HomeMy WebLinkAbout930718.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR PLACEMENT
ALTERNATIVES COMMISSION FUNDS FOR WELD MENTAL HEALTH CENTER, INC. AND
AUTHORIZE CHAIRMAN TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado,
pursuant to Colorado statute and the Weld County Home Rule Charter, is vested
with the authority of administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Notification of Financial
Assistance Award for Placement Alternatives Commission Funds between Weld Mental
Health Center, Inc. and the Weld County Department of Social Services, commencing
June 1, 1993, and ending May 31, 1994, with the further terms and conditions
being as stated in said notification, and
WHEREAS, after review, the Board deems it advisable to approve said
notification, a copy of which is attached hereto and incorporated herein by
reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, ex-officio Board of Social Services, that the Notification of
Financial Assistance Award for Placement Alternatives Commission Funds between
Weld Mental Health Center, Inc. and the Weld County Department of Social Services
be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is,
authorized to sign said notification.
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following vote on the 2nd day of August, A.D. , 1993, nunc pro tunc
June 1, 1993.
( I / y/ Aduein
BOARD OF COUNTY COMMISSIONERS
ATTEST: , J y'ft WELD COUNTY, COLORADO�j�Weld Co/unOt')y[ILClerk tothe Board (n1�i�.r�zg ,�kY�'G'l
/ Constance L. Harbert, Chairman
U
4 ? etjil W. H Q st r, Pro-Teem
APPJ.OVED 9S TO FORM: 4;;)///;1
eorge Bax er
ty Attorney 4).t- K. Hall
'Barbara J. Kirkm yer
930718
Welt ,ounty Department of Social Sen _es
Notification of Financial Assistance Award
for Placement Alternatives Commission (PAC) Funds
Type of Action Contract Award No.
X Initial Award
Revision of Earlier Action FY92-PAC-500
Issued on (RFP-PAC-9200)
Contract Award Period Name and Address of Contractor
Beginning 06/01/93 and Weld Mental Health Center
Ending 05/31/94 Intensive Services
1306 11th Avenue
Greeley, CO 80631
Computation of Awards Monthly Program Capacity 4
Monthly Average Capacity 3
Unit of Service
Description
A match of two families per worker per 80
hours per month for up to 6 weeks to The issuance of the Notification of
provide intensive services as long as Financial Assistance Award is based
required to stabilize the situation with upon your Request for Proposal (RFP) .
families with 34 hour crisis The RFP specifies the scope of
intervention. (20 hours per week) services and conditions of award.
Except where it is in conflict with
this NFAA in which case the NFAA
Cost Per Unit of Service governs, the RFP upon which this award
is based is an integral part of the
Hourly Rate Per $ 25.14 action.
Unit of Service
Based on Average Special conditions
Capacity
1) Reimbursement for the Unit of
Monthly Rate Per $2,011.33 Service will be based on an hourly
Unit of Service rate per child or per family.
Based on Average
Capacity 2) The hourly rate will be paid for
only direct face to face contact
Total Yearly $72,408.00 with the child and/or family or as
Services Budget specified in the unit of cost
(Subject to the Availability of computation.
Federal and State Funds)
3) Unit of service costs cannot exceed
Enclosures: the hourly, monthly, and yearly
cost per child and/or family.
Signed RFP
4) Rates will only be paid on approved
and open cases with the Department
of Social Services.
Appro ls: Program Offic' 1:
LL
d
BY ,�I -s �l � � /��' By
Constance Harbert, Chairman Oy'24p) J A. riego, 'rest
Board of Wel County Commissionefs W 1 Co ty Depa ment of
S ial Services
Date: -)G",≥
Date: 9 `i9-92)
930718
INVITATION TO BID
DATE: December 23, 1992 RETURN BID TO: Pat Persichino
Director of
BID NO: RFP-PAC-93003 General Services
915 10th Street
P.O. Box 758
Greeley, CO 80632
DIRECT INQUIRIES TO: Pat Persichino. Director of General Services
SUMMARY
Request for Proposal (RFP-PAC-93003) for: Alternatives to Placement
out of the Home Programs
Deadline: March 2, 1993, 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 new grants
pursuant to the Board of Weld County Commissioners authority under the Alternatives to Out-
of Home-Placement Act of 1979 . The Placement Alternatives Commission wishes to approve a
twelve month program targeted to run from June 1, 1993 through May 31, 1994, at targeted
funding levels of increments up to $482,431.00. This program announcement consists of five
parts, as follows:
PART A. . .Administrative Information
PART B. . .Background, Overview and Goals
PART C. . .Statement of Work
PART D. . .Bidder Response Format
PART E. . .Evaluation Process
Delivery Date
(After receipt of order) BID MUST BE SIGNED IN INK
Dale F Peterson
TYPED 0 PRINTEDi5GNATURE
VENDOR Weld Mental Health Center, jnr V( l.,ile CD' I �,r.c-...N
Handwritten Signature By Authorized
Officer or Agent of Vender
ADDRESS 1106 11th Avpmip TITLE Exerntive flirertor DATE 3/1/ 13
Graaley, Colorado ZIP R06'11 PHONE 4 (l0';) 353-'1686
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
93071q
RFP-PAC-93003 `s Attachmr t A
COVER PAGE
ALTERNATIVES TO OUT OF HOME PLACEMENT PROGRAMS
PLACEMENT ALTERNATIVES COMMISSION
PROGRAM YEAR 1993
BID # RFP-PAC-93003
Client Group(s) to be Served: Families with children at risk of out-of-home placement
Name of Applicant Agency: Weld Mental Health Center, Inc.
