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Home My WebLink About20001538 RESOLUTION RE: APPROVE TWO NOTIFICATION OF FINANCIAL ASSISTANCE AWARDS FOR CORE SERVICES FUNDS AND AUTHORIZE CHAIR TO SIGN -ALTERNATIVE HOMES FOR YOUTH 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 Alternative Homes for Youth 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 Alternative Homes for Youth 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 ,//�� I COUNTY, COLO DO ATTEST: /aI, %4r4KiIkerhair Weld County Clerk to th s3s XCUSED / . J. eile, Pro Tem i Deputy Clerk to the Bo ups U "1 , r e E. Baxter 7VED AS TO FO Dale Hall ut orney EXCUSED Glenn Vaad 2000-1538 ee ss /A//eniin !/e N9ves SS0027 / Weld County Department of Social Services Notification of Financial Assistance Award for Families,Youth and Children Commission(Core) Funds Type of Action CoLtract Award No. X Initial Award FY00-CORE-007 Revision (RFP-FYC-00008) — Contract Award Period Name and Address of Contractor Beginning 94&1/2000 and Alternative Homes For Youth Ending 05/31/2001 Multisystemic Therapy 9201 W. 44th Avenue Wheatridge, CO 80033 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Improve both individual and family functioning Award is based upon your Request for Proposal(RFP). through in-home and in-office services. A The RFP specifies the scope of services and conditions maximum of 36 clients for an average of 20 of award. Except where it is in conflict with this weeks, with an average of 5.9 hours per week of NOFAA in which case the NOFAA governs, the RFP family preservation services. The program will upon which this award is based is an integral part of the serve both males and females from ages 12-18, action. with a primary caretaker. Appropriate youth will Special conditions • have one or more issues involving delinquency, 1) Reimbursement for the Unit of Services will be based drug and alcohol,family conflict, school issues, or on a hourly rate per child or per family. mental health concerns. 2) The hourly rate will be paid for only direct face to face contact with the child and/or family, as evidenced by Cost Per Unit of Service client-signed verification form, and as specified in the unit of cost computation. Hourly Rate Per $76.01 3) Unit of service costs cannot exceed the hourly and Unit of Service Based on Approved Plan yearly cost per child and/or family. 4) Payment will only be remitted on cases open with, and Enclosures: referrals made by the Weld County Department of X Signed RFP:Exhibit A Social Services. Supplemental Narrative to RFP: Exhibit B 5) Requests for payment must be an original submitted to the Weld County Department of Social Services by the Recommendation(s) end of the 25th calendar day following the end of the —Conditions of Approval month.The provider must submit requests for payment on forms approved by Weld County Department of Social Services. Approv ls: Program Official: B WU BY ft arbara J. Kirkmeyer, Chair Judy Gri Direct. Board of Weld County Commissioners Weld unty epartment of Social Services Date: __,(26_ to-o2UOO Date: fl? /,2JD/QO rr ` // 2000-1538 • SIGNS , D R P E nIuBIT A 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 JA--ME5 .2 Alf-4so./ TYPED OR PRINTED SIGNATURE VENDOR AiIPrnn'in ( �pv✓IPS �pr�ntnFh (Name) H dwritten Signature By Authorized Officer or Agent of Vender ADDRESS 17201 W citlaiht5 uAl.. TITLE V. P. - Ptobie4 w5 !J hectic, dgt ; CD &OO 33 DATE .7i-12/—e5O PHONE# � 3n ) 6140 -55440 The above bid is subject to Terms and Conditions as attached hereto and incorporated. REP-FTC-00008 Attached A INTENSIVE FAMILY THERAPY PROGRAM BID PROPOSAL FAMILY PRESERVATION PROGRAM 20(10/2001 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2000-2001 BID #RF'P-FTC 00008 NAME OF AGENCY: 41 4e r n a 4-+ OP 'NO tVi e c (At' ye,I.k _ADDRESS: 520 1 by LH H-. 4tipr, a (. t4J h pa f-r i rice rr, g 0r 33 PHONE: (,21)- 1 GIL/0 - 5SyO CONTACT PERSON: ( n -n a A 1 rDem n a 1 r( TITLE: 0 11r(fit) r or Pr's S S i n Hai ;Set kit CPS DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Intensiove Family Therapv-Program must provide for thrsapeutic intervention through one or more qualified family therapists. typical y 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, 2oet> End May 31.2000 End 00421 3/ Z°/ TITLE OF PROJECT: M U 14i .S ar%.. I t •c k iv I r The rn p ( Al T J �?� J �aliaid 3 . 3 - 00 _Name an•/ignature of Person Preparing Document Date 3 -2/- OD _Name an ignature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL,RFOULREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Propo oriaFor renewal bids,please indicate which of the required sections have not changed from Program Fund Year 3ll.to Program Fund Year 2000-2001. Indicate No Change from FY 1998-1999 JAL Project Description a Target/Eligibility Populations JAI Types of services Provided Measurable Outcomes Service Objectives Workload Standards .L Staff Qualifications Unit of Service Rate Computation Program Capacity per Month AI Certificate of Insurance RFP-FYC-00008 Attached A Date of Meeting(s)with Social Services Division Supervisor: Comments by SSD Supervisor: • P ' .c ti. �! LI,iis /F ‘1bY 11—± j � 14 r i i' I Y-- 1-1; 2r f- C_'✓_ I � I d ' i� i �ij.{'��I� 7 17A' , 4 -1�Y'�i� ', l �l � /- ' I / �J—�r l '1/,E.-//1 :�-� .° 1" .11 le'( J Name and Signature of SSD Supervisor Date ,> -/(J DC) Drano -7 of 17 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy(MST) Vendor Alternative Homes for Youth (AHFY) I. PROJECT DESCRIPTION The overall mission of the AHFY MST Program is to strengthen families. This can be accomplished by either preventing placement or reunifying children and their families. MST is a family and home based treatment that addresses the known factors associated with serious antisocial behavior in children and adolescents. To promote service access and maximize the generalization of treatment gains, MST is provided via a home-based model of service delivery by clinicians with caseloads no larger than six. Hence, MST attempts to comprehensively address risk factors and build protective factors by providing intense treatment in the natural environments where adolescents and their families function—homes, schools and neighborhood settings. MST has been successful in reducing long—term rates of rearrest and out—of home placement for violent and chronic juvenile offenders. The keys to the AHFY MST Program success are: 1. Parents are seen as the solution rather than the problem. MST therapists empower parents by using identified strengths to develop viable natural support systems and effective parenting. 2. MST directly addresses the multiple factors that contribute to delinquency. MST therapist work with families on setting and enforcing rules, promoting friendships with prosocial peers and improving academic/vocational performance. 3. MST reduces barriers to treatment. MST uses the family preservation model of service delivery with small caseloads, services 24 hours a day, 7 days a week, convenient meeting times in the families natural environment. 4. MST emphasizes therapist accountability and treatment outcomes. Families are surveyed regularly to determine consumer satisfaction and family/therapist engagement. 5. MST is a complex treatment model and involves an extensive quality assurance protocol. MST services can be provided to families that have a primary caretaker willing to manage the child's behavior. The goal of the program's interventions is to protect children while preventing placement or reunifying children and.their families. These interventions occur between parent-child, between married couples, between parents with joint custody, with non nuclear family members, with schools, with peers and within the community. 4 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative Homes for Youth (AHFY) II. TARGET/ELIGIBILTY POPULATION The Alternative Homes for Youth (AHFY) Multisystemic Therapy(MST) team will target youth at risk for out of home placement or youth needing transitional services to successfully return home. The program will serve both males and females, from the ages of 12 to 18, which have a primary caretaker willing to manage the youth's behavior. The target population served will be youth with multi-problems. Appropriate youth will have more than one of the following: delinquency, drug and alcohol, family conflict, school issues, or mental health concerns. Since there is no evidence that MST is effective in keeping the following youth safe or the community safe the AHFY MST team will not accept youth with active suicidal, homicidal or psychotic behavior. These behaviors need to be stabilized before a referral to the MST team is appropriate. In addition the AHFY MST team will not accept sexual offenders in the absence of other antisocial behavior or where offense-specific treatment is required Total number of clients to be served: 36 Total individual client and ages: 10-14 will be 15 15-16 will be 16 17-18 will be 5 Total family units: 36 Sub-total of individuals who will receive Bicultural services: 50% Bilingual services: 0% Sub-total of individuals who will receive services in South Weld County: 15 Sub-total of individuals who will have access to 24-hour services: 36 The monthly maximum program capacity: 12 The monthly average capacity: 16 Average stay in the program (weeks): 20 Average hours per week in the program: 4 5 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative Homes for Youth (AHFY) III. TYPE OF SERVICES TO BE PROVIDED The AHFY MST Program will be providing family-centered services to ensure engagement of families referred to the team. The following are the key elements of these services: 1. Recognizing that the family is the constant in the youth's life, while the service systems and personnel within those systems fluctuate. 2. Facilitating parent/professional collaboration at all levels of service provision. 3. Honoring the racial, ethnic, cultural and socioeconomic diversity of families. 4. Recognizing family strengths and individuality and respecting different methods of coping. 5. Sharing with parents, on a continuing basis and in a supportive manner, complete and unbiased information. 6. Encouraging and facilitating family to family support and networking. 7. Understanding and incorporating the developmental needs of adolescents and their families into service delivery systems. 8. Designing accessible service delivery systems that are flexible, culturally competent, and responsive to family-identified needs. 9.Therapists exhibit a high level of commitment to families as evidenced by: • Persistence: assumes responsibility for engagement and strives to prevent "dropping out" • Creativity: utilizes own strengths and family strengths to increase probability of change • Responsibility: assumes responsibility for change; does not blame family or other systems for failure to support change • Action-orientation: developing the vast majority of interventions and guiding parents in conducting interventions • Knowledge: having a strong working knowledge of empirically supported treatment models • Flexibility: revising strategies/interventions as needed • Investment: developing skills needed to develop interventions and closely monitoring the interventions The AHFY MST Program will be providing family-centered services in three stages. During each stage one assigned AHFY MST team therapist provides services. The therapist works with the assigned Social Services caseworker to ensure coordinated case management of all providers involved with the family. The AHFY MST team therapist has case consultation with their AHFY team supervisor and a consultant from MST Services in South Carolina on a weekly basis. The AHFY MST supervisor is also available to co-facilitate sessions with the AHFY MST therapist. Start up Time Frame: 12 weeks Number of Sessions (per week): 4 Number to be served: 4 Start up involves comprehensive, diagnostic and treatment planning with the family as full collaborators. First, referral behaviors are described in clear'behavioral descriptions. All key participants are identified and outcomes written from each 6 Program Category Intensive Family Therapy Program Bid Category Program Title Mulltisystemic Therapy(MST) Vendor Alternative Homes for Youth (AHFY) participant's perspective. Second overarching goals are developed to guide the direction of treatment. Achievement of the overarching goals results in the elimination or reduction of the frequency and intensity of the referral behavior. These goals become the measurements to determine the success of the program. Third weekly intermediary goals contribute to achieving overarching goals. The intermediary goals target the most immediate and powerful drivers of behavior. These intermediary goals are measured weekly as met, partially met, not met. Fourth intervention development targets who, what, when and how to make change happen to achieve the intermediary goals. The interventions are designed to promote responsible behavior and decrease irresponsible behavior among family members. The interventions require daily and weekly effort by family members. Interventions are individualized to provide therapeutic flexibility to service provision. Middle Time Frame: 6 weeks Number of Sessions (per week): 3 Number to be served: 1 Middle of the program is the practice stage. Multiple interventions are having successful outcomes. Family members are practicing identifying strengths and developing strategies to use them to decrease referral behaviors. AHFY MST therapist is able to collaborate with the family in developing weekly intermediary goals. Intermediary goals are measured weekly as met, partially met, not met. Family is generating ideas for daily and weekly interventions. The interventions continue to assist families in resolving conflicts and disagreements decreasing child maltreatment, running away and to the behavior constituting status offenses. End Time Frame: 2 weeks Number of Sessions (per week): 1 Number to be served: I Ending involves transition to ending services or transition to support services within AHFY's continuum of care or another agency. When applicable of MST Services families will be referred to North Range Community Mental Health center for ongoing medication monitoring, Island Grove Regional Treatment Center for drug and alcohol services/urinalysis, Individual Group Therapy Service (IGTS) for outpatient individual and family therapy, and Partners Inc. for individual youth services. AHFY can also offer its Community Adolescent Based Services (CABS) program to families. CABS offers family therapy, individual therapy recreation fees, tutoring,job supervision, and vocational assistance. Each family will be provided only those services purchased by the caseworker for the individual youth or family at the same hourly rate as AHFY's MST program. Services will be purchased for a month and can be renewed at the request of the caseworker for the family. Interventions in this stage are designed to,promote treatment generalization and long- term maintenance of therapeutic change. This is accomplished by empowering caregivers to address family members' needs across multiple systematic contexts. 