Loading...
HomeMy WebLinkAbout940482.tiff RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR PLACEMENT ALTERNATIVES COMMISSION FUNDS FOR WELD MENTAL HEALTH CENTER, HOME BASED OPTION B, 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, Home Based Option B, 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, Home Based Option B, 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. BOARD OF COUNTY COMMISSIONERS ATTEST: 4 WELD COUNTY, COLORADO Weld County Clerk to the Board / O12i2SA H. Webster /CChairman BY: � Deputy Clerk to the Board Da:77:2:11, P oiTem APPROVED AS TO FORM: t 4Geor aBaxter County Att nay Constance L. Harbert Barbara J. Kirk yer 940482 4c nOlR C C f,t.j L4,)/'-1,/-S ., Wel. county Department of Social Set .ces 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 Home Based Option B 1306 11th Avenue Greeley, CO 80631 Computation of Awards Monthly Program Capacity 4 Monthly Average Capacity 3 Unit of Service Description Up to 5 hours of services weekly will be delivered over the period of 4-6 weeks. The issuance of the Notification of Financial Assistance Award is based Cost Per Unit of Service upon your Request for Proposal (RFP) . The RFP specifies the scope of services Hourly Rate Per $ 26.43 and conditions of award. Except where Unit of Service it is in conflict with this NFAA in Based on Average which case the NFAA governs, the RFP Capacity upon which this award is based is an integral part of the action. Monthly Rate Per $ 584.00 Unit of Service Special conditions Based on Average Capacity 1) Reimbursement for the Unit of Service will be based on an hourly Total Yearly $21,722.76 rate per child or per family. Services Budget (Subject to the Availability of 2) The hourly rate will be paid for Federal and State Funds) only direct face to face contact with the child and/or family or as specified in the unit of cost computation. Enclosures: 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. Approvals: Program Official: Gilp BY ) /OM BY W. H. Webs er, Chairman 57 /qy A. G , rec r Board of Weld County Commissioners We Cou Depa en of So al Services Date: ..4/23/9.` Date: S/�VeN 940482 INVITATION TO BID DATE: January 7, 1994 RETURN BID TO: Pat Persichino Director of General Services BID NO: RFP-PAC-94004 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-94004) for: Family Preservation Program Deadline: February 22, 1994 , Tuesday, 10:00 a.m. The Placement Alternatives Commission, an advisory commission eld County grants Department of Social Services , announces that competing applications 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 3482 , 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 BID MUST BE SIGNED IN INK (After receipt of order) Dale F Petercnn MRW M'r1i TYPED 0 PRINTED �IGNAtU RE VENDOR Weld Mental Health Center, Tnc. - PO Q A-A--0- \ Handwritten Signature By Authorized Officer or Agent of Vender -CM TITLE Executive Director DATE -'2! -C / ADDRES51306 Eleventh Avenue PHONE on- 'z R Greeley, Cnlrcral° ZIP 80631 (3n )) 353 �fi_6 The above hid is subject to Terms and Conditions as attached hereto awl incorporated. 940482 RFP-PAC-94O04 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 Client Group(s) to he Served: Families with children_at_r sk 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 . 1994 End May 31 , 1905 Title of Project: Mobile Mental Health Team Amount Requested: X28.541 .00 Signatures: a 4)-0f cl Dan E. Dailey Date Name and Signature of Per n aring P posal „ , � 2 - 9 4 Dale F. Peterson Date Name and Signature of Chief Administrative Officer of Applicant Agency PROPOSED FAMILY PRESERVATION PROGRAM CATEGORY Please initial to indicate the bidder's chosen category (only one category per bid) Home Paged Intensive Family Intervention Option 1 X Home Based Intensive Family Intervention Option 2 Intensive Family Therapy Sexual Abuse Treatment Day Treatment Life Skills Individualized/Innovative Services 940482 RFP-PAC-94004 