Address: 1306 Eleventh Avenue
City: Greeley. Colorado 80631
Phone: (303) 353-3686
Contact Person: Dan E. Dailey
Title: Director, Children and Family Services
Approximate Project Dates: Start June 1 . 1993
End May 31 . 1994
Title of Project: In-Home Intensive Services Team
Amount Requested: $72,408.
Signatures: � NS
Dan E. Dailey
Name and Signa re of erson eparing Proposal Date ar
Dale F. Peterson SLo� 1 n�o— -
Name and Signature of Chief Administrative Officer of Date
Applicant Agency
xx Continuing Project under Weld County PAC New Project
How many years? 1_5
xx Proposed Program will eliminate the need xx Proposed Project
for out of home placement will lower the
cost of out of
home placement
Other: The Proposed Project will
MANDATORY PROPOSAL REQUIREMENTS
Please initial to indicate that the following required sections are included in
this proposal:
Statement of Need
Population to be Served
Program Implementation
Program Components
Provision of Services & Administrative Capability
Past Performance
Letters of Support (New Programs Only)
Evaluation Results (Ongoing Programs Only)
Budget
Program Evaluation and Continuation
R3071f}
TABLE OF CONTENTS
Cover Page overleaf
Table of Contents a
Program Narrative 1
1 . Statement of Need 1
2 . Population to be Served 1
3 . Program Implementation 2
4. Program Components 2
5 . Provision of Services and Administrative Capability 2
6 . Past Performance 3
7B. Evaluation Results 4
8 . Budget 4
9 . Program Evaluation and Continuation 4
Attachments
A. Cover page overleaf
B . Implementation Plan 5 - 9
C . Past Performance 10 - 14
D . Evaluation Results 15 - 19
E . Hourly Unit Rate Cost Computation Sheet 20 - 21
F . Program Performance 22
G . County Placement Alternative Plan Final Budget Page 23
a
P307 1.q
D. Program Narrative
1. Statement of Need
The child and adolescent population at risk of out-of-home placement is presently underserved by the
private and public mental health and social services systems of Weld County. In fiscal year 1992-93,
the Children and Family Services Program (CFSP) of the Weld Mental Health Center, Inc. (WMHC) admitted
more than 600 children and adolescents to its outpatient services in addition to continuing to work with
those already on its rolls. Of the children and adolescents admitted to the CFSP, approximately 90% fit
the Colorado Division of Mental Health (DMH) definition of severely emotionally disturbed by virtue of
the severity and nature of their presenting problems, out-of-home placement, or a combination of these
factors. The OMB estimates the youth population in need of mental health services in Weld County to be
over 1500 in any given year. A waiting list for admission to outpatient services ranging from 15 to 75
children and their families exists at any given time at the CFSP. Many families do not receive the
timely opportunity to deal with their difficulties with the assistance of trained professionals because
the CFSP cannot get to them rapidly enough. The In-Home Intensive Services Team (IST) is designed to
deal directly and promptly with the most troubled of those families. This proposal seeks to maintain the
current level of services available through the IST. The Colorado State Department of Social Services
reports that last year nearly 34,000 families were served by local departments of social services.
Approximately 54,000 children were provided services, 80% in their own homes and 20% requiring placement
in out-of-home care. In the previous fiscal year, according to data from the Weld County Department of
Social Services (WCDSS) , there are more than 220 Weld County children in out of home placements with the
majority in foster families and the rest in group homes, child placement agencies. and in residential
child care facilities (RCCF) . There were more than 1200 reports of abuse received by the WCDSS in the
past year. More than 110 Dependency and Neglect Petitions are filed annually in response to these
reports. One continually hears of the shortage of foster homes in which to place the children in need.
Placement Alternative Commission "slots" have been significantly reduced by questionable redefinitions of
whom may have access to them. There are not sufficient resources for the children and their families.
2. Population to be Served
The following eligibility criteria must be met before IST services will be offered:
a. The family must reside in Weld County;
b. There must be a risk of imminent out-of-home placement of at least one family member aged birth
to 18 years (or such placement has already occurred) precipitated by a recent or ongoing situation which
severely threatens the family's ability to adequately cope with that and related situations:
c. At least one parent/guardian must consent to work with the team with the goal of keeping the
family together: and
d. As services are to be delivered in the family's home, there must not be a high potential for
physical danger to project staff.
The following categories of children and adolescents (independent of age, gender, ethnicity) who meet
SB26 guidelines will be served by the IST:
a. Youths suffering from the effects of significant sexual and/or physical abuse and neglect to the
extent they are unable to maintain effective daily functioning at home and at school;
b. Youths who are unable to control suicidal and/or homicidal behavior thus placing themselves,
their families, and their communities at risk;
c. Youths who present with behaviors that are temporarily beyond the ability of their parents and
their community to manage;
d. Youths suffering from significant cognitive impairment and/or mental illness to the extent they
can no longer be maintained in the family setting and/or at school.
At least 44 families will be served. Referrals will flow from individual caseworkers at WCDSS to Rosi
Anson, Supervisor of the Ongoing Child Protection Team there to Dan Dailey, IST director. The final
decision as to proper.level of mental health services will be made by WMHC.
1
3. Program Implementation
The overall goal of the project is to enable families with children at risk of out-of-home placement or
who already have children placed out of their homes to care for those children in a healthful manner in
the home environment. Specific goals and objectives are:
Goal A. Rapidly improve and stabilize family functioning to enable the family to care for the children in
the home setting.
Objective Provide crisis intervention and other services within three days of referral to 44 families to
either prevent out-of-home placements of children and adolescents in foster and group homes, residential
child care facilities, juvenile detention facilities, and in psychiatric hospitals or to return youths
from such facilities to their family homes within three weeks of referral.
Goal B. Improve overall functioning of families to enable them to care for their children in their own
homes on a long term basis.
