HomeMy WebLinkAbout940483.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR PLACEMENT
ALTERNATIVES COMMISSION FUNDS FOR WELD MENTAL HEALTH CENTER, FAMILY
THERAPY, 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 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 the Weld Mental
Health Center, Family Therapy, commencing June 1, 1994, and ending May 31, 1995,
with 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
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
the Weld Mental Health Center, Family Therapy, 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 23rd day of May, A.D. , 1994.
ATTEST�/Waal? BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
Weld County Clerk to the Board _ ',P� I� / it IC 41
4j . Webster, hair an
BY: ���/1/� icpC,� q
Deputy Clerk to t$..Board \ Dale . Hall, 1727- em
APP ED AS TO FORM: 6,
George 21. Baxter
County Attor y Constance L. Harbert
arbara J. Kirk yer
940483
Wel ;ounty Department of Social Set :es
Notification of Financial Assistance Award
for Placement Alternatives Commission (PAC) Funds
Type of Action Contract Award No.
X Initial Award FY94-PAC-500
(RFP-PAC-9200)
Contract Award Period Name and Address of Contractor
Beginning 06/01/94 and Weld Mental Health Center
Ending 05/31/95 Family Therapy
1306 11th Avenue
Greeley, CO 80631
Computation of Awards Monthly Program Capacity 8
Monthly Average Capacity 6
Unit of Service
Description
Services will be delivered for up to 24
weeks for up to 6 families per month with The issuance of the Notification of
5 hours of services per week. Financial Assistance Award is based
upon your Request for Proposal (RFP) .
Cost Per Unit of Service The RFP specifies the scope of services
and conditions of award. Except where
Hourly Rate Per $ 25.46 it is in conflict with this NFAA in
Unit of Service which case the NFAA governs, the RFP
Based on Average upon which this award is based is an
Capacity integral part of the action.
Monthly Rate Per $ 547.00 Special conditions
Unit of Service
Based on Average 1) Reimbursement for the Unit of
Capacity Service will be based on an hourly
rate per child or per family.
Total Yearly $36,665.00
Services Budget 2) The hourly rate will be paid for
(Subject to the Availability of only direct face to face contact
Federal and State Funds) with the child and/or family or as
specified in the unit of cost
Enclosures: computation.
Signed RFP
3) Unit of service costs cannot
exceed the hourly, monthly, and
yearly cost per child and/or
family.
4) Rates will only be paid on
approved and open cases with the
Department of Social Services.
Approva s: / Program Official}By 7
TBy W.`H. Webster, Chairman .SJ qy Ju Gri go, Di ctor
Board of Weld County Commissioners Weal , oun Depar nt
'/ Social Services �/
Date: �a°3/97 1 �a/� I
Date: b / /
940483
INVITATION TO BID
DATE: January 7, 1994 RETURN BID TO: Pat Persichino
Director of
BID NO: REP-PAC-94004 General Services
915 1.0th Street
P.O. Box 758
Greeley , CO 80632
DIRECT INQUIRIES TO: Pat Persichino, Director of General Services
SUMMARY
Request for Proposal (REP-PAC-94004) for: Family Preservation Program
Deadline: February 22, 1994 , 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 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 a twelve month program targeted to run from June 1, 1994
through May 31, 1995 , at targeted funding levels of increments up to 5L82 , 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 pororw, M31,1_, =8 1
TYPED PRINTED SIGNATURE
VENDOR Weld Mental Health Center, Tne
Handwritten Signature By Authorized
Officer or Agent of Vender
ADDRESS1306 Eleventh Avenue . TITLEExecuti_ve Director DATE ; `,2 I - ?</
Greeley, Cnloradn ZIP 80631 _ PHONE # ( 303) 353 =�86
The above bid is subject to Terms and Conditions as, attached hereto and i : urporatei.
940483
RFP-PAC-94004 Attachment A
Page 1 of 2
COVER PAGE
ALTERNATIVES TO OUT OF HOME PLACEMENT PROGRAMS
PLACEMENT ALTERNATIVES COMMISSION
PROGRAM YEAR 1994
BID # RFP—PAC-94004
t [12_ Group(s) t0 he. Served: Ld11 l;.e5 with children at risk )tout-!)t om ila ut_
Name of Applicant Agency: Weld Mental Health Center. Inc.
