng Across Cultures, University of Northern Colorado. • Presenter: Conflict Resolution, Communication Skills, and Setting Limits and Boundaries, Norti' Coiurado Medical Center. CAMPUS SERVICE: University of Northern Colorado Officer • Professional and Administrative Staff Council (President's Office) • Co-chairperson, Student Advisory Committee, Hispanic Cultural Center • Secretary, Macintosh Computing Society Member • Undergraduate Research Council • Cesar Chavez Cultural Center Cinco de Mayo Week Committee • Professional Development Award/Scholarship Committee • Relations with UNC Board of Trustees Committee • Salary Equity Committee • Exempt Staff Evaluation and Performance Committee • Team UNC Fund Raising Committee • Academic Excellence Week Task Force • Campus Advisory Committee, Cesar Chavez Cultural Center Other • Reviewer/Evaluator for "UNC Works In Progress" conference. • Submitted and published an article in the International Student Services' newsletter entitled, Communicating Across Cultures. PROFESSIONAL AFFILIATIONS • ASPIRE member (Association of Special Programs In Region Eight) • CABE member (Colorado Association of Bilingual Education) • NCEOA member (National Council of Educational Opportunity Associations) HONORS AND AWARDS • Distinguished Alumni, Department of Sociology, University of Northern Colorado • Fellowship, Graduate Study-Rutgers School of Criminal Justice Fellowship, Rutgers State University of New Jersey, Newark, NJ • Scholarship, National Hispanic Scholarship Fund • Scholarship, Candelaria Scholarship, University of Northern Colorado, Greeley, CO PROFESSIONAL DEVELOPMENT AND TRAINING • National McNair Scholars Research Symposium-6th Annual, Penn State, College Park, PA. • National Council of Educational Opportunities Association (NCEOA) Proposal Writing Conference, San Francisco, CA. • Reporting Student and Project Performance,Monterey Bay,CA. • First, Second, and Third Annual Rocky Mountain McNair Scholars' Research Symposium & Gracuate Education Conference, Fort Collins,CO. • NCEOA 16th and 17th Annual Policy Seminar, Washington, DC. • NCEOA, Seminar on Relations with the U.S. Department of Education, Washington, DC. • NCEOA Proposal Writing Conference,San Juan,Puerto Rico. • Association of Special Programs in Region Eight (ASPIRE) Colorado Chapter, 1995-1998 State Meetings, Denver, Ft. Collins, CO. • Annual Rocky Mountain Teacher Education Consortium Conference,Greeley,CO. • Di verse Learners Academy, Leadville and Pueblo, CO. • National McNair Scholars Research Symposium, University of California, Irvine, CA. • Parent/Teacher Youth Leadership Conference, Breckenridge, CO. • National Association of Bilingual Education Conferences, Albuquerque, NM and Orlando, FL. • Northern Colorado Hispanic Chamber of Commerce Conference, Greeley, CO. • ASPIRE Regional Conference, Fargo, ND. • National McNair Scholars Research Symposium-4th Annual, Penn State, College Park, PA. • Scuth East Association of Educational Opportunity Programs Conference, Director Training, Asheville, NC • Cultural Diversity Conference, Greeley, CO. PERSONAL STRENGTHS • Communicate: Ability and extensive experience in communicating with a diverse populatii n. • Counsel: Formally trained to work with a variety of individuals in multiple settings • Leader: Ability to lead individuals and manage environments and situations. REFERENCES Dr. David Gonzalez University of Northern Colorado Division of Professional Psychology, McKee Hall Greeley, CO 80639 (970) 351-1639 Dr. Wendell Osorno University of Northern Colorado Division of Professional Psychology, McKee Hall Greeley, CO 80639 (970) 351-1635 Dollie Zamora Coordiator of Communication Greeley/Evans School District Six 811 15th Street Greeley, CO 80631 PERSONAL DATA SHEET Identifying Information: Name : Laurence "Larry" P. Kerrigan, Ph. D. Address : 1706 19th Avenue Greeley, CO 80631 DOB: 9/20/32 Phone : ( 303 ) 353-3373 - business Degrees : BSC - Business Economics , from Creighton University , 1954 . MS - Economics , from St . Louis University , St . Louis , Mo. , 1963 . MA - Theology, from St . Mary ' s University, Regis College Campus , Toronto , Ontario , Canada , 1967 . Ph . L. - Philosophy , St . Louis University, St . Louis , Mo . 1960 , ( Ecclesial Degree ) . Ph . D. - California School of Professional Psychology , Berkeley/Alameda Campus , 1974 , Clinical Psychology. Currently a licensed psychologist in the state of Colorado . Educational Background : 1950-54 Creighton University , Business economics , 1954-56 Marquette University , Milwaukee , WI . , Classical studies and ascetical theology , 1956-57 Springhill College , Grand Coteau LA. Campus , Classical studies , 1957-60 St . Louis University, Philosophy and Economics , 1963-67 St . Mary ' s University, Toronto Campus , Theology , 1971-74 California School of Professional Psychology , clinical psychology , Berkeley/Alameda Campus Positions field: 1969-71 Member of Board of Directors , Campion College , Prairie du Chien , WI . 1968-71 Director , Department of Psychology , Campion College . 1971-74 Director of Student Counseling Center , Long Mountain College . 1975-80 Director of Short-term Children and Family Team, Weld Mental Health Center , Greeley , CO . 1975-87 Clinical Psychologist , Child and Family Team , Welt. Mental Health Center, Greeley, CO . 1975-88 Co-founder of Weld County Child Protection Team, 1987-88 Member of Executive Board , Weld Mental Health Center , Greeley , CO . Honors Received : 1968-69 and Teacher of the year, Campion College . 1970-71 1972-73 Class Representative to Campus Executive Committee , and California School of Professional Psychology 1973-74 Work and Experiential Background : 1959-60 Counselor at Dismas Halfway House for ex-convicts , St. Louis , Missouri , 1960-63 Teacher-counselor-coach , Marquette Prep High School , Milwaukee , WI . 1964-67 Counselor-therapist at Street Haven and Sancta Maria Halfway Houses for women and at the Don ( metro ) Jail in Toronto , Canada. 1967-68 Teacher and Campus Counselor at Creighton University , Omaha, ND . 1968-71 Teacher at Campion College , Prairie du Chien , W [ . , Director of Psychology Department , Department chairman. 1970-71 Director and Staff member of a total environment for Inter-city boys , late grade school age from Milwaukee , WI . 1971-73 Director of Student Counseling , Lone Mountain College , San Francisco , CA. Teacher at the Lone Mountain College , San Francisco , California. 1973-74 Psychologist Trainee at San Francisco Mental i1eals_h Center , Richmond District , Outpatient Care . 1974-75 Private Practice , So . Bay Human Services Center , San Diego , CA. Part-time instructor at California School of Professional Psychology , San Diego , CA. 1975-80 Director , Short-'Perm Therapy Team, Children and Family Unit , Weld Mental Health Center , Greeley , CO . 1980-87 Member of Children and Family Therapy Team , Weld Mental Health Center , Greeley , CO . 1987- present Full time private practice with Joyce ShoheL Ackerman , Ed . D . , Licensed Psychologist , Greeley , CO . Par!. time practice at Weld Mental Health Center , Greeley , CO . Publication : Kerrigan , Laurence P . - The Relationship Between Therapist and Client ' s Perceptions of One Therapy Session . Published Doctoral. Dissertation , University of California School of Professional Psychology . Copyright , 1974 . Workshhopsand Special Training. : Since 1974 , 1 have attended an average of about three workshops per year . Most, of these workshops have presented specialized training in the following areas : Neuro-linguistic training , Autogenic and relaxation training , Visualization-Imagery- Hypnosis , Cognitive-Behavioral Therapy , Ericksonian approaches to hypnotherapy and psychotherapy, Family therapy, Strategic family therapy , Sexual abuse , dynamics and applied treatment , Paradoxical intention psychotherapy , and other related areas . In Lhe last fifteen years , I have taught classes and cor.ducted workshops in the following subjects : The Psychology of Dreams Emotional and Physical health through Visualization and Imagery Western Psychotherapies and Eastern Ways of Liberation Cognitive and Behavioral Therapy Hypnosis in Pain and Ilabi. L Control The Psychology of Consciousness and Meditation Sherri R. Malloy, Ph.D. Licensed Clinical Psychologist Office: Home: Mental Health Center of Boulder County 24 Alles Drive 1333 Iris Avenue Greeley, Colorado 80631 Boulder, Colorado 80304 (970) 351-7218 (303) 413-6301 Education Ph.D. Double Major: Child Clinical Psychology; Clinical Psychology. August 1993 University of Colorado, Boulder. M.A. Department of Psychology, Clinical Program. University of July 1989 Colorado, Boulder. B.A. Major: Psychology; Minor: Spanish. Arizona State University. May 1987 Summa Cum Laude. Teaching Cert. Roston Montessori Teacher Training Institute. August 1977 Orange, California. Montessori Elementary Education Certificate. Clinical Experience August 1991- Child and Family Psychotherapist, Mental Health Center of Boulder March 1997 County, Boulder, Colorado. Provided outpatient psychotherapy to children and their families. Parent, teacher, and other agency consultation. September 1992- Psychology Intern; Denver General Hospital, Denver, Colorado. August 1993 Outpatient assessment, consultation, and treatment to children, adolescents, and adults; Inpatient treatment to adolescents & their families. Consultation to multidisciplinary hospital staff. Attended regular seminars and case conferences Completed an additional rotation in neuropsychology. August 1990- Psychotherapist, University of Colorado, Farrand Residence Hall. May 1992 Provided individual, conjoint, and group psychotherapy to Farrand residents. Psychiatric consultation to faculty and staff. Presented seminars and workshops to faculty', staff, and students. August 1988- Emergency Psychiatric Services Clinician, Mental Health Center August 1992 of Boulder County, Boulder, Colorado. Evaluation and disposition planning for clients with psychiatric emergencies. Composed a training manual for emergency psychiatric clinicians 2 Malloy January 1988- Psychotherapy Intern, Raimy Psychology Clinic, May 1992 Department of Psychology, University of Colorado, Boulder. Provided outpatient psychotherapy to adults, families, and children. Parent and teacher consultation. February 1986- Intake Clinician; Group Facilitator, Tri-City Behavioral Health Jule 1987 Center, Mesa, Arizona. Conducted intakes for the adult team. Facilitator for children's psychotherapy groups. Administrative and Supervisory Experience Jan 1996- Team Leader, Mental Health Center of Boulder County, Boulder, present Colorado. Clinical and administrative supervision of a team of psychologists and psychotherapists. Budgeting. Supervision of support staff. Coordinate outpatient services/consultation to joint agency programs, including Head Start, Specialized Foster Care, Post-Adopt, 1178, School-Based Services, Boulder Day Nursery anal People's Clinic. August 1990- Adult Team Coordinator, Raimy Psychology Clinic, Department August 1991 of Psychology, University of Colorado, Boulder. Chaired the adult team meetings and case conferences. Assisted clinic director ‘sith administrative tasks. August 1990- Peer Counselor Supervisor, Farrand Residence Hall, University of May 1991 Colorado, Boulder. Developed and implemented a peer counseling training program. Provided ongoing training and supervision to peer counselors. January 1989- Supervisor in Training, Raimy Psychology Clinic, August 1991 Department of Psychology, University of Colorado, Boulder, Received training and supervision in supervisory techniques. Supervised the psychotherapy of first-year clinical psychology graduate students. June 1989- Adult Team Intake Coordinator, Raimy Psychology Clinic, August 1990 Department of Psychology, University of Colorado, Boulder. Intake and disposition of psychotherapy clients. September 1989- Clinical Supervisor, Emergency Psychiatric Services Team, August 1992 Mental Health Center of Boulder County, Boulder, Colorado. Trained and supervised Masters level student interns in emergency clinical assessment techniques, legal and procedural practices, and psychological report 6.Titing. February 1988- Volunteer Trainer, Maslin House for Chronically Mentally Ill, May 1989 Mental Health Center of Boulder County, Boulder, Colorado. Recruited and trained volunteer college students to work with the chronically mentally ill population at this facility. 3 Malloy Publications December 1994- Columnist: The Boulder County Parent, a monthly publication of the present Parenting Place, Boulder, Colorado. Circulation: 8,000. Topics include child development and parenting concerns. Teaching Experience August 1989- Psychology Instructor, From Range Community College, May 1992 Boulder Campus, Colorado. Fall 1988 Head Teaching Assistant, Department of Psychology, University of Colorado, Boulder. Trained and supervised graduate level Teaching A ssi stan ts. August 1987- Teaching Assistant, Department of Psychology, University of May 1989 Colorado, Boulder. August 1977- Montessori Elementary Teacher, Roston Montessori School, May 1983 Orange, California; and subsequently, Tempe Montessori School. Tempe, Arizona. Taught preschool through second grade classes. Responsibilities included academic program planning and implementation, supervising teacher assistants, conducting parent • teacher conferences, academic record-keeping, and giving educational presentations to parents. August 1976- Student Teacher, Roston Montessori Teacher Training Institute, August 1977 Anaheim, California. Taught in a Montessori classroom under the supervision of a certified Montessori teacher. Duties were the same as in the entry above. Presentation Topics and Trainings Given Play Therapy Engaging so-called "resistant" clients Psychotherapy with adolescents and their families Case Conferences Parent-Toddler Attachment Patterns Child Abuse Child Psychopathology Stress Management Workshop Depression and Risk of Suicide in College Students 4 Malloy Research Projects Adult Attachment Style and College Functioning (Doctoral Dissertation), 1992 Parent-Toddler Attachment Relationships (Masters Thesis), 1990 Post-Divorce Visitation Patterns and Parent-Toddler Attachment, 1988 Effects of Divorce on Children, 1987 Mental Health Center Client Satisfaction Study, 1986 Clinical Assessment Trained in the use of the following assessment tools: WISC-Ill MMPI Draw-a-Person Kinetic Family Drawing Thematic Apperception Test Rorschach Inkblot Test Sacks Sentence Completion Test Strong-Campbell Interest Inventory Professional Affiliations 1997- present Member: Internal Review Board MHCBC 1996-1997 Member: Professional Advisory Board, Mental Health Center of Boulder County 1991- 1992 Co-Chair: Multi-Ethnic Action Committee, Department of Psychology, University of Colorado, Boulder. 1991- 1993 Member: American Psychological Association, Division 12, Clinical Child Psychology. 1989- 1991 Member: Multi-Ethnic Action Committee, Department of Psychology, University of Colorado, Boulder. 1988- 1989 Student Representative: Department of Clinical Psychology, University of Colorado, Boulder. 1987- 1989 Member: Developmental Psychology Research Group, Department of Psychology, University of Colorado, Boulder. 1987- present Member: (Intermittent) American Psychological Association. 5 Malloy Honors and Awards 1988 Department of Clinical Psychology Scholarship; University of Colorado, Boulder. 1987 Phi Beta Kappa 1987 Academic Scholarship, Arizona State University, Tempe, Arizona. 1986 Phi Kappa Phi Honor Society 1986 Golden Key National Honor Society 1979 West Valley College Track Team, West Valley, California; State Champions, 1977 Fellowship Award; Roston Montessori School, Orange, California. Additional Training Regular participation in bi-monthly seminars, case conferences and supervision held at the Mental Health Center of Boulder County. Readings and professional conferences in the field of clinical psychology. Other Experience 1996-present Vice President (elected), Suburban Ditch Company, Greeley, Colorado. 1983- 1985 Small Business Owner/Operator: Graphicolor, Phoenix, Arizona Photography and advertising design. Commercial and portrait: photography, advertising design, sales, supervised salespeople, performed administrative tasks. 1982- 1985 Dance Aerobics Instructor, International Fitness Center, Mesa, Arizona. Choreographed dance routines, taught classes regularly. made public presentations on behalf of the fitness club, and participated in an ongoing certification/training program in exercise physiology and dance choreography. 6 Malloy Addendum Graduate Coursework: Child Development/Psychopathology Developmental Psychology Developmental Psychopathology Child Psychotherapy Clinical Practicum (six semesters) Theory and Issues in Developmental Psychology Personality/Psychotherapy Advanced Psychopathology' Advanced Personality Theory Clinical Study of the Individual Adult Psychotherapy Family Research and Therapy Research Methodology/Statistics General Statistics (two semesters) Research Practicum (four semesters) Research Problems in Clinical Psychology Assessment Projective Testing Objective Testing Courses for Distributed Minor Multicultural Psychology Community Mental Health Marriage and Family Counseling Behavioral Neuroscience: Clinical and Pathological Perspective Nicole Warnygora 3200 Azalea Drive # IC-4 Fort Collins, Colorado 80526 (970) 407-1578 Education Master of Arts Agency Counseling: Marriage and Family Therapy August 9, 1998 University of Northern Colorado, Greeley, Colorado, G.P.A. 4.0/4.0 Bachelors of Arts Major: Psychology Minor: Political Science May 23, 1993 Augsburg College, Minneapolis, Minnesota, G.P.A. 3.5/4.0 Experience Mental Health Therapist North Range Behavioral Health, Carson Children's Center/Children's Acute Treatment Unit. Greeley, Colorado • Provided individual therapy to children in a day treatment program • Provided family therapy to the children and families • Facilitated a children's group • Evaluated, diagnosed, and created treatment plans for children • Consulted with parents, teachers, psychiatrist, social worker, and the courts to ensure quality and continuity of care • Collaborated with teachers, parents, and social workers, to enable the child to have a successful transition to public school Test Supervisor Career Services Center, University of Northern Colorado, Greeley, Colorado (8/95 - ('resent i • Coordinated national testing program including administration of the ACT, SAT. and GRP. • Trained, hired and supervised testing personnel Child and Family Therapist Intern North Range Behavioral Health, Greeley, Colorado (1/97— 6/97) • Provided individual therapy to children, and provided family therapy • Facilitated a children's group for clients in a day treatment program • Evaluated, diagnosed, and created treatment plans for a variety of children • Consulted with parents, teachers, social workers, and the courts to insure quality and continuity in client care and treatment • Provided services to a diverse population including deaf clients Childcare Relief Worker Families First, Aurora, Colorado (2/96 — 10/97) • Created a safe environment for children ages 3 -12 who were removed from parental hones • Responded, assessed and made referrals for crisis phone calls • Facilitated group discussion for children at the crisis center • Monitored parental phone calls and visits to ensure safety for the children Nicole Warnygora, Page 2 Habilitation Counselor/Program Coordinator Paragon Services Incorporated, Duluth, Minnesota (1/94 - 8/95) ♦Developed programs to assist dual diagnosis clients achieve independence • Supported families with children with emotional disturbances or developmental disabilities and were at risk for out of home placement • Supervised and trained staff • Coordinated services to provide consistency between service providers Program Coordinator Nekton Services Incorporated, Duluth, Minnesota (7/93 - 12/93) • Coordinated the set-up of a group home for three autistic young women • Developed program plans and daily activities • Supervised, coordinated, scheduled, and trained staff • Designed a training manual and trained staff personnel in functional American Sign Language Family Counselor Intern Minneapolis Crisis Nursery, Minneapolis, Minnesota (9/92 - 5/93) • Responded, assessed and made referrals for crisis phone calls • Performed short-term personal counseling with parents • Provided behavioral assessments and programs for children in the homes of clients Program Counselor / Program Coordinator Dungarvin Alternative Services Inc., Saint Paul, Minnesota (9/91 - 7/93) • Coordinated client assessments with the interdisciplinary team • Completed behavior analysis for the purpose of program development • Developed and implemented programs for children who were developmentally disabled and emotionally disturbed in their home environment Counselor Day Care Systems Incorporated, Superior, Wisconsin (Summers 1988, '89, '90, &'91 • Responsible for the care of three children with autism • Implemented programs during the summer to provide fun for the children Volunteer Kindergarten Teacher, Saint Paul's Church, Duluth, Minnesota Tutor, Minneapolis, South High School Tutor, Multi-Cultural Center, Augsburg College, Minneapolis, Minnesota Honors & Award for Excellent Student Employee, Career Services, University of Northern Colorado 1996 Activities Non— Resident Scholarship for Academic Excellence, 1996 Weld County United Way Special Needs Child Care Committee, 1999 SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B RECOMMENDATION(S) itaitt Inc yin Ackerman and Associates, P.C. 1750 25th Avenue, Suite 101 Greeley, Colorado 80634 (970)353-3373 fax(970)353-3374 May 20, 2000 Weld County Department of Social Services Attn: Judy Griego PO Box A Greeley, CO 80632 Dear Judy, This letter is in response to your letter of May 10, 2000, concerning recommendations and/or conditions of our bids. I have discussed these with Frank Aaron and have incorporated clarification to these recommendations and conditions at his suggestion. Concerning: 1 . RFP 006-00 Foster Parent Consultation: We accept the condition that we will notify WCDSS a minimum of 30 days in advance if we anticipate over expenditure of the $40,000.00 allocated 2. RFP 00008#1 Family Group Decision Making: We accept the condition that the food allowance is for EPP referrals only. 3. RFP 000081/2 Goal Achievement Program (GAP) Intensive Family therapy: We accept without conditions or recommendations. 4. RFP 00008#3 Mediated Conflict Resolution, Intensive Family therapy: We accept the condition that referrals will be issued initially for one therapist. We will request a new referral if a second therapist is needed. 5. RFP #00010 Option B We accept the recommendation that time spent with the family will be limited to four hours per week. (If no progress is being made, we will do everything possible to limit the duration to 30 hours and transition the client to other services.) If progress is being made, we will continue at a "step-down" level to a maximum of 60 hours and will provide a treatment report summary for WCDSS. (If at 60 hours a small number of families require limited extra services, it will be up to 15 hours at a time.) 6. RFP #00007 Sex Abuse Treatment We accept the recommendation that a goal of Part A,B, and O, is to serve no more than six months. Part D, maintenance, is however intended to provide up to ten hours over no less than four months to maintain skills for safety. Maintenance up to one year is often necessary when sexual abuse has occurred. Sincerely, \•%,_\\,\ Joyce Shohet Ackerman, Ed.D. Licensed Psychologist JSA/cs • DEPARTMENT OF SOCIAL SERVICES F PO BOX A F GREELEY,CO 80832 Administration and Public Assistance(970)352-1561 hiDe Child Support(970)352-8933 iggive COLORADO May 10, 2000 Ms. Joyce Ackerman, Ed. D. • Ackerman and Associates, P.C. 1750 25 Avenue Suite 101 Greeley CO 80631 Re: RFP 006-00 Foster Parent Consultation RFP 00008 #1 Family Group Decision Making-Intensive Family Therapy RFP 00008 #2 Goal Achievement Program-Intensive Family Therapy RFP 00008 #3 Family Conflict Resolution-Intensive Family Therapy RFP 00010 Option B RFP 00007 Sex Abuse Treatment Dear Ms. Ackerman: The purpose of this letter is to outline the results of the RFP Bid process for PY 2000-2001 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). 1. RFP 006-00, Foster Parent Consultation: Condition: The Department of Social Services shall be notified a minimum of 30 days prior to over expenditure. The budget for PY 2000-2001, June I, 2000, through May 31, 2001, is $40,000. 2. RFP 00008 #1, Family Group Decision Making, Intensive Family Therapy: Condition: Food allowance will be paid for EPP referrals to Family Group Decision Making(FGDM); however, there will be no food allowance paid under Core Services referrals. Page 2 Ackerman and Associates, P.C. Results of RFP Bid Process for PY 2000-2001 3. RFP 00008 #2, Goal Achievement Program (G.A.P.), Intensive Family Therapy Approved wills no conditions or recommendations. 4. RFP 00008 #3, Mediated Family Conflict Resolution, Intensive Family Therapy Condition: Referrals will be issued initially for one therapist. A new referral wil' be needed for assignment of two therapists. 5. RFP 00010, Option B Recommendation: The time spent with the family will be limited to four horns, rather than six. Step-down can be used for ongoing services. Everything possibh must be done to limit the duration to 30 hours and transition the client to other services. 6. RFP 00007, Sex Abuse Treatment Recommendation: The program goal is to serve no more than six months. Any change from this must be explained in the case plan and limited to that duration B. Required Response by FYC Bidders Concerning FYC Commission Recommendations and Conditions 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: 1. FYC Commission Recommendations: You are requested to review the FYC Commission recommendations and to: a. accept the recommendation(s) as written by the FYC Commissiom.: or b. request alternatives to the FYC Commission's recommendation(s). or c. not accept the recommendation(s) of the FYC Commission. • Please provide in writing how you will incorporate the recommendation(: into your bid. If you do not accept the recommendation, please provide written reasons why. All approved recommendations under the NOF/A will be monitored and evaluated by the FYC Commission. Page 3 Ackerman and Associates, Y.C. Results of RFP Bid Process for PY 2000-2001 2. FYC Commission Conditions: All conditions will be incorporated as part of your RFP Bid and Notification of Financial Assistance Award (NOFAA). If you do not accept the condition(s you will not be authorized as a vendor unless your mitigating circumstances arc accepted by the FYC Commission and the Weld County Department of Social Services. If you do not accept the condition, you must provide in writing reasons why. A meeting will be arranged to discuss your response. Your response to the above conditions will be incorporated in the RFP Bid and Notification of Financial Assistance Award. If you wish to arrange a meeting to discuss the above conditions and/or recommendations, pleas° do so through Elaine Furister, 352.1551, extension 6295, and one will be arranged prior to Wednesday, May 24, 2000. Sincerely, fly A. riego, D ctor i V cc: Esteban Salazar, Chair, FYC Commi ion Frank Aaron, Social Services Administrator JG:ef Weld County Department of Social Services Notification of Financial Assistance Award for Families, Youth and Children Commission (Core) Funds _ype of Action Contract Award No. _ X Initial Award FY00-PAC-4000 Revision (RFP-FYC-00008) Contract Award Period Name and Address of Contractor Beginning 06/01/2000 and Ackerman and Associates P.C. Ending_ 0`+/31/2001 Intensive Family Therapy -Mediation 1750 25th Avenue, Suite 101 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 both individual and family functioning The RFP specifies the scope of services and :ondiuons through in-home and in-office services. A of award. Except where it is in conlict with this maximum of two families per month(24 per year) NOFAA in which case the NOFAA goi ern:. the REP with 6 hours of face-to-face meetings per family. upon which this award is based is an intc;ral part of the Services can assist the family in finding action. behavioral solutions to the existing conflict, not sexual abuse conflicts. Special conditions Cost Per Unit of Service 1) Reimbursement for the Unit of Services will be based Hourly Rate Per $ 99.50 on a hourly rate per household, per therapist. Unit of Service Based on Approved Plan 2) The designated rate will be paid for only direct face to face contact with the child and/or famil), as evidenced Enclosures: by client-signed verification form, and as specified in the unit of cost computation. X_ Signed RFP:Exhibit A 3) Unit of service costs cannot exceed the designate rate X Supplemental Narrative to RFP: Exhibit B and yearly cost per child and/or family. Recommendation(s) 4) Payment will only be remitted on cases !Tell with, and referrals made by the Weld County Deportment of X Conditions of Approval Social Services. 5) Requests for payment must be an original submitted to the Weld County Department of Social `Services by the end of the 25th calendar day following the end (if the month of service. The provider must submit requests for payment on forms approved by Weld County Department of Social Services. Appr als: , Program O ficiah B A././ By V arbara J. Kirkmeyer, Chair Judy A. iego, rector Board of Weld County Commissioners Weld C my Department o Social Services Date: OG -:24 -.2cn,u Date: / C C% _ .2a-k' -/337 SIGNED RFP EXHIBIT A CI r INVITATION TO BID T ac_ DATE:Felbruary 28, 2000 BID NO: RFP-FYC-00008 rvv,rc,2 RETURN BID TO: Pat Persichino, Director of General Services /\e So (" cev. 915 10th Street, P.O. Box 758, Greeley, CO 80632 SUMMARY Request for Proposal (RFP-FYC-00008) for:Family Preservation Program--Intensive Family Therapy Program Family Issues Cash Fund or Family preservation Program Funds Deadline: March 23, 2000, Tuesday, 10:00 a.m. The Placement Alternatives Commission, an advisory commission to the Weld County Department of Social Services, announces that competing applications will be accepted for approved vendors pursuant to the Board of Weld County Commissioners authority under the Statewide Family Preservation Program (C.R.S. 26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement (C.R.S. 26-5.3-101). The Placement Alternatives 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 Intensive Family Therapy Program mc.st provide for therapeutic intervention through one or more qualified family therapists, typically with all family members, to improve family communication, function, and relationships. 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 -1, - o -o o o.c,m, (Ater receipt of order) .__§T BE SIGNED IN INK i MIA*Dv c C TYPED OR PRINTED SIGNATURE VENDOR kli(�TShatl �(� I �� 1 � � �� ' \,1\v (Name) Han�n wr�tten Signature By Authorized Offfcer or Agent of Vender ADDRESS \ 35 R' & . TITLE,1r C cLNt y L`(� . � �� DATE `` 3 2 — - • PHONE # 17(;— 3. 2 -3 '3,`7% The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 RFP-FYC-00008 Attached A INTENSIVE FAMILY THERAPY PROGRAM BID PROPOSAL FAMILY PRESERVATION PROGRAM 2000/2001 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2000-2001 //�� BID #RFP-FYC-00008 /-T NAME OF AGENCY: G.420i'/t'ketin at A SSo c 40 ne Ac- _ADDRESS: + l).CV :ZS t 1. 4 it,2 A..e-, S4.,tce /0/ 6ree l7 , Co ?O c :t j- -- PHONE: (V) 135 3T-332?�A-92O .-3r7- 33?Y� CONTACT PERSON:`�uy<42Sk0k4 r AAk€711 et d TITLE: /1)(cit.()/or r -_ DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Intensive Family Therapy Program must provide for therapeutic intervention through one or more qualified family therapists. typically with all family members. to it prove fami y communication. functioning.and relationships 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start June 1. 2000 Start End May 31. 2000 End TITLE OF PROJECT: alt-nt/hon !il-eol ik i-el IC /-&-, // rJn Pict 45c/id .-(oi, o. c )L- ,-,-- A. 0 _Na an Signature of Person Preparing Document Date �` \.�x�.C11.��; ,u..- >t b 3 - 2 C, - C) -- Na an Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2000-2001 to Program Fund Year 2000-2001. Jndicate No Change from FY 1998-1999 _ ✓ Project Description IV A _j,! Target/Eligibility Populations __! Types of services Provided _. I Measurable Outcomes __I Service Objectives _j! Workload Standards _j! Staff Qualifications __I/ Unit of Service Rate Computation _ ✓ Program Capacity per Month \/.. _ V Certificate of Insurance Page 26 of 32 RFP-FYC-000008 Attached A `i p Date of Meeting(s) with Social Services Division Supervisor: a —% - Ci Comments by SSD Supervisor: ` ( La) . ( `r1:Le-h— iLa I (tL.. ft -,CI " rk_ IL l(l"/`41-,R cc-Lc L/ ; 6 A ,-c (• ._LI ILIf f ( iri-Il rl cp ti., Al:,"- i `Lr (1 r s (1/, -1/ :/L-tT ft (�/�.f v 11! f kw -- 4 lLA'1 , ;li 0d -\-ill ? L i of ry L - 1 LL- (U X111-' .4)( ,L d - . L(_; • , . ti.�ha4n �Itr.{( , . ry ii Lk'," AiL It •'(I )l , !%.� d'Lr1LFI QL,'' ,1- ° 'ii_ ' A- , C --Mi tee L. Let 3- a> -op Name and Signature of SSD Supervisor Date r /, t Page 27 of 32 RFP-FYC-00008 Attached A Program Category Intensive Family Therapy Program Bid Category p� Project Title itc.ka/n'� not (p-rapt r � I Con F/! C* fee.ro/u tea. Vendor F}uLar /7ss o c. - PROJECT DESCRIPTION Provide a brief one-page description of the project. II. TARGET/ELIGIBILITY POPULATIONS Provide a one-page brief description of the proposed target/eligibility populations. At a minimum your description must address: A. Total number of clients to be served. B. Total individual clients 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. Sub-total of individuals who will have access to 24 hour services. G. The monthly maximum program capacity. fi. The monthly average capacity. I. Average stay in the program (weeks). J. Average hours per week in the program. III. TYPE OF SERVICES TO BE PROVIDED Provide a two-page description of the types of services to be provided. Address if your project will provide the service minimums as follows: A. Comprehensive, diagnostic and treatment planning with the family and other service providers. B. Therapeutic intervention with flexibility to bring in other services, if needed. C. Co-facilitated therapeutic services provided by one or more qualified family therapists. D. Therapy that is designed to resolve conflicts and disagreement within the family, contributing to child maltreatment, running away, and to the behavior constituting status offenses. 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 PAC 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 measurable outcomes for each area as described below: Page 28 of 32 RFP-FYC-00008 Attached A A. Children receiving services do not go into placement. B. Families remain intact. C. Reunification of children with families. D. Improvements in parental competency, parent/child conflict management as determined or measured by pre and post placement functional tests. E. More cost efficient services through the Intensive Family Therapy Program than the placement of the child. F. Therapeutic outcomes include fundamental changes in the family functioning and dynamics. 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 Family Conflict Management-Mediation and counseling designed to resolve conflicts and disagreement within the family contributing to child maltreatment, running away and other offenses. B. Improve Parental Competency - capacity of parents to maintain sound relationships with their 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 work load standards and quantitative measures. Address, at a minimum, the following areas: A. Number of hours per day, week or month. B. Number of individuals providing the services. C. Maximum caseload per worker. (Generally 12 families per worker. Eight to 10 families per worker if the worker provides case management services to the families on the caseload.) D. Modality of treatment E. Total number of hours per day/week/month(Minimum average of two hours of sei vice per family per week. F Total number of individuals providing these services. G. The maximum caseload per supervisor. (Minimum of 6 workers per supervisor.) H. Insurance. Page 29 of 32 RFP-FYC-00008 Attached A VII. STAFF QUALIFICATIONS Provide a one-page description of staff qualifications and address, at a minimum, the following: A... Will your staff who are providing direct services have the minimum qualifications in education and experience. Describe. B. Total number of staff available for the project. C. Will staff have expertise in family therapy as demonstrated by specialized training, workshops and experience. El. Will staff have a minimum of eight hours per year of continuing education; i.e. courses, workshops, and/or review of literature to be documented by county. E. Will staff have a minimum of one hour per week of clinical supervision provided by someone with advanced skills in Intensive Family Therapy. F. Will the clinical supervisor(s) be involved in regular training to keep current in state-of-the-art counseling modalities and findings. Page 30 of 32 RFP-FYC-00008 P/p .