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HomeMy WebLinkAbout20001540 RESOLUTION RE: APPROVE TWO NOTIFICATION OF FINANCIAL ASSISTANCE AWARDS FOR CORE SERVICES FUNDS AND AUTHORIZE CHAIR TO SIGN - ISLAND GROVE REGIONAL TREATMENT CENTER, INC. 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 two 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 Island Grove Regional Treatment Center, Inc., 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 two 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 Island Grove Regional Treatment Center, Inc., be, and hereby are, 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 Ad) WELD COUNTY, COLORADO ATTEST: L %ta u_z' A �'�_._7'- 1861 " - parbara J. Kirkmeyer, Chair ,. Weld County Clerk to th- :oa . '( ������ - /EXCUSED / a �4 „ M. J. Geile, Pro-Tem BY: - • 1� rd .� . _ Deputy Clerk to the Board - l� eorgerE. Ba r APPROyED AS TO FO i - ---Y Dale K. Hall Cnttorn y i EXCUSED Tenn Vaad 2000-1540 �; SS rs�andGrcvz P��ioi1Q/ TpCtfiYlP�1 f( T r °soon 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-3001 Revision (RFP-FYC-00008) Contract Award Period Name and Address of Contractor Island Grove Regional Treatment Center, Inc. Beginning!J6/01/2000 and Individualized Family Systems Intensive Family Therapy Ending 05/31/2001 1140 M Street Greeley, CO 80631 Computation of Awards Description Unit of Service Improve both individual and family functioning The issuance of the Notification of Financial Assistance through in-home and in-office services. A Award is based upon your Request for Proposal (HIP). maximum of 60 families a year, 14 units active at The RFP specifies the scope of services and conditions any one time, with an estimated average stay in of award. Except where it is in conflict with this intensive therapy of 25 weeks (in-home or in- NOFAA in which case the NOFAA governs. the REP clinic), an average of one-two contacts per week upon which this award is based is an integral part of the of 3 clock hours of contact. action. Cost Per Unit of Service Special conditions Hourly Rate Per Unit of Service 1) Reimbursement for the Unit of Services will be based Based on Approved Plan -$ 98.75 on a hourly rate per child or per family. 2) The hourly rate will be paid for only direct lace to face Enclosures: contact with the child and/or family, as evidenced by _X Signed RFP:Exhibit A client-signed verification form, and as specified in the _X Supplemental Narrative to RFP: Exhibit B unit of cost computation. Recommendation(s) 3) Unit of service costs cannot exceed the hourly and yearly cost per child and/or family. X Conditions of Approval 4) Payment will only be remitted on cases open with. and referrals made by the Weld County Department of Social Services. 5) Requests for payment must be an original submitted to the Weld County Department of Social Services by the end of the 25th calendar day following the end of the month of service. The provider must submu requests for payment on forms approved by Weld County Department of Social Services. Approva s: Program Official: By t/ / By 1 arbara J. Kirkmeyer, hair Judy Grietg , Direct Board of Weld County Commissioners Weld-Count I Department of Social Services Date: _Ini l.-.2yao -_ Date: C �%C% 2000-1540 SIGNED RFP EXHIBIT A SUPPLEMENTAL NARRATIVE TO RFP: EXHIBIT B CONDITIONS OF APPROVAL • ISLAND GR .o , -- R0MLX^INmAND _ REGIONAL TREATMENT CENTER, INC . Est 19/4 May 16, 2000 Frank Aaron Social Services Administrator Weld County Department of Social Services P.O. Box A Greeley, CO 80632 Re: RFP 00008, Intensive Family Therapy RFP 00007, Sex Abuse Treatment Dear Frank: I received notification of acceptance of our bids for RFP 00008 and RFP 00007. RFP 00007 was accepted without any conditions or recommendations. RFP 00008 was accepted on condition that we discuss specifics of the program with Social Services staff regarding how many weeks, number of hours required for each referral, and the step-down plan. Island Grove accepts this condition and understands that it will be incorporated into our RFP Bid and Notification of Financial Assistance Award (NOFAA). I will have Scott Wykes, Family Services Program Manager, contact your agency to schedule a meeting with social services staff to describe the elements requested above. Scott will contact appropriate staff by June 1, 2000, to arrange a convenient time to review the Intensive Family Therapy program. If you need any further information, please do not hesitate to contact me. Sincerely, \ - B,I Dea , MA, CAC III Executive Director cc: John Wilde Scott Wykes ���1y A Behavioral Health Agency Specializing in Alcohol/Drug Abuse !1 1140re Ml Street,Greeley,Care CO ces/ • ,n,AX(9]0) •(9 0l3 �� 349 (r��f Intensive TrealmenVA<ule Care Services/Administration•(9701 J56 666a � Community Counseling Center (970)351-6678/Fort Lupton Branch•(303)857-6365 • 0 atDEPARTMENT OF SOCIAL SERVICES PO BOX A GREELEY,CO 80632 Administration and Public Assistance(970)352-1561 Child SluRe May 10, 2000 CC4PITn, I xecutOive Director Island Grove Regional Treatment Center 1140 M Street Greeley, CO 80631 Re: RFP 00008, Intensive Family Therapy RFP 00006, Sex Abuse Treatment Dear Ms. Dean: 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 00008• Intensive Family Therapy: Condition: Discuss with Social Services staff specifically how many weeks and the number of hours required for each referral, and the step-down plan. 2. RFP 00007, Sex Abuse Treatment: Approved with no conditions or recommendations.. B. Required Response by RFP Bidders Concerning FYC Commission Condition The Weld County Department of Social Services is requesting your written response lo the FYC Commission's condition. Please respond in writing to Frank Aaron, Social Services Administrator, Weld County Department of Social Services, P.O. Box A, • Greeley, CO, 80632, by Wednesday, May 24, 2000, close of business, as follows: ., Page 2 Island Grove Regional Treatment Center Results of RFP Bid Process PY 2000-2001 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 are 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, v , 10 i Jlu y A. Gri go, Dir tor / 4Cou y Department of Social Services JG:ef cc: Esteban Salazar, Chair, FYC Commission Frank Aaron, Social Service Administrator INTENSIVE FAMILY THERAPY FAMILY PRESERVATION PROGRAM DEPARTMENT OF SOCIAL SERVICES WELD COUNTY 2000/2001 BID PROPOSAL RFP-FYC # 00008 Island Grove Regional Treatment Center, Inc. 1140 M Street Gree/ey, CO 80631 INVITATION TO BID DATE:February 28, 2000 BID NO: RFP-FYC-00008 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-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 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 (After receipt of order) BID MUST BE SIGNED IN INK PJ DEAN TYPED OR PRINTED SIGNATURE Island Grove Regional VENDOR Treatment Center, Inc. (Name) Han ten Signature By Authorized Officer or Agent of Vender ADDRESS 1140 M Street TITLE Executive Director Greeley, CO 80631 DATE March 22, 2000 PHONE # (970) 356-6664 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 NAME OF AGENCY: ISLAND GROVE REGIONAL TREATMENT CENTER, INC.. ._ADDRESS: 1140 M Street, Greeley, CO 80631 PHONE: ( 970 ) 356-6664 Program. Manager of CONTACT PERSON: Scott Wykes TITLE: Family Services 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 June 1, 2000 End May 31.2000 End May 31., 2001 TITLE OF PROJECT: Intensive Family Therapy Program r N. ) ( I l C _ � jj Ar Scott Wykes March 22, 2000 _Name and S gnateofS Person Preparing Document Date 'r&L BJ Dean March 22, 2000 Name n 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 flange from FY 1998-1999 _/_ Project Description ja) _✓ Target/Eligibility Populations 00 awl 54) _V Types o.`services Provided uJ _✓ Measurable Outcomes ilo G�SW' ✓ Service Objectives kle cki ) Workload Standards sit kA&M .50 _.1". Staff Qualifications (,ja c,V, L :)[I'I Unit of Service Rate Computation i, ` sui Program Capacity per Month Sl c k1 -SZ _t7 Certificate of Insurance U Page 26 of 32 RFP-FYC-00008 Attached A Date of Meeting(s)with Social Services Division Supervisor: Comments by SSD Supervisor: ,, L � 41 [ lt� (IJ_TJ> tftfiTP �t.a. Jim' / lt `Cf ' � � !'Cv--- _ �� ,g7/' l i r i l id t:a ; eti / ti° � �, .d (2, a t /- - — — (_ C,_Ct- �,- c_- I l C Ce1 , �_ (ki c� Name and Signature of SSD Supervisor Date �r� Page 27 of 32 RFP -FYC -00008 Intensive Family Therapy Program Bid Category Intensive Family Therapy -Family Preservation Program Island Grove Regional Treatment Center, Inc. PROJECT DESCRIPTION Most families face enough challenges to test even the most successful families. Add an accompanying element such as substance misuse by any of its members and the disruptior can be so extensive that parent's face losing their substance-involved children or children lose their parents to the control of chemicals. These high-risk situations require effective interventions. Island Grove Center's Intensive Family Therapy Program has remained current on developments in Family Therapy to deliver such interventions. The IFT Program is specifically geared to assist substance-involved families in reclaiming their lives from this undermining influence. Using a Strength based perspective, our staff focuses or building family strengths with the goal of reunifying the family and retaining children safely in their homes. Each referred family is provided with in-home or in-clinic family sessions. Solution-based models of family therapy have demonstrated success in working with this population in a time-efficient, goal-directed manner. The clinical staff has expertise in both couples and family therapy, as well as recent developments in drug and alcohol abuse counseling. This combination of skills provides our staff with the tools to pave opportunities for families to choose more responsible and mutually satisfying ways of living. The frequency of sessions and the duration of the program is assessed and determined by the clinical team, in collaboration with the caseworker and the involved family In addition to family sessions, case aide support, group therapy, and other auxiliary services can be accessed by individual family members. Truly, an individualized and customized family treatment plan can be a reality. The following menu is available to augment and reinforce goal attainment with the approval to bill other authorized funding, such as the ADAD Menu. • Sobriety support groups • Domestic violence education and therapy • Substance abuse education • Women's Therapy Group • Pregnant Women's services • Vocational assessment and planning • Antabuse monitoring • Urinalysis and breathalyzer testing As demonstrated in the past, our family services team will maintain and nurture collaborative relationships with case workers to facilitate timely, flexible, and appropriate services to support the case plan. II. TARGET/ELIGIBILITY POPULATIONS Our Intensive Family Therapy team will serve eligible, substance-involved families within Weld County. Due to proven demand, we are currently capable of carrying an average of 14 family cases at any given time, for a total of 60 family units over the upcoming funding period. We have the flexibility to expand the availability of our team to accommodate additional referrals. This could include more than 150 children within these families, from preschool ages on up, within the year. We will also accept referred families where children are at high risk for substance misuse Length and intensity of treatment vary among the families, depending on the severity of their challenges and their willingness to use the resources available to them. We estimate the average duration of the program to cover a twenty-five-week span, with an