Address: t306 Eleventh Avenue _-.-_-._-- -- - _-- --------- ---._.._.__
City: Greeley, Colorado 80631 — —— — -
Phone: (303) 353-3686
Contact Person: Dan E. Dailey
Title: Director. Children and Family Services
kpnro7dmate Project Pates: Start June j„. 1994
End ?lay 31 . 1995
Title of Project: Intensive Family Therapy
Amount Requested: S36,665 ---- /
Signatures: d/�a
Pan E. Dailey (Date
)11
Name and Signature of Per Preparing P posal c1
Dale F. Peterson ° 20 — 5 `
Name and Signature of Chief Administrative Officer of Date
Applicant Agency
PROPOSED FAMILY PRESERVATION PROGRAM CATEGORY
Please initial to indicate the bidder' s chosen category (only one category per bid)
Home Based Intensive Family Intervention
Option 1
Home Based Intensive Family Intervention
Option 2
X Intensive Family Therapy
Sexual Abuse Treatment
Day Treatment
LiteSkills
Individualized/Innovative Ser'. i''es
94047,93
RFP-PAC-94004 Attachment A
Page 2 of 2
TYPE OF PROJECT
Continuing Project under Weld County PAC
How many years?
e td"'' Pro iect
X____ Proposed Program wlii slimin it8 the need for out :)1 hone PlaC elilent
Proposed Program will lower the cost of out of home placement
--- Other: The Proposed Program will — ------_-_-_-- —
MANDATORY PROPOSAL REQUIREMENTS
Please initial fo indicate that the following required sections are included in this
proposal :
Statement of Need
_ Population to he Served
It Program Requirements
Types of Services Provided
21
0 I Provision of Services & Administrative
Capability
Past Performance
RID Letters of Support (New Programs Only)
Budget
Program Evaluation and Continuation
940=783
TABLE OF CONTENTS
Cover Page overleaf
Tibto conto_ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Program Narrative 1
1 , Statement of Need 1
2. Population to be Served 1
4. Types of Services Provided 2
F. ' .Yon . f Ser- �es and "dm'.' t
5. Past Performance 1
7A. Letters of Support 3
8. Budget 4
9. Program Evaluation and Continuation 4
Attachments
A. Cover page overleaf
2. Pr. r°-n moor:r,.n°nt' 5 -
C. Past Performance na
D. Evaluation Results na
E. Hourly Unit Rate Cost Computation Sheet 10 - 11
F. Program Performance 12
C. Count, Placon( nt Alternative Plan Final Budget nag, 13
T!.
a
91104‘1.93
D. Program Narrative
1. Statement of Need
The child and adolescent population at risk of out-of-home placement continues to be 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 DMH
_n at es the youth olrniol ion in need of ;mental health _ .ry res in Weld County to be over 1500 in any Ziven
year. 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'.5 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 were 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 (HCCF) . 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. There is a perennial shortage of appropriate foster homes in which to place these
children in need. Placement Alternative Commission "slots" have been significantly reduced by continuing and
questionable redefinitions of whom may have access to them. There are not sufficient resources for the
children and their families in this county. This proposal seeks to establish a new level of services
vailal;l Ch•oulth "he WMHC. Thn Family Therapy vreiect LIFT) is designed to deal directly and
promptly with the some of the most troubled of those families.
2. Population to be Served
The following eligibility criteria must be met before IFT 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
tor 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;
d. There must be a manageable level of risk of harm to the targeted child(ren) .
e. There must be a reasonable possibility that IFT services can bring about sufficient improvement in
parental competency so as to allow a child already in placement to safely return home within six months of
provision of IFT services or to allow a child to be safely maintained in his or her home.
The following categories of children and adolescents (independent of age, gender, ethnicity) who meet SB26
guidelines will be served by the IFT:
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 or those abused and/or neglected
youths whose parents do not possess sufficient parental competency to safely care for their children;
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 16 families will he served annually. Referrals will flow from individual caseworkers at WCDSS to
through a designated supervisor there to Dan Dailey, IFT director. The final decision as to the appropriate
level of mental health services will he made by the WMHIC.
