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Home My WebLink About930716.tiff RESOLUTION RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR PLACEMENT ALTERNATIVES COMMISSION FUNDS FOR NORTH COLORADO PSYCHCARE 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 North Colorado PsychCare and the Weld County Department of Social Services, commencing June 1, 1993, and ending May 31, 1994, with the further terms and conditions being as stated in said notification, and WHEREAS, after review, the Board deems it advisable to approve said notification, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, ex-officio Board of Social Services, that the Notification of Financial Assistance Award for Placement Alternatives Commission Funds between North Colorado PsychCare and the Weld County Department of Social Services bc , and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is, authorized to sign said notification. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 2nd day of August, A.D. , 1993, nunc pro tunc June 1, 1993. �� / �G� �J BOARD OF COUNTY COMMISSIONERS ATTEST: ✓lj� �� 6� WELD COUNTY, COLORADO ;/, L.--' Weld County Clerk to the Board _ ._::‘,/, f/0 � ,.,-1 2. e ,/,L,.. • Constance L. Harbert, Chairman BY: %� f�2 f ( /le> C .� .7 y` _ 4 IV\\I tr' '� ,-, t�c-) 4~ Deputy Clerk to the Board > W. H. /Webster, Pro-Tern f" c APPROVED AS TO FORM: Le ..-,.rt r // A 7_r _- ELL c /� !Jar � -C�nty Attorney , --self K. Hall / Barbara J. Kirkmeyer s' 930116 C. c. ..>.�l-� 1 F✓ ? Welt aunty 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 Revision of Earlier Action FY92-PAC-60O Issued on (RFP-PAC-9200) Contract Award Period Name and Address of Contractor Beginning 06/01/93 and North Colorado Psychcare Ending 05/31/94 928 12th Street Greeley, CO 80631 Computation of Awards Monthly Program Capacity 2 Monthly Average Capacity 1.5 Unit of Service Description One hour of direct services to the client by staff of Youth Passages per 40 hours The issuance of the Notification of per week up to 6 weeks Financial Assistance Award is based upon your Request for Proposal (RFP) . Cost Per Unit of Service The RFP specifies the scope of services and conditions of award. Except where Hourly Rate Per $ 16.56 it is in conflict with this NFAA in Unit of Service which case the NFAA governs, the RFP Based on Average upon which this award is based is an Capacity integral part of the action. Monthly Rate Per $2,720.00 Special conditions Unit of Service Based on Average 1) Reimbursement for the Unit of Capacity Service will be based on an hourly rate per child or per family. Total Yearly $37,740.88 Services Budget 2) The hourly rate will be paid for (Subject to the Availability of only direct face to face contact Federal and State Funds) with the child and/or family or as specified in the unit of cost Enclosures: computation. Signed RFP 3) Unit of service costs cannot exceed the hourly, monthly, and yearly cost per child and/or family. 4) Rates will only be pai.d on approved and open cases with the Department of Social Services. Approvals: Program Offici 1: By !/ r By Constance Harbert, Chairman +•,; 1 A. G iego, ' ecto Board of Weld County Commissioners Weld Cou _ Depar ent ip - Soci l Services Date: :N / Date: f cj 9 J — INVITATION TO BID ___- _-___e_emDATE : ber 1992 RETLB".: 3ID Pat Persicnino Director of :T_P C_9�003 Genera, Service_ 3_✓ .._ ._ 9:.5 10th Street 3 .0. 3o.. 755 Greeley, CO 30632 . _rs_chiac , Director of General �: Pat Services SU NAR': Request for Proposal (RFP-PAC-93OO3) for: Alternatives to Placement out of the Home Programs Deadline: March 2, 1993 , Tuesday, 10:00 a.m. The Placement Alternatives Commission, an advisory commission to the Weld County Department of Social Ser:ices , announces that competing applications will be accepted for new grants pursuant to the Board of Weld County Commissioners authority under the .Alternative_ to Out- of Home-Placement Act of 1979 . The Placement Alternatives Commission wishes to approve a twelve month program targeted to run from June 1, 1993 through May 31, 1990 , at targeted funding levels of increments up to 3432. 