7 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative Homes for Youth(AHFY) IV. MEASURABLE OUTCOMES The program goal for youth successfully discharged from the program will be measured by: (a) the number of youth able to remain in their homes six and twelve months after discharge, (b) a decrease in recidivism at six and twelve months after discharge, (c) the number of youth attending school and achieving passing grades and/or maintaining employment at six and twelve months after discharge, and (d) families reporting whether they feel the youth is doing the same, better or worse at six and twelve months after discharge. 'The method to measure these outcomes will be completion of an interview with the family. At intake the child and family, and other service providers including caseworker, probation officer, guardian ad lidum will participate in a clinical interview to con plete a comprehensive preplacement interview. Information from the interview will be entered into a database to provide a baseline of behavior(see attached).The baseline will include information on the child's legal history, school performance, employment history, drug/alcohol history, and placement history. When the youth is discharged his final monthly report and termination report will be reviewed and the information entered into the database to provide a comparison to the baseline behavior. This data comparison forms the initial review of the program outcomes. The first review of the A.HFT MST Program outcomes will provide three quantitative measures. The data will show the number of children who stayed at home with their families and did not require placement due to participation in the program. The data will show the number of children who were referred from placement to the AHFY MST Program and were reunified with their family and able to stay at home at discharge from the program. This data will show the number of families who remained intact at discharge from the program. This same data will be collected via a phone interview with the families, whose children remained at home at discharge, six and twelve months after discharge from the program. This data will be analyzed to see the number of children who continued to remain at home with their families. Thus showing the number of children who received services whom did not go into placement, the number of children who were able to stay reunified with their family and number of families who remained intact. The baseline data on the child's legal history, school performance, work history and drug/alcohol use will be gathered again at discharge as well as six and twelve months after discharge. When the youth is discharged his final monthly report and termination report will be reviewed and the information entered into the database to provide a comparison to the baseline behavior. . This same data will be collected via a phone interview with the families, whose children remained at home, at discharge six and twelve months after discharge from the program. This data will be analyzed to show that fundamental changes in family functioning and dynamics did occur. 8 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative Homes for Youth (AHFY) Overall research suggest that parents influence their children and are primary in predicting their child's involvement in illegal activities, school failure and drug/alcohol use. Hence if the data collected at discharge, six, and twelve months shows a decrease in behavior constituting status offenses and increase in prosocial behaviors the AHFY MST Program will show that services resulted in fundamental changes in the family functioning and dynamics. Therefore showing positive outcomes for the families provided services through the AHFY MST Program. The phone interview completed at six and twelve months after discharge will also ask families if they feel their son or daughter has regressed, stayed the same or improved. This data will be collected to measure the family's perception of improvements. This data will be analyzed to determine number of families who feel satisfaction with the impact of th.e AHFT MST Program on their families. 9 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative'Homes for Youth (AHFY) V. SERVICE OBJECTIVES The overriding goal of MST is to empower parents with the skills and resources needed to independently address the inevitable difficulties that arise in child rearing and to empower youth to cope with family,peers, school and neighborhood problems. This is accomplished through a pragmatic and goal-oriented home based model of service delivery. At the family level, parents and children who are at risk frequently display high rates of conflict and low levels of affection. Parents frequently disagree about discipline strategies and have their own personal problems, which interfere with their ability to provide necessary parenting. Family interventions in MST often attempt to provide the parent with the resources they need to parent effectively and to develop increased family structure and cohesion. Interventions might include monitoring, reward and discipline strategies,prompting parents to communicate effectively, problem solving day to day conflicts and developing indigenous social support networks with friends, extended family, church and so forth. At the peer level a frequent goal of treatment is to decrease the youth's involvement with delinquent and drug using peers and to increase association with prosocial peers. Interventions for this purpose are optimally conducted by the parents and might consist of actively supporting and encouraging associations with non-problem peers by providing transportation and increased privileges. Significant sanctions are applied to discourage associations with deviant peers. At the community level parents develop strategies to monitor and promote the youth's school performance and/or vocational functioning. Typically included in this domain are strategies for opening and maintaining positive communication lines with teachers and for restructuring after school hours to promote academic efforts. Adherence to this MST treatment model is essential. Effectiveness of MST has demonstrated that strong adherence to the model is correlated with strong case outcomes. Adherence is the primary focus of the weekly consultation process and on site supervision practices. The MST consultant provides weekly consultation to each treatment team. Consultation sessions focus on promoting adherence to MST treatment principles, developing solutions to difficult clinical problems, and designing plans to overcome any barriers to attaining strong treatment adherence and favorable outcomes for youths and families. The MST clinical supervisor provides task-oriented, analytically focused clinical supervision on-site. The overarching objective of the MST clinical supervision is to facilitate therapists' acquisition and implementation of the conceptual and behavioral skills required to achieve adherence to the MST treatment model. The MST Adherence Measure for therapist ensures the follow through for each family of MST treatment principles. The questionnaire(see attached) is first administered during the second week of therapy. The caller will ask the primary caretaker to answer 26 questions about the last two to three sessions. From that point the questionnaire is administered every four weeks. The questions are than entered at the MST Institute web site and scores on the therapist adherence to MST principals are made available. The MST consultant and MST supervisor to increase the therapist skills with the families use these scores. This creates a rigorous quality control program. It is this close monitoring of clinical practice that assures treatment fidelity.This strategy should achieve the service objectives. Family conflict management should be enhanced thus decreasing disagreements contributing to child maltreatment, running away and other offenses. Parents should develop consistent monitoring skills providing both consequences and rewards that will actually enhance their relationship with their children through clear instruction and fair discipline regular supervision and care. Parents will have built social support linkages by tapping resources for information, feedback; caring and practical needs form the beginning of the AHFY MST Program. 10 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative Homes for Youth (AHFY) VI. WORKLOAD STANDARDS Number of hours per week: 70 Number of individuals providing the services: 2 Maximum caseload per worker: 6 Modality of treatment: MST is an intensive family and community based treatment that addresses the multiple determinants of serious antisocial behavior in youth. The MST approach views individuals as being nested within a complex network of interconnected systems that encompass individual, family, and extrafamilial factors. In MST the ecology of interconnected systems is viewed as the client. To achieve successful outcomes with these youth intervention is generally necessary in a combination of these systems. Total Number of hours per week: Start up Time Frame: 12 weeks Number of Sessions (per week): 4 Number of System Interventions (per week): 3 Number to be served: 4 Total Hours direct service per week per family: 7 Total Hours direct service per month per family: 28 Middle Time Frame: 6 weeks Number of Sessions (per week): 3 Number of System Interventions (per week): 2 Number to be served: 1 Total Hours direct service per week per family: 5 Total Hours direct service per month per family: 20 End Time Frame: 2 weeks Number of Sessions (per week): 1 Number of System Interventions (per week): 1 Number to be served: 1 Total Hours direct service per week per family: 2 Total Hours direct service per month per family: 8 'Total Number of individuals providing services: 2 'The maximum caseload per supervisor: 8 Insurance: Certificate attached 11 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative Homes for Youth (AHFY) VII. STAFF QUALIFICATIONS The staffing pattern for the AHFY MST team is one supervisor and two therapists. Each therapist will be a Master-level or highly competent, clinically skilled Bachelor-level professional. The supervisor is a licensed clinical social worker with clinical experience with family based services prior to the completion of MST training. Each youth referred to the program is assigned a therapist who designs individualized interventions in accordance with MST treatment principles that address specific needs of the youth and family. Training in MST is intensive and ongoing. The basic elements of training for clinical staff include a week of orientation training, weekly consultation with an expert in MST, and quarterly booster training. Before being assigned any MST cases, all AHFY MST therapists participated in training targeted at knowledge base development and skill development. The five day orientation familiarized the team with the behavior problems addressed by MST; described the theoretical and empirical underpinnings of MST; reviewed the family, peer, school, and individual intervention strategies used in MST, taught how to conceptualize cases and interventions in terms of the nine principles of MST; and provided the team practice in developing MST interventions. The weekly phone consultation is to facilitate and reinforce MST conceptualization of cases. Weekly paperwork is faxed to the MST Consultant and than during the phone call intervention strategies are reviewed to ensure they are clearly connected to intermediary and overarching goals. The phonically facilitate critical thinking such that therapist can articulate how they know if interventions are working or not and why. The quarterly 1.5 day booster training is provided on-site by the weekly MST consultant. These sessions are designed to provide the therapist and supervisors training in special topics. The booster sessions also are designed to allow for discussion of particularly difficult cases. There are three distinct levels of supervision that occur with a MST team. These are peer supervision, on-site clinical supervision, and MST consultation. The AHFY MST therapist work as a team. This enables sharing of hands-on sharing of knowledge of community resources, someone to share case experiences and ideas, someone from whom 1:0 learn new intervention approaches and particular clinical styles. The AHFY MST Therapist meet as a team weekly for 1.5 hours with the on-site clinical supervisor to review cases. The on-site supervisor is also available by telephone for questions and emergencies. The hourly weekly phone consultation with the MST consultant focuses on promoting adherence to MST principles, developing solutions to difficult clinical problems, and designing plans to overcome barriers to obtaining strong treatment adherence and favorable outcomes for children and families. The MST on-site supervisor and MST consultant also consult monthly by phone and spend an additional .5 day together during the MST booster session. This time is to ensure that the on-site supervisor is keeping current in state-of-the-art counseling modalities and findings based on on- going research conducted by the MST Institute. 12 ]2FP-FYC-00008 Attached A VIII. COMPUTATION OF DIRECT SERVICE RATE This form is to be used to provide detailed explanation of the hourly rate your organization will charge the Core Services Program for the services offered in this Request for Proposal. This rate may only be used to bill the Weld County Department of Social Services for direct, face-to-face services provided to clients referred for these services by the Department. Requests for payment based on units of service such as telephone calls, no shows, travel time, mileage reimbursement, preparation, documentation, and other costs not involving direct face-to-face services will not be honored. Likewise, billings must be for hours of direct service to the client, regardless of the number of staff involved in providing those services. Therefore, it is imperative that this rate be sufficient to cover all costs associated with this client, regardless of the number of staff involved in providing these services. (Explanations for these Lines are Provided on the Following Page) Total Hours of Direct Service per Client I ( S Hours [A] Total Clients to be Served ._.