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Home My WebLink About940481.tiff RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR PLACEMENT ALTERNATIVES COMMISSION FUNDS FOR WELD MENTAL HEALTH CENTER, HOME BASED OPTION A, 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 A, 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 A, 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: MBOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO {o _ et ilz9 /I Weld County Clerk to the Boar t H. Webster Cha rman BY: 4yCSe. B old Da a all, r/o tm APPROV AS TO FORM: r 'il,,� 4 eo a Baxter County Atto ney onstance L. Harbert i(hid _., / �.(/l� arbaraa J. Kir me r 940481 <Sfl/l/GZ Ct i .`-`..s ; 112P-°fr e_ Welt ounty Department of Social Ser. :es Notification of Financial Assistance Award for Placement Alternatives Commission (PAC) Funds Type of Action Contract Award No. X Initial Award FY92-PAC-5OO (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 A 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 $ 25.20 action. Unit of Service Based on Average Special conditions Capacity 1) Reimbursement for the Unit of Monthly Rate Per $1,649.00 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 $72,562.00 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 the hourly, Enclosures: costper monthly, and childand/orfamily. Signed RFP 4) Rates will only be paid on approved and open cases with the Department of Social Services. Approvals �j��/� Program Official: {�� By J4/4 2`-" N By 4*bster, Chairman J-2 /gy Ju . Griego, Q4° Board of Weld County Commissioners Wel ounlj Depaenf x/'2-0 Soc 1 Services Date: S / /q11 Date: 940481 INVITATION TO BID DATE: January 7, 1994 RETURN BID TO: Pat Persichino Director of BID NO: RFP-PAC-94004 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-94OO4) 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 5482,431.00. 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 TYPED OR INTED IGN URE VENDOR Weld Mental Health Center, Tne n9, 3 P.9.A A-@+'\ Handwritten Signature By Authorized Officer or Agent of Vender t/ ADDRESS1g06 Eleventh Avenue TITLE Executive Director DATE 2 - 2 1 - GrAaloy, rnlnradn ZIP 8n631 PHONE 11 (303) 353 3186 The above bid is subject to Terms and Conditions as attached hereto and incorporated. 940481 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 Client Group(s) to be Served: Families with children at risk ofout-of-home pjacement 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 . 1995 Title of Project: In-Home Intensive Services Team Amount Requested: $72,562.00 Signatures: c,60/iti Dan E. Dailey Name and Signature of Pe Preparing groposal Date Dale F. Peterson fig I --?c( 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) X Home Based Intensive Family Intervention Option 1 Home Based Intensive Family Intervention Option 2 Intensive Family Therapy Sexual Abuse Treatment Day Treatment _ Life Skills Individualized/Innovative Services 940481 RFP-PAC-94004 Attachment A Page 2 of 2 TYPE OF PROJECT X Continuing Project under Weld County PAC How many years? 2.5 Now Project X 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 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 16) Program Requirements 4'C Types of Services Provided CProvision of Services & Administrative Capability SOPast Performance ">40 Evaluation Results Budget 14) Program Evaluation and Continuation 940481 • 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 Th?quirements 4. Types of Services Provided 2 3 5. Provision of Services and Administrative Capability 3 6. Past Performance 3 7B. Evaluation Results 3 S. Budget 4 9. Program Evaluation and Continuation 4 Attachments A. Cover page overleaf F 1 B. Program Requirements _ n C. Past Performance 11 - 15 D. Evaluation Results 16 - 19 E. Hourly Unit Rate Cost Computation Sheet 20 - 21 F. Program Performance 22 G. County Placement Alternative Plan Final Budget Page 23 H. Budget FormaE a 940481 • 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 ed emotionallythe disturbedbyvirtuethe severity CFS9 % fit Colorado ado Division of Mental Health (DMH) definition of severely nature of their presenting problems, nut-of-home placement, or a combination of these factors. The DMA est matos the Youth pi_uittion in need of mental health ervicos in weld County to be over 1500 in any 'ea =ear. The In-Home Intensive Services Team STI is designed to deal directly and promptly with the mrrl troubled of those families. This proposal seeks to maintain the current level of services available through the 1ST. 