Attachment APage 2 of 2 TYPE OF PROJECT Continuing Project under Weld County PAC How many years? X New Project Proposed Program will eliminate the need for out of home placement Proposed Program will lower the cost of out of home placement Other: The Proposed Program willMANDATORY PROPOSAL REQUIREMENTS Please initial to indicate that the following required sections are included in this proposal : Statement of Need Population to be Served Program Requirements Types of Services Provided Provision of Services & Administrative Capability ) Past Performance Eig) Letters of Support (New Programs Only) Budget Program Evaluation and Continuation 940482 TABLE OF CONTENTS Table of Contents a Program Narraticc, 1 . Statement of Need 1 2. Population to be Served 1 3. Program Requirements 1 2 4. Tres of CO-.. nr, ;-; c. 9 . . . . . . . . . . . . . . . . . _ . . ? 5. Provision of Services and Administrative Capability 4. Past Performance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.4 7A. Letters of Support 4 8. Budget 4 9. Program Evaluation and Continuation 4 Attachments A. Cover page overleaf B. Program Requirements 5 — 10 C. Part Parf.rnanre na D. Evaluation Results na E. Hourly Unit Rate Cost Computation Sheet 11 - 12 F. Program Performance 13 G. County Placement Alternative Plan Final Budget Page 14 H. Budgc-t Fr,rn.+t 15 940482 • 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 con children and adolescents to its outpatient services in addition to continuing to work with those already colts. rjrthe ''hildren and ali,I---s"-n -. o-... .-d to t a crsp, an :fmatel 05% fit the C:,iaaado Nyi ;.r or . .n ..' F.,a'-tb rtlfn der i :.,n LI rtl:rbod by vi tu:, Jf the -verity and nature of their presenting problems, out-of-home placement, or a combination of these factors, The ➢9II estimates the youth population in need of mental health services in Weld County to be over 1500 in any given year. The Colorado State Department .'f Soc=at F'r`-io_._ reports that last year nearly 34,000 families, were fetveA by local departments of octal srvices. 'wproimatelv 54,0110 ntildr"n were provided cer Tres by those local departments, 80% in their own homes and 20% requiring placement in out-ef-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 (RCCF) . There were more than 1200 reports of abuse received by the WCDSS in the past year. Typical of other years, more than 110 Dependency and Neglect Petitions in Weld County were filed in response to these reports. There is a perennial :hostage of appropriate foster homes in which to place these children in need. Placement Alternative f'waeu''on ,1':t to r (' ;^t „ iio'-,t rilinuinz -tr't mv't' mahl: redefinitions of whom may have access to them. There are not _efficient feseuvre- for the children and their families in this county. The Mobile Mental Health Team (MMHT) , as proposed herein, is designed to deal directly and promptly with some of the most troubled of those families. 2. Population to be Served The following eligibility criteria must he met before MMHT 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 for 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 to protect the children from further harm in accordance with a safety plan: 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; e. There must he a manageable level of risk of harm to the targeted child(ren) ; and f. There is a reasonable possibility that services can bring about sufficient improvement in parental competency to allow the childlrenl to return home or to safely reside in the home. The following Fate ories of children And l,l ie¢rnnf5 (independent of age. gender, ethnicity) who meet SP26 guidelines will be served by the MMHT: 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 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 40 families will he served annually by the MMHT. Referrals will flow from individual caseworkers at WCDSS to a wCDSs n;nner 'isor them to Dan Dailey, MMRT