Objective a. When aggression and/or violence has been determined to have been part of the family's
problem, 90% of the families will report and demonstrate a marked reduction in the use of
violence/aggression within and outside the family.
Objective b. At termination and six months after termination of IST services, 85% of the families will
remain intact.
Objective c. Seventy-five percent of the successfully terminated families will remain intact 12 months
after termination of in-home services.
Objective d. Fewer than 10% of discharged children will enter another PAC program.
Objective e. Fewer than 10% of the children served will be in a more costly placement at discharge and
fewer than 15% will be in such a placement six months after discharge.
4. Program Components
The WMBC provides families with intensive, home-based crisis intervention, mental health assessment and
treatment, case management, and education services, modeled after the nationally known Bomebuilders
program. The following principles guide the IST's approach:
a. To intervene immediately;
b. To provide brief and intensive treatment;
c. To focus treatment on problem identifying/solving and goal setting;
d. To involve families in treatment; and
e. To link clients and their families with other community services and resources.
Crisis services are available 24 hours per day, seven days per week to provide screening, evaluation and
assessment, intervention, and follow-up planning to clients. Services, tailored specifically to each
client family, are offered on a short-term basis, focussing on those issues and problems precipitating
the crisis and on using the crisis to mobilize the youth and his or her family to develop new ways to
cope and prevent further crises. The average period of involvement ranges from four to six weeks.
Services are delivered primarily in clients' homes but will be available wherever necessary to optimize
results.
These aspects of the project--rapid response to referrals, accessibility of therapists at home during
evenings and weekends. the time available for client families, the location of the services, the staffing
pattern, the low caseloads, and the brief duration of the services--produce a much more powerful
intervention than one which offers only one or two of the components. The WMBC believes that families
deserve strong. effective support in attempting to learn productive ways to cope with problems before the
last resort of placement of children outside the home is utilized.
The services provided by IST are culturally sensitive and competent. They are designed to be consistent
with the culture and belief systems of the client families. Training for all staff to educate and
sensitize them to the needs and cultural differences of the residents of Weld County occurs on a regular
basis.
5. Provision of Services and Administrative Capability
The WMBC is a private, non-profit corporation governed by a board of directors, currently chaired by Kent
Jackson. It is licensed by the State of Colorado as a comprehensive community mental health center
serving all of Weld County. The WMBC has been in existence since 1962, becoming a comprehensive
2 230171,9
community mental health center in November. 1967. Dale Peterson, MSW, MHA, is the WMBC's Executive
Director. Charlene Harris, WMBC Business Manager, is responsible for fiscal aspects of the project. The
150+ employees of the WMHC (of whom 10 serve in administrative capacities) are surety bonded.
The IST is staffed by two masters level mental health clinicians (currently Lisa Accola-Dickson and
Barbara Moore) whose training included crisis intervention and family systems theory. Each member of
the team has three or more years experience working with children, adolescents, and families. Each team
member has undergone special training in the philosophical and practical aspects of family preservation
before seeing her first client. Responsibility for clinical supervision of the team is assigned to
Richard E. Hawkins, BA. Mr. Hawkins has over 20 years of experience in the provision of and supervision
of mental health services, including the running of a 75 bed residential child care facility, teaching,
consulting, and working as an outpatient therapist/ case manager with CFSP for the past seven years.
Overall administrative responsibility is assigned to Dan E. Dailey, BA, Director of the CFSP, who has
more than 20 years experience in mental health treatment and administration. He reports directly to the
Executive Director of the WMHC.
At present, the IST is the only program in Weld County delivering the services as described herein. The
Parent Advocate Program of Child Advocacy Resource and Education, Inc. (CARE) and the Mobile Mental
Health Team (MMHT) of the CFSP also provide home-based services further defining the continuum of care
the families of Weld County deserve. The IST, however, offers the most intensive and comprehensive
services. It is further differentiated from the CARE program in its direct therapeutic focus and the
brevity of its service delivery--four to six weeks versus 12 months--and its direct connection to an
ongoing source of mental health services for its client families. The IST will often be able to prepare
clients for successful involvement in the services offered by CARE. The MMHT, currently funded by grant
funds which expire in 8/93, offers services to a wider array of families and crisis definitions. Client
families are not required to be at risk of having a child placed. Thus it is not as specialized nor as
intensive, serving at least twice as many client families by design as IST.
6. Past Performance
The WMHC provides inpatient, residential, partial care, and outpatient treatment services including
group, family, and individual therapy as well as case management, educational, and vocational services.
Programmatically, the WMBC is made up of the Community Support Program which serves adults who are
chronically and severely mentally ill. the Acute Treatment Unit which is a highly structured, intensive
residential treatment program for chronically and seriously mentally ill adults, and the Children and
Family Services, Adult Outpatient, and Peer Counseling Programs which primarily provide outpatient
services. An outreach office in Fort Lupton is staffed to serve citizens living in the southern portion
of Weld County. The WMHC is funded through the Colorado Division of Mental Health, county and local
governments, the United Way of Weld County, victim compensation funds, grants. private donations.
contracts for service with a variety of agencies, Medicaid, Medicare, third party insurance payments, and
fees for services.
For the period 6/1/92 through 2/28/93, this project is meeting all objectives set forth in its grant
request. For the purposes of this grant, data from 6/1/92 through 12/31/92 when the project was funded
by the Colorado Trust and from 1/1/93 through 2/28/93 when the project was funded by PAC is included
here. Twenty-six families have been served, with 91% completing their treatment plans (three are
currently receiving IST services.) Four of the five families served by the IST in its first months of
practice (January and February, 1992) remain intact 12 months after termination of services. Of the
other families completing services:
100% remained intact at termination:
90.5% remained intact at three months after termination:
85.7% accepted referrals for ongoing services from CFSP or another agency;
85.7% reported improved levels of communications within the family
compared to pre-treatment levels; and
100% reported and demonstrated significantly decreased levels of violence within the family compared
to pre-treatment levels.