<p c€' cti Attached A VIII. COMPUTATION OF DIRECT SERVICE RATE This form is to be used to provide detailed explanation of the hourly ra:e 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 to : hours of direct service to the client, regardless of the number of staff involved in providing those services. Therefore, it is imperative that this rate be sufficient to cover all costs associated with this client, regardless of the number of staff involved in providing these services. (Explanations for these Lines are Provided on the Following Page) Total Hours of Direct Service per Client 6, Hours [A] Total Clients to be Served � T Clients [B] Total Hours of Direct Service for Year 1 Lit? Hours [C] (Line [A] Multiplied by Line [B] U 7 Cost per Hour of Direct Services $ ' 19, 9 G'7 Per Hour [Di Total Direct Service Costs $ / 7 I t1 3 �f.'� [El (Line [C] Multiplied by Line [D] ) /`'' /'•' gds Administration Costs Allocable to Program $ ,S -c/{ J `^ [F] Overhead Costs Allocable to Program $ SS /5-c [G] Total Cost, Direct and Allocated, of Program$ DECO ca' ;.4 [H] Line [E] Plus Line [F] Plus Line [G] ) Anticipated Profits Contributed by this Program $ 7 i7 [I] Total Costs and Profits to be Covered by this Program(Line [H] Plus Line [I] ) $ i f' (c5 & [d] tTotal Hours of Direct Service for Year / "/ [K] (Must Equal Line [C] ) 440-201k4,011/ Rate per Hour of Direct, Face-to-Face Service tc be Charged to Weld County Department of 3-0 Social Services fry y . [L] ��"Y-2a9.e rA-& pi /te-tct `) 7. 7S" flee—, rem ryi v— n-C A /teat Page 31 of 32 Lz� . RFP-FYC-00008 Attached A Day Treatment Programs Only: ! " Direct Service House Per Client Per Month [M] Monthly Direct Service Rate $ [tf [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 conpleeting 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, anc 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, Suprlits, 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 act;vities 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 tc 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 kJ] 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 Pequest 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 Addendum to computation of direct service rate for RFP FYC 00008 Bid number 3 for Ackerman and Associates P.C. The rate of 199.00 per face to face contact hour represents the highest possible rate per hour of service and applies to the mediations that require two therapists. Some service will be billed at$99.50 per hour ( mediations where only one therapist will mediate) and some will be billed at the above rate of 199.00 per hour when two therapists will mediate in complex families or in bilingual situations. There really should be two rates listed Rate A at 99.50 per hour (the one mediator program) and Rate B at 199.00 per hour. ( the two mediator program) As we expect the proposition of six hours of contact to be 50% with one mediator and 50% with two mediators the actual cost per hour in that formula would be 149.75 per hour. This however, creates payment and accounting difficulties for us as providers. Unfortunately, the bid mechanism does not reflect this cost savings that are reflected in this proposal and in the billing we are actually proposing. As well, because this is a time limited treatment which is very effective in early family intervention, it may actually save monies over more expensive longer treatment programs. This is also not reflected in the bid comparisons as they are currently structured. Please consider listing a Rate A and a Rate B for the two types of services provided. Project Description 2000-2001 Ackerman Mediated Family Conflict Resolution Qyerview: Ackerman and Associates, P.C. proposes to continue its program of intensive clinical mediation begun in 1994. However, the name of the program is being changed to better differentiate it from other mediation services now being used through Weld County Department of Social Services. Our new name - Mediated Family Conflict Resolution better differentiates what we do (and have been doing since 1994) to have families work out their own disputes. Our process is specifically oriented to family change and should be differentiated from other mediations oriented primarily to the specifications of the legal system to assist the clients and their attorneys to resolve the socio-legal specifics of a Dependency and Neglect Case. We will continue to use the short term Mediated Family Conflict Resolution model we created to resolve family disputes with some improvements over our last submission. The primary change, which will result in significant cost reduction for WCDSS, is the use of one mediator rather than two in some of the cases. Unfortunately, this cost savings is not reflected in the final bid price per therapy hour as the Department of Social Services has asked for the bid to reflect the maximum cost for a treatment session and not the likely cost in order to budget against cost overruns. We have added a section to the budget justification to help this be better understood. Overall this change will reduce the average cost by about 25%. Also, we want the project to be understood as a form of therapeutic intervention that should occur early on in the process of a Dependency and Neglect case and not at the point of termination of parental rights. Our Mediated Family Conflict Resolution model involves meetings with a family unit whose internal conflicts have caused them to be imminently at risk. They are either imminently facing out of home placement or the family has a member in foster placement and the purpose of the Mediated Family Conflict Resolution is to reunify that family. Modifications developed over the last year have involved on a few occasions extending the Mediated Family Conflict Resolution model to eight hours instead of six and in some cases reducing the number of mediators to one. For 2000- 2001, we anticipate using the one mediator model in most Mediated Family Conflict Resolutions except where the primary language is Spanish and in cases of complex interactions where two mediators may be needed as determined by the outcome of the first session. We anticipate at least 50% will be Mediated Family Conflict Resolutions with one mediator using a six hour model. This will reduce the cost of these Mediated Family Conflict Resolutions by 50% Caseworkers are encouraged to explore with us if Mediated Family Conflict Resolution is appropriate in any situation where they encounter a dispute, which because it is unresolved, prevents progress to either avoid placement or to reunite the 1 child with family. Whether or not Mediated Family Conflict Resolution could assist a family is a determination on a case by case basis. With more than six years of use of therapeutic Mediated Family Conflict Resolution with WCDSS, we have continued to be impressed by the responsiveness that families in crisis have had to the opportunity to mediate their difficulties and the stability of the results of the majority of these Mediated Family Conflict Resolutions. Purpose: The purpose of the Mediated Family Conflict Resolution is to reach agreement among the family members on the behavioral changes that are needed within the family. Such changes have a very clear purpose. That purpose is to either prevent outplacement or to return the child from outplacement. Our experience in the past six years has demonstrated a very high success rate with families who have been referred by the caseworkers for these services. A very high success rate at continuing to avoid outplacement that persists at least six months after the end of the Mediated Family Conflict Resolution has also been demonstrated. Fewer families have been referred for reunification than for avoiding placement. Reunification has also been very successful. An additional goal for this year is to increase use of these services for smoothing and speeding the process of reunification. Overall, the purpose of this request is to continue this program for the next twelve month period under a renewal bid as permitted by the application rules, with the cost saving measures as we describe them in this proposal. Mediated Family Conflict Resolution has been most successful in dealing with youth in conflict primarily because it is easier to identify how Mediated Family Conflict Resolution can assist in these families. fesign: The Mediated Family Conflict Resolution consists of three, two hour sessions with one mediator at each session. Rarely we extend to eight hours for the Mediated Family Conflict Resolution if the progress has been difficult. Typically, the first session consists of establishing the setting for the Mediated Family Conflict Resolution. At the first session the family members each present their own viewpoint concerning the conflicts that have brought them into Mediated Family Conflict Resolution. What does each member need changed so that the family either avoids placement or achieves reunification? The second session consists in large part of mediation of short-term solution, focused goals between the family members. It is this second phase that is sometimes extended when families have difficulty def ning agreement areas they can work on. The final mediation session has involved establishing a written contractual agreement between the family members as to what they will do to either avoid placement or achieve reunification. In prior years, one month after the contract is developed, the family has a short follow up session to ascertain their status and to refer them to additional resources as needed. We will make the follow up optional based on telephone contact as another cost saving measure. The situations which will require a two mediator model are in Spanish speaking families and in families who are demonstrating a high level of complexity such that a 2 second mediator is needed. In the case of a needed second mediator, the caseworker will be informed prior to the next session if a second mediator will be needed. Other Considerations: We have had the capacity to serve two or three families per month in this program. The majority of our referrals have been for adolescents rather than for young children. We are able to operate at a higher capacity than this limit if the demand for these services is present. Within the two family per month range we expect to continue being able to respond to requests from the caseworker by the next business day and to contact the family to set up schedules within a few days of accepting the case. Over the past year the level of adolescent referral has decreased and we would like to improve the level of appropriate adolescent referral by developing educational programs for the caseworkers in Youth in Conflict. We would like to continue to rnake an enhanced effort to bring the success of the program to the attention of the caseworkers who serve younger children. Many of the younger child cases are not appropriate for prevention of immediate outplacement through Mediated Family Conflict Resolution due to the need to physically or sexually protect the children. Those children may benefit from expedited permanency planning using family group conference services. However, the short term intensive therapeutic Mediated Family Conflict Resolution model described here is also particularly useful with families of younger children in the area of reunifying families. By the family members explicitly clarifying their own specific behaviors needed for reunification to occur, Mediated Family Conflict Resolution would be expected to shorten the time between placement and reunification. In the case of impending divorce the family is not reunifying, but Mediated Family Conflict Resolution can create ongoing relationships that preserve the psychological concept of family. Target/Eligibility Populations A Total number of clients to be served in this twelve month program has been calculated as follows. Three families per month times twelve months equals thirty six families per year. If we assume a family size of five, two adults and three children, then the total client pool to be served is 180 individuals. That number includes at least 36 individuals who face either imminent outplacement or need reunification. Over the past years, we did about half of our work related to prevention of outplacement. However, the use of this program was about 50% lower in 1999-2000 than in prior years due, we believe, to some confusion by caseworkers as to the differences between therapeutic and a parental rights termination mediation process run by another program. 3 B. Distribution of clients. Total number of clients we will serve is approximately 180 as calculated above. Our experience suggests we would expect approximately 72 of these would be adult members of the family and approximately 108 would be minors. The age distribution of the children would tend toward the older children based on our history with Weld County Social Services. We estimate that about 50 would be older than ten with an average age of about 14 and about twenty would be under ten. The older group would most likely be teenagers in conflict with their family most often concerning issues related to their maturation into adults. The younger group will consist of children of no particularly predictable age whose parents are in conflict, usually in relation to instability in the marriage. We prefer to not attempt Mediated Family Conflict Resolution in a case of ongoing spouse abuse or sexual abuse This is because one of the requirements for Mediated Family Conflict Resolution to succeed is the ability of the parties to speak without inherent threat of retribution. However, individual cases should be discussed with us by the caseworker. We have learned from our experience over the last six years of this program that our initial guarded impression of a case's potential for success based on the written record has often proved to be very pessimistic. It appears that where Mediated Family Conflict Resolution is concerned, an analysis of the written record alone may undervalue surprising problem solving strengths of even very dysfunctional families C. Families Served. We would anticipate serving 24 -36 family units. Occasionally, we find that the family Mediated Family Conflict Resolution may involve extended family members who might be considered a separate family unit. For simplicity, we count the referred family as the family unit. We can increase the number of families served if the need is present. 0. Sub total who will receive bicultural/bilingual services. We have a Hispanic member of the staff , Emily Jaramillo-Bansberg, M.A., who is a psychotherapist fluent in Spanish. One of the mediator's (JSA) doctoral work was on Hispanic patient's mental health treatment patterns compared to Anglo patients in Weld County. We anticipate we can serve up to one hundred percent of the total referred in a bicultural manner and, with the proviso stated below, up to 25% or more in a bilingual setting Vie can provide bicultural/bilingual services for any family who needs them so long as there is sufficient English proficiency to conduct the Mediated Family Conflict Resolution primarily in English with occasional Spanish translation. We can provide services completely in Spanish for other types of counseling. Those families who are strictly monolingual in Spanish may be served by other modalities within Ackerman and Associates, such as short term solution focused therapy. To date this has riot been a barrier to primarily Spanish language Mediated Family Conflict Resolutions we have completed. E. We can provide services in South County if Social Services can provide a site to do such work. To date, this mechanism has not been utilized and we would be willing to examine other possible means of delivering Mediated Family Conflict Resolutions to 4 South County populations. The families from South County have come to Greeley for these Mediated Family Conflict Resolutions over the past six years without apparent difficulty. F. Accessibility. On weekdays all providers of Ackerman and Associates are accessible through a 24 hour answering service and pager system. On weekends, this 24 hour access reaches the provider on call, all of whom are Ackerman and Associates providers and all Associates on call are licensed Mental Health providers. G. Maximum per month. The program maximum is three families per month. This capacity can be increased by one family per month if the demand is present. H. The monthly average capacity is two families per month. I. The average stay in the program is six hours over a three week period (one two hour session per week). This is followed by an optional follow up at one month. The case is closed at the one month follow up decision. Even though a few cases go to eight hours we do not expect the average to change as we have had a few cases that complete the Mediated Family Conflict Resolution in less than six hours. Types of Services Provided We will continue to provide Mediated Family Conflict Resolution services for referred families using meetings with the family for two hour periods over a three week period. At the first meeting, each family member states their viewpoint about the conflict and what they feel needs to change to avoid placement outside the home or to achieve reunification. The second and third sessions are when we clarify the various positions taken and negotiate agreement. These agreements have usually resulted in maintaining the child in the home environment. Occasionally, the family agrees to avoid involuntary outplacement by soliciting the voluntary assistance of other family members for a place for the child to live temporarily. Every time we have reached agreement we have either prevented outplacement to foster care or achieved reunification. Historically ,the only failures that have resulted in this process occur when one party midway into the Mediated Family Conflict Resolution refuses to participate further. This has happened about one time in ten Mediated Family Conflict Resolutions. Over the past years, the program's success rate is again approximately 90% as measured by the achievement of an effective written agreement to avoid placement or return the child to the home. Nearly all participants who reach agreement have a very high level of satisfaction with the Mediated Family Conflict Resolution process. We do not have access to the long term follow up of these families and are concerned that over the course of months to years they may well need appropriate assistance in maintaining the commitments they reach in Mediated Family Conflict Resolution. 5 In terms of the criteria for the PAC process: A Comprehensiveness: Mediated Family Conflict Resolution does not attempt to provide a comprehensive assessment or diagnosis of the family in a traditional psychotherapeutic model. It does allow the family assisted by the mediators to develop a contractual agreement for what the family must do to either avoid outplacement or achieve reunification. This results in an outcome, that is a treatment plan the family has a high level of commitment to. Mediated Family Conflict Resolution brings "ownership" of the treatment plan because of the process through which it was developed. In our experience, 90% of the families so far treated over the past six years have developed a treatment plan in the form of a contract. B. Access to other services: The therapeutic interventions that the family specifies in their contract go back to the caseworker. We have the flexibility to include in the agreement the family reaches, the services the family feels it needs, to implement their contractual goals.This is often done in final mediated agreements. The caseworker can then match up these services with the goals stated. Over the course of the past four years nearly all the families who reached the contracting stage of the process avoided out placement or achieved reunification, most on a permanent basis as far as we know. C. Co-Facillitation: We anticipate 50% of Mediated Family Conflict Resolutions would be conducted by two therapist/mediators. 20% would be bilingual/Spanish Mediated Family Conflict Resolutions and 30% would be in complex families where two mediators are clinically needed. 50% of the Mediated Family Conflict Resolutions will b≥ conducted by one mediator without additional therapists present. The 50% that are co-facillitated would use Joyce with Emily Jaramillo-Bansberg for bilingual families or Joyce Ackerman, Ed.D. and Laurence Kerrigan, Ph.D. for the complex families D. Conflict Resolution: The Mediated Family Conflict Resolutions are designed specifically to resolve conflict within a family unit. Running away, threats of running away and other acting out behaviors of teenagers are particularly amenable to Mediated Family Conflict Resolution. Where child maltreatment is due to neglect rather than active abuse, neglectful behavior has also been treatable within the Mediated Family Conflict Resolution model. Spouse abuse and sexual abuse of a child are usually not treatable within the framework of the mediation model. However, we have succeeded in Mediated Family Conflict Resolutions where the adults were separated by a restraining order and the Mediated Family Conflict Resolution took place in the presence of an officer of the jail. We expect that one hundred percent of the clients accepted by the program will fit within this form of treatment. We intend to provide the types of services described above to twenty-four families in the 2000-2001 contract year. 6 Measurable outcomes Measurable outcomes are of two varieties. One type is termed formative outcomes and the other type is called summative outcomes. Formative outcomes measure how the program is proceeding while the treatment takes place. Summative outcomes are the results of the treatment. In terms of formative measures we have the following... 1. Did the family follow through with the referral from their caseworker? 2. Did the family attend the three Mediated Family Conflict Resolution sessions 3. Did the family produce a final contract agreement for preventing placement or achieving reunification? 4. Did the family complete a one month follow up session by telephone? The one month follow up is not charged to direct costs. This represents further cost reduction over the bids in prior years when this was conducted face to face. In our experience we have had an excellent follow through for contacting us (above 90% over the life of the program). This data is based on a comparison of referral documents received compared to the record of appointments of the family. Nearly all who we schedule attended a first session. 95% attended a second session. 85-90% attended the third session and completed contracts. The data on attendance and production of contracts and follow up are from the family's records. Summative outcomes At one month after completion of the contract, we determine the following information. Is the child still in the home? How well has the contract been adhered to? This measures if family behavior is different compared to their behavior before Mediated Family Conflict Resolution. The other long term or summative outcomes are listed below. A The child receiving services does not go into placement. We estimate that four of five index children referred to the program stay out of placement. The majority of those placed are from families that do not complete the Mediated Family Conflict Resolution process. For those who complete the process we estimate that 95% avoid placement at one month and that the majority avoid placement on a permanent basis. It would be useful to evaluate this with all the families that have participated in this process since its inception in 1994. If funds are available for such an evaluation we would undertake it and report the results to WCDSS. We expect similar results in our proposed project for 2000-2001 for families who negotiate a mediated contract. B. Families remain intact. The concept of remaining intact has at least two 7 components. One is, does the family remain psychologically intact. Specifically, even if the child is not living at the parents physical residence, the family unit (including the index child) maintains the psychological goal of staying a family unit. Since 1994, in at least one case of reunification and a number of cases of avoiding placement, we found that the families' solution was the index child living with a relative or friend rather than using Social Services placement mechanisms. Aside from cases described above, nearly all of those who completed mediated agreements meet the criteria of the family remaining physically intact. Physically intact means the child remained or returned to the parent's residence based upon the one month follow up. We expect at least an 80% success rate on these criteria of families remaining physically intact for those who complete the program in 2000-2001. Our success rate on these criteria over the past six years has been better than 90% on those who have remained physically intact at the one month visit. C. Reunification of children with their families. While fewer referrals have beer made to our program for reunification, those referrals have achieved reunification in all cases based on the one month follow up. In the next year we would collect this data in the same manner and expect the rate of success to be 80% or better. D. Improvement in parental competency and parent child conflict management are expected to occur in all families who complete treatment. The persistence of these changes can be measured at one month and anecdotal evidence is that the majority persist much longer than this. We examine the satisfaction level of the parents with the Mediated Family Conflict Resolution process and determine the parent's relationship with the index child at those times. We will measure these criteria by parental self report and by their reported satisfaction with the Mediated Family Conflict Resolution process at one month after the contract is completed. E. Cost effectiveness. Our Mediated Family Conflict Resolution program appears quite successful in preventing outplacement or to assist reunification and these effects last for at least six months. We can demonstrate this high rate of cost effectiveness because we provide a carefully structured time limited intensive service and have a very high success rate with this program. F. Does this program produce fundamental change in family dynamics? Let's define fundamental changes as those changes that persist to the one month follow up. We measure this based on self reported behaviors and compare to those behaviors the family agreed to in the contract. Using this method we can measure if fundamental change has occurred. Using the one month criteria, we set the goal that 75% of the families will have the changes persist to one month. In fact, a larger number than this have reported persistent change at one month. The nature of the change appears to be in the problem solving styles and skills the families take out of the Mediated Family Conflict Resolution experience. The modeling of a successful method of negotiation and problem solving seems to lower the level of conflict within 8 the home. No one is suggesting that the Mediated Family Conflict Resolution solves the families' problems. Rather, a method of conflict minimization and reduced conflict has been apparently acquired by some of the families who go through the Mediated Family Conflict Resolution experience. Service objectives We have the following service objectives: A. Improvement of family conflict management. The Mediated Family Conflict Resolution program is specifically designed to resolve conflicts that either precipitated the likely imminent placement of the child or which prevent the reunification of the child with the family. So long as the conflict does not center specifically on sexual abuse of the child or ongoing serious physical abuse of a child or spouse, Mediated Family Conflict Resolution can assist the family in finding behavioral solutions to the existing conflict. Further, Mediated Family Conflict Resolution provides a demonstration to the family that even serious long standing difficulties can be worked out or at least not precipitated. Mediated Family Conflict Resolution should encourage the family members to work toward a structure in which more open communication can be encouraged. B. Improved parental competency in this treatment model seems to center on the parents developing more age appropriate strategies. In dealing with conflicts with their child especially with teenagers, the areas of discipline, protection, instruction and supervision seem most responsive to improvement. With younger children the Mediated Family Conflict Resolution gives the parents the opportunity in a relatively formal setting to clarify the roles each parent expects of the other. In their relationship relative to expectations concerning child rearing practices and in age appropriate expectations they can have for the child, Mediated Family Conflict Resolution seems able to improve parental performance. C. The ability of the family to access resources is enhanced by the Mediated Family Conflict Resolution process. When the need for a specific service becomes apparent to the family during the Mediated Family Conflict Resolution, that need is written down as an item for the family contract. The strength of the Mediated Family Conflict Resolution process is the identification by the family of the resources they need to gain access to. The contract is sent to Social Services that assists in follow up We have a separate program called the GAP program to promote implementation of the goals families make. The methods used to ascertain if the service objectives are met include the reported satisfaction level of the families with the Mediated Family Conflict Resolution process at one month. At one month we compare how the family reports it is doing to the objectives they set for themselves in their contracts as well as to the criteria stated in 9 the measurable objectives section of this document. Workload Standards A. The program has a capacity of two families per month. The cost of the average Mediated Family Conflict Resolution would be $597 for one mediator and $1194 for two mediators. Two Mediated Family Conflict Resolutions per month is 12 hours of face to face meetings per month. This represents 12 hours of therapist time per month or 144 hours of therapist time per year. At $97.50 per hour (the same as last year) the cost is $14,328 over the year if 100% of Mediated Family Conflict Resolutions used one mediator. If one hundred percent of the mediations are with two meditators the cost would be $28,656. The most likely cost will be $21,482 for 24 mediations with 505 using one mediator and 50% using two. The most likely fee per average hour contact hour is 1.5 time 99.50 or $149.25. As an historical comparison, in 1994-96 rate our rate was 89.27 per hour and maximum cost was projected at $27,852 using two mediators in all Mediated Family Conflict Resolutions. Overall we are reducing costs for this program about 25% by reducing the number of mediators in the session from two to one in 50% of the cases and by eliminating the face to face follow up session. B and C. There are seven licensed providers four psychologists, two professional counselors and a psychotherapist who will provide these services. Joyce Ackerman who supervises this contract is certified as a mediator. D. The modality of treatment is an intensive Mediated Family Conflict Resolution model for conflict resolution. E. Hours /month The total number of therapist/mediator treatment hours is 12 per month or 144 per year based on the single mediator Mediated Family Conflict Resolution model. If one hundred percent were using two mediators the hours would be would be 288 per year. The most likely number is 210 hours per year or 17.5 hours per month, assuming the projected 50% single modey50% two mediator mode . F. Staff There are seven individual providers supported by two office professior als in the practice. G. Supervisor This contract would be supervised by Joyce Shohet Ackerman, Ed.D. who would monitor the project for compliance. Staff Qualifications A. and B. Staff Qualifications Seven staff are available for the project. They exceed the minimum qualifications specified as documented below The staff are: Joyce Shohet 10 Ackerman, Ed.D., Licensed Psychologist and mediator; Laurence P. Kerrigan, Ph.D., Licensed Psychologist; Emily Jaramillo-Bansberg, psychotherapist, Karen Bender M.A., L.P.C., Licensed Professional Counselor; Nicole Warnygora, M.A. L.P.C., Licensed Professional Counselor and Susan Bromley, Psy. D, M.S.W., Licensed Psychologist/ Licensed Social Worker. C. Training The staff has extensive training in family therapy and mediation as documented by their extensive work experience. Collectively, the eight providers have practiced in their field for a total of more than 60 years with a range of 2 to more than 30 years and an average length of practice of about 12 years. Resumes are available if desired. D. Continuing education As a part of their work, all providers in this private practice group maintain continuing education programs, more than the minimum eight hours required. They participate in workshops and other activities. These continuing education requirements arise from other contractual arrangements with managed care companies and from within their own professional societies. E. Supervision All licensed providers are independent and not required to have clinical supervision. Emily Jaramillo-Bansberg, M.A. is in process for liscensure as a professional counselor and is supervised by Sherri Malloy, Ph.D. in that process. All the staff have advanced skills in intensive family therapy. The contract superviso' (JSA) will monitor the specifications made in this proposal. F. Supervisor continuing education. The supervisor of the project is involved in ongoing training to keep current with her profession through advanced workshops and seminars and as a member of the Colorado Council of Mediators and the American Psychological Association. Unit of service rate computation We have calculated the unit of service rate based on the instructions. We used 1999 data for our agency which had eight direct service providers and two secretaries Based on last year's rate of $97.50, we will offer the rate of $99.50 per hour of face to face therapist time. This rate provides less than five percent profit for the corporation Budget Justification Each Mediated Family Conflict Resolution uses six hours of therapist time. The cost per therapist per hour is $99.50. 50% of the mediations are to be done by one therapist 50% by two therapists The cost for an hour using two therapists is $199 per hour. We use the figure of twenty-four evaluations per year to generate the total face to face hours of the project to arrive at the yearly total which equal 144 hours. the following table is provided to show what the costs would be in various combinations 11 Therapists Per mediated Hour Per Mediated Resolution one mediator 99.50 per hour 597 per unit two mediators 199 per hour 1194 per unit 50/50 model 149.75"hour" 895 per"unit" We will specify in our monthly reports how many mediations are of which types and the running totals and percentatges of each type as a cumulative total over the contract period to assist the department in appropriate budgeting of costs PAC money is tracked through a computer data base system for management of large Mental Health Practices which we have converted from a system called MediMac we used over the past five years. The system allows us to track payments by client and by source of payment and any payment through the PAC will be tracked in this manner. No special issues are presently related to project audit to our knowledge and a random independent comprehensive audit of this program has been conducted in a previous year for which no discrepancies were found. Audit of the program will be conducted on a yearly basis. Ackerman and Associates, P.C. is a type S professional corporation and not a 501.c.3. For 1999, Ackerman and Associates had a profit on gross revenues of approximately 2.9% based on total profit share as a percentage of gross income. 12 Branch B/A Producer# Issue Date Renewal/Replacement N.). 32 A 0002360 04/27/1999 RENEWAL PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. Item DECLARATIONS CERTIFICATE NUMBER: 4SP- 2032570 1. NAMED INSURED: ACKERMAN AND ASSOCIATES PC ADDRESS 1750 25TH AVENUE (Number & Street, Town, GREELEY CO 80631 County, State & Zip No.) 2. POLICY PERIOD: From 05/01/1999 To 05/01/2000 (12:01 A.M. Standard Time At Location Of Designated Premises) 3. COVERAGE: LIMITS OF LIABILITY I'REN1IUN1 Professional Liability $1 ,000,000 $3,000,000 $_ ,686.00 each Incident Aggregate 4. BUSINESS OF THE INSURED: Psychology 5. THE NAMED INSURED IS: ( ) Sole Proprietor (including Independent Contractors) ( ) Partnership (X ) Corp)ratior: ( ) OTHER: 6. This policy shall only apply to incidents which happen on or after: a) the policy effective elate shown on the Declarations; or b) the effective date of the earliest claims-made polio .ssued by the Company to which this policy is a renewal; or c) the date specified in any endorsement hereto. 05/01/1992 7. This policy is made and accepted subject to the printed conditions of this policy toge he] with the provisions, stipulations and agreements contained in the following form(s) or enc orsementi s): PLC -2008 ( 10/94 ) POE-8004 PLE-2167 PLE-208 P0N-2003 PLE-8036 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel Office Address: 1776 West Lakes Parkway Town and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 IMENMEMME INTERSTATE INN RANCE C,RUIN' MOMMEMMEME PLP-2012 (06/93) (Elec.) LAsEH. Branch B/A Producer # Issue Date RenewallRL ace,teru 32 A 000236005/05/1999 — DIFPL HATE - PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2050203 1. NAMED INSURED: SUSAN PLOCK BROMLEY PSYD ADDRESS 1621 13TH AVENUE (Number & Street, Town, GREELEY CO 80631 County, State & Zip No.) 2. POLICY PERIOD: From 04/01/1999 To 04/01/2000 (12:01 A.M. Standard Time At Location Of Designated Premists) 3. COVERAGE: LIMITS OF LIABILITY PRE MU. \I Professional Liability $1 ,000,000 83,000, 000 m 9. JC each Incident Aggregate 4. BUSINESS OF THE INSURED: Psychology 5. THE NAMED INSURED IS: ( X ) Sole Proprietor (including Independent Contractors) ( ) Partnership ( ) Cor.