average between one to two contacts per week for an estimate of three clock hours of contact at the outset of treatment. Later stages of this time period would typically decrease services to bimonthly contacts. The upper end of the intensity could involve twelve hours of contact per week, for a brief period, in the most extreme cases. Our referred families will be contacted within two business days to arrange for the initial assessment. Depending on the family's schedule, the assessment will occur, typically in-home, within seven business days from the moment of referral. In case of crisis, all referred family members will have access to 24-hour response through our Acute Care Services unit and available on-call family services counselors. Services to South Weld County families have previously comprised approximately one-fourth of our total enrollment. We have been responding to these families through accessing our Ft Lupton office or providing in-home sessions in the further outlying areas such as Dacono Hudson, or Frederick. Recognizing the need for bilingual/bicultural services, we are prepared to serve up to twelve Spanish-speaking families this year. If a family refuses treatment or appears inappropriate for outpatient services, we will immediately contact the caseworker and discuss other referral possibilities. This may include referrals :o Intensive Outpatient, residential services, or other special program areas. III. TYPES OF SERVICES TO BE PROVIDED A. Comprehensive assessments and treatment planning: Family services counselors will complete an in-depth family assessment during the initial home visit for all accepted referrals to determine to what extent substance involvement and other factors impact the family's functioning, as well as to identify strengths the family brings to their situation. The Browning Outcomes Survey Scale (BOSS)will be used to gather a pre-and post- treatment measure. The Department of Human Services -Alcohol and Drug Abuse Division requires us to implement the ASAM criterion and ASI instrument to match level of treatment with level of care needed. The family's primary counselor will collaborate with the family to develop a treatment plan that will prioritize and specify measurable objectives. Frequently, families incorporate goals of accessing community resources and other providers. 2 B. Therapeutic interventions that may include an array of auxiliary services: In addition to weekly family therapy sessions and available case management services, individual family members and DSS case workers may find it beneficial to supplement or follow-up the IFT service base with other Island Grove Center offerings or additional community support. The IFT family member could have, at their disposal, therapy groups for women's issues, education and therapy for domestic violence offenders, counseling support and education for pregnant and postpartum women (Medicaid reimbursable), vocational assessment, substance abuse education, detoxification, residential treatment, urinalysis, and breathalyzer monitoring. Virtually every related and necessary service can be accessed within Weld County at Island Grove Center or via the collaborative relationships that Island Grove has with an extensive list of other community providers There are many caring and competent professionals invested in the families that we share. Other funding streams, such as the ADAD Menu, have been utilized in the past to access existing Island Grove services when authorized by the caseworker. We estimate that 50% of our referred IFT families could benefit from being involved in additional monitored services. C. Co-facilitated therapeutic services by qualified family therapists: Many family sessions are facilitated by pairs of master's level family therapists. This strategy, usually comprised of a male and female team, is utilized when therapeutically beneficial to the family. It is employed discriminately to contain costs and to manage staff time and coverage, yet it may comprise 25% of the family sessions. Other staff combinations such as concurrent individual therapy have been useful in meeting the specific needs of some family members. D. Therapy that is designed to dissolve conflicts and restore respectfulness within the family: Family counselors will consistently use solution-based models of family therapy. Solution building and outcome-based strategies have demonstrated success within the brief and managed care models of service provisions. Focusing on a family's strengths, this model integrates well with the services of other providers. The therapy is designed to empower families to implement respectful and responsible conflict skills, restore family boundaries, and discover life without the involvement of drugs and alcohol. The instrument chosen, the BOSS, indicates measure of relational skills, family goal attainment, and levels of conflict. IV. MEASURABLE OUTCOMES A. Children receiving services do not go into out-of-home placement We can anticipate that 80% of families completing all recommended treatment will not lose children to placement. Our communication with caseworkers will verify these outcomes. B. Families remain intact: Similarly, we expect that 80% of.families completing this program will remain intact and continue to improve. Post-discharge version of the BOSS should indicate sustained positive changes. It will be administered by telephone six months after the family is discharged. The BOSS results from the 1998-99 fiscal year indicated that of the referrals to the Island Grove Intensive Family therapy program, 55% successfully ended treatment, 6%were discharged due to incarceration, 23%were moved to more restrictive treatment and only 16% were unsuccessfully discharged. 3 C. Reunification of children with families: The program design for IFT, by its nature, will include, ideally, as many family members in the solution-building process as there are available. Without this involvement, the progress toward goal attainment is slower and much more difficult. Our goal is set at 85% satisfactory completion of all families referred. Satisfactory completion is defined as: All significant family members were included in the treatment plan and completed stated goals prior to discharge. D. Improvements in parental competency, parent/child conflict management: Therapeutically, the focus of much solution building will be in regard to the areas of competency. We feel the BOSS instrument will give us a measure of these areas within the sub-scales. There are desired obvious behavioral outcomes we want to see, such as kids going to school clean drug screens, etc. All of these incidents will be recorded as the counselor becomes informed, recorded in the base file, and data brought together within the submitted quarterly reports. E. Cost efficient IFT services in comparison to placing the child:We estimate our average monthly treatment costs per family to be under$400. With an average satisfactory completion time frame of six months, the high end of the total costs would still be at only $2,400.00. F. Therapeutic outcomes include fundamental changes in the family functioning and dynamics:We believe that the regular administration of the pre and post BOSS will indicate improvement in significant family functioning. Other indicators will be recorded such as child's school performance, any out-of-home placement decisions, and ooserved achievements between sessions. V. SERVICE OBJECTIVES A. Improve Family Conflict management Family sessions are targeted toward demonstrating family skill building in conflict resolution and sensitive communication. In addition to the instrument mentioned throughout the proposal, the family's individual treatment plan will indicate progress or continued deficits. B. Improve Parental Competency: Instruments such as the BOSS will provide measures of the quality of the relationships within the family. The counselor's home visit reports will also indicate basic safety, supervision, and nutrition needs being met. Additional referrals to participate in other provider's programs will be recommended as needed. Specialized materials will be purchased and utilized to address the impact of substance abuse on parenting abilities. C. Improve Ability to Access Resources: The program's responsibility, in addition to establishing a working, therapeutic atmosphere with the family, is to be a vehicle, literally, at times, to connect families to their communities. Our clinical staff will arrange for transportation of family members to sessions and other agency or community resources, as it applies to the completion of the treatment plan. As a result, the family may continue these sustaining relationships long after their treatment" ends. 4 Documentation within the case files will indicate the community net that is being woven with the family that is validating their positive directions. Our minimal goal for each family is that one or more of its members establish at least two appropriate community contacts during their course of treatment. These could include such links as peer support groups for sobriety, Job Service, United Way agency volunteering, Food Bank, recreatior center involvement, or Sunrise Community Health, etc. VI. WORKLOAD STANDARDS A. Number of hours per day, week, or month: Families are generally involved in one family session per week, 1 to 1.5 hours in duration. One or more family members may have additional individual sessions of one hour per week and/or auxiliary support services ranging from 1 to 3 hours per week. A minimum average would be 2 hours per week but could range up to 12 hours, if even only periodically. We clearly want the family to have all possible resources and services available to them. On the other hand, we want to individualize the response to the presenting needs, without always assuming that"more is better." B. Number of individuals providing the services: We have access to three degreed counselors and one case manager. C. Maximum caseload per worker. With a staggered caseload, in that families will be at a range of service needs, and with the assistance of our case manager, our counselors can handle a case load of twelve families. Their administrative duties are kept to a minimum so that full attention can be focused on direct services. D. Modality of treatment:All IFT core services will be on an outpatient basis. E. Total number of hours per week: Our Weld County families will be receiving between 1 to 2 hours of service per week/per family (less in later stages of treatment). F. Total number of individuals providing these services: 3 G. Maximum caseload per supervisor. 10 H. Insurance: Flood & Peterson Insurance, Inc. -see attached documentation VII. STAFF QUALIFICATIONS • Scott D. Wykes, Family Services Program Manager Doctoral Candidate, Counselor Education and Supervision emphasis in Marriage and Family Therapy M.A. Pastoral Counseling Licensed Professional Counselor(LPC) Experience: 3 years Intensive Family Therapy , 6 years general therapy 5 Anne Gleditsch, Counselor- Family Services M.A. —Agency Counseling, emphasis in Marriage and Family Therapy CAC III Experience: 4 years Family Therapy 9 years general therapy Judi Ashley, Counselor- Family Services LMFT(Licensed Marriage and Family Therapist) M.A. -Agency Counseling, emphasis in Marriage and Family Therapy CAC III Experience: 5 years Family Therapy 17 years general therapy In addition to this core clinical staff whose education and experience is specifically in family services, we also have available a case manager, clerical assistance, administrative project supervisor, and additional contracted clinical supervisor, Dr. William Walsh, Director of the Marriage and Family Program at the University of Northern Colorado. All staff will have a minimum of 16 clock hours of continuing education annually. Scott D. Wykes, our Program Manager and contact person for the IFT program, has a large role in tie clinical monitoring of the program's daily operation. He interacts with all involved staff numerous times per week and tracks case load, service hours provided, and responds to on-call crises, comprising approximately six hours of his work week. He supplements this ongoing supervision with periodic it- services, presenting alone or with Dr. Walsh. Dr. Walsh meets twice each month with our clinical team for 1.5 to 2 hours each session. Dr. Walsh is a well-respected clinician and scholar of innovative models of family therapies. He is well versed and practiced in the ongoing professional development of the field, in addition to mentoring bright and enthusiastic professionals such as Island Grove's Family Therapy team. C.