3
7B. Evaluation Results
The IST has met all of its project and cost effectiveness outcome objectives. Attachment D details these
results.
8. Budget
The IST requires an annual operating budget of S72,408.13. down from $72,950.00 last year due largely to
reduced administrative and supervisory costs. Personnel expenses account for S60,993.13, or 84.3% of the
total budget, and will provide for 2.15 full-time equivalents (FTE) . Each therapist/case manager will be
paid $24,000 annually. Rick Hawkins, project coordinator, will spend 10% of his time working with the
IST at a cost of $3,100. Dan Dailey, project director, will devote five percent of his time at a cost
of 81.937.50 to the IST. Fringe benefits are calculated at 15% of salaries, or $7,955.63 annually.
The operations portion of the budget is $951.85 monthly, or $11,415 annually, which is 15.7% of the
total. Each of the two therapist/case managers will travel an estimated 700 miles per month and will be
reimbursed at the present WMHC rate of 5.21 per mile equalling $294.00 monthly. Rent for office space
for the workers and supervisors will not exceed $64.75 per month, calculated from current expenditures.
Clinical and office supplies are calculated to match the current monthly rates within WMHC of S175.62,
including one tone leased pager for each clinical worker ($12.00/pager/month or $24 monthly) . Telephone
expense of $23.25 monthly is calculated from current expenses of the CFSP. Utility expense of S17.44
monthly is based on current utilization rates. Professional Liability Insurance will cost $49.67 per
month per FTE, or $106.79. Secretarial/bookkeeping/data entry support expense will be $37.50 per FTE per
month or $80.63. calculated from costs currently being incurred for similar activities. Expenses for
project evaluation support of $38.77 monthly are derived from current experience with such services on a
per FTE basis. Psychiatric and psychological backup and support costs of $150 monthly is based on one
hour of a psychiatrist's and of a psychologist's time per month at $95.00 and $55.00 per hour,
respectively.
9. Program Evaluation and Continuation
The evaluation of this project will be focused on the degree to which its major goals and objectives are
met. The data to be evaluated will be obtained via numerous routes and sources. The Colorado Client
Assessment Record (CCAR) will be used to assess the levels of functioning of the individuals admitted to
the IST. The CCAR has been utilized by the entire public mental health system of Colorado for over a
decade. It contains nine level of functioning scales which are described by anchor points in a manual
that defines the use of the CCAR. Overall patterns of scores on such key areas as family functioning,
interpersonal relations, role performance, and feeling and affective processes will be of special
interest. It is expected the interventions of the IST will lead to positive changes in these areas as
well as the total of scores in all levels of functioning. Both pre- and post-intervention data will be
obtained. Assessment efforts in this area will be closely coordinated with current DMH research efforts.
Other objectives will be assessed via monthly follow-up contacts with families. Observations by IST
members and by other professionals involved with the families will also form the bases for studying goal
and objective attainment. The level of agreement and disagreement between the family members and
involved professionals regarding these observations will be studied as well. Demographic data will be
obtained and maintained for each individual and family accepted into the project. Data which are
specific to this project will be combined with the data information system already in place at WMBC to
provide a very comprehensive and understandable means by which to study the effectiveness of this
project. Whenever feasible, pre- and post-intervention data will be obtained and utilized.
The WMHC is committed to the continuation of this project and will pursue any reasonable options to fund
it in perpetuity. Continued funding for this project through the Weld County Placement Alternatives
Commission will be sought as the WMRC believes the IST is definitive in terms of what PAC programs are
required to provide. Many clients of the project will be Medicaid eligible. Funding for the■ through
the "Rehab Option", which permits billing Medicaid for other than clinic-based services, will be sought
although it must be remembered the WMHC is limited in the amount of Medicaid it may earn each year and
is, in effect, punished when it exceeds that limit or "cap." The WMHC will approach the DMH in its
budget negotiations to switch a substantial portion of the cost of this project to that entity.
4
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Attachment B
Page 1 of 5
IMPLEMENTATION PLAN
Title of Project: In-Home Intensive Services Team
Objective 1 : When aggression and/or violence has been determined to have been
part of the family's problem, 90% of the families will report and demonstrate a
marked reduction in the use of violence/aggression within and outside the family.
PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM)
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE
Activity Person(s)( ) Time Frame
Responsible Dates
Initial Assessment of Family IST Treatment Staff At admission
Therapy, Case Management, Education, IST Treatment Staff Ongoing
Crisis Intervention
Follow—up Assessments of Family IST Treatment Staff At termination,
Dan Dailey, BA three and 12
months post
termination
Psychological/psychiatric Consultation William Crabbe, PhD As needed
Scott Shannon, MD
Theron Sills, MD
Clinical Supervision Richard Hawkins, BA Ongoing
Administrative Supervision Dan E. Dailey, BA Ongoing
5
Attachment B
Page 2 of 5
IMPLEMENTATION PLAN
Title of Project: In-Home Intensive Services Team
Objective 2: At termination and three months after termination of IHIST services.
85% of the families will remain intact.
PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM)
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE
Activity Person(s) Time Frame
Responsible Dates
Therapy, Case Management, Education, IST Treatment Staff ongoing
Crisis Intervention
Psychological/Psychiatric Consultation William Crabbe, PhD as needed
Scott Shannon, MD
Theron Sills, MD
Clinical Supervision Richard Hawkins, BA ongoing
Administrative Supervision Dan Dailey, BA ongoing
Data Collection IST Treatment Staff At termination
Dan Dailey, BA & again three
Neil Benson, PhD months later
•
230"I1fl
Attachment B
Page 3 of 5
IMPLEMENTATION PLAN
Title of Project: In-Home Intensive Services Team
Objective 3: Seventy five percent of the successfully terminated families will be
intact 12 months after termination of in-home services.
PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM)
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE
Activity Person(s) Time Frame
Responsible Dates
Therapy, Case Management, Education, IST treatment staff ongoing
Crisis Intervention
Psychological/Psychiatric Consultation William Crabbe, PhD as needed
Scott Shannon, MD
Theron Sills, MD
Clinical Supervision Richard Hawkins, BA ongoing
Administrative Supervision Dan Dailey, BA ongoing
Data Collection IST Treatment Staff 12 months
Dan Dailey, BA post suc-
Neil Benson, PhD cessful com-
pletion
7
•
Attachment B
Page 4 of 5
IMPLEMENTATION PLAN
Title of Project: In-Home Intensive Services Team
Objective 4: Fewer than 10% of discharged children will enter another PAC program
after discharge from the IST.
PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM)
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE
Activity Person(s) Time Frame
Responsible Dates
Therapy, Case Management, Education, IST Treatment Staff Ongoing
Crisis Intervention
Psychological/Psychiatric Consultation William Crabbe, PhD As needed
Scott Shannon, MD
Theron Sills, MD
Clinical Supervision Richard Hawkins, BA Ongoing
Administrative Supervision Dan E. Dailey, BA Ongoing
Data Collection IST Treatment Staff At discharge,
Dan Dailey, BA six and 12
Neil Benson, PhD months after
discharge
8
P ()'71f3
Attachment B
Page 5 of 5
IMPLEMENTATION PLAN
Title of Project: In-Home Intensive Services Team
Objective 5: Fewer than 10% of the children served will be in a more costly
placement at discharge and fewer than 15% will be in such placements six months
after discharge.
PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM)
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE
Activity Person(s) Time Frame
Responsible Dates
Therapy, Case Management, Education, IST Treatment Staff Ongoing
Crisis Intervention
Follow—up Assessments of Family IST Treatment Staff At termination,
Dan Dailey, BA and six months
post termina-
tion
Psychological/Psychiatric Consultation William Crabbe, PhD As needed
Scott Shannon, MD
Theron Sills, MD
Clinical Supervision Richard Hawkins, BA Ongoing
Administrative Supervision Dan E. Dailey, BA Ongoing
Data Collection IST Treatment Staff Six months
Dan Dailey, BA post suc-
Neil Benson. PhD cessful com-
pletion
9
Q�T� 7 fJ
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Attachment C
Page 1 of 5
PAST PERFORMANCE
Target Performance*
Program Name: Intensive Services Team xx Twelve Month Program 6/1/92 - 5/31/93, OR
Agency Name: Weld Mental Health Center _ Nine Month Program 9/1/92 - 5/31/93
1. Objective 1 Target Performance* Progress to meet
(Outline the objective) objectives as of
2/28/93
Provide services to maintain 30 to 35 families 22 families served
children in their homes
Please comment on performance. If actual performance is not meeting target
performance, the potential contractor must describe reasons for deficient performance
and describe how the program will meet its planned performance by 5/31/93.
IST is on target. At the current rate of use by families in this category, IST will
serve at least 30 families before the end of the grant year.
10 930919
•
Attachment C
Page 2 of 5
PAST PERFORMANCE
Target Performance*
Program Name: Intensive Services Team xx Twelve Month Program 6/1/92 - 5/31/93, OR
Agency Name: Weld Mental Health Center _ Nine Month Program 9/1/92 - 5/31/93
1 . Objective 2 Target Performance* Progress to meet
(Outline the objective) objectives as of
2/28/93
Provide services to families 5 to 10 families 4 families served
to speed return of child-
ren from placements
Please comment on performance. If actual performance is not meeting target
performance, the potential contractor must describe reasons for deficient performance
and describe how the program will meet its planned performance by 5/31/93.
IST is on target with four families served in this category nine months into the
grant year. An additional one or two reunification families are anticipated to be
referred to IST.
11
R rin
Attachment C
Page 3 of 5
PAST PERFORMANCE
Target Performance*
Program Name: Intensive Services Team xx Twelve Month Program 6/1/92 - 5/31/93, OR
Agency Name: Weld Mental Health Center _ Nine Month Program 9/1/92 - 5/31/93
1. Objective 3 Target Performance* Progress to meet
(Outline the objective) objectives as of
2/28/93
85% of families served 85% families intact at 100% families intact at
will remain intact at termination and at termination; 90% intact
termination and three three months after at three months after
months after termina- termination termination
tion
Please comment on performance. If actual performance is not meeting target
performance, the potential contractor must describe reasons for deficient performance
and describe how the program will meet its planned performance by 5/31/93.
1ST is on target. Target is actually being exceeded at this point by several
percentage points. Nothing is anticipated which would cause these figures to
significantly drop over the next three months.
12 „o i,3q�230"1.9
Attachment C
Page 4 of 5
PAST PERFORMANCE
Target Performance*
Program Name: Intensive Services Team xx Twelve Month Program 6/1/92 - 5/31/93, OR
Agency Name: Weld Mental Health Center _ Nine Month Program 9/1/92 - 5/31/93
1 . Objective 4 Target Performance* Progress to meet
(Outline the objective) objectives as of
2/28/93
Families served 75% 80%
will remain intact
12 months after the
termination of IST
services
Please comment on performance. If actual performance is not meeting target
performance, the potential contractor must describe reasons for deficient performance
and describe how the program will meet its planned performance by 5/31/93.
IST is on target. Four of the five families served in January and February, 1992,
remain intact and doing generally well. The one family which is not intact is not
regarded as a failure for IST as it was thought by WMHC staff to be in the targeted
child's best interests that he not remain at home.