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, HOe in their own homes and 20% requiring placement in out-of-home care, In the previous fiscal sear. accnrain€, 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. 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 ouestionable redefinitions of whom may have access to them, There are not sufficient resources for the children and their families in this county. 2. Population to be Served The following eligibility criteria must be met before 1ST 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 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 be 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 child(renl to return home or to safely reside in the home. 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 40' families will be served annually. Referrals will flow from individual caseworkers at WCDSS to Rosi Anson, Supervisor of the Ongoing Child Protection Team there to Dan Dailey, 1ST director, The final decision as to the appropriate level of mental health services will be made by the WMRC. 1 9404181 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 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 to return youths from such facilities to their family homes within three weeks of referral Irunificatioe Goal es Goal B. Improve overall functioning of families via improved family conflict management, improved parental competency, improved household management competency, and an improved ability to gain access to and use appropriate resources in the community to enable the families to 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 1ST 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 1ST 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 er:ices. 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 WMRC provides families with intensive, home-based crisis intervention, mental health assessment and treatment, case management, and education services, modeled after the nationally known Romebuilders program. The following principles guide the IST'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 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 WMRC 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. 940481 The services provided by 1ST are culturally sensitive and competent. They are designed to be consistent with the culture and belief systems of the client families. Training to educate and sensitize staff 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 WMHC is a private, non-Profit corporation governed by a hoard of directors, currently chaired by Michael !.Azar- fl is licensed by 'lie 'tae of Colorado ,., a comprehensive community mental health center serving e11 of Weil County. The WMHC ear been in s'Astence .ince 1962. beneming 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 1ST is staffed Au two masters level mental health clinicians 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. Each member of the team will meet the minimum qualifications of a Colorado Department of Social Services Caseworker III. 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) also provide hnme-.rsed services further defining the continuum of care the families of Weld County deserve. The 1ST, 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. 6. Past Performance The WMAC 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 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 5/1/93 through 2/21/94, this project is meeting ail objectives set forth in its ^rant request. Twenty-six families have been served, with 91% completing their treatment plans (three are currently receiving 1ST services.) Four of the five families served by the 1ST 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 Ievels. 7B. Evaluation Results The 1ST ha::: met all of it; pro ba_t and cost effect i, .n-ss mrh_ome object ices, .attachment n .lrr.,i Is these ret:,rl' . 3 940461 8. Budget The IST requires an annual operating budget of $72,562 up from 572,408.13 last year due largely to increases in travel expenses based on previous years' experiences. Administrative and supervisory overhead is reduced however. Personnel expenses account for 555,200, or 76.1% of the total budget which will provide for 2.00 full-time equivalents (FTE). Each therapist/case manager will be paid $24,000 annually. Fringe benefits are calculated at 15% of salaries, or $7,200 annually. The non-personnel portion of the budget is $17,362 annually, which is 23.9% of the total. Each of the two therapist/case managers will travel an estimated 800 miles per month and will be reimbursed at the present WMHC rate of 5.21 per mile equalling 54,032 annually. Pent for office space for the workers and