>.Dra:it r ( ) OTHER: 6. This policy snail only apply to incidents which happen on or after: a) the policy effecti. (Jute shown on the Declarations; or b) the effective date of the earliest claims-made polev issued by the Company to which this policy is a renewal; or c) the date specified in 3:1v endorsement hereto. 04/05/1996 7. This policy is made and accepted subject to the printed conditions of this policy tog2th' wr,h the provisions, stipulations and agreements contained in the following form(s) or endoi,,emeno „ PLJ -2008 ( 10/94 ) POE-8004 PLE-2167 PLE- 20_ 1 PEN- 2003 PLE-8035 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel Office Address: 1776 West Lakes Parkway Town and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 AMMEMEMMISI INTERSTATE INSURANCE GROUP PLP-(1;12 (06 93) (Elec.) Issue Date: 01/06/00 C*)TAllanRecceiPTOCal PROFESSIONAL LIABILITY OCCURRENCE INSURANCE POLICY FOR Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN DEVELOPMENT PRACTITIONERS ACA Insurance Trust Inc. 5999 Stevenson Avenue 0,a tnsy(li Policy Number: CL10073400 Administered by: Alexandde,VA22304Js00 TRUST Tol Fret 1.800.347-68471284 :;'.;f""" ITEM DECLARATIONS INDIVIDUAL POLICY 1. NAMED INSURED: Norma Karen Bender 2. ADDRESS: 1104 Twin Peaks Circle Longmont, CO 80503-2170 3. POLICY PERIOD: From: 02/04/00 To: 02/04/01 12:01 A.M.Standard Time at Location of Designated Premises 4. Tht insurance afforded is only with respect to such of the following types of insurance as indicated by specific premium charge or charges: COVERAGE PREMIUM A. PROFESSIONAL LIABILITY S 290 . 00 B. GENERAL LIABILITY $ 0 . 00 TOTAL PREMIUM: $ 290 . 00 5. LIMITS OF LIABILITY: $1 , 000 , 000 each Incident or each Occurrence $3 , 000 , 000 in the Aggregate 6. THE NAMED INSURED IS: Sole Proprietor(incl.Individual) Partnership Corporation X Other(refer to Item 7 below) 7. BUSINESS OF THE NAMED INSURED: Part-Time Self-Employed (Rating Category) Counselor/Human Development Prof essiDna1 8. This policy is made and accepted subject to the printed conditions of this policy together with the provisions,stipulations and agreements contained in the following form(s)or endorsement(s): CPL•0004.0199 CPL•0005•0199 CPL.0006.0199 NOTICE THIS PCLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE FOR YOUR RISK RETENTION GROUP. CPL-0005.0199.00 EXECUTIVE RISK SPECIALTY CO. THIS IS A CLAIMS MADE POLICY-PLEASE READ CAREFULLY 12/03/99 - A PSYCHOICGISTS PRCFESSIONA . LIA£ILITT POLICY *** RENEWAL *** NOTICE. A LOWER LIMIT OF LIABILITY APPLIES TO JUDGMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS or SE EJAL MISCONDUCT(SEE THE SPECIAL PROVISION"SEXUAL MISCONDUCT" IN THE POLICY). DECLARATIONS POLICY NO: 801-000500E ACCOUNT NO: CC—KERL175-0 00997458 ITEM 1 la; NAME- AND ADDRESS OF INSURED ITEM 1. (b)ADDITIONAL NAMED INSUREDS. LAURENCE P. KERRIGAN. Ph.D. 1750 25TH AVE. SUITE •L0L GREELEY . CC 80631 TYPE OFORG: INDIVIDUAL ITEM 2 ADDITIONAL INSUREDS: ITEM 3 POLICY PERIOD-. FROM: 12/01/99 TO: 12/01/00 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATE'.) HERE N ITEM 4. LIMITS OF LIABILITY: (a) $ 1.000.000 EACH WRONGFUL ACT OR SERIES OF CONT NU ),JS. HE EF.TEL OR INTERRELATED WRONGFUL ACTS OR cm-U HREN-r bl $ 5.000 DEFENSE REIMBURSEMENT (c) $ 3.000.000 AGGREGATE ITEM 5 PREMIUM SCHEDULE: CLASSIFICATION NUMBER RATE ANNUAL PREMIUM___ 15T PSYCHCLCGIST 1 1254.00 1 .254.00 DEFENSE LIMIT .00 SURPLUS LINES TAX 1 _27.52 INSFECTICN FEE 1 2.51 • • STEM 6 RETROACTIVE DATE. 12/01/91 TOTAL PREMIUM. 1 •2C4. 12 ITEM EXTENDED REPORTING PERIOD ADDITIONAL PREMIUM (If exercised): $ 2.265.24 ITEM 8. POL CY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY- 322138 (7/95 ED. ) 822137 AUTHORIZED COMPANY REPRESENT I E THIS IS NOT A BILL. PREMIUM HAS BEEN PAID. Branch B Producer# Issue Date Renewal lI,tc';mer.t .32 A 0002360 03/02/1999 FENF. AL PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY_ Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2055185 NAMED INSURED: SHERRI MALLOY PHD ADDRESS 24 ALLES DRIVE (Number & Street, Town, GREELEY CO 80631 (county, State & Zip No.) POLICY PERIOD: From 04/01/1999 To 04/01/2000 (12:01 A.M. Standard Time At Location Of Designated Premise,) 3, COVERAGE: LIMITS OF LIABILITY PR _ MITs', Professional Liability S1 ,000,000 $3,000,000 ' 95 _ , each Incident Aggregate BUSINESS OF THE INSURED: Psychology THE NAMED INSURED IS: x ) Sole Proprietor (including Independent Contractors) ( ) Partnership ( CO ,0i .:• ) OTHER: This polio shall only apply to incidents which happen on or after: a) the policy of ect '.ate shown on the Declarations; or b) the effective date of the earliest claims-made pc ,_‘ issued bs the Company to which this policy is a renewal; or c) the date specified n ;:n endorsement hereto. 04/01/1998 This polio is made and accepted subject to the printed conditions of this poliov to;<tl ( w: the prosisions, stipulations and agreements contained in the following formfs) or emit : (en Ls P _ d-2008 X10/94 ) POE-8004 PLE -2167 PLE - 223 ' 2003 PLE -8035 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO. ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke-Van Orsdel. Incorporate,: Office Address: 1776 \Vest Lakes Parkway flown and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 mimmimm INTERSTATE INSURANCE EROLP PLP•2O12 106.93) (Elec.) -- —_ -94 E.. ASEP: EVEREST NATIONAL INSURANCE COMPANY MENTAL HEALTH PRACTITIONER'S PROFESSIONAL LIABILITY POLICY DECLARATIONS Renewal of No. NOTICE: A SUB-LIMIT OF LIABILITY APPLIES TO "CLAIMS" ARISING OUT OF "SEXUAL MISCONDUCT". POLICY NO. 2200009922-991 ITEM 1: NAME AND ADDRESS OF INSURED: SEND ALL INQUIRIES TO: Nicole Ray Warnygora ROCKPORT INSURANCE ASSOCIATES 1 800 Angelo Court PROGRAM ADMINISTRATOR Fort Collins, CO 80528 P 0 BOX 1809 ROCKPORT, TX 78381-1809 1-800-423-5344 ITEM 2 ADDITIONAL INSUREDS: NONE I"EM 3-. DESCRIPTION OF BUSINESS: MENTAL HEALTH PRACTITIONERIS) L EM 4: POLICY PERIOD: FROM 05/20/1999 TO 05/20/2000 12:01 am STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED 1ERf'r., ITEM 5: LIMITS OF LIABILITY: $ 1,000,000 EACH WRONGFUL ACT OR EACH OCCURRENCE SUBJEC " TO $25,000 SUB-LIMIT OF LIABILITY FOR ALL "WRONGFUL CTS' INVOLVING "SEXUAL MISCONDUCT". $ 3,000,000 AGGREGATE ITEM 6: PREMIUM SCHEDULE: CLASSIFICATION NUMBER RATE ANNUAL PREMIUM CATEGORY M2 1 263.00 $ 263.00 TOTAL PREMIUM S 263.00 ITEM 7 POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY: 190.00 0195, 189.00 0195, EEO 25 501 12 98, 193.00 0195,194.00 0195 May 21 . 1999 �' ._✓JCL .C AR/V) AUTHORIZED COMPANY REPRESENTAI IVE 189 00 0195 O Everest National Insurance Company, 1995 MEMORANDUM OF INSURANCE Date Issued 11/03'1999 Memorandum Holder This memorandum is issued as a matter ACKERMAN & ASSOCIATES ATTN DONNA of information only and confers no SUITE 101 rights upon the holdr. This 1750 25 AVENUE memorandum does not i mend, extend GREELEY CO 80634 or alter the coverages afforded by the Certificate listed below. Company Affording Coverage Producer Chicago Insurance Company Kirke Van Orsdel Owner 1776 West Lakes Parkway Covered Person (Status) West Des Moines, Iowa 50398 EMILY L JARAMILLO—BANSBERG MA Fmplo�ee This is to certify that the Certificate listed below has been issued to the insured named herein for the policy period indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this memorandum may be issued or may pertain, the insurance afforded by the Certificate described herein is subject to all the terms, exclusions and conditions of such Certificate. Tilt limits shown may have been reduced by paid claims. Certificate Type of Insurance Number Effective Date Expiration Date Limits Professional Liability each incident : .000. 10C) or occurrence Occurrence 80M-4003488 11/01/1999 11/01/2000 3,000. )00 in the aggregate each incident General Liability or occurrence Occurrence in the aggregate Should the'. above described Certificate be canceled Insured before the expiration date thereof, the issuing company w- 11 endeavor to mail written notice to the named Memorandum Holder, but failure to mail such EMILY L JARAMILLO-BANSBERG M1 notice she ll impose no obligation or liabilty of any 183 50 AVENUE PLACE kind upon the company, its agents or representatives. GREELEY CO 80634 Authorized Representative: e 4ab TRUCK INSURANCE EXCHANGE E FARMERS INSURANCE EXCHANGE FIRE INSURANCE EXCHANGE % o•wPf MEMBERS of FARMERS INSURANCE GROUP OF COMPANIES ��`•��o",","►� 12 :ra.I_,y HOME OFFICE 4680 WILSHIRE BLVD.,LOS ANGELES,CALIFORNIA 90010 �+ amed DR JOYCE SHOHET ACRERMAN PC Pod Insured Court . Mailing . 1750 25TH AVE SUITE 101 Prematic Acct No. Address 07-04-362 04576 38 07 GREELEY CO 80631 Agent Policy Number Type of The named insured is an individual unless otherwise stated: ❑ Partnerslt ® Corp. Business OFFICE ❑ Joint Venture LJ Organization(Other than Partnership or Joint Venture 2. Policy Period from 07/01/99 (not prior to time applied for) to 07/01/00 12:01 a.m.Standard Time. If this policy replaces other coverages that end at noon standard time on the same day this policy begins, this policy will not take effect until the other you gage ends. Thisre policy wiprll continue inueaor sucor cessive policy periods as follows: If we elect to continue this insurance,we wil renew this policy if policy period subject to our premiums, rules and forms then in effect. 3. Insured location same as mailing address unless otherwise stated: 1750 25TH AVE SUITE 101 GREELEY CO 80631 4. Mortgage Holders Loan# Loan# 5. Premium$ 492.00 ❑ "X"If Mortgage Holder Pays 6. Policy Forms and Endorsements attached at inception: E0079-ED1 2521551290 565310-ED2 S0700-ED3 E6036-ED1 E4168-ED1 E4004-ED1 E4216-ED1 E3026-ED1 7. We provide Insurance only for those coverages Indicated by a specific limit or by an al COVERAGES LIMITS OF INSURANCE DEDUCTIBLE A-Building $ SECTION 1 B-BusIness Personal Property 5250 applies unless other $ 50,000 0 lion Inc cated b anE C-Loss of Income(Not exceeding 12 consecutive months) �s'00 D500 �s Property OPTIONAL COVERAGES ACTUAL LOSS SUSTAINED NONE _ and — Swimming Pool/Fences and Walkways Loss of �X Building Glass(Blanket) $ Above applies s Income x Outdoor Sign Coverage REPLACEMENT COST able 1 00 p $ 100 unless other_ Valuable Papers(In addition to$1000 included.) — option InOi- [] Earthquake Damage cated. See Coverages x SECTION II D-Business Liability-Including Products and Completed A,B,&C of the applicable ins. lima. Operations. (Annual aggregate applies for all occurrences LIMITS l A grregate) _during the policy period) (Annual Aggregate) $ 1,000,000 Liability E-Fire Legal Liability$75,000 Included unless other option indicated by an ® and 0$100,000 0$150,000 each occurrence(Subject to the annual aggreagate shown for Coy.D) Medicals F-Medical Payments to Others(Subject to the annual aggregate shown for Coverage D) $5,000 each person Limit of Liability C.]Professional Liability ((Annual Aggregate) (see attached endorsement) E3 I-V COVERED —_ SECTION III 9reement I-Employee Dishonesty DEDUCTIBLE Agreement II-Broad Form Money and Securities-Inside $5,000 NONE $1,000 $250 _Agreement III-Broad Form Money and Securities-Outside Crime _Agreement IV-Medical Payments $1$500 each person NON000 NON _— Agreement V-Forgery or Alterations E $2,500 NONE 58.5308 2-112 2ND EDITION Countersigned Authorized Representative — — JOYCE SHOHET ACKERMAN, ED.D. 1750 25th Avenue, Suite 101 Greeley, Colorado 80634 Phone: 353-3373 PERSONAL DATA SHEET Date of Birth: August 3, 1950 Health: Excellent Married, two children CERTIFICATION/LICENSURE Licensed Clinical Psychologist, State of Colorado since 1984 Listed in National Register of Health Service Providers in Psychology since 1986 Staff Privileges, North Colorado Medical Center, Greeley, Colorado since 1985 Certified Teacher (K-12) for Emotionally Disturbed, Learning Disabled and retarded. Certified Teacher, Elementary Level PROFESSIONAL MEMBERSHIP American Psychological Association Colorado Psychological Association Colorado Psychological Association- elected board member 1986-1989 HONORS President's Award - Colorado Psychological Association, 1989 EDUCATION 1978 - 1981 Ed.D. in Counseling Psychology University of Northern Colorado December 1981 graduate 1972 - 1974 M.S. in Education (E.D./L.D.) Lesley College, Cambridge, Massachusetts August 1974 graduate 1968 - 1971 B.S. in Special Education and Elementary Education with a minor in psychology Boston University, Boston, Massachusetts December 1971 graduate PROFESSIONAL EXPERIENCE 1981 - PRESENT Clinician in private practice in Northern Colorado. Among responsibilities are: Diagnosis, therapeutic intervention and referral for adults, families, children and groups. Primary areas are: anxiety disorders, mood disorders and adjustment disorders. Typical problems include: trauma, physical abuse, job stress. Orientation used-primarily cognitive- behavioral therapy. Also, developing, organizing and presenting workshops and consultative programs to community, schools, organizations and agencies. Approximately 30 hours per week. 1986 - Present Consulting psychologist on interdisciplinary team for in-patient rehabilitation program. Progressive Care Rehabilitation Center, Greeley, Colorado. Medical Director Dr. Judith Vaughan, Neurologist. Adults with traumatic injuries-Primary problems are: psychological aspects of physical rehabilitation, grief counseling, and brief group counseling using cognitive-behavioral goal oriented therapy. Approximately 10 - 15 hours per week. 1989 - 1992 Head Injury Treatment Team North Colorado Medical Center, Greeley. Approximately 5 hours per week. Team coordinator - Dr. John McVicker, Neurosurgeon. 1986 - 1989 Consulting Psychologist for Family Recovery Center (in-patient substance abuse/chemical dependency program), North Colorado Medical Center, Greeley, Colorado. Coordinator Ruth Wick R.N. Approximately 5 hours per week. 1986 - 1989 Provider and Coordinator for Mental Health Services in Northern Colorado for Peak Health Care (HMO). Peak mental health services utilized a three session model for initial services followed by referral. Activities included coordination of Psychological and Psychiatric Services for approximately the last two years of the contract. Peak was purchased From Lincoln National by Biodyne in late 1989. Peak Supervisor - Elaine Taylor Approximately 10 hrs./week. 1983 - 1986 Psychologist subcontractor for a Vietnam Veteran's Counseling Program funded by the Veteran's Administration. Principal Contractor Dr. Robert Stewart 1980 - 1987 Part time faculty member with responsibilities for classes, workshops and community programs in parenting skills. Family/Life Education Program Aims Community College, Greeley, Colorado August 1980 Clinical Internship on Children's Team of to Community Mental Health Center. Responsibilities August 1981 included: consultation to schools and community programs; therapy for children and families; and assessment of diverse mental health programs. Assistant program Evaluator-Developed evaluation tools to determine cross-cultural perceptions of expectations and satisfaction with services. Supervisors - Dr Joan Gillespie and Dr. Laurence P. Kerrigan. Weld Mental Health Center, Greeley, Colorado (Full time). Adults, Adolescents, Families. Primary areas anxiety disorders, mood disorders and adjustment disorders. Typical problems included: trauma, physical abuse substance abuse, job stress. Orientation used- Primarily cognitive-behavioral therapy. 1980 Group Facilitator-Regional and National Conferences in cross-cultural community needs. Flagstaff, Arizona - Colorado Springs, Colorado August 1975 Chairperson of the Department of Education and to Behavioral Science at an accredited, Indian controlled July 1978 community college on the Navajo Reservation. Administration responsibilities included: Supervision and evaluation of faculty; budget preparation and management; curriculum development and integration of Navajo culture; personnel recruitment and selection; class scheduling and program development. Also, faculty member with academic responsibilities for instruction in Psychology, Child Development and Counseling courses, advising and counseling students. Navajo Community College, Tsaile, Arizona (Full time) September 1974 Education Specialist and counselor at an Indian to controlled primary and secondary school on the August 1975 Navajo Reservation. Coordinated community resource program which included: Counseling, Student assessment, prescriptive programming, , staff development and curriculum. Also, adjunct faculty for the University of New Mexico and for Navajo Community College at the Rough Rock Demonstration school, Rough Rock, Arizona. (Full time) September 1972 Designed and coordinated Learning Center Program to for Dedham Public Schools. A program and crisis June 1974 intervention center for emotionally disturbed children. Responsibilities included: Diagnostic prescriptive programming, counseling, supervision and training of aides, tutors and volunteers, and consultation with regular classroom teachers. Also organized group and individual meetings with parents. Also, adjunct faculty for Curry College assisting in in-service instruction for Dedham School System employees. Dedham Public Schools, Dedham, Mass. (Full time) February 1972 Learning Disabilities Specialist. Consultation to staff, to prescriptive programming and teaching school age June 1972 children. Somerville Public Schools, Somerville, Mass. (Full time) Summer 1971 Chosen as state mental health intern. coordinated Tutoring Center for emotionally disturbed children. Responsible for: tutoring children, supervising aides, (high school dropouts) and consulting with psychiatric staff. Somerville Mental Health Clinic, Somerville, Mass. WORKSHOPS AND SPECIAL TRAINING 1993 - August Hospital Practice for Psychologists APA National Convention in Toronto, Canada- "Psychology and National Health Reform", "National Health Insurance: Policy Considerations, Benefit Designs, and Economic Realities", and "Marketing: Psychology's Key to National Health Reform. 1993 "Using the New MMPI-2 and MMPI-A" Mountain Crest Hospital, Denver, Colorado. 1993 Disaster Relief Training. Alan Keck, through Colorado Psychological Association, Denver, Colorado. 1992 - Fall Short Term Therapy. Bernard Bloom, University of Northern Colorado, Greeley, Colorado. 1990 - Fall National Cognitive Rehabilitation Conference, Richmond, Virginia. 1990 - Summer Post graduate training: 1. Adult Neuropsychological Method based on Lezak Neuropsychological assessment, 1983. 2. Child Neuropsychology, Dr. Hynd. 3. Child Neuropsychological Methods. 1989 Provider of Neuropsychological evaluations for Vocational Rehabilitation, Greeley, Colorado. 1988 Cognitive Rehabilitation Training Program, Dr. Sena, Ph.D., Colorado Springs, Colorado. 1988 - Present Psychologist - Head Injury Treatment Team at North Colorado Medical Center, Greeley, Colorado. 1987 Halstead Reitan Neuropsychological Assessment Training. Ralph Reitan, Ph.D., Washington, D.C. Summer 1986 Albert Einstein School of Medicine, Workshop on Adolescent Therapy, Cape Cod, Mass. 1985 to present North Colorado Interdisciplinary Team of Child Custody Member and participant. Fall 1985 Interdisciplinary Workshop on Child Custody, Keystone, Colorado. Summer 1984 Workshop in Clinical Use of Hypnosis, Boston, Mass. Winter 1983 Workshop on In-patient Programs for Service Related Disorders, Cheyenne Veterans Administration Hospital. Fall 1983 Veteran's Administration Workshop on Post Traumatic Stress Syndrome, Denver Veteran's Center. Fall 1981 Post-Doctoral Supervised Candidate for Licensure to (psychology) under Gale R. Giebler, Ph.D. Licensed Winter 1984 Psychologist and Susan Spilman, Ph.D., Licensed Psychologist. 1980 - 1981 Intern-Weld County Sexual Abuse Team, Greeley, Cob. Summer 1981 Independent Study of Child Sexual Abuse, University of Northern Colorado. Spring 1981 Interdisciplinary Workshop on Assessment of Sexual Assault, Boulder Social Services. Summer 1979 Biofeedback Training related to labor and delivery. Summer 1974 Participant in Institute on Obstacles to Learning. Joint Symposium between McLean psychiatric Hospital, Harvard University and Lesley Graduate School. Cambridge, Massachusetts. Summer 1973 Kennedy Memorial Hospital, Boston, Massachusetts. Participant, Summer Aphasia Institute. PUBLICATIONS Ackerman A., Ackerman J.S., Kelley K, Hale K. Family Planning Attitudes of Traditional and Acculturated Navajo Indians. Kev Issues in Population and Food Policy. University Press of America, pp. 178-171 (1979). Ackerman, J.S., Client Expectations and Satisfaction with Community Mental Health Center Services: A Cross-Cultural Analysis Between Hispanics and Anqlos. Published Doctoral Dissertation, University of Northern Colorado. copyright 1981. FACULTY VITA May 1999 NAME: BROMLEY, Susan Plock SOCIAL SECURITY NUMBER: 483-50-9243 POSITION: Associate Professor of Psychology Department of Psychology College of Arts and Sciences University of Northern Colorado Greeley, CO 80639 HOME ADDRESS: 1621 13th Avenue Greeley, CO 80631 TELEPHONE: Office: (303) 351-2236 Home: (303) 352-8750 EMAIL:sbromlev@bentley.unco.edu EDUCATION: Year(51 Degree Institution Area of Study 1983 PsyD University of Denver Clinical Psychology School of Professional Psychology Denver, Colorado 1968 MSSA Case Western Reserve University Casework (MSW) School of Applied Social Sciences Cleveland. Ohio 1965 BA Mt. Holyoke College Economics/Sociology South Hadley. Massachusetts WORK EXPERIENCE --Professional.1 cadmic ears Institution/Organization Position Responsibilities I 996-Pres University of Northern Colorado Assoc. Professor Psychology Teaching/Resea.ch 1985-96 University of Northern Colorado Asst. Professor Psychology Teaching/Researh 1983-84 University of Northern Colorado Asst. Professor Psychology Teaching WORK EXPERIENCE --Professional Non-Academic: Year(s) Institution/Organization Position Responsibilities 1996-present Ackerman and Associates Psychologist Clinical 1984-85 Kaiser Permanente Psychotherapist Clinical Lakewood. Colorado 970-S0 Bethesda Mental Health Center Psychology Intern Clinical! Denver, Colorado Administrative 1968-79 Denver General Hospital Clinical Social Worker/ Clinical! Denver. Colorado Supervisor Administrative AREA OF SPECIALIZATION: Behavioral Medicine/Pain Management/Clinical Hypnosis RESEARCH AREAS/INTERESTS: Hypnosis/Pain Assessment and Management/Women's Issues/Teaching Methods PROFESSIONAL ACTIVITIES: Colorado Licensure: Psychology License#1086 PUBLICATIONS --Professional/furled: \lusgrave-Marquart,D.,Bromley, S.P. &Dailey,M.B. (1997)"Personality, academic attribution, and suostance ibuse as predictors of academic achievement in college students".Journal of Social Behavior and Personality. 12(2). l;(11-511. Karlin, N.J. and Bromley, S.P. (1996). Differences in caregivers of demented and lucid chronically ill family members. Journal of Alzheimer's Disease and Related Disorders and Research Retzlaff. P. and Bromley, S. (1994). Counseling personality disorders. In Ronch, J.L., VanOrnum, W. & Stillwell. C (Eds)The counseling sourcebook' A practical reference on contemporary issues. New York: Crossroad Publishing group. pp.466-474. Bromley, S. and Hewitt,P. (1992). Fatal attraction: The sinister side of women's conflict about career and family Journal of Popular Culture. 26(3), pp. 17-24. Retzlaff, P. and Bromley, S. (1991). "A Multi-Test Alcoholic Taxonomy: Canonical Coefficient Clusters". Journal of Clinical Psychology. 47(2), pp. 299-309. Bromley, S.P. (1985). "Treatment of Pain: Theory and Research" in Zahourek, R. (Ed.). Clinical Hvpnoc.is and therapeutic Suggestion. New York: Grune and Stratton. Reprinted in Zahourek, R. (Ed.) (1990). New York: Bnmer/Mazel, Inc., pp. 77-98.. PROFESSIONAL PRESENTATIONS --Juried. Vickisson, J.W. and Bromley, S.P. (1999)"Hypnosis: Attitudes, knowledge and experience among psychology and nursing students Accepted for a paper presentation at the American Psychological Association Convention, Boston I August) Campbell, J. S_ Titus. J. and Bromley S. P. (1998). "Neuroanatomy teaching technique for introductory psychology students. Poster presented at the joint WPA/RMPA convention, Albuquerque, NM. (April) 13romlev. S. (1997)(Chair)"Linking through honors programs: The cross-discipline course). Paper presentation as part of a symposium titled"Creating links between psychology and other disciplines"., American Psychological association Convention, Chicago. (August) Bromley, S. , Gilliam D., &Johnson, T. (1995). "Assessment of student created tests as an evaluation nethod"_ Poster presented at the American Psychological Association Convention, New York City. (August) Bromley, S. (1994). "Student created tests as an evaluation method". Poster presented at 16th Annual N ttional institute on the Teaching of Psychology. St. Petersburg, Florida {arli . N and Bromley. S. (1992). " Similarities and differences for caregivers of demented and lucid chronicalh ill". Poster presented at the Rocky Mountain Psychology Association Convention,Boise, Idaho. (April) vlontoy a, K.J. and Bromley, S ( Chair) (1992). " Changes in undergraduate counseling styles in an introductory counseling theories course". Paper presented at the Rocky Mountain Psychology Association Conventior. Base. Idaho (April) Bromley, S. (1992). " Connected learning methods to faciliate research understanding". Paper presentation a: part cf panel titled, `Teaching techniques in the social sciences", Western Social Science Association Convention. Denver, Colorado. (April) Bromley, S.,Ramirez, S., and McCoy, J. (1991). " Impact of a health psychology course on student health betrefs". Foster presented at the Rocky Mountain Psychology Association Convention,Denver, Colorado. (April) Karlin. N. and Bromley, S. (1991). " Support,burden and affect among caregiver of dementia and nondetaenna patients". Poster presented at the American Psychology Association, San Francisco, California. (August' Bosley, G. and Bromley, S. (1990). Post death ritual in a Colorado community. Paper presentation at the American Psychology Association, San Francisco, California, (August) Bromley, S. (1990). "Husbands at Childbirth: Who Does It Help?"Paper presentation at Far West Popular Culture Association, Las Vegas, Nevada (January) Hewitt. P. and Bromley S. (1989). "Images of Work and Intimacy in'Turning Point'and'Fatal Attractior"'. Paper presentation National Convention of Popular Culture Association and American Culture Association, St Louis Missouri. (Session Chair) P.etzlaff,P and Bromley, S. (1989). "The Basic Personality Inventory: Alcoh Sub-Group Identification". Poster session at the Joint Convention of the Rock Mountain Psychological Association and Western Psychological Association Reno. Nevada. Bromley. S. (1988). "Our Culture Affects Our Pain." Paper presentation, National Convention of Popular Culture Association and American Culture Association,New Orleans,LA. (March). Bromley, S. (1987). "Husband-Assisted Autohypnosis for Labor and Delivery: A Clinical Model". Paper presented at Rocky Mountain Psychological Association, Albuquerque, New Mexico(April). Bromley. S. and Loy, P. (1987). "Politics of PMS". Paper presentation Association of Women Psychologists, Denver, Colorado (March). PROFESSIONAL PRESENTATIONS --Invited: Strongin, D. & Bromley, S. (1999). Student and faculty reactions to the introduction of a graduate ethics course In Miller, R. (Chair)Ethics in college teaching. Symposium conducted at the Rocky Mountain Psychological Association, Ft. Collins, CO(April) Bromley, S. (1999). Issues of religion and spirituality with therapists and clients. In S. Bromley(Chair) Religion and spirituality in research, practice and the classroom. Symposium conducted at the Rocky Mountain Psychological Association, Ft. Collins, Co (April) Bromley. S. (1998)Hypnosis, psychology and managed care. In S. Bromley(Chair) Complementary, nontraditional and indigenous healing practices. Symposium conducted at the combined meetings of the Western and Rocky Mountain Psychological Associations. Albuquerque. (April) Bromley, S. (1998). Complementary healing methods: A psychological and artistic exploration. In L Wickerlitren (Chair). Interdisciplinary courses involving psychology: A sampler. Symposium conducted at the combined meetings of the Western and Rocky Mountain Psychological Associations, Albuquerque. (April) Handelsman, M.M., Bromley, S.P. & Davis, S.F. (1995). "Clinical Psychologist, Counseling Psychologist. Clinical Social Workder, or Psychology Professor: Which Degree is Right for Me?" Psi Chi invited panel presentation. Pock Mountain Psychological Association, Boulder.CO(April). Bromley, S. (Co-Chair), Seibert,P. (Co-Chair), Knuckey, D.,Bohlin,M., Zaweski, C., Watson, D., Hammon West, K. &Robins, J. (1994). "Training the Teaching Assistant" Invited Panel Presentation ,Rocky Mountain Psychological Association,Las Vegas, Nevada(April) Broniley, S. (1993). "Hypnosis in Dentistry." Presentation at Monthly Meeting of Weld County Dentist s• Association, Greeley, Colorado(February). Broniley, S. (1993). "Learning about the author as a way to understand research." Presentation at "Teaching Take Out", CTUP Special Event. WPA/RMPA Convention, Phoenix, Arizona(April). Allen, M. and Bromley, S. (1993). Co-Chairs Two CTUP Special Event Sessions, "Teaching Take Out: Lxperiences in Collaborative Learning", Western Psychological Association/Rocky Mountain Psychological Association Convention, Phoenix, Arizona (April). Broniley, S. (1993). Chair, Invited Symposium, "Psychological and Social Perspectives on Male Violence Against Women", Western Psychological Association/Rocky Mountain Psychological Association Convention, Phoem Arizona(April). Bromley, S. (1992). " Enhancement of student research and writing skills in any course". CTUP Workshop presented at the Rocky Mountain Psychology Association Convention, Boise, Idaho. (April) Broniley, S. and Karlin, N (1992). "General and health locus of control of adult caregivers". Poster session at the 1lNC Research Forum, Greeley, Colorado. Broniley, S. (1992). Panel member in Mental Health Symposia for Victim Compensation Convention as part of the Colorado Organization for Victim Assistance Conference. (Estes Park/October) Itolocofski, Bromley,Foster and Mean (1988). "Hypnosis: Research and Clinical Perspectives," symposmm presentation,Colorado Psychological Association, Greeley(March). Bromley, S. (1986). "Pain: A Psychological Event". Presentor- 20th Annual Emotional Crisis Workshop, University of Northern Colorado, Greeley, Colorado (July). LECTURES--Invited: Broniley, S. (1998) "Psychological methods of pain control" Invited lecture for the annual meeting of the Weld County Arthritis Society. Bromley, S. (1998). "Hypnosis for pain control of arthritis" Invited lecture for"Brown Bag" lunch series sponsored by the Greeley Medical Clinic. Itromley, S. (1998)"Headache Control -Psychological Methods". Invited lecture as part of a seminar titl:d"!opine with headache". Sponsored by the Greeley Medical Clinic. Bromley, S. & Ackerman J. (1998). "What to do to handle burnout" A workshop conducted for foster parents working with Weld County Social Services. Bromley, S. (199 ). Keynote speaker for Golden Key Honor Society Induction Ceremony, University of Colorado. Boulder. Co. (November) Broniley. S. (1992). Keynote speaker for Sophomore Honor Society Induction Ceremony. Bromley, S. (1991) Featured speaker. UNC Acadmic Honors Convocation. (April) Bromley, S. (1991). Banquet speaker Emotional Crisis Workshop, Greeley, Colorado. (July) 4 ≤RANTS: Bromley, S( 1994)Honors Grant($500)to attend research training at the Society for Clinical Hypnosis meeting. San Francisco(October) Bromley, S. (1994). Research and Publications award of$1500.00. "Assessment protocols to measure the efficacy of hypnotic treatment for injured workers. Karlin, N. and Bromley, S. (1990). Research and Publications award of$2,4440.00. "Control, support. bnrdcn. and affect differences among dementia and non-dementia caregivers". BOOK /GRANT REVIEWS: Grant review for Boise State Department of Education(1995) Review of Santrock, J. (1991). The science of mind and behavior. W.C. Brown and Benchmark. Review of McKee. P. Bc Thiem, J. (1993). Real life; Ten stories of aging. University of Colorado Press PROFESSIONAL CONSULTATION/PRACTICE: .ear(sl Institutiont/Oraattization Role 1996-presnt Ackerman and Associates Clinical Psychologist 1988 Bonnet Good Samaritan Center Pain Management Consultant and framer 1984-85 Denver Metropolitan Dental Care Consultant in Pain Management 1984 Iowa Association of Registered Physical Therapists Hypnosis for Pain Management Consultant And Teacher PROFESSIONAL ASSOCIATION PARTICIPATION: Mentbershig 1986-present Rocky Mountain Psychological Association 1988-present American Psychological Association(Divisions 2, 30, 35) 1989-present Greeley Area Mental Health Network 1987-88 Association of Women in Psychology 1980-89 Colorado Psychological Association 1988 CPA Program Committee Member for Spring Meeting--Greeley Coordinator SERVICE: EXTERNAL: NATIONAL SERVICE: 1994-present Rocky Mountain Coordinator-American Psychological Association, Division 2 -Teaching of Psychology I )92-94 Co-Chair, Rocky Mountain Region Council of Teachers of Undergraduate Psychology (FTC.Pi 1991-94 Mountain States Regional Academic Coordinator, Golden Key National Honor Society REGIONAL/STATE SERVICE. I?99 -Moderator for Stanley G. Hall Lecturer- Viney, W. (1999). A larger canopy for psychology: Unifying themes and pragmatic empiricism. Presented at the Rocky Mountain Psychological Association Convention, P: Collins. CO(April) I)89- present Rocky Mountain Psychology Association 1998-1999 Ex-Officio Board Member As Division 2 Coordinator 1992-1998 Board Member 1995- 1998 Elected Chair, Groups Under-Represented in Psychology Committee 1992-94 Co-Chair, Groups Under-Represented in Psychology Committee 1991 Coordinator of Student Volunteers, RMPA Convention, Denver, Colorado c 1995 Psychology Chair-CCHE Faculty to Faculty Conference(October) COMMUNITY SERVICE: 1998 Member, Weld County Medical Society Commitee on Alternative and Complementary Healing 1997-1998 UNC Loaned Executive-United Way of Weld County 1991- 1996 Board Member, 19th Judicial District Victim Compensation Board 1995-96 Chair 1990-93 Board Member, Weld County Area Agency on Aging 1992-93 Chair 1991-92 Vice-Chair 1986-Present Exam Supervisor-American Institute for Property and Liability Underwriters/Insurancc Institute of America 1987-present Clinical Psychologist - pro-bono work with individual clients and community training INTERNAL: DEPARTMENTAL: 1993-present Member, Department Executive Committee 1985-88. 1995-present Co-Advisor Psi Chi National Honor Society 1996-1999 Guest lecturer for Psi Chi Grad Night on getting into clinicallcounseling grad programs 1989-91,93, 95-present Department Representative, CCHE Faculty to Faculty Conference 1987- 94 Department Representative to graduation ceremonies 1986-94 Library Representative 1983, 86 89, 90-93,97.98 Member, Faculty Search and Screen Committee 1990-92 Member,Psychology Department Undergraduate Committee(Chair 1992) 1987-88 Co-Coordinator Semester Conversion Committee COLLEGE: 1992.93,96,97 Member of faculty invited to teach in the Cluster Program 1990-93 Graduation Marshall, Arts& Sciences 1988-89 Member, Arts and Sciences Teacher Education Committee 1986-89 Chair, Interdisciplinary Committee to develop and revise Human Development N1ajor in the College of Arts and Sciences and Psychology Department UNIVERSITY: 1992-94 1996-Present Member-Research and Publications Board 1993-94 Chair-Elect I'M-present Founding Co-Advisor, Golden Key Honor Society 1992-95 Member-UNC Women's Commission 1992-94 Co-Chair- Assessment Task Force 1989-90 Faculty Representative. Student Fee Allocation Committee 1986-89 Member, Faculty Senate 1988-89 Secretary 1987-88 Vice-Chair 1986-87 At-Large Member, Executive Committee 1986-89 Member, Academic Policies Committee 1986-87 Member, Elections Committee 1988 Representative, Western States Faculty Leadership Conference, Reno. 1988 Senate Representative, Statewide Commission Advisory Connotive 1988 Advisor,In-Touch Helpline 1985-86 Volunteer Therapist, UNC Counseling Center 0 GRADUATE STUDENT COMMITTEES--Doctoral.- 998 Committee Member, Shu-Shin Lu,Professional Psychology [997-prsnt Committee Member, Christine Rogers, Professional Psychology 1995-1997 Committee Member,Lisa Ing, Special Education 994-pres Committee Member, Marla Gallagher,Educational Psychology 1993 Committee Member, Hsiu-Lan Ma, Science Ed. -Oral Comprehensives 1993 Committee Member, Jerry Buford, School Psychology, "Treatment of depressive symptoms of early adolescents". 