(co Clients [B] Total Hours of Direct Service for Year q 2.118 Hours [C] (Line [A] Multiplied by Line [B] Cost per Hour of Direct Services $ 45: 90 Per Hour [D] Total Direct Service Costs $ 220000 [E] (Line [C] Multiplied by Line [D] ) Administration Costs Allocable to Program $ I5O O O (F) Overhead Costs Allocable to Program $ I ZSbO [G] Total Cost, Direct and Allocated, of Program$ 3 O7 5 00 [H] Line [E] Plus Line [F] Plus Line [G] ) f r- Anticipated Profits Contributed by this Program $ (53 7 6 [I] Total Costs and Profits to be Covered by this Program(Line [H] Plus Line [I] ) $ 32 2_8-7 S [J] Total Hours of Direct Service for Year q 2t b [g] (Must Equal Line [C] ) Rate per Hour of Direct, Face-to-Face Service to be Charged to Weld County Department of Social Services $ -76 . O I [L] Page 31 of 32 Program Category Intensive Family Therapy Program Bid Category Program Title Multisystemic Therapy (MST) Vendor Alternative Homes for Youth (AHFY) IX. PROGRAM CAPACITY BY MONTH The maximum number of clients to be served by the current staff is 12 per month. The minimum number of clients needed to support the program is 6 clients per month in the start up stage of treatment. 13 FROM : RIEDMRN-DOWNTOWN PHONE NO. : 303 831 6344. 3 , Mar. 13 2000 01:2OPM PS ��. � p . ;_�' .. ..• � 3/13/190 � ; .. :. I CERTIFICATE OF INS 25-S I':=::. ,, .<. . ` PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF Riedman Corporation INFORMATION ONLY AND CONFERS NO RIGHTS UPON 1650 Pennsylvania St THE CERTIFICATE HOLDER. THIS CERTIFICATE Denver, CO 80203-1390 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE (303) 831-1717 AFFORDED BY THE POLICIES BELOW. -^ss& m COMPANIES AFFORDING COVERAGE Ikst� .z INSURED COMPANY A: RELIANCE INSURANCE COMPANY ALTERNATIVE DEIIS HOMES FOR YOUTH COMPANY B: PINNACOL 9201 WEST H0VENU COMPANY C: RLI INSURANCE COMPANY .9:201 WEST 44TH AVENUE. WHEAT RIDGE, CO 80033 COMPANY D: �� 'a. `t`?` -•"X--�� ..._�•,:msµ,I COVERAGES I �^...n j ` �-vo;'is'�'"`" �` :a��.�'•'�8::-a f:F��. I T`h—is i p a Thrs is to certify that policies of•—insurance listed below have been issued to the tnsmred named a"oave for the policy period indicated„ notwithstanding any requirement, term or condition of any contract or other document with reispect 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 shorn may have been reduced'by patdrelaims. s :acif.. , I CO 13I INSURANCE I; , `?,!I POLICY NUMBER & DATES 1 A�„ r'ttT I LIMITS I,.s,3g :r• rfc -&5 A GENERAL LIABILITY ZX3017176 S 2, 000,000 General Agg [X] Comm Gen Liab Eff 07/01/99 Exp 07/01/00 $ 2, 000, 000 Pro/Co Ops Agg [ ] CM [X] Occur $ 1,000, 000 Pers/Adv Inj [ I OCP Eff / / Exp / / $ 1,000,000 Ea Occurrence $ 50,000 Fire Damage [ 3 Eff / / Exp / / $ 5,000 Medical Exp A AUTO LIABILITY ZX3017176 ( ]Any [ ]All Own Eff 07/01/99 Exp 07/01/00 $ 1, 000, 000 CST, [X]Schd (X] Hired $ BI (person) [X]Non-Owned Eff / / Exp / / $ BI (accident) [ ] ( ] $ Property Dam GARAGE LIABILITY $ Auto-Each Acc [ ]Any Auto Eff / / Exp / / $ Other-Ea Acc [ ] [ ] $ -Aggregate C EXCESS LIABILITY RXL0257360 $ 2,000, 000 Occurrence [ ]UMbrella Form Eff 07/01/99 Exp 01/01/00 $ 2, 000, 000 Aggregate [X]Other Than Umb - (WC Stet Lmts ( ]Other-- B IWC/EMP LIABILITY 1453282 $ 100, 000 EL Each Acc [ ] Incl ( ] Excl Eff 07/01/99 Exp 07/01/00 $ 100,000 EL Dis-Ea Smp 500, 000 EL Polt Prop/Part/Execs Eff / / Exp / / Description of operations/locations/vehicles/special items CANCELLATION - , I CERTIFICATE HOLDER Igmg, Should any of the above described policies , be cancelled before the expiration date thereof, the issuing company will endeavor WELD COUNTY DEPT OF SOCIAL SRVCS ' to mail 30 days written notice to the ATTN: PAT PERSICHINO, DIR GEN'L SV, certificate holder named to the left, but 915 - 10TH STREET failure to mail such notice shall pose no GREELEY CO 80632 obligation or liability of any kind upon e any, Sts agents or reps. brined Representativet qPnles; Clnen2 Tz.es, Mar TB,,1999 C.ient Po afn:e IS . eena 92 tJ'. • 'indent ARECOJ Kane - rC:PO[d; .[„2P;ECN j'. FOLLOU OP CKYCPMAIIL7F Tea m fr 8 Mdnt[m 12 Month a F' Lntane natacn Fctio;,: Up To:Raw Cy Fa:Low Cy jf ®ale e`, Contact: IPerson Contacted: tgo mpReted ay, FC[[CA7:0 9r1 r naDEMEa7 - ST8KC2BE BF SUCCESS POLLC80 OP QUI:SU:CMS ( Current grade aaeaeLr ;. Es yoctt;U; attending sctoaL? Number of: days absent? C C r C Has yenta .graduated? ,Has youth c@taaneda Cents' ncate c CempRet:cd? COmd, CC)©at., (C)e1ete, 7 -' CS, CC)t[mer Fite, fl)ernnnate ' HDardeo®y; ( )emt, (P)re�eneys; CSDearch, F$ -. Order, <Esc> =: Exit ' ._�_ ... .._ FaRes, cEntot ffiEes, , Mar ,18;,.'1999- ' c&nen' Profile [Sxr en °53 If', } CdCTD=f. fln ut 216533 Name - Pt13Ut.q Ha zo S©CE'R" aczEP-A3Il_ 256n0E0P E - ST6HD0VG€O OF SIDOCCSS t . IF®IL1®4D U'F QUEST:OHS Intake cation ' Fe2Eova 9u l"oIlEcac FoIlIlow OCcw m�aoy.LIlLegaR, eyrcts. ''.na the yoatth been Enycllu d Er?. 3 3 1; -Eno many daays''servcd fir; 90S CdsteotEoo, etc.D? 2 ' .; 3 3 01eaa anarn9'days'ict Se_xa:... . Seruff e= r eidnnero4% 0 0 U 6 ,Hayter, t'ff mores; to:[2ted? W w^ C c U Huat5ier off'!a Gisdeaneaoors? 3 3 Ko hero off ff¢Eodies? 0 0 3 a4-0mrober'cff,Coroenictions? 0 13 5 0 C C&Ddd; G Dii CD)elete, t t3, CODtCcer GiPe, 'CTD¢rerinate Q70Darde.opcyn CM eM4, CPDrecuous'_SS;:earc0o,'.ff2,H- 3rder,%<Esc> -';SM o �`• 4�. :Files, CIlnent �s➢es ?hr 185. 1995LA• ti , CTa¢cut gCwu C�aeo¢ @SUCC�; fA� C1a C SDZ: ,r,_N.S° ACCIPT2301 BEFALliCP E -. STSK]Fr., SY SUCCESS Term:- 6Month t2 Month ,CFOLL©4. OOR @CC$rECbS Tntaye .cation Foillo a Co Tallinn dip LCoTTevc =OOse, �`r saofmstamc¢sa , � s i2allitionuuosecs Cacxd;? , I' a,CCac�t¢s CCoercanot ` Barbiturates Cd'o:4nersS? El Sniffing (IgTdeipaa¢ct®Cas)? n�arett¢s? , J)d!d, C ed=t, CC,`� e2¢ t - CD)tner Tsa¢,'C1Derumacat¢ CBIarafiCo®7, C6l)esst, CPCrecaouus,'C$Dearoau, ff$ - Br ecs; <Esc> - Esan4 I affixes; Y CCnent lies,' - - -P9ar ES;1 99 CIl,eont Proffa7e QSereen:-12 . c�96 ICIlnent •- CaCCCID 1 P".aroe - REICH xCAECN C : ;., EMPL3'.734.ENT - STIKIECVLC OF SUCCESS i te.rnn- 6 Month 12 241,onth rl ,F®L7.eCF EP QLOEST0E2HS 'make nation oon GolIloac 'Jo Goll ow Up . GolEoss Up, ills the �o:ath ecmpLopee? KC N'oonher of hours ;Ter week • reurreatCy eomp is Ped? C C C a u IIIIUN?TSCCVECH i'9IICP G" 1C`P - SUSEMivC CG SUCCESS rerrn- 66 Month E2 Month ,F®R. 341,' EP C.KF2Mpr:CPp ;Intake nation Lre:inav Sp GeIlCC‘n Up GoToat C , Up 4 inhere is sPeuth '2..i ins? £5 i ?IP 2ot fed the: pooy:4Lb has:. - - it CCDaa, CEDmina, G)eliete,.I - TS, (althea.. rile, CCD .rro5ooath 2r.DareCopj, ELaDeas4', CL)rennous CSDearop TS - Greer, <Est> - Exit ' '_ "1 Case Summary for Supervision & Consultation Family: Therapist: Date_ Genogram Reasons for Referral Initial Goais\Desired Outcome Participant Anticipated behavioral change Type\Frequency\Duration of Services Therapist Signature\Degree\Date Parent Signature\Date Youth Signature\Date Case Summary for Supervision & Consultation Family: Therapist: Date: Weekly Review L Overarching\Primary MST Goals IL Previous Intermediary Goals Met Partially Llof JR Barriers to Intermediary Goals IV, Advances in Treatment V/.,. Assessment of"fit" between identified problems and their broader systemic context. VI, New Intermediary Goals for Next Week Therapist Signature\Degree\Date Parent Signature\Date Youth Signature\Date Alternative Homes for Youth Monthly Progress Report Name: XXX Dates: 12/04/99 to 12/30/99 Date of Birth: 03/05/82 Admission Date: 12/04/99 ACTIVITIES: Employment 1. 00 hours Free Time 4.00 # of Job Hunting 9.50 hours Physical Activities 5. 00 # of Staffing 1.00 # of Visits 4. 00 4 of Tutoring 1. 00 hour Vocational 2.00 hours Dental Appointment 1.00 # of THERAPY: Case Management 4.00 4 of Group Therapy 10.00 hours Individual Therapy 5.00 hours Milieu Treatment 25.50 days Therapeutic Home Vst 0.50 days Wilderness Experience 1.00 day URINALYSIS: 06/04/99 Urinalysis-Negative 06/08/99 Urinalysis-Negative 06/12/99 Urinalysis-Negative 06/15/99 Urinalysis-Negative 06/19/99 Urinalysis-Negative 06/20/99 Urinalysis-Negative 06/25/99 Urinalysis-Negative 06/26/99 Urinalysis-Negative 06/27/99 Urinalysis-Negative DISCHARGE PLAN: Xxx will complete MST on or before 03-05-2000 . He will continue to live at home, attend school and work part time. Therapist Date TERMINATION REPORT NAME: DATE OF BIRTH: CASEWORKER: COUNTY: DATE OF ENTRY: DATE OF EXIT: I. PRESENTING PROBLEMS: List as stated in Treatment Plan. II. DIAGNOSTIC INFORMATION: List current Diagnostic Info.if RTC A client. If not dJ.,1et this category from report III. REVIEW OF TREATMENT PLAN GOALS: List all goals and review of goals. IV. DATE OF DISCHARGE: V. PLANNED SUCCESSFUL UNPLANNED UNSUCCESSFUL V. DISCHARGED TO: VI. FURTHER RECOMMENDATIONS: THERAPIST DEGREE DATE MST Therapist Adherence Measure Page 1 of 3 MST Adherence Measure Note to users: To use this quality assurance instrument, you must first register your MST program with the MST Institute. For additional information about the registration process, please contact the MST Institute at msti@rnstinstitute.org. A. Please complete the following: 'TEAM ID#: •:THERAPIST ID#: IFAM LY ID#: liTlis,TE OF COMPLETION WITH FAMILY cam„adyyi: �C No If this is not the first administration, is this caregiver the r Yes same person as before?: N/A(First ;Administration) B. Next, using the Primary Caregiver Responses, complete the table that follows: • Regardiiing your East 2-3 sessions: Not at A . Some ' Pretty Very all :little ' much much 1. The sessions were lively and energetic. C r C r C .2. The therapist tried to.understand how r r C my farrti-ly's problems alit fit together. • 3. My family and the therapist worked C C r C C together effectively. 4. My family knew exactly which• problems we were working on. 5. The therapist recommended that family members do specific things to solve our C C C C C problems. 6. The therapist's recommendations required family members to work on r C C C C our problems almost every day. httn://vsturw mstinctitntft nra/the.ranict2 htmi n�ini i nn Y. MST Therapist Adherence Measure Page 3 of 3 21. The therapist understood what is good r r r r r about our family. '22. The therapist's recommendations made r r r r r good use of our family's strengths. Not at all A little Some Pretty much 'Very much 23. My family accepted that part of the therapist's job is to help us change r r r r • r certain things about our family. 24. During the session, we talked about some experiences that occurred in r r r r r previous sessions. • 25. The therapist's recommendations should help family members to r r r r r become more responsible. 26. 'There were awkward silences and r r r r r pauses during the session. • Thank you for taking the time to complete this survey. 1. Click on the Submit Survey button below to send your responses to us and receive your scores. 2. If you are entering multiple surveys, clear the previous entries by clicking on the Clear All Answers button before entering a new set of responses. L 7.: fete tatetatal This questionnaire was created by Perseus SurvevSolutions Live. httn•//www mctinctinrte nro/theranict2 html m/n1 own ALTERNATIVE HOMES FOR YOUTH MST BOOSTER TRAINING March 9 & 10, 2000 Laurie A. Westlake, Ph.D. MST Consultant THURSDAY, 3/9 9:00 to 12:00: MST Case Organization & Integration 1. MST Analytical Process: The "Do-Loop" Writing Overarching Goals For Referral Behaviors Finding the "Fit" For Referral Behaviors Using Information About "Fit Drivers" To Develop Interventions Interventions That Target "Drivers" Are Weekly Intermediary Goals 2. Prioritizing Intermediary Goals: Which Goals First? Alignment And Engagement With Parents/Caregivers Structure: Rules, Consequences And Monitoring To Manage Youth Behavior Immediate Plan To Target Imminent Behavior Problem That Could Lead To Placement Immediate Plan To Promote Safety When Danger To Self Or To Others Is Imminent 4- 3. Challenging Circumstances: Using Behavioral Sequence Data and Developing Safety Plans A. Using Data From Behavioral Sequences To Develop Intermediary Goals Negative Caregiver-Youth Interactions (Case Example) Aggression (Case Example) Problems With School Attendance (Case Example) Substance Abuse (Case Example) • MST Case Organization & Integration, Continued P.? B. Developing Safety Plans Danger To Self (Case Example) Danger To Others (Case Example) 12:00 to 1:15: GROUP LUNCH 1:15 to 5:00: Engagement Evidence That Reflects Engagement/Nonengagement Bathers To Engagement Overcoming Bathers To Engagement Team members will focus on current MST cases which include evidence for problems with engagement. Team members will discuss and role-play specific means to improve engagement. FRIDAY, 3/10 9 to 12: Peer Interventions Role of Negative Peers in Delinquent Behavior Assessment of Peer Involvement Peer Interventions Case Presentation Team members will present two current MST cases that include evidence for negative peer involvement or absence of prosocial peer involvement. Team members will discuss and role-play MST assessment of negative peer involvement and interventions to increase prosocial peer activities. 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-9000 Revision (RFP-FYC-00006) Contract Award Period Name and Address of Contractor Alternative Homes for Youth Beginning 06/01/2000 and 9201 W. 44th Avenue Ending 05/31/2001 Wheatridge, CO 80033 Computation of Awards Description Unit of Service The issuance of the Notification of Financial Assistance Award is based upon your Request for Proposal (RFP). This program provides a comprehensive, The RFP specifies the scope of services and conditions Therapeutic alternative to placement that of award. Except where it is in conflict with this addresses behavioral,psychological, family NOFAA in which case the NOFAA governs, the RFP issues and academic enrichment, with a strong upon which this award is based is an integral part of the emphasis on vocational exploration. A monthly action. maximum of 14 youths (12-18), five- eight hours of site-based services per day, 40 Special conditions hours per week for 24 weeks. 1) Reimbursement for the Unit of Services will be based Cost Per Unit of Service on a monthly rate per child or per family. 2) The monthly rate will be paid for only direct face to Monthly $ 1.490.41 face contact with the child and/or family or as specified Based on Average Capacity in the unit of cost computation. 3) Unit of service costs cannot exceed the hourly and yearly cost per child and/or family. Enclosures: 4) Payments will only be remitted on cases open with, and X Signed RFP:Exhibit A referrals made by the Weld County Department of Supplemental Narrative to RFP: Exhibit B Social Services. Recommendation(s) 5) Requests for payment must be an original submitted to _ the Weld County Department of Social Services by the Conditions of Approval end of the 25th calendar day following the end of the month of service. The provider must submit requests for payment on forms approved by Weld County Department of Social Services. A Aryls: Program Official: By JQ,SJ.ilhA—J By arbara J. Kirkmeyer, hair Jud . Crri ,Directo Board of Weld County Commissioners Wel aunty epar-tment of Social Services Date: O( -a4-�poo Date: b � (;C�� o?0CV -/538 SIG ii. D RFP EXHIBIT A INVITATION TO BID DATE: February 28, 2000 BID NO: RFP-FYC-00006 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-00006) for:Family Preservation Program-I-Day Treatment Program Fames 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 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 Day.Treatment Program Category must provide a comprehensive, highly structured program alternative to placement or more restrictive placement that provides therapy and education for children. 