1
Sd047t 3
3. Program Requirements
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 family based services within three days of referral to 16
families to either prevent out-of-home placements of children and adolescents in foster and group homes,
residential child car`: facilities, juvenile detention facilities, and in psvchial.ric hospitals (family
preservation services' or to return youths from such facilities to their family homes within six months of
services provision :reunification ser;ices.l
Goal H. Improve overall functioning of families via intensive family therapy and ancillary activities designed
to improve family conflict management, parental competency, household management competency, and to provide
an increased ability to gain access to and use appropriate resources in the community thereby enabling the
families to safely and appropriately care for their children in their own homes on a long term basis.
Objective a. Eighty-five percent of families which receive either family preservation or reunification
services through the IFT will measure significantly lower on the risk assessment scales at time of termination
of services than they did at time of referral.
Objective b. At termination, six and 12 months after termination of IFT services, 90% of the families
receiving family preservation services will remain intact.
Objective c. Seventy percent of children currently in long term placement who are provided reunification
services will return to their own home and not reenter out-of-home placement within 12 months of completion of
services.
Objective d. Fewer than 10% of discharged children will enter another FPP 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.
Objective f. Eighty percent of the families receiving either family preservation or reunification Services
will not have a substantiated incident of abuse or neglect within 12 months of successful completion of
services.
4. Types of Services Provided
The WMHC will provide families with intensive, family based crisis intervention, mental health assessment and
treatment, case management, and education services for up to five hours per week for 24 weeks. The following
principles guide the IFT's approach:
a. To intervene immediately:
b. To provide brief and intensive treatment;
c. To focus treatment, using existing family strengths, on identifying and solving problems, and on realistic
goal setting;
d. To involve and empower families in treatment; and
e. To link clients and their families with and educate them in the effective use of other community services
and resources.
Crisis services will be continually available to provide screening, evaluation and assessment, intervention,
and follow-up planning to clients. Services, tailored specifically to each client family, will initially
focus on those issues and problems precipitating the crisis which lead to IFT referral. Family treatment will
then move on to dealing with longer standing issues which impede the family's ability to safely and
effectively function as a unit. The average period of involvement will be 24 weeks. Services will be
delivered primarily at WMHC offices but will be held in clients' homes or at other sites when indicated.
These aspects of the project--rapid response to referrals, accessibility of therapists via phone during
evenings and weekends, time intensive family therapy and case management services, the relatively low
caseloads. and the moderate duration of the services--produce a powerful intervention resource. The WMHC
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 bs lFT ire cu l tu-tl iv sons i ti••e and competent. They are designed to he consistent ,iih
the culture and . . lief :;.stems c` the client f.imili-': Training to educate and sense ise staff to the needs
and cultural 'Ii fteren es of the residents of Weld Count occurs on a regular basis.
2
9404193
•
5. Provision of Services and Administrative Capability
The WMHC is a private, non-profit corporation governed by a board of directors, currently chaired by Michael
Lazar. It is licensed by the State of Colorado as a comprehensive community mental health center serving all
of Weld County. The WMHC has been in existence since 1962, becoming a comprehensive community mental health
center in November, 1967. Dale Peterson, MSW, MBA, is the WMHC's Executive Director. Scott Wong, WMHC
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 IFT will be staffed by a full-time masters level mental health clinician whose training included crisis
intervention and family s v,leas theory. The person to be hired a ill have at leant three years expe n cncr
;rking with children. adolescents, trd families and will meet the minimum qualifications of a Colorado
Department of Social Services Caseworker III. S/he will undergo special training in the philosophical and
practical aspects of family preservation. Overall administrative responsibility will he assigned to Dan E.
Dailey, BA, Director of ,the CFS?, who has more than 21 Year^ experience in mental health treatment and
administration. He reports directly to the Executive Director of the WMIIC.
At present, the IFT will be the only program in Weld County designed to have its sole function be the delivery
of services as described herein. The WMHC and other providers may from time to time provide this level of
services in brief spurts to selected families. As envisioned, the IFT will often be able to prepare clients
for successful involvement in significantly lower levels of intervention such as more typical outpatient
therapy models or education programs.
6. Past Performance
The NBC provides inpatient. residential, partial rare. and outpatient treatment services including group.
family, and individual therapy as well as case management, educational, and vocational services.
Programmatically, the WMHC 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.
This proposal, if funded, will increase the capacity of the WMHC to meet the burgeoning demands for more
intensive services to Weld County children and their families. The increase will not have to come at the
expense of some other offering of the WMHC as would occur if we were to shift internal emphasis to accomplish
the goals and objectives of this proposal.