\KATHRYN\FAMSERV\DSS 00-01\IFT Bid Proposal 00-01 doc 6 RFP-FYC-00008 ATTACHMENT A Intensive Family Therapy Program Bid Category Intensive Family Therapy - Family Preservation Program Island Grove Regional Treatment Center, Inc. Total Hours of Direct Service per Family Unit 12.4 Hours [A] Total Family Units to be Served 60 Families [B] Total Hours of Direct Service for Year 744 Hours [C] (Line [A] Multiplied by line [B] Cost per Hour of Direct Services $35.12 Per Hour [D] Total Direct Service Costs $26,128.18 [E] (Line [C] Multiplied by Line [D] Administration Costs Allocable to Program $35,709.57 [H Overhead Costs Allocable to Program $11,632.97 [G] Total Cost, Direct and Allocated, of Program $73,470.72 [H] (Line [E] Plus Line [F] Plus Line [G]) Anticipated Profits Contributed by this Program $0.00 [I] Total Costs and Profits to be Covered $73.470.72 [J] by this Program (Line [H] Plus Line [I]) Total Hours of Direct Service for Year 744 [K] (Must Equal Line [C]) Rate per Hour of Direct, Face-to-Face Service $ 98.75 [L] to be Charged to Weld County Department of Social Services Day Treatment Programs Only: [M] Direct Service Hours Per Client Per Month Monthly Direct Service Rate [N] 03%2012@€0 16:47 3634497365 BOULDER INS Assoc R4(,,_ rA//�� ,,��+'I►►� bATF{MM/DDIIfYI VoRa '' � :' � Li . . - • 03/20/2000 HROouCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Talbot Boulder Insurance Associate HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ODES NOT AMEND. EXTEND OR 01 zeth :street ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Boulder, CC:) 80301 COMPANY American Compensation Ins Co A rin wRED _.�._..._ _ --CO - Island Grove Regional Treatment Center B COMPANY B 1140 M Street COMPANY C Greeley CO 00632 — r'"'"' COMPANY 0 COVERAGES' ..:.: o. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ICO I TM OF INWRANOE POLICY NUMBER POLICY EFFECTIVE 'POLICY ATION LIMIT: I.TiI DATE IMNIMD/YII OMIT IMMIDMMIDDIYYI I`GENERAL LIABILITY GENERAL AGGREGATE . • COMMERCIAL GENERAL LIABILITY 1 PRODUCTS•COMPIOP A00 • I CLAIMS MADE El OCCUR ', PERSONAL 6 ROY INJURY a I ,OwNE1'R'1-s 6 CONTRACTOR'S PR0T EACH OCCURRENCE L• _ FINE OAMAGE(Any ore 1vs1 E MED LAP IA"!one ANION • AUTOMOMILA UASIUTY COMBINED SINGLE LIMIT • ANY AUTO ILL OWNED AUTOS BODILY INJURY • (Pr pP�•ont SCI"'EDV LF:D AUTOS ,-_—7.1 RIG WOES BODILY INJURY F IPn FccIdenO • 1 NON.OWNED AUTOS .�. _--- � - PROPERTY DAMAGE • ` _ -, °ARAM LIABILITY f AUTO ONLY•EA ACCIDENT • _ ----ANY AUTO I OTHER T _ MAN AUTO ONLY: _. ._. I _. EACH ACCIDENT I AGGREGATE • __._�__ -. (*01 5 UAPIUTY I EACH OCCURRENCE 1 UMBRELLA FORM AGGREGATE _ • I-^ ^__ DINER T'INAN UMBRELLA FORM • A WOIa:E116COMPENSAT10NANQ ACCO0040794 10/01/1999 f10/O1/2000 f we STATU- ; EOM. �TORYLIMIT:Li Eq _�._..—�._.. EMPLOYERS'UAIILRY EL EACH ACCIDENT • J, 7 t PROPRIETOR! INCL EL DISEASE POLICY LIMIT I PART NERSIEXLCUTIY E - - _ CIFE;CER5 ARE EXCt Ei DISEASE•EA EMPLOYEE • _ - OTHER •oE&CRIPfON OF OPERATION$ILOCAT•ONININICLZIMPECIAI.REM& CertAficate Holder shall read. weld County Colorado, by and through the Hoard of County Con1l+lissioners of weld County. its employees end agents FAO( Insured: Jill Marcy 970-356-1349 CERTIFICATE HOWit • • ,.. : . . .. ... .... CAiOCEt.DItioa weld County Colorado SHOULD MY OF TI•E MOVE DE&CIUMMD POLICIES IS CANCELLED BMW THE Board of County Coa dseionere EIIFIRAT�IOI1N DATE THER IN AN EOF. THE ISSUING COMPANY MINA INOEAYOR IL TO MA 0]5 10th St reet 30 okra w1Irr1N NOTICE To TFPS CERTIFICATE HOLOBR NAMED To TIPS LEFT. COT0Ary+ notice for non-payment CUT FAILJM TO MAIL SUCH NOTICE$HALL IMPOSE NO OIUOATION OR UMIUTY :reeley CO 80632 Of N•Y1 RIND UPON THE COMPANY. ITS AGENTS OR REIREBEENTATIVE$ --, AUTOO seNTATIVE -.,D La e.44.11 S 4if9* , :_ . o�i1C>i�tit�'CARPoS aTtoN Ilse AdsI23.57324 Client# : 13740 ISLGR ACTIRQ,~ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY) 03/20/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 211 First Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. --aton, CO 80615 /0 454-3381 INSURERS AFFORDING COVERAGE INSURED INSURER A:Frontier Insurance Ccmpuny, Inc . ISLAND GROVE REGIONAL I INSURER B:ST PAUL FIRE & MARINE INSURANCE C TREATMENT CENTER INC r -- INSURE-Ro: 1140 M STREET h INSURER D: GREELEY,. CO 80631 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE. FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS ANI`CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR.• TYPE OF INSURANCE POLICY NUMBER P DATE(MM/DDIYY) DATYM EXPIRATION - LIMITS - - - -- A ! GENERAL.LIABILITY G20002952200 04/01/00 04/01/01 EACH OCCURRENCE - SL, 000, QQQ ',I X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any ann Ire) $S 0 , (1 Q Q CLAIMS MADEI X'I OCCUR MEDEXP(Any one 001-:•01) $5,-00Q PERSONAL&ADVINJI IRY s1, 000, 300 -_-- _-.- _-. - GENERAL AGGRESA- $ 3 , 000, Jcc GENtAGGREG_AT_E LIMITAPLIESPER:P PRODUCTS-COMPIUP ASS s3 , 0010 , )00 POLI(:v., JECT r ,' LOO•B AUTOMOBILE LIABILITY FK06602680 04/01/00 04/01/01 COMBINED s.NGLEI M,T XIANYAUTO (Ea accident) OOC1 , 000 ALL OWNED AUTOS BODILY INJURY 1SCHEDUI_EO AUTOS (E'er person) H'.RED AUTOS BODILY INJURY X , NON-OWNED AUTOS (Pe,-accident) - ---I -- --- ---- - — PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ONLYLENTT $ ANY AU-0OTHER THAN EA ACC $ - • AUTO ONLY: AGG S EXCESS LIABILITY EACH OCD URRE NCFI 5 ' ,' AGGREGATE $ OCCUFI CLAIMS MADE', DEDUCTIBLE . RETENTION $ III - 'WCSTATU- 'i107H- .,WORKERSCOMPENSATIDNAN❑ ITORYL IMITS .' ER _ EMPLOYERS'LIABILITY E.L.EACH ACCIDEN- $ IE.L.DISEASE-EAEMP,SIYEE $ i E.L.DISEASE-POL IC+LIMIT $ AIDTHERPROFESSIONAL 020000136202 04/01/00 04/01/01 $1 , 000 , CCC PER CCC. LIABILITY $3 , 000 , 00C AGGREGATE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS AD DE BY ENDORSEMENT/SPECIAL PROVISIONS WELD COUNTY, COLORADO, BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, ITS EMPLOYEES & AGENTS, AND THE STATE OF COLORADO ARE NAMED AS ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR IN REGARDS TO THE OPERATIONS OF THE INSURED. CERTIFICATE HOLDER • ADDMONALINSURED;INSURER LEI ItR: _ CANCELLATION SHOULD ANYOFTHEASOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION WELD COUNTY COLORADO DATE THEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAI L6 Q_ DAYSWRITTEN 'ARD OF COUNTY COMMISSIONERS NOTICETOTHE CERTIFICATE HOLDERNAMEDTOTHE LEFT,BUTFAILURE TO DO SO SHALL - _'' WELD COUNTY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 915 - 10 STREET REPRESENTATIVES. GREELEY, CO 80631 AUTHORIZED REPRESENTATIVE Rood Pt/S LS?" Ii7scaaleC, , _-L - ne--- ACORD 25-S(7/97)1 of 2 #148710 JMG 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon• • ACORD 25•S(7197)2 Of 2 #148710 Weld County Department of Social Services Notification of Financial Assistance Award for Families, Youth and Children Commission (FYC) Funds Type of Action Contract Award No. _X Initial Award FY00-PAC-3002 Revision (RFP-FYC-00007) Contract Award Period Name and Address of Contractor Beginning 06/01/2000 and Island Grove Regional Treatment Center,Inc. Ending 05/31/2001 Individualized Family Systems Sexual Abuse Treatment 1140 "M" Street Greeley, CO 80631 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance This program is to develop a sexual abuse Award is based upon your Request for Proposal (RIP). treatment program that will address and treat The RFP specifies the scope of services and conditions the individual needs of the entire family. Initial of award. Except where it is in conflict with this assessment to determine specific treatment NOFAA in which case the NOFAA governs_ the R f P needs or the family. Subcontract with upon which this award is based is an integral part of the professionals in the field who have already action. established their specialty in dealing with victims, non-offending parents, and siblings, or Special conditions adolescent and adult perpetrators. Stage 1 of the program will serve an estimated 30 families 1) Reimbursement for the Unit of Services will be based per year; Stage 2, 32 families; Stage 3, 10 on an hourly rate per child or per family. families. Recommendation is 18 months 2) The hourly rate will be paid for only direct face to face involvement with all tracks of the program, an contact with the child and/or family, as evidenced by average of four hours per week. client-signed verification form, and as specified in the unit of cost computation. Cost Per Unit of Service 3) Unit of service costs cannot exceed The hourly and Hourly Rate Per $ see rate chart yearly cost per child and/or family. Unit of Service Based on Approved Plan 4) Payment will only be remitted on cases open with, and referrals made by the Weld County Department of Enclosures: Social Services. _X Signed RFP:Exhibit A 5) Requests for payment must be an original submitted to Supplemental Narrative to RFP: Exhibit B the Weld County Department of Social Seri ices by the Recommendation(s) end of the 25th calendar day following the end of the Conditions of Approval month of service. The provider must submit requests for payment on forms approved by Weld County Department of Social Services. Appro/�v,l,s�: Progra Officiatel By A.{� �6 him Ay - By . i ieli 13arbara J. Kirkmeyer, hair Judy. Gri g , Dire or Board of Weld County Commissioners Wel County Department of Social Services Date: O4,"aXo-a?OGv Date: (Cp 0 _ — oW)0O -/s 4O SIGNED RIP EXHIBIT A SEXUAL ABUSE TREATMENT PROGRAM FAMILY PRESERVATION PROGRAM DEPARTMENT OF SOCIAL SERVICES WELD COUNTY 2000/2001 BID PROPOSAL RFP-FYC # 00007 Island Grove Regional Treatment Center, Inc. 1140 M Street Greeley, CO 80631 1I INVITATION TO BID RFP-FYC 00007 DATE:February 28, 2000 BID NO: RFP-FYC-00007 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-00007) for:Family Preservation Program--Sexual Abuse Treatment 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 Sexual Abuse Treatment Program must provide for therapeutic intervention through one or more modalities to prevent further sexual abuse perpetration or victimization. This program announcement consists of five parts, as follows: PART A...Administrative Information PART D...Bidder Response Format PART B...Background, Overview and Goals PART E...Bid Evaluation Process PART C..Statement of Work Delivery Date _ (After receipt of order) BID MUST BE SIGNED IN INK DJ- Dean TYPED OR PRINTED SIGNATURE • Island. Grove Regional )n VENDOR Treatment Center, Inc. (Name) Han itten Signature By Authorized Officer or Agent of Vendor ADDRESS 1140 M Street TITLE Executive Director Greeley, CO 80631 DATE March 22, 2000 PHONE ; (970) 356-6664 - The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 RFP-FYC-00007 Attached A SEXUAL ABUSE TREATMENT 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-00007 NAME OF AGENCY: ISLAND GROVE REGIONAL TREATMENT CENTER, INC. ADDRESS: 1140 M Street, Greeley, CO 80631 PHONE: f___870) 356-6664 Program Manager of CONTACT PERSON: Scott Wykes TITLE: Family Services DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Sexual Abuse Treatment Program triusi provide for thera eutic intervention through one or more modalities to prevent further sexual abuse perpetration or victimization. 