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 Jp,wa,Es ,' ,Vase v TYPED OR PRINTED SIGNATURE VENDOR , A/ATI✓L Ant-5 bin yaim (Name) H written Signature By Authorized Officer or Agent of Vendor ADDRESS .92O/ 4-? 1-79734 4UFdue- TITLE &E aes,oewry "Ea /l)flt4r 4 Z>4e CD 8etP33 DATE 31-1D-4:0 PHONE # f`≤3) %WI ,J-5-40 En: /la" The above bid is subject to Terms and Conditions as attached hereto and incorporated. Page 1 of 32 * w• T I. PROGRAM DESCRIPTION The Greeley Day Treatment Program utilizes a non-medical model of treatment. It is one of eight programs under the Alternative Homes For Youth umbrella. The Day Treatment Program has been successfully providing services to youth and families within the Greeley community since 1994. The program is geared towards providing services that meet the needs of male and female youth between ages of 12 and. 18. The program provides a comprehensive, highly structured program alternative to placement that addresses behavioral, psychological, family issues and academic enrichment. There is also a strong emphasis placed on vocational exploration. Services are available from 8:00 a.m. - 5:00 p.m. with extended evening and weekend hours for family therapy and for tracking and support services. Evaluation criteria measure recidivism, school and/or work attendance and parent satisfaction. The survey is conducted 6 and 12 months after discharge. MISSION The Mission of the Greeley Day Program is to reduce the likelihood of placement outside the home. • By providing individual and family opportunities for the development of effective problem solving skills and constructive communication. • To help youth in rediscovering how to learn and succeed in school. • To increase responsibility on part of the youth. • To develop self respect through challenging experiences. • To empower the youth and their families to achieve future goals. II. TARGET/ELIGIBILITY POPULATION Youth to be Served A. An average of 14 youth, ages 12 to 18 years, will receive services within a 12-month period. B. IQ of 60 or Above Non-Psychotic Male and Female Ages 12 - 18 years old (average age has been 15.3). Court ordered to the program Condition of bond,probation or deferred judgrnent. - C. An average of 14 family units will be served, involving parents and siblings. D. 33°' of youth served will receive biculturau uiiinguai services. E. The total number of individuals who receive services in south Weld County will be determined by referral and transportation. F. Monthly maximum program capacity is 14 youth. G. Monthly average capacity is 7 youth. H. Average stay in program is 24 weeks. I. Average hours in program per week is 40 hours. III. TYPES OF SERVICES A. The Greeley Day Treatment Program provides a minimum of 5 hours and maximum of 8 hours of site-based services per day, for ages 12 to 18 years. PROGRAM SERVICES * Individual, Group and Family Therapy * Psychological assessments * Structured level system * Positive Peer Milieu * Regular staffing and communication with appropriate agencies, (i.e., social services probation and public schools) * Educational services * Relationship skill building increasing/enhancing self-esteem. PROGRAM SERVICES (continued) * Basic living skills * Vocational services * Drug/Alcohol monitoring and counseling * Parent and mental health education and support groups * Transportation within 10 miles B. Community Collaboration Efforts 1. Weld Count_Department of Human Services Referrals and Case Management Services which include staffing, treatment planning and discharge. 2. Weld County Department of Mental Health Case Management/coordination of therapeutic services and testing. 3. Colorado Department of Education Department of Education: staff certification, training and inservices. Weld County School District 6: case management, staffing, and testing (IEP). 4. Island Grove Case Management Services Group Therapy Services Drug and Alcohol Assessment and Urinalysis Testing 5. Individual Group Therapy Service (IGTS) Individual and Family Therapy C. Program Components 1. Educational Approved School Program by the Colorado Department of Education 2 - Certified Teachers Vocational/Independent Living Skills (average 1 hour per week) Physical health needs (nutrition, medical, sex education, HIV, contraception, etc.) Reintegration into public schools (average 1 hour per week) Educational Testing and assessment (as needed) 2. Therapeutic Individual counseling services (average 1 hour per week) Group counseling services (average 10 hours per week) Family counseling services (average 1 hour per week) Island Grove-Substance Abuse Group (average 1 hour per week) Psychiatric Consultation(as needed) Psychological Testing (as needed) 3. Behavioral Utilization of Therapeutic Crisis Intervention Daily life supervision and interaction Peer Dynamics Behavioral modification Refusal Skills Life Skills 4. Recreational Wilderness Program (minimum of 2 trips offered per youth) Therapeutic Initiatives and Team Building activities (average 1 hour per week) Team Sports (average 1 hour per week) D. Parental/Caretaker Involvement 1. Day Treatment includes parental involvement in all program components as indicated in the Treatment Plan and as required. 2. Day Treatment advocates family therapy and encourages parents/guardians to participate in all phases of treatment. E. Assessment and Plan 1. Educational services are provided by 2 certified teachers. Pre-and Post-testing will be provided using the Woodcock Johnson Assessment Tool. 2. Vocational and Independent living skills are provided by certified teachers and counselors for age appropriate youth. Experiential activities and job coaching are also provided. 3. A contract for therapeutic services is established for every youth and family that outlines the frequency and level of services needed. This information is documented in the treatment plan and reviewed on a monthly basis. Individual and Family Therapy will occur weekly. 4. Physical health needs, i.e., sex education, REV, contraception, nutrition, etc., are covered within the program's curriculum. Medical and dental appointments need to be scheduled prior to placement or will be scheduled within 30 days of placement 5. Mental health needs such as psychotropic medications and testing are monitored through the treatment plan and recommendations for these additional services will be coordinated during case reviews and treatment staffing. The program is capable of administrating medications and coordinating mental health services. F. ProActive Planning (transition) 1. The reintegration plan will be outlined and discussed 30 days prior to discharge. The program will maintain on-going communication with the school district to ensure continuity of care. 2. Monthly staffing will occur between the Greeley Day Treatment staff and the IGTS therapists to monitor treatment progress. The program will also schedule two follow- up sessions with the youth and family to further insure family stability. 3. Within 10 days of being discharged from Day Treatment, program staff will follow- up with telephone contact to the youth and family to check on progress and offer support. 4. A 6 and 12 month follow-up evaluation will be conducted on all youth and families who have been discharged from the program. The evaluation will measure client satisfaction, and progress in school, employment, family dynamics, recidivism and stability within the community. 5. A collaborative effort in utilizing community resources will be established to insure that personal and family growth is sustained, (i.e., Vocational Rehabilitation Summer Youth Employment, etc.). IV. MEASURABLE OUTCOMES A. 70% of the youth who complete the Day Treatment Program will be residing in their homes 6 months after being discharged from the program. B. 70% of the youth, will enter public school upon graduation from the program. Project Monitoring and Evaluation Internal monitoring/evaluation of the program will include a quarterly review of the program by Alternative Homes For Youth's Quarterly Assurance Review Team. The team will ensure compliance with the AHFY Quality Assurance Manual. Program evaluation will be coordinated at six-month and one-year intervals to reevaluate youths successful reintegration into the community. Areas that will be tracked will be employment, school, illegal activities, and any commitments or new offenses with the judicial system. The data will be compiled to evaluate the outcome of the program to prevent imminent placement of children and to reunify children in placement with their families. The program will monitor daily, weekly, and monthly services by utilizing the ECHO Client Record Management System. This computerized data collection system will provide the project up-to-date information about delivery of services and the utilization of these services. Each service is documented in quarter hour increments. The program will also fill out quarterly client progress reports as prescribed by Weld County Department of Social Services. V. SERVICE OBJECTIVES A. Fewer than 30% of the youth will be placed within six months of Day Treatment graduation/discharge. B. 70% of the youth discharged from Day Treatment will be enrolled in public school. C. The Day Treatment Program will assist families in the awareness and identification of community resources that can be utilized regarding family management issues (i.e., human services, vocation, housing, medical/health, mental health, education, and legal resources.). The evaluation methods that will be utilized include the computerized ECHO Client Record Management System that allows for client follow-up 6 months and 1 year after discharge. The follow-up procedure is able to quantify service objectives. The ECHO System will also track client and parental involvement in community and state sponsored services on a weekly basis. VI. WORKLOAD STANDARDS A. An average of 14 youth and families will receive services within a 12 month period. B. The duration and length of time within the program is an average 24 weeks. C. Total number of hours per day/week/month. Day- 8 hours per day Week - 40 hours per week(40 hours service) Month- 173 hours per month. D. We anticipate no more than 14 youth total in Greeley Day Treatment Program. The Program is staffed with, I Tracker/Counselor, 1 Treatment Leader, 1 Counselor/Wildemess Experience Coordinator and 1 Teacher. STAFF QUALIFICATIONS Day Treatment staff will meet or exceed the minimum Merit System qualifications in education and experience. A. Counselors will have a minimum of a Bachelor's degree in Social Work, Psychology, Sociology or closely related field. Treatment Leader will have a minimum of a Master's degree of Social Work and three years of clinical supervision experience. B. The number of staff at Day Treatment. 1 - Counselor/Wilderness Experience Coordinator 1 -Tracker/Counselor 1 -Treatment Leader 1 -Certified Teacher C. Staff to youth ratio for youth 12 to 18 years of age. 1 -Counselor to 10 youth 1 -Treatment Leader to 10 youth VIH.. COMPUTATION OF DIRECT SERVICE RATE Direct Time (Per Month) Hours 1 Direct client contact 394 Indirect Time 2 Completion of Paperwork 26 3 Travel 4 4 Court Appointments 2 5 Vacation 32 6 Sick Leave 13 7 Case Management 22 8 Other 52 9 Subtotal 151 10 Total Time Available Per Month 545 (Sum of 1-8) RFP-FYC-00005 through 00011 TERMS AND CONDITIONS RFP-FYC- 00005 through 00011 1. The Contractor agrees it is an independent contractor and that its officers and employees do not become employees of Weld County,nor are they entitled to any employee benefits as Weld County Employees if this RFP/Bid is accepted by the Board of County Commissioners. 2. Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of Contractor or its employees, volunteers, or agents while performing duties as described pursuant to this RFP/Bid. Contractor shall indemnify, defend, and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers, and agents. The Contractor shall provide adequate liability and worker's compensation insurance for all its employees,volunteers, and agents engaged in the performance as prescribed under the RFP/Bid. 3. No portion of this Bid shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, nor shall any portion of the RFP/bid be deemed to have created a duty of care with respect to any persons not a party to this RFP/Bid. 4. No portion of this RFP/Bid shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsection,paragraph, sentence, clause, or phrase of this RFP/Bid is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this RFP/Bid and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 6. No public official or employee of Weld County, Colorado, and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved RFP/13id or the proceeds thereof 7. The Contractor assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under an approved RFP/Bid. 8. The Contractor assures that sufficient, audit able, and otherwise adequate records that will provide accurate, current, separate, and complete disclosure of the status of the funds received under the RFP/Bid are maintained for three(3) years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, federal, and state auditors and representative to audit and monitor the Contractor. Page 2 of 32 RFT-INC-00005 through 00011 9. The Contractor assures that authorized local, federal, and state auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on-site visits, all contract activities, supported with funds under this RFP/Bid to ensure compliance with the terms of this RFPBi.d. Contracting parties agree that monitoring and evaluation of the performance of the RFP/Bid shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. 10. A RFP/Bid which is approved by the Board of County Commissioners of Weld County, shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns and shall constitute a contract without further action by the Board. The Contractor or Social Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 11. The Contractor assures that it will fully comply with the Weld County Family Preservation Program regulations promulgated, and all other applicable federal and state laws, rules and regulations. The Contractor understands that the source of funds to be used under this RFP/Bid is: Family Preservation/Family Support Funds of the Omnibus Budget Reconciliation Act of 199"1. 12. The Contractor assures and certifies that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a Federal department or agency; b. Have not, within a three-year period preceding this RFP/Bid,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph 12(b) of this certification; and d. Have not within a three-year period preceding this RFP/Bid, had one or more public transactions (federal, state, and local) terminated for cause or default. 