supervisors '.ill not exceed 5 per month, calculated from current expenditures. Telephone e,<pense of ≤233 monthly is .i_ul ted from current e'cbenies of the CC'; ,vpen:r of S17 anntb7y lo based i current �ti Lzati an rates. Clinical and office supplies are calculated to match the current monthly rates within WMHC of $175. including one tone leased pager for each clinical worker (S14.95/pager/month) . Professional Liability Insurance will cost $62.50 per month per FTE, or S1500 annually. Secretarial/bookkeeping/data entry support expense will be $37.50 per FTC per month or $900 yearly, cal en kited, from -:oats current]:; being incurred for similar activities. Expenses for project evaluation support of $40 monthly (8480 annually) are derived from current experience with such services on a per FTE basis. Psychiatric and psychological backup and support costs of S150 monthly is based on one hour each of a psychiatrist's and psychologist's time per month at hourly rates of 595 and 555, respectively. 9. Program Evaluation and Continuation The evaluation of this project will be focused on the degree to which its maior 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 1ST 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 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 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 N'lHC is committed Lu 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 IST is definitive in terms of what PAC programs are required to provide. 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 WMBC 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 t0 that entity. 4f(ldlR1 Attachment B Page 1 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT Title of Project: In-$ore Intensive Services Team __X__ Home Based Intensive Family Intervention Option 1 Objective 1 : Fiehty-fib=o._eercant of ffteiliee whi-h r'-- Home Based intensive Family Intervention . . 'jpi`i- Option •• 'cn_jfisa:a _ Tntettei .•r: Fam11•- Therapy lower do risk assessment scales at tige_lf Sexual Abuse Treatment successful termination of services, Day Treatment PROGRAM SPECIFIC OBJECTIVES (MINIMUM OF THREE PER PR(`np m) I•i fe :MUST BE RELATED TO CLIENT OUTCOME PERFORMANCE Iriti:•i'lualized/Innuti'ative Service 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 of services Dan 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 q flL R1 Attachment B Page 2 of 6 • PROGRAM REQUIREMENTS TYPE OF PROJECT Title of Project: In-Home Intensive Services Team __I__ Rome Based Intensive Family Intervention Option 1 Objective 2' It_l;P,tAi_nation, six acnd._12 months aft.eX. Home Based Intensive Family Intervention 'erminatioT .f '�';' ,;ar`.�i: ..��!4[. IYri Orti.'n 'UA.rL_S,1.?.�r�231�nk�rt. ?nten5l'.'e Family Tlt:•*:ors• Sexual Abuse Treataent Day Treatment PROGRAM SPECIFIC OBJECTIVES !MINIMUM OF THREE PER PROGRAM) _ Life Skills MUST BP 3sLATFD Tn +;LIEYT OiTCO'W PERFORMANCE ?ndividualiz.ed/Innovative Services Activity Person(s) Time Frame Responsible Dates T1erary, Case Management, Education, IST Treatment Staff ongoing frills Tntervention 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 IST Treatment Staff At termination Dan Dailey, BA & again six and Neil Benson, PhD 12 months later 940481 • Attachment B Page 3 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT Title of Project: In-Home Intensive Services Team _$_ Home Based Intensive Family Intervention Option 1 nbj^ctive ;; 5nventy five mrr_enf,_nf the successfully Rome Based Intensive Family Intervention r• rmin112.1 ft;d'1_'s wit 1_e in�i'!__._Pz:i�1'� )pti.,n .'. •?i`i,t_ !t;rM,_�yal i•)ti^t..�,L_'f_�''�i':? ,—_ Intensi.•e Family Thyrayy Sexual Abuse Treatment Day Treatment PROGRAM SPECIFIC OBJECTIVES i MINIMUM OF THREE PER PROGRA`' _. Life Skills OUST BF vFLdTED TO CLIENT ''UTCOMF PERFORMANCE Individualized/Innovative Service!: Activity Person(s) Time Frame Responsible Dates Tluer::py, 17j 3P Management, Fdu:.atica. IST treatment staff on"oin' Irt•rr•ention Psychological/Psychiatric Consultation William Crabbe. PhD as needed Russ Johnson, MD Theron Clinical Supervision Dan Dailey. BA ongoing Administrative Supervision Dan Dailey. BA ongoing Data Collection 1ST Treatment Staff 12 months post successful completion Dan Dailey, BA Neil Benson, PhD • Attachment B Page 4 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT t P.:.in,.; L^` „ r lrt More, Pied Int.ni e Family i1t4:•.,-ritt'ir1 Objective 4: Fewer than lob of discharged children will Home Based Intensive Family Intervention erter a t r_P. QTszsr'am after di. cbarr�e Option 2 `_L'ATthe ISM__ .,_-- Intensi va Family Therapy Sexual AL,rse 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 Therapy, Case Management, Education. IST Treatment Staff Ongoing Crisis Intervention Psychological/Psychiatric Consultation William Crabbe. PhD As needed Russ Johnson. MD Theron Sills, ID Clinical Supervision Dan Dailey, BA Ongoing Administrative Supervision Dan Dailey. BA Ongoing Data Collection 1ST Treatment Staff At discharge, six and 12 months post services Dan Dailey, BA Neil Benson, PhD 8 940481 • Attachment B Page 5 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT 1, Ti. :e r.r Pr7h'rl . 