The CFSP currently employs approximately 11FTE who will deliver nearly 12,000 hours of service to more than
600 youths and their families this fiscal year. The CFSP has consistently increased its level of service to
Weld County families over the past few years.
The WMHC has successfully operated its In-Home Intensive Services Team, based on the nationally acclaimed
Humebuilders Program, for three years combining funding through the Colorado Trust and the Weld County PAC,
Similarly, the Victim and Law Enforcement (VALE) Board of Weld County has funded for three years a 0.75FTE
triage worker, hired to initially screen and admit child abuse victims to outpatient services of the WMHC.
For the past two years, United Way of Weld County has funded a 0.25FTE mental health worker to assure that no
gaps in the mental health care of abused children occurred at the WMHC. The Family Education Network of Weld
County has recently approved a grant which will enable WMHC to deliver mental health services on-site to Head
Start children and their families via a 1.0FTE psychologist. The WMHC record in service delivery through
these specialized projects and through its other services is exemplary.
7A. Letters of Support
Letters of support accompany this document as Attachment XXX.
•
9404:93
8. Budget
The IFT will require an annual operating budget of $36,665. Personnel expenses account for $27,600. or 75.3%
of the total budget which will provide for 1.00 full-time equivalent therapist/case manager who will be paid
$24,000 annually. Fringe benefits are calculated at 15% of salaries, or $3,600 annually.
The non-personnel portion of the budget is 89,065 annually, which is 24.7% of the total. Project
administrative services will cost $1150 annually ($1000 in salary and $150 in fringe benefits.) Clinical
supervision costs will be $1495 yearly. The therapist/case manager will travel approximately 400 miles per
month and will he reimbursed at the present WMIIC rate of 5.21 per mile equalling 91.,008 annually Rent for
office space for the worker . telephone expense, and utility expense_ is based on oltrrni. utilization rates
amounting to -'6 0 annually. Clinical and office supplies are calculated to match the urrent nordhiy rates
within WMHC of $87.50, including one digital pager ($14.95/month) . Professional Liability Insurance will
cost 562.50 per month, or $750 annually. Secretarial/bookkeeping/data entry support expense will be $37.50
per month or S450 yearly, calculated from costs currently being incurred for similar activities. Expenses
for project evaluation support of $21 monthly (S252 annually) are derived from current experience with such
services on a per FTE basis. Psychiatric consultation, backup, and support services will cost $190 monthly
($2280 annually) based on two hours of a psychiatrist's time per month at an hourly rate of 595.
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 he obtained via numerous routes and sources. The Colorado Client Assessment.
Rocord AR) will he used to assess the levels of functioning of the individuals admitted to the `FT. 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 IFT 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 he obtained. Assessment efforts in this
area will be closely coordinated with current FMB research efforts.
Other objectives will be assessed via monthly follow-up contacts with families. Observations by the IFT
worker 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 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.
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 WMHC believes the IFT will easily meet the terms of what PAC programs are required to provide
and become a valued community resource. Many clients of the project will be Medicaid eligible. Funding for
them 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 DMA in its budget
negotiations to switch a substantial portion of the cost of this project to that entity although the DMA has
been reluctant to underwrite new projects.
940 v
Attachment B
Page 1 of 5
PROGRAM REQUIREMENTS
TYPE OF PROJECT
Title of Project: Intensive Family Therapy Home Based Intensive Family Intervention
Option 1
i ; 's: Z:`. ;[+. of fgill.lLi ..::!1 <s.{ _111'r ____ Home iia:?'itl InL.'n:;i'. . .....: rnt�-rvenli.ii
remain intact at dischat .e and for the Intensive Family Therapy
following 1 _ months, Sexual Abuse Treatment
_— Day Treatment
PROGRAM SPECIFIC OBJECTIVES ''MINIMUM nF THREE PER PROGRAM) Life Skills
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Individualized/Innovative Services
Activity Person(sl Time Frame
Responsible Dates
•
•erF:;1 knsese,lenl .,f r:,mi'. 'FT Tr. m.rF c!.iff At :i.lmir^•sc'n
Therapy. Case Management. Education. IFT Treatment Staff Ongoing
Crisis Intervention
Follow—up Assessments of Family IFT Treatment Staff At termination of services
Dan Dailey. BA
Data Collection IFT Treatment Staff 12 months post successful completion
Dan Dailey, BA
Neil Benson, PhD
Psychiatric Consultation/Services James Medelman, MD As needed
Russ Johnson, MD
Theron Sills, MD
Clinical Supervision Dan Dailey, BA Ongoing
Administrative Supervision Dan Dailey, BA Ongoing
•
9104:fl3
Attachment B
Page 2 of 5
PROGRAM REQUIREMENTS
TYPE OF PROJECT
Tit1P of Project: Intens_i'119.i!v Tllerapv_ _ Rome Based Intensive Family Intervention
Opti.,n I
el,;.,,.t_,4. i,.--_Ix.r.:i; t..!,;n1ra_11. .. Z`J In f'.r,jr _._.._ Hone p;l , l ..1'r... :►111,. r,, -,rventinn
ire for children sn placed prior to re- Option 2
terra! wijl be less than six months. Intensive Family Therapy
_ Sexual Abuse Treatment
Day Treatment
PROCJIAM SPECIFIC OBJECTIVES (MINIMUM OF TL'REE PER PROGRA^I1 _ Life Skills
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Individualized/Innovative Services
Activity Person(sl Time Frame
Re nonsible
Tllerar:y, Ca:'e '4'n•►gemert , ^rtuCI(ion. IFT Treatment Staff ,'nvine.