13. The Appearance of Conflict of Interest applies to the relationship of a contractor with Social Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. Page 3 of 32 RFP-FYC-00005 through 00011 During the term of this RFP/Bid, if it is approved by the Board of County Commissioners, the contractor shall not enter into any third party relationship that is a conflict of interest or gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,the contractor shall submit to Social Services a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall_constitute grounds for Social Services' termination, for cause, of its contract with the contractor. 14. Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this RFP/Bid, if it is approved by the Board of County Commissioners. Except for purposes directly connected with the administration of the Family Preservation Program, no information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian. Contractor shall have written policies governing access to, duplication and dissemination of, all such information. Contractor shall advise its employees, agents and subcontractors, if any,that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. 15. Proprietary information for the purposes of this contract is information relating to a party's research, development,trade secrets,business affairs, internal operations and management procedures and those of its customers, clients or affiliates,but does not include information(1) lawfully obtained from third parties, (2) that which is in the public domain, or(3) that which is developed independently. Neither Party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of an executed contract. Any proprietary information removed from the State's site by the Contractor in the course of providing services under this RFP/Bid will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. Page 4 of 32 RFP-FYC-00005 through 00011 PART A ADMINISTRATIVE INFORMATION 1. Legislative Authority The Family Preservation Program and the Emergency Assistance for Families with Children at Imminent Risks of Out-of-Home Placement authorize the Board of Weld County Commissioners to expend funds for the development and implementation of alternatives to out-of-home placement of children. 2. Issuing Office This Request for Proposal (RFP) is issued for the Board of Weld County Commissioners by the Director of General Services for the benefit of the Placement Alternatives Commission. The Director of General Services is the SOLE point of contact concerning this RFP. All communication must be done through the Director of General Services. 3. Purpose 'This RFP provides prospective bidders with sufficient information to enable them to prepare and submit proposals for consideration by the Board of County Commissioners of Weld County to satisfy the need for expert assistance in the completion of Placement Alternatives Commission goals of this RFP. 4. ; co e • This RFP contains the instructions governing the proposal to be submitted and the material to be included therein; mandatory requirements which must be met to be eligible for consideration; and other requirements to be met by each proposal. Page 5 of 32 RFP-FYC-00005 through 00011 5. Schedule of Activities SCHEDULE OF ACTIVITIES DATE(S) ACTIVITIES DESCRIPTION A. Announcement to February 22, 2000, Announcement activities will included: Prospective Bidders through February 25, 2000 - a request to all prospective bidders to Concerning Request for pick up a bid packet(s) on February Proposal 28, 2000. - a budget estimate - a requirement to all prospective bidders that the bidders must attend a Prospective Bidders Conference on February 28, 2000, or a bidder will not be allowed to compete in Bid No. RFP-FYC-00005 through 00011 Activities will include: 1. Sending letters to our current contractors. 2. Advertising the announcement to prospective bidders through newspapers & radio. 3. Releasing a press release. B. Prospective Bidder February 28, 2000, (1:00 The Prospective Bidder Conference will be Conference p.m. to 3:00 p.m.) mandatory and will include: the RFP Bid Format for renewing current programs approved for FY 1999-2000. - the RFP Bid Format for all prospective bidders or current providers requesting major changes to programs approved for FY 1999-2000. an overall description of the RFP process a release of the REP Bid Package which will include: A. The RFP Bid Format, B. The latest version of the Family Preservation Program criteria, Page 6 of 32 RFP-FYC-00005 through 00011 C. An opportunity by Bidders to ask questions about the RFP Bid Package, and D. A listing of Assigned Social Services Division Supervisors. (Each Prospective Bidder will be required to meet with its assigned Social Services Supervisor to discuss the design of its project prior to its formal submission as indicated by the signature of the assigned Social Services Supervisor in the final Bid submittal.) C. Written Inquiries from March 2, 2000,by 5:00 FYC Bidders p.m. D. Response Conference to March 6, 2000 The Response Conference to Written Inquiries Written Inquiries, (1:00 p.m. to 3:00 p.m.) will be mandatory and will include: Submitted by FYC - a written response to Written Inquiries Bidders Submitted by FYC Bidders - a written response to vendors requesting renewal of FY 1999-2000 bids - a unit cost description - the evaluation instrument to be used by the FYC to assess the quality of the RFP bids E. FYC Bid meeting with March 1, 2000, through Assigned Social Services March 14, 2000 Supervisor F. Submission Deadline March 23, 2000,by 10:00 a.m. according to the Weld County Purchasing Time Clock G. Pre-award Visits March 27 & 28, 2000 (Estimates; optional) H. FYC Final Approval of April 5, 2000 2000-2001 Plan (estimate) I. Board of Weld County April 10, 2000 Page 7 of 32 • RFP-FYC-00005 through 00011 Commissioner Plan Approval (estimate) J. Colorado Department of April 20, 2000 Human Services Plan Submission Approval (estimate) K. Contract Finalization May 31, 2000 Approval (estimate) L. A contract period June 1, 2000—May 31, (estimate) for 12 month 2001 (Family Preservation programs. Program Funds) 6. Invitation for Proposals On behalf of the Board of County Commissioner of Weld County, the Families, Youth and Children Commission is hereby contacting prospective bidders who have an interest or are known to do business relevant to this RFP. All interested individuals/firms who were not contacted are invited to submit a proposal in accordance with the policies, procedures and dates set forth herein. In the event of"No Bid", please sign Invitation and Bid page, indicating "No Bid" and return to the Director of General Services. 7. Written Inquiries Prospective bidders may make written inquiries concerning this RFP to obtain clarification on requirements. No inquiries will be accepted after March 2, 2000, 5:00 p.m. Send all inquiries to: Pat Persichino, Director of General Services, Bid Number RFP-FYC-00005 through 00011 inquiry. Responses to bidder's inquiries will be made in writing and/or through a response conference by the Families, Youth and Children Commission, on behalf of the Board of County Commissioners, Weld.County,on March 6, 2000, from 1:00 p.m. to 3:00 p.m. at the Weld County Department of Social Services Annex, 315B N 11 Avenue, Second Floor Conference Room, Greeley, Colorado, to all prospective bidders. 8. Modification or Withdrawal of Proposals Proposals may be modified or withdrawn, by the bidder, prior to the established due time and date. 9. Proposal Submission Proposals must be received on or before the time and date indicated in the-Schedule of Activities. No proposals will be accepted after this time. Bidders mailing their proposals shall allow sufficient mail delivery time to ensure receipt of their proposals by the time specified. The proposal package shall he delivered or sent by certified mail to: Pat Persichino Page 8 of 32 RFP-FYC-00005 through 00011 Director of General Services 915 10th Street P.O. Box 758 Greeley, CO 80632 Bid Number: RFP-FYC-00005 through 00011 Proposals which are determined to be at variance with this requirement will not be accepted. Six (6) copies (total, including original) of the proposal must be submitted and sealed in a package showing the following information on a white label. Bidder's Name Bid Number: RFP-FYC-00005 through 00011 Proposal due: March 23, 2000; 10:00 a.m. The Invitation and Bid page MUST be signed in ink by the bidder or an officer of the bidder legally authorized to bind the bidder to the proposal. Unsigned proposals will be REJECTED. 10. Late Proposals Late proposals will not be accepted. It is the responsibility of the bidder to ensure that the proposal is received by the Director of General Services on or before the proposal opening date and time. 11. Addendum or Supplement to Request for Proposal In the event that it becomes necessary to revise any part of this RFP, an addendum will be provided to each vendor who received the original RFP at the prospective Bidder Conference of February 28, 2000, from 1:00 p.m. to 3:00 p.m. 12. Oral Presentations/Site Visits Bidders may be asked to make oral presentations or to make their facilities available for a site inspection by the Families, Youth and Children Commission evaluation committee. Such presentations and/or site visits will be at the bidder's expense. 13. Acceptance of RFP Terms A proposal submitted in response to this RFP shall constitute a binding offer. Acknowledgment of this condition shall be indicated by the autographic signature of the bidder or an officer of the bidder legally authorized to execute contractual obligations. A submission in response to this RFP acknowledges acceptance by the bidder of all terms and conditions including compensation, set forth herein. A bidder shall identify clearly and thoroughly any variations between its offer and the Placement Alternatives Commission's RFP. Failure to do so shall be deemed a waiver of any rights to subsequently modify the terms of performance. Page 9 of 32 RFP-FYC-00005 through 00011 14. Protested Solicitations and Awards Any actual or prospective bidder or contractor who is aggrieved in connection with the solicitation or award of a contract may protest to the Board. of County Commissioners of Weld County. The protest shall be submitted in writing within seven working days after such aggrieved person knows or should have known of the facts giving rise thereto. 15. Budgets Proposals MUST include Budget Information, as described under Attachment A of the application. 16. Proprietary/Confidential Information Any restrictions on the use or inspection of material contained within the proposal shall be clearly stated in the proposal itself. Proposals submitted in response to this RFP are subject to the terms of Article 72 Public (open)Records of the Colorado Revised Statutes. 17. RFP Response Material Ownership All materials submitted regarding this RFP becomes the property of the Board of Commissioners of Weld County. Responses may be reviewed by any person after the Letter of Intent has been issued, subject to the terms of Colorado Revised Statutes 24-72-202 through. 24-72-206/Public (open) Records. The Board of County Commissioners of Weld County has the right to use any or all information/material presented in reply to the RFP, subject to limitations outlined in Proprietary Information. Disqualification of a bidder does not eliminate this right. 18. Bid Prices Estimated bid prices are not acceptable. 19. Selection Time The Families, Youth and Children Commission, on behalf of the Board of County Commissioners of Weld County, intends to make recommendations concerning proposal selection on or about April 8, 1999. The Board of County Commissioners of Weld County will make the final selection of proposals within two weeks of the Families, Youth and Children Commissions recommendation. Upon selection and approval by the State if appropriate, the Board of County Commissioners of Weld County will issue a Letter of Intent, and a contract must be completed and signed by all parties concerned, on or before the date indicated in Schedule of Activities. The bidder understands that the FYC's final approval of 2000-2001 plans and the Board of Weld County Commissioners' approval are based on allocations established by the State Department of Human Services. The contract between Social Services and the bidder will be adjusted according to final allocations provided by the State Department of Human Services. These actions may result in modifications to the original approved Bid. If the proposal selection date is not met, through no fault of the Board of County Commissioners of Weld County; the Board of County Commissioners of Weld County may elect to Page 1.0 of 32 • RFP-FYC-00005 through 00011 cancel the Letter of Intent and make the award to the next most responsible bidder. 20. Award of Contract The award will be made to that bidder whose proposal, conforming to the RFP, will be the most advantageous to Weld. County,price and other factors considered. 21. Acceptance of Proposal Content The contents of the proposal(including persons specified to implement the project) of the successful bidder are contractual obligations if the bid is accepted by the Board of County Commissioner of Weld County. 22. Standard Contract The Board of County Commissioners of Weld County reserves the right to incorporate standard state contract provisions into any contract resulting from this RFP (Ref Special Provisions). 23. RFP Cancellation The Board of County Commissioners of Weld County reserves the right to cancel this Request for Proposal at any time, without penalty. 24. Weld County Ownership of Contract Products/Services Proposals, upon established opening time, become the property of Weld County. All products/services produced in response to the contract resulting from this RFP will be the sole property of Weld County. The contents of the successful bidder's proposal will become contractual obligations. 25. Incurring Costs Weld County is not liable for any costs incurred by bidders in the course of preparing and submitting their bids. 26. Non-Discrimination The bidder shall comply with all applicable state and Federal laws, rules and regulations involving non- discrimination on the basis of race, color, religion, national origin, age or sex. 27. Rejection of Proposals The Board of County Commissioners of Weld County reserves the right to reject any or all proposals and to waive informalities and minor irregularities in proposals received and to accept any portion of a proposal or all items proposed if deemed in the best interest of Weld County. Page 11 of 32 RFP-FYC-00005 through 00011 28. Parent Company If a bidder is owned or controlled by a parent company, the name,main office address, and parent company's tax identification number shall be provided in the proposal. 