director. The final decision as' to the appropriate level of men',al health services will he site by the W41HC. Program Requirements 'he overall coal ei the . vote_. if te -nahl-e tmMilie5 with children ,.r . -.k of out-of-home r 'ement or who already have children placed out of their homes to care for those chiljr,'n in a healthful manner in 940,182 • 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 40 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 (family preservation services) or ,eturn :oaths :roll etch "Tier to `h~• f rpil� rune= o1 t,.in three weeks of referral (reunification to _ r.l i iii parental Goal B. Improve overall functioning of tamilies via improved family cunfL c management . xmP competency, improved household management competency. and an improved ability to gain access to and use arwir_priate resourccc in "he community to nimble the families to appropriately care for their children in their own homes o❑ a In trrel i'a$15. Objective a. Sights five percent of families which receive either family preservation or reunification services through the MMHT will measure significantly lower on the risk assessment scales at time of termination of services. Objective b. At termination, six and 12 months after termination of MMHT services, 90% of the families 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 Objective d. Fewer than l0� of dischsa reed children will enter another PAC 'FPP) r.roirrs . Objective e. Fewer than 10% of the children served will he 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 families reeeiwing either `ieil preservation or reunification services will not have a substantiated incident of abuse or neglect 12 onth; of successful completion of services. 4. Types of Services Provided The WMHC will provide families with moderately intensive, home-based crisis intervention. mental health assessment and treatment, case management, and education services, modeled after a previous project of the CFSP also known as the Mobile Mental Health Team. The following principles guide the MMHT's approach; a. To intervene immediately; b. To provide brief and moderately 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 available 24 hours per day, seven days per week to provid screening, to eachclient evaluation and assessment, intervention. r;1 fnito•.-•in planning. to clients. Services, tailored specifically family, are offered on a short-term basis, focussing on those issues and problems precipitating the ciisi:; and on using the crisis to mobilize the youth and his or her family to develop new ways to cope and prevent further crises. Up to five hours of services weekly will be delivered over the period of involvement which ranges from four to six weeks. Services will be 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 WMHC believes that families deserve strong, effective support in attempting to learn productive ways to cone °,ith problems before the last resort of placement of children outride the home is jti toed 1.,, . . r ' ere t. They ire esi gel to n i ,tent with ti .. %r o�vl,a 'r{nT t :•t illy n culln tad t1 e i. "•n tf 1f ..e nord_. tl _ _ , 1 ' ..r . -t � Mini ., ,tucnl And 'pilot ai differences of rliw :ssidents f Well rbom" r t' . -i r: resulr baSi . 2 • 5. Provision of Services and Administrative Capability The WMEC 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 _I'iNT will be ic.e !all= Staffed b- n V-`-FTE masher ie.