12-Month approximate Project Dates: X 12-month contract with actual time lines of Stan June 1, 2000 Start June 1, 2000 End May 31. 2001 End May 31, 2001 TITLE OF PROJECT: Sexual Abuse Family Therapeutic Interventions (SAFTI) Program AMOUNT REQUESTED: C \ c u it� 1/t/,{C Scott Wykes _ March 22, 2000 Name and Signature of Per tit Preparing Document Date ��JJ ��,., BY Dean March 22, 2000 Name an ,S)gnature 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 1999-20110 X Project Description MWT &&lime -.. -ti.; __K Target'EligibilityPopulations CA.�n�ij,�•�.,, l 5-w' _.7: Types of services Provided rn1c ,pc���A���y� "" =5j _7 Measurable Outcomes AL; `^"" 3^' —5ij _X Service Objectives r c++lcaw-e- 5°' ?C_ Workload Standards - . _SC Staff Qualifications QC ck&,r��it,��.�a� , . ttil _X Unit of Service Rate Computation - d.__-""` -4w Program Capacity per Month ckvwg_i.94)r _ _ Certificate of Insurance Page 25 of 32 RFP-FYC-00007 Attached A `)ate of Meeting(s) with Social Services Division Supervisor: 3/ / o Comments by SSD Supervisor: da Yt.e.Lc _ d d '. __ -- d?ti4-[Pet.,-"? /w��t-Gt �t-s4YLAFO.e.tLM .74T 4T ,.....e.,...7----,,�----.-- a• ,,;.t,� o-7 G/ ..-k r.4c�P c--,�/ -- �� 37170°Name and Signature of SSD Supervisor Date Page 26 of 32 RFP - FYC - 00007 Program Category: Sexual Abuse Treatment Program Project Title: Sexual Abuse Family Therapeutic Interventions Vendor: Island Grove Regional Treatment Center, Inc. I. PROJECT DESCRIPTION Island Grove Regional Treatment Center, Inc. has redesigned and refined a comprehensive, client focused SAFTI program that addresses the needs of individuals displaying inappropriate conduct in regards to the expression of sexuality. The program consists of three stages described as follows: Stage I A twelve-week psycho-educational group for adolescents (10-17) and their families. This stage addresses the inappropriate expression of emotion through gestures. behaviors, and comments that are sexually offensive in nature and content. Stage II An 18-24 month Offense-Specific treatment for adolescent offenders (10-17) and their families. Comprised of individual, group, and family therapy sessions, polygraph examinations and clinical assessments. Adult Sex Offender Assessments are offered through this stage of the program, however, no further treatment will be offered. Stage III A six-month follow-up program for adolescents (10-17) who have been released from Residential Offense-Specific programs and are in need of integration back into their families and communities. Comprised of individual and family sessions that are stepped down in frequency and one polygraph examination. Since family compositions and sexual abuse situations are so diverse, the stages within this program seek to individualize the components based on the presenting and developing issues of each case. Therefore, key personnel of the new SAFTI Team are grounded in strength- focused systemic family therapy. Current literature reflects how competency-based family therapy is more effective and less time consuming than traditional methods. We have seen the need for this upgrade in the SAFTI Program based on our experience in working with the Weld County Department of Social Services and, as a result, have developed the three specific stages of which Stage II contains a five-phase treatment model. Based on the initial family assessment and collateral information gathered, the subsequent steps will be determined to acquire additional specialized assessments as needed to engage the family members in the beginning of, as well as throughout, the treatment process. We have hired and subcontracted professionals who specialize in: • The assessment of adult offenders • The assessment and treatment of adolescent offenders • The assessment and treatment of victims • The assessment and treatment of involved families Stage I Island Grove Regional Treatment Center Inc. has designed a comprehensive educational program that addresses the needs of adolescent individuals who find themselves confronted 1 with their own inappropriate sexual behavior resulting in suspension from school, rejection from family members, sentencing to detention centers, etc. This psycho-educational program, in group format, is designed to educate adolescent males and their family members in the appropriate conduct of sexual expression and emotional management. Stage II Island Grove Treatment Center SAFTI Program will continue an Offense Specific treatment program for adolescent sex offenders (10-17) and their families under Stage II. This stage of the program is available in two packages. Both packages offer a step-down reduction in costs and services. Scheduled evaluation periods determine criteria for continuing, referring or discharging clients. The initial phase is divided into the choice of two packages to which the resulting phases (II-V) may be added. The five-phase treatment schedule is described as follows: Phase I Package A (1st month - see attached schedule) Phase I Package A of the SAFTI program includes an initial family assessment, an individual perpetrator assessment, a polygraph examination, and intensive family therapy. The family assessment seeks to address the family dynamics that encourage secrecy and silences as well as providing an evaluation of the parents' ability to insure the safety of the victim. The effects of the sexual abuse on the victim and the rest of the family ecology are assessed using the Brief Basic Background—2 (BBB-2, see attachment#1). A family therapy specialist meets with the family twice during a one-week period to conduct this assessment beginning with the Browning Outcome Survey Scale (BOSS, see attachment #2), which is used as a pre-test, post-test measurement tool. At this time the family is advised of the perpetrator's Contract for Treatment (see attachment#3), the program's Discharge Criteria (see attachment#4), costs for which the family may be responsible, and the Schedule of Treatment as outlined in the five phase process (see attachment#7) The individual perpetrator assessment includes a review of the perpetrator's psychosocial history, academic education, and offender knowledge base through clinical interviews and other means. Releases are signed to obtain corroborating documentation and at this time the contract for treatment is reviewed and agreed upon. The perpetrator meets weekly with Anne Gleditsch for a total of four sessions. The result of this assessment helps determine the perpetrator's appropriateness for inclusion in group therapy. A polygraph examination is scheduled and completed during this time in order to facilitate honesty and to reveal any additional victims that have been previously unknown. It is the family's responsibility to schedule this exam as soon as possible to avoid being placed on a waiting list, hindering assessment. The family is provided the names and telephone numbers of the polygraph providers on the first contact. Intensive Family Therapy is conducted twice weekly to solidify safety in the home for each family member. Throughout the course of treatment the family will establish goals of family therapy that will help to prevent re-offending, to improve parental competency, to improve family conflict management, to improve personal and relational competencies, and to improve the ability to access resources. Contact with the family during Phase I is most critical when the offending adolescent continues to reside in the home with the victim. 2 Phase I (Package B) (15` month - see attached schedule) Phase I Package B is designed identical to Package A with the additional benefit of a formal Sex Offender Assessment complete with psychometric measures. These measures may be critical in determining cognitive and emotional deficits that may contribute to the offender's behavior. Following the completion of Phase I (A or B), a consultation with the caseworker and the treatment team maps a treatment strategy for each referral. A determination is made using the results of the individual assessment (and sex offender assessment if Package B), family assessment, and polygraph. An individual deemed inappropriate will be referred back to the referring caseworker. A referral deemed appropriate to continue all services will do so under the Phase II schedule. Phase II (2n° to 6'h month - see attached schedule) In Phase II, family members are assigned to therapists as needed. Adolescent offenders are enrolled in an offender's group and meet twice weekly to reduce offender problem behaviors and to promote the prevention of re-offending. The facilitator, Anne Gleditsch, authors and mails monthly progress reports (see attachment#6) to caseworkers, parents, and probation officers alike to keep them informed. This offense specific group was upgraded last year following an intensive training presented by Gail Ryan of the Kempe Center. A second polygraph examination is conducted by the end of this phase. Perpetrators who admit new victimization that takes place during the treatment duration no longer meet the criteria to stay in the program and, as a result, are referred back to the referring agency. The majority of the non-offending family members are assigned to family therapy specialists who meet with family members weekly. The same criteria and goals are achieved during this time period as described in Phase I. Victims are assigned to individual therapy specialists as needed. At the completion of Phase II, the family and the perpetrator are assessed by a consultation with the treatment team and the caseworker to determine the appropriateness-of reducing group attendance to once weekly. In Phase II, secrecy and silences are broken in the family dynamics and the process of ensuring the safety of all family members is established. The treatment team, caseworker, and family determine the appropriateness of family therapy being reduced to twice per month. This determination moves the referral to a Phase III status. Phase III (7`h —12`h month - see attached schedule) In Phase III, the referral is attending weekly group sessions, twice-monthly family sessions, and the completion of one polygraph examination. At the completion of 12 months, the perpetrator and the family are evaluated for progress in treatment. Treatment after one year includes transference to Phase IV status Phase IV (13t to 181h month - see attached schedule) The Phase IV status includes the referral completing monthly family sessions, weekly group sessions and one polygraph examination. At the end of this phase, a referral is staffed to determine if discharge is appropriate. Exit Interviews are conducted with referrals that have 3 met the discharge criteria. Referrals not meeting the discharge criteria continue to Phase V of treatment. Phase V (19t to 24th month - see attached schedule) Phase V consists of monthly family sessions, weekly group sessions, one polygraph examination, and Exit interviews. The discharge criterion that was not adequately achieved for discharge in Phase IV will be stressed with the referral and family. At the completion of Phase V, the referral has received all the benefits of our Stage II SAFTI program The perpetrator and the family will be referred to another agency at discharge from this program should they not assess positively as having