1993-1998 Committee Member, Pat Flanagan. CSPA , Orals, "A comparison of attitudes and pracices of teaching faculty regarding student academic dishonesty at a two year and four year insututit c" 1991 Committee Member, Mike Propriano, School Psychology 1990-94 Committee Member, Paul Jantz, School Psychology, 1989 Committee Member.Mike Peters. Vocational Rehabilitation . "The Effectiveness of Vocational Evaluation for Various Disabling Conditions 1987 Committee Member, Ane Marie Kajenckii, English, " The Concept of Free Association in \ ireinia Woolf s The Waves" 1986 Committee Member, Fuming Liao, Mechanical Kinesiology, "Development and Valida ion of a Method for Providing Immediate Feedback Information on Speed and Angle of Release in Shotputting" GRADUATE STUDENT COMMITTEES --llacter+• 1998 Vanessa Ewing, Committee Member 1997 Stephanie Blasi, Committee Member 997 John Nickisson. Chair 1994 David Watson, Committee Member 1994 Tiernan Mcllwaine. Committee Member 1994 Jerrod McCoy, Committee Member 1991 Sheldine Runyan. Committee Member 19`n Sue Cole, Committee Chair, "Influences on Occupational Goals of Selected Male and Female ,ollcge Students". [990 Jerry Benner, Committee Member 1990 Kurtis Armstrong. Committee Member."Attitudinal Consequences of Pre-Employment and R mdom Employee Drug Testing" 1989 Michelle Hozer. Committee Member 1989 Anne Schnittgrund, Committee Chair, " Age and Electrothermal Biofeedback Training" 1988 Cherri Hockett. Committee Member, "The Effects of Turnover on Those Who Remain in an Organization" 1988 Tony Ambrosio. Committee Member, "The Belief in a Just-World and the AIDS Epidemic Predictors of Altitudes Towards Individuals with AIDS" 1988 Steve Foster, Committee Chair, "Hypnotic Susceptibility Ma Function of Locus of Control and Director Indirect Inductional Deepening and Suggestion Style" 1988 Lisa Dillon, Committee Chair. "Cognitive-Behavioral Approach to the Treatment of Elderly Rheumatoid Arthritis Subjects" 1987 Deanna Holmes, Committee Member 1987 Darlene Nold, Committee Member, "Reading and Writing Assessment Tests as Predictors of Success in the Basic Peace officer Academy at Aims Community College" 987 Dan May, Committee Member 1986 Jeff Schiels_ Committee Member, "The Reformulated Hypothesis: Is Its dominator of Learned Helplessness Literature Justifiable?" 1986 Linda Coulthard-Morris. Committee Member. "Biofeedback of Cortical Slow Wave Potentials Hand Temperature and Muscle Tension in Normal and Attention Deficit Disorder with Hyperactivity Children" TEACHING: Honors Activities; 1999 UNC Research Day, Faculty Panel Coordinator, " Complementary Healing Methods" 1999 Thesis Coordinator-Kristin Pietryzick, Jennifer Kimberling, Cristine Dickey 1997 Thesis Co-Advisor Kelly Kinser 1997 Honors Connection Course development-Alternative Healing Methods 1996-pres Honors Co-Coordinator, Psychology Department 1989-94 Honors Coordinator, Psychology Department 1994 Thesis Co-Advisor, Diane Musgrave, "The Relationships Among Personality Traits, Alcohol, Caffeine, and Nicotine Consumption,and Academic Performance in College Students" 1994 UNC Researh Day, Faculty Panel Coordinator, "Hypnosis: Theory and Research" 1993 UNC Research Day, Faculty Panel Coordinator, "Non-traditional Theories of Therapy Serving Women and Minorities". 1993 Thesis Co-Advisor.Linda Norman, "Clozapine and Event Related Brain Potentials in Schizophrenics" 1992 Thesis Advisor, Deborah Knuckey, "The Effect of Touch on AffectAmong Strangers Under Mildly Stressful Conditions" 1992 UNC Research Day, Faculty Panel Coordinator 1992 UNC Research Day, Faculty Panel Coordinator(2 student panels)"Sex Roles and Psychology", The Power of Social Influence 1989 Thesis Advisor, Geri Bosley, "Post Death Ritual in a Small Colorado Community" 1988 Thesis Advisor, Pam Clasen, "The Use of Relaxation and Imagery Techniques in Pain Management" 1989 Honors Connection Course Development courses Taught' (1-4 Scale with 1 as Highest) (*1-5 Scale with 5 as highest) DATE COURSE TITLE FIRS ENR AVG.R.ATING Ni' 198 8 PSY 101 IntroSeminar Psychology 1 43 W 1987 PSY 101 IntroSeminar Psychology 1 16 1.12 NV 1986 PSY 101 IntroSeminar Psychology 1 32 1.24 F' 1997 PSY 120 Principles of Psychology 4 107 3 76 F 1996 PSY 120 Principles of Psychology 4 139 F 1991 PSY 120 Principles of Psychology 4 119 1.64 F 1991 PSY 120 Principles of Psychology 4 161 1.67 F 1983 PSY 120 General Psychology 3 42 ---- Sp 1984 PSY 121 Intro to Psychology I 4 40 ---- Sum 1988 PSY 230 Human Growth &Development 5 55 ---- Sp 1988 PSY 230 Human Growth &Dcvclopmcnt 5 60 158 W 1988 PSY 230 Human Growth &Development 5 90 138 F 1987 PSY 230 Human Growth & Dcvclopmcnt 5 45 1 54 N✓ 1987 PSY 730 Human Growth & Development 5 75 1.54 Sp 1987 PSY 230 Human Growth &Dcvclopmcnt 5 90 -- Sum 1986 NY 230 Human Growth &Development 5 47 -- F 1986 PSY 210 Human Growth &Dcvclopmcnt 5 80 136 V✓ 1986 PSY 230 Human Growth &Development 5 80 1 47 N; 1986 PSY 230 Human Growth & Dcvclopmcnt 5 52 1.27 F: 1985 PSY 230 Human Growth & Development 5 56 153 F 1985 PSY 230 Human Growth &Development 5 85 156 Sp 1984 PSY 265 Social Psychology 3 26 ---- N4 1984 PSY 265 Social Psychology 3 23 ---- Sp 1998 PSY 373 Health Pwchologv 3 40 4 11 F 1998 PSY 323 Health Psychology 3 19 4 08 Sp 1997 PSY 323 Health Psychology 3 44 4 17 S F 1995 PSY 323 Health Psychology 3 47 Sp 1994 PSY 323 Health Psychology 3 41 1.69 F 1992 PSY 323 Health Psychology 3 49 Sp 1992 PSY 423 Health Psychology 3 42 1.69 F 1990 PSY 423 Health Psychology 3 1 66 F 1988 PSY 423 Health Psychology 3 35 136 Sp 1986 PSY 330 Child& Adolescent Psych 3 27 1 4 Sp 1993 PSY 331 Maturity&Aging 3 40 Sp 1991 PSY 331 Maturity & Aging 3 46 1 62 F 1989 PSY 331 Maturity &Aging 3 23 1.45 F 1988 PSY 331 Maturity & Aging 3 27 1 40 Sp 1988 PSY 430 Maturity& Aging 3 44 158 Sp 1987 PSY 430 Maturity& Aging 3 34 -- Sp 1986 PSY 430 Maturity& Aging 3 36 1 52 F 1998 PSY 455 Abnormal Psychology 3 49 4.24 Sp 1997 PSY 455 Abnormal Psychology 3 49 4 03 F 1995 PSY 455 Abnormal Psychology 3 32 Sp 1993 PSY 355 Abnormal Psychology 3 37 Sp 1992 PSY 355 Abnormal Psychology 3 42 1 26 Sp 1991 PSY 355 Abnormal Psychology 3 37 137 F l990 PSY 355 Abnormal Psychology 3 1 46 Su 1990 PSY 355 Abnormal Psychology 3 31 Sp 1990 PSY 355 Abnormal Psychology 3 37 138 Sp 1990 PSY 355 Abnormal Psychology 3 42 1.53 Sp 1989 PSY 355 Abnormal Psychology 3 78 1.51 Sp 1986 PSY 358 Abnormal Psychology 3 41 1 54 VV 1984 PSY 358 Abnormal Psychology 3 31 Su 1998 PSY 350 Theories of Personality 3 20 4 10 Su 1990 PSY 357 Theories of Personality 3 21 1.45 VJ 1988 PSY 357 Theories of Personality 3 40 1 57 F 1987 PSY 357 Theories of Personality 3 55 138 V4 1987 PSY 357 Theories of Personality 1 37 173 F 1986 PSY 357 Theories of Personality 3 54 _- F 1983 PSY 357 Theories of Personality 51 F 1998 PSY 407 Intro to Counseling Theories 3 20 4 31 Sp 1998 PSY 407 Intro to Counseling Theories 3 20 4 42 F 1997 PSY 407 Intro to Counseling Theories 3 15 4 71 F 1996 PSY 407 Intro to Counseling Theories 3 19 F 1995 PSY 407 Intro to Counseling Theories 3 19 Sp 1994 PSY 407 Intro to Counseling Theories 3 F 1993 PSY 407 Intro to Counseling Theories 3 24 1 32 Sp 1993 PSY 407 Intro to Counseling Theories 3 22 F 1992 PSY 407 Intro to Counseling Theories 3 25 1 18 Sp 1992 PSY 407 Intro to Counseling Theories 3 22 1 21 F 1991 PSY 407 Intro to Counseling Theories 3 44 1 26 Sp 1991 PSY 407 Intro to Counseling Theories 3 33 1 21 F 1990 PSY 407 Intro to Counseling Theories 3 Sp 1990 PSY 407 Intro to Counseling Theories 3 16 1 12 F 1989 PSY 407 Intro to Counseling Theories 3 24 1 20 Sp 1989 PSY 407 Intro to Counseling Theories 3 18 131 F 1987 PSY 407 Intro to Counseling Theories 3 26 1 21 F 1986 PSY 407 Intro to Counseling Theories 41 1 57 Sum 1927 PSY 499 Psychology of Sex Roles 3 16 1 18 Sum 1989 NY 508 Emotional Crisis Workshop 1-2 39 "" "Frontiers of Mental Health And Education" Sum 1988 PSY 508 Emotional Crisis Workshop 2-3 63 "Mind/Body Interactions" Sum 1987 PSY 508 Emotional Crisis Workshop 2-3 106 "Relationships" Sum 1991 PSY 595 Health Psychology 3 15 (ip 1998 PSY 620 Assessment& Interviewing 2 9 4.31 F 1992 PSY 620 Assessment & Interviewing 2 12 1.66 1' 1990 PSY 620 Assessment &Interviewing 2 1.02 f 1988 PSY 620 Issues in Behavioral Medicine 3 5 2.08 f 1997 PSY 621 Practicum College Teaching 2 10 4.77 F 1996 PSY 621 Practicum College Teaching 2 10 F' 1993 PSY 621 Practicum College Teaching 2 13 1.45 F' 1992 PSY 621 Practicum College Teaching 3 13 \l' 1984 PPSY 670 Tests and Measurements 3 20 5p 1997 HON 200 Honors Connections Seminar: Alternative Healing Methods 2 20 3 67 of•1 Sp 1989 HON 200 Honors Connection Seminar IL 2 9 *** "Love" Sum 1986 Elderhostel "Dream On" NC (25) Sum 1987 Elderhostel "Mind/Body Interactions" NC 19 *** courses Developed: 1997 HON 200_ Alternative Healing Methods 1991- PSY 595,Issues in Health Psychology, Summer 1989- 23rd Annual Emotional Crisis Workshop. Frontiers of Mental Health and Education. Summer 1988- PSY 620. Assessment in Behavioral Medicine, Fall (Revised Spring 1998) 1988- PSY 423. Health Psychology. Fall 1988- 22nd Annual Emotional Crisis Workshop, Mind/Body Interactions. Summer 1987- 21st Annual Emotional Crisis Workshop. Relationships. Summer 1987- Mind/Body Interactions- Elderhostel Program, Summer 1087- PSY 499. Psychology of Sex Roles - Summer 1986- Dream On -Eldcrhostcl, Summer Directed Studies: Graduate. 1995- Cynthia Holley_ Hypnosis 1P94 - Tara Johnson, Hypnosis Theory and Practice 1994 - Marla Gallagher. Sociometric Processes I P94 - Marla Gallagher, Cluster Development in Intro Psychology Classes 1'99? - Bruce Holoman. Hypnosis Research and Practice 1988 - Paul Jantz_ Hypnosis for Pain With Children 1988 - Lori Kocheyar, Women as Leaders 1988 - Jerri Israel, Alan Shaw, Issues in Health Psychology 1988 - Steve Foster. Michele Hozer. Teaching Apprenticeship 1')87 - Tony Ambrosio, Hypnosis Models 1 486 - Candy Disch. Psychological Testing C ndc rgraduate: 1998 Jennifer Altman - Exercise and Psychology 19)96- Kindra Sanchez -Biracial Identity 1')96 - Jenna Weatherbee -Pain Coping Styles 9)95- Allison Ellis - Psychological Theories in Business Management 1995 - Holli Elrick. Counseling and the Hearing-Impaired Child 1')94 - Lewis Garza, Etiology of Schizophrenia 11' 1994 - Suzanne Bodetko, Autogenic Training 1994 - Rebecca Furstenberg, Impact of Alzheimer's Disease on Families 1994 - Bonnie Sarton,Hypervzgilence in Youth(Hon 351) 1993 - Mary Jo Hamilton.Hypnosis Theory 1994 - Greg Schooley, Forgiveness as a Therapy Tool 1993 - Jason DeBueno. Youth Advocacy 1993 - Kelley Ferguson-Women in Psychology 1993 - David Rosenberg-Offender Programs 1992 - Robin Trostel, Analysis of Learning Styles 1992 - Robin Trostel. Health Locus of Control 1992 - Roberta Inman, Family Violence and Lesbians (Hon 351) 1991 - Mark Kahl.Back Pain 1.991 - Tracy Moulton, Treatment of Sexual Abuse 1.991 - Mice McPherson. African American Women and Higher Education 1.991 - Jody Humer, Hypnosis: Theory and Practice 1990 - Jimmie Berg. Women's Learning Styles 1989 - Elary Violett, Cognition and Pain Management 1989 - Geri Bosley. Chris Snodgrass,Bev Foster, Elary Violett, Issues in Personality 1989 - Penny Vaughn, Female Pioneers in Social Work 1989 - Lori Peterson. Pain and the Elderly 1988 - Peer Training for Hotline Service 1987 - Tracy Boh. Issues in Child Abuse 987 - Julie Stoddard, Grief and Divorce 1987- Eric Bouch. Hypnosis Models 1987 - Mike Lesser, Assessment in Sport Psychology 1986 - Lynne Sheffield, Childhood and Loss 986 - Jennifer March, Adolescence Practica 1998- Andrea Lamb-Hypnosis and golf performance 998- Reberra Varoula - Women's Place 1998: Greeley Medical Clinic -Gay Lemons,Renae Smith 1998- Ackerman and Associates-Amy Manuel, Kristin Pietrzyk, Jennifer Kimberling, Greg Pedersen 1997- Greeley Medical Clinic- Lori Darst, Barbara Glode, Ann Marie McCullen, Jeff Titus 1993 - Greg Schooley, Breavement Research 1993 - Di Smice, Women's Commission 1992 - Mary Jo Hamilton, Hypnosis Research 1992 - Carol Sexton. Psychology Testing 1992 - Lisa Schlott. Learning Styles PROFESSIONAL DEVELOPMENT ACTIVITIES: Workshops, Clinics. Symposia, Conferences: (Excluding Conferences as a Presentor) 1999- EMDR training and Level 1 certification 1998 Qualitative research lecture series-UNC 1998- Lewis M. Tcrman Western Regional Teacher's Conference sponsored by APA Division2 in conjamcLon with the WPA/RMPA joint convention. 1 998- "Spirituality and health in counseling", CAHEC Workshop, Greeley 1998- 'Divorce Basting: Solution oriented brief therapy with couples". Colorado Assoc. Marriage and "am•I' 1997 - Health Maintenance -Legal and Ethical Issues 1997- Body and Soul: Healing in the 90's '996- Celebrating our Essence: Women's Health and Spirituality 1995 - International Society for Clinical and Experimental Hypnosis -Research Workshop. San Francisco. A (30 more hours toward certification) 1989 - "Minding the Body. Mending the Mind". CAHEC Workshop. Ft. Collins I1 1988 - "Demystifying Publishing", CAHEC Workshop. NCMC, Greeley 985 - "Attentional Deficit Disorders in Children",Meichenbaum, Denver 1980 - International Society for Clinical and Experimental Hypnosis - 30 certification hours. Denver Numerous other workshops on Parent Loss, Child Abuse, Grantsmanship, Short-Term Treatment, Supen ision. Paw Management, Medical Terminology, Depression. Personality Disorders Courses Taken (}edit. 1994- EPRE 603 -Analysis of Variance {edit 1993 - EPRE 602 - Elements of Statistics 1990- EPRE 700 -Advanced Research Methods l'rcrinning Education Credit: 1976 - C.U. Medical School - Medical Ethics 1')72 - C.U. School of Nursing -Hypnosis(10 weeks) 1969 - University of Chicago-Kubler-Ross. Death and Dying HONORS AND AWARDS: 998- Distinguished Service Award-Rocky Mouintain Psychological Association 1998- Arts and Sciences Teacher of the Year Award-one of thre in Social Sciences 998- "Wonderful Outstanding Woman" Award -Highlighted in October newsletter- Women's Resource Center 1993 - Commencement Banner Carrier. Arts and Sciences 1993, 91,89, 88 -Mortar Board Favorite Professor 992 - Sudent Representative Council University Professor of the Year L)92 - Student Representative Council University Advisor of the Year 1989 - Arts and Sciences Achievement Award 1988 - Honors Advisor of the Year 1984 - Psi Chi. University of Northern Colorado Chapter 1')82-83 - Writing Associateship-Rocky Mountain Women's Institute &�, bB� FCa, :c':Css-9`_14 - . 9/28/99 CURRICULUM VITAE N. Karen Bender, MA, LPC 1104 Twin Peaks Circle Longmont, Colorado 80503 Phone: 303-678-8940 BUSINESS ADDRESS: 2919 W. 17th Ave.. Suite 214 Longmont, Colorado 80503 Phone: 303-678-0268 MARRIED: Brice J. Bender, MD, Aprl 26, 1974 CHILDREN: Sara C. Bender, born 3/13/79 and Melissa K. Bender, born 9/8/80 EDUCATION: Bachelor of Arts, Chemistry University of Colorado at Denver, 1977 Master of Arts in Agency Counseling, Emphasis in Marriage and Family University of Northern Colorado, 1993 Externship: Mental Health Center of Boulder County, Longmont Branch, Community Support Services Team, Sept. '92 to June '93 Currently enrolled in Professional Psychology Doctoral Program University of Northern Colorado (course work nearly completed) WORK EXPERIENCE: Feb. '94 to present Private practice, Individual adult clients and couples, Longmont. Fall '95: Counselor and presenter in multidisciplinary PMS program. Longmont Clinic. March '95 to May '96: Domestic Violence Counselor, Longmont Coalition for Women in Crisis, Individual adult clients; women's groups: domestic violence curriculum, support. and parenting. June '93 to Sept. '93: Therapist, Mental Health Center of Boulder County, Longmont Branch, Women's Issues Group. Sept. '84-Dec. '86: Cardiopulmonary Technologist, part-time Longmont United Hospital, 1950 W. Mountain View Ave., Longmont, Colorado 80501. June '79-April '82: Supervisor, Pulmonary Laboratory, Presbyterian/St. Luke's Medical Center. 601 E. 19th Ave., Denver, CO 80203 Jan. '76-June '79: Supervisor, Pulmonary Laboratory, St. Joseph Hospital, 1835 Franklin St., Denver, CO 80206 1975-1979 Clinical Instructor, Front Range Community College, 3845 W. 112th Ave.. Westminster, CO 80030. VOLUNTEER EXPERIENCE Sept '98 to Sept. '99: Doctoral Student Representative. Division of Professional Psychology. University of Northern Colorado. Sept. '94 to Mar. '95: Volunteer therapist: Longmont Coalition for Women in Crisis. Individuals and groups: domestic violence curriculum and parenting. Jan. '94 to July '95: Volunteer therapist: St. Vrain Valley Child Development Council, Inc., Head Start Program. Individuals, families, parent support groups that include parenting curriculum. June '93 to Aug. '93: Volunteer Co-therapist: Mental Health Center of Boulder County. Drug Treatment Team, Women's Group: History of Sexual and Drug Abuse. Co-therapist: Lisa Franseen. June '93 to July '93: Volunteer Co-therapist: Mental Health Center of Boulder County. Longmont Branch. Children's group: Attention Deficit Disorder. Co- therapists: John Fallon, MSW, and John Gerson, Ph.D. Nov. '91 to May '92 Volunteer individual counselor: University of Northern Colorado Counseling Center Feb. 1991 to Feb. 1992: Master's Student Representative. Division of Professional Psychology, University of Northern Colorado. Sept. '91 to Oct. '91: Volunteer Counselor A Woman's Place, Greeley, Co 1990 to 1992: Scholarship Committee for American Association of University Women, 1990-1991: Member Board of Directors for Longmont Coalition for Women in Crisis. PROFESSIONAL ORGANIZATIONS; Co-chairman, Public Relations, Information and Education Committee, Child and Family Advocacy Team (Boulder County Child Sexual Abuse Task Force), June '95 to August '97. Facilitator, Longmont Study Group, Colorado Society for the Study of Dissociation, May '95 to August '97. bk. bE:e FFi: 303-b51-J=1R Member: American Counseling Association, Colorado Counseling Association, and Eating Disorders Professionals of Colorado. Associate Member: American Psychological Association. PUBLICATIONS: N. Karen Estridge Bender Slonim, N. B., & Estridge, N. K. (1969). Ozone —An underestimated environmental hazard. Journal of EnvironmentaLHealth, 31, 577. Slonim, N. B., & Estridge, N. K. (1970). The acid-base surface --- A 3- dimensional visual model Rocky Mountain Medical Journal. 67, 59. Slonim, N. B., & Estridge, N. K. (1970). Carbon dioxide--- Environmental health aspects. Journal of Environmental Health, 33,171. Slonim, N. B., & Estridge, N. K. (1970). The acid-base surface: A three- dimensional visual model for analysis of acid-base information. Journal of Medical Education. 45, 828. Slonim, N.B., & Estridge, N. K. (1971). Carbon dioxide ---Environmental health aspects. In T. J. DeKornfeld (Ed.). Selected papers in inhalation therapy. Flushing, NY: Medical Examination Publishing, Co.. Inc. Slonim, N. B., & Bender, N. K. (1974). Responses to carbon dioxide containing atmospheres. In N. B. Slonim (Ed.). Environmental physiology. St. Louis: The C. V. Mosby Co. Slonim, N. B., & Bender, N. K. (1976). A tabular history: Cardiopulmonary technology as a profession. CVP, The Journal of Cardiovascular and Pulmonary Technology , 4, 31. Bender. N. K. (1977). Relevant respiratory physiology. The post-surgical patient, Spirometry. In V. Archuleta, O. B. Plummer, and K. D. Hopkins, A demonstration model for the project "Training nurses to improve patient education Boulder, Colo.: Western Interstate Commission for Higher Education. Bender, N. K. (1988). Future trends in education, SWEA Bridge, 3, 5. (St. Vrain Valley Education Association) PRESENTATIONS: Fall '95: Co-presenter with Haven Howell, M.D., multidisciplinary PMS program, Longmont Clinic. October '98: Co-presenter with Sean O'Halloran and Christine Rogers: A Roundtable discussion entitled: "Facing our Clients' Trauma: implications for Counselors in Training," at Rocky Mountain Association for Counselor Educat on and Supervision RESUME Emily L. Jaramillo-Bansberg 183 50th Avenue Place Greeley,Colorado 80634 (970) 353-1388 Office Telephone: (970) 351-2417/Email: ejaramil@che.unco.edu EDUCATION • Master of Arts: Psychology/Counseling, University of Northern Colorado,Greeley, CO • 'Graduate Fellowship Study: Rutgers State University of New Jersey, Newark, NJ • 13achelor of Arts: Sociology, University of Northern Colorado, Greeley, CO EMPLOYMENT Associate Director The Center for Human Enrichment University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 August 1997-Present Ensure efficient administration of the Student Support Services TRIO project which includes curriculum and instruction, technology,advising,and tutoring. Review the non-competing continuation and annual port ormanc e reports. Assist with the provision of professional opportunities for Center employees. Oversee the state funded Bridging Opportunities Program that focuses on recruiting incoming freshmen and transfer sh ioents inh the Center for Human Enrichment. Direct the Ronald E. McNair Postbaccalaureate Achievement Program (see below). Director Ronald E. McNair Postbaccalaureate Achievement Program University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 March 1996-Current Direct all efforts to ensure efficient administration of the McNair federal TRIO grant. Co-author l.S- Department of Education McNair proposal. Responsible for the compilation, analyzation, and submission of Non-Competing Continuation and Annual Performance Reports to the Department of Education. Molitor project's federal and matching budgets, supervise and train staff members,and plan, develop, and dire( t all student scholar activities. Collaborate with campus departments in order to exceed program objectives Responsible for coordinating, editing, and publishing the UNC McNair Scholars Journal. Identify, -,cr.nt, and select program scholars. Ensure the completion of scholars' academic research projects. Provide acac emic advising and guidance to McNair scholars. Direct the academic year research seminar series, the r)•idontial Summer Research Internship, and other scholarly activities that prepare scholars for doctoral stun . Coordinate research and scholarly activities between faculty mentors and McNair scholars. Counselor/Assistant Director Ronald E. McNair Postbaccalaureate Achievement Program University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 October 1995- February 1996 Assisted in the implementation of the McNair program (funded October 1995). Facilitated the recruitment and selection of McNair scholars. Compiled and submitted federal reports. Informed and collaborated with campus offices and departments. Implemented an academic workshop series based on student needs. Provided academic advisement and guidance to McNair scholars. Assistant Coordinator,Academic Advising Student Support Services University of Northern Colorado, Center for Human Enrichment,Greeley, CO January 1995-August 1995 Provided academic advisement and guidance to federal TRIO Student Support Service participants Maintained student record database. Assisted with the compilation of federal reports. Served as liaison to the athletic department and the financial aid office. Assisted in the supervision of peer advisors. Prc a ided technological assistance within the program. Assistant Coordinator,Macintosh Computer Laboratory Student Support Services University of Northern Colorado,Center for Human Enrichment, Greeley,CO 80639 August 1994-December 1994 Supervised, scheduled, evaluated, and trained lab employees. Provided technical assistance and advisement to federal TRIO Student Support Service participants in a learning environment. Maintained and ordered consumable computer supplies. Evaluated and ordered computer software and hardware. RELATED EXPERIENCE Admissions Office Assistant University of Northern Colorado, Admissions Office, Greeley, CO December 1985 -December 1988 Assisted in the daily operations of the UNC Admissions Office. Received and reviewed applications and distributed accordingly. Filed, typed, and performed data-entry on all incoming freshman, transfer, re-entry, and non-traditional students. Trained and supervised co-workstudy employees on office procedures, FERPA, and the CCHE Index system. Provided general information to incoming students and parents. Co-Instructor University of Northern Colorado, Center for Human Enrichment CSPA 359: Paraprofessionals in Student Affairs, Academic Peer Advisors Co-facilitated the instruction for training of peer advisors who advised Student Support Service participants at the Center for Human Enrichment. Coordinated curriculum and instruction for pre-service and on-:oing training for a staff of fifteen peer advisors. Counselor Intern North Colorado Medical Center, Family Recovery Center, Greeley, CO January 1996-July 1996 Facilitated psychotherapy counseling groups and individual counseling for chemically dependent ai I eating disorder patients. Performed case management from admission to discharge. Presented psycho-educational information to patients, family members, and staff. Designed a portfolio brochure distributed to health care and managed care providers. Clinical Care Assistant Weld Mental Health Center, Greeley, CO September 1994 - February 1995 Monitored and supervised the daily activities of chronically mentally ill patients in a learning/self development environment. Facilitated group and individual counseling sessions. Coordinated patient recreational activities. Prepared written and oral reports. Correction Technician The Restitution Center, Greeley, CO February 1989- February 1990 Conducted informal counseling with non-violent felony offenders in a residential setting. Responsible for the supervision of clients. Distributed client medications as prescribed. Performed searches and confiscat,td contraband. Prepared written and oral reports. Instructed clients on self-development and new life :if proaches as alternative methods of coping. PRESENTATIONS • Moderator: "Research & Policy Affecting the Education of the Mexican Child in the 21st Century," University of Northern Colorado. • Moderator: Second Annual McNair Scholars Research Symposium and Graduate Education Conference. • Panelist: Minority Students in Graduate School, Colorado State University. • Presenter: Financing a Graduate Education, Applying to Graduate School, Cultural Sensitivity and Awareness,Hispanic Women in Higher Education, Introduction to the Internet, and Communicating Across Cultures, University of Northern Colorado. • Presenter: Conflict Resolution, Communication Skills, and Setting Limits and Boundaries, North Colorado Medical Center. CAMPUS SERVICE: University of Northern Colorado Officer • Professional and Administrative Staff Council (President's Office) • Co-chairperson, Student Advisory Committee, Hispanic Cultural Center • Secretary, Macintosh Computing Society Member • Undergraduate Research Council • Cesar Chavez Cultural Center Cinco de Mayo Week Committee • Professional Development Award/Scholarship Committee • Relations with UNC Board of Trustees Committee • Sian/ Equity Committee • E (empt Staff Evaluation and Performance Committee • Team UNC Fund Raising Committee • Academic Excellence Week Task Force • Campus Advisory Committee, Cesar Chavez Cultural Center Other • Reviewer/Evaluator for"UNC Works In Progress"conference. • Submitted and published an article in the International Student Services' newsletter entitled, Communicating Across Cultures. PROFESSIONAL AFFILIATIONS • ASPIRE member (Association of Special Programs In Region Eight) • CABE member (Colorado Association of Bilingual Education) • NCEOA member (National Council of Educational Opportunity Associations) HONORS AND AWARDS • Distinguished Alumni, Department of Sociology, University of Northern Colorado • Fellowship, Graduate Study-Rutgers School of Criminal Justice Fellowship, Rutgers State University of New Jersey, Newark, NJ • Scholarship, National Hispanic Scholarship Fund • Scholarship, Candelaria Scholarship, University of Northern Colorado, Greeley, CO PROFESSIONAL DEVELOPMENT AND TRAINING • National McNair Scholars Research Symposium-6th Annual, Penn State, College Park, PA. • National Council of Educational Opportunities Association (NCEOA) Proposal Writing Conference, San Francisco, CA. • Reporting Student and Project Performance, Monterey Bay,CA. • First, Second, and Third Annual Rocky Mountain McNair Scholars' Research Symposium & Graduate Education Conference, Fort Collins,CO. • NCEOA 16th and 17th Annual Policy Seminar, Washington, DC. • NCEOA, Seminar on Relations with the U.S. Department of Education, Washington, DC. • NCEOA Proposal Writing Conference,San Juan,Puerto Rico. • Association of Special Programs in Region Eight(ASPIRE) Colorado Chapter, 1995-1998 State Meetings, Denver, Ft. Collins, CO. • Annual Rocky Mountain Teacher Education Consortium Conference,Greeley,CO. • Diverse Learners Academy, Leadville and Pueblo, CO. • National McNair Scholars Research Symposium, University of California, Irvine, CA. • Parent/Teacher Youth Leadership Conference, Breckenridge, CO. • National Association of Bilingual Education Conferences, Albuquerque,NM and Orlando, FL. • Northern Colorado Hispanic Chamber of Commerce Conference,Greeley, CO. • ASPIRE Regional Conference, Fargo, ND. • National McNair Scholars Research Symposium-4th Annual, Penn State, College Park, PA. • South East Association of Educational Opportunity Programs Conference, Director Training, Asheville, NC. • Cultural Diversity Conference, Greeley, CO. PERSONAL STRENGTHS • Communicate: Ability and extensive experience in communicating with a diverse population. • Counsel: Formally trained to work with a variety of individuals in multiple settings • Leader: Ability to lead individuals and manage environments and situations. REFERENCES Dr. David Gonzalez University of Northern Colorado Division of Professional Psychology, McKee Hall Greeley, CO 80639 (970) 351-1639 Dr. Wendell Osorno University of Northern Colorado Division of Professional Psychology, McKee Hall Greeley, CO 80639 (970) 351-1635 Dollie Zamora Coordiator of Communication Greeley/Evans School District Six 811 15th Street Greeley, CO 80631 PERSONAL- DATA SHEET Identifying Information : Name : Laurence "Larry" P. Kerrigan, Ph . D. Address : 1706 19th Avenue Greeley, CO 80631 DOB: 9/20/32 Phone : ( 3031353-3373 - business Degrees : BSC - Business Economics , from Creighton University , 1954 . MS - Economics , from St . Louis University , St . Louis , Mo . , 1963 . MA - Theology, from St. Mary ' s University, Regis College Campus , Toronto , Ontario , Canada , 1967 . Ph . L. - Philosophy, St. Louis University, St . Louis , Mo . 1960 , ( Ecclesial Degree ) . Ph. D. - California School of Professional Psychology , Berkeley/Alameda Campus , 1971 , Clinical Psycho.._ogy . Currently a licensed psychologist :in the state of Colorado . Educational Background : 1950-54 Creighton University , Business economics , 1954-56 Marquette University, Milwaukee , WI . , Classical studies and ascetical theology , 1956-57 Springhill College , Grand Coteau LA. Campus , Classical studies , 1957-60 St . Louis University , Philosophy and Economics , 1963-67 St . Mary ' s University, Toronto Campus , Theology 1971-74 California School of Professional Psychology , clinical psychology, Berkeley/Alameda Campus Positions Held : 1969-71 Member of Board of Directors , Campion College , Prairie du Chien, WI . 1968-71 Director, Department of Psychology , Campion Col_.ege . 1971-74 Director of Student Counseling Center , Long Mountain College . 1975-80 Director of Short-term Children and Family Team , Weld Mental Health Center , Greeley , CO . 1975-87 Clinical Psychologist , Child and Family Team , Weld Mental Health Center , Greeley , CO . 1975-88 Co-founder of Weld County Child Protection Team, 1987-88 Member of Executive Board , Weld Mental Health Center , Greeley , CO . Honors Received : 1968-69 and Teacher of the year , Campion College . 1970-71 1972-73 Class Representative to Campus Executive Committee , and California School of Professional Psychology 1973-74 Work and Experiential Background : 1959-60 Counselor at Dismas Halfway House for ex-convicts , St . Louis , Missouri , 1960-63 Teacher-counselor-coach , Marquette Prep High School , Milwaukee , WI . 1964-67 Counselor-therapist at Street Haven and Sancta Maria Halfway Houses for women and at the Don ( metro ) Jail in Toronto , Canada. 1967-68 Teacher and Campus Counselor at Creighton University , Omaha, NB . 1968-71 Teacher at Campion College , Prairie du Chien , W . Director of Psychology Department , Department chairman. 1970-71 Director and Staff member of a total envi.ronmen ; for Inter-city boys , late grade school age from Milwaukee , WI . 1971-73 Director of Student Counseling , Lone Mountain College , San Francisco , CA . Teacher at the Lone Mountain College , San Francisco , California. 1973-74 Psychologist Trainee at San Francisco Mental health Center, Richmond District , Outpatient Care . 1974-75 Private Practice , So . Bay Human Services Center , San Diego , CA. Part-time instructor at California School of Professional Psychology , San Diego , CA . 1975-80 Director , Short-'Perm Therapy Team, Children and Family Unit , Weld Mental Health Center , Greeley , • CO . 1980-87 Member of Children and Family Therapy Team, Weld Mental Health Center , Greeley , CO . 1987- present Full time private practice with Joyce Shohet Ackerman , Ed . D . , Licensed Psychologist , Greeley , CO . Part Lime practice aL Weld Mental Health Center , Greeley , CO . Publication : Kerrigan , Laurence 1' . - The Relationship Between Therapist and Client ' s Perceptions of One Therapy Session . Published Doctoral Dir,scrLrrl. ion , Universi.t.y of California Sc boo l of Professional Psychology . Copyright , 1J'14 . Worksliousand !; c i_�l _Training : Since 1974 , I have attended an average of- about three workshops per year . Most of these workshops have presented specialized training in the following areas : Neuro-linguistic trainin , Autogenic and relaxation training , Visualization-Imagery- Hypnosis , Cognitive-Behavioral Therapy , Ericksonian approaches to hypnotherapy and psychotherapy , Family therapy, Strategic family therapy , Sexual abuse , dynamics and applied treatment , Paradoxical intention psychotherapy , and other related areas . In the last fifteen years , I have taught classes and condu ted workshops in the following subjects : The Psychology of Dreams Emotional and Physical Health through Visualization and Imagery Western Psychotherapies and Eastern Ways of Liberation Cognitive and Behavioral Therapy Hypnosis in Pain and Habit Control. The Psychology of Consciousness and Meditation Sherri R. Malloy, Ph.D. Licensed Clinical Psychologist Office: Home: Mental Health Center of Boulder County 24 Alles Drive 1333 Iris Avenue Greeley, Colorado 80631 Boulder, Colorado 80304 (970) 351-7218 (303) 413-6301 Education Ph.D. Double Major: Child Clinical Psychology; Clinical Psychology. August 1993 University of Colorado, Boulder. M.A. Department of Psychology, Clinical Program. University of July 1989 Colorado, Boulder. B.A. Major: Psychology; Minor: Spanish. Arizona State University. May 1987 Summa Cum Laude. Teaching Cert. Roston Montessori Teacher Training Institute. August 1977 Orange, California. Montessori Elementary Education Certificate. Clinical Experience August 1991- Child and Family Psychotherapist, Mental Health Center of Boulder March 1997 County, Boulder, Colorado. Provided outpatient psychotherapy to children and their families. Parent, teacher, and other agency consultation. September 1992- Psychology Intern; Denver General Hospital, Denver, Colorado. August 1993 Outpatient assessment, consultation, and treatment to children, adolescents, and adults; Inpatient treatment to adolescents & their families. Consultation to multidisciplinary hospital staff. Attended regular seminars and case conferences. Completed an additional rotation in neuropsychology. August 1990- Psychotherapist, University of Colorado, Farrand Residence I all. May 1992 Provided individual, conjoint, and group psychotherapy to Farrand residents. Psychiatric consultation to faculty and staff. Presented seminars and workshops to faculty, staff, and students. August 1988- Emergency Psychiatric Services Clinician, Mental Health Cemur August 1992 of Boulder County, Boulder, Colorado. Evaluation and disposition planning for clients with psychiatric emergencies Composed a training manual for emergency psychiatric clinicians 2 Malloy January 1988- Psychotherapy Intern, Raimy Psychology Clinic, May 1992 Department of Psychology, University of Colorado, Boulder. Provided outpatient psychotherapy to adults, families, and children. Parent and teacher consultation. February 1986- Intake Clinician; Group Facilitator, Tri-City Behavioral Health July 1987 Center, Mesa, Arizona. Conducted intakes for the adult team. Facilitator for children's psychotherapy groups. Administrative and Supervisory Experience Jan 1996- Team Leader, Mental Health Center of Boulder County, Boulder. present Colorado. Clinical and administrative supervision of a team of psychologists and psychotherapists. Budgeting. Supervision of support staff. Coordinate outpatient services consultation to point agency programs, including Head Start, Specialized Foster Care Post-Adopt, 1178, School-Based Services, Boulder Day Nursers, anc People's Clinic. August 1990- Adult Team Coordinator, Raimy Psychology Clinic, Department August 1991 of Psychology, University of Colorado. Boulder. Chaired the adult team meetings and case conferences. Assisted clinic director troth administrative tasks. August 1990- Peer Counselor Supervisor, Farrand Residence Hall, University )I May 1991 Colorado, Boulder. Developed and implemented a peer counseling training program. Provided ongoing training and supervision to peer counselors. January 1989- Supervisor in Training, Raimy Psychology Clinic, August 1991 Department of Psychology, University of Colorado, Boulder. Received training and supervision in supervisory techniques. Supervised the psychotherapy of first-year clinical psychology graduate students, June 1989- Adult Team Intake Coordinator, Raimy Psychology Clinic, August 1990 Department of Psychology, University of Colorado, Boulder. Intake and disposition of psychotherapy clients. September 1989- Clinical Supervisor, Emergency Psychiatric Services Team, August 1992 Mental Health Center of Boulder County, Boulder, Colorado. Trained and supervised Masters level student interns in emergency clinical assessment techniques, legal and procedurt,l practices, and psychological report writing. February 1988- Volunteer Trainer, Maslin House for Chronically Mentally III. May 1989 Mental Health Center of Boulder County, Boulder, Colorado. Recruited and trained volunteer college students to work with the chronically mentally ill population at this facility. 