13
Attachment C
Page 5 of 5
PAST PERFORMANCE
Target Performance*
Program Name: Intensive Services Team xx Twelve Month Program 6/1/92 - 5/31/93, OR
Agency Name: Weld Mental Health Center _ Nine Month Program 9/1/92 - 5/31/93
1 . Objective 5 Target Performance* Progress to meet
(Outline the objective) objectives as of
2/28/93
Reduce the level of 90% of families discharged 100% of families dis-
violence/aggression will report/demonstrate charged reported such
present in families such a reduction a change
served by IST
Please comment on performance. If actual performance is not meeting target
performance, the potential contractor must describe reasons for deficient performance
and describe how the program will meet its planned performance by 5/31/93.
IST is on target. This is a difficult area for us to assess objectively. We are
searching for some type of instrument to use rather than relying strictly on the
families' reports and our subjective observations. We do believe, however, that we
are getting strong results in this area.
14
®30TH
Attachment D
Page 1 of 5
EVALUATION RESULTS
(Continuing Projects ONLY)
I. Title of Project: In-Home Intensive Services Team
II. How many years has the Project been funded by PAC? 1 .5
III. Please provide a description of the Project 's evaluation criteria and of
how the Program outcomes and cost effectiveness were to be measured
(This narrative should be replicated from the Project's approved RFP
Bid for any or part of the PY1992-1993 period of June 1 , 1992 through
May 31 , 1993) .
from RFP-PAC-92001 by WMHC:
"b. Goals and Objectives
The primary goal of the project is to enable families with children at risk of out-
of-home placement to care for those children in a healthful manner in the home
environment.
Family Service Goals:
1. For those families referred primarily for prevention of out-of-home placement
the goals are to:
Goal A. Rapidly improve family functioning to enable the family to care for the
children in the home setting.
Objective Provide timely crisis intervention to 30 to 35 families to prevent out-of-
home placements of children and adolescents at local and state psychiatric
hospitals as well as placements in residential treatment programs and, juvenile
detention settings.
Goal B. Improve overall functioning of families to enable them to care for their
children in their homes on a long term basis.
Objective Work closely with all family members on their individual and family
functioning skills so that at termination and three months after termination of in-
home services, 85% of the families will remain intact. Seventy five percent of the
successfully terminated families will be intact 12 months after termination of in-
home services.
2. For those families seeking reunification, the goals of the project are to:
Goal A. Help families create a stabilized home environment as quickly as possible
to facilitate the return of children currently in out-of-home placements.
Objective a. Reduce the level of violence, aggression and other inappropriate
behaviors which are barriers to children returning to/residing in their homes.
Objective b. Work closely with 5 to 10 families and the out-of-home placement
settings, WCDSS, other key agencies, and other community resources with which they
are involved to facilitate return of children to their home as soon as it is deemed
appropriate.
Goal B. Help the entire family cope effectively with the return of the
child(ren) . Objective Work with families on an intensive basis so that all family
members are committed to goal of maintaining all family members in home setting.
Goal C. Help the entire family learn effective ways of dealing with its problems so
that the children can be effectively cared for on a long term basis.
15
Attachment D
Page 2 of 5
Objective Work intensively with all family members on individual and family-related
coping skills. At closure and at three months after termination of in-home
services, 85% of the families will remain intact. Seventy five percent of the
successfully terminated families will be intact 12 months after termination of in-
home services. When aggression and/or violence has been determined to have been
part of the family's problem, 90% of the families will report and demonstrate a
marked reduction in the use of violence/aggression within and outside the family.
Program Service Goals:
This project will work with 35 to 40 client families per year who will be recruited
from existing caseloads of referring agencies and other families which enter the
service system each year. The CFSP will work closely with each partner agency to
ensure the IST operates continually at full capacity. Relevant objectives are to
reduce admissions to PsychCare from 55 children and adolescents to 40 in the first
year of operation of the IST (with a corresponding reduction in length of stay from
4.6 to 4.0 days or less) , reduce the current annual CFSP rate of admission to other
inpatient facilities from 14 to 10 youth, and to facilitate the reduction of the
number of youths in RCCFs, other intensive out-of-home placements, and detention
settings. The IST also seeks to promote the coordination of the community services
to multi-problem families to assure continuity of care and provision of
comprehensive follow-up services.
Costs for each family completing services within the project will be 81595 when IST
involvement is completed in four weeks as planned. This amount is less than two
months of group home care, six months of foster care, three months of therapeutic
foster care, one month of care in a residential child care facility, or two to
seven days of inpatient psychiatric care. By effectively dealing with families
without resorting to out-of-home care, significant cost savings are achieved. "
"7. Evaluation and Continuation
a. Evaluation
The evaluation of this project will be focused on the degree to which the IST
achieves it major goals and objectives. The data by which to conduct the
evaluation will be obtained via numerous routes and sources.
The Colorado Client Assessment Record (CCAR) will be used to assess the levels of
functioning of the individuals admitted to the Intensive Services Team. The CCAR
has been utilized by the entire public mental health system of Colorado for over
a decade. It contains nine level of functioning scales which are described by
anchor points in a manual that defines the use of the CCAR. Overall patterns of
scores on such key areas as family functioning, interpersonal relations, role
performance, and feeling and affective processes will be of special interest. It
is expected the interventions of the intensive team will lead to positive changes
in these areas as well as the total of scores in all levels of functioning. Both
pre- and post-intervention data will be obtained. Assessment efforts in this area
will be closely coordinated with current DMH research efforts.
Other objectives will be assessed via monthly follow-up contacts with families.