431.00 . This program announcement consists of five parts , as fo'_'_ows : PART ... . .Administrative Information PART 3 . . .Background, Ove r'iew and Goals ?ART C. . .Statement of Work PART 0 . . .Bidder Response Format ?ART E. . ._valuation Process_ Delivers- Date (After receipt of order) BID MUST 3E SIGNED IN INK Karl p c,Siis TYPED OR PRINTED SIGNATURE VENDOR North Colorado PsvohCare handwritten =tare 3y Authorized DBAOfficer or Agent Youth Passages Handwritten Vender ADDRESS 928 12 Street "ITS 5"ouch nasgactee DATE Greeley, CC 80631 Zh PHONE ri (303) ? -1P. 6 The The above bid Is subject to Terms and Conditions as attached hereto and incorporated. AttachnREP-PAC-9'-003 ent "- COVER ?AGE AL'.^_'RNATI^S TO OUT OF PLACEMENT PROGRAMS PLACEMENT AL:'ERNATIVES COMNISSIoN PROGRAM YEAR 1993 RFP-PAC-93003 ro to oe ser e=: Children aged 10 to 1P et r; k placement fame of - '_cars. =.sere.: North Colorado PsvchCare (DBA Youth Pggpria--) 928 12 Street City: Greeley. on R(1FP' Phone: 303352-10% Contact Peron: Pirh1"r' "unccht ,.PsyD .___e: Coordinator ABoles n -- - Approx. �. iaatz Project Dates : tar. June _ . 1993 d May 21. '.?c Title of Project: Youth Passages PAC Program Amount Requested $51,571.53 3/1 /4 -3 RichardMunsc-h�= __ ? on ?repot -.c Propcsa_ Date S z1:� and - -_ at-rz oc - -_- _ `_ _ _ -246/4 :;ame a.__ __ atu__ of __..._..atra__':e 0-=- - o .App__ca..t Agency - -- ter -- ..our.-,; PAC NewProject Continuing . _ _.._ _.. ^--LL now many wears? .4 Proposed Program l eliminate the need Proposed Program ., : lower out o;. Acme. --meat will -� _ the cost ci out of home placement :1 Proposei ?roc-am will MANDATORY PROPOSAL REQUIREMENTS Ple=ase initial to indicate that the following required sections areincluded in this proposal : ia^^ =__teement of Need �., population to be Served ('✓�- Program :mnleme=.tat:on P^^ Program Components )'✓' Provision of Sec- ices & Capability p V Past Performance letters of Support (New Programs Only) Budget Support h^�` Program evaluation and Continuation NORTH COLORADO PSYCHCARE (DBA YOUTH PASSAGES) TABLE OF CONTENTS 1 Statement of Need Population to be Served 1 Program Implementation 2 Program Components 2 Provision of Services and 3 Administrative Capability Past Performance 4 4 Budget Program Evaluation and Continuation 4 Attachments B1 B2 B3 Cl C2 C3 D1 D2 D3 D4 El E2 Fl F2 G Sample Schedule PAC PROPOSAL 1. STATEMENT OF NEED Youth Passages Adolescent Partial Hospitalization Program has been designed to address the multifaceted needs of educational, experiencing significant emotional, behavioral, interpersonal , and familial problems.psychiatric such,,itrserves es adolescents suffering from a wide range of p y partial hospitalization program, Youth Passages can intensively treat these adolescents while simultaneously minimizing the disruption and stigma often associated with inpatient treatment ltsorhothe other per week restrictive settings. Youth Passages offers "40p " ours perl, of treatment and utilizes milieu, individual, group, cexper is behavioral, and family therapy- When indicated, psychotropic edited BOCES medication is also administered. In addition, classroom staffed by an affective needs teacher addresses academic and behavioral issues in the classroom. Until the opening of Youth Passages, adolescents needing a more intensive treatment modality than outpatient therapy, were necessarily treated outside of our community and/or separated from family.e often Indeed, in order to assure the adolescent' s safety, they hospitalized because there were no intermediate levels of care available. Youth Passages is currently the sole community provider of adolescent partial hospitalizationiven the evel of utilization of our program Youth Daily Census: of clients vitaldneed2within our community. Passages, appears to be meeting However, some of the adolescents and families that most desperately need our services do not have adequate financial resources to access our program. 