3 Malloy Publications December 1994- Columnist: The Boulder County Parent, a monthly publication of the present Parenting Place, Boulder, Colorado. Circulation: 8,000. Topics include child development and parenting concerns. Teaching Experience August 1989- Psychology Instructor, Front Range Community College, May 1992 Boulder Campus, Colorado. Fall 1988 Head Teaching Assistant, Department of Psychology, University of Colorado, Boulder. Trained and supervised graduate level Teaching Assistants. August 1987- Teaching Assistant, Department of Psychology, University of May 1989 Colorado, Boulder. August 1977- Montessori Elementary Teacher, Roston Montessori School, May 1983 Orange, California; and subsequently, Tempe Montessori School, Tempe, Arizona. Taught preschool through second grade classei. Responsibilities included academic program planning and implementation, supervising teacher assistants, conducting paren. teacher conferences, academic record-keeping, and giving educational presentations to parents. August 1976- Student Teacher, Roston Montessori Teacher Training Institute August 1977 Anaheim, California. Taught in a Montessori classroom under the supervision of a certified Montessori teacher. Duties were the same as in the entry above. Presentation Topics and Trainings Given Play Therapy Engaging so-called "resistant" clients Psychotherapy with adolescents and their families Case Conferences Parent-Toddler Attachment Patterns Child Abuse Child Psychopathology Stress Management Workshop Depression and Risk of Suicide in College Students 4 Malloy Research Projects Adult Attachment Style and College Functioning (Doctoral Dissertation), 1992 Parent-Toddler Attachment Relationships (Masters Thesis), 1990 Post-Divorce Visitation Patterns and Parent-Toddler Attachment, 1988 Effects of Divorce on Children, 1987 Mental Health Center Client Satisfaction Study, 1986 Clinical Assessment Trained in the use of the following assessment tools: WISC-I II MMPI Draw-a-Person Kinetic Family Drawing Thematic Apperception Test Rorschach Inkblot Test Sacks Sentence Completion Test Strong-Campbell Interest Inventory Professional Affiliations 1997- present Member: Internal Review Board MHCBC 1996-1997 Member: Professional Advisory Board, Mental Health Center of Boulder County 1991- 1992 Co-Chair: Multi-Ethnic Action Committee, Department of Psychology, University of Colorado, Boulder. 1991- 1993 Member: American Psychological Association, Division 12, Clinical Child Psychology. 1989- 1991 Member: Multi-Ethnic Action Committee, Department of Psychology, University of Colorado, Boulder. 1988- 1989 Student Representative: Department of Clinical Psychology, University of Colorado, Boulder. 1987- 1989 Member: Developmental Psychology Research Group, Department of Psychology, University of Colorado, Boulder. 1987- present Member: (Intermittent) American Psychological Association. 5 Malloy Honors and Awards 1988 Department of Clinical Psychology Scholarship; University of Colorado, Boulder. 1987 Phi Beta Kappa 1987 Academic Scholarship, Arizona State University, Tempe, Arizona. 1986 Phi Kappa Phi Honor Society 1986 Golden Key National Honor Society 1979 West Valley College Track Team, West Valley, California; State Champions. 1977 Fellowship Award; Roston Montessori School, Orange, California. Additional Training Regular participation in bi-monthly seminars, case conferences and supervision held at the Mental Health Center of Boulder County. Readings and professional conferences in the field of clinical psychology. Other Experience 1996-present Vice President (elected), Suburban Ditch Company, Greeley, Colorado. 1983- 1985 Small Business Owner/Operator: Graphicolor, Phoenix, Arizona Photography and advertising design. Commercial and portrait photography, advertising design, sales, supervised salespeople, performed administrative tasks. 1982- 1985 Dance Aerobics Instructor, International Fitness Center, Mesa, Arizona. Choreographed dance routines, taught classes regularly. made public presentations on behalf of the fitness club, and participated in an ongoing certification/training program in exercise physiology and dance choreography. • 6 Malloy Addendum Graduate Coursework: Child Development/Psychopathology Developmental Psychology Developmental Psychopathology Child Psychotherapy Clinical Practicum (six semesters) Theory and Issues in Developmental Psychology Personality/Psychotherapy Advanced Psychopathology Advanced Personality Theory Clinical Study of the Individual Adult Psychotherapy Family Research and Therapy Research Methodology/Statistics General Statistics (two semesters) Research Practicum (four semesters) Research Problems in Clinical Psychology Assessment Projective Testing Objective Testing Courses for Distributed Minor Multicultural Psychology Community Mental Health Marriage and Family Counseling Behavioral Neuroscience: Clinical and Pathological Perspective Nicole Warnygora 3200 Azalea Drive # K-4 Fort Collins, Colorado 80526 (970) 407-1578 Education Master of Arts Agency Counseling: Marriage and Family Therapy August 9, 1998 University of Northern Colorado, Greeley, Colorado, G.P.A. 4.0/4.0 Bachelors of Arts Major: Psychology Minor: Political Science May 23, 1993 Augsburg College, Minneapolis, Minnesota, G.P.A. 3.5/4.0 Experience Mental Health Therapist North Range Behavioral Health, Carson Children's Center/Children's Acute Treatment Unit. Greeley, Colorado • Provided individual therapy to children in a day treatment program • Provided family therapy to the children and families • Facilitated a children's group • Evaluated, diagnosed, and created treatment plans for children • Consulted with parents, teachers, psychiatrist, social worker, and the courts to ensure quality and continuity of care • Collaborated with teachers, parents, and social workers, to enable the child to have .a successful transition to public school Test Supervisor Career Services Center, University of Northern Colorado, Greeley, Colorado (8/95 - Present p • Coordinated national testing program including administration of the ACT, SAT, and GRF • Trained, hired and supervised testing personnel Child and Family Therapist Intern North Range Behavioral Health, Greeley, Colorado (1/97 — 6/97) • Provided individual therapy to children, and provided family therapy • Facilitated a children's group for clients in a day treatment program • Evaluated, diagnosed, and created treatment plans for a variety of children • Consulted with parents, teachers, social workers, and the courts to insure quality and continuity in client care and treatment • Provided services to a diverse population including deaf clients Childcare Relief Worker Families First, Aurora, Colorado (2/96— 10/97) • Created a safe environment for children ages 3 -12 who were removed from parental homes • Responded, assessed and made referrals for crisis phone calls • Facilitated group discussion for children at the crisis center • Monitored parental phone calls and visits to ensure safety for the children Nicole Warnygora, Page 2 Habilitation Counselor/ Program Coordinator Paragon Services Incorporated, Duluth, Minnesota (1/94 - 8/95) •Developed programs to assist dual diagnosis clients achieve independence • Supported families with children with emotional disturbances or developmental disabilities and were at risk for out of home placement • Supervised and trained staff • Coordinated services to provide consistency between service providers Program Coordinator Nekton Services Incorporated, Duluth, Minnesota (7/93 - 12/93) • Coordinated the set-up of a group home for three autistic young women • Developed program plans and daily activities • Supervised, coordinated, scheduled, and trained staff • Designed a training manual and trained staff personnel in functional American Sign Language Family Counselor Intern Minneapolis Crisis Nursery, Minneapolis, Minnesota (9/92 - 5/93) • Responded, assessed and made referrals for crisis phone calls • Performed short-term personal counseling with parents • Provided behavioral assessments and programs for children in the homes of clients Program Counselor/Program Coordinator Dungarvin Alternative Services Inc., Saint Paul, Minnesota (9/91 - 7/93) • Coordinated client assessments with the interdisciplinary team • Completed behavior analysis for the purpose of program development • Developed and implemented programs for children who were developmentally disabled and emotionally disturbed in their home environment Counselor Day Care Systems Incorporated, Superior, Wisconsin (Summers 1988, '89, '90, &'91 • Responsible for the care of three children with autism • Implemented programs during the summer to provide fun for the children Volunteer Kindergarten Teacher, Saint Paul's Church, Duluth, Minnesota Tutor, Minneapolis, South High School Tutor, Multi-Cultural Center, Augsburg College, Minneapolis, Minnesota Honors & Award for Excellent Student Employee, Career Services, University of Northern Colorado 1996 Activities Non— Resident Scholarship for Academic Excellence, 1996 Weld County United Way Special Needs Child Care Committee, 1999 SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS OF APPROVAL vie Ackerman and Associates, P.C. 1750 25th Avenue, Suite 101 Greeley, Colorado 80634 (970)353-3373 fax(970)353-3374 May 20, 2000 Weld County Department of Social Services Attn: Judy Griego PC) Box A Greeley, CO 80632 Dear Judy, This letter is in response to your letter of May 10, 2000, concerning recommendations and/or conditions of our bids. I have discussed these with Frank Aaron and have incorporated clarification to these recommendations and conditions at his suggestion. Concerning: 1 . RFP 006-00 Foster Parent Consultation: We accept the condition that we will notify WCDSS a minimum of 30 days in advance if we anticipate over expenditure of the $40,000.00 allocated 2. RFP 00008#1 Family Group Decision Making: We accept the condition that the food allowance is for EPP referrals only. 3. RFP 00008#2 Goal Achievement Program (GAP) Intensive Family therapy: We accept without conditions or recommendations. 4. RFP 00008#3 Mediated Conflict Resolution. Intensive Family therapy: We accept the condition that referrals will be issued initially for one therapist. We will request a new referral if a second therapist is needed. 5. RFP #00010 Option B We accept the recommendation that time spent with the family will be limited to four hours per week. (If no progress is being made, we will do everything possible to limit the duration to 30 hours and transition the client to other services.) If progress is being made, we will continue at a "step-down" level to a maximum of 60 hours and will provide a treatment report summary for WCDSS. (If at 60 hours a small number of families require limited extra services, it will be up to 15 hours at a time.) 6. RFP #00007 Sex Abuse Treatment We accept the recommendation that a goal of Part A,B, and C, is to serve no more than six months. Part D, maintenance, is however intended to provide up to ten hours over no less than four months to maintain skills for safety. Maintenance up to one year is often necessary when sexual abuse has occurred. Sincerely, Joyce Shohet Ackerman, Ed.D. Licensed Psychologist JSA/cs • h t.. <, DEPARTMENT OF SOCIAL SERVICES PO BOX A GRE LEY,CO35 80532 Administration and Public Assistance(970)352-1561 • Child Support(970)352-8933 COLORADO May 10, 2000 Ms. Joyce Ackerman, Ed. D. Ackerman and Associates, P.C. 1750 25 Avenue Suite 101 Greeley CO 80631 Re: RFP 006-00 Foster Parent Consultation RFP 00008 #1 Family Group Decision Making-Intensive Family Therapy RFP 00008 #2 Goal Achievement Program-Intensive Family Therapy RFP 00008 #3 Family Conflict Resolution-Intensive Family Therapy RFP 00010 Option B RFP 00007 Sex Abuse Treatment Dear Ms. Ackerman: The purpose of this letter is to outline the results of the RFP Bid process for PY 2000-2001 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 �.he following recommendations and/or conditions regarding your RFP bid(s). 1. RFP 006-00, Foster Parent Consultation: Condition: The Department of Social Services shall be notified a minimum or 30 days prior to over expenditure. The budget for PY 2000-2001, June 1, 2000, through May 31, 2001, is $40,000. 2. RFP 00008 #1, Family Group Decision Making, Intensive Family Therapy: Condition: Food allowance will he paid for EPP referrals to Family Group Decision Making(FGDM); however, there will be no food allowance paid under Core Services referrals. Page 2 Ackerman and Associates, P.C. Results of RFP Bid Process for PY 2000-2001 3. RFP 00008 #2, Goal Achievement Program (G.A.P.), Intensive Family Therapy: Approved with no conditions or recommendations. 4. RFP 00008 #3, Mediated Family Conflict Resolution, Intensive Family Therapy Condition: Referrals will be issued initially for one therapist. A new referral will be needed for assignment of two therapists. 5. RFP 00010, Option B Recommendation: The time spent with the family will be limited to four hours, rather than six. Step-down can be used for ongoing services. Everything possibh must be done to limit the duration to 30 hours and transition the client to other services. 6. RFP 00007, Sex Abuse Treatment Recommendation: The program goal is to serve no more than six months. Any change from this must be explained in the case plan and limited to that duration B. Required Response by FYC Bidders Concerning FYC Commission Recommendations and Conditions 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: 1. FYC Commission Recommendations: You are requested to review the FYC Commission recommendations and to: a. accept the recommendation(s) as written by the FYC Commission; or b. request alternatives to the FYC Commission's recommendaticn(sl; or c. not accept the recommendation(s) of the FYC Commission. Please provide in writing how you will incorporate the recommendation(.) into your bid. If you do not accept the recommendation, please prov ide written reasons why. All approved recommendations under the NOF AA will be monitored and evaluated by the FYC Commission. Pave 3 Ackerman and Associates, P.C. Results of RFP Bid Process for PY 2000-2001 2. FYC Commission Conditions: All conditions will be incorporated as part of your RFP Bid and Notification of Financial Assistance Award (NOFAA). If you do not accept the condition(s) you will not be authorized as a vendor unless your mitigating circumstances arc accepted by the FYC Commission and the Weld County Department of Social Services. If you do not accept the condition, you must provide in writing reasons why. A meeting will be arranged to discuss your response. Your response to the above conditions will be incorporated in the RFP Bid and Notification of Financial Assistance Award. If you wish to arrange a meeting to discuss the above conditions and/or recommendations, please do so through Elaine Furister, 352.1551, extension 6295, and one will be arranged prior to Wednesday, May 24, 2000. Sincerely, L.11, py A. riego, Di ctor cc: Esteban Salazar, Chair, FYC Commi ion Frank Aaron, Social Services Administrator JG:ef 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 FY00-PAC-17000 Revision (RFP-FYC-00008) Contract Award Period Name and Address of Contractor Beginning 06/01/2000 and Ackerman and Associates P.C. Ending_ 05/31/2001 Intensive Family Therapy-Goal Achievement Program (GAP) Greeley, CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Improve both individual and family Award is based upon your Request for Proposal (REP). functioning through in-home and in-office The RFP specifies the scope of services and conditions services. The program has a capacity of 14 of award. Except where it is in corflict with this families per month. This is approximately 20 NOFAA in which case the NOFAA governs. the REP hours face-to-face meetings per month. At upon which this award is based is an integral part of the each meeting one therapist is present. action. The modality of treatment is a short-term solution focused treatment. Special conditions Cost Per Unit of Service 1) Reimbursement for the Unit of Services will be based on a hourly rate per child or per family Hourly Rate Per $99.50 2) The hourly rate will be paid for only direct lace to lace Unit of Service Based on Approved Plan contact with the child and/or family, as evidenced by client-signed verification form, and as :pee ified in the unit of cost computation. Enclosures: 3) Unit of service costs cannot exceed the monthly and X Signed RFP:Exhibit A yearly cost per child and/or family. Supplemental Narrative to RFP: Exhibit B 4) Payment will only be remitted on cases with, and Recommendation(s) referrals made by the Weld County Department of Social Services. Conditions of Approval 5) Requests for payment must be an original submitted to the Weld County Department of Social Sen ices by the end of the 25th 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. Appro Is: Program Official: U By / y- arbara J. Kirkmeyer, Chair Judy 9f. Grieg hector Board of Weld County Commissioners Weld County Department of Social Servicer Date: a -.2G -.20oo Date: 0 OCR SIGNED RFP EXHIBIT A INVITATION TO BID DATE:February 28, 2000 BID NO: RFP-FYC-00008 RETURN BID TO: Pat Persichino, Director of General Services • 8 �) 915 10th Street, P.O. Box 758, Greeley, CO 80632 bna.c SUMMARY Request for Proposal (RFP-FYC-00008) for:Family Preservation Program--Intensive Family Thera Program Family Issues Cash Fund or Family Preservation Program Funds Deadline: March 23, 2000,Tuesday, 10:00 a.m. The Placement Alternatives Commission, an advisory commission to the Weld County Department of Social Services, announces that competing applications will be accepted for approved vendors pursuant to the Board of Weld County Commissioners authority under the Statewide Family Preservation Program (C.R.S. 26-5.5- 101) and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement (C.R.S. 26-5.3-101). The Placement Alternatives 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 Intensive Family Therapy Program must provide for therapeutic intervention through one or more qualified family therapists, typically with all family members, to improve family communication, function, and relationships. 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 -2C% - Cl C1.. ``co �\)ar�� t�kra : . � �)) (After receipt of order) BID UST`BE SIGNED IN INK _Joyce Shohet Ackerman Ed.D. TYPED OR PRINTED SIGNATURE ACKERMAN & ASSOCIATES P.C. VENDOR !� (Name) Han writ n Signature By Authorized Officer or Agent of Vender 1750 25th Avenue Suite 101 President ADDRESS TITLE_ Greeley, Colorado 80634 DATE 3 -mac ' a c, PHONE #! 970-353-3373 (353-3374 fax) The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 RFP-FYC-00008 , 7 Attached A E (-cox Cl clC uz ,� . �rC' /c& �_ Date of Meeting(s) with Social Services Division Supervisor: 'C n. Comments by SSD Supervisor: B LL�2 '} CA S' (Gz �� Y� 4, 't ( ( -t.Yf Mfr"Li tl �tir , e it ,, t w °`�- kic n / �e�" rp� t-� C. 'Y� :. 1.1 - iC-d;, P `+ ` (i t�aLt �C `t�C.(4.i �y I �" Jt . ,� _�) — L Lee 3 - 8 vc, Name and Signature of SSD Supervisor Date 71/ Page 27 of 32 RFP-FYC-00008 Attached A Program Category Intensive Family Therapy Program Bid Category Project Title The Goal Achievement Program Vendor Ackerman & Associates P.C. PROJECT DESCRIPTION Provide a brief one-page description of the project. II. TARGET/ELIGIBILITY POPULATIONS Provide a one-page brief description of the proposed target/eligibility populations. At a minimum your description must address: A. Total number of clients to be served. B. Total individual clients 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, Sub-total of individuals who will have access to 24 hour services. G. The monthly maximum program capacity. H. The monthly average capacity. 1. Average stay in the program (weeks). J. 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. Address if your project will provide the service minimums as follows: A. Comprehensive, diagnostic and treatment planning with the family and other service providers. B. Therapeutic intervention with flexibility to bring in other services, if needed. C. Co-facilitated therapeutic services provided by one or more qualified family therapists. D. Therapy that is designed to resolve conflicts and disagreement within the family, contributing to child maltreatment, running away, and to the behavior constituting status offenses. 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 PAC 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 measurable outcomes for each area as described below: Page 28 of 32 RFP-FYC-00008 Attached A A. Children receiving services do not go into placement. B. Families remain intact. C. Reunification of children with families. D. Improvements in parental competency, parent/child conflict management as determined or measured by pre and post placement functional tests. E. More cost efficient services through the Intensive Family Therapy Program than the placement of the child. F. Therapeutic outcomes include fundamental changes in the family functioning and dynamics. 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 Family Conflict Management -Mediation and counseling designed to resolve conflicts and disagreement within the family contributing to child maltreatment, running away and other offenses. B. Improve Parental Competency- capacity of parents to maintain sound relationships with their children and provide care, nutrition,hygiene, discipline, protection, instructions, and supervision. 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 work load standards and quantitative measures Address, at a minimum, the following areas: A. Number of hours per day, week or month. B. Number of individuals providing the services. C. Maximum caseload per worker. (Generally 12 families per worker. Eight to 10 families per worker if the worker provides case management services to the families on the caseload.) I). Modality of treatment Total number of hours per day/week/month (Minimum average of two hours of service per family per week. F. Total number of individuals providing these services. G. The maximum caseload per supervisor. (Minimum of 6 workers per supervisor.) H. Insurance. Page 29 of 32 RFP-FYC-00008 Attached A VII. STAFF QUALIFICATIONS Provide a one-page description of staff qualifications and address, at a minimum, the following: A. Will your staff who are providing direct services have the minimum qualifications in education and experience. Describe. B. Total number of staff available for the project. C.. Will staff have expertise in family therapy as demonstrated by specialized training, workshops and experience. I). Will staff have a minimum of eight hours per year of continuing education; i.e. courses, workshops, and/or review of literature to be documented by county. E. Will staff have a minimum of one hour per week of clinical supervision provided by someone with advanced skills in Intensive Family Therapy. F. Will the clinical supervisor(s)be involved in regular training to keep current in state-of-the-art counseling modalities and findings. Page 30 of 32 Project Description 2000-2001 The Goal Achievement Program Overview:Ackerman and Associates P.C. proposed in 1996 to use a time limited, solution focused therapy model. Its original purpose was to assist in the implementation of Family Service Plan, court ordered care plans and to assist in implementing the results of mediation. We called this the Goal Achievement Program or GAP. We propose to continue this program in 2000- 2001 with a number of modifications. Our past program was too time limited and its use was restricted to only a small number of cases. The proposal presented here is revised to better meet the needs for a clearly time limited intensive treatment model for families resisting implementing their treatment objectives. Discussion with social services has suggested that a 15-20 hour intensive therapy model based on the GAP concepts we have used over the past four years will be more cost effective in helping to reduce use of more expensive longer term treatment modalities such as home based treatment. A progress assessment called the Family Implementation Report will document what has been achieved and what may still be needed for the families in the program. In this way WCDSS will be able to better plan for resources needed for individuals undergoing any further treatment after the GAP program. We will strive to clearly demarcate the specific situation that brought the family into treatment with social services from more general areas for psychological improvement in these families. The purpose of this highly structured time limited system is to enable family members to implement their own care plans to succeed in avoiding out of home placement. Families needing the GAP program are either imminently at risk of outplacement need to be reunified or face imminent reunification failure and have failed or are failing to implement the behaviors required of them. The model provides up to 20 hours of solution focused therapy over no more than a five month period. Further cost savings are achieved through fee reduction for group services. Pvroose: The purpose of the time limited, solution focused therapy is to implement the short term changes needed to either prevent placement of reunify the family. Clearly defined, achievable, structured behavioral changes are responsive to short term therapy because they have a very clear focus and do not necessarily require resolution of underlying personality factors to succeed. Although such long term personality style change may well improve the health of the individual and the family, achievement of long term change is not necessarily a prerequisite to reunification or prevention of placement. As long as functionality of the family in relation to the safety of the child can be restored and the child is protected within the umbrella of the child protection statutes, the goals of the GAP program can be achieved. 1 The GAP program will create a time limited therapeutic environment for the family to establish a process of change. The GAP program is the place where the implementation of the goals set out for this family can be achieved if the family is making poor progress in their own attempts to move forward. We anticipate four types of referrals. Area One - For Implementation of the Family Service Plan or a court ordered plan A Family Service Plan is created for every family at Social Services. The FSP is expected to assist them to change in a way that is in the best interests of the child, avoids placement or achieves reunification. Unfortunately, the family level of acceptance and implementation of the Family Service Plan is often less than ideal. Those who fail to adequately implement their FSP are thus likely to remain a status where out of home intervention is ongoing and appropriate. Families who are failing to implement their family service plan are appropriate for GAP referral. When the court has ordered a care plan for a family, there is likely a perception of diminished control on the part of the parents. The court has told the family what to do. This does not mean that the family has accepted what it must do. Nor does it mean that the family has the psychological skills to achieve the goals the court has set. Even when the family sincerely embraces the court's requirements, they may, at least psychologically, only have a vague or general sense how to do it. Such families are also appropriate for GAP referral Elimination of these psychological barriers can be achieved through solution focused therapy by enhancing the level of control the family has in achieving the goals of the plan. In families that are resisting intervention by social services and are about to enter (or reenter) foster placement, short term therapy would focus on the implementation of the care plan goals. A major objective of the therapy is to build a sense of ownership in the solutions achieved. If foster placement is necessary, this model should shorten the length of foster placement. The therapy of reunification would focus on the implementation of goals that specify what behaviors need to be achieved to reunify the family. If the family treatment proceeds rapidly, the cost of that placement should be minimized. Area two: Use of the Goal Achievement Program may reduce entry into more extensive and expensive treatment. Use of GAP as a time limited plan to precede more intensive therapy is a useful cost saving strategy. Some families may succeed in treatment in this shorter term model if it is applied early in the process and thus have need for less services over time in longer term programs such as Home Based or Day Treatment. We anticipate those families can be identified by having a discrete and well quantified set of goals they need to achieve to meet Social Services requirements for the protection of the child. Area Three: Family specific caseworker referrals. Other situations will occur in 2 relation to specific families and will become known to the caseworker who will refer to GAP for short term treatment in relation to child protection. Some aspects of this may include specific parental attitudes toward discipline, religious beliefs about corporal punishment, short term issues related to discipline in the parents own upbringing or other issues. Area Four GAP m-y reduce renewals for more expensive forms of treatment. Use of this time limited model may reduce the need for renewal for longer based and more expensive programs such as Option B. The new rules for this contract cycle require that all clients at the end of their program treatment will exit with clear continuing objectives for treatment if further treatment is needed to protect the child. GAP is a logical lower cost program for this situation to implement these remaining psychological changes and life skills programs are appropriate for acquisition of specific skills needed. The GAP program will help the family define its role in how the plan will be implemented. Since they must be the ones to change, a short term focused treatment model will assist them to accept that requirement and to determine how this will work in their particular case. GAP is intended as an early intervention tool ( Areas one, two and three) or as a final program (Area four) after a prior program has achieved a partial success, but has not remedied all safety concerns and does not justify a full renewal of that treatment model. The therapeutic role provided through the GAP program is first one of achieving psychological acceptance of the care plan. What are the ways the family will decide to change to meet the requirements of the Court or Social Services in the shortest possible time? Finding the answers to this question is the overall purpose of the short term therapy. From this point the family can return to direct caseworker supervision. If they continue to fail to implement the plan they would be able to return to GAP for more focused work on what they will do only if in the opinion of the caseworker and the supervisor as well as the treating therapist this would be an appropriate treatment protocol. Some should be able to step down to a life skill support program for a specific area of difficulty. Design: The time limited, solution focused therapy consists of fifteen to twenty hours of therapy in a period of five months. The structure of how the therapy is arranged is variable. For purposes of the bid it is projected as weekly therapy over twenty weeks. However, the providers can structure this time to be more concentrated if needed. The key design feature is to achieve implementation of the goals that are developed for the family. Whether those goals were developed through mediation, the Family Service Plan, the court ordered care plan or refined in the first few sessions of the GAP referral, progress should be evident by the tenth hour of treatment. In addition to monthly reports, a treatment summary will be prepared after the tenth session and 3 forwarded to social services. The treatment summary at the tenth session is the basis for seeking a program renewal if it is deemed clinically appropriate. However, we anticipate the need for renewal to be unlikely to be clinically appropriate in this model of treatment. The GAP program will seek to enhance the adoption by the participant of objectives set forth by Social Services or the Courts by moving from an adversarial to a problem solving/therapeutic model of interaction. The therapeutic needs of the diversity of families requires some clinical flexibility on the part of the therapists in scheduling. Scheduling also needs to be done considering other criteria, particularly cost effectiveness. Families needing reunification will be on a faster track (if it is clinically appropriate) since the judicious reduction of foster placement time is quite cost effective. Delivery of services may be either in the family home or in the office setting. As currently envisioned the program will be a combination of individual and family sessions coupled with group treatment modalities for treating issues in common across families - such as parenting skills, being a teen, women's issues, assertiveness, communications. Group services are at a reduced fee of 50% of individual/family sessions and are based on any number of the family participating in the group for the same fee as one participant from the family. A group consists of clients from two or more cases. Other Considerations: Since intensive inpatient treatment programs and more expensive Home Based treatment programs have been a major source of the expenditure of Social Services funds locally, including the GAP program as a less expensive goal focused short term model is appropriate. The evaluation at the end of the fifteen to 20 hours called hereafter the FAMILY'S IMPLEMENTATION REPORT will specify any unresolved issues in cases where further treatment is needed. There is no risk of the program running up excessive costs for any one family because of the time limited session model. The program does not seek renewals for a second round of treatment unless this is the lowest cost option appropriate for achieving success as determined by the case worker and supervisor. The families and the caseworker will evaluate if further treatment is needed at the end of the GAP process by reviewing with the therapist the FAMILY'S IMPLEMENTATION REPORT the family produces at the completion of the GAP process. Individuals needing further treatment after GAP should be placed in other programs in the community if they are likely to eventually succeed or should graduate to a less intense program in a closely monitored follow up for specific life skill support specified in the Family's Implementation Report produced through this process. Only rarely should they return to the GAP program. This will only be when there is a clearly achievable objective to meet in a few additional sessions. 