29. Contract Cancellation Weld County reserves th.e right to cancel, for cause, any contract resulting from this RFP, by providing a timely written notice to the contractor. 30. Non-Collusion The bidder affirms,by signing the Invitation and Bid document, that the proposed bid price has been arrived at independently without collusion, consultation or communication as to any other bidder or with any competitor; the said bid price was not disclosed by the bidder and was not knowingly discussed prior to the submission, directly or indirectly, to any other bidder or to any competitor; and directly or indirectly, to any other bidder or to any competitor; and n.o attempt was made by the bidder to induce any other person, partnership or corporation to submit a proposal for restricting competition. 31. Taxes Weld County as purchaser, is exempt from all Federal taxes under Chapter 32 of the Internal Revenue Code (Registration No. 84-730123K) and from all State and Local Government Use Taxes (Ref. Colorado Revised Statutes Chapter 39-26.114(a).) Seller is hereby notified that when materials are purchased in certain political subdivisions the seller may be required to pay sales tax even though the ultimate product or service is provided to Weld County. This sales tax will not be reimbursed by either Weld County or the State. 32. Assignment Except for Assignment of Antitrust Claims, neither party to any resulting Contract may assign any portion of the RFP/Bid without the prior written consent of the other party. 33. Bid Bond/Security If the specifications contained herein so state, a bid security in an amount equal to 5%of your proposal shall be furnished to Weld County. See 24-105-201, C.R.S. 34. Contractor's Performance and Payment Bonds If the specifications contained herein so state, the contractor will be required to furnish a performance bond and a labor and material payment bond. A certified or cashiers check or bank money order may be accepted in lieu of the bonds. Page 12 of 32 RFP-FYC-00005 through 00011 35. Insurance If the specifications contained herein so state, the contractor shall procure, at its own expense, and maintain for the duration of the work, the following insurance coverage; Weld County, Colorado,by and through the Board of County Commissioner of Weld County, its employees and agents, shall be named as additional named insured on the insurance. A. Standard Workman's Compensation and Employer's Liability. 1) As required by State Statute including occupational disease, covering all employees at work site. B. General Liability (PL &PD) (Minimum). 2) Combined single limit- $500,000 written on an occurrence basis. 3) Any aggregate limit will not be less than $1 million. • Page 13 of 32 1. RFP-FYC-00005 through 00011 4) Contractor must purchase additional insurance if claims reduce the annual aggregate below $500,000. 5) State of Colorado to be named as additional insured on each comprehensive general liability policy. 6) Certificate of insurance to be provided to Weld County and must be attached to the RFP Bid. 7) Insurance shall include provisions preventing cancellation without 60 days prior notice by certified mail to Weld County. C. Automobile Liability (Minimum). 1) Contractor to carry a minimum of$500,000 combined single limit auto insurance. D. Additional coverage may be required in specific solicitations. For any insurances that are required by this RFP, a completed Standard Certificate of Insurance Form shall be provided to Weld County by the potential contractor prior to the start of any contract. 36. Indemnification To the extent authorized by law, the contractor shall indemnify, save-and hold harmless Weld County, its employees and agents, against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees incurred as a result of any act or omission by the contractor, or its employees, agents, subcontractors, or assignees pursuant to the terms of this contract. 37. Venue The laws of the State of Colorado Weld County shall govern in connection with the formation,performance and the legal enforcement of any resulting contract. Further, the provisions of Title 24, C.R.S. as amended, Article 101 and through 1.12, and rules adopted to implement the statutes, govern this procurement. 38. Certifications The Bidder certifies that it has currently in effect, all necessary licenses, approvals, insurance, etc. required to properly provide the services and/or supplies covered by its bid. Page 14 of 32 _.—, RFP-FYC-00005 through 00011 PART B BACKGROUND, OVERVIEW, AND GOALS Under C.R.S. 26-5.5-101 (Family Preservation Program) and C.R.S. 26-5.3-101 (Emergency Assistance for Families with Children at Imminent Risk of Out of Home Placement), the State of Colorado, through the Board of Weld County Commissioners, funds the Weld County Department of Social Services through a Family Issues Cash Fund and Family Preservation Program funds. The Family Preservation Program is a program that focuses on family strengths by directing intensive and time limited services to families to protect children, to prevent placement, and to reunify children and their families. The definition is based upon the following elements: A. Directed toward families B. Focused on family strengths C. Protects children D. Prevents placement or reunifies children and their families E. Time limited F. Family must be receptive to the services; however, exceptions shall be made for families who are court ordered. G. Intervention occurs at critical points. The Family Preservation Program is composed of several services that all share common purposes and elements. The Family Preservation Program has two primary goals: 1) prevent imminent placement of children; and/or 2) reunify children in placement with their families. A. For purposes of the Family Preservation Program, imminent placement is defined to mean that without intervention, a child will be placed out of the home immediately. B. For purposes of Family Preservation Program to "reunify with their family" or"to return to their own home" is defined to mean to return to the home of a parent, adoptive placement, independent living placement, foster-adoption placement, or to live with a relative if the case plan is for the child to remain with the relative on a permanent basis. Page 15 of 32 RFP-FYC-00005 through 90011 To assist the Board of Weld County Commissioners in the effective use of these funds, the Board of Weld County Commissioners appointed Weld County's Families, Youth and Children Commission to: A. Annually prepare a plan for the provision of Family Preservation Program Services. The primary goals under the plan shall be to prevent imminent placement of children out of the home and to reunite children who have been placed out of the home. B. Review, on an ongoing basis, the effectiveness of programs within Weld County which are designed to prevent or reduce placement and report its findings to the Board of Weld County Commissioners annually. The Families, Youth and Children Commission is pursuing contractors who demonstrate the capability of meeting the FYC's goals and objectives, and will adhere to Family Preservation Program eligibility guidelines. Any public or private agency,non-profit,private for profit or community based organization(CBO) or business may receive funding; however, support and commitment to the project being proposed must be demonstrated by other appropriate local agencies and organizations in order to receive favorable consideration for funding. Page 16 of 32 RFP-FYC-00005 through 00011 PART C STATEMENT OF WORK Program Requirements A. OUT-OF-HOME PLACEMENT CRITERIA Not every child/youth at risk needs out-of-home placement. These criteria are designed to provide a decision making model to assist in determining whether Family Preservation Program services and/or out-of-home placement are indicated. All three criteria must be met. Criteria#1: The child/youth may be at imminent risk of out-of-home placement (as defined in 26- 5.3102(b), C.R.S.) because one or more of the following conditions exist. 1. abandonment by or incarceration of parent/relatives/caretakers; 2. abuse/neglect - as defined in the Children's Code; 3. domestic violence- as defined in Section 18-6-800.3, C.R.S.; 4. conditions that exist to such a degree for either the child or caretaker so that the caretaker is unable to care for the child. a. substance abuse; drug exposed infants b. mental illness c. disability d. physical illness e. homelessness 5. beyond control of parents; 6. danger to self, others, or community; 7. infant or young child of teen parent in placement; 8. delinquency - adjudicated delinquent meeting current out-of-home placement criteria written pursuant to Section 19-2-1602, C.R.S.; 9. relinquishment or termination of parental rights; Page 17 of 32 RFP-FYC-00005 through 00011 10. child/youth returning home from out-of-home placement or moving to less restrictive level-of-care (LOC). Criterion#2: Before considering placement, an assessment is completed to determine the level of risk. If assessment of risk determines that the child is at imminent risk of out-of-home placement, then child/family strengths are determined, and the appropriate services and/or community supports (reasonable efforts) needed to address the existing Criterion#1 conditions are identified. When these services are not immediately available, or absent, unsuccessful, or exhausted, placement in the Family Preservation Program and/or out-of-home may be considered. Reasonable efforts include the intervention strategies and advocacy efforts used: 1. to identify/locate appropriate parent/relative caretaker's ability to protect children; 2. to assess the parent/relative/caretaker's ability to protect children; 3. to assist the parent/relative/caretaker and/or child/youth in assessing and utilizing the identified services to address th.e presenting conditions. Criterion#3: When placement is the best choice of available options/alternatives at this time to reduce risk to the child/youth while continuing reasonable efforts to resolve the conditions which led to imminent risk, then, placement in the Family Preservation Program and/or out-of-home may occur. B. The Core Services Program has two primary goals: 1)prevent imminent placement of children; and/or 2) reunify children in placement with their families. 1. For purposes of the FYC Services Program, imminent placement is defined to mean that without intervention, a child will be placed out of the home immediately. 2. For purposes of the FYC Services Program to "reunify with their family" or"to return to their own home" is defined to mean to return to the home of the parent, adoptive placement, guardianship, independent living placement, foster-adoption placement, or to live with a relative if the case plan is for the child to remain with the relative on a permanent basis. C. Proposals receiving consideration under this RFP must provide services in Weld County. D. Creative and innovative model programs which lead to the reduction of foster care costs and avoid duplication will be encouraged. Page 18 of 32 aNt.K'm.w:'.K:�:iOCXC�sPv'�c��•.a_.gv-.v.�. . �- RFP-FYC-00005 through 00011 II. Fiscal Provision A. Applicants must complete all budget forms specified within the application kit. B. Funding shall be under a 12-month estimated contract from June 1, 2000, through May 31, 2001. C. The Contractor shall make provisions for an independent financial,audit to be performed annually. To the maximum practicable extent, the audit shall identify, examine, and report the income and expenditures specific to operation of the State-funded program or services. One copy of the audit report, together with associated special reports and the management letter, if any, shall be furnished to Board of County Commissioners no later than September 30th each year. III. Standards of Responsibility A. The bidder selected, as a result of this RFP, must be responsible for all program costs including personnel, operating, travel, equipment, audit, and capital items. Bidders must have available the necessary financial, material, equipment, facility, and personnel resources and expertise, or the ability to obtain them since no start-up funds will be made available. All contracts are set up so as to reimburse the contractor for allowable expenses as budgeted. B. The bidding agency must be able to document a satisfactory record of program performance, financial solvency, and a satisfactory record of integrity. C. The bidding agency must be a not-for-profit organization incorporated as 501(c)(3) agency. Agencies in the process of applying for 501(c)(3) status must be fully incorporated by contract start date. Private for profit business and local and state units of government are also eligible to bid for funds. D. The RFP must reflect the appropriate time limits of the program needed to reduce risk and enhance the safety of the subject children. The RFP should reflect the precise number of sessions needed for the program to be effective, the number of sessions per week, and the cost for each session. The RFP should also reflect an average cost per family and number of sessions needed. B. The RFP must reflect a process to eliminate renewals or reduce the cost of the program should it have to be reinstated. Preference will be given to programs that incorporate a step-down plan, such as (a) fewer sessions per week or per month after intensive sessions in the first part of the program, (b) transition to ending of services or support services from bidders agency, or (c) transition to another agency. F. All renewal requests must be in writing and reflect cause for renewal. Renewal requests must be submitted in writing to the Department of Social Services 60 days prior to the end of the Page 19 of 32 RFP-FYC-00005 through 00011 original service date. Social Services will reserve the right to request a meeting on any request for renewal the Department needs clarified. G. The RFP must include the program design that reflects maximum number of hours in the three stages of the program: start up, middle, and end of services. No service fees will be paid for any programs that exceed these measurements per month. H. In the RFP process, all clients who are to be carried over into Core Services Program Year 2000-2001 must submit a letter to the Department justifying the carryover by June 1, 2000, the start of the Core Services program year. The letter should be sent to the current caseworker, Ms. Elaine Furister, FYC Support Staff, and the program area supervisor. The contractor must agree to: 1. Contractors must agree are required to provide a case management plan on each referred family within 30 days of the date the bidder receives the referral. The case management plan will be monitored and modified monthly to measure progress toward goals. Copies of the case management plan must be sent to the caseworker, program area supervisor, and Ms. Elaine Furister, FYC Support Staff, at Weld County Department of Social Services, P. O. Box A, 315 B N 11 Avenue, Greeley, Colorado, 80632. The case management plan, at minimum, will include goals, timelines, and measurement of success. 