Observations by IST members and by other professionals involved with the families
will also form the bases for studying goal and objective attainment. The level of
agreement and disagreement between the family members and involved professionals
regarding these observations will be studied as well . Demographic data will be
obtained and maintained for each individual and family accepted into the project.
Data which are specific to this project will be combined with the data information
16
02 0919
Attachment D
Page 3 of 5
system already in place at WMHC to provide a very comprehensive and understandable
means by which to study the effectiveness of this project. Whenever feasible, pre-
and post-intervention data will be obtained and utilized. "
IV. What are the outcomes based on the Project's evaluation criteria. Be
factual and specific.
A. Cost effectiveness: (especially as it relates to eliminating the
need for out of home placement or lowering the cost of out of home
placement) .
The IST was successful in meeting its cost effectiveness projections. Services
were delivered at the projected $1595 figure. All families completing IST services
were intact at termination of those services; 90.5% were intact three months post
termination; four of the five families who completed IST services at least one year
ago also remain intact. Clearly, IST worked to maintain the physical integrity of
the families it served, thus significantly lowering and in some cases eliminating
the need for out of home placement.
B. Program Outcomes:
For the period 6/1/92 through 2/28/93, this project is meeting all objectives set
forth in its grant request. For the purposes of this grant, data from 6/1/92
through 12/31/92 when the project was funded by the Colorado Trust and from 1/1/93
through 2/28/93 when the project was funded by PAC is included here. Twenty-six
families have been served, with 91% completing their treatment plans (three are
currently receiving IST services.) Four of the five families served by the IST in
its first months of practice (January and February, 1992) remain intact 12 months
after termination of services. Of the other families completing services:
100% remained intact at termination;
90.5% remained intact at three months after termination;
85.7% accepted referrals for ongoing services from CFSP or another agency;
85.7% reported improved levels of communications within the family
compared to pre-treatment levels; and
100% reported and demonstrated significantly decreased levels of violence
within the family compared to pre-treatment levels.
C. Other:
There is nothing further to report at this time.
V. What significant refinements have the agency undertaken to improve its
evaluation system?
The WMHC is still struggling to fully evaluate the data gained from this project.
All data gathered to date has been evaluated by hand with no computer assistance as
yet. The data is ready to be entered into an SPSS+ program as soon as all the
"bugs" are worked out which is anticipated to be not later than 6/1/93. Some
objectives for the project have been rewritten to provide more meaningful outcome
data, particularly in the timing of assessing families' response to IST services.
17
91071 fl
Attachment D
Page 4 of 5
VI. Describe long-term evaluation and assessment efforts to track
participant outcomes and the cost efficiency of the Project? Be
specific.
All data currently gathered will be maintained in usable form to track IST results
longitudinally. The WMHC is committed to modifying IST and its other offerings to
best serve its clients. Thus, we will examine as much as possible the long term
results of IST interventions not only in terms of the specific children targeted by
the IST in its work but also their siblings.
VII. What are the outcomes based on the Project's long-term evaluation and
assessment efforts.
A. Cost effectiveness: (especially as it relates to eliminating the
need of out of home placement or lowering the cost of out of home
placement.
No data beyond the 12 month data reported above and elsewhere have been collected
and analyzed. We are encouraged by being able to slightly reduce costs per family
served in this proposal.
B. Program Outcomes:
No data beyond the 12 month data reported above and elsewhere has been collected
and analyzed. The WMHC is convinced of the effectiveness of the IST in responding
to families in crisis and is dedicated to maintaining the IST as part of the larger
service delivery system.
C. Other Outcomes:
There are none to report at this time.
VIII. Describe the program deficiencies identified by the Bidder's evaluation
system and describe how these deficiencies were corrected or being
solved. Identify Program deficiencies that were unable to be
corrected.
The WMHC is pleased to have met all goals and objectives contained in our
successful bid to offer IST services through grants from the Weld County Placement
Alternatives Commission and The Colorado Trust. It is of concern that referrals
are much more difficult to come by at the time of this writing (January and
February, 1993) . No complaints have been received by the project director or his
superiors which would help to explain this reduced flow of clients. Nor does it
seem to fit that changes in the definition of whom is eligible for programs funded
by PACs would have such a severe impact on the number of referrals. Workers from
IST sought and obtained time to meet With the Youth in Conflict Team and the
Ongoing Child Protection Team (a meeting with the Intake Child Protection Team was
sought but refused by the supervisor of that team) in late 1992 to help with the
transition from Colorado Trust funding which required no WCDSS approval of
referrals to PAC funding which
18
Attachment D
Page 5 of 5
does require such approval. It was the IST's intention to answer any and all
questions and concerns the WCDSS teams had. To the best of my knowledge, no
concerns were expressed; all questions were answered. The WNHC is continuing to
seek meetings to work through difficulties others may have with IST and to maintain
open lines of communications with WCDSS.
IX. Describe any Project or audit issues from other outside evaluators (PAC
Foster Care Evaluator, etc.) or auditors. Describe how these projects
or audit issues were resolved.
No project or audit issues have been raised by evaluators outside the WNHC. The
WMHC's annual performance audit examined the IST's operations, passing them without
comment.
19
7o91f
PAC FUNDS Attachment E
Hourly Unit Rate Cost Page 1 of 2
Computation Sheet
I. Program Name: In-Home Intensive Services Team (IST)
II. Agency Name: Weld Mental Health Center, Inc.
III. The project's unit of service definition is:
A. The project will provide what type of service to each client.
Intensive, home-based crisis intervention, mental health assessment and
treatment, case management, and education services
B. This service will be provided for 19.2 (maximum)
hours per week for up to 6 (maximum stay in the
program) weeks.
IV. The hourly Unit Rate is based on:
Check one
A. An individual client who is aged through
xx B. A family unit as described as follows: A child at
imminent risk of placement, his or her siblings residing at home, his
or her parent(s)/guardian(s) and other extended family members who
may reside in the home.