€'l ] ent ,l h'slth clinician 'chose training included inlersen'ion sod ' ,i i . sssrems ! Deers ;lie hay- at :ass throe years exprienre ocrlainfl with children, adolescents, and families and will have undergone special training in the philosophical And practical aspects of family preservation. The staff member will meet the minimum qualifications of a Colorado Department of Social Services Caseworker III. Overall administrative responsibility is assigned to Dan E. ParentBA. Dir,.r' L,r .:f the x550 whh has mere than 23 yars < NperiPnC,' in mental health treatment and administration. He reports directly to the Executive Director of the WMHC. At present, two programs are delivering in-home services to at risk families in Weld County. The Parent Advocate Program of Child Advocacy Resource and Education, Inc. (CARE) provides home-based life skills and educational services. The In-Home Intensive Services Team (IST) of the WMHC offers the more intensive and comprehensive treatment and case management services. The IST and the MMHT are further differentiated from the CARE program in their 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 As it is envisioned_ the '4MHT could he mace availshte to families who do not need the added intensi ti of the IST but who clearly need similar services if the family is to remain intact or a child is to he returned safely from placement. The MMHT will often be able to prepare clients for successful involvement in the services offered by CARE or more traditional outpatient treatment sources. Up until June, 1993, these throe service-Parent Advor ci..•, 1ST, •tp(Hm__,,efinod he continuum of hone based services aimed at families at risk of having a child placed out of the home. Two year funding for the earlier, pilot v rsion of the MMHT came from the Child and Adolescent Special Services Project administered in Colorado by the DMH. Despite meeting all its established goals. its funding was not renewed by DMH which reported no available funds for continuation of services. The advent of the Family Preservation Project legislation leads the way for renewal of the MMHT's efforts. 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 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 Lorton is staffed to serve riti ..ens 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 ever increasing demands for services to this target population and will enable the delivery of more intensive services. The increase will not have to come at the expense of other services within WMHC as would occur if we were to shift internal emphasis to accomplish the goals and objectives contained herein. The CFSP currently employs approximately I1FTE 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 vMHC has aocc egg fill'.' neera!,-d its 1ST for three years combining funding through the Colorado Trust and ths . oi.;l. n,. 'a, ' ,, I ,. r H ^d :o+ Thfonsonent 1':11 F1 Pr ITI of Weld Cron,'. fon,lnd for lace- Arc 'he h.-7,177 tr ..e r .log i' ',_ , , wear ,3A ulmit'' child AhlTe lm, . .ferred nlPatient ., of the he Pltt !w„ years, I_,ni'ed Way of 'cell (logo' ha ' f u.'di..-.l _"FTF mental health worker to assure that n , gals in the mental health care of abused rhild7,r. ourred .at the 440Jc2 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.OFTE 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 received to date accompany this document as Attachment XXX. 8. Budget ` cr The MMHT will require an annual operating budget of 528,54i Pei soi <.'per e . .'."oun 5_'0on, 71 .5% of the total budget which will provide for 0.75FTE Annual salary per FTE will be 4241,000, or 519.000. Fringe benefits are calcc;a t at 7 . _ alar . or 52.400 annually. The to oamop t= e! . b bud got s ,A ' annu=.1 y . or 2h, f rh' ,ldnri ,ti .r.,_ lon will amount to 486' (salary 7.0 plus 15% fringe benefits) annually. Clinics! supervision expense will be $1121. Professional Liability Insurance will cost 8563 annually. Psychiatric and psychciogical consultation, backup, and support services will cost $150 monthly ($1,800 annually) based on one hour of a psychiatrist's and a psychologist's time per month at hourly rates of $95 and $55, respectively. The therapist/case manager will travel an estimated 800 miles per month and will he reimbursed at the present WMHC rate of 5.21 per mile equalling $2,016 annually. Clinical and office supplies are calculated to match the current annual rate per FIE within WilMC of 51050, or 5787. including one digital pager (Si4.95/month) . Secretarial/bookkeeping/data r‘hisv support csperse oili s535 yearly. lr;ulxf d from rflats currentlybeing incurred for similar activities. Expenses for protect evaluation support of ^t.J annually ayittta- -nn f r 'nee with such services. Annual rent for office space for the worker, including telephone and utility expense, is Cased on current utilization rates amounting to $473 annually. 