792:11(12.L-L_—°' l",> ILL" ' r' VI_ .Tort: n.:li . .. Tri;: n:jvo Family Irltr-.t`.'en: ion ')nt i+)n Objective 5: Fewer than lO% of the children served will Home Based Intensive Family Intervention be in a more costly placement at discharge Option 2 Ind fPwgr_thai' than IT; wil _Le 'i ��U�]] ---- Intensive Family TiteriPY. placements Ri`: months after +li SC3a1r?r _-- •exiu,l ',lius' Trea:..wn` 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 Re:,ponzihle Dale.* Therapy, -- - Therapy, Case Management, Education, 1ST Treatment Staff Ongoing Crisis Intervention Follow-up Assessments of Family IST Treatment Staff At termination and six months post- Dan Dailey, RA 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 Colltctivn 1ST Treatment Staff ;i; months po:;L :;ucaessfu! 1 tl aina'in Dan Dailey, BA Neil Benson, PhD 9 940481 • Attachment B Page 6 of 6 PROGRAM REQUIREMENTS TYPE OF PROJECT Title of r;,i�c!: ,_; _(jum .. °3i_ inn C�'1�-1� r"_t a_ _1— Home Ba.;al Itttenriv Inler,:on'icr Option I Objective 5: Eighty oArrpnt of families receiving IST Home Based Intensive Family Intervention services .1ill_,20 Y_A bstantiztg_L1J'lsi. Option 2 dent of Ahn0 or n�R art .ithiji_u_Dig.ri l" -- Intensive Family Tl, raPv n r v, r�5• _-_ Sexual .\bu:>e Treal.u„-nt ,! 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 aeespopsiblD Dates Therapy. Case Management, Education, IST Treatment Staff Ongoing Crisis Intervention Follow-up Assessments of Family IST Treatment Staff At termination and 12 months post- Dan Dailey, PA 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 1ST Treatment Staff Twelve months post successful termination Dan Dailey, BA Neil Benson. PhD 10 940481 • Attachment C Page 1 of 5 PAST PERFORMANCE Program N.ime: In tens'. Servi,-es Team .\ enc. Time: Weld Mental Health 1 . Objective 1 Target Performance=" Progress to meet. (Outline the objective) objectives as of 2/28/94 Reduce aggression/violence 90% 100% of families com- pleting program re- ported improvement Please comment ,`ft perfr'.rnai',t=:-. If actual performance i.c not meeting target performance, the potential contractor must describe reasons for deficient performance and describe how the program will meet its planned performance by 5/31/94. IST is on target. All families completing services for whom violence and aggression were problems reported significant reductions in the amount of violent and aggressive behaviors used within the home and outside the family environment. • • 11 • 940481 Attachment C Page 2 of 5 PAST PERFORMANCE Prog Name ft,tens Cervices Team _ Agency „e: Weld Mort7,a Health renter 1 . Objective 2 Target Performance* Progress to meet (Outline the objective) objectives as of 2/28/94 Families will remain intact 85% Of the families com— pleting services, 85% remained intact or were reunited 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 5/31/94. IST is on target with 85% of families seen to date intact either by having avoided out-of-home placement or via the return of a child to the family who was placed out of the home at time of referral . In two of those families which are not intact after termination of services, it is deemed to be in the best interests of those • children not in the home to have been placed out of the family home. 12 • 940481 • Attachment C Page 3 of 5 PAST PERFORMANCE Program Name: Intensivn Ser• ices Team _. Agency Name: Weld Mental Health Center___ 1 . Objective 3 Target Performa.nce,; Progress to meet (Outline the objective) objectives as of 2/28/94 Families to remain intact 75% 92% of families which one year post services successfully completed services are intact one year post 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 5/31/94. 