2. Provide a monthly client progress report as above within twenty-five working days immediately after the month of service. The monthly progress report must be attached to the monthly billing for payment to be honored. Failure to submit such monthly reports will result in delays or forfeiture of payment. Monthly Reports-will be submitted no later than twenty-five (25) working days past the end of the month of service. It is expected, at a minimum, that these reports will reflect: - presenting problem(s) of the client/family, - specific services provided, - extent of client(s)participation and commitment to program, - client(s)progress to date, - anticipated discharge date. 3. Report to Social Services a monthly brief report on the status of the program as prescribed by Social Services; 4. Submit a final narrative summary of program outcomes to Social Services within 30 days after the completion date; 5. Report expenditures and case disbursement at agreed upon times. 6. Submit monthly FYC completed billing forms to Social Services, Resource Services, Supervisor within twenty-five calendar days of the month following service in order to Page 20 of 32 em.w._ _�. 4.,_:__......... ...,......mss...:....::........... ... ... .... RFP-FYC-00005 through 00011 receive payment. Failure to submit in a timely and complete manner shall result in forfeiture of payment; 7. Work with family to prepare to pay for services beyond established time frame. A complete and timely billing form is identified by and must include the following elements. (See Attachment A of the Request for Proposal): a. The billing must be an original billing signed by the provider and/or designee. b. The billing must include all forms designed for Core Services reimbursement and approved by the Department of Social Services; Core Services Authorization of Funds,Project Report, Update Report, and signed client verifications for each client serviced during the billing period. c. Each client who has a current referral, both receiving services and not receiving services during the service month, must be listed on the billing form. A service summary must be provided by the provider for clients who have active referrals during the billing month in order to direct issues to the caseworker and court. 1). Core Services Authorization forms must be submitted completely filled in with an original signature from the provider and/or designee. 2). Project reports must include the client's full name, Weld County household number, referral number, hours served, hourly rate, and total billed for the month the service was provided. 3). Verification forms must include the client's signature at the time of service, date of service, hours served, client household number and Core service referral number. Payment through Core Services Program funds will be made only for direct client contact with the appropriate identifying client signature included on the verification form. 4). Requests for payment must be date stamped by the Department of Social Services by the 25th day of the month following the service month. Requests for payment received after the 25th of the month following service will not be honored. 8. Will develop and utilize evaluation tools (pre and post assessment test instruments) to collect necessary data in cooperation with.Social Services staff to monitor effectiveness of program; 9. Will meet with Social Services FPP Supervisor quarterly (more if needed) to review program usage and effectiveness to discuss necessary improvements to better serve families or increase referrals; Page 21 of 32 • RFP-FYC-00005 through 00011 10. Be available to meet with DSS staff to explain program, time lines of response to referrals and answer questions to enhance program. 11. Be available for the Families, Youth and Children Commission and the Effectiveness and Outcomes Committee review and attendance at the FYC meetings. • Page 22 of 32. RFP-FYC-00005 through 00011 PART D BIDDER RESPONSE FORMAT INFORMATION TO BE INCLUDED IN PROPOSALS The following requirements exist which must be met by all proposals submitted. It is required that bidders address the proposal requirements in the following fonnat and use the exact replication of forms included in the attachments to these guidelines. Failure of the bidder to provide all information requested in this RFP may result in disqualification of the proposal. A. Invitation for Bid The Invitation for Bid page must be signed in ink by the bidder or an officer of the bidder legally authorized to bind the bidder to the proposal. Unsigned proposals will be rejected. This should be the first page of the document. The Invitation and Bid page should be signed for the bid proposal submitted. B. Cover Page This page must follow the Invitation to Bid page in the document. Proposals must contain an original copy with original signatures, and six copies of the proposal (Attachment A). C. Program Narrative The body of the proposal must clearly and concisely describe the overall plan for the program. However, the bidder must use the prescribed form (excluding charts and attachments). However, the only attachments to the proposal must be those specifically related to the project: 1. Project Description (10 points) The overall mission, purpose, and design of the project should be described in this section. 2. Target/Eligibility Population (5 points) A profile of clients to be served including such factors as age; number of clients to be served, and duration of time to be served. The Bidder must address both Part C, statement of work and the target/eligibility populations Section for the Family Preservation. 3. Types of Services Provided (15 Points) Service components should be described in this section. Services should be based on the needs of clients, the community, the statewide Family Preservation(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). Services description must address the Types of Services Provided section for the Family Preservation Program. A copy of the Bidder's Certificate of Insurance must be attached to the RFP. Page 23 of 32 RFP-FYC-00005 through 00011 4. Measurable Outcomes • 4 (10 Points) A list of measurable outcomes of the Family Preservation Program is to be addressed as required the Measurable Outcomes Section. The Bidder must address what methods the Bidder will use to measure, evaluate, and monitor the outcomes. 5. Service Objectives (10 Points) The Service Objectives section provides for service objectives as developed by the FYC and the Bidder. The Bidder must address what methods the Bidder will use to measure, evaluate, and monitor the objectives. 6. Workload Standards (10 Points) The Bidder must address the workload standards as described in the Workload Standards Section. 7. Staff Qualifications (10 Points) The Bidder must address the Staff Qualifications Section as required by the PAC. 8. Unit of Service Rate Computation (15 Points) The budget must be submitted in an hourly unit rate cost of direct delivery of services to a individual or family unit. The Bidder must address the Unit of Service Rate Computation Section of the Family Preservation Program. 9. Program Capacity by Month (15 Points) A description of maximum and minimum client capacity per month necessary to support program. Page 24 of 32 PART'E — EVALUATION PROCESS A. An evaluation committee composed of Families, Youth and Children Commission members, except those FYC members who have submitted proposals for consideration under RFP-FYC 00005 through 00011, - will judge the merit of proposals received in accordance with the general criteria defined in the RFP and the adequacy and completeness of the proposal. In addition to-the evaluation committee's independent reviews, the evaluation committee will obtain: 1) Independent reviews from representatives fioiiiVe Colorado Department of Human Services and the Weld County Department of Social Services who will judge the merit of proposals received in accordance with the general criteria defined"i'[i the RFP and the adequacy of the proposal. 2) A performance report submitted by the EXC.Effectiveness and Outcomes Committee in accordance with criteria defined by the The recommendations of this evaluation committeeil4ex'forwarded to the Board of Weld County Commissioners. The Board of Weld County Commis liers will make the final approval of the Family Preservation Program Plan. .vim , -.. Failure of the bidder to provide any information requested innthe_RFP may result in disqualification of the proposal. The sole objective of the evaluation committee will be a ecommend-the bidder whose proposal is most responsive to Weld County's needs while within the available resources. The specifications within the RFP represent the minimum performance necessary Tai response. B. Evaluation Criteria Mandatory Proposal requirements include: 1. Project Description (10 Points) 2. Target/Eligibility Populations _ ( 5 Points) 3. Type of Service Provided (15 Points) 4. Measurable Outcomes (10 Points) 5. Service Objectives (10 Points) 6. Workload Standards (10 Points) 7. Staff Qualifications (10 Points) 8. Unit of Service Rate Computation (15 Points) 9. Program Capacity by Month (15 Points) Total Points 100:_ The proposal must obtain minimum Points of-75% of total possible points to be considered for funding. Attachments A. Family Preservation Program Bid Proposal DAY TREATMENT PROGRAM BID PROPOSAL Page 25 of 32 • RFP-FYC-00006 . Attached A FAMILY PRESERVATION PROGRAM 2000/2001 BID PROPOSAL APPLICATION PROGRAM FUNDS YEAR 2000-2001 BID #RFP-FYC-00006 NAME OF AGENCY: ALTEMAT VPJ /TOMES iQiie Jaunt _ADDRESS: 11/0 UN ST/zar (i n& y Co d/ PHONE: ( 70) 353-6610 CONTACT PERSON: BIRCH /it/L..Tal TITLE: >eDI. &tiro D Iizt -rese DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Day Treatment Program Category must provide a comprehensive. highly structured rroogram alternative to placement that provides therapy and education for children 12-Month approximate Project Dates: 12-month contract with actual time lines of: Start June 1. 2000 Start .'uNF. /, -2000 End May 31, 2001 End O14-9 31/ .205V TITLE OF PROJECT: Aeltie.AlAtT7la. i*1/ES k/2- `, CLLT11 --- (4/ 4)4.9 l izeA e.t,r /// �w 3 /D - oo Named Signature of Person Preparing Document Date .3-/o -oo Namd�an.d Signature Chief Administrative Officer Applicant Agency Date MANDATORY PROPOSAL REOFTREMENTS For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Posposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 1999-2000 to Program Fund year 2000-2001. Indicate No Change from FY 1999-2000 �A/Project Description A6 citi 4foe- a Target/Eligibility Populations Types of services Provided tttt- rMeasurable Outcomes 4C Service Objectives ,� �{ Wor kload Standards AS C✓f f t..— Staff Qualifications A She of Service Rate Computation hL Program Capacity per Month /yO C#4A&i. a Certificate of Insurance 446{rry/v j Page 26 of 32 RFP-FYC-00006 Attached A Date of Meeting (s) with Social Services Division Supervisor: tin IACIQO1 c1 go&O Comme is by SSD Supervisor:/ S/-fh�vtE Z-a nr a S A-?/ rn N0 db41 -f S Aryl-latg7 o • A7 rr .v4 cre /6wreS F'/��,,a /.,-ter, 7' �V r S' �/t e- o S r yO c' ,t G I h n # iac a/ Y� CA—r?�/� �(iC-- /19; 1c' 4c / ,cc (,Cr' RAWA ln09/ ,34 EN �/gyve pr1�--cT,/ _ G n 1 Yr)/ j4Avvv e- S , 7441,4-44,�E .. E= S' l/j r2 a7 1/-a,�,'L C b k/Or r/ V1 I /t & }PY'\/..Q O /V1 "Ale t.17 �'_8-v.n rvt t.,,,:e.&4nv - r• S' (✓� �.R_ G,_e/S 7r, i!/S i s S f 'Qv�vc� p ; 1 fi rayr, S'ho,./ 'Cm� (ALJ.e , Name and Signature of SSD SupervisbrJ Date 4f /1R2/L`SSre` Page 27 of 32 RFP-FYC-00006 Attached A Program Category Day Treatment Program Bid Category Project Title Vendor PROJECT DESCRIPTION Provide a brief one-page description of the project. II. TARGET/ELIGIBILITY POPULATIONS Provide a one page brief description of the proposed target/eligibility populations. At a minimum your description must address: A. Total number of clients to be served. B. Total individual clients and the children's ages. C. Total family units. D. Sub-total of individuals who will receive bicultural/bilingual services. E. Sub-total of individuals who will receive services in South Weld County. F. The monthly maximum program capacity. G. The monthly average capacity. H. Average stay in the program (weeks). I. Average hours per week in the program. III. TYPE OF SERVICES TO BE PROVIDED Provide a two-page description of the types of services to be provided. Please address if your project will provide the service minimums as follows: A. Site based services (The Bidder must state that a minimum of site based services of 5 hours per day, ages eight through twenty-one (21) and two and one-fourth hours minimum per day for children ages three to seven) will be provided. B. Community collaboration efforts. The Bidder must describe its community collaborative efforts with: I. The Department of Social Services. 2. The Department of Mental Health. 3. The Department of Education. 4. Others (Please Describe). C. Program components. The Bidder must describe the program components of: 1. Educational 2. Therapeutic 3. Behavioral 4. Recreational D. Parental/Caretaker involvement in all program components as indicated in the case plan and as required. Page 28 of 32 RFP-FYC-00006 Attached A E. Assessment and plan to meet the needs of child and family including: 1. Education through a certified teacher. 2. Vocational/Independent living for age appropriate children. 3. Individual and family therapy which includes all family members. 4. Physical health needs, i.e., nutrition, medical, dental, sex education, HIV, contraception, etc. 5. Mental health needs such as psychotropic medications, etc. F. Proactive planning for transition to public school setting or independent living: 1. Reintegration into public school. 2. Follow-up for individual and family therapy. 3. Completion of Day Treatment. 4. Identifies progress/outcomes. 