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 ICCAR) will be used to assess the levels of functioning of the individuals admitted to the MMHT. 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 MMHT 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 DMA research efforts. Other objectives will be assessed via monthly follow-up contacts with families. Observations by MMHT members and by other nriifossionru r 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 he sought as the WMHC believes the MMHT is designed to be definitive in terms of what PAC programs are required to provide. Some glientg of the project will he Medicaid eligible. Funding?for them through the "Rehab Option", which permits hilling Medicaid for other than cline based services. will be Pought although menherrd 'h, IHr .t,., 0e^rn Modi i7d t ma. :un aarh -en, and in • ffyct . it oust he i,., 1 , -'puni.h'-1 tin i! r ,�.i�.: that lip 1 r -...r . The MANG Jpirp.ich the gmq ihi. t.udget n.ynti iti,ins to switch a gubpanjial nor) i,n s he Penf of IhrJ PrPiect Le ' hat ant 4 940482 Attachment B Page 1 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT Title of Project! mobil_ Mental Health Team (MMR1'1 • _— Home Based Intensive Family Intervention `}r ,r • Oh!-1k- ! ; t -}•_. _ F 7 t `i.^h - Porte nA•."1 Tuk,egi%,0 r:A!11' ?nt:?rvt!nt I'm ceive either family preservation t)r reunt..ti_. ')Ption .. r'tinn g . v'ces will >e a u a y Intensive Family Therapy lra?� 2t1 ri<k asapss 'nt ir:des at LIAf. .z.. • _ Y Sexual Abuse Treatment T,- . tment PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PR'GRAM1 - Life Skills MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Individualized/Innovative Services Activity Person(s) Time Frame Pr_pnn ib11e flares - Initial :7.zes Inent of riimil} "!T - "ttment Staff P .L.'.:'![':..'l.lt Therapy. Case Management, Education, MMAT Treatment Staff Ongoing Crisi Int. r''ention Follow-up Assessments of Family M HT Treatment Staff At termination of services D,In Dailey BA Psychological/Psychiatric Consultation William Crabbe, PhD As needed Russ Johnson. MD Theron Sills, MD Clinical Supervision Dan Dailey, BA Ongoing Administrative Supervision Dan Dailey, BA Ongoing Attachment B Page 2 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT Title of Project: Mobillt_linfit Healt?LCCsI>a_ t1$T}__....._ -- Home Based Intensive Family Intervention oi!!•;,! - t ,t .. r,n i r,. termination 21_ ,.1fiT service. r.LQ.i. !1s families will remain intact, Intensive Family Therapy Se':ua l Abuse Tr.,a t ment Dar Treatment PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER FRr•'RAM) Life is j 1 l MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Indi';idualized/Innuvati•:e Se::ices Activity Person(s) Time Frame Re:Pensible __Dales I•r '9 T "'_' eent Stem Therapy, ::a:;�.' Nana�r..aent. Edur,�ct i t. S..H Crisis Intervention Psychological/Psychiatric Consu{tai,>n William (ratite, PhD as needed Russ Johnson, MD Theron Sills, MD Clinical Supervision Dan Dailey, BA ongoing Administrative Supervision Dan Dailey, BA ongoing Data Collection MMHT Treatment Staff At termination Dan Dailey, BA & again six and Neil Benson, PhD 12 months later 6 9404:F2 • Attachment B Page 3 of 6 • PROGRAM REQUIREMENTS TYPE OF PROJECT•Title ,i Prr..jeot.; Home Ras..d Intensive Family intervention it? ,. v a„r . R.,.. ,; ..., rr:aii . Tr.... :..ni• .n Option 2 t.erntinat s.Milies Intensive Family Therapy �tor tr reirar;np of M •R VrP.9 _� -- . Y_- SeN:;a1 Abuse Treatment Da r,climent t,tv Skills PROGRAM SPEJIFTC OBJECTIVES i`?i`.EMUM ''F THREE FER P:�nr.;(.",M' —___-- T Services MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE --- Individualized Innovative Person(s) Time Frame Activity n }Pe Re ;nenSihle ThcrYp; Case aan-tgnnen* r,l;.r:rttnn. MMRT tr.