1ST is on target. Target is being exceeded at this point by a good margin. • • • 13 9104: 1 Attachment C Page 4 of 5 PAST PERFORMANCE Program `:are: Intensive, Services Team -_- Qgenc Name: Well iental Health Center 1 . Objective 4 Target Performance* Progress to meet objectives as of (Outline the objective) • 2/28/94 10% Nine percent of families Limited o of families will completing IST services move to pher PAC programs required additional ser- vicer completing IST see vices from other PAC vices programs 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 5/31/94. IST is on target here. This outcome is somewhat difficult to assess due to a variety of issues such as confidentiality. It is not necessarily negative, either, in our viewpoint that families might move from one provider to another. • • 14 940481 Attachment C Page 5 of 5 PAST PERFORMANCE Program 'fame: Int ens_ve Services Team A,^Son,7.Y Name: Weld -len}_n 1 Hi?c9 1 th ('?n er 1 . Objective S Target Performance* Progress to meet (Outline the objective) objectives as of 2/28/94 Avoiding more costly placements 10% at discharge, 15% Nine percent of target six months after children were in more costly placements at discharge and at six months post-discharge Please comment on performance. If actual performance is not meeting target performance. the potential contractor must describe reasons for deficient performance and describe hcw the program will meet its planned performance by 5/31/94. 1ST is on target. It is interesting to note our belief that the children represented in this statistic are appropriately placed in these more costly facilities, that the IST assisted in determining the inadequacy of the families to effectively deal with these children. 15 940481 Attachment D Page 1 of 4 EVALUATION RESULTS (Continuing Projects ONLY) I . Title of Project: In-Home Intensive Services Team TT . How many years has the Project been funded by PAC? 2.5 _ 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 PY1993-1994 period of June 1 , 1993 through May 31 , 1994) . from RFP-PAC-93003 by WMHC: "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. 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 positivechanges 16 Qn nl o4 Attachment D Page 2 of 4 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 coerdin,ted with our, ?nt II research efforts . Other objectives will be assessed via monthly follow-up contacts with families. Observations by 1ST 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 WNHC 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 nut of home placement or lowering the cost of out of home placement) . The 1ST was successful in meeting its cost effectiveness projections. Services were •delivered slightly under the projected $1595 figure. All families successfully completing 1ST services were intact at termination of those services; 90.5% were intact three months post termination; more than 85% of those families who completed 1ST services at least one year ago also remain intact. Clearly, 1ST 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 6/1/93 through 2/28/94, this project is meeting all objectives set forth in its grant request. Thirty-three families have been served, with 84% completing their treatment plans (two are currently receiving 1ST services.) Of the other families completing services: 85% remained intact at termination; 90% remained intact at three months after termination; 92% accepted referrals for ongoing services from CFSP or another agency; 100% 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: • For the entire fiscal 1993-94 fiscal year. this project will likely not serve the number of families originally intended. This is due to the resignation of one of the workers in late 1993 and subsequent difficulties finding an adequate replacement for her. 17 9404131 • Attachment D Page 3 of 4 V' . What significant r linements have the agency undeftak2n to imrrove its :-valuation sx•stea The WMHC is still struggling to fully evaluate the data gained from this project. All data gathered to late has been evaluated by hand with minimal computer assistance as yet. We plan to experiment with a variety of rating scales over the coming fiscal year to enable us to more fully and adequately assess the impact of IST services. 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 tracic IST results longitudinally detailing participant outcomes and the cost efficiency of the project. 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. We are encouraged by being able to slightly reduce costs per family served in this proposal . The project continues to demonstrate its ability to effectively reduce the need for out-of-home placement for a wide variety of families and to do so in a cost effective manner. IST services continue to be delivered at a rate less than would typically be required to place a child in foster care. An added benefit to the IST is its accomplishments in terms of diverting children other than the targeted child in each home from out-of-home placement as well. B. Program Outcomes: The WMHC continues to demonstrate the effectiveness of the IST in positively responding to families in crisis, assisting them to maintain the physical integrity and regain the emotional integrity necessary to continuing to function as a family. The WMHC 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. 