5. Reinforces gains. Provide your quantitative measures as they directly relate to each service. At a minimum, include a number to be served in each service component. Describe your internal process to assure that FYC resources will not supplant existing and available services in the community; e.g. mental health capitation services, ADAD and professional services otherwise funded. IV. MEASURABLE OUTCOMES Provide a two page description of your expected measurable outcomes of the project. Please address the following measurable outcomes: A. The children completing the Day Treatment Program will be residing in their own homes 6 months after discharge from the program. B. The children will enter public school upon graduation from Day Treatment. Describe your quantitative measures: Also, describe the methods you will use to measure, evaluate, and monitor each quantitative measure. V. SERVICE OBJECTIVES Provide a one page description of your expected service objectives and quantitative measures. Address, at a minimum, the following ways the project will: A. The number of children placed within six months of Day Treatment graduation/discharge. B. The number of children that were enrolled in public school from graduation/discharge from the Day Treatment Program. C. Improve ability to access resources - services shall assist parents to work with other sources in the community and ahead the local, state, and federal governments. Describe the methods you will use to measure, evaluate, and monitor each service objective. Page 29 of 32 RFP-FYC-00006 Attached A VI. WORKLOAD STANDARDS Provide a one page description of the project's work load standards and quantitative measures. Address, at a minimum, the following areas: A. Total number of children and families served. B. Duration/length of time in program. C. Total number of hours per day/week/month. D. Total number of individuals providing these services. E. Insurance. VII. STAFF QUALIFICATIONS Provide a one page description of staff qualifications and address, at a minimum, the following: A. Will your staff who are providing direct services have the minimum qualifications in education and experience. Describe. B. Total number of staff available for the project. C. Total number of counselor and/or treatment leader(s) to the number of children ages 5 years to 13 years. (Minimum expectation is 1 staff member to 8 children.) D. Total number of counselor and/or treatment leader(s) to the number of children ages 16 years and over. (Minimum expectation is 1 staff member to 10 children.) Page 30 of 32 RFP-FYC-00006 Attached A VIII. COMPUTATION OF DIRECT SERVICE RATE This form is to be used to provide detailed explanation of the hourly rate your organization will charge the Core Services Program for the services offered in this Request for Proposal. This rate may only be used to bill the Weld County Department of Social Services for direct, face-to-face services provided to clients referred for these services by the Department. Requests for payment based on units of service such as telephone calls, no shows, travel time, mileage reimbursement, preparation, documentation, and other costs not involving direct face-to-face services will not be honored. Likewise, billings must be for hours of direct service to the client, regardless of the number of staff involved in providing those services. Therefore, it is imperative that this rate be sufficient to cover all costs associated with this client, regardless of the number of staff involved in providing these services. (Explanations for these Lines are Provided on the Following Page) Total Hours of Direct Service per Client Hours [A] Z Total Clients to be Served / - Clients [B] Total Hours of Direct Service for Year 7 72 Hours [C] (Line [A] Multiplied by Line [B] Cost per Hour of Direct Services $ /8.03 Per. Hour [Dl p Total Direct Service Costs $ Dsi ��S. O (El (Line [C] Multiplied by Line [D] )Administration Costs Allocable to Program $ 3 1ST` , • (..yy.5 [F) Overhead Costs Allocable to Program $ 25; /57. 4 8 [C] Total Cost, Direct and Allocated, of Program$ /V? SA 27 [H] Line [El Plus Line [F] Plus Line [G] ) --e) -- Anticipated Profits Contributed by this Program $ [I] Total Costs and Profits to be Covered .��y ` by this Program(Line [H] Plus Line [I] ) $ l ` /4/71` .�WW' /7 [J] Total Hours of Direct Service for Year /`0 [K] (Must Equal Line [C] ) Rate per Hour of Direct, Face-to-Face Service to be Charged to Weld County Department of Social Services $ 3 63 [L] Page 31 of 32 RFP-FYC-00006 Attached A Day Treatment Programs Only: /� Direct Service House Per Client Per Month T!! [M] Monthly Direct Service Rate $ ( ‘7g0• l! [N] [A] This is an estimate of the total hours of direct, face-to-face service each client will receive from the time he or she enters the program until completing the program. [B] This is an estimate of the number of clients who will be served during the period from June 1, 2000, through May 31, 2001. [D] This represents the average hourly salary and benefits that your organization pays its direct service providers plus any costs which are directly attributable to the face-to- face session with the client. [F] This represents the salary and benefits of direct service, supervisory, and clerical personnel which are not incurred in providing direct, face-to-face service to the client, but can be allocated to this program for time spent on the program for activities such as travel, phone conversations, "no-shows, " discussions with involved parties, meeting preparation, and report completion. [G] This represents the Agency Overhead costs, such as Rent, Utilities, Supplies, Postage, Travel Reimbursement, Telephone Charges, Equipment, and Data Processing which are not incurred in providing direct, face-to-face service to the client, but can be allocated to this program for time spent on the program for activities such as travel, phone conversations, "no-shows," discussions with involved parties, meeting preparation, and report completion. [H] This represents the Grand Total Costs directly attributable or allocable to this program. It should be a reasonable assumption that if you decided to discontinue this program, your agency would realize a reduction in costs approximately equal to this amount. [I] This represents the total amount of profit your firm expects to realize as a result of operating this program. Any difference between Lines [H] and [J] must be substantiated by an amount indicated on this line. [LI This is the actual direct, face-to-face hourly service rate at which you will be requesting payment for the services provided under the conditions of this Request for Proposal. [M] To be completed by prospective providers of the Day Treatment Program only, this line represents the estimated number of hours per month your organization will provide direct, face-to-face services per client. [N] To be completed by prospective providers of the Day Treatment Program services only, this line represents the actual direct, face-to-face monthly service rate at which you will be requesting payment for the services provided under the conditions of this Request for Proposal. Calculated by multiplying Line [L] by Line [M] . Page 32 of 32 ATTACHMENT A 5310.213 (2/79) • COLORADO STATE DEPARTMENT OF SOCIAL SERVICES • AUTHORIZATION FOR CONTRACTUAL SERVICES • I. COUNTY -DATE 2. Name of Provider 3. Address 4. City State _Tap THE DESCRIBED SERVICE IS AUTHORIZED FOR THE CLIENT INDICATED: 5. Name of Client Houehold# Cat. Cat Grp, 6. Description Sv. Code 7. APPROVAL: Caseworker Date Co.Director or Supervisor 8_TO BE COMPLETED BY PROVIDER :DATE OF SERVICE CHARGES S I CERTIFY THE SERVICE AUTHORIZED WAS PROVIDED ON THE DATE INDICATED AND THE CHARGES ARE MADE PURSUANT TO A BONA FIDE CONTRACT BETWEEN ME AND THE COUNTY DEPARTMENT OF SOCIAL SERVICES INDICATED. Provider's Signature Date Prepare in Triplicate,Original and Oat copy to Provider.One Copy for Pending File. Cocnpleted Provider's Forms-Original to County Finance Ofike-Copy to Case Record I , WELD COUNTY CORE SERVICES PROGRAM PROJECT REPORT Remit to: Elaine Furister,Weld County Department of Social Services Month of Service P.O.Box A,315 B N 11 Avenue,Greeley,CO 80632 • Telephone: 970.352.1551, Ext. 6295 FAX: 970.346.7698 eholds Referred #of Households Enrolled #of Households Served #of Households Monthly Expenditure Expenditures to Date :ring Month During Month During Month Discharged During Month ion Reason Codes: SEP-Successfully Ended Program; M-Moved; UL-Unable to Locate; RCCF-Entered a Residential Facility;FCR-Foster Care Review;OT-Explain, r.' sferred to Another Program More Restrictive; FC-Entered Foster Care;NT-Terminated;Unable to Work with Client; RH-Returning to Relative ?''' ame Direct Date Termination lient Casewor er Provi•er Initial Case Monthly Funding Total Cost !,,?ygym yJ't Service Service Reasons Survey Survey Survey Management Progress Source of Program ttl434A Date Ended Plan(Date) Report to Date ;j*'zl m I .lii•iy,ItI y;;(i,�� I I tr^n—II, f3 , tied ill 0 :.11' �12if47, 7, 7 R 1 r5:j 'Pill)* `NI :ti. , b r Y I ,[1'x; . 0'"� Il rL��t ^T' 7 :`!�ir;mnit . :Ili V y nb . Lb'}- Jzo I v:Ar Source: EPP-Expedited Permanency Planning; M-Medicaid; CI-Client Insurance; O.Other I wr1Y WELD COUNTY CORE SERVICES PROGRAM MONTHLY REQUEST FOR REIMBURSEMENT Remit to: Elaine Punster, FYC Support Staff Name of Program Month of Service Weld County Department of Social Services o Providers: List all clients currently enrolled in your program. P.O. Box A,315 B N 11 Avenue,Greeley,CO 80632 Enter 0 if no services were provided during billing month Telephone: 970.352.1551,extension 6295 FAX: 970.346.7698 Fame HH# Referral Approved Approved Maximum Maximum Rate per Monthly S frd 1 P t''14 3O q�8, bll,tu,1 , Sa'n, eP6) n• } • # Entry Date Exit Date Hrs/Service Sessions/Service Unit Total : , y' l',/r 14i eitn b 04 ) 11744( :1" 1 Period Period *Tit k..11�9y1,-Isla r rlrljli7h�r"�4 1 t el„,.;,.f. •�11�i lh�r'l 6.,.V, t1 4 n i4 i I� 1 '1 _ �I'ri1F" a 6� .+uvt., t 1 k 0. h,ttP.. 1 H<1'5 a r d1 e 1"'"t jT' rrr, r �vllil rI Y di I1 ,[, L� 7 iglu s 11 ul .r.,,:,;.,„,,,r 1 1 ' r✓d ,, l , c.„ j r r, , fi ti2 r[ I t}la ni al r l ,r Aril"r7 , ,. ' rllal klllii ,°i 111117, 1,41,, r1Jr �,rl i1 j01,lc :p i V p L1 •,44,-;,-;",•.-1-i.%„1,4.• r y1 �+ - �:� rl � dE 111 Jill 4,10'..4 IaF x.14,' 'uJR 1,``I�I dl `4jr'r� tt I ( r}}41Rul T �7;77'1 nn T 41..1 1I tr yrI �`''�Ir { r a �] 1 ,1 1 1[4:1f,,'{ Ir i lIP4r IJ� it:O7 ,,A-:;;;„1:,:,,,,w'SIi a ' till I, i'� � IS!t it l Y,' 11 11_T51 1',r-I I C> ( I ID el 11 II I ' Itil• di.li N11 •1 s i L • 1 Ira dJl h rll Nan ;74-44-14,-71771-rU l 1- 'I, 1,7177,l o l I I 1l4r 1111 1 1411 1 r4r Uri -0 1,41;•;"•;;' , rl ,r t�f w d 1 I. 1 Irlll I„;1. 94 "'ii„ _ _ .k 5l 11 aI I. 1 l r pl 4{{ Ii -1 fll , h a tll 11 rf+ t d }}+ 1 y "H k I , , l" J Ilt e. ...I �.IP i ;4 ,,,, 'll r 1 ^ 1 {r✓!lt 'I ,{ I [ ,575{ l..i'1 l 1,t';� ;',FP-4114r;51.7 lk .,4;I.'trr<hi; 1 1 Ji,;,0.;;•••4•4,14.11;r r. 4414,4O.1,4;244,1; I,.. ,. I iN``1r 11•4'1'•1•1 1 I l ;1-4,rI,; I j\ ll 11 ii i 1 1 l , 1•l i,. t'1 .144{ r•14;41;1,k;:;,frl l 1'll";,•4-4•141-‘ ;;•t',1••.1;2. lI'7.77,7i—,71;,-77.°i l, y ',i717-177y-T-77, t. lI, I >t 1:1 �lxi 1 a '1 , i i 1•a 1,u < 3 JJL! 4iy jlili``1i 14;� lllll 1 i• 14,•,�r t, tdi 61/11 );; • �:ylY l ii"," e J.i...,IrJ�'11J1 h' l'':.' / La : �[ N 1.11;♦iltr o�4IMi� liatl tlr4,tr,frytq s J,F !I'm'''. ''.S rvice Codes: CE-Computation Error;NR-No Referral;EED-Exceeds End Date;EMI-I-Exceeds Maximum Hours;EMS-Exceeds Maximum Sessions;NP-Not Paya tle; ient Delayed; SPD; Submitted Past Deadline; NDC-No Face to Face Contact;NV-No Client Verification; ICMP-Initial Case Management Plan Needed; PR-Progress ceded 0 r ri CORE SERVICES PROGRAM YEAR 2000-2001-CLIENT VERIFICATION FORM Notice to Provider.This verification form must be completed at the time of service by all clients served during the service month.No request for payment of services will be honored for billed services unless accompanied by the appropriate signed client verification form. Payment for services will not exceed maximum hours or sessions as stated in provider's RFP. Section I: (To be completed by the provider) . Primary Client billed: • Total Hours Billed Household Number. Referral Number: Contact Person: SECTION H(To be completed by client) Client signatures must be signed at the time of service.Your signature verifies that services were provided by the service provider for direct face-to-face contact only,for the hours indicated Date II— Hours Client Signature Notice to Provider:Attach all client verification forms to the monthly billing when submitting your request for Payment for Contractural Serviceds.All Requests for payment must be received by the 25th day of the month following service in complete form. Send original signed billing and verifications to: Elaine Furister,Weld County Department of Social Services P.O.Box A,315 B N 11 Avenue,Greeley,CO, 80632 Telephone:970352.1551,extension 6295;FAX:970.3463698 ' Mar 13 CO 01 : 57p P. 1 FROM : RIEDMRN-DOUNTOt,nJ PHONE NO. : 303 831 6344 Mar. 13 2000 01:20PM P1 131):j_ ) - ;ail 3/13/190 I '�;I CER'T'IFICATE OF INS 25 S � ; = `- �'_r PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF Riedman Corporation INFORMATION ONLY AND CONFERS NO RIGHTS UPON 1650 Pennsylvania St THE CERTIFICATE HOLDER . THIS CERTIFICATE Denver, CO 80203-1390 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE (303) 831-1717 AFFORDED BY THE POLICIES BELOW . INSURED 4i.j4;.;.w,,I COMPANIES AFFORDING COVERAGE k ;:wx ALTERNATIVE HOMES FOR YOUTH COMPANY A:COMPANY B: REANCLLIE INSURANCE COMPANY A'IT.N: DENISE DOZRMAN 9201 WEST 44TH AVENUE COMPANY C: RLI INSURANCE COMPANY WURAT RIDGE, CO 80033 COMPANY D: Miega��e:tit, "�., -"447.m - ��-�, s""y; I COVERAGES I'-'ss,.≥.:. '• -._.'"'.:,nXr.u, s. � : - �'• c.� ?ic x�•Yx I:Thi x„ t— certify i f.rt l.� MI This is to certaty that policies of�insuraace listed below have been issued to the insured named move for the policy period indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and.conditions of such .policies, Limits shown may have been .reduced by paid claims ,,,.yi.,��„�.. ..,�f�... 'COIN' INSURANCE Im6Al POLICY NUMBER & DATES Ir- l:.i?'„a?cw:I LIMITS I,s,:ps ;_au? y.S.,'asec VG:='r'cI A GENERAL LIABILITY ZX3017176 $ 2, 000, 000 General Agg [X] Comm Gen Liab Eff 07/01/99 Exp 07/01/00 $ 2,000, 000 000, 000 Pro/Co Ops Co OpInj Eff / / Exp / / $ Agg [ ] [X1 Occur 1, 000,000 Ea Occurrence [ ) OCP $ 50,000 Fire Damage [ 1 Eff / / Exp / / $ 5,000 Medical Exp A AUTO LIABILITY ZX3017176 [ ]Any I JA11 Own Eff 07/01/99 Exp 07/01/00 $ 1,000,000 CSL [XISchd IX] Hired $ SI (person) [X1Non-Owned Eff / / Exp / / $ SI (accident) [ 1 [ 1 $ Property Dam GARAGE LIABILITY $ Auto-Each Acc ' [ ]Any Au( lo Eff / / Exp / / $ Other-Ea Acc $ -Aggregate C EXCESS LIABILITY RXL0257360 $ 2,000,000 Occurrence [ ] Umbrella Form Eff 07/01/99 Exp 07/01/00 $ 2, 000,000 Aggregate [XJOther Than Umb — [XI WC Stat Lmts [ 1 Other` B WC/EMP LIABILITY 1453282 $ 100, 000 EL Each Acc { ] Incl [ ) Excl Eff 07/01/99 Exp 07/01/00 $ 500,000 EL Dis-Pol Lmt Prop/Part/Execs $ 100,000 EL Dis-Ea Emp Eff / / Exp / / Description of operations/locations/vehicles/special items CANCELLATION rib CERTIFICATE HOLDER Iw `Ls Should any of the above described policies I be cancelled before the expiration date thereof, the issuing company will endeavor .WELD COUNTY DEPT OF SOCIAL SRVCS to mail 30 days written notice to the ATTN: PAT PERSICHINO, DIR GEN'L SV certificate holder named to the left, but 915 - 10TH STREET failure to mail such notice shall pose no GREELEY CO 80632 obligation or liability of any kind upon ,L 8O f}ins agents or reps CillyA Ja'-yJi 4.4iireized Representative I- Hello