≥gtmen st :f f .prig,,'n,. Crisis Intervention • Psyrholo„ical/Fsy hial ric Consultation Wi l l i.,m PhP •:s needed Russ Johnson. '•1D Theron Sills. MD Clinical Supervision Dan Dailey. BA on,oins Administrative Supervision Dan Dailey. BA ongoing Data Collection MMBT Treatment Staff 12 months post successful completion Dan Dailey, BA Neil Benson. PhD 7 940482 Attachment B Page 4 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT It P } P t Pl (MMHT1 Home Based Intensive Family Intervention Title of Pre.'s'rt; MQb',e "i �_ 1 FI a�L�'—T J° _ .. '!i Tf1tf'11:i i Vn ".iiA:l: Y: .. :'i:t enter another P.C program after dischar '. Intensive Fami1} Therapy' from the MM1Q• Sexual Abuse Treatment Day Treatment llq PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PR CRAM) Life Sirluali:e�i!?nnovatire Service MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Person(s) Time Frame • Activity Dates i?esnnn�ik�l�� p Caze Maragelarnt , Edue3tion, DMMHT Treatment. Staff nw';i;lp Th_r��ry• ' Crisis Intervention • Nychologil :l/Psychiatric Consultation William Crabbe. PhD 4s needed • Russ Johnson. Mr • Theron Sills. MD Clinical Supervision Dan Dailey. BA Ongoing Administrative Supervision Dan Dailey, BA Ongoing Data Collection MMHT Treatment Staff At discharge, six and 12 months post services Dan Dailey, BA Neil Benson, PhD A 9404.-E2 • Attachment B Page 5 of 6 PROGRAM REQUIREMENTS • TYPE OF PROJECT + Tw IiTi Home Based Intensive Family Intervention Ti F t e of Project: _±1nbi]?M�nk31_��31.�b—3m - - -.ot' .. Ewrlt Int ens fni._. •:r.ri! he [n a mor' •'r•stly ni remen! :t` ad fewer than than l'3% will tie i f_' ch Intensive Family Therapy Sexual 'uuse Treatment _—.._ Day Treatmi-'nt PROGRAM SPECIFIC OBJECTIVES. (MINIMUM "F TRREE PER P!?('GRAM' Life Suitts MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Individualized/Irmo'° ive Service Activity Person(s) Time Frame Resrcnibl' Dntns Therapy, Cdse moment, Education. ;'vi:i7 ..••a►meut Staff On.i'iin:; Crisis Intervention Follow-up Assessments of Family MMHT Treatment Staff At termination and =i': months post- Dan Dailey, BA kcrsrirai icn Psychological/Psychiatric Consultation William Crabbe, PhD As needed Russ Johnson, MD Theron Sills, MD Clinical Supervision Dan Dailey, BA Ongoing dministrative Supervision Dan Dailey, BA Ongoing Data Collection MMHT Treatment Staff Six months post successful termination I!an'Dailey. BA Neil Benson, PhD C) Q 1111OO • Attachment B Page 6 of 6 • PROGRAM REQUIREMENTS TYPE OF PROJECT Title. of Project: �?b_l.Le..�1PG 1_�T?�l►h-T"km MEP Home Based Intensive Family Intervention r: F i.Tn 1 par:Po i:` .•si •_ �•r.' .n Services will not have a substantiated inci_ Option 3 ' dent of abuse or_. eglect within 12 months Intensive Family Therapy SeKuat Abuse Treatment Day Tiealmr•nl PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PROGRAM) ^.__ Life Skills • MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Individualized/Innovative S+:rvices Activity Person(s) Time Frame Respnnsihle notes __-- Therapy. Case Manag+rmefl►: . F1,✓:aticn. MI! .yea m. nt 1!14 Crisis Intervention Follow-up Assessments of Famili 1'IHT Treatment St.,ff .\t termination and 12 months post- Dan Dailey. BA termination Psychological/Psychiatric Consultation William Crabbe, PhD As needed Russ Johnson, MD Theron Sills, MD Clinical Supervision Dan Dailey, BA Ongoing • Administrative Supervision Dan Dailey, BA Ongoing Data Collection MMHT Treatment Staff Twelve months post successful termination Dan Dailey. BA Neil Benson, PhD 10 Q ?.7 PAC FUNDS Attachment E • Hourly Unit Rate Cost Page 1 of 2 Computation Sheet I. Program Name: Mobile Mental Health Team (MMHT) I J . :,g"c'.• Mane: Weld M.