4 We structured this treatment approach to have a maximum cost of $1950 per family to be cost effective and in some cases a more useful intermediate step before placement in more costly treatment for appropriate referrals. Referrals have been stable over the past several years at about one family per month for our initial shorter term program, but should increase as this provides a lower cost option than home based treatment in a manner that is not open ended or likely to become long term psychotherapy. The program is very easily measured because it will always have a clear starting point for each family. The strategy to operationally adapt or individually tailor the requirements of social services or the courts to the families specific needs or dynamics will define the level of success achieved in complying with the goals of therapy. Resolved and unresolved issues will be stated in the Family Implementation Plan for each family and sent to the caseworker at the conclusion of up to the 15 to 20 sessions of treatment. Finally, this program appears to have filled a need for the Weld County Department of Social Services on at least two levels. First, based on discussions we have had with our supervisors, the GAP program appears to fill a gap that truly exists in the continuum of care for families that meet the PAC criteria. Second, this is a lower cost intervention design which may be cost efficient in avoiding more expensive alternatives to placement. Target/Eligibility Populations A. Total number of clients to be served in this twelve month program has been calculated as follows. Three families per month times twelve months equals thirty-six families per year. If we assume a family size of five, two adults and three children, then the total client pool to be served is 180 individuals. That number includes at least 36 individuals who face either imminent outplacement or need reunification. These calculations make an assumption of a relatively even distribution between the three groups. We have the capacity to serve more than this number if demand for the services is there. We projected our maximum capacity for last year as forty eight families and expected 36 families to be served. The number of families we served was closer to one third of the expected total. However, we would expect the totals to rise next year as the program becomes better known and understood. Our projected total for 2000 -2001 is 36 families. B. Distribution of clients. Total number of clients we will serve is approximately 180 as calculated above. We would expect approximately 72 of these would be adult members of the family and approximately 108 would be minors. We estimate that they would be distributed across the age range from 1 to 17. The older children would most likely be teenagers in conflict with their family most often concerning issues related to their maturation into adults. The younger group will consist of children of no 5 particularly predictable age whose parents are in conflict usually in relation to instability in the marriage, neglect or abuse. Neglect or abuse may be present in either group. C. Families Served. We anticipate serving thirty-six family units. This estimate reflects the changes in the program to better meet the needs of Social Services. D. Sub total who will receive bicultural/bilingual services. We anticipate we can serve twenty-five percent or more of the total referred in a bilingual manner. All of the staff have extensive cross cultural experience. We have a member of the staff, Emily Jaramillo-Bansberg, M.A. , who is a master's level clinical psychotherapist fluent in Spanish. She is also Hispanic. She has specific training in solution focused therapy and specializes in working with children, teenagers and families. Joyce Ackerman, Ed.D. has spent several years working in American Indian reservation populations. Larry Kerrigan, Ph.D., has more than twenty years experience as a therapist in Greeley working with the Hispanic population through the Weld Mental Health Center and Susan Bromley, Psy.D., is both a social worker and a psychologist with extensive experience training students in cross cultural sensitivity. Where there is a very young child, Sherri Malloy (Gonzales), Ph.D.. who has bicultural experience at the Boulder Mental Health Center can use a brief play therapy session to demonstrate to the parents the impact of the family disruption of the younger children. Nicole Warnygora, M.A., L.P.C. and Karen Bender, M.A., L.P.C also have clinical experience with bicultural families. E. We can provide services in South County if Social Services can provide a site to do such work. F._Accessibility. On weekdays, all providers of Ackerman and Associates are accessible through our office secretary and through cell phones and pagers. After hours we maintain a 24 hour answering service and pager system. On weekends, this 24 hour access reaches the provider on call who is always a licensed Mental Health provider. We also provide Saturday sessions. G. Maximum per month. The program maximum is fourteen families per month. H. The monthly average capacity is seven families per month. I. The average stay. in the program is expected to be 15 hours over a four month period. The maximum stay is 20 hours over a five month period. Scheduling would be flexible and would attempt to maximize effective treatment in terms of achieving the best avoidance of placement or the most efficient return from placement. Group treatment would be used at a rate of one half of the proposed rate of this bid so each hour of group treatment would be equivalent to one half hour of individual treatment 6 Types of Services Provided We propose to provide up to a maximum of 20 hours of short term solution focused treatment. We would use a flexible scheduling model which would allow the therapist clinical judgment in meeting the needs of the family and maximizing the cost effectiveness of the treatment. During the first two sessions, specific goals will be identified and shared with the caseworker. Development of the Family Implementation Report would begin at the first session and progress will be documented by the last session of the GAP program. For all families, the last session will be the summation and evaluation session to review the Family Implementation Report. (For those families that terminate without notification, the therapist will write an end of treatment summary which will serve as a summation and therapeutic recommendations to the caseworker.) The final session explicitly summarizes for the family what they have achieved and what they need to continue to work on. It also creates a structured record in the same format for all families so the program can be evaluated on how well it succeeded in helping implement specific changes that correlate with accelerated reunification or are associated with avoiding placement. In terms of the criteria for the PAC process: A. Comprehensiveness: Solution focused therapy does not attempt to provide a comprehensive assessment or diagnosis of the family in a traditional psychotherapeutic model. It focuses the family on rapidly achievable solutions to the problems related to either their mediation contract, their Family Service Plan or their court ordered care plan. We would require that the referred families have their Family Service Plans and their court ordered plans as applicable shared with the program at the time of referral. B. Access to other services: The purpose of short term therapy is to explicitly solve problems and lower barriers to achievement of the care plan. If the solution to a concern involves the referral to other services the caseworker will be notified at or before the conclusion of treatment and that service can be arranged for the family if they have not done so themselves. C. Consultation: Because there will be seven providers of short term focused therapy in the same group, each provider will have the opportunity to consult with other providers in Ackerman and Associates of similar services. We will use a consultation 7 mechanism which preserves client anonymity. The therapy sessions will be conducted by a single provider. D. Conflict Resolution: This GAP process is amenable to conflict resolution assuming conflict reduction is one of the goals that needs to be achieved by the family. Cognitive behavioral and other techniques are used to clarify issues in dispute which cause psychological distress. From that point strategies are developed to resolve those issues. The creation of an outcome document (The Family Implementation Report) documents the points of action taken in relation to improving the family functioning in relation to the conflict (issue of child protection) that brought them into the Social Services system. Measurable outcomes are of two varieties. One type is termed formative outcomes and the other type is called summative outcomes. Formative outcomes measure how the program is proceeding while the treatment takes place. Summative outcomes are the results of the treatment. In terms of formative measures we have the following... 1. Did the family follow through with the referral from their caseworker? 2. Did the family attend the sessions that were scheduled? 3. Did the family need all possible hours allowed? 4, Did the family complete the FAMILY's IMPLEMENTATION REPORT portion of the program or was it completed by the therapist? We expect a 100% follow through for contacting us. This data will be based on a comparison of referral documents received compared to the record of appointments of the family. We expect 95% to attend a first session, 95% to attend a second or further session. We expect that 90% will complete five or more sessions. We expect 80% to complete the Family Implementation Report. Summative outcomes A The child receiving services does not go into placement. At the final session (or in the therapists summary) the length of time between the referral to the end of treatment will be recorded. We expect 85% of the index children referred to avoid placement. B. Families remain intact. Physically intact means the child remained or returned to the parents residence as specified in the treatment plans. We expect 70% of the families referred to remain physically intact and an additional 20% to remain psychologically intact (placed with a relative) as a result of this model. In our experience psychological intactness is usually accompanied by less formal care relationships than foster care such as living with other relatives who were previously 8 not willing to assist. C. Reunification of children with their families. Short term GAP therapy should be very amenable for the reunification of families because the family will have a Family Service Plan, a court ordered plan or a specific goal designed with the caseworker. The nature of the therapy will keep these goals focused before the family. We would expect reunification therapy to be more intense in terms of being done over a shorter time frame. We would measure the length of time between initiation of short term therapy and the reunification in these cases. We expect that 70% of the families will be reunified by this process. D. Improvement in parental competency and parent child conflict management are expected to occur in all families who complete treatment. The persistence of these changes can be measured by self report or later follow up if funded. The areas for further measurement at a later time would be derived from the Family's Implementation Report. Parental competency questions will be linked to the treatment plans. Did the families achieve the behaviors needed to meet the goals of the treatment plan during the therapy process? E. Cost effectiveness. The program is expected to be cost effective. The cost of this program is projected at a maximum of $1990 per family for 20 treatment hours. On the average 15 hours of treatment would cost $1492.50. Cost per individual or family treatment hour would be $99.50. Cost for group treatment would be $49.75 per session hour regardless of the number of family members attending Use of group time would not extend the twenty hour maximum as the maximum cost is capped at $1990 per case. Of course, treatment time may prove to be shorter than the projected fifteen hour average. If outplacement ( foster care at $450 per month) is shortened by three to four months or reunification accelerated by three to four months the program pays for itself. Further, if any patients can use this program as an alternative to either inpatient or day treatment programs or home based programs by using our intensive outpatient approach, cost effectiveness increases substantially as a lower cost program is replacing a higher priced program to achieve the same result. Also use of this program for finishing treatment after another program rather than a full renewal to another more expensive program would be cost effective. F. Does this program produce fundamental change in family dynamics? The process of solution focused therapy has the family define the behavioral goals for itself early in the process. At the last session these goals will be listed and the family will report 1) if that goal has been met and 2) if they think the change is likely to last for more than two months from that date. Item two provides a benchmark for evaluation of ongoing behavioral change. While the program is not focused on fundamental change it does provide a model for successful problem solving and 9 learned problem solving skills interpersonal and negotiation skills are important as tools for producing fundamental change in the family. Service objectives We have the following service objectives: A Improvement of family conflict management. The goals of family conflict management and preventing conflict which places the child imminently at risk are expected to be one of the goals most families will need to work on during the GAP program. B. Improved parental competency in PAC sponsored programs seems to center on each parent developing more age appropriate and family system appropriate strategies to prevent situations from reoccurring that again need Social Services intervention. In dealing with conflicts with their child especially with teenagers, the areas of discipline, protection, instruction and supervision often need examination and practice to attain sustainable solutions. With younger children, the therapy gives the parents the opportunity to implement and better define the roles each parent expects of the other. Those parental behavioral goals specified in the referral from the caseworker to the GAP program will be the ones worked on. Thus.we help achieve goals that increase parental competency. C. The ability of the family to access resources is a strength of the short term therapy model. Short term therapy has one of its origins in programs designed to assist employees which is called the employee assistance plan or EAP model. EAP services specialize in directing people to the resources they need to solve a specific problem, using a very focused approach. The services recommended are determined by the explicit problems presented and what has caused those problems. Determination of additional services needed is a standard portion of short-term therapy. This needs to take place within the framework of the referral. It is necessary to balance the need for immediate solutions, to protect the child, with the desire for optimal improvement in trying to solve all current and future issues for the family. Usually in the first session, goals are clarified. In the subsequent sessions resources are specified that are needed to help reach those goals. The methods used to document the service objectives will be a comparison of the stated goals of the treatment plan with the summative evaluation completed in the last session. For the project we will report on the type of goals and how well they were achieved using this short term treatment model, the numbers of children who were reunited or avoided placement, and the other summative criteria listed under measurable objectives. 10 Workload Standards A. The program has a capacity of 14 families per month. We anticipate an average of seven. This is approximately a maximum of 70 hours of face to face meetings per month. At each meeting, one therapist is present. This represents 840 hours of therapist time per year. At our rate of$99.50 per hour the cost maximum is $83,580 per year. The monthly maximum is $6965 if no more than fourteen per month are in the program at any time, and no more than five hours per month of client time per family is used. B and C. There are seven providers/four licensed psychologists, two professional counselors and a bilingual master's level therapist who will provide these services. AIN have specific training in short term solution focused care treatment. All have work experience as providers who have used this model in treatment. D. The modality of treatment is a short term solution focused treatment. E. Hours/month The total number of therapist hours is 70 per month or 840 per year. F. Staff There are seven individual providers supported by two administrative professionals in the practice. G. Supervisor This contract would be supervised by Joyce Shohet Ackerman, Ed.D.. who would monitor the project for compliance. Providers are individually licensed and do not require clinical supervision except for one therapist who is being supervised by a licensed psychologist in the practice. H Insurance All providers carry one million/three million liability, Ackerman and Associates carries an additional one million/three million liability policy on the group and a general liability policy which meets the required criteria for this application is on file with the county and is provided through Farmers Insurance. Staff Qualifications A. and B. Staff Qualifications Seven staff members are available for the project. They exceed the minimum qualifications specified as documented below. The staff are- Joyce Shohet Ackerman, Ed.D., Licensed Psychologist; Susan Bromley Psy. D., Licensed Psychologist (and Licensed Social Worker); Emily Jaramillo-Bansberg, M.A. psychotherapist; Laurence P. Kerrigan, Ph.D., Licensed Psychologist; Sherri Malloy (Gonzales) Ph.D., Licensed Psychologist ; Karen Bender, M.A., L.P.C. and Nicole Warnygora, M.A., L.P.C. All of these are solution-focused, therapy providers. C. Training The staff has extensive training in family therapy and short term therapy as 11 documented by their extensive work experience. Collectively, six of the seven providers have held licenses in their field for a collective total of more than 60 years with a range of 1-20 plus years, and an average length of liscensure of about 10 years. Resumes are available upon request. D. Continuing education As a part of their work in the private sector all providers in this group maintain continuing education programs, more than the minimum eight hours required. They participate in workshops and other activities. This proposal's continuing education requirements coincide with the requirements of other contractual arrangements and are being met on an ongoing basis by members of the group. E. Supervision Six of the seven providers are independently licensed and not required to have clinical supervision. One therapist , Emily Jaramillo-Bansberg, M.A. who is working toward liscensure, is supervised by Sherri Malloy (Gonzales), Ph.D., a licensed psychologist in the practice. All the staff have advanced skills in intensive family therapy. The contract supervisor will monitor the specifications made in this proposal. F. Supervisor continuing education The supervisor of the project is involved in ongoing training to keep current with her profession through advanced workshops and seminars. Ackerman and Associates, P.C., of which the supervisor is the president, has more than ten years contracting experience for major managed care companies as short-term, solution focused therapy providers in Weld County. By contract, we have provided more than 1000 short-term therapy sessions per year, for three of the last five years. Dr. Ackerman manages all short-term, solution focused therapy contracts for Ackerman and Associates. Unit of service rate computation We are requesting a small increase from $97.50 per hour to the rate of $99.50 per hour for the GAP program. It provides $59.70 for the therapist and overhead expenses of $39.80 per therapist hour. This is the proportion of therapist fees to overhead that we have set for all programs of Ackerman and Associates. Group services will be billed at one-half this rate and will apply to any session where one or more members of the family are in group. No additional fee will be charged for additional family members in group or individual/family sessions. Group is defined as a session containing clients from different cases. An individual/family session is any session with an individual, couple, or family unit from the same case. The overall profit margin for Ackerman and Associates, P.C., for 1999 was 2.9 % of gross revenues. 12 Budget Justification/ Standards of responsibility for 2000-2001 bids These rates are reasonable and customary for providers of the licensed doctoral level and breadth of training assembled in this proposal. Our fees, we believe, are justified by the documented success rate we have demonstrated in the application of short-term, solution focused therapy techniques for prevention of placement. PAC money is tracked through a computer data base system called MediMac which we have used for the past 60 months. (We are in the process of transition to a new accounting software. Both systems allow us to track payments by client and by source of payment. Any payment through PAC will be tracked in this manner. No special issues are presently related to project audit to our knowledge and a random project audit for WCDSS has shown no discrepancies. Audits will be conducted on a yearly basis. Ackerman and Associates, P.C. is a type S professional corporation and not a 501.c 3. Modifications to meet the bid requirements for 2000-2001 have been added as follows: Standard of responsibility III D: The RFP reflects the precise number of sessions needed to be effective, the number of sessions per week and the cost of each session. For this program, these are fifteen to twenty individual/family sessions , one session per week on average, and the cost of each session is $99.50 per individual or family hour. Group sessions can be substituted for individual family sessions at $49.75 per group hour. Two group hours is the equivalent of one individual/family hour. Standard of responsibility Ill E : The RFP must eliminate renewals or reduce the cost of the renewal, should it need to be reinstated. The mechanism to reduce renewals is that renewals will not be accepted except for specific short-term goal therapy. The goal of this program is for less than one in ten families to need a renewal. A renewal will have a maximum of ten hours of treatment provided. This will be done over an additional five month period, once every other week, as a step down protocol. The only reason for acceptance of a renewal is if the client did not completely meet the criteria to return the child safely to the home. It is likely that a few additional hours of short- term, solution focused treatment, will significantly increase the protection of the child Standard of responsibility III F: The RFP has a process for renewals sixty days ahead of the program termination. This is the ten hour administrative review. If the client is not making progress, transition to another program may be initiated at this time Standard of responsibility III G: The RFP reflects a maximum number of hours in three stages of the program. We anticipate the average use of the program to be approximately equal in the first year in each of these three areas on a family by family 13 basis. The first eight hours of therapy will occur in the first third of the time for that family, the second six hours will occur in the second third of the treatment, and the last six hours will occur in the last third of treatment. No family will complete treatment of twenty hours in less than three months and no family will take longer than six months. Families that need less than twenty hours of treatment will need less time proportionately. As this is a new rule and its implications are unclear at this time, we request a direct meeting with Social Services, in a timely manner. If there is any concern in relation to this standard of responsibility in the next fiscal year, we can remedy any potential concerns if they arise. Standard of responsibility III H: The RFP requirement for a letter regarding carry over into the 2000 -2001 project period is acknowledged. No clients are anticipated for carry over status at this time. Standard of responsibility I is acknowledged. For the GAP program, the case management plan will be developed with the family at their first meeting. A monthly report will be provided. A final narrative will be provided, and all other aspects of the bid process adhered to. 14 RFP-FYC-00008 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 or units of service such as telephone calls, no shows, travel time, mileage reimbursement, preparation, documentation, and other costs not involving direct face-to-face services will not be honored. Likewise, billings must be for hours • of direct service to the client, regardless of the number of staff involved in providing those services. Therefore, it is imperative that this rate be sufficient to cover all costs associated with this client, regardless of the number of staff involved in providing these services. (Explanations for these Lines are Provided on the Following Page) Total Hours of Direct Service per Client Hours [A] Total. Clients to be Served / Clients [B] Total Hours of Direct Service for Year _ )It e7 _ Hours [C] (Line [A] Multiplied by Line [B] Cost per Hour of Direct Services $ .57 7O Per Hour [D] Total Direct Service Costs $ T / i / 8. Co _ [El (Line [C] Multiplied by Line [D] ) Iq 8 d o Administration Costs Allocable to Program $ A _ [F] 63ay .?- Overhead Costs Allocable to Program $ _ [CI 7, yI0 jeeti- Total Cost, Direct and Allocated, of Program$ _ [H] Line [E] Plus Line [F] Plus Line [G] ) Anticipated Profits Contributed by this Program $ ote2 g2o jegiA [1] Total Costs and Profits to be Covered J-9a by this Program(Line [H] Plus Line [I] ) $ /!t ' J L [j] Total Hours of Direct Service for Year D _[K] (Must Equal Line [C] ) Rate per Hour of Direct, Face-to-Face Service to be Charged to Weld County Department of Social Services $' qi7eSel [L] Page 31 of 32 RFP-FYC-00008 Attached A Day Treatment Programs Only: ---- Nil Direct Service House Per Client Per Month [M] Monthly Direct Service Rate $ NA. [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 perioc. 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 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 IL] by Line [M] . Page 32 of 32 Branch B/A Producer# Issue Date Renewal/Replacement No. 32 A 0002360 04/27/1999 RENEWAL PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2032570 NAMED INSURED: ACKERMAN AND ASSOCIATES PC ADDRESS 1750 25TH AVENUE (Number & Street, Town, GREELEY CO 80631 County, State & Zip No.) 2 POLICY PERIOD: From 05/01/1999 To 05/01/2000 (12:01 A.M. Standard Time .At Location Of Designated Premisesi • 3. COVERAGE: LIMITS OF LIABILITY PREMIUM Professional Liability $1,000,000 $3,000,000 $1 ,686.00 each Incident Aggregate 4. BUSINESS OF THE INSURED: Psychology 5. THE NAMED INSURED IS: ( ) Sole Proprietor (including Independent Contractors) ( ) Partnership (X ) Corporation ( ) OTHER: 6. This policy shall only apply to incidents which happen on or after: a) the policy effective date shown on the Declarations; or b) the effective date of the earliest claims-made policy issued by the Company to which this policy is a renewal; or c) the date specified in anv endorsement hereto. 05/01/1992 7. This policy is made and accepted subject to the printed conditions of this policy together with the provisions, stipulations and agreements contained in the following form(s) or endorscmenUs): PLJ-2008 ( 10/94 ) POE-8004 PLE-2167 PLE-208 ' P0N-2003 PLE-8036 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel Office Address: 1776 West Lakes Parkway Town and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 EIS NIERSTATE INSURANCE CROUP PLP-2O12 (06/93) (Elec.) Bran;:h B2 AA Producer # Issue Date05/1 / DUPLICATE PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2050203 1. NAMED INSURED: SUSAN PLOCK BROMLEY PSYD ADDRESS 1621 13TH AVENUE (Number & Street, Town, GREELEY Co 80631 County. State & Zip No.) POLICY PERIOD: From 04/01/1999 To 04/01/2000 (12:01 A.M. Standard Time At Location Of Designated Premises) 3. COVERAGE: LIMITS OF LIABILITY PREMIUM Professional Liability $1 ,000,000 $3,000,000 $7c)9. 00 each Incident Aggregate 4. BLSINESS OF THE INSURED: Psychology 5. THE NAMED INSURED IS: X ) Sole Proprietor (including Independent Contractors) ( ) Partnership ) Corpor atia: OTHER: 6. This policy shall only apply to incidents which happen on or after: a) the policy effective date shown on the Declarations: or b) the effective date of the earliest claims-made Iioli. issued by the Company to which this policy is a renewal: or c) the date specified in Inv endorsement hereto. 04/05/1996 7. This policy is made and accepted subject to the printed conditions of this policy togethe, with the provisions, stipulations and agreements contained in the following form(s) or en,loNemeLtHI: PL. J -2008 ( 10/94 ) POE-8004 PLE-2167 PLE -2081 P0N -2003 PLE -8035 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke Van Orsdel Office Address: 1776 West Lakes Parkway Town and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 INTERSTATE INSURANCE GROUP PLP-2O122 (06/93) (Elec.) _" -. •4 'Ed _ASERI Issue Date: 01/06/00 ll The race rocal P PROFESSIONAL LIABILITY OCCURRENCE ``,) Alliance INSURANCE POLICY FOR Risk Retention Group PROFESSIONAL COUNSELORS AND HUMAN DEVELOPMENT PRACTITIONERS ACA Insurance Trust.Es. 5999 Stevenson Avenue ACA IXsy(4.& Policy Number: CL10073400 Administered by: Alexandria,VA 22304.3300 TRUST Tel Frey.1.600.341.6647 t284 rc' ITEM DECLARATIONS INDIVIDUAL POLICY 1. NAMED INSURED: Norma Karen Bender 2. ADDRESS: 1104 Twin Peaks Circle Longmont, CO 80503-2170 3. POLICY PERIOD: From: 02/04/00 To: 02/04/01 12:01 A.M.Standard Time at Location of Designated Premises 4. The insurance afforded is only with respect to such of the following types of insurance as indicated by specific premium charge or charges: COVERAGE PREMIUM A. PROFESSIONAL LIABILITY S 290 . 00 B. GENERAL LIABILITY S 0 . 00 TOTAL PREMIUM: S 290 . 00 5. UMITS OF LIABILITY: $1, 000 , 000 each Incident or each Occurrence $3 , 000 , 000 in the Aggregate 6. THE NAMED INSURED IS: Sole Proprietor(incl.Individual) Partnership Corporation X Other to Item 1 below) 7. BUSINESS OF THE NAMED INSURED: Part-Time Self-Employed (Rating Category) Counselor/Human Development Profess icnal 8. This policy is made and accepted subject to the printed conditions of this policy together with the provisions,stipulations and agreements contained in the following fermis)or endorsement(s): CPL•0004-0199 CPL.0005.0199 CPL-0006.0199 NOTICE THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP. YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENCY GUARANTY FUNDS ARE NOT AVAILABLE FOR YOUR RISK RETENTION GROUP. CPLi0005.0199.00 EXECUTIVE RISK SPECIALTY CC. THIS IS A CLAIMS MADE POLICY-PLEASE READ CAREFULLY 12/03/99 - A PSYCHOLOGISTS PROFESSIONAL LIABILITY POLICY •1* RENEWAL *** NOTICE: A LOWER LIMIT OF LIABILITY APPLIES TO JUDGMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS OF SEXUAL MISCONDUCT(SEE THE SPECIAL PROVISION "SEXUAL MISCONDUCT" IN THE POLICY). DECLARATIONS POLICYNO. 8c1-0005006 ACCOUNT NO: CC—KERL175-0 0099745E NAME AND ADDRESS OF INSURED. ITEM 1 (b) ADDITIONAL NAMED INSUREDS. LAURENCE P. KERRIGAN, PH.D• 1750 25TH AVE. SUITE *L01 GREELEY• CC 80631 TYPEOFORG: INDIVIDUAL ITEM 2 ADDITIONAL INSUREDS: ITEM 3 POL-CY PERIOD: FROM: 12/01/99 TO: 1 2/0 1/0 0 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE INSURED AS STA TED HEREIN ITEM 4. LIM'TS OF LIABILITY (a) $ 1.000.000 EACH WRONGFUL ACT OR SERIES OF CONTrtIUOJIV RE881 -_ OR INTERRELATED WRONGFUL ACTS OR OE CUR DNC'F bl $ 5.000 DEFENSE REIMBURSEMENT (c) $ 3.000 .000 AGGREGATE ITEM 5 PREMIUM SCHEDULE:CLASSIFICATION NUMBER RATE ANNUAL PREMIU_ M_ _ 1ST PSYCHOLOGIST 1 1254.00 1 .254.00 DEFENSE LIMIT .00 SURPLUS LINES TAX 1 37.62 INSPECTION FEE 1 2.51 ITEM 6 RETROACTIVE DATE 1 2/0 1/9 1 TOTAL PREMIUM: 1 .294. 13 ITEM F EXTENDED REPORTING PERIOD 2 ,265.24 ADDITIONAL PREMIUM (If exercised): $_- - _-_ _-- ITEM 8 POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY. "---- 322138 (7/95 ED. ) 822137 AUTHORIZED COMPANY REPRESEN'r.T LL'E THIS IS NOT A BILL. PREMIUM HAS BEEN PAID. Bra 2. 0002360 /1 Date Renewal Fr1�E_c rent '�: 4. PSYCHOLOGISTS PROFESSIONAL LIABILITY CLAIMS-MADE INSURANCE POLICY PURCHASING GROUP POLICY NUMBER: 452-0002000 NOTICE: THIS IS A CLAIMS-MADE POLICY, PLEASE READ THE POLICY CAREFULLY. Item DECLARATIONS CERTIFICATE NUMBER: 45P- 2055185 NAMED INSURED: SHERRI MALLOY PHD ADDRESS 24 ALLES DRIVE ( Number & Street, Town, GREELEY CO 80631 (ounts , State & Zip No.) POLICY PERIOD: From 04/01/1999 To 04/01/2000 ( 12:01 A.M. Standard Time At Location Of Designated Premises) 3.I _ COVERAGE: LIMITS OF LIABILITY I RE `,IIL`H Professional Liability $1 , 000,000 $3, 000,000 each Incident Aggregate BUSINESS OF THE INSURED: Psychology IE NAMED INSURED IS: ( X ) Sole Proprietor (including Independent Contractors) ( ) Partnership ( ) Cot- /can OTHER: This police shall only apply to incidents which happen on or after: a) the polio, eto (.0 date shown on the Declarations; or b) the effective date of the earliest claims-made issued by the Company to which this policy is a renewal; or c) the date specified endorsement hereto. 04/01/1998 his police is made and accepted subject to the printed conditions of this polio :ciyth, wcl. the piosisions. stipulations and agreements contained in the following form(s) or e.nE) . •,r.�_ ).) P _ J -2008 ( 10/94 ) POE-8004 PLE- 2167 PLE- 2031 POP(-2003 PLE-8035 ( 09/97 ) CHICAGO INSURANCE COMPANY 55 E. MONROE STREET, CHICAGO, ILLINOIS 60603 REPRESENTATIVE: Agent or Broker: Kirke-Van Orsdel, Incorporated Office Address: 1776 West Lakes Parkwas Town and State: West Des Moines, IA. 50398 Toll-free Number: 1-800-852-9987 INTERSTATE NSLRANICE GROUP mimmEmmEmmw PLP-h12 (00.93) (Elec.) - '94. LE0 LASER) MEMORANDUM OF INSURANCE Date Issued 11/03/1999 Memorandum Holder This memorandum is issued as a matter ACKERMAN & ASSOCIATES ATTN DONNA of information only and confers no SUITE 101 rights upon the holder. This 1750 25 AVENUE memorandum does not amend, extend GREELEY CO 80634 or alter the coverages afforded by the Certificate listed below. Company Affording Coverage Producer Chicago Insurance Company Kirke Van Orsdel 1776 West Lakes Parkway Covered Person (Status) °e West Des Moines, Iowa 50398 EMILY L JARAMILLO-BANSBERG MA -x Emploeee This is to certify that the Certificate listed below has been issued to the insured named herein for the po0cy period indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this memorandum may he issued or may pertain, the insurance afforded by th_e Certificate described herein is subject to all the terms, exclusions and conditions of such Certificate. The limns shov,n may have been reduced by paid claims. Certificate Type of Insurance Number Effective Date Expiration Date Limits Professional Liability or occ incident ence 1 . 000,000 Occurrence 80M-4003488 11/01/1999 11/01/2000 3,000,000 in the aggregate each incident General Liability or occurrence Occurrence in the aggregate Should the above described Certificate be canceled Insured before the expiration date thereof, the issuing company will endeavor to mail written notice to the named Memorandum Holder, but failure to mail such EMILY L JARAMILLO-BANSBERG MA notice shall impose no obligation or 1iabi1ty of any 183 50 AVENUE PLACE kind upon the company, its agents or representatives. GREELEY CO 80634 Authorized Representative: , ,� e ,-- EVEREST NATIONAL INSURANCE COMPANY MENTAL HEALTH PRACTITIONER'S PROFESSIONAL LIABILITY POLICY DECLARATIONS Renewal of No. NOTICE: A SUB-LIMIT OF LIABILITY APPLIES TO "CLAIMS" ARISING OUT OF "SEXUAL MISCONDUCT". POLICY NO. 2200009922-991 ITEM 1: NAME AND ADDRESS OF INSURED: SEND ALL INQUIRIES TO: Nicole Ray Warnygora ROCKPORT INSURANCE ASSOCIATES 1 800 Angelo Court PROGRAM ADMINISTRATOR Fort Collins, CO 80528 P 0 BOX 1809 ROCKPORT, TX 78381-1809 1-800-423-5344 ITEM 2 ADDITIONAL INSUREDS: NONE ITEM 3: DESCRIPTION OF BUSINESS: MENTAL HEALTH PRACTITIONER(S) ITEM 4: POLICY PERIOD: FROM 05/20/1999 TO 05/20/2000 12:01 am STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN ITEM 5: LIMITS OF LIABILITY: $ 1,000,000 EACH WRONGFUL ACT OR EACH OCCURRENCE SUB.IEC' `0 A 825,000 SUB-LIMIT OF LIABILITY FOR ALL "WRONGS INVOLVING "SEXUAL MISCONDUCT". $ 3,000,000 AGGREGATE ITEM 6: PREMIUM SCHEDULE: CLASSIFICATION NUMBER RATE ANNUAL PREMIUM CA-"EGORY M2 1 263.00 $ 263.00 TOTAL PREMIUM $ 263.00 ITEM 7 POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY: 190.00 0195, 189.00 0195, EEO 25 501 12 98, 193.00 0195,194.00 0195 May 21, 1999 ?y. -.✓JCL P6/62,4w AUTHORIZED COMPANY REPRESENTATIVE 1 89.00 0195 © Everest National Insurance Company, 1995 TRUCK INSURANCE EXCHANGE E FARMERS INSURANCE EXCHANGE FIRE INSURANCE EXCHANGE f0 MP, MEMBERS of FARMERS INSURANCE GROUP OF COMPANIES 4,+UP1111 I�♦HOME OFFICE:4680 WILSHIRE BLVD.,LOS ANGELES,CALIFORNIA 90010 /-.i. DR JOYCE SHOHET ACKERMAN PCProd. Count II. Mailing . 1750 25TH AVE SUITE 101 Prematic Acct No. Address 07-04-362 04576-38-07 GREELEY CO 80631 Agent Policy Number of The named Insured is an individual unless otherwise stated: ElPartnershl ® Corp. Bus Tye OFFICE ElJoint Venture LJ Organization(Other than Partnership or Joint Venture) 2. Policy Period from 07/01/99 (not prior to time applied for) If this policy replaces othere overages that end at noon standard time on the same day this i policy begins,Ss t�Time. coverage ends. This policy will continue for successive policy periods as follows: If we elect to ntnue this slinsurawilncel twekwill(renew this fect until t polcy other f you pay the required renewal premium for each successive policy period subject to our premiums,rules and forms then in effect. 3. Insured location same as mailing address unless otherwise stated: 1750 25TH AVE SUITE 101 GREELEY CO 80631 4. Mortgage Holders Loan# Loan# 5. Premium$ 492.00 ❑ "X"if Mortgage Holder Pays 6. Policy Forms and Endorsements attached at inception: E0079-ED1 2521551290 565310-ED2 S0700-ED3 E6036-ED1 E4168-ED1 E4004-ED1 E4216-ED1 E3026-ED1 7. We provide insurance only for those coverages Indicated by a specific limit or by an Ell COVERAGES LIMITS OF INSURANCE DEDUCTIBLE A-Building $ SECTION 1 B-Business Personal Property Ezso applies b other $ 50,000 n non Indicated edby an� _ C-Loss of Income(Not exceeding 12 consecutive months �S oo❑ssoo L�E__ Property OPTIONAL COVERAGES ) ACTUAL LOSS SUSTAINED NONE — and Swimming Pooi/Fences and Walkways $ Loss of X Building Glass(Blanket) Above Uti Income TOutdoor Sign Coverage $ 100 un REPLACEMENT COST appliesunle 100 . Valuable Papers(In addition to$1000 included.) aless other . a option Indi- [] Earthquake Damage toted See Coverages % --1 SECTION II 0-Business Liability-Including Products and Completed LI ,8 C of the applicable ins. limit. Operations.