Crisis Intervention
P_'•l:hlatric Consultation/Services • James Mdelman, MD as needed
Russ Johnson, MD
Theron Sills, MD
Clinical Supervision Dan Dailey. BA ongoing
Administrative Supervision Dan Dailey, BA ongoing
Data Collection IFT Treatment Staff At termination
Dan Dailey, BA
Neil Benson, PhD
6
94047S3
Attachment B
Page 3 of 5
PROGRAM REQUIREMENTS
TYPE OF PROJECT
Home Based Intensive Family Intervention
Title of Project: In�_ nsive Family Therapy' -- Option 1
^g� Home ^ `. `:Itei i' ' F.imiI; i:iierver.f.i?n
,}, T•F•irr t' 1^`` .,f •'iiYr•}:;���_.•�,( .•',_•�u1(.1�'_.' y ...:
,San
233121_1P'Lt.....-• :• 4 ice' .:.='r. ,-,rt;on
from the_IFT. _ Intensive Family Therapy
Sexual Abuse Treatment
Darr Treatment
PROGRAM SPECIFIC OBJECTIVES (MINIMUM F THREE PER PROGRAM) Life `.'i i i is
YC OBJECTIVES O f (; PROGRAM)
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE
individualized/Innovative Services
ActivitY Person(s) Time Frame
Responsible Dates
n:.tment Sl.tf !'-+grog
'"'tr•rapy. 'a9e Management . Education. ,. - ..
Crisis Intervention
Psychiatric Consultation/Services James Medelman, MD As needed
Russ Johnson. MD
Theron Sills, MD
Clinical Supervision Dan Dailey. BA Ongoing
Administrative Supervision
Dan Dailey, BA Ongoing
Data Collection IFT Treatment Staff At and post discharge
Dan Dailey, HA
Neil Benson. PhD
904791
Attachment B
Page 4 of 5
PROGRAM REQUIREMENTS
TYPE OF PROJECT
Title of Project: Intensive Family TheramY Home Based Intensive Family Intervention
Option 1
-•r - ��.,IJn, �+. n '.f;�' , i t, Ir{ 1 Cer'.PI •:i1i Homer !lased Intensive Family Intervention
IT.in A mr. ntl,. ;;L rr�emen' .'. 1°.;,•lta• Option
and fewer than than 154 will he in snrh L_ Intensive Family Therapy
nlacement_s_..r'tnd rannths after discharge Sexual Abuse Treatment
Day Treatment
PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM) __, Life Shills
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Individualized/Innovative Services
Activity Person(s) Time Frame
Resvnnsible Dates
:..c ''ei" Management . Ed:i atiun. IFT Treatment Staff Oneuir
Crisis Intervention
Follow-up Assessments of Family IFT Treatment Staff At termination and at six and 12 Months post-
Dan Dailey. E:1 termination
Psychiatric Consultation/Services James Medelman, MD As needed
Russ Johnson, MD
Theron Sills, MD
Clinical Supervision Dan Dailey, BA Ongoing
Administrative Supervision Dan Dailey, BA Ongoing
Data Collection IFT Treatment Staff Si:. and 12 months post successful termination
Dan Dailey, BA
Neil Benson, PhD
8
Attachment B
Page 5 of 5
PROGRAM REQUIREMENTS
TYPE OF PROJECT
Title of Project: Intensive Family Therapy Home Based Intensive Family Intervention
Option 1
- .f f i1 ; ._i, 'G'" Home Based Intensive Famil Interventi,'n
F.i7'tltY �Frr ent (.. 'l fl_ f>`; -�:. �.`.i.r_..� �
s.r'rvic:e.s will not have t sub;:t.tnti_at.'.1 foci- Cr fun 2
dent of abase, or neglect within 12 months X Intensive Family Therapy
of completion of cervical, Sexual Abuse Treatment
Day Treatment.
PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM) Life Skills
MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Individualized/Innovative Services
Activity Person(s) Time Frame
Responsible Dates
Therapy. Case Managemen , Education, IFT Trey ment Staff ?ngcing
Crisis Intervention
Follow-up Assessments of Family IFT Treatment Staff %t termination .and 12 months post-
Dan Dailey. BA tcrminaI '. n
Psychiatric services/consultation James Medelman. MD As needed
Russ Johnson, MD
Theron Sills. MD
Clinical Supervision Dan Dailey, BA Ongoing
Administrative Supervision Dan Dailey, BA Ongoing
Data Collection IFT Treatment Staff Twelve months post successful termination
Dan Dailey. BA
Neil Benson. PhD
9
9 O:"P 1
PAC FUNDS Attachment E
Hourly Unit Rate Cost Page 1 of 2
Computation Sheet
I . Program Name: Intensive Family Therapy (IFT)
I r _ 'enr` lane: Weld _ fa Heath Thr± ?rr , _.
III. The project' s unit of service definitio❑ is:
A. The project will provide what type of service to each client.
Intensive family therapy including comprehensive assessments, crisis
intervention, treatment, and case management services
B. This service will be provided for four (4) (maximum)
hours per week for up to 26 (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 16 .
The monthly maximum program capacity is eight (8) .
The monthly average capacity is six (6) .
Average stay in the program is twenty-four (24) weeks.
Average hours per week in the program is five (5) .
ITT . 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 60% .or $15.28 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 nn average capacity is 40% or $10. 18 per hour.
C. Total hourly rate per unit of service based nn average
cost (A+B+C) . S25.46
D. Total proposed yearly budget for services $36.665.00
10
RFP-PAC-94004 Attachment E
Page 2 of 2
VII. Unit of service rate computation
1 . Travel to & from client' s home O,35hrs/week
totals an average of
2. Paper work required by weld
County Department Social
Services totals an average of 0.25hrs/week
3. Supervisor meetings totals
an average of 0. 19hrs/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
1 .00hrs/week
5. Court testimony required by Social
Services totals an average of 0.05hrs/week
6. Administrative costs total an 0. 13hrs/week •
average of
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 0.03hrs/week
Please. describe below:
Not less than 10 continuing education
hours per worker per year as required
in RFP
8. Sub-total indirect costs 2.00hrs/week
9. Direct services to clients
(Face to face contact) totals 3.OOhrs/week
an average of
Total average hours of service
to be provided per week 5.00
Weekly direct services to clients total an average of: 76.32' '' 60%
Weekly iri it nt services t ''. tents t.Gt a1 an a\ :.rage c4:2 50.9_ 40%
11
9 0'1::"J:3
RFP-PAC-940O4 Attachment F
Page 1 of 1
PROGRAM PERFORMANCE
Program Name: Intensive Family Therapy FY1993 - 1994 FYI994 - 1995
(A) (B) (C)
fhjer.tives Tar;;<<. Per'.>rmance" Actual Performance Target Performance
(1 nz r94 thLJ rql'.2_02/2.13/9A 0..E011,L94_tD_,05/ .1/9'
1. Avg. number of children
.--a?ric Lrer....iugnt.11._...�.--
2. Avg. number of months in
program for children who
v d' na 24
3. Avg. cost per month per
child na na S 547
•
4. e of children at home or
less restrictive setting
at discharge na na 90
e of children at home or
less restrictive setting 6
months after discharge na -. - na R5
6. Avg. savings of
alternative vs. projected
placement na na $ 712 (foster care)
7. Avg. % of treatment goal
met per child discharged na na 85
8. : of children who entered
another PAC Program after
discharge na na 10
9. % of children who are in
more costly placement at
discharge na na 10
10. % of children who are in
more costly placement 6 •
months after discharge na na 15
Attachment G
COUNTY PLACEMENT ALTERNATIVES PLAN FINAL BUDGET PAGE
FY 1994 - 1995
(1) (2) (3) (4) (5)
PROGRAM FAMILY FOSTER ITHER TOTAL
NAME PRESERVATION CARE FUNDS PROGRAM
PROGRAM REQUESTED PROVIDED
FUNDS FOR PROJECT FOP PROJECT
REQUESTED
Intensive Family Treatment 536,665.00 $36,665.00
(IFT)
TOTALS $36,665.00 $36,665.00
How will PAC money be accounted for separately from other agency money?