^'iL'1 TT• i }t ' ' tr. -- - III . The project's unit of service definition A. The project will provide what type of service to each client. Intensive. home-based crisis intte education r'ien ,smental ental health assessment anti nd treatment, case management, a 5.0 (maximum) B. This service will be provided for . 6 (maximum stay in the hours per week for up to program) weeks. IV. The hourly ranit. Rate is has'-d on: Check one A. An individual client who is aged through • • xx B. A family unit as described as follows: A child at his imminent risk of placement, his or her siblings residing at home, or her parents)/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 fog_IAI weeks. • Average hours per week in the program is five(5) . VI. Description of i n.i+ of scr.•ire rust 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 55% or $14.54 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 c.apaci ty is lt,rjt or $1 1 .89 per hour. C. Total hourly r.'tte pe- unit :,f s r';it'" based on cost (A+B+C) . S2h.43 D. Total proposed yearly budget for services s2 .14! .no 11 9404:82 RFP-PAC-94004 • Attachment E Page 2 of 2 VII. Unit of service rate computation 1 . Travel to & from client's home 2.OOhrs/week totals an average of Parer work. 'cio ,i b: Wold County Department of Social Services totals an average of 0. 10hrs/week Suprjrvioor r.eti1 tot-kc an average of _ O_25hrs/ . ek 4. Case management services of: a. making referrals to other services needed by clients; h. 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 ensuro the best interests of tha rli9ntaro served; and e. planning of services to best serve the client totals an average of n.75hrs/'leek 5. Court testimony required by Social Services totals an average of 0.O0hrs/week 6. Administrative costs total an 0.25hrs/week average of Please describe below: Program Director's time based on .025FTE at average capacity minus WCDSS report preparation time 7. Other costs total an average of 0.0 hrs/week P1l.,aso dncrrihn below: 8. Sub-total indirect costs 3.35hrs/week 9. Direct services to clients (Face to face contact) totals 4.15hrs/week an average of Total average hours of service to be provided per week — 7.5050 r ...h1 d _rot service? ta client? total 7fl a,, e •,F• S 1111'. 4P 55 tndirort icon to clients ti I an v razo u . . 17 9404: 32 • RFP-PAC-940O4 Attachment F Page 1 of 1 PROGRAM PERFORMANCE Program Name: Mobile Mental Health Team FYI993 - 1994 FY1994 - 1995 (Bl • T;lr:a" Perlornarr..' ii f•l .. :^rm:xr.r T%r•..t n.,i •.vi...0 06/Ot/93 to O5!31/9A 0A/01/93 to Ot/28/9_ O6101/94 to `1".'?11q~ 1. Avz. number of children 2. Avg. number of months in program for children who have been discharged na na 1 3. Avg. cost per month per child —- — —� -- — _..._ _--._� __._.TEL _-- ----- S 4 4. of children at home or less restrictive setting 4t discharge na na 90 5. % of children at home or less restrictive setting 6 P n1 —._na _--_ 85 — m t a r�isr_ha[&-`—_,------ �_—.____-- 6. Avg. savings of alternative vs. projected placement na na 41.276 tfoster care) 7. Avg. % of treatment goal met per child discharged na na 85 8. a of children who entered another PAC Program after • 9. a 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 15 9404.92 Attachment G COUNTY PLACEMENT ALTERNATIVES PLAN FINAL BUDGET PAGE FY 1994 - 1995 (1) (2) (3) (4) (5) PROGRAM FAMILY FOSTER OTHER TOTAL NAME PRESERVATION CARE. FUNDS PROGRAM PROGRAM PEOUESTED PROVIDED r i.,ND S FOR PPO.1rOT FOP ppn TECT REQUESTED Mobile Mental Health $28,541 .00 $28,541 .00 Team (MMHT) TOTALS $28,541 .00 $28,541 .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 MMHT as well as to track any revenues generated from other sources. Accounts for each revenue source will he maintained separately. The WMHC is independently audited annually. 