grasped the concepts of treatment. Successfully completed referrals will receive proper documentation. (It should also be noted that should an offense occur within the treatment time frames, immediate discharge could be forthcoming as noted in the contract.) H. TARGET POPULATIONS Island Grove Center will provide services to all appropriate individuals and families that present for all Stages of the Island Grove Treatment Center Sexual Abuse Family Therapeutic Interventions (SAFTI) Program. Stage I Program Island Grove Treatment Center seeks to serve referrals to the adolescent program from probation, DSS, courts, schools, and family requests. Ages of referrals range between 10 and 17 years of age and include minors who exhibit behaviors such as "mooning'', stalking classmates or other youths, sexist remarks and gestures, offensive sexual gestures/remarks, phone harassment, etc. Clients will be limited to those in the normal range or above of intellectual functioning. Enrollment in the twelve-week group will be open and consistent attendance will be required. Two to three groups will be run simultaneously depending on the need and will be limited to ten members each. During the course of the fiscal year it will be possible to serve an estimated 30 clients and their families with the breakdown as follows: Perpetrators under 18 30 Non-offending family members 60 Stage II Program In the Stage II program, we are estimating 82 total clients to be served. If we approximate serving 32 total families, we predict, given our trends from previous years, that this will encompass the following sub categories: a. Victims under the age of 18 25 b. Perpetrators under the age of 18 24 c. Non-abusing spouse/parent 25 d. Adult offenders for evaluation only 8 Because of the specialty and recommended intensity of the sexual abuse program, we are not prepared to offer extensive bilingual programming. Consequently, the subtotal of individuals receiving bilingual services will be limited to the assessment phase only with the assistance of a Spanish-speaking interpreter. This may involve only three individuals over the fiscal year. 4 Service to south Weld County will be limited to individuals, estimated at five, who can arrange to access the core of services in Greeley. Case management can be arranged to provide transportation to those deemed in need of such services (attachment #5) All individuals enrolled can have access to 24-hour services through our Acute Care Services unit. If appropriate and necessary, an outpatient counselor can be reached or will return calls within a 24-hour period. Our maximum ongoing program capacity is 12 families, with an average at eight We know that engaging and maintaining these families in treatment is difficult without effective engagement or consequences. While we would like to recommend at least 18 months of involvement, we estimate that families will be involved on an average of four hours per week if involved with all tracks of the program. Stage III Program Island Grove Treatment Center will provide services to referrals from other treatment agencies that are residential in nature. The Stage III Program meets the needs of referrals that have completed all aspects of residential treatment and are in need of integration back into families and communities. Only referrals who have successfully completed a residential Offense-Specific treatment program will be considered. We estimate that we can serve 10 referrals and their families with the break down as follows: Perpetrators under the age of 18 10 Non-offending family members 40 III. TYPES OF SERVICES TO BE PROVIDED Stage I Individuals attending the program will undergo an initial assessment to include a clinical interview with the individual and family, review of school records, legal records, police reports and other corroborative information provided by outside sources. A Browning Outcome Survey Scale (BOSS) will be administered to serve as a pre-test, post-test measure. The educational curriculum includes segments addressing anger management, emotion management, sex education, cognitive and behavioral restructuring, etc. Additionally, each member will present to the group a special project that will demonstrate knowledge learned. Parents will be in attendance to view the presentation. The family components will address issues related to the referral and other goals that the family may desire. Stage II The SAFTI Adolescent Sex Offender program will lean heavily on the front-end assessments (family, individual, polygraph, and sex offender assessments) to determine the course of treatment for all involved family members. The first contact will be made by one of Island Grove's family therapists from the SAFTI Program. The assessment sessions that take place in the first month will determine the eligibility of the referral, the need for further specialized assessments, as well as provide the opportunity to have disclosures signed and the family becoming oriented to the program offerings. This will also be the period where collateral information from the caseworker is gathered including the police report of the referring incidents. The most comprehensive assessments involve the adolescent perpetrator. Extensive history- taking and psychometric testing (if Package B or if an adult) comprise several sessions to 5 gather the necessary information regarding the sex offender. We have found it useful to include polygraph testing. This is done at the onset of assessment and at the close of every six months of treatment. Polygraph examinations have the potential of being investigative in content. Any new information is included and forwarded in the assessment report to the caseworker. Without this level of thoroughness for perhaps the pivotal member of the family, effective treatment is not likely. Due to the special nature of this type of testing, we have access to two providers to administer and interpret the examination results. The providers are Amich and Jenks, Certified Polygraphers in Denver with a new Greeley location, and Glenn Knipscheer. The assigned family therapy specialist will evaluate involved family members. We have found it useful to have available resources to assess for involvement in substance misuse and domestic violence, as well as, vocational planning and neuropsychological issues. Individual families will be seen as a unit. The victim(s) or non-offending parent(s) may be seen individually if coalitions of secrecy are detected between family members for brief periods. As needed we will assign specific clinicians for certain program functions. There are two important tasks of family sessions in early stages, especially when the perpetrator is a youth. One is to establish safety in the home and the second is to educate the families about the effects the perpetration may have had on family members such as the cultivation of secrecy and the hyper- responsibility that many families and victims are recruited into. Once family sessions have progressed so that it is appropriate and safe to do so, the perpetrator will join the sessions. The offending family member will be integrated in the process only if they have progressed sufficiently in their own therapy so that the victim is not further traumatized. Anne Gleditsch, facilitator of the adolescent offender treatment group, along with the family team, will decide when this would be safe. To insure a coordinated therapeutic effort, the clinical team will arrange twice-monthly clinical supervision/staffing and additional conferences with the caseworker, the guardian ad litem, attorneys, probation officers, and DSS unit supervisors involved with the family. Through these opportunities we will stay current on resources and providers, and insure there is no duplication of community services. Additional Service The SAFTI program is able to offer Sex Offender Evaluations for adults through a contract provider. When an adult perpetrator has been evaluated and found appropriate for treatment. he/she will be referred to another provider for treatment. The SAFTI Program no longer provides offense-specific treatment for adult offenders (attachment#5). Stage III • The goal of the Stage III Program is facilitate and monitor a referral's integration back into the community and their particular family. Referrals who have successfully completed adolescent residential Offense-Specific Treatment only will be accepted. Referrals to Stage III will meet weekly on an individual basis and in family sessions to assess treatment needs, to determine knowledge base, and to establish goals of treatment. As in Stage II, the treatment will be front loaded for the first month and then "stepped down" for the second and third months to bi-weekly for individuals and twice monthly for families. The fourth through the sixth month will include bi- weekly individual sessions and monthly family sessions with a polygraph at the end of the treatment phase. 6 IV. MEASURABLE OUTCOMES A. Reduced rate of recidivism of sexual abuse perpetration: With a family actively engaged in recommended components for a period of at least three months for Stage I, eight months for Stage II, and six months for Stage III, our objective is to reduce the percent of re- offending at no more than 15%. This will include targeting any victim in the community or within the home. The scope of victimization also includes any incident report or arrests that are incidents of non-physical sexual misconduct such as indecent exposure or voyeurism. We will use all available information including therapists' reports, DSS reports, polygraphs, and police records, as well as therapeutic disclosures. We will review recidivism on a quarterly basis. B. Decrease in re-victimization: Similar to above, yet focusing on the solution building efforts performed by the perpetrator, the victim and other non-offending family members, our objective is to reduce any further incidents with the identified victim throughout the family's involvement in the program. We propose to limit re-offending to a maximum of 10% We will review recidivism on a quarterly basis. This goal was met during 1999. C. Reduce problem behaviors: By providing a range of services to the offender, our objective is to assist in reducing the number of symptoms and decreasing conduct problems. We can only project that aiding in the resolution of the offending, the offender, as a victim will not perpetrate in the future. Current research indicates that less than one-third of perpetrators were themselves victims of childhood sexual abuse. Particularly in female victims, they are more likely to harm themselves, rather than to victimize others. Our data will include the observation of indicators, such as self-harming incidents, general misconduct, or sexual acting- out with no targeted victims. D. A percentage of child abuse victims receiving services do not go into placement: Considering all factors, to include the perpetrator's behavior, the non-offending parent's (s') ability to insure safety, and the victim's responses that may effect out-of-home-placement, our objective is to retain 75% of these children safely in the home. E. Improvement in parental competency as measured by pre and post placement functional test: Our-team will use the Browning Outcome Survey Scale (BOSS) upon enrollment and at discharge, which gives overall measures of family functioning. Thus far, the BOSS has been instrumental for the family in expressing concerns regarding the problem and the family dynamics. F. More rapid reunification of children with families: Each family will be the subject of our internal clinical staffing, as well as the multi-disciplinary team meetings held to address the progress and difficulties within the course of treatment. If "safety-feasible," our objective is to attempt reunification between seven and twelve months if the perpetrator is placed outside the home. G. Gain additional understandings regarding cultural attitudes on childhood sexual abuse in the community: We will gather and compare attitudes about childhood sexual abuse from client interviews. We will then prepare an annual report to the Department of Social Services regarding the information gathered to help us better understand any cultural differences in attitude towards sexual abuse. We need the option of adding or deleting instruments in an attempt to provide more useful information regarding the measurable constructs we are tracking. 