Scott Wong, Business Manager of WMHC, will set up separate cost centers for the
funds used to operate the IFT 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.
1 "3
940493
Attachment H
Page 1 of 1
BUDGET FORMAT
A. DIRECT COSTS $24,000
Staff salaries 1,000
Staff frinv benefits Subtotal $27 600
E. INDIRECT COSTS $ 1 ,000
Di.reCtor salary 150
Director fringe benefits 1 ,495
Clinical supervision 750
Professional liability insurance 2,250
Psychiatric services/consultation 2,008
Travel 1 ,050
Clinical and office supplies 450
Support staff 252
Project evaluation 252
[;.ant/Utilities/Phone Subtotal $ 9,065
Total $36,665
•
14
•
940483
WELD MENTAL HEALTH CENTER, INC.
BOARD MEMBER LIST
JANUARY 3, 1994
Michael A. Lazar, President
Attorney At Law
Bank One Plaza
822 7th Street, Suite 300
Greeley, CO 80631
351-6930 (Home)
353-6700 (Work) Term: 6-30-95
Lori Johnson-Berke, Vice-President George Baxter
2605 34th Avenue Weld County Commissioner
Greeley, Colorado 80631 P.O. Box 758
659-1684 (Work) Term: 6-30-96 Greeley, Colorado 80632
356-4000 ext. 4200 (work) Term: 6-30-9(
Hazel J. Chick, Secretary
Homemaker/Retired Teacher Sally Harms
16470 Weld County Road 86 17486 Weld County Road 8
Ault, Colorado 80610 Brighton, Colorado 80601
834-2346 Term: 6-30-94 659-4949 (Home)
752-5800 (work) Term: 6-30-96
Dr . Robert P. Metz, Treasurer
UNC Assistant Vice President Carla Lujan
Student Affairs 1862 10th Avenue
2413 27th Avenue Court Greeley, Colorado Term: 6-30-95
Greeley, Colorado 80631 351-2161 (Home)
330-0251 (Home)
351-2303 (Work) Term: 6-30-94 Joy Keyser Pickar
P.O. Box 834
Kent L. Jackson, Past President Eaton, Colorado 80615
State Farm Insurance 454-3567 (Home)
3912 W. 21st Street Road 351-5150 (Work) Term: 6-30-96
Greeley, CO 80631
330-5174 (Home) Ron Wood, Chief of Police
351-5107 (Work) Term: 6-30-95 Greeley Police Department
919 7th Street
Rhoten A. Smith, Ph.D. Greeley, Colorado 80631
Retired 350-9660 (Work) Term: 6-30-96
3707 16th Street Road
Greeley, Colorado 80631 Gretchen Karst
330-3256 (Home) Term: 6-30-96 318 Pine
LaSalle, Colorado 80645
Alvina Derrera 284-5180 (Home) Term:
23569 Blake Street
Johnstown, Colorado 80534
587-4277 (Home)
353-9251 (Work) Term: 6-30-95
940-':93
LIFE-TIME MEMBERS
Maryellen Clifford
6302 North 73rd Street
Scottsdale, AZ 85250-5500
Cornelia Dietz
Director, Eldergarden
1713 Glen Meadows Drive
Greeley, Colorado 80631
Bernard C. Kinnick
2212 27th Avenue
Greeley, Colorado 80631
John Martin
147 South Denver Avenue
Ft. Lupton, Colorado 80621
857-2471 (Home)
857-4800 (Work)
Hazel J. Chick
16470 Weld County Road 86
Ault, Colorado 80610
834-2346 (Home)
Harry Ashley
9 10493
ISSUE OATE(MM/OD/1'Y)
mk4Hi ® CERTIFICATE OF INSURANCE �0l/20/94
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
PRODUCER & Peterson Insurance Inc CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE
Flood DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
P.O. Box 578 POLICIES BELOW.