18 940481 • Attachment D Page 4 of 4 VIII. Describe the program deficiencies identified i the Bidder's evaluation system and describe how these deficiencies were corrected nr being solved. Identify Program deficiencies that were unable to be corrected. The WP1HC 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. No complaints have been received by the project director or his superiors from any source have been received to date. The WIIHC is committed to working through any difficulties others may have with the IST. 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 WMHC. The WMHC's annual performance audit examined the IST's operations, passing them without comment. 19 PAC FUNDS Attachment E Hourly Unit Rate Cost Page 1 of 2 Computation Sheet I. Program Name: In-Home Intensive Services Team (TST 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 20.0 (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 40 . 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 twenty (20) , 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 55% or $13.86 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 45% or 511 .34 per hour. C. Total hourly rate per unit of service based on average cost (A+B+C) . $25.20 D. Total proposed yearly budget for services $72,562.00 20 940481 Attachment E RF1? PAC 94004 Page 2 of 2 VII . Pnit of service rate computation 2. Paper work required by Weld r]: tn' '- Dera•-hr.l.,nt of Social 3. Supervisor meetings totals n hrs/�.aeek an average of 4 , Case management services ot. a.. making referrals to other sec ices needed by clients: t � ,�.g, �� l *I f to. ,n;,:re elionts obtain and benefit from I 1.1 r -r rc j: ._t agencies: d advocacy to ensure the best interests of the client are e. planning of rvices to best _ he choir' 1 hr= ' .>�l totals an average of 9. Court testimony required by Social 0. 1 hr.s/week Services totals an average of 6. Administrative costs total an 1 .0 hrs/week average of Please describe below: Program Director' s time based on .O FTF at average capacity minus WCDSS report preparation time 7. Other costs total an average of 0.0 hrsjweei o : Pleas° Pscrihe below: 8. Sub—total indirect costs 9.0 hrs/week 9. Direct services to clients !Face to face contact) totals l _O hrs/w°Pk an a, _,rag„ of Tot h me .)f ne n c-ci � I l -c - �� r 'ir 21 9 Q.r Prif Attachment F RFP-PAC-94004 Page 1 of 1 PROGRAM PERFORMANCE Program Name: -;1_.'..,„,. In - . . (Ai ar,t,: l Perfnrmarre TIr et PertvrmJr. .t Target PNrforq:+n�.r'. r-.�„ •ter, iN,. i vr. n'../r!‘„:?.' . _ . . .. 4 3.61 • Avg. number of childr••n _. _ Served U.ST mnflttL _.._----•�- .._..—. 1 1 1 2. Avg. number of months in program for children who __._.. .-- .,. 85 90 ": ,f .-: ldren at ',tulip or 95 les re tr i,_t:'.e i t in:: .`._----.._- ._. ._.. - o: children .it home or less restrictive setting 6 ___...- --•--- - -- - - --_� _after discharge -- - —�-- - S 3805 (RCCF) $ 3805 IRCCFI $ 3500 (R:(;F} 6. Avg. savings of $ 265 (Foster) S 211 tF�ster+ S 265 (Foster) alternative vs. projected __•— _. _, nlacem w Avg,, "Z nt t.ratment ,:oa1 45 _ met nrL child di,,chatgad — — y. % of children who cuteted In another PAC Program after — __ _ _— 9 10 9. Z of children who are in 10 more costly placement at di Ss,h3ree . q 1 :O. : of 7hilctren who are in 10 more rustl. pl:u:ement A 22 Attachment or COUNTY PLACEMENT ALTERNATIVES PLAN FINAL BUDGET PAGE FY 1994 i,795 (4) 1-F "t UPES F':AT11N CAPE FUNDS "L ToelG `." h,rnlrStvn PROVIDED --- ------- X7'1, 552.00 1n-dome Intensive 372,562.00 fir' 1neC moan (T3T', wry TOTALS How will PAC money be accounted for separately from other agency money? Scott Wong, Business `tanager of WMHC, will set up separate cost centers for the funds used to operate the 1ST as well as to track any revenues generated from thor senrces . Accounts for each revenue source will be maintained separately . , err i irdrper U nil rcTh H-1 ciluall� Attachment H Page 1 of 1 BUDGET FORMAT A. Sta`f salaries 7 .20} } ? c cZ-i��no 1: 'lt'fit!i t.� . �_ti 0 . 200 E. INDIRECT COST 2.0.710Dirotor salary '-0}? Director fringe benefits ? "ni) Clinical supervision 1 .990) nrof'.,csiOnai liability insurance } o }1 `;.syohiatric/Psychological services/consultation Sur port staff E•: : Prr.jert csvalua.t.i.on 1 ,� „ Rc.r.tirtilitiPc Thine:' F1l . ' Total $72. 