7 V. SERVICE OBJECTIVES A. Improve Parental Competency: In addition to the instruments mentioned under "Measurable Objectives," our aim is to also increase the participants' ability to be clear in communication, improve a sense of personal agency, build and maintain appropriate connections with other family members and, most importantly, assure safety in the home Our belief is that healthier relationships make healthier parents. Many of these objectives will intersect and parallel the objectives under"Improve Personal and Relational Competencies." The offender's sexual behavior and related thinking will be the focus of much of his treatment. This can be documented within the therapy session and monthly progress reports, and underscored using periodic polygraph examinations. B. Improve Family Conflict Management: The Browning Outcomes Survey Scale (BOSS) will allow us to measure degrees of family functioning at three intervals; admission, discharge, and six month follow-up. Many of the individual improvements will generalize into better family interaction and problem resolution strategies. When all participants have been evaluated by their respective therapists as to the appropriateness of the offender in joining the family therapy, those sessions will begin. The sessions will continue to reinforce the changes made throughout the family's therapy, such as maintaining the "safety plan," and identifying potential "relapse warning signs." C. Improve Personal and Relational Competencies: Increasing personal efficacy, implementing respectful and sensitive communication, and restoring healthy boundaries will be goals for all participants. For the children, we can also monitor school functioning, a reduction of any trauma symptoms present upon admission, and any acting out or misconduct !n response to the abuse. D. Improve Ability to Access Resources: Much of Island Grove's services have included community resource-building specific to substance misuse as an integral part of treatment service delivery. This will be particularly underscored with this high-risk group of families and will include a broad base of needed community links. FOLLOW-UP EVALUATION' At six months post-discharge, staff will contact these families in person or by telephone to administer the final phase of the BOSS. We will collect data on other life situation demographics, such as placement of children, parental employment, housing, or arrests We will also provide the agency's Client Satisfaction survey for comments on treatment experiences at Island Grove Regional Treatment Center. • VI. WORKLOAD STANDARDS All of the services provided within each of the Stages are on an outpatient basis. Stage I, II, and III adolescent treatment will be provided in group or individual settings at our clinic or at the contractor's site. Family therapy will be provided at the Island Grove Clinic or at the client's home. The maximum caseload per staff will depend on the combinations of family members that are referred, but we are estimating that each therapist will serve 8-10 clients and their families. Our clinical Supervisor, Dr. William Walsh, will meet twice each month with the SAFTI team to strategize optimum interventions. He will be directly supervising the team. Dr. Jack Gardner 8 will continue to provide Offense-Specific Psychological evaluations when requested for by caseworkers and consultants. The Program Manager, Scott D. Wykes, will oversee the operations of the program, coordinate the participation of the community professionals in the case staffing of the families, monitor budget and billing information, and submit required reports as outlined in the RFP agreement. All contractors have submitted their required insurance forms to Island Grove Center. The requested verification for Island Grove Regional Treatment Center's coverage is attached at the end of this document. VII. STAFF QUALIFICATIONS All counseling and administrative staff operating independently has at a minimum, a master's degree, and numerous years of therapeutic experience. Our subcontractors have all been specifically trained in the treatment of sex offenders or victims of sexual assault. • C!KATRRYN\FAMSER\ADSS 00-01\SAFTI Bid Proposal 00-01.doc 9 �� �- rJJJ 1v.„ J•JJ��Ji J4J YVLL1._ 1J -r�.J.•_ r .- �i A CORD,. i " OATF�MMRIO;YY, PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Talbot SolaldeZ Insurance Associate HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 1301 28th Street ALTER THE COVERAGE AFFORDED EY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Boulder, CO 80301 COMPANY American Compensation Iris Co A INSURED COMPANY Island Grave Regional Treatment Center 8 1140 M Street COMPANY C Greeley CO 80631 COMPANY 1 D CO AGES r • THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACY OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. co I TYRE DF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION UIMITi LTR I DATE wommarrYI DATE IMM/ODIYYI GENERAL UABIUTT GENERAL AGGREGATE • ---. --- COMMERCIAL GENERAL LIABILITY PRODUCTS•COMP/OP AGG I• _ CLAIMS MADE n OCCUR PERSONAL I.ADV INJURY 0 OWNERS 5 CONTRACTOR'S PROT ;AC"'OCCURRENCE I• FIRE DAMAGE lAny Ant Ia& • .--. - MEO EEP{Airy 01V wpm, • T -r AUTOMOBILE UAOIUTY I -� COMBINED SINGLE LIMIT •f ANY AUTO All OWNED AUTOS BODILY INJURY • MN WIER) SCHEDULED AUTOS _._. HIIEO AUTOS BODILY INJURY • 11'w/coerntl NON-OWNED AUTOS •„_,v,-.-Y___ 1I ----'- PROPERTY DAMAGE • GARAGE UAKIUTY ! AUTO ONLY.EA ACCIDENT ANY ALTO OTHER THAN AUTO ONLY: EACH ACCIDENT • r AGGREGATE • `_ __ EXCESS UABIUTY EACH OCCURRENCE :• �` r-UMBRELLA FORM AGGREGATE • OTHER THAN UMORELLA FORM • wC STATU. 'aril- , A WOREER$CCMPENSATIORAND ACCO0040794 10/01/1999 10/01/2000 f prosy Loon ._— EMPLOYERS'UAIILITY EL EACH ACCIDENT THE PROARIL-TOR! PARTNERS E%fCUTIVE INCL EL DISEASE-POLICY LIMIT • —, OFFICERS ARE EXCL El DISEASE•EA EMPLOYEE • —__---� OTHER DESCRIPTION OF OPERAT10NSILOCATEMEIVEMCLIi/OPECIAL ITEM& Certificate molder shall read: weld County Colorado, by and through the Board of County Commissioners of weld County. its employees and agents FAX Insured: Jim Korey 910-356-13.9 tiERTflh!`iAT °F#E �lEIX:.: weld County Colorado memo ANY OF TIE ABOVE'DUMBED POLICES BE CANCILLIO BEFORE TIE Dosrd of County Commissioners IEMCATPOM DATE THEREOF. THE *SUMO COMPANY WILL ENDEAVOR TO MAIL ' 915 10th Street 30 gyDAYS vow-row NOTICE TO THEetIMPICATE HOLDER NAMED TO TIE LIFT. W a TO M/Nl SUCH N0T10E MI__L.IMPOSE NO OBLIGATION OR ILWLITY Greeley CO 80632 Of ANTI RIND UPON THE COMPANY. ITS AGENTS OR REPPOSENTATIVFE.�^ ACTH SENTATIVf I AG '`:?.C 1(Ii l t ON 1886 J AdS*2357324 1 L,htt r- ACORD-.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/UD/YY) l.) 3/2C/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 211 First Street I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Eaton, CO 80615 ____ 7 3 454-:3381 INSURERS AFFORDING COVERA GE INSURED ;INSURER A:Frontier Insurance Company, Inc ISLAND GROVE REGIONAL INSURER B:ST PAUL FIRE & MARINE INSURA'�TCE. _ 1140 M STREET ---•- ________.. - _-- --... _ INSURER D: GREELEY, CO 80631 INSURER=: ___�--_--- _-...-.-_-- __--- - -- COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO1 WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BF ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND t:ONDITIONS OF sUCH POLICIES. AGGREGATE UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . INSR' — POLICY EFFECTIVE POLICY EXPIRATION LTR I TYPE OF INSURANCE POLICY NUMBER DATEINIMIDOMO DATE IMMIRD1YYI LIMITS A I GENERAL LIABILITY G20002952200 04/01/00 04/01/01 EACH OCCURRENCE __ S1i OQQ OQO •X 'COMMERCIAL GENERAL LIABILITY FIRE DAMAGE jAny one I Ire) $50 0 )0 __ _ ICLA MS MADE: X I OCCUR MED EXP(Any one perso',) $5, 000 I — PERSONAL 6ADVINJUFV $1LOOO, 000 GENERAL AGGREGATE 'S 3,_Q o0{) 000 GE_N'LAGGREG_A" IE E LIMIT APPLSPER: ( PRODUCTS-COMP/OPA3GI:3, 000,000 POLICY f I JECT I LOC 1i B 'AUTOMOBILELIABILITY FK06602680 ' 04/01/00 04/01/01 COMBINED SINGLE LIMIT ' X I ANY AUTO (Ea accident) =1 , 000 , 000 ALL OWNED AUTOS BODILY INJURY _ SCHEDULED AUTOS (Per person) -- _-S- —_ _--- I X HIRE DAUIDS BODILY INJURY I X NON-OWNED AUTOS (Per accident) --- - -- -- I--I _- _ - PROPERTY DAMAGE S I '(Per accident) GARAGE LIABILITY AUTO ONLY-EAACCICENT S __-- E - ANY AUTO ! OTHER THAN AACC_S — -- -- AUTO ONLY: AC.G -S EXCESS LIABILITY EACH OCCURRENCE _S - — - OCCUR CLAIMS MADE I _A_GG_ ..-.--_-- _-___ _ -_ - DEDUCTIBLE I -----..-.-_-_ 1 RETENTION S I I I WORKERS COMPENSATION AND ITQRYTLIANTIII .:_-1-Ri_ EMPLOYERS LIABILITY E.L.EACH ACCIDENT f • E.L.DISEASE-EAEMPL'O?EE E --- - E.L.DISEASE-POLICY L'WTI a A OTHERPROFESSIONAL 020000136202 04/01/00 104/01/01 $1, 000 , 00'0 PM OCC. LIABILITY I $3 , 000 , 000 AGGREGATE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS WELD COUNTY, COLORADO, BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, ITS EMPLOYEES & AGENTS, AND THE STATE OF COLORADO ARE NAMED AS ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR IN REGARDS TO THE OPERATIONS OF THE INSURED. CERTIFICATE HOLDER J ADDmoNAL INSURED;INSURER ItII_R _. CANCELLATION SHOULD ANY OF THE ABOVE DESCPJBEDPOUCIES BE CANCELLED BEFORE THE EXPIRATION WELD COUNTY COLORADO' DATETHEREOF,THEISSUINGINSURERWILLENDEAVORTOMAILf;.'0__DAYSWRI,EN =CARD OF COUNTY COMMISSIONERS NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT.BL FAILJRE TD 0O SO SHALL WELD COUNTY IMPOSE NO OBLIGATION OR UABILIIY OF ANYKIND UPON THE INSIJRER,1T5 AGENTS OR 915 - 10 STREET REPRESENTATIVES. GREELEY, CO 80631 AUTHORIZED REPRESENTATIVE ACORD 25-S (7(97)1 of 2 #148710 JMc 0 ACORD CORPORATION 1988 • IMPORTANT • If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD25-S(7197)2 of 2 #148710 Attachment 1 Brief Basic Background II (BBB2) Family name: Therapist: _ Immediate Family: What family members are living at home and/or away? What are the ages of each family member? Describe the relationship (closeness, conflict, etc.). Name age Mother, Father, Where Living Other info. Step, etc. Developmental History: Please describe your home life when the problem is not happening. What sort of problems have you already eliminated from your household over time? In your own words, briefly describe how alcohol or drugs have effected your family. Part B (of the BBB2) What issues other than substance misuse have effected your family? Many themes occur in every family's story. Try to locate where your family is right now on the following scales of themes (Circle the number). loving Hateful 10 9 8 7 6 5 4 3 2 1 (Just Right) (Worst it's ever been) Satisfaction Sadness 10 9 8 7 6 5 4 3 2 1 Clear Communication Poor Communication 10 9 8 7 6 5 4 3 2 1 Cooperation Chaos 10 9 8 7 6 5 4 3 2 1 Close/Connected Detached 10 9 8 7 6 5 4 3 2 1 Responsible Blaming 10 9 8 7 6 5 4 3 2 1 Confidence/Calm Worry 10 9 8 7 6 5 4 3 2 1 Privacy Barging in 10 9 8 7 6 5 4 3 2 1 Involved in Community Isolated 10 9 8 7 6 5 4 3 2 1 Harmony Conflict 10 9 8 7 6 5 4 3 2 1 