V. Program Statistics
Total number of clients to be served in the 12 month program is 44 .
The monthly maximum program capacity is four (4) .
The monthly average capacity is three (3) .
Average stay in the program is four (4) weeks.
Average hours per week in the program is not less than sixteen (16) .
VI . Description of unit of service cost between direct and indirect
services.
Base the computation on the hourly rate per unit of service cost based
on the average capacity.
A. The portion of direct services to the hourly rate per unit cost
based on average capacity is 59% or $14.84 per hour. (only
face-to-face contact with the client for services)
B. The portion of indirect services to the hourly rate per unit cost
based on average capacity is 41% or $10.30 per hour.
C. Total hourly rate per unit of service based on average
cost (A+BIC) . $25.14
D. Total proposed yearly budget for services $72,408. 13
20
9.30'11"
RFP—PAC-93003 Attachment E
Page 2 of 2
VII . Unit of service rate computation
1 . Travel to & from client's home
totals an average of 3.2 hrs/week
2. Paper work required by Weld
County Department of Social
Services totals an average of 0.5 hrs/week
3. Supervisor meetings totals
an average of 1 .3 hrs/week
4. Case management services of:
a. making referrals to other services needed by clients;
b. providing linkage to ensure clients obtain and benefit from
the services to which they have been referred;
c. monitoring the client through contacts with individuals and
agencies;
d. advocacy to ensure the best interests of the client are
served; and
e. planning of services to best serve the client
totals an average of 2.1 hrs/week
5. Court testimony required by Social
Services totals an average of 0.1 hrs/week
6. Administrative costs total an
average of 1 .0 hrs/week
Please describe below:
Program Director's time based on
.05FTE at average capacity minus
WCDSS report preparation time
7. Other costs total an average of 0.0 hrs/week
Please describe below:
8. Sub-total indirect costs 8.2 hrs/week
9. Direct services to clients
(Face to face contact) totals
an average of 11 .0 hrs/week
Total average hours of service
to be provided per week 19.2
Weekly direct services to clients total an average of: $ 276.54 57%
Weekly indirect services to clients total an average of:$ 206. 15 43%
21
RFP-PAC-93003 Attachment F
Page 1 of I
PROCRAN PEIPOIllICE
Target Performaacet
INDICATE TIE TYPE 0P COIT1ACT lillD
ii Twelve Month Program 6/1/92 - 5/31/93, OR
Nine Month Program 9/I/92 - 5/31/93
Program lame: In-home Intensive Services Team FT1992 - 1993 FTI993 - 1994
(A) (g) (C)
Objectives Target Performance* Actual Performance Target Performance
06/01/52 to 05/31/93 06/01/92 to 01/31/93 06/01/93 to 05/31/94
1. Avg. number of children 4 3.6 4
served per month
2. Avg. number of months in 1 1 1
program for children who
have been discharged
3. Avg. cost per month per $1595 $ 1595 $ 1515
child
4. I of children at home or 85 100 85
less restrictive setting
at discharge
5. 1 of children at home or 85 90 85
less restrictive setting 6
months after discharge
6. Avg. savings of $ 3805 (RCCF) $ 3805 (RCCF) $ 3945 (RCCF)
alternative vs. projected $ 265 (Foster) $ 265 (Foster) $ 385 (Foster)
placement
7. Avg. I of treatment goal 85 89 85
met per child discharged
8. 1 of children who entered 8/A 5 I0
another PAC Program after
discharge
9. 1 of children who are in N/A 0 10
more costly placement at
discharge
10. 1 of children who are in N/A 5 15
more costly placement 6
months after discharge
22
("i)"19
Attachment G
COUNTY PLACEMENT ALTERNATIVES PLAN FINAL BUDGET PAGE
FY 1993 - 1994
(1) (2) (3) (4) (5)
PROGRAM PAC FOSTER OTHER TOTAL
NAME FUNDS CARE FUNDS PROGRAM
REQUESTED REQUESTED PROVIDED
FOR PROJECT FOR PROJECT
In—Home Intensive $72,408. 13 $72,408.13
Services Team (IST)
TOTALS
How will PAC money be accounted for separately from other agency money?
Charlene Harris, Business Manager of WMHC, will set up separate cost centers for
the funds used to operate the IST as well as to track any revenues generated
from other sources. Accounts for each revenue source will be maintained
separately. The WMHC is independently audited annually.
23
DEPARTMENT OF SOCIAL SERVICES
4IS
P.O. 806
GREELEY,COLORADO 80632 I Administration and Public Assistance(303)352-1551
Child Support(303)352-6933
C Protective and Youth Services(303)352.1923
OFood Stamps(303)356-3850
FAX(303)353-5215
COLORADO
MEMORANDUM
TO: Constance Harbert, Chairman
Board of County Commissioners
FROM: Judy Griego, Director, Social Services a
DATE: July 29, 1993
SUBJECT: Notification of Financial Assistance Award between Weld County
Mental Health and the Weld County Department of Social Services
Enclosed for Board approval is a Notification of Financial Assistance Award
between the Weld County Mental Health and the Weld County Department of
Social Services for Placement Alternatives Commission (PAC) funds.
The Placement Alternatives Commission (PAC) reviewed proposals under a
Request for Proposal process and are recommending approval of this bid.
1. Total award would be $72,408.
2. The period of the award is June 1 , 1993 through May 31, 1994.
3. The Intensive Services Program would provide a match of two families
per worker per 80 hours per month for up to six weeks to provide intensive
services as long as required to stabilize the situation with families with 34
hour crisis intervention. (20 hours per week)
If you have any questions, please telephone me at extension 6200.
JAG:jac
930718
cc, 1
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