(Annual aggregate applies for all occurrences LIMMITS OF LIABILITY (Annual Aggregate) during the policy period.) $ 1,000,000 Liability E-Fire Legal Liability$75,000 Included unless other option indicated by an ® and U$100,0000$150,000 each occurrence(Subject to the annual aggreagate shown for Cov. 0) Medicals F-Medical Payments to Others(Subject to the annual aggregate $5,000 each person shown for Coverage D.) Limit of Liability Professional Liability Aggregate) ty(see attached endorsement) $ RI I-V COVERED SECTION III Agreement I-Employee Dishonesty DEDUCTIBLE $ _Agreement II-Broad Form Money and Securities-Inside $11,000 NONE Agreement III-Broad Form Money and Securities-Outside ,000 $250 $ Crime Agreement IV-Medical Payments 000 $250 Agreement V-Forgery or Alterations $500, each person NONE $2,500 NONE _ 56-5208 2-at 2ND EDITION Countersigned Authorized Representative JOYCE SHOHET ACKERMAN, ED.D. 1750 25th Avenue, Suite 101 Greeley, Colorado 80634 Phone: 353-3373 PERSONAL DATA SHEET Date of Birth: August 3, 1950 Health: Excellent Married, two children CERTIFICATION/LICENSURE Licensed Clinical Psychologist, State of Colorado since 1984 Listed in National Register of Health Service Providers in Psychology since 1986 Staff Privileges, North Colorado Medical Center, Greeley, Colorado since 1985 Certified Teacher (K-12) for Emotionally Disturbed, Learning Disabled and retarded. Certified Teacher, Elementary Level PROFESSIONAL MEMBERSHIP American Psychological Association Colorado Psychological Association Colorado Psychological Association- elected board member 1986-1989 HONORS President's Award - Colorado Psychological Association, 1989 EDUCATION 1978 - 1981 Ed.D. in Counseling Psychology University of Northern Colorado December 1981 graduate 1972 - 1974 M.S. in Education (E.D./L..D.) Lesley College, Cambridge, Massachusetts August 1974 graduate 1968 - 1971 B.S. in Special Education and Elementary Education with a minor in psychology Boston University, Boston, Massachusetts December 1971 graduate PROFESSIONAL EXPERIENCE 1981 - PRESENT Clinician in private practice in Northern Colorado. Among responsibilities are: Diagnosis, therapeutic intervention and referral for adults, families, children and groups. Primary areas are: anxiety disorders, mood disorders and adjustment disorders. Typical problems include: trauma, physical abuse, job stress. Orientation used-primarily cognitive- behavioral therapy. Also, developing, organizing and presenting workshops and consultative programs to community, schools, organizations and agencies. Approximately 30 hours per week. 1986 - Present Consulting psychologist on interdisciplinary team for in-patient rehabilitation program. Progressive Care Rehabilitation Center, Greeley, Colorado. Medical Director Dr. Judith Vaughan, Neurologist. Adults with traumatic injuries-Primary problems are: psychological aspects of physical rehabilitation, grief counseling, and brief group counseling using cognitive-behavioral goal oriented therapy. Approximately 10 - 15 hours per week. 1989 - 1992 Head Injury Treatment Team North Colorado Medical Center, Greeley. Approximately 5 hours per week. Team coordinator - Dr. John McVicker, Neurosurgeon. 1986 - 1989 Consulting Psychologist for Family Recovery Center (in-patient substance abuse/chemical dependency program), North Colorado Medical Center, Greeley, Colorado. Coordinator Ruth Wick R.N. Approximately 5 hours per week. 1986 - 1989 Provider and Coordinator for Mental Health Services in Northern Colorado for Peak Health Care (HMO). Peak mental health services utilized a three session model for initial services followed by referral. Activities included coordination of Psychological and Psychiatric Services for approximately the last two years of the contract. Peak was purchased From Lincoln National by Biodyne in late 1989. Peak Supervisor - Elaine Taylor Approximately 10 hrs./week. 1983 - 1986 Psychologist subcontractor for a Vietnam Veteran's Counseling Program funded by the Veteran's Administration. Principal Contractor Dr. Robert Stewart 1980 - 1987 Part time faculty member with responsibilities for classes, workshops and community programs in parenting skills. Family/Life Education Program Aims Community College, Greeley, Colorado August 1980 Clinical Internship on Children's Team of to Community Mental Health Center. Responsibilities August 1981 included: consultation to schools and community programs; therapy for children and families; and assessment of diverse mental health programs. Assistant program Evaluator-Developed evaluation tools to determine cross-cultural perceptions of expectations and satisfaction with services. Supervisors - Dr. Joan Gillespie and Dr. Laurence P. Kerrigan. Weld Mental Health Center, Greeley, Colorado (Full time). Adults, Adolescents, Families. Primary areas anxiety disorders, mood disorders and adjustment disorders. Typical problems included: trauma, physical abuse substance abuse, job stress. Orientation used- Primarily cognitive-behavioral therapy. 1980 Group Facilitator-Regional and National Conferences in cross-cultural community needs. Flagstaff, Arizona - Colorado Springs, Colorado August 1975 Chairperson of the Department of Education and to Behavioral Science at an accredited, Indian controlled July 1978 community college on the Navajo Reservation. Administration responsibilities included: Supervision and evaluation of faculty; budget preparation and management; curriculum development and integration of Navajo culture; personnel recruitment and selection; class scheduling and program development. Also, faculty member with academic responsibilities for instruction in Psychology, Child Development and Counseling courses, advising and counseling students. Navajo Community College, Tsaile, Arizona (Full time) September 1974 Education Specialist and counselor at an Indian to controlled primary and secondary school on the August 1975 Navajo Reservation. Coordinated community resource program which included: Counseling, Student assessment, prescriptive programming, , staff development and curriculum. Also, adjunct faculty for the University of New Mexico and for Navajo Community College at the Rough Rock Demonstration school, Rough Rock, Arizona. (Full time) September 1972 Designed and coordinated Learning Center Program to for Dedham Public Schools. A program and crisis June 1974 intervention center for emotionally disturbed children. Responsibilities included: Diagnostic prescriptive programming, counseling, supervision and training of aides, tutors and volunteers, and consultation with regular classroom teachers. Also organized group and individual meetings with parents. Also, adjunct faculty for Curry College assisting in in-service instruction for Dedham School System employees. Dedham Public Schools, Dedham, Mass. (Full time) February 1972 Learning Disabilities Specialist. Consultation to staff, to prescriptive programming and teaching school age June 1972 children. Somerville Public Schools, Somerville, Mass. (Full time) Summer 1971 Chosen as state mental health intern. coordinated Tutoring Center for emotionally disturbed children. Responsible for: tutoring children, supervising aides, (high school dropouts) and consulting with psychiatric staff. Somerville Mental Health Clinic, Somerville, Mass. WORKSHOPS AND SPECIAL TRAINING 1993 - August Hospital Practice for Psychologists APA National Convention in Toronto, Canada- "Psychology and National Health Reform", "National Health Insurance: Policy Considerations, Benefit Designs, and Economic Realities", and "Marketing: Psychology's Key to National Health Reform. 1993 "Using the New MMPI-2 and MMPI-A" Mountain Crest Hospital, Denver, Colorado. 1993 Disaster Relief Training. Alan Keck, through Colorado Psychological Association, Denver, Colorado. 1992 - Fall Short Term Therapy. Bernard Bloom, University of Northern Colorado, Greeley, Colorado. 1990 - Fall National Cognitive Rehabilitation Conference, Richmond, Virginia. 1990 - Summer Post graduate training: 1. Adult Neuropsychological Method based on Lezak Neuropsychological assessment, 1983. 2. Child Neuropsychology, Dr. Hynd. 3. Child Neuropsychological Methods. 1989 Provider of Neuropsychological evaluations for Vocational Rehabilitation, Greeley, Colorado. 1988 Cognitive Rehabilitation Training Program, Dr. Sena, Ph.D., Colorado Springs, Colorado. 1988 - Present Psychologist - Head Injury Treatment Team at North Colorado Medical Center, Greeley, Colorado. 1987 Halstead Reitan Neuropsychological Assessment Training. Ralph Reitan, Ph.D., Washington, D.C. Summer 1986 Albert Einstein School of Medicine, Workshop on Adolescent Therapy, Cape Cod, Mass. 1985 to present North Colorado Interdisciplinary Team of Child Custody Member and participant. Fall 1985 Interdisciplinary Workshop on Child Custody, Keystone, Colorado. Summer 1984 Workshop in Clinical Use of Hypnosis, Boston, Mass. Winter 1983 Workshop on In-patient Programs for Service Related Disorders, Cheyenne Veterans Administration Hospital Fall 1983 Veteran's Administration Workshop on Post Traumatic Stress Syndrome, Denver Veteran's Center. Fall 1981 Post-Doctoral Supervised Candidate for Licensure to (psychology) under Gale R. Giebler, Ph.D. Licensed Winter 1984 Psychologist and Susan Spilman, Ph.D., Licensed Psychologist. 1980 - 1981 Intern-Weld County Sexual Abuse Team, Greeley, Cola Summer 1981 Independent Study of Child Sexual Abuse, University of Northern Colorado. Spring 1981 Interdisciplinary Workshop on Assessment of Sexual Assault, Boulder Social Services. Summer 1979 Biofeedback Training related to labor and delivery. Summer 1974 Participant in Institute on Obstacles to Learning. Joint Symposium between McLean psychiatric Hospital, Harvard University and Lesley Graduate School. Cambridge, Massachusetts. Summer 1973 Kennedy Memorial Hospital, Boston, Massachusetts. Participant, Summer Aphasia Institute. PUBLICATIONS Ackerman A., Ackerman J.S., Kelley K, Hale K. Family Planning Attitudes of Traditional and Acculturated Navajo Indians. Key Issues in Population and Food Policy. University Press of America, pp. 178-171 (1979). Ackerman, J.S., Client Expectations and Satisfaction with Community Mental Health Center Services: A Cross-Cultural Analysis Between Hispanics and Anglos. Published Doctoral Dissertation, University of Northern Colorado. copyright 1981. FACULTY VITA May 1999 NAME: BROMLEY, Susan Plock SOCIAL SECURITY NUMBER: 483-50-9243 POSITION: Associate Professor of Psychology Department of Psychology College of Arts and Sciences University of Northern Colorado Greeley, CO 80639 HOME ADDRESS: 1621 13th Avenue Greeley, CO 80631 TELEPHONE' Office: (303)351-2236 Home: (303) 352-8750 EMAIL:sbromley/aThentley.unco.edu EDUCATION: Years) Degree Institution Area of Study 1983 PsyD University of Denver Clinical Psychology School of Professional Psychology Denver, Colorado 1968 MSSA Case Western Reserve University Casework (MSW) School of Applied Social Sciences Cleveland, Ohio 1965 BA Mt. Holyoke College Economics/Sociology South Hadley. Massachusetts WORK EXPERIENCE --Professional Academic: Ygoi(51 Institution/Organization Position Responsibilities 1996-Pres University of Northern Colorado Assoc. Professor Psychology Teaching/Research 1985-96 University of Northern Colorado Asst. Professor Psychology Teaching/Research 1783-84 University of Northern Colorado Asst. Professor Psychology Teaching WORK EXPERIENCE --Professional Non-Academic Years) Institution/Organization Position Responsibilities 1996-present Ackerman and Associates Psychologist Clinical 1184-85 Kaiser Permanente Psychotherapist Clinical Lakewood. Colorado 9'79-80 Bethesda Mental Health Center Psychology Intern Clinical/ Denver, Colorado Administrative I .,8-79 Denver General Hospital Clinical Social Worker/ Clinical/ Denver. Colorado Supervisor Administrative AREA OF SPECIALIZATION: Behavioral Medicine/Pain Management/Clinical Hypnosis RESEARCH AREAS/INTERESTS: Hypnosis/Pain Assessment and Management/Women's Issues/Teaching Methods PROFESSIONAL ACTIVITIES: Colorado Licensure: Psychology License#1086 PI IBLICATIONS—Professional/furred: Musgrave-Marquart, D.,Bromley, S.R &Dailey,M.B. (1997)"Personality,academic attribution, and substance abuse as predictors of academic achievement in college students". Journal of Social Behavior and Personably 12(2), :it)1-511. Karlin, N.J. and Bromley, S.P. (1996). Differences in caregivers of demented and lucid chronically ill family members. Journal of Alzheimer's Disease and Related Disorders and Research Retzlaff P. and Bromley, S. (1994). Counseling personality disorders. In Ronch, J.L., VanOrnum, W. & Stilly,ell_ 11s.C. (Eds)The counseling sourcebook: A practical reference on contemporary issues. New York: Crossroad Publishing group. pp.466-474. Bromley, S. and I Lewitt, P. (1992). Fatal attraction: The sinister side of women's conflict about career and family. Journal of Popular Culture. 26(3). pp. 17-24. Retzlaff, P. and Bromley, S. (1991). "A Multi-Test Alcoholic Taxonomy: Canonical Coefficient Clusters". Journal of Clinical Psychology.47(2), pp. 299-309. Bromley, S.P. (19R5). "Treatment of Pain: Theory and Research" in Zahourek, R. (Ed.). Clinical Hypnosis and Therapeutic Suggestion. New York: Grime and Stratton. Reprinted in Zahourek, R. (Ed.) (1990). New York: Bruner/Mazel, Inc., pp. 77-98.. PROFESSIONAL PRESENTATIONS --furled: Nickisson, J.W. and Bromley, S.P. (1999)"Hypnosis: Attitudes,knowledge and experience among psychology and nursing students". Accepted for a paper presentation at the American Psychological Association Convention. Boston. (August) Campbell. J. S., Titus, J. and Bromley S. P. (1998). "Neuroanatomy teaching technique for introductory psychology students. Poster presented at the joint WPA/RMPA convention, Albuquerque, NM. (April) Bromley, S. (1997) (Chair)"Linking through honors programs: The cross-discipline course). Paper presentation as part of a symposium titled"Creating links between psychology and other disciplines"., American Psychological Association Convention, Chicago. (August) Bromley, S. , Gilliam D., &Johnson, T. (1995). "Assessment of student created tests as an evaluation method'. Poster presented at the American Psychological Association Convention, New York City. (August) Bromley, S. (1994). "Student created tests as an evaluation method". Poster presented at 16th Annual Naional Institute on the Teaching of Psychology, St. Petersburg, Florida. Karlin, N. and Bromley. S. (1992). " Similarities and differences for caregivers of demented and lucid chroniailly ill"_ Poster presented at the Rocky Mountain Psychology Association Convention,Boise, Idaho. (April) Montoya, K.J. and Bromley, S. ( Chair) (1992). " Changes in undergraduate counseling styles in an introducton counseling theories course". Paper presented at the Rocky Mountain Psychology Association Convention, Boise Idaho(April) Bromley, S. (1992). " Connected learning methods to faciliate research understanding". Paper presentation as part of panel titled, `Teaching techniques in the social sciences", Western Social Science Association Convention, Denver, Colorado. (April) 13romley. S., Ramirez, S., and McCoy, J. (1991). "Impact of a health psychology course on student health beliefs". Poster presented at the Rocky Mountain Psychology Association Convention,Denver, Colorado. (April) Karlin, N. and Bromley, S. (1991). " Support,burden and affect among caregiver of dementia and nondementia patients". Poster presented at the American Psychology Association, San Francisco, California. (August) Bosley, G. and Bromley, S. (1990). Post death ritual in a Colorado community. Paper presentation at the American Psychology Association, San Francisco, California. (August) Bromley, S. (1990). "Husbands at Childbirth: Who Does It Help?" Paper presentation at Far West Popular Culture Association, Las Vegas, Nevada (January). Hewitt, P. and Bromley S. (1989). "Images of Work and Intimacy in'Turning Point'and'Fatal Attraction". Paper presentation National Convention of Popular Culture Association and American Culture Association, St. Louis Missouri. (Session Chair) Retzlaff,P. and Bromley, S. (1989). "The Basic Personality'Inventory: Alcoh Sub-Group Identification". Poster session at.the Joint Convention of the Rock Mountain Psychological Association and Western Psychological Association. Rena Nevada. Bromley, S. (1988). "Our Culture Affects Our Pain." Paper presentation,National Convention of Popular Culture Association and American Culture Association, New Orleans,LA. (March). Bromley, S. (1987). "Husband-Assisted Autohypnosis for Labor and Delivery: A Clinical Model" Paper presented at. Rocky Mountain Psychological Association, Albuquerque, New Mexico(April). Bromley, S. and Loy, P. (1987). "Politics of PMS". Paper presentation Association of Women Psychologists, Denver, Colorado (March). PROFESSIONAL PRESENTATIONS --Invited: Strongin, D. & Bromley. S. (1999). Student and faculty reactions to the introduction of a graduate ethics course In Miller,R. (Chair)Ethics in college teaching. Symposium conducted at the Rocky Mountain Psychological Association. Ft. Collins, CO(April) Bromley, S. (1999). Issues of religion and spirituality with therapists and clients. In S. Bromley(Chair) Religion and spirituality in research, practice and the classroom. Symposium conducted at the Rocky Mountain Psychological Association, Ft. Collins, Co(April) Bromley, S. (1998)Hypnosis, psychology and managed care. In S. Bromley(Chair) Complementary, nontraditional and indigenous healing practices. Symposium conducted at the combined meetings of the Western and Rocky Mountain Psychological Associations, Albuquerque. (April) Bromley, S. (1998). Complementary healing methods: A psychological and artistic exploration. In L. Wickerlgren (Chair). Interdisciplinary courses involving psychology: A sampler. Symposium conducted at the combined meetings of the Western and Rocky Mountain Psychological Associations, Albuquerque. (April) Handelsman, M.M., Bromley, S.P. & Davis, S.F. (1995). "Clinical Psychologist, Counseling Psychologist. Clinical Social Workder, or Psychology Professor: Which Degree is Right.for Me?" Psi Chi invited panel presentation, Rocky Mountain Psychological Association, Boulder, CO(April). Broniley, S. (Co-Chair), Seibert, P. (Co-Chair),Knuckey,D.,Bohlin,M., Zaweski, C., Watson, D., Hammon, D , West, K. &Robins, J. (1994). "Training the Teaching Assistant" Invited Panel Presentation ,Rocky Mountain Psychological Association, Las Vegas, Nevada(April) Bromley, S. (1993). "Hypnosis in Dentistry." Presentation at Monthly Meeting of Weld County Dentistn Association, Greeley, Colorado(February). Bromley, S. (1993). "Learning about the author as a way to understand research_" Presentation at "Teaching"fake Out"_CTUP Special Event. WPA/RMPA Convention, Phoenix, Arizona(April). Allen, M. and Bromley, S. (1993). Co-Chairs Two CTUP Special Event Sessions, "Teaching Take Out: E..penences PI Collaborative Learning", Western Psychological Association/R.ocky Mountain Psychological Association Convention, Phoenix, Arizona (April). Bromley, S. (1993). Chair, Invited Symposium, "Psychological and Social Perspectives on Male Violence Against V/omen", Western Psychological Association/Rocky Mountain Psychological Association Convention, Phoenix Arizona (April). Bromley, S. (1992). " Enhancement of student research and writing skills in any course". CTUP Workshop presented at the Rocky Mountain Psychology Association Convention,Boise, Idaho. (April) Bromley, S. and Karlin, N. (1992). "General and health locus of control of adult caregivers". Poster session at the UNC Research Forum, Greeley, Colorado. Bromley, S. (1992). Panel member in Mental Health Symposia for Victim Compensation Convention as part of the Colorado Organization for Victim Assistance Conference. (Estes Park/October) Bolocofski,Bromley, Foster and Mean(1988). "Hypnosis:Research and Clinical Perspectives," symposium presentation, Colorado Psychological Association, Greeley(March). Bromley, S. (1986). "Pain: A Psychological Event". Presentor-20th Annual Emotional Crisis Workshop Lniversity of Northern Colorado, Greeley, Colorado(July). LECTURES--Invited: B rooky, S. (1998) "Psychological methods of pain control" Invited lecture for the annual meeting of the Weld County Arthritis Society. Bromley, S. (1998). "Hypnosis for pain control of arthritis"Invited lecture for"Brown Bag" lunch series sponsored by the Greeley Medical Clinic. Bromley, S. (1998)"Headache Control-Psychological Methods". Invited lecture as part of a seminar titled "Coping with headache". Sponsored by the Greeley Medical Clinic. Bromley, S. & Ackerman J. (1998). "What to do to handle burnout" A workshop conducted for foster parents working with Weld County Social Services. Bromley, S. (1995).Keynote speaker for Golden Key Honor Society Induction Ceremony, University of Colorado, Boulder. Co. (November) Bromley, S. (1992). Keynote speaker for Sophomore Honor Society Induction Ceremony. Bromley, S. (1991)Featured speaker. UNC Acadmic Honors Convocation. (April) Bromley, S. (1991)_ Banquet speaker Emotional Crisis Workshop, Greeley, Colorado. (July) 1 GRANTS: Bromley, S( 1994)Honors Grant ($500)to attend research training at the Society for Clinical Hypnosis meeting, San Francisco(October) Bromley, S. (1994). Research and Publications award of$1500.00. "Assessment protocols to measure the efficacy of hypnotic treatment for injured workers. Karlin, N. and Bromley, S. (1990). Research and Publications award of$2,4440.00_ "Control, support,burden and affect differences among dementia and non-dementia caregivers". 13 0K/GRANT REVIEWS: Grant review for Boise State Department of Education(1995) Re\icw of Santrock, J. (1991). The science of mind and behavior. W.C. Brown and Benchmark. Review of McKee. P. &Thiem. J. (1993). Real life: Ten stories of aging. University of Colorado Press PROFESSIONAL CONSULTATION/PRACTICE: Year(sl Institution/Organization Role 1996-presnt Ackerman and Associates Clinical Psychologist 1988 Bonnet Good Samaritan Center Pain Management Consultant and I raincr 1984-85 Denver Metropolitan Dental Care Consultant in Pain Management 1984 Iowa Association of Registered Physical Therapists Hypnosis for Pain Management Consultant And Teacher PROFESSIONAL ASSOCIATION PARTICIPATION: Membership 1`186-present Rocky Mountain Psychological Association 1988-present American Psychological Association(Divisions 2, 30, 35) 1989-present Greeley Area Mental Health Network 1787-88 Association of Women in Psychology 1980-89 Colorado Psychological Association t:188 CPA Program Committee Member for Spring Meeting--Greeley Coordinator SERVICE: EXTERNAL: NATIONAL SERVICE: 1'194-present Rocky Mountain Coordinator-American Psychological Association, Division 2 -Teaching of Psychology 1 )92-94 Co-Chair, Rocky Mountain Region Council of Teachers of Undergraduate Psychology (CRP) 1991-94 Mountain States Regional Academic Coordinator, Golden Key National Honor Society REGIONAL/STATE SERVICE. 1399 -Moderator for Stanley G. Hall Lecturer-Viney, W (1999). A larger canopy for psychology: Unifying themes and pragmatic empiricism.Presented at the Rocky Mountain Psychological Association Convention, Ft Collins, CO(April) 1389- present Rocky Mountain Psychology Association 1998-1999 Ex-Officio Board Member As Division 2 Coordinator 1992-1998 Board Member 1995- 1998 Elected Chair, Groups Under-Represented in Psychology Committee 1992-94 Co-Chair, Groups Under-Represented in Psychology Committee 1991 Coordinator of Student Volunteers,RMPA Convention. Denver, Colorado. 5 995 Psychology Chair-CCHE Faculty to Faculty Conference(October) COMMUNITY SERVICE: 1998 Member, Weld County Medical Society Commiee on Alternative and Complementary Healing 1997-1998 UNC Loaned Executive-United Way of Weld County 1991- 1996 Board Member, 19th Judicial District Victim Compensation Board 1995-96 Chair 1990-93 Board Member, Weld County Area Agency on Aging 1992-93 Chair 1991-92 Vice-Chair 1986-Present Exam Supervisor-American Institute for Property and Liability Undenvriters/Insurance Institute of America 1987-present Clinical Psychologist -pro-bono work with individual clients and community training INTERNAL' DEPARTMENTAL: 1993-present Member,Department Executive Committee 1985-88. N95-present Co-Advisor Psi Chi National Honor Society 1996-1999 Guest lecturer for Psi Chi Grad Night on getting into clinicallcounseling grad programs. 1')89-91,93, 95-present Department Representative, CCHE Faculty to Faculty Conference 1987 - 94 Department Representative to graduation ceremonies 1986-94 Library Representative 1983, 86 89, 90-93,97,98 Member,Faculty Search and Screen Committee 1990-92 Member,Psychology Department Undergraduate Committee(Chair 1992) 1087-88 Co-Coordinator Semester Conversion Committee COLLEGE: 1992,93,96.97 Member of faculty invited to teach in the Cluster Program 1990-93 Graduation Marshall, Arts& Sciences I^)88-89 Member. Arts and Sciences Teacher Education Committee 1')26-89 Chair, Interdisciplinary Committee to develop and revise Human Development Major in the College of Arts and Sciences and Psychology Department UNIVERSITY: 1992-94 I )96-Present Member-Research and Publications Board 1993-94 Chair-Elect I982-present Founding Co-Advisor, Golden Key llonor Society 1992-95 Member-UNC Women's Commission 1992-94 Co-Chair- Assessment Task Force 1489-90 Faculty Representative. Student Fee Allocation Committee 1)86-89 Member, Faculty Senate 1988-89 Secretary 1987-88 Vice-Chair 1986-87 At-Large Member. Executive Committee 1986-89 Member, Academic Policies Committee 1986-87 Member, Elections Committee 1988 Representative, Western States Faculty Leadership Conference, Rcno_ 1988 Senate Representative. Statewide Commission Advisory Committee 1988 Advisor, In-Touch Helpline 1985-86 Volunteer Therapist, UNC Counseling Center 6 GRADUATE STUDENT COMMITTEES--Doctoral- 1998 Committee Member, Shu-Shin Lu,Professional Psychology 1997-prsnt Committee Member, Christine Rogers, Professional Psychology 1995-1997 Committee Member, Lisa big, Special Education Io94-pies Committee Member, Marla Gallagher,Educational Psychology 1997 Committee Member,Hsiu-Lan Ma, Science Ed. -Oral Comprehensives 993 Committee Member, Jerry Buford, School Psychology, "Treatment of depressive symptoms of early adolescents". 1497-1998 Committee Member, Pat Flanagan, CSPA,Orals, "A comparison of attitudes and practices of teaching faculty regarding student academic dishonesty at a two year and four year institution 1991 Committee Member, Mike Propriano, School Psychology 990-04 Committee Member, Paul Jantz, School Psychology, 7989 Committee Member, Mike Peters, Vocational Rehabilitation. "The Effectiveness of Vocational Evaluation for Various Disabling Conditions 1987 Committee Member, Ane Marie Kajenckii, English,"The Concept of Free Association in Virp inia Woolf The Waves" 1986 Committee Member, Fuming Liao, Mechanical Kinesiology, "Development and Validation o! Method for Providing Immediate Feedback Information on Speed and Angle of Release it Shotputting" GRADUATE STUDENT COMMITTEES --Masters: 1'':98 Vanessa Ewing, Committee Member 1907 Stephanie Blasi, Committee Member 1997 John Nickisson, Chair 1904 David Watson, Committee Member 1994 Tiernan Mcllwaine. Committee Member 1094 Jerrod McCoy, Committee Member 1993 Sheldine Runyan, Committee Member E)97 Sue Cole, Committee Chair, "Influences on Occupational Goals of Selected Male and Female College Students" 1')90 Jerre Benner, Committee Member 99t) Kurds Armstrong, Committee Member,"Attitudinal Consequences of Pre-Employment and Rwtdom Employee Drug Testing" 1^)89 Michelle Hozer. Committee Member 089 Anne Schnittgrund-Committee Chair, " Age and Electrothermal Biofeedback Training" 1')88 Cherri Hockett. Committee Member. "The Effects of Turnover on Those Who Remain in an Organization" I')88 Tony Ambrosio, Committee Member. "The Belief in a Just-World and the AIDS Epidemic' Predictors of Attitudes Towards Individuals with AIDS" 1988 Steve Foster, Committee Chair, "Hypnotic Susceptibility Ma Function of Locus of Control and Director Indirect Inductional Deepening and Suggestion Style" 1 )88 Lisa Dillon. Committee Chair, "Cognitive-Behavioral. Approach to the Treatment of Elderly Rheumatoid Arthritis Subjects" I!)87 Deanna Holmes, Committee Member 1927 Darlene Nold, Committee Member, "Reading and Writing Assessment Tests as Predictors of Success in the Basic Peace officer Academy at Aims Community College" 1987 Dan May, Committee Member 1')86 Jeff Schiels, Committee Member, "The Reformulated Hypothesis: Is Its dominator of Learned Helplessness Literature Justifiable?" 1986 Linda Coulthard-Morris. Committee Member. "Biofeedback of Cortical Slow Wave Potentials. Hand Temperature and Muscle Tension in Norma] and Attention Deficit Disorder with Hyperactivity Children" TEACHING: Honors Activities' 1999 UNC Research Day, Faculty Panel Coordinator, " Complementary Healing Methods" 1999 Thesis Coordinator-Kristin Pietryzick, Jennifer Kimberling, Cristine Dickey 1997 Thesis Co-Advisor Kelly Kinser 1997 Honors Connection Course development-Alternative Healing Methods 1996-pres Honors Co-Coordinator, Psychology Department 1989-94 Honors Coordinator, Psychology Department 1494 Thesis Co-Advisor, Diane Musgrave, "The Relationships Among Personality Traits, Alcohol, Caffeine, and Nicotine Consumption, and Academic Performance in College Students" 1994 UNC Researh Day, Faculty Panel Coordinator,"Hypnosis: Theory and Research" 1993 UNC Research Day-Faculty Panel Coordinator, "Non-traditional Theories of Therapy Serving Women and Minorities". 1993 Thesis Co-Advisor, Linda Norman, "Clozapine and Event Related Brain Potentials in Schizophrenics" 1992 Thesis Advisor, Deborah Knuckey, "The Effect of Touch on AffectAmong Strangers Under Mildly Stressful Conditions" 1992 UNC Research Day, Faculty Panel Coordinator 1992 UNC Research Day, Faculty Panel Coordinator(2 student panels) "Sex Roles and Psychology", The Power of Social Influence 1989 Thesis Advisor, Geri Bosley, "Post Death Ritual in a Small Colorado Community" 1988 Thesis Advisor, Pam Clasen, "The Use of Relaxation and Imagery Techniques in Pain Management" 1989 Honors Connection Course Development Q9urses Taught' (1-4 Scale with 1 as Highest) (*1-5 Scale with 5 as highest) DATE COURSE TITLE FIRS ENR AVG.RATING 198 8 PSY 101 IntroSeminar Psychology 1 43 -- `X 1987 PSY 101 IntroScminar Psychology 1 16 I.12 ?'„' 1986 PSY 101 IntroSeminar Psychology 1 32 1.24 F 1997 PSY 120 Principles of Psychology 4 107 1 76 F 1996 PSY 120 Principles of Psychology 4 119 F 1993 PSY 120 Principles of Psychology 4 119 1.64 F 1991 PSY 120 Principles of Psychol ogy 4 161 1.67 F 1983 PSY 120 General Psychology 3 42 ---- Sp 1984 PSY 121 Intro to Psychology I 4 40 ---- Sum 1988 PSY 230 Human Growth &Development 5 55 ---- Sp 1988 PSY 230 Human Growth &Dcvclopmcnt 5 60 1.58 W 1988 PSY 230 Human Growth &Development 5 90 138 F 1987 PSY 230 Human Growth &Dcvclopmcnt 5 45 1.54 W 1987 PSY 230 Human Growth &Development 5 75 1 54 Sp 1987 PSY 230 Human Growth &Dcvclopmcnt 5 90 -- Sum 1986 PSY 230 Human Growth & Development 5 47 -- F 1986 PSY 230 Human Growth &Dcvclopmcnt 5 80 1.36 W 1986 PSY 230 Human Growth &Development 5 80 1.42 V?' 1986 PSY 230 Human Growth &Dcvclopmcnt 5 52 1.27 F 1985 PSY 230 Human Growth &Development 5 56 1.53 F 1985 PSY 230 Human Growth &Dcvclopmcnt 5 85 1.56 '.Sp 1984 PSY 265 Social Psychology 3 26 ---- V,' 1984 PSY 265 Social Psychology 3 23 ---- Sn 1998 PSY 323 Health Psychology 3 40 4.11 F 1998 PSY 323 Health Psychology 3 39 4.08 SP 1997 PSY 373 Health Psychology 3 44 4.37 S F 1995 PSY 323 Health Psychology 3 47 Sp 1994 PSY 323 Health Psychology 3 41 1.69 F 1992 PSY 323 Health Psychology 3 49 Sp 1992 PSY 423 Health Psychology 3 42 1.69 F 1990 PSY 423 Health Psychology 3 1.66 F 1988 PSY 423 Health Psychology 3 35 1.36 Sp 1986 PSY 330 Child& Adolescent Psych 3 27 14 Sp 1993 PSY 331 Maturity& Aging 3 40 Sp 1991 PSY 331 Maturity &Aging 3 46 1.62 F 1989 PSY 331 Maturity & Aging 3 23 1.45 F 1988 PSY 331 Maturity &Aging 3 27 1.40 Sp 1988 PSY 430 Maturity&Aging 3 44 1.58 Sly 1987 PSY 430 Maturity& Aging 3 34 -- Sp 1986 PSY 430 Maturity& Aging 3 36 1.52 F 1998 PSY 455 Abnormal Psychology 3 49 4.24 Sly 1997 PSY 455 Abnormal Psychology- 3 49 4.03 F 1995 PSY 455 Abnormal Psychology 3 32 Sp 1993 PSY 355 Abnormal Psychology 3 37 Sp 1992 PSY 355 Abnormal Psychology 3 42 1 26 Sp 1991 PSY 355 Abnormal Psychology 3 37 1.37 F 1990 PSY 355 Abnormal Psychology 3 1 46 Su 1990 PSY 355 Abnormal Psychology 3 3l Sp 1990 PSY 355 Abnormal Psychology 3 37 138 Sp 1990 PSY 355 Abnormal Psychology 3 42 1.53 Sp 1989 PSY 355 Abnormal Psychology 3 78 1 51 Sp 1986 PSY 358 Abnormal Psychology 3 41 154 W 1984 PSY 358 Abnormal Psychology 3 31 Su 1998 PSY 350 Theories of Personality 3 20 4.10 Su 1990 PSY 357 Theories of Personality 3 21 1 45 W 1988 PSY 357 Theories of Personality 3 40 1 57 F 1987 PSY 357 Theories of Personality 3 55 138 V 1987 PSY 357 Theories of Personality 3 37 133 F 1986 PSY 357 Theories of Personality 3 54 -- F 1983 PSY 357 Theories of Personality 3 51 F 1998 PSY 407 Intro to Counseling Theories 3 20 4 31 Sp 1998 PSY 407 Intro to Counseling Theories 3 20 4 42 F 1997 PSY 407 Intro to Counseling Theories 3 15 4 71 F 1996 PSY 407 Intro to Counseling Theories 3 19 F 1995 PSY 407 Intro to Counseling Theories 3 19 Sp 1994 PSY 407 Intro to Counseling Theories 3 F 1993 PSY 407 Intro to Counseling Theories 3 24 1 32 S1'+ 1993 PSY 407 Intro to Counseling Theories 3 22 F 1992 PSY 407 Intro to Counseling Theories 3 25 118 Sp 1992 PSY 407 Intro to Counseling Theories 3 22 121 F 1991 PSY 407 Intro to Counseling Theories 3 44 1 26 Sp 1991 PSY 407 Intro to Counseling Theories 3 33 1.21 F 1990 PSY 407 Intro to Counseling Theories 3 Sp 1990 PSY 407 Intro to Counseling Theories 3 16 1.12 F 1989 PSY 407 Intro to Counseling Theories 3 24 120 Sly 1989 PSY 407 Intro to Counseling Theories 3 18 L3] F 1987 PSY 407 Intro to Counseling Theories 3 26 121 F 1986 PSY 407 Intro to Counseling Theories 3 41 1.57 Sum 1987 PSY 499 Psychology of Sex Roles 3 16 1.18 Sum 1989 PSY 508 Emotional Crisis Workshop 1-2 39 *** "Frontiers of Mental Health And Education" Sum 1988 PSY 508 Emotional Crisis Workshop 2-3 63 "MindBody Interactions" Sum 1987 PSY 508 Emotional Crisis Workshop 2-3 106 "Relationships" Sum 1991 PSY 595 Health Psychology 3 15 Sp 1998 PSY 620 Assessment & Interviewing 2 9 4 31 F 1992 PSY 620 Assessment & Interviewing 2 12 1.66 F 1990 PSY 620 Assessment&Interviewing 2 1.03 F 1988 PSY 620 Issues in Behavioral Medicine 3 5 208 F 1997 PSY 621 Practicum College Teaching 2 10 4.77 F 1996 PSY 621 Practicum College Teaching 2 10 F 1993 PSY 621 Practicum College Teaching 2 13 1.45 F 1992 PSY 621 Practicum College Teaching 2 13 1984 PPSY 670 Tests and Measurements '0 Sp 1997 HON 200 Honors Connections Seminar: Alternative Healing Methods 2 20 3.67 of a Sp 1989 HON 200 Honors Connection Seminar 11: 2 9 *** "Love" Sum 1986 Eldcrhostel "Dream On" NC (25) Sum 1987 Elderhostel "Mind/Body Interactions" NC 19 *** Courses Developed: 1997 HON 200.Alternative Healing Methods 1991- PS? 595,Issues in Health Psychology, Summer 1989- 23rd Annual Emotional Crisis Workshop. Frontiers of Mental Health and Education. Summer 1988- PS?620, Assessment in Behavioral Medicine, Fall (Revised Spring 1998) 1988- PSY 423. Health Psychology, Fall 1988- 22nd Annual Emotional Crisis Workshop, Mind/Body Interactions, Summer 19%7- 21st Annual Emotional Crisis Workshop, Relationships. Summer 1987- Mind/Body Interactions- Eldcrhostcl Program, Summer 1987- PSY 499. Psychology of Sex Roles - Summer 1986- Dream On -Elderhostel, Summer Directed Studies: Graduate: 1995- Cynthia Holley. Hypnosis 1994 - Tara Johnson, Hypnosis Theory and Practice 1994 - Marla Gallagher, Sociometric Processes 1994 - Maria Gallagher, Cluster Development in Intro Psychology Classes 992 - Bruce Holoman. Hypnosis Research and Practice 1988 - Paul Jantz, Hypnosis for Pain With Children 1988 - Lori Kochevar, Women as Leaders 1988 - Jerri Israel, Alan Shaw, Issues in Health Psychology 1988 - Steve Foster. Michele Hozer. Teaching Apprenticeship 1987 - Tony Ambrosio, Hypnosis Models 1986 - Candy Disch. Psychological Testing 1 udergraduatc: 1998 Jennifer Altman - Exercise and Psychology 1996- Kindra Sanchez -Biracial Identity 1996 - Jenna Weatherbee -Pain Coping Styles 1995- Allison Ellis - Psychological Theories in Business Management I9')5 - Holli Elrick. Counseling and the Hearing-Impaired Child I L 94 - Lewis Garza, Etiology of Schizophrenia In 1994 - Suzanne Bodetko, Autogenic Training 1994 - Rebecca Furstenberg, Impact of Alzheimer's Disease on Families 1994 - Bonnie Sarton,Hypervigilence in Youth(Hon 351) 1993 - Mary Jo Hamilton,Hypnosis Theory 1994 - Greg Schooley,Forgiveness as a Therapy Tool 1993 - Jason DeBueno,Youth Advocacy 1993 - Kelley Ferguson-Women in Psychology 1993 - David Rosenberg-Offender Programs 1992 - Robin Trostel, Analysis of Learning Styles 1992 - Robin Trostel. Health Locus of Control 1992 - Roberta Inman,Family Violence and Lesbians(Hon 351) 1991 - Mark Kahl, Back Pain 1991 - Tracy Moulton,Treatment of Sexual Abuse 1991 - Mice McPherson. African American Women and Higher Education 1991 - Jody Hurner,Hypnosis:Theory and Practice 1990 - Jimmie Berg, Women's Learning Styles 1989 - Elary Violett, Cognition and Pain Management 1989 - Geri Bosley, Chris Snodgrass,Bev Foster,Elary Violett, Issues in Personality 1989 - Penny Vaughn, Female Pioneers in Social Work 1989 - Lori Peterson, Pain and the Elderly 1988 - Peer Training for Hotline Service 1987 - Tracy Boh, Issues in Child Abuse 1987- Julie Stoddard, Grief and Divorce 1987 - Eric Bouch, Hypnosis Models 1987- Mike Lesser, Assessment in Sport Psychology 1986 - Lynne Sheffield. Childhood and Loss 1986 - Jennifer March, Adolescence Practica 1998- Andrea Lamb-Hypnosis and golf performance 1998- Rebecca Varoula- Women's Place 1998- Greeley Medical Clinic -Gay Lemons, Renae Smith 1998- Ackerman and Associates-Amy Mnnel, Kristin Pietrzyk, Jennifer Kimberling, Greg Pedersen 1997- Greeley Medical Clinic- Lori Darst, Barbara Glode, Ann Marie McCullen, Jeff Titus 1993 - Greg Schooley, Breavement Research 1993 - Di Smice, Women's Commission 1992 - Mary Jo Hamilton,Hypnosis Research 1992 - Carol Sexton. Psychology Testing 1992 - Lisa Schlott,Learning Styles PROFESSIONAL DEVELOPMENT ACTIVITIES: Workshops, Clinics, Symposia, Conferences: (Excluding Conferences as a Presentor) 1099- EMDR training and Level I certification 1998 Qualitative research lecture series -UNC 1998- Lewis M. Ternan Western Regional Teacher's Conference sponsored by APA Division2 in conjunction with the WPA/RMPA joint convention. 