13. What specific actions have you been taking to deal with the problem? How To Make Your Counseling More Effective 14. On a scale of i to 10, rate the seriousness or the problem Client's Initial Questionnaire right now: 1 2 3 4 5 6 7 8 9 10 Setting Goals and Finding Solutions is the Important First Step: Unbearable, No problems. Unable to cope, Handling things great, Your opinions, thoughts and feelings are most Desperate for help No need for help important. How you describe what you want to change 15. Suppose that you accomplish all your goals in therapy and can help you and your therapist set specific therapy goals the problem is greatly improved or solved. Briefly describe and find solutions more quickly and easily how you think things would he different in your life: This booklet is designed to help you provide the kind of details that will make your therapy more effective. Please take a few minutes now to complete each item. When finished, give this booklet to your therapist. This is an important part of your therapy. Thank you! Instructions: (Please Print) There is a total of 15 questions. Most items have two parts, (a) and (b). In � W. simply circle the number Your Name Today's Date that best represents how you feel the problem has Your Therapist's Name changed over the last few months. Thank you for taking the time to share your thoughts and feelings. This will be a real help in your therapy. Then, in part b�, briefly describe in your own words Please give the completed booklet to your therapist. , how the problem has bothered or distressed you within RETURN 1O: the last 7 days. Go through the questions quickly, putting down the first thing that conies to mind (please print clearly). Now, please read these instructions again, then begin.... OS B U/i BROWNING OUTCOMES SURVEY SCALE _._. _ _.. for Brief Therapy BOSS''. BROWNING OUTCOMES SURVEY SCALE • 1-800-410-7766 Copyright ,L Charier H.Browning.Ph.D.. Bernie];J.Browning, Ph.1). 1. (a) How would you rate the problem today as compared to 11. (a) To what extent have you been able to control a few months ago? self-destructive habits or patterns on your own? 1 2 3 4 5 6 7 1 2 3 4 S . 6 7 Much Moderately Slightly About Slightly Moderately Much Totally Moderately Slightly Sometimes Slightly Moderately Totally Worse Worse Worse The Same improved Improved Improved Unable Unable Unable ,Able Able Able Able (b) Please briefly describe the problem that brought you (b) Describe the efforts you've made on your own to for counseling as it affects you now: control self-destructive habits or patterns in your life: 2. (a) How well do you understand the problem today as compared to a few months ago? 1 2 3 4 5 6 7 12. (a) To what extent do you believe that therapy can enable Much Moderately Slightly About Slightly Moderately Much you to find solutions to your problems? Less Less less The Same More More More Aware Aware Aware Aware Aware Aware 1 2 3 4 5 6 7 (b) In your own words, briefly state what or whom you Totally Moderately Slightly Not Sure Slightly Moderately Totally think (a) causes the problem to occur, (b) makes the Unable Unable Unable Able Able Able problem worse, and (c) helps make the problem better: (h) What are the solutions you hope to find through your • Causes the problem: counseling? • Makes the problem worse: • Helps make the problem better: • Please continue next page 9. (a) How effective are you today handling the problem as 3. (a) Compared to a few months ago, how would you rate am' compared to a few months ago? physical or medical symptoms caused by your problem? 1 1 3 4 5 7 1 i i 4 5 6, 7 ' Much Mtuferately Slightly About Slightly Moderateh Much Much Moderately Slightly About Slightly Moderately Much I ess I ess 1 esc !'tie c_,TO' More !Ain't. N.Illi e worse worse Worse the Same hupto%ed tntprored tmpmeed Effective Effective Effective Effective Effective Effective • u (b) In your own words, ht7etl�' describe what you sr tried ., (b) Please briefly state how the problem affects you do to handle the problem until now: physically or medically! (l.or example, physi ai p symptoms, doctors visits, medications, etc.): 4. (a) How is the problem affecting your work or school performance now as compared to a few months ago? 10. (a) When you think about the problem now, how would 1 2 3 4 5 6 7 you rate your thoughts and feelings about the future - Much Moderately Slightly About Slightly Moderately Much compared to how you felt a few months ago? Worse Worse Worse The Same Improved Improved 1 2 3 4 5 6 7 (b) The problem causes me to (check one or more): Much Moderately Slightly About Slightly Moderately Much Less Less Less The Same More More More Be late for work Cl Miss work completely Cl Hopeful Hopeful Hopeful Hopeful Hopeful Hopeful Have conflicts with people at work Cl Have trouble (h) When you think about the problem, describe your concentrating Cl Have poor work performance Cl thoughts and feelings about the future: • In your own words, briefly describe how the problem affects your work performance: '. r. S. (a) How is the problem affecting your relationships with 7. (a) Compared to a few months ago, how does your problem others today as compared to a few months ago! affect your attitude and feelings about yourself? 1 2 3 4 5 6 7 I 2 3 4 5 6 7 Much Moderately Slightly About Slightly Moderately Much Much Moderately Slightly About Slightly Moderately Much Worse Worse Worse The Same Improved Improved Improved Worse Worse Worse The Same Improved Improved Improved (h) Briefly comment on how the problem affects your (h) Briefly state how you think the problem affects your relationships with others at this time: attitudes and feelings about yourself? 6. (a) How do you think others who know you would rate your 8. (a) How much are you aware of sources of help for the problem today compared to a few months ago? problem now as compared to a few months ago? 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Much Moderately Slightly About Slightly Moderately Much -totally Aware AveAvvpie About Use Use Use Worse Worse Worse The Same Improved Improved Improved Unaware But Don't But-Use The Same Slightly Moderately Much Use Rarely More More More (b) In your own words, briefly state how you think others who know you would describe your problem now: (b) Aside from therapy, what resources are you aware of that can help you handle the problem? • • Please rnntinnc ext page P; Attachment 3 . ISLAND ; GROVE Ho¢4x IS ail ISLAM COMMUNITY COUNSELING CENTER, INC. SEXUAL ABUSE TREATMENT PROGRAM Est. 1974 OFFENDER TREATMENT CONTRACT , hereby enter into agreement with Island Grove Treatment Center's Sexual Abuse Family Therapeutic Interventions (SAFTI) , to allow their staff to provide me with treatment services designed to increase non-deviant sexual behavior and arousal patterns and/or reduce deviant sexual behavior and arousal patterns. The primary goal of treatment is to prevent recidivism. I understand and agree to the following conditions regarding my treatment: 1) I agree to be completely honest and assume full responsibility for my offenses and my behavior. 2) I agree, if deemed appropriate by treatment staff, to make a detailed clarification to my victim(s) and a statement that what happened was not the victim's fault. 3) I agree to sign an acknowledgment of non-confidentiality and waiver and to sign any releases of information required to obtain information about my behavior. 4) I will attend all treatment sessions, attend on time, and notify the appropriate staff member as soon as possible about any situation that affects my attendance or promptness. I understand that the only acceptable excuse for absence or lateness is a verifiable medical emergency. 5) I will not disclose any information regarding another client to anyone outside this program. 6) I will actively participate in treatment to the satisfaction of staff and other group members. 7) I understand that treatment may include periods of individual and family • therapy in addition to weekly group therapy. Treatment can generally be expected to last a minimum of 12 to 24 months before a pre-exit assessment is completed. Treatment will include: A) Writing a detailed autobiography; B) Completing readings; written assignments and-counseling in such areas as stress management, assertiveness, self- esteem, sexuality, commtuucation, and victim empathy; C) implementing a plan to avoid high risk situations. I understand that I will be asked to discuss these tasks and assignments in group therapy. The First Choice in Affordable Alcohol/Drug Services DA 1513 11th Ave-.•Greeley, CO 80631 •970/351-6678• Fax (970)352-7457 p ,„°^ ,.• 145 1st St.•Ft.Lupton,CO 80621 • 303/857-6365•Fax (303) 857-1391 8) I understand that my offense has had an impact on my family. In order to assist my family and myself in the recovery process, I agree that my family will participate in treatment on an as needed basis as determined by treatment staff. This will include individual and family treatment. 9) I uzdc-stand that ongoing assessment of my progress through psychological and physiological evaluation will be part of my treatment. 10) I will comply with all conditions of probation and parole. 11) I will not attend any session while under the influence of alcohol or drugs. 12) I will not become verbally threatening or assaultive towards any staff member or client whether inside or outside of the office. 13) I agree not to be in any adjunctive treatment of any kind without prior approval for Island Grove Sex Offender Treatment Center's Sexual Abuse Family Therapeutic Interventions (SAFTI) staff. 14) I agree not to initiate or maintain contact with my victim(s) of any kind without prior approval of Sex Offender Treatment Team. 15) I agree not to have any change of residence or job, if employed, without prior approval of the Sex Offender Treatment Team 16) I agree not to leave the state without prior approval of Probation/Parole Officc and Sex Offender Treatment Team 17) I agree not to use pornography of any kind. 18) If the treatment team so recommends, I agree to be out of the family and away from my victim(s) until I have successfully completed Sex Offender Treatment 19) I also agree to the following special conditions: 20) I also agree to allow Island Grove to audio visually record my treatment, both individually and in group, for the purpose of professional education and furthering the treatment process. I understand that any such materials will only be viewed in a professional context. I understand that my Probation/Parole Officer and/or 1)55 may be notified immediately of any violation of this contract. I also understand that local or state police departments may be contacted if necessary to maintain victim or community safety.- I also understand and:agree that any violation of the conditions of this contract may be grounds for termination from the program at the discretion of the staff. I agree that the staff may terminate my treatment for any other problem behavior not outlined above. The First Choice in Affordable Alcohol/Drug Services 1513 11th Ave.•Greeley, CO 80631 •970/351-6676• Fax(970)352-7457 D M1w D..+m 145 1st St.• Ft. Lupton,CO 80621 •303/857-6365• Fax(303)857-1391 f.` 1 . ISLAND GROVE NO MAN 15 AN 1SLNAA UNIOHINsu r COMMUNITY COUNSELING CENTER, INC. E5t. 1974 If I have any questions about the Treatment Contract, I have discussed them to my satisfaction with the person in chargo of my treatment. By signing this I give my voluntary consent to participate in all the above. Signature of Client Date Signature of Staff Member Date Signature of Guardian Date Signature of Witness Date • The First Choice in Affordable Alcohol/Drug Services DAD 1513 11th Ave. •Greeley, CO 80631 •970/351-6678• Fax(970)352-7457 N, 145 1st St.