Greeley, CO 80632 COMPANIES AFFORDING COVERAGE
I COMPANY A St . Paul Ins . Co .
LETTER
COMPANY B
LETTER
INSURED
Weld Mental Health COMPANY
Y C
1306 11th Avenue LETTER — —
Greeley, CO 80631 COMPANY
OM A Y D
ER
COMPANY E
LETTER
I
COVERAGES ".:
This IS TO CERTIFY THAT THE OF FOR THE POUCY INDICATED. NOTWITHSTANDING ANYPOUCIES REQUIREMENT.INSURANCE D BEEN TO INSURED
TERM SORCONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT PERIOD
RESPECT TO WHICH THIS
CERFICATE
SOTS AND MAY
BECO ISSUED OR
SUCH POLICIES.. UMITS SHOWN MAY
MAY PERTAIN. THE INSURANCE AFFORDED BEEN REDUCED BY THE POUCIES
PDDSCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
POLICY EFFECTIVE POLICY EXPIRATION( LIMITS
CO TYPE OF INSURANCE I POLICY NUMBER DATEIM M/D D/YVI DATEIM M/OD/YY) j
LTR
A GENERAL LIABILITY II FKO8300395 01/01/94 ' 01/01/95 GENERAL AGGREGATE IS 1, 000 , 000
PRODUCTS-COMP/OP AGG. S 1, 000 , 000
I X 'COMMERCIAL IMSMADE RAL
'PERSONAL&ADV.INJURY S 1 , 000 , 000
CLAIMS MADE FTC OCCURUR.I [EACH OCCURRENCE S 1, 000 , 000
(OWNER'S&CONTRACTOR'S PROT. FIRE DAMAGE(Any one lire) S 100 , 000
_ I MED.EXPENSE(My one Persaryl S 5, 000
01/01/94 11 01/01/95 COMBINED SINGLE $1, 000, 000
A iI AUTOMOBILE LIABILITY FKG8300395 LIMIT
' ANY AUTO
BODILY INJURY a
ALL OWNED AUTOS (Per Person)
X SCHEDULED AUTOS
BODILY INJURY S
x HIRED AUTOS (Per accident)
x NON-OWNED AUTOS
GARAGE LIABILITY PROPERTY DAMAGE S
n
(EACH OCCURRENCE S
I U jE%C REILIAY AGGREGATE S
Ill UMBRELLA FORM
1 I OTHER THAN UMBRELLA FOAM1 II I STATUTORY LIMITS
WORKER'S COMPENSATION 1 'EACH ACCIDENT S
AND ❑ISEASE.POLICY LIMIT S
EMPLOYERS'LIABILITY I DISEASE-EACH EMPLOYEE S
OTHER FKO8300395 01/01/94 (101/01/95 $15, 000/-0- ded.
A Employee
Dishonesty
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Certificate Holder is named as additional insured in regard to the
General Liability only - funding purposes .
CANCELLATION
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
State of Colorado MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Departmentt of Institutions LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR
3550 West Oxfgord Avenue , UABIIOF ANY KIND UPON THE M Y.Fs A S OR REPRESENTATNES.
Denver, CO 80236 UTHORIZEO AE ESENTAT %"
VRP 0 ACOIRD CORPORATION 1990
41--) a
DEPARTMENT OF SOCIAL SERVICES
P.O. 806
GREELEY,COLORADO 80632 Administration and Public Assistance(303)352-1551
Child Support(303)352-6933
C Protective and Youth Services(303)352-1923
Food 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: May 20, 1994
SUBJECT: Notification of Financial Assistance Award between the Family
Therapy Program of the Weld Mental Health Center and the Weld County
Department of Social Services
Enclosed for Board approval is a Notification of Financial Assistance Award
between the Family Therapy Program of the Weld Mental Health Center 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 $36,665.00
2. The period of the award is June 1, 1994, through May 31, 1995.
3. The Family Therapy Program of the Weld Mental Health Center will deliver
services for up to 24 weeks for up to 6 families per month. These
services will be provided 5 hours per week.
If you have any questions, please telephone me at extension 6200.
JAG:aas
940483
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