14 AR(9,1'5X'7. Attachment H Page 1 of 1 BUDGET FORMAT A. DIRECT COSTS S18.000 Staff salaries Ct. ff Fry ^_' 1-,enef;t 2.40() • Subtotal S2C.400 • B. INDIRECT COSTS S 750 Director salary Director fringe benefits 1 ,121 Clinical supervision 563 Professional liability insurance 1 ,800 Psychiatric/Psychological services/consultation Travel 2,016787 Clinical and office supplies Support staff 338 ,80 Project evaluation Pent/Utilities/Phone Subtotal $ 8, 141 Total $28,541 • • 1 , 940 R2 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 • George Baxter 34th 2605 34th Avenue Lori Johnson-Berke, Vice President Weld County Commissioner P.O. Box 758 O. B Colorado 80632 Greeley, Colorado 80631 P. 659-1684 (work) Term: 6-30-96 Gr356-4000 ext. 4200 (Work) Term: 6-30-9( Hazel J. Chick, Secretary Sally Harms Homemaker/Retired Teacher weld17486 County Colorado Road 80601 8 Ault, Colorado 80610 Brighton, 834-2346 Term: 6-30-94 659-4949 (Home) 752-5800 (Work) Term: 6-30-96 Dr . Robert P. Merz, 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 940482 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 940482 ISSUE DATE AO411:11k CERTIFICATE OF INSURANCE o/94(MM/DD/YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND PRFlood & Peterson Insurance Inc CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE lOdDOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P.O. Box 578 POLICIES BELOW. Greeley, CO 80632 COMPANIES AFFORDING COVERAGE COMPANY St . Paul Ins . Co. LETTER COMPANY B LETTER INSURED Weld Mental Health COMPANY C E TER 1306 11th Avenue Greeley, CO 80631 COMPANY D LETTER COMPANY E LETTER COVERAGES - -THIS IS TO CERTIFY THAT THE OF INDICATED,INDICATED, NOTWITHSTAND NG ANYCIESREQUIREME _NT, TERM CE SORDCONDmON OF ANY CONTRACT OR OTHER BELOW HAVE BEEN ISSUED TO THE RDOCUMENT WITH RE PECT TO WHICH THE POUCY PERIOD CEFICATE MAY CERTUSIOTE AND BE ISSUEDSUCH POLICIES.OR ELI INSURANCE SHOWN AFFORDED BY THE MAY HAVE BEEN POU PBYOUCIES PDESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, I CO TYPE OF INSURANCE POLICY NUM BER IPDAT(MM/DDT( 'PDATE(MM/DOT I LIMITS LTR AI GENERAL LIABILITY FKO8300395 01/01/94 01/01/95 (GENERAL AGGREGATE $ 1, 000 , 00 I jPR000CT5-COMP/OP AGO. S 1, 000 , 000 X OMMERCIAL GENERAL LIABILITY PERSONAL&ADV.INJURY !$ 1 , 000 , 000 LS&C NTR T 'SO PROTICUR I 1 EACH OCCURRENCE S 1 , 000 , 000 WNER'SBCONTRACTOR'S PROT.I I FIRE DAMAGE(Any one fire) $ 100 , 000 I I MEO.E PENSE(MY one person)] S 5 , 000 ii I01 01 94 01/01/95 COMBINED SINGLE 51, 000 , 000 A IAu7oMoeaEungary FKO8300395 / / LIMIT ANY AUTO BODILY INJURY S ALL OWNED AUTOS (Per person) X SCHEDULEDAUTOS Per per on) S X HIRED AUTOS BO(Per DILY INJURY X NON-OWNED AUTOS GARAGE LIABILITY— PROPERTY DAMAGE S EACH OCCURRENCE S EXCESS LIABILITY AGGREGATE 5 UMBRELLA FORM OTHER THAN UMBRELLA FORMI STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT S AND DISEASE-POLICY LIMIT $ EMPLOYERS'LIABILITY III DISEASE-EACH EMPLOYEE S OTHER FKO8300395 01/01/94101/01/951 $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 OATE 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 OBLIGATION OR UABI�Y`OF ANY KIND UPON THE M- NY,FS A .S OR REPRESENTATNES. 3550 West Oxfgord Avenue UTHORI2EO AE ESENTATI Denver, CO 80236 940482 VP p O ACOAID CORPORATION 1990 a - DEPARTMENT OF SOCIAL SERVICES P.O. BOX GREELEY,COLORADO 80632 ig Administration and Public Assistance(303)352-1551 Child Support(303)352-6933 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 DATE: May 20, 1994 SUBJECT: Notification of Financial Assistance Award between Home Based Program Option B of Weld Mental Health Center and the Weld County Department of Social Services Enclosed for Board approval is a Notification of Financial Assistance Award between Home Based Program Option B 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 $21,722.76 2. The period of the award is June 1, 1994, through May 31, 1995. 3. The Home Based Program Option B of Weld Mental Health Center will provide up to 5 hours of services to families weekly for a period of 4-6 weeks. If you have any questions, please telephone me at extension 6200. JAG:aas 940482 Hello