• Ft. Lupton,CO 80621 •303/857-6365• Fax(303)857-1391 Attachment 4 ISLAND GROVE COMMUNITY COUNSELING CENTER, INC. Est 1974 Criteria for Discharge Offense Specific treatment All of the following must be demonstrated, defined, understood, and consistent through out treatment. • Being open and honest in group (no secrets) Li Follow offender treatment contract (treatment guidelines) Elimination of critical/deviant thinking errors Li Acknowledgement of risk; avoiding high-risk situations; prepared Safety Plan must be complete and signed off on by all persons involved (family, case worker, probation, treatment provider) a Understanding and being able to define the re-offense chain o Consistent definition of abusive interactions Li Recognition of the dysfunctional cycle (abuse cycle) Li Ability to interrupt abuse cycle Li Understanding defense mechanisms o Demonstrating changed pattern of coping i7 Demonstrating empathy o Completion of one or more polygraph assessments J Completion of one or more plethysmograph assessments (depending on age of perpetrator) • Meet with another provider for exit interview; one of Island Groves consultants I have read and understand the above information. Client Signature: Date: _ Counselor's Signature: _Date: The First Choice in Affordable Alcohol/Drug Services (jADA'/ 1513 11th Ave.•Greeley, CO 80631 •970/351-6678•Fax(970)352-7457 145 1st St. • Ft. Lupton,CO 80621 •303/857-6365•Fax(303)857-1391 """' Attachment 5 SEXUAL ABUSE FAMILY THERAPEUTIC INTERVENTIONS Island Grove Regional Treatment Center, Inc. Fee Schedule and Direct Service Rates ASSESSMENTS Initial Family Assessment 25 . 0 Exit Interviews 90.00 Adolescent Sex Offender (in-house) 350.00 Adolescent Sex Offender (contracted) 575.00 Adult Sex Otfender (contracted) 600.00 Domestic Violence 135.00 General Psychological Evaluation 280.00 Vocational Assessment 175.00 Alcohol and Drug Evaluation 1 50.00 THERAPEUTIC SERVICES Individual Session 85.00 hour Family Session 97.50/hour Stage I Group 40.00/person Case Aide Services 35.00/person/hour Stage II Group Sessions 55.00/person ADDITIONAL PROGRAM FEES Plethysmograph* $ 225.00/examination — Polygraph* 225.00/examination _ Court Appearance 160.00/staff/day Psychiatric Services, if contracted* 105.00/hour Training Stipend 300.00/statf Provide DSS Training 50.00/hour/staff Clinical Supervisor (Dr. William Walsh) 90.00/hour _ Clinical Supervision/Staffing (Line Statf) 30.00/hour/staff Sex Otfender Assessment Stating 90.00/hour *Fees outside of Island Grove Center's contractual arrangements may be subject to change. C:\f:A'1HRYN\FAMSERV\DSS 00-01\00-01 SAFTI Fee Sched.doc Attachment 6 i ISLAND GROVE COMMUNITY COUNSELING CENTER, INC. Es' 1974 February 29, 2000 TO: (Caseworker's name) Weld County DSS P.O. Box 'A' Greeley, CO 80631 CC:(parent's name) (other individuals concerned) RE: (group member's name) The purpose of this letter is to inform you on (group members's name)'s attendance, participation, goals, issues and concerns for the month of February 2000. The group, counselor and(group member's name) prepared this report. ATTENDANCE: PARTICIPATION: - GOALS/TREATMENT ISSUES: ., /\ra Jr The First Choice in Affordable Alcohol/Drug Services ?DAD 1513 11th Ave.•Greeley,CO 80631 •970/351-6678• Fax(970)352-7457 mmaon� 145 1st St.• Ft. Lupton, CO 80621 •303/857-6365•Fax(303)857-1391 ISSUES (group member's name) TALKS ABOUT IN GROUP: CONCERNS: If you have any questions, please contact me at (970) 392-0261. Sincerely, Anne Gleditsch MA, NCC, CACIII Group member's name Attachment 7 Island Grove SAFTI Program Stage I Stage I of the Island Grove SAFTI Program is designed to address the needs of referrals 10-17 years of age who have demonstrated objectionable behavior in regards to expression of emotion through the means of inappropriate words, gestures and behaviors that have a sexual content or nature. It is an educational program twelve weeks in length and contains family components. Referrals displaying behaviors needing more restrictive treatment may be considered for Stage II at any time during the process of Stage I. Treatment Content Amounts Monthly Costs Stage Costs Group Sessions 12($40.) lx weekly $ 160.00 $480.00 Family Sessions 3($98.75) lx monthly $ 98.75 $296.25 Monthly Total Cost $258.75 Total Program Stage Cost $776.25 Island Grove SAID"ft Program Stage II Stage 1I of the Island Grove SAFTI program serves adolescents between the ages of 12.17 who are referred for Offense Specific treatment on an outpatient basis.Stage II is designed with two packages (A&B)including five phases. The difference is found in Phase I,which has an optional Sex Offender Assessment(Package B)comprised of psychological measures that may be of benefit in court processing. Length of treatment varies according to each referral and the national average for length of treatment is approximately 18 months. Package A Phase I 1°`month Amounts Phase Cost Individual Sessions 4($85.) lx weekly $340.00 Polygraph 1($225.) $225.00 Family Assessment 1($250.)2x week $250.00 Family Therapy 6($98.75)2x weekly $592.50 Monthly Cost Total $1407.50 Phase I(A)Total Cost $1407.50 *bic$im Sessions 4($85) Ix weekly $340.00 Revised Monthly Cost Total $1747.50 Revised Phase I(A)Cost Total $1747.50 Package B Phase I In month Amounts Phase Cost Individual Sessions 4($85.) lx weekly $340.00 Family Assessment 1($250.)2x week $250.00 Family Therapy 6($90.)2x weekly $ 592.50 Sex Offender Assessment 1(5600.) $600.00 Assessment staffing 1($135.) $ 135.00 Polygraph 1(5225.) $225.00 Monthly Cost Total $2142.50 Phase I(B)Total Cost 52142.50 *victim Sessions 4(585) lx weekly $340.00 Revised Monthly Cost Total $2482.50 Revised Phase I(B)Cost Total $2482.50 At this point, the family and perpetrator will be staffed by the treatment team to determine if the referral is appropriate to continue treatment with our program.If so the perpetrator will be placed in a group treatment program and the family will continue with the family sessions. Not all families will have victims that will require services and so the addition of the victim services will be on a referral basis.Funds for victims may be accessed through Victim Assistance or VALE monies and may not contribute to the cost of services for the referral. Packages A &B Phase II 2nd to 6th months Amounts Monthly Costs Phase Costs Group Sessions 8($55.)2x week $440.00 $2200.00 Family Sessions 4($98.75) lx week $ 395.00 $1975.00 Monthly Cost Total S 835.00 Polygraph Exam 1($225.)End of 6 mos. $225.00 Phase 11(5 month)Total Cost $4400,00 Victim Sessions 2($85.)2x month $ 170.00 $850.00 Revised Total Monthly Cost $1005.00 Revised Phase 11(5 month) Total Cost $5025.00 At this point the family and the perpetrator will be assessed to determine the appropriateness of attending group lx weekly and family sessions twice monthly. If so the following will apply: Phase In 7th to 12th month Amounts Monthly Costs Phase Costs Family Sessions 2($98.75)2x monthly $ 197.50 $1185.00 Group Sessions 4($55.) lx weekly $220.00 $1320.1X) Monthly Cost Total S 417.50 Polygraph Exam 1($225.)End of 6 months $225.00 Phase III(6 months) Total Cost $2730.00 *Victim Sessions 2($85.)2x monthly $ 170.00 $1020.00 Revised Total Monthly Cost $587.50 Revised Phase III(6 months) Cost Total $3750.00 At the completion of 12 months the perpetrator and the family will be evaluated with the discharge criteria and progress in treatment. Should the referral meet discharge criteria the addition of**Exit interviews will occur.Treatment recommendations after one year include the following, Phase IV 13t to 18th month Amount Monthly Costs Phase Costs Family Sessions 1($98.75) lx month $98.75 $592.50 Group Sessions 4($55.) lx week $220.00 $1320.00 Monthly Cost Total S 318.75 Polygraph Exam 1(5225.)End of 18 mos. 5 225.00 Phase IV(6 months)Total Cost $2137.50 *Victim Sessions 2($85.)2x monthly $ 170.00 $1020.00 Revised Monthly Cost Total $488.75 Revised Phase IV(6 months)Cost Total $3157.50 At this point the perpetrator and the family will be staffed to determine if discharge is appropriate. If discharge is a possibility then the Exit Interviews**will take place. If discharge is not appropriate and the client and family continue treatment,the following will apply: In Phase V the perpetrator and the family will focus upon the issues that they failed to demonstrate successful knowledge base of in Phase IV. A family and perpetrator may be discharged at any point in Phase V as long as the polygraph is complete and the areas that needed to be addressed were completed at some point. Phase V 19 to 24 months Amount Monthly Costs Phase Cost Family Sessions 1($98.75) lx month $ 98.75 $592.50 Group Sessions 4(855.) lx week $220.00 $1320.00 Monthly Cost Total $318.75 Polygraph Exam 1($225.)End of 24 months $225.00 Exit Interviews 2(98.75)2x month $ 197.50 Phase V(6 months)Cost Total $2335.00 *Victim Sessions 2(385.)2x monthly 8 170.00 $1020.00 Revised Monthly Cost Total S 488.75 Revised Phase V Cost Total $3355.00 At this point the client and the family will have received all the benefits of our program. The perpetrator and the family will be referred to another agency at discharge from this program should they not assess positively as having grasped the concepts of treatment. It should also be noted that should an offense occur within any phase of the treatment time frames,immediate discharge would be forthcoming. Total for Package A 12 months $8,537.50 Total for Package B add$635 00 *victims $10,522.50 18 months $10,675.00 *victims $13,680.00 24 months $13,010.50 *victims $17,035.50 **Exit Interviews 2(898.75) 2x month $ 197.5(/ At some point within the course of treatment,a referral may reach discharge criteria prior to 18 or even 12 months of treatment. When the possibility of discharge is considered,Exit interviews will be conducted at an additional cost if not cond'cted within Phase V of the treatment process. Adult Sex Offender Evaluation An additional service that may be contracted through the Island Grove SAFTI Program is an adult sex offender assessment.This service is provided for adult referrals that are court ordered or volunteer for a sex offender assessment including polygraph examination, psychometric measures,clinical interviews, and background checks. The cost for the services is as follows: (1) Sex Offender Assessment 1($600.) $600.00 (1)Polygraph Exam 1(8225.) $225.00 Total $825.00 Island Grove SAFTI Program Stage III Stage III of the Island Grove SAFTI Program is a six-month follow-up program designed to provide services for clients who have successfully completed Offense Specific residential treatment programs and who have been returned to their families and communities.The main purpose of Stage III is to monitor clients in a step down process so that the client and the family may be integrated successfully. Phase I 1°L month Amounts Monthly Costs Phase Costs Individual Sessions 4($85.) $340.00 $340.00 Family Sessions 4($98.75) $395.00 $395.00 Monthly Cost Total $735.00 Phase I Cost Total $735.00 Phase II 2nd-3rd month Individual Sessions 4(585.) $170.00 $340.00 Family Sessions 2($98.75) $98,75 $197.50 Monthly Cost Total $268.75 Phase II Cost Total $537.50 Phase TII 4'h-6h month Individual Sessions 3($85.) $ 85.00 $255.00 Family Sessions 3(98.75) $ 98.75 $296.25 Monthly Cost Total $183.75 Polygraph Exam 1($225.) $225.00 Phase III Cost Total $776.25 Complete Program Cost Total $2048.75 Additional Costs Monthly Clinical Supervision to cover Stages I,II, and III of the SAFTI Program. Dr. Walsh 2($135.)2x monthly $270.00 12 month total $3240.00 (3)Staff 3($375)2x monthly $225.00 12 month total $2700.00 Hello