1998- "Spirituality and health in counseling", CAHEC Workshop, Greeley 1998- `Divorce Busting: Solution oriented brief therapy with couples". Colorado Assoc. Marriage and F amik 1 997 - Health Maintenance -Legal and Ethical Issues 1997- Body and Soul: Healing in the 90's 1996- Celebrating our Essence: Women's Health and Spirituality 1995 - International Society for Clinical and Experimental Hypnosis-Research Workshop- San Franciseo_CA (30 more hours toward certification) 1989 - "Minding the Body, Mending the Mind". CAHEC Workshop. Ft. Collins 11 1'988 - "Demystifying Publishing", CAHEC Workshop, NCMC.. Greeley f)85 - "Attentional Deficit Disorders in Children", Meichenbaum, Denver '380 - International Society for Clinical and Experimental Hypnosis-30 certification hours.Denver Numerous other workshops on Parent Loss, Child Abuse, Grantsmanship, Short-Term Treatment, Supen'ie.ion_ Pain Management. Medical Terminology. Depression. Personality Disorders Courses Taken C)'edit: 1)94- EPRE 603 -Analysis of Variance udir 1)93 - EPRE 602 -Elements of Statistics 1 )90- EPRE 700 -Advanced Research Methods (:/Ufnuing Education Credit: 1)76 - C.U. Medical School -Medical Ethics 1)72 - C.U. School of Nursing -Hypnosis(10 weeks) 1)69 - University of Chicago-Kubler-Ross.Death and Dying HONORS AND AWARDS: 19x8- Distinguished Service Award-Rocky Mouintain Psychological Association 1998- Arts and Sciences Teacher of the Year Award-one of titre in Social Sciences 1398- "Wonderful Outstanding Woman" Award-Highlighted in October newsletter-Women's Resource Center 1393 - Commencement Banner Carrier, Arts and Sciences 1)93, 91,89, 88 - Mortar Board Favorite Professor 1992 - Sudent Representative Council University Professor of the Year 1)92 - Student Representative Council University Advisor of the Year 1)89 - Arts and Sciences Achievement Award 1)88 - Honors Advisor of the Year 1384 - Psi Chi. University of Northern Colorado Chapter 1')82-83 - Writing Associateship-Rocky Mountain Women's Institute 1� bk. BDi- R < 103-651-9514 9/28/99 CURRICULUM VITAE N. Karen Bender, MA, LPG 1104 Twin Peaks Circle Longmont, Colorado 80503 Phone: 303-678-8940 BUSINESS ADDRESS: 2919 W. 17th Ave.. Suite 214 Longmont, Colorado 80503 Phone: 303-678-0268 MARRIED: Brice J. Bender, MD, April 26, 1974 CHILDREN: Sara C Bender, born 3/13/79 and Melissa K. Bender. born 9/8/80 EDUCATION: Bachelor of Arts, Chemistry University of Colorado at Denver, 1977 Master of Arts in Agency Counseling, Emphasis in Marriage and Family University of Northern Colorado, 1993 Externship: Mental Health Center of Boulder County, Longmont Branch, Community Support Services Team, Sept. '92 to June '93 Currently enrolled in Professional Psychology Doctoral Program University of Northern Colorado (course work nearly completed) WORK EXPERIENCE: Feb. '94 to present Private practice, Individual adult clients and couples, Longmont. Fall '95: Counselor and presenter in multidisciplinary PMS program. Longmont Clinic. March '95 to May '96: Domestic Violence Counselor, Longmont Coalition for Women in Crisis, Individual adult clients; women's groups: domestic violence curriculum, support, and parenting. June '93 to Sept. '93: Therapist, Mental Health Center of Boulder County, Longmont Branch, Women's Issues Group. Sept. '84-Dec. '86: Cardiopulmonary Technologist, part-time Longmont United Hospital, 1950 W. Mountain View Ave., Longmont, Colorado 80501. June '79-April '82: Supervisor, Pulmonary Laboratory, Presbyterian/St. Luke's Medical Center, 601 E. 19th Ave., Denver, CO 80203 1-4 Jan. '76-June '79: Supervisor, Pulmonary Laboratory, St. Joseph Hospital, 1835 Franklin St., Denver, CO 80206 1975-1979 Clinical Instructor, Front Range Community College, 3845 W. 112th Ave.. Westminster, CO 80030, VOLUNTEER EXPERIENCE Sept. '98 to Sept. '99: Doctoral Student Representative. Division of Professional Psychology. University of Northern Colorado. Sept '94 to Mar. '95: Volunteer therapist: Longmont Coalition for Women in Crisis. Individuals and groups: domestic violence curriculum and parenting. Jan. '94 to July '95: Volunteer therapist: St. Vrain Valley Child Development Council, Inc., Head Start Program. Individuals, families, parent support groups that include parenting curriculum. June '93 to Aug. '93: Volunteer Co-therapist: Mental Health Center of Boulder County. Drug Treatment Team, Women's Group: History of Sexual and Drug Abuse. Co-therapist: Lisa Franseen. June '93 to July '93: Volunteer Co-therapist: Mental Health Center of Boulder County, Longmont Branch. Children's group: Attention Deficit Disorder. Co- therapists: John Fallon, MSW, and John Gerson, Ph.D. Nov. '91 to May '92: Volunteer individual counselor: University of Northern Colorado Counseling Center Feb. 1991 to Feb. 1992: Master's Student Representative. Division of Professional Psychology, University of Northern Colorado. Sept. '91 to Oct. '91: Volunteer Counselor: A Woman's Place, Greeley, Co 1990 to 1992: Scholarship Committee for American Association of University Women. 1990-1991: Member Board of Directors for Longmont Coalition for Women in Crisis. PROFESSIONAL ORGANIZATIONS: Co-chairman, Public Relations, Information and Education Committee, Child and Family Advocacy Team (Boulder County Child Sexual Abuse Task Force), June '95 to August '97 Facilitator, Longmont Study Group, Colorado Society for the Study of Dissociation, May '95 to August '97. o El* BEH FRR L03-651-5514 Member: American Counseling Association, Colorado Counseling Association, and Eating Disorders Professionals of Colorado. Associate Member: American Psychological Association. PUBLICATIONS: N. Karen Estridge Bender Slonim, N. B., & Estridge, N. K. (1969). Ozone ---An underestimated environmental hazard. Journal of Environmental Health, 31, 577. Slonim, N. B., & Estridge, N. K. (1970). The acid-base surface --- A 3- dimensional visual model. Rocky Mountain Medical Journal. 67, 59. Slonim, N. B., & Estridge, N. K. (1970). Carbon dioxide --- Environmental health aspects. Journal of Environmental Health, 33,171. Slonim, N. B., & Estridge, N. K. (1970). The acid-base surface: A three- dimensional visual model for analysis of acid-base information. Journal of Medical Education, 45, 828. Slonim, N.B., & Estridge, N. K. (1971). Carbon dioxide ---Environmental health aspects. In T. J. DeKornfeld (Ed.). $elected papers in inhalation therapy. Flushing, NY: Medical Examination Publishing, Co.. Inc. Slonim, N. B., & Bender, N. K. (1974). Responses to carbon dioxide containing atmospheres. In N. B. Slonim (Ed.). Environmental physiology. St. Louis; The C. V. Mosby Co. Slonim, N. B., & Bender, N. K. (1976). A tabular history: Cardiopulmonary technology as a profession. CVP, The Journal of Cardiovascular and Pulmonary Technology , 4, 31. Bender, N. K. (1977). Relevant respiratory physiology. The post-surgical patient, Spirometry. In V. Archuleta, O. B. Plummer, and K. D. Hopkins, A demonstration model for the project "Training nurses to improve patient education, Boulder, Colo.: Western Interstate Commission for Higher Education. Bender, N. K. (1988). Future trends in education, SVVEA Bridge, 3, 5 (St. Vrain Valley Education Association) PRESENTATIONS: Fall '95: Co-presenter with Haven Howell, M.D., multidisciplinary PMS program, Longmont Clinic. October '98: Co-presenter with Sean O'Halloran and Christine Rogers: A Roundtable discussion entitled: "Facing our Clients' Trauma: Implications foi Counselors in Training," at Rocky Mountain Association for Counselor Education and Supervision. RESUME Emily L. Jaramillo-Bansberg 183 50th Avenue Place Greeley, Colorado 80634 (970) 353-1388 Office Telephone: (970) 351-2417/ Email: ejaramil@che.unco.edu EDUCATION • Master of Arts: Psychology/Counseling, University of Northern Colorado,Greeley, CO • Graduate Fellowship Study: Rutgers State University of New Jersey, Newark, NJ • Bachelor of Arts: Sociology, University of Northern Colorado, Greeley, CO EMPLOYMENT Associate Director The Center for Human Enrichment University of Northern Colorado, Center for Human Enrichment,Greeley, CO 80639 August 1997-Present Ensure efficient administration of the Student Support Services TRIO project which includes curricuh.m and instruction, technology,advising, and tutoring. Review the non-competing continuation and annual F erforrnancc reports. Assist with the provision of professional opportunities for Center employees. Oversee the state funded Bridging Opportunities Program that focuses on recruiting incoming freshmen and transfer sti bents into the Center for Human Enrichment. Direct the Ronald E. McNair Postbaccalaureate Achievement Pr&gram (see below). Director Ronald E. McNair Postbaccalaureate Achievement Program University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 March 1996-Current Direct all efforts to ensure efficient administration of the McNair federal TRIO grant. Co-author t..S. Department of Education McNair proposal. Responsible for the compilation, analyzation, and submission of Non-Competing Continuation and Annual Performance Reports to the Department of Education. Monitor project's federal and matching budgets, supervise and train staff members, and plan, develop, and direct all student scholar activities. Collaborate with campus departments in order to exceed program objectives. Responsible for coordinating, editing, and publishing the UNC McNair Scholars Journal. Identify, r.'rust and select program scholars. Ensure the completion of scholars' academic research projects. Provide acac _min advising and guidance to McNair scholars. Direct the academic year research seminar series, the r sidi'ntial Summer Research Internship, and other scholarly activities that prepare scholars for doctoral stud - Coordinate research and scholarly activities between faculty mentors and McNair scholars. Counselor/Assistant Director Ronald E. McNair Postbaccalaureate Achievement Program University of Northern Colorado, Center for Human Enrichment, Greeley, CO 80639 October 1995- February 1996 Assisted in the implementation of the McNair program (funded October 1995). Facilitated the recru tinent and selection of McNair scholars. Compiled and submitted federal reports. Informed and collaborated vvith campus offices and departments. Implemented an academic workshop series based on student needs. Provided ar ademik advisement and guidance to McNair scholars. Assistant Coordinator,Academic Advising Student Support Services University of Northern Colorado, Center for Human Enrichment, Greeley, CO January 1995-August 1995 Provided academic advisement and guidance to federal TRIO Student Support Service participants Maintained student record database. Assisted with the compilation of federal reports. Served as liaises to thr athletic department and the financial aid office. Assisted in the supervision of peer advisors. Pro\ided technological assistance within the program. Assistant Coordinator,Macintosh Computer Laboratory Student Support Services University of Northern Colorado,Center for Human Enrichment, Greeley, CO 80639 August 1994-December 1994 Supervised, scheduled, evaluated, and trained lab employees. Provided technical assistance and advisement to federal TRIO Student Support Service participants in a learning environment. Maintained and ordered consumable computer supplies. Evaluated and ordered computer software and hardware. RELATED EXPERIENCE Admissions Office Assistant University of Northern Colorado, Admissions Office, Greeley, CO December 1985-December 1988 Assisted in the daily operations of the UNC Admissions Office. Received and reviewed applicatiore and distributed accordingly. Filed, typed, and performed data-entry on all incoming freshman, transfer. re-entry, and non-traditional students. Trained and supervised co-workstudy employees on office procedures, FERPA, and the CCHE Index system. Provided general information to incoming students and parents. Co-Instructor University of Northern Colorado, Center for Human Enrichment CSPA 359: Paraprofessionals in Student Affairs, Academic Peer Advisors Co-facilitated the instruction for training of peer advisors who advised Student Support Service participants at the Center for Human Enrichment. Coordinated curriculum and instruction for pre-service and on-going training for a staff of fifteen peer advisors. Counselor Intern North Colorado Medical Center, Family Recovery Center, Greeley, CO January 1996-July 1996 Facilitated psychotherapy counseling groups and individual counseling for chemically dependent and eating disorder patients. Performed case management from admission to discharge. Presented psycho-educational information to patients, family members, and staff. Designed a portfolio brochure distributed to health care and managed care providers. Clinical Care Assistant Weld Mental Health Center, Greeley, CO September 1994- February 1995 Monitored and supervised the daily activities of chronically mentally ill patients in a learning/self- development environment. Facilitated group and individual counseling sessions. Coordinated patient recreational activities. Prepared written and oral reports. Correction Technician The Restitution Center, Greeley, CO February 1989- February 1990 Conducted informal counseling with non-violent felony offenders in a residential setting. Responsib'e f r the supervision of clients. Distributed client medications as prescribed. Performed searches and confiscat?cl contraband. Prepared written and oral reports. Instructed clients on self-development and new life approa‘hes as alternative methods of coping. PRESENTATIONS • Moderator: "Research & Policy Affecting the Education of the Mexican Child in the 21st Century," University of Northern Colorado. • Moderator: Second Annual McNair Scholars Research Symposium and Graduate Education Conference. • Panelist: Minority Students in Graduate School, Colorado State University. • Presenter: Financing a Graduate Education, Applying to Graduate School, Cultural Sensitivity and Awareness, Hispanic Women in Higher Education, Introduction to the Internet, and Communicating Across Cultures, University of Northern Colorado. • Presenter: Conflict Resolution, Communication Skills, and Setting Limits and Boundaries, North Colorado Medical Center. CAMPUS SERVICE: University of Northern Colorado Officer • Professional and Administrative Staff Council (President's Office) • Co-chairperson, Student Advisory Committee, Hispanic Cultural Center • Secretary, Macintosh Computing Society Member • Undergraduate Research Council • Cesar Chavez Cultural Center Cinco de Mayo Week Committee • Professional Development Award/Scholarship Committee • Relations with UNC Board of Trustees Committee • Salary Equity Committee • E:>empt Staff Evaluation and Performance Committee • Team UNC Fund Raising Committee • Academic Excellence Week Task Force • Campus Advisory Committee, Cesar Chavez Cultural Center Other • Reviewer/Evaluator for "UNC Works In Progress" conference. • Submitted and published an article in the International Student Services' newsletter entitled, Communicating Across Cultures. PROFESSIONAL AFFILIATIONS • ASPIRE member (Association of Special Programs In Region Eight) • CABE member (Colorado Association of Bilingual Education) • NCEOA member (National Council of Educational Opportunity Associations) HONORS AND AWARDS • Distinguished Alumni, Department of Sociology,University of Northern Colorado • Fellowship, Graduate Study-Rutgers School of Criminal Justice Fellowship, Rutgers State University of New Jersey, Newark, NJ • Scholarship, National Hispanic Scholarship Fund • Scholarship, Candelaria Scholarship, University of Northern Colorado, Greeley, CO PROFESSIONAL DEVELOPMENT AND TRAINING • National McNair Scholars Research Symposium-6th Annual, Penn State, College Park, PA. • National Council of Educational Opportunities Association (NCEOA) Proposal Writing Conference, tian Francisco, CA. • Reporting Student and Project Performance, Monterey Bay,CA. • First, Second,and Third Annual Rocky Mountain McNair Scholars' Research Symposium & Grail late Education Conference,Fort Collins,CO. • NCEOA 16th and 17th Annual Policy Seminar, Washington, DC. • NCEOA, Seminar on Relations with the U.S. Department of Education, Washington, DC. • NCEOA Proposal Writing Conference,San Juan,Puerto Rico. • Association of Special Programs in Region Eight (ASPIRE) Colorado Chapter, 1995-1998 State N loetings, Denver, Ft. Collins, CO. • Annual Rocky Mountain Teacher Education Consortium Conference,Greeley,CO. • Diverse Learners Academy, Leadville and Pueblo, CO. • National McNair Scholars Research Symposium, University of California, Irvine, CA. • Parent/Teacher Youth Leadership Conference, Breckenridge, CO. • National Association of Bilingual Education Conferences, Albuquerque,NM and Orlando, FL. • Northern Colorado Hispanic Chamber of Commerce Conference,Greeley, CO. • ASPIRE Regional Conference, Fargo, ND. • National McNair Scholars Research Symposium-4th Annual, Penn State, College Park, PA. • Scuth East Association of Educational Opportunity Programs Conference, Director Training, Asheville, NC • Cultural Diversity Conference, Greeley, CO. PERSONAL STRENGTHS • Communicate: Ability and extensive experience in communicating with a diverse population'. • Counsel: Formally trained to work with a variety of individuals in multiple settings • Leader: Ability to lead individuals and manage environments and situations. REFERENCES Dr. David Gonzalez University of Northern Colorado Division of Professional Psychology, McKee Hall Greeley, CO 80639 (970) 351-1639 Dr. Wendell Osorno University of Northern Colorado Division of Professional Psychology, McKee Hall Greeley, CO 80639 (970) 351-1635 Dollic Zamora Coordiator of Communication Greeley/Evans School District Six 811 15th Street Greeley, CO 80631 PERSONAL . DATA SHEET Identifying Information: Name : Laurence "Larry" P. Kerrigan , Ph. D. Address : 1706 19th Avenue Greeley, CO 80631 DOB: 9/20/32 Phone : ( 303 ) 353-3373 - business Delrees : BSC - Business Economics , from Creighton University , 1954 . MS - Economics , from St . Louis University , St . Louis , Mo . , 1963 . MA - Theology , from St . Mary ' s University, Regis College Campus , Toronto , Ontario , Canada , 1967 . Ph. L. - Philosophy , St . Louis University , St . Louis , Mo . 1960 , ( Ecclesial Degree ) . Ph . D. - California School of Professional Psychology , Berkeley/Alameda Campus , 1974 , Clinical Psychology . Currently a licensed psychologist in the state of Colorado . Educational Background : 1950-54 Creighton University, Business economics , 1954-56 Marquette University, Milwaukee , WI . , Classical studies and ascetical theology , 1956-57 Springhill College , Grand Coteau LA. Campus , Classical studies , 1957-60 St . Louis University , Philosophy and Economics , 1963-67 St. Mary ' s University, Toronto Campus , Theology , 1971-74 California School of Professional Psychology , clinical psychology , Berkeley/Alameda Campus Positions Held : 1969-71 Member of Board of Directors , Campion College , Prairie du Chien , WI . 1968-71 Director , Department of Psychology, Campion College . 1971-74 Director of Student Counseling Center , Long Mountain College . 1975-80 Director of Short-term Children and Family Team, Weld Mental Health Center , Greeley, CO . 1975-87 Clinical Psychologist , Child and Family Team , Weld Mental Health Center , Greeley, CO . 1975-88 Co-founder of Weld County Child Protection Team, 1987-88 Member of Executive Board , Weld Mental Health Center , • Greeley , CO . Honors Received : 1968-69 and Teacher of the year , Campion College . 1970-71 1972-73 Class Representative to Campus Executive Committee , and California School of Professional Psychology 1973-74 Work and Experiential Background_ 1959-60 Counselor at Dismas Halfway House for ex-convicts , St . Louis , Missouri , 1960-63 Teacher-counselor-coach , Marquette Prep High School , Milwaukee , WI . 1964-67 Counselor-therapist at Street Haven and Sancta Maria Halfway Houses for women and at the Don ( metro ) Jail in Toronto , Canada. 1967-68 Teacher and Campus Counselor at Creighton University , Omaha, NB. 1968-71 Teacher at Campion College , Prairie du Chien , WI . , Director of Psychology Department , Department chairman. 1970-71 Director and Staff member of a total environment for Inter-city boys , late grade school age from Milwaukee , WI . 1971-73 Director of Student Counseling , Lone Mountain College , San Francisco , CA. Teacher at the Lone Mountain College , San Franc: sco , California. 1973-74 Psychologist Trainee at San Francisco Mental Health Center , Richmond District , Outpatient Care . 1974-75 Private Practice , So . Bay Human Services Center , San Diego , CA . Part-time instructor at California School of Professional Psychology , San Diego , CA. 1975-80 Director , Short-Term Therapy '1'eanl, Children and Family Unit , Weld Mental Health Center , Crecle:' , CO . 1980-87 Member of Children and Family Therapy Team , Weld Mental Health Center , Greeley , CO . 1987- present Full Lime private practice with Joyce Shohet Ackerman , Ed . D . , Licensed Psychologist , Greeley , CO . Part time practice aL Weld Mental Health Cente - , Greeley , CO . Publication : Kerrigan , Laurence P . - The lieIationshi.p Between 'I'herapi ;t and Client ' s Perceptions of One Therapy Session . Published Doctoral Dissertation , University of Californic School of Professional Psychology . Copyright , 1971 . Workshops and Special -Training : Since 1974 , I have attended an average of• about three workshops per year . Most of these workshops have presented specialized training in the following areas : Neuro-linguistic training , Autogenic and relaxatio❑ training , Visualization-Imagery - Ilypnosis , Cognitive-Behavioral Therapy , Ericksonian apprDaclles to hypnotherapy and psychotherapy, Family therapy, Strategi : family therapy , Sexual abuse , dynamics and applied treatment , Paradoxical intention psychotherapy , and other related areas . In the last fifteen years , 1 have taught classes and conducted workshops in the following subjects : The Psychology of Dreams Emotional and Physical health through Visualization and Imagery Western Psychotherapies and Eastern Ways of Liberation Cognitive and ❑ehavioral Therapy Hypnosis in Pain and Habit Control. The Psychology of Consciousness and Meditation Sherri R. Malloy, Ph.D. Licensed Clinical Psychologist Office: Home: Mental Health Center of Boulder County 24 Alles Drive 1333 Iris Avenue Greeley, Colorado 80631 Boulder, Colorado 80304 (970) 351-7218 (303) 413-6301 Education Ph.D. Double Major: Child Clinical Psychology; Clinical Psychology. August 1993 University of Colorado, Boulder. M.A. Department of Psychology, Clinical Program. University of July 1989 Colorado, Boulder. B.A. Major: Psychology; Minor: Spanish. Arizona State University. May 1987 Summa Cum Laude. Teaching Cert. Roston Montessori Teacher Training Institute. August 1977 Orange, California. Montessori Elementary Education Certificate. Clinical Experience August 1991- Child and Family Psychotherapist, Mental Health Center of Boulder March 1997 County, Boulder, Colorado. Provided outpatient psychotherapy t children and their families. Parent, teacher, and other agency consultation. September 1992- Psychology Intern; Denver General Hospital, Denver, Colorado. August 1993 Outpatient assessment, consultation, and treatment to children, adolescents, and adults; Inpatient treatment to adolescents & their families. Consultation to multidisciplinary hospital staff. Attended regular seminars and case conferences Completed an additional rotation in neuropsychology. August 1990- Psychotherapist, University of Colorado, Farrand Residence Ha.1. May 1992 Provided individual, conjoint, and group psychotherapy to Farrand residents. Psychiatric consultation to faculty and staff. Presented seminars and workshops to faculty, staff, and students. August 1988- Emergency Psychiatric Services Clinician, Mental Health Cenie: August 1992 of Boulder County, Boulder. Colorado. Evaluation and disposition planning for clients with psychiatric emergencies. Composed a training manual for emergency psychiatric clinicians 2 Malloy January 1988- Psychotherapy Intern, Raimy Psychology Clinic, May 1992 Department of Psychology, University of Colorado, Boulder. Provided outpatient psychotherapy to adults, families, and children. Parent and teacher consultation. February 1986- Intake Clinician; Group Facilitator, 'fri-City Behavioral Ilealth July 1987 Center, Mesa, Arizona. Conducted intakes for the adult team. Facilitator for children's psychotherapy groups. Administrative and Supervisory Experience Jan 1996- Team Leader, Mental Health Center of Boulder County, Boulder, present Colorado. Clinical and administrative supervision of a team of psychologists and psychotherapists. Budgeting. Supervision of support staff. Coordinate outpatient services/consultation to joint agency programs, including Head Start, Specialized Foster Care, Post-Adopt, 1178, School-Based Services, Boulder Day Nursery, and People's Clinic. August 1990- Adult Team Coordinator, Raimy Psychology Clinic, Department August 1991 of Psychology, University of Colorado, Boulder. Chaired the adult team meetings and case conferences. Assisted clinic director wi.h administrative tasks. August 1990- Peer Counselor Supervisor, Farrand Residence Flall, University of May 1991 Colorado, Boulder. Developed and implemented a peer counseliq; training program. Provided ongoing training and supervision tc peer counselors. January 1989- Supervisor in Training, Raimy Psychology Clinic, August 1991 Department of Psychology, University of Colorado, Boulder. Received training and supervision in supervisory techniques. Supervised the psychotherapy of first-year clinical psychology graduate students. June 1989- Adult Team Intake Coordinator, Raimy Psychology Clinic, August 1990 Department of Psychology, University of Colorado, Boulder. Intake and disposition of psychotherapy clients. September 1989- Clinical Supervisor, Emergency Psychiatric Services Team, August 1992 Mental Health Center of Boulder County, Boulder, Colorado. Trained and supervised Masters level student interns in emergency clinical assessment techniques, legal and procedural practices, and psychological report writing. February 1988- Volunteer Trainer, Maslin House for Chronically Mentally Ill, May 1989 Mental Health Center of Boulder County, Boulder, Colorado. Recruited and trained volunteer college students to work with the chronically mentally ill population at this facility. 3 Malloy Publications December 1994- Columnist: The Boulder County Parent, a monthly publication of the present Parenting Place, Boulder, Colorado. Circulation: 8,000. Topics include child development and parenting concerns. Teaching Experience August 1989- Psychology Instructor, Front Range Community College, May 1992 Boulder Campus, Colorado. Fall 1988 Head Teaching Assistant, Department of Psychology, University of Colorado, Boulder. Trained and supervised graduate level Teaching Assistants. August 1987- Teaching Assistant, Department of Psychology, University of May 1989 Colorado, Boulder. August 1977- Montessori Elementary Teacher, Roston Montessori School, May 1983 Orange, California; and subsequently, Tempe Montessori School, Tempe, Arizona. Taught preschool through second grade classes. Responsibilities included academic program planning and implementation, supervising teacher assistants, conducting parent- teacher conferences, academic record-keeping, and giving educational presentations to parents. August 1976- Student Teacher, Roston Montessori Teacher Training Institute, August 1977 Anaheim, California. Taught in a Montessori classroom under thi; supervision of a certified Montessori teacher. Duties were the same as in the entry above. Presentation Topics and Trainings Given Play Therapy Engaging so-called "resistant" clients Psychotherapy with adolescents and their families Case Conferences Parent-Toddler Attachment Patterns Child Abuse Child Psychopathology Stress Management Workshop Depression and Risk of Suicide in College Students 4 Malloy Research Projects Adult Attachment Style and College Functioning (Doctoral Dissertation), 1992 Parent-Toddler Attachment Relationships (Masters Thesis), 1990 Post-Divorce Visitation Patterns and Parent-Toddler Attachment, 1988 Effects of Divorce on Children, 1987 Mental Health Center Client Satisfaction Study, 1986 Clinical Assessment Trained in the use of the following assessment tools: WISC-Ill MMPI Draw-a-Person Kinetic Family Drawing Thematic Apperception Test Rorschach Inkblot Test Sacks Sentence Completion Test Strong-Campbell Interest Inventory Professional Affiliations 1997- present Member: Internal Review Board MHCBC 1996-1997 Member: Professional Advisory Board, Mental Health Center of Boulder County 1991- 1992 Co-Chair: Multi-Ethnic Action Committee, Department of Psychology, University of Colorado, Boulder. 1991- 1993 Member: American Psychological Association, Division 12, Clinical Child Psychology. 1989- 1991 Member: Multi-Ethnic Action Committee, Department of Psychology, University of Colorado, Boulder. 1988- 1989 Student Representative: Department of Clinical Psychology. University of Colorado, Boulder. 1987- 1989 Member: Developmental Psychology Research Group, Department of Psychology, University of Colorado, Boulder. 1987- present Member: (Intermittent) American Psychological Association. 5 Malloy Honors and Awards 1988 Department of Clinical Psychology Scholarship; University of Colorado, Boulder. 1987 Phi Beta Kappa 1987 Academic Scholarship, Arizona State University, Tempe, Arizona. 1986 Phi Kappa Phi Honor Society 1986 Golden Key National Honor Society 1979 West Valley College Track Team, West Valley, California; State Champions. 1977 Fellowship Award; Roston Montessori School, Orange, California Additional Training Regular participation in bi-monthly seminars, case conferences and supervision held at the Mental Health Center of Boulder County. Readin.,s and professional conferences in the field of clinical psychology. Other Experience 1996-present Vice President (elected), Suburban Ditch Company, Greeley, Colorado. 1983- 1985 Small Business Owner/Opera.tor: Graphicolor, Phoenix, Arizona. Photography and advertising design. Commercial and portrait photography, advertising design, sales, supervised salespeople, performed administrative tasks. 1982- 1985 Dance Aerobics Instructor, International Fitness Center, Mesa, Arizona. Choreographed dance routines, taught classes regularly. made public presentations on behalf of the fitness club, and participated in an ongoing certification/training program in exercise physiology and dance choreography. 6 Malloy Addendum Graduate Coursework: Child Development/Psychopathology Developmental Psychology Developmental Psychopathology Child Psychotherapy Clinical Practicum (six semesters) Theory and Issues in Developmental Psychology Personality/Psychotherapy Advanced Psychopathology Advanced Personality Theory Clinical Study of the Individual Adult Psychotherapy Family Research and Therapy Research Methodology/Statistics General Statistics (two semesters) Research Practicum (four semesters) Research Problems in Clinical Psychology Assessment Projective Testing Objective Testing Courses for Distributed Minor Multicultural Psychology Community Mental Health Marriage and Family Counseling Behavioral Neuroscience: Clinical and Pathological Perspective Nicole Warnygora 3200 Azalea Drive# K-4 Fort Collins, Colorado 80526 (970) 407-1.578 Education Master of Arts Agency Counseling: Marriage and Family Therapy August 9, 1998 University of Northern Colorado, Greeley, Colorado, G.P.A. 4.0/4.0 Bachelors of Arts Major: Psychology Minor: Political Science May 23, 1993 Augsburg College, Minneapolis, Minnesota, G.P.A. 3.5/4.0 Experience Mental Health Therapist North Range Behavioral Health, Carson Children's Center/Children's Acute Treatment Unit Greeley, Colorado • Provided individual therapy to children in a day treatment program • Provided family therapy to the children and families • Facilitated a children's group • Evaluated, diagnosed, and created treatment plans for children • Consulted with parents, teachers, psychiatrist, social worker, and the courts to ensure quality and continuity of care • Collaborated with teachers, parents, and social workers, to enable the child to have a successful transition to public school Test Supervisor Career Services Center, University of Northern Colorado, Greeley, Colorado (8/95 - Present) • Coordinated national testing program including administration of the ACT, SAT. and ()RI' • Trained, hired and supervised testing personnel Child and Family Therapist Intern North Range Behavioral Health, Greeley, Colorado (1/97— 6/97) • Provided individual therapy to children, and provided family therapy • Facilitated a children's group for clients in a day treatment program • Evaluated, diagnosed, and created treatment plans for a variety of children • Consulted with parents, teachers, social workers, and the courts to insure quality and continuity in client care and treatment • Provided services to a diverse population including deaf clients Childcare Relief Worker Families First, Aurora, Colorado (2/96 — 10/97) • Created a safe environment for children ages 3 -12 who were removed from parental homes • Responded, assessed and made referrals for crisis phone calls • Facilitated group discussion for children at the crisis center • Monitored parental phone calls and visits to ensure safety for the children Nicole Warnygora, Page 2 Habilitation Counselor/Program Coordinator Paragon Services Incorporated, Duluth, Minnesota (1/94 - 8/95) *Developed programs to assist dual diagnosis clients achieve independence • Supported families with children with emotional disturbances or developmental disabilities and were at risk for out of home placement • Supervised and trained staff • Coordinated services to provide consistency between service providers Program Coordinator Nekton Services Incorporated, Duluth, Minnesota (7/93 - 12/93) • Coordinated the set-up of a group home for three autistic young women • Developed program plans and daily activities • Supervised, coordinated, scheduled, and trained staff • Designed a training manual and trained staff personnel in functional American Sign Language Family Counselor Intern Minneapolis Crisis Nursery, Minneapolis, Minnesota (9/92 - 5/93) • Responded, assessed and made referrals for crisis phone calls • Performed short-term personal counseling with parents • Provided behavioral assessments and programs for children in the homes of clients Program Counselor/Program Coordinator Dungarvin Alternative Services Inc., Saint Paul, Minnesota (9/91 -7/93) • Coordinated client assessments with the interdisciplinary team • Completed behavior analysis for the purpose of program development • Developed and implemented programs for children who were developmentally disabled and emotionally disturbed in their home environment Counselor Day Care Systems Incorporated, Superior, Wisconsin (Summers 1988, `89, '90, &'91) • Responsible for the care of three children with autism • Implemented programs during the summer to provide fun for the children Volunteer Kindergarten Teacher, Saint Paul's Church, Duluth, Minnesota Tutor, Minneapolis, South High School Tutor, Multi-Cultural Center, Augsburg College, Minneapolis, Minnesota Honors & Award for Excellent Student Employee, Career Services, University of Northern Colorado 19»6 Activities Non—Resident Scholarship for Academic Excellence, 1996 Weld County United Way Special Needs Child Care Committee, 1999 RFP-FYC-00008 Attached A INTENSIVE FAMILY THERAPY PROGRAM BID PROPOSAL FAMILY PRESERVATION PROGRAM 2000/2001 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2000-2001 BID #RFP-FYC-00008 ACKERMAN & ASSOCIATES P.C. NAME OF AGENCY: ADDRESS: 1750 25th Avenue Suite 101, Greeley, Colorado 80634 PHONE: L9.70 ) 353-3373 ( 353-3374 fax) CONTACT PERSON: Joyce Shohet Ackerman Ed.D. TITLE: Psychologist, PresidentAckerman and Associates DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Intensive Family Therapy Program must provide for therapeutic intervention through one or more qualified family therapists.typically with all family members,to improve family communication. functioning. and relationships 12-Month approximate Project Dates: _ 12-month contract with actual time lines of: Start. June 1.2000 Start End May 31. 200Q End TITLE OF PROJECT: The Goal Achievement Program \ \ �.cq,_ 4)3L).n.. \�6, u--0---a-14e.„ fl.4 Joyce Shohet Ackerman Ed.D/Alan Ackerman Ph .D. _Nawe and Signature of Person Preparing Document Date Jo ce Shohet Ackerman Ed.D. —2C) — C C _ _Name and Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REQUIREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 2000-2001 to Program Fund Year 2000-2001. Indicate No Change from FY 1998-1999 / _1/ Project Description c�f.4r _,Z Target/Eligibility Populations _ __t./Types of services Provided _k_ Measurable Outcomes /Service Objectives __Z Workload Standards _v_ Staff Qualifications V_ Unit of Service Rate Computation -V--- _Z-Program Capacity per Month _✓ Certificate of Insurance Page 26 of 32 Hello