9i 24 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) 353-6703 (Work ) Term: 6-30-95 George Baxter Lori 34t venrke, Vice President Weld County Commissioner 2605 34th Avenuue P.O. 758 Greeley, Colorado 80631 2.0. Box Colorado 80632 659-1684 (Work) Term: 6-30-96 Gree356-4000 ext. 4200 (Work) Tdrm: 6-30-9E Hazel J . Chick, Secretary Sally Harms Homemaker/Retired Teacher 17486 Hard County Road 8 Ault,16470 Weld o County o80610 Road 86 Brighton, Colorado 80601 Colorado 834-2346 Term: 6-30-94 659-4949 (Home) 752-5800 (Work) Term: 6-30 -96 Dr . Robert P. Herz, 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 o7 (Home)ord80615 State Farm Insurance 3912 W. 21st Street Road 351-5150 (Work) Term: 6-30-96 Greeley, CO 80621 330-5:74 (Home ) Ron Wood, Chief of Police 351-5107 (Work) Term: 6-30-95 Greeley Police Departmen . 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 Alvira Derrera 284-5180 (Home) Term: 2356 Blake Street Johnstown, Colorado 80534 587-4277 (Home ) 3`3-3251 (Work ) Term: 6-30-95 940-7F1 ' 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 9I04901. DATE(MM/❑D/YY) CERTIFICATE OF INSURANCE ISSUE 94 AtoOltIk THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Flood CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS'CERTIFICATE Flood & Peterson Insurance InC DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P .O . Box 578 POLICIES BELOW. Greeley, CO 80632 I COMPANIES AFFORDING COVERAGE coMPANv A St . Paul Ins . Co . LETTER _ COMPANY B LETTER - INSURED COMPANY C Weld Mental Health LETTER 1306 11th Avenue CO 80631 I COMPANY D Greeley, I LETTER — - COMPANY I E I LETTER - COVERAGES TERM USTED C BELOW HAVE OF ANY CONTRACT OR OTHER DOCUMENTND WITH FOR RESPECT TO WHICH PERIOD D INDICATED.N S CERTIFY THAT THE POLICIES OF INSURANCE BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY OCEm1FIANOTWITHSTANDING ISSUE ANY PERTAIN, ICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY.HAVE BEEN REDUCED BY PAID CLAIM 01 /95 LIMITS (POLICY EFFECTIVE POLICY EXPIRATION, CO TYPE OFIHSURANCE POLICY NUMBER DATEIMM/ODn'Y) OATE(MM/DD/YY LTR 01/01/94 01/ �IGENERALAGGREGmE S 1 , 900 00'' FKO8300395 A GENERAL MMER IAL PRODUCTS-CLOMP/OF AGG.' S 1 , 000 000 }{ COMMEAIMSMADE _X OCCUR PERSONAL&ACV INJURY S 1 000 r 00'0 CLSI&CONTRA T .00CUR. EACH OCCURRENCE - 1 )00 r 00.) OWNER'S&CONTRACTOR'S PROL' !FIRE DAMAGE(Any one,rte) L. LOO , 00.0 ——' MED.IXPENSE I"one Person) A 01/01/94 ', 01/01/95 IcomeiNEDSINGLE 02 ' ( D0 AUTOMOBILE LIABILITY FKO8300395 - --. l ANYAUTO BOWLYINJURY - - (Perperson) 1ALL OWNED AUTOS _-----i rX i SCHEDULED AUTOS ( BODILY INJURY I S ( BODI(PeraLY INJU X HIRED AUTOS —----- CX-, NON-OWNED AUTOS 'pgOPERTY DAMAGE S F— GARAGE GELLABILITY -- _ OCCURRENCE S EACH OCCUR AGGREGATE iSSLIABILPY I--- - _--ES XCESS UMBRELLA FORM I, ---------------------------- '-- - STATUTORY LIMITS OTHER THAN UMBRELLA FORM U _A.-__ ---. IEACHACCIDENT I S- WORKER'S COMPENSATION - - ------ AND (DISEASE-POLICYLIMIT I S - - 0101 DISEASE-EACH EMPLOYEE i S -_-_I EMPLOYERS'LIABILITY I 0 der--� 94101/O1/95 $15 , 000/ � FKO8300395 / / OTHER A , Employee — — ' Dishonesty --- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Certificate Holder is named as additional insured in regard to the funding purposes . fleneral "',,ability only - -- - - CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCLLLE[BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE ofState me Colorado In LEFT, BUT FAILURE TO MAIL SUCH_NOTICE SHALL IMPOSE NO OBUGATION OR Departntt of n LIABIH 7V OF ANY KND UPON THE OM NV.' S A NTS OR REPRESS 3550 West Oxfgord Avenue UTMORIZEOAE ESENTATI �/ `lA Ty1l Denver, CO 80236 �� IC �� I /Tv VRP ©Acorn CORPORATION 1990 , DEPARTMENT OF SOCIAL SERVICES 4441, P.O. 806 2 GREELEY, COLORADO 80632 Nip Administration and Public Assisiance(303)352-1551 Child Support 1303)352-6933 C Protective and Youth Services 352-192.3 Food Stamps(303)356-3850 C. 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 Home Based Program Option A of the Weld Mental Health Center and the Weld County Department of Social Services Enclosed for Board approval is a Notification of Financial Assistance Awaid between Home Based Program Option A of the Weld Mental Health Center and the Weld Coanty 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 $72,562.00 2. The period of the award is June 1, 1994, through May 31, 1995. 3. The Home Based Program Option A of the Weld Mental Health Center would match two families per worker for 80 hours per month for up to 6 weeks io 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:aas 94O4 81 Hello