2 . POPULATION TO BE SERVED Youth Passages serves clients aged 12-18 from diverse ethnic and socioeconomic backgrounds. Both males and females are treatedca ,tons Youth Passages. A wide range of diagnostic categories, dy and problem behaviors are served. Many of our clients areeducational, experiencing severe emotional, behavioral, interpersonal, and family problems. A large number are classified as special education students, many are clients of Department of Social Services, and a fair number have criminal histories. N rth Cioloradodo P to sychCa e 4 is a 27-10 designated facility. Program capacity Length of stay be clients once the program is fully imp is contingent upon severity of pathology and clinical progress. Thus, while the mean stay has been approximately 21 treatment days, the client' s length of treatment could vary from aalewl toeeks sttoPseveral eral months. Client referrals begin with a phone Program Coordinator. A brief sketch of the client and presenting issues are gathered. If the client appears to be an appropriate pp p In candidate for Youth Passages an intake session is scchheduled. Iiadepth assessment occurs in the intake. If the client funds pp for ars pprope an admission date is set. We propose using clients with insufficient resources who meet the following guidelines for out-of-home placements: 1 CRITERIA #1 (at _east one of -_le .Je__OW, a. The child is need of protection b. There is a finding of mental illness c. The child' s behavior constitutes danger to the community CRITERIA #2 : a. Appropriate community resources are absent/exhausted CRITERIA #3 : a. Out-of-home placement is most likely to remedy the dysfunction. 3 . PROGRAM IMPLEMENTATION The primary overall goals of Youth Passages include: 1 . Stabilization and treatment of the presenting problems 2 . Improving family dynamics and level of functioning 3 . Preventing more restrictive treatment placements 4 . Maintaining the patient in the community and within the family system and home school district 5 . Addressing and resolving educational problems Each client is thoroughly assessed with regards to individual and family systems dynamics as part of our intake process. An individualized treatment plan based on this and other relevant data will be implemented within 3 program days. Individual, milieu, group, and experiential therapy will be implemented on the first day of attendance. Family Therapy will be initiated within 5 program days from admission. See attachment B for specific measurable outcome-based goals. 4. PROGRAM COMPONENTS Each client will receive individual, milieu, group, experiential and family therapy, as well as state certified education (via our BOCES school program) . Routine psychological evaluation, provided to all clients in the initial stage of treatment_, mayk include a brief screening/assessment for psychopathology via standardized psychological tests such as the Minnesota Multiphasic Personality Inventory or the Millon Adolescent Personality Inventory. Further psychological testing/evaluation and psychotropic medications will be administered on an as needed basis. In addition, psychoeduational classes covering a wide variety of issues and skills (ie: assertiveness training, drug and alcohol use, problem solving, relaxation training, etc) are offered. See attached sample schedule. All clients are admitted to the program and attended by a North Colorado Medical Center staff physician and case managed by a Master' s or Doctoral Level mental health professional . The therapeutic community is strengthened by daily community meetings and a behavior modification system. By addressing client' s individual and family needs with this intensive multi-modal approach, it is believed that those clients at risk for out-of-home placement and/or placement in increasingly restrictive and costly facilities can be prevented. 5 . PROVISION OF SERVICES AND ADMINISTRATIVE CAPABILITY Youth Passages utilizes a medical model approach with a multi- disciplinary staff . Currently, Youth Passages is staffed with a board certified child/adolescent psychiatrist, acting as the program medical director, a Doctoral level psychologist (Program Coordinator) , a Master' s level affective needs teacher, a Master' s level mental health therapist, a Certified Therapeutic Recreation Specialist, and a Psychiatric Team Assistant. Program hours are 8 am to 4 pm Monday 2 A cas management vstem is utilized. The Pr -Tram Coordinator will be responsible for a_ client tracking and repoi _ng requirements. Clinical and educational staffings are held at least once every two weeks to coordinate treatment and discharge planning. All agencies involved in the adolescent' s care are invited to attend and participate in these staffings. There is no risk of duplication of services, given that Youth Passages is currently the sole county provider of adolescent partial hospitalization programming. Fiscal accountability for funding received through this grant shall be the responsibility of the Manager of North Colorado PsychCare. Funds shall be allocated to meet individual client needs when pay- ment resources are insufficient. (Note: Medicaid funding will be considered as payment in full, assuming no change in current reimbursement mechanisms) . North Colorado PsychCare will document for all patients charges incurred, 3rd party/self payment resources obtained, if any, and PAC funding offset. PAC funds will be accounted for separately from all other reimbursement sources. 6. PAST PERFORMANCE Youth Passages is a program offered by North Colorado PsychCare which is, in turn, a division of North Colorado Medical Center. Because we have been in operation since March 10 , 1992 , we can only provide a brief baseline of program outcomes. Judging from patient satisfaction surveys, informal feedback, and outside agency contact it appears that our program has been extremely successful in stabilizing family dynamics, addressing individual and family dysfunction, and improving school performance. We have successfully intervened with children slated for State hospitalization and or residential care outside of Weld County. During and following treatment at Youth Passages, clients have been maintained in their home or in foster care within Weld County. We have also successfully prevented numerous potential inpatient admissions to our inpatient psychiatric unit, PsychCare, thereby realizing great cost savings and avoiding further family disruption. Since the inception of Youth Passage' s PAC program on 9/1/92 we have received four (4 ) referrals and have treated two (2 ) of these referrals. Our first two referrals did not result in admission due to: (1) geographical distance precluding attendance or (2) the refusal of the family system and client to engage in the process. Regarding the two referrals we have treated, the first we met Objectives #2 and #3 but were unable to meet #1 (maintaining client in the home) . The second client we met all three objectives (see attached C) . We believe that as our program becomes more familiar and accessible to Weld County Department of Social Services where all referrals originate, that utilization of our program will increase. It is difficult to extrapolate efficacy trends from a sample of two. However, when considering our identified objectives with respect to our larger client population (those not in the PAC program yet frequently presenting similar dynamics) we believe we will have great success in meeting our objectives with future Youth Passages PAC fund clients. 7 . EVALUATTJN RESULTS (See attached D) 5)",1x71 ' 3 1 8 . BUDGET (Based on 9 months) TIME PERIOD: 1 Ju ' 93 - 31 May ' 94 a. Total amount of budget: x51, 571. 53 b. Maximum number of clients served: 2 . 0 c. Average number of clients served: 1. 5 d. Annual cost of client or family served: $ 4 , 080 (30 program days @ $136) e. (1)Monthly cost of client or family served: $ 2 , 720 (20 program days @ $136) f . Average number of hours served per client/ family per week: 40 g. Hourly cost per client/family: $ 16 . 56 [Note: Total program cost per client/family member of alternative placement targeted at $4 , 080 , assuming 30 treatment days] 9 . PROGRAM EVALUATION AND CONTINUATION The effectiveness of utilizing PAC funds to cover patients care at Youth Passages will be evaluated by measuring compliance with the following outlined objectives: Objective #1 : 75% of clients will actively engage and participate in Youth Passages' on-site school and at time of discharge will continue education in a state approved school Objective #2 : By the time of discharge 75% of clients will not be dangerous to themselves or others thereby enabling them to function within the community at large Objective #3 : 75% of clients families/foster families will consistently and actively engage in treatment planning, family therapy and program activities . Data for Objective #1 will be gathered from review of educational section of medical record and from case manager' s discharge summary. Data for Objective #2 will be gathered from discharge summaries. Data for Objective #3 will be gathered from patient' s medical record. Data for all the objectives will be collated into one report. Cost effectiveness will be demonstrated via utilization of Attachment C (Cost Saving Analysis) . Youth Passages will continue our commitment to serve individual clients once these funds have been exhausted. This commitment has been demonstrated already by both Youth Passages and PsychCare. 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Program Name: Youth Passaged P.nr Program __. .Agency Name: Yn,.+h Passages of North Colorado PsvrhCare The proect _ unit of service definition is : One hour of direct services to the client by staff of Youth Passages per 40 hours/week up to 6 weeks :. The orolect will provide what type or service to each __lent. Partial hospitalization B. This dervice will be provided for a 40 (maximum; hours per week for up to 6 (maximum stay the program) weeks. IV. The hourly Unit Rate is based on: Check one y ._. An individual client who is aged la through ip B. A family unit as described as follows: V. Program Statistics Total number of clients to be served in the :2 month program is 12 The monthly maximum program capacity is 2 The monthly average capacity is 1.5 Average stay in the program is 6 weeks. Average hours per week in the program. is 40 • 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 N or $ 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 .e or S oer hour. Total hourly rate per unit of service based on average cost be-F-C; . 16 SE D. Total proposed Yearly budget for services S S1 771 *All clients receive a minimum of 40 hours per week of direct service. Any indirect services occur simultaneously. In general, we estimate that as an organization 251 of our time is dedicated to indirect services. I am unsure of hob; to reflect this within this format as these figures appear to be mutually exclusive given the layout.. r, Tft'j • . RFP-PAC-92003 Attachment F VII. Unit of service race computation Page 2 of 2 1. Travel to & from client ' s home totals an average of 0 hrs/weer 2 . Pape_ work required by weld County Department of Social Services totals a average of hrs/week 3 . Supervisor meetings totals an average of hrs/week 4 �., services of:Case manag_ment a. making referrals to other services needed by clients : b. providing linkage to ensure clients obtain and benefit from the services to which they have been referred; c. monitoring the client through contacts with individuals and agencies ; d. advocacy to ensure that the best interests of the client are served: and e. planning of services to best serve the client. Totals an average of hrsiweek 5. Court testimony required by Social Services totals an average of 0 hrs/week 6. Administrative costs totals an average of hrsweek Please describe below: 7. Other cast= totals an average of hrs, wee'.k Please describe below: 8. Sub-total indirect costs hrs%week 9 . Direct services to clients (Face to face contact) totals an average of 40 hrs/week Total average hours of service to be provide per week 40 Weekly direct services to clients total an average of : Weekly indirect services to clients total an average of:S 4° _ ��1 1i =1 I II ' ' • I it 1 U1 < - - I ^ I : I i I I 00 i 1 i ^ i l j 7 < I I O 6 �I -,I 1 i •�-' .r �'1' I I 7 Z „ 1 i :, •I O X i. - III 'i ra t7 01 O O .�? _ •i i al C O O li w"..J _-. I N N ° , 0 Sra�— — �n •- II - %... {/} i t/} { I I Tj V zi '. W _ ..I I i 1 3 w — -. ... ' I J'1 ' J C..) f^ ! -1 Z -- j = O •rl• LC) t.0 c,-; Z G • 0 r-1 l0 O I I y pn 1� 1 :. O 4 I O k Ci,` 5 i,i4 i >4c. .1 cr lJ CO >= I G v �' • C% N ' .� 1 rV•H Z C tf)- .1) t .--f T (n Ic < E — I L;i 1 OCJ ti r. I ! W I •Q,- ,.,. _ ci ,- r. .1_1 e-, .t U i •-I L. C • d :J < - I I I • J ri — r. I O U I 0 d� Z Z rte+ i c...: to i!) I l0 i co I -. • c... 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O -H --I m 1. 0 v' ,G 0 0 >+ 3 rood a) y H ❑ ,C J U 3 -4:3 H 0 O 01 0 44 E a) rC5 14 0> H 0 a, m -.>i .00 >1 uz .. -H -H E G -HI G .. 0 'b U >i it H '1' l0 01 U 0 G E O ro 1 O ..i 0 1. -, E 0 0 0 0 0 -rn.0 4-4 U 0 > > CC O O ro 4-I O 0 > > O op r00 O. ro O-4 b C 4) 41 U U W '0 0 U 0 CU CU O ,G 0 C -^ -r -n•n Hi * E 0 .0 .0 0 0 0 00 4 • ....C:.r....11��:... G COUNTY PLACEMENT ALTERNATIVES PLAN FINAL BUDGET PAGE • FY 1993 - 1994 (1) (2) (3) (4) (5) PROGRAM ?AC FOSTER OTHER TOTAL NAME FUNDS CARE FUNDS ?ROG Rsi REQUESTED REQUESTED PROVIDE:: FOR PROJECT FOR PROJECT Youth Passages Program $51,571.53 ---- $51,571.53 TOTALS $511571.53 How will ?AC money be accounted for separately from other agency money? See Page 3, Section V I , O, z. ' I 0H I r ....E1Z W I z1 HI I y+ O �' W I z E-+ m C4 I ' I�I to I H H .. I �+ Z U' U` o X 1 z z z U Z O H H H P ,, H W �� b. O H 4 [, U Ui O H o I o O 3 H Eta w 4.3 l r. 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O x' w g a a1 ' a 0 `. o N ✓ U I o 'l3 +C o 41 4I O I ,-' : u. o z r W E-+ w , v a ' I I b 0 0, U gI G a U at g, U g g' I r, O U� tool 0 a rn s-I a� m r qI ' W i 3I , U I cn ` 00 ° to I ( ' 1 I O O Hr{ .1 0 tr[ O j o 0 ! O .. .i N .. .. r) .-I m I r't 0 y I O ri .-4 N H ' p CA H 1 I I I H N N I ri nI I I 1 I in i O o O I I I 1 I I ,--I W 0 O O Hi m O O Ift 0 i!1 0 O 1 ••..I Z C In o ..i .. .• .-I r- r-4 ch rn l p? rl H •. .• OI HI NN CI G) H n c0 I o+ ra I H .-I H r♦ •-1 N I N I M i i 4.4 I IN i . 'It:w.i • 1. STATEMENT OF NEED Youth Passages Adolescent Partial Hospitalization Program has been designed to address the multifaceted needs of adolescents experiencing significant emotional, behavioral , educational , interpersonal , and familial problems . As such, it serves adolescents suffering from a wide range of psychiatric disorders . As a partial hospitalization program, Youth Passages can intensively treat these adolescents while simultaneously minimizing the disruption and stigma often associated with inpatient treatment or other restrictive settings . Youth Passages offers "40 plus" hours per week of treatment and utilizes milieu, individual , group, experiential , behavioral , and family therapy. When indicated, psychotropic medication is also administered. In addition, an accredited BOCES classroom staffed by an affective needs teacher addresses academic and behavioral issues in the classroom. Until the opening of Youth Passages , adolescents needing a more intensive treatment modality than outpatient therapy, were necessarily treated outside of our community and/or separated from family. Indeed, in order to assure the adolescent' s safety, they were often hospitalized because there were no intermediate levels of care available. Youth Passages is currently the sole community provider of adolescent partial hospitalization services . Given the level of utilization of our program since its March ' 92 inception (Average Daily Census: 6 . 2 , # of clients served = 52 as of 12/31/92) Youth Passages appears to be meeting a vital need within our community . We believe that the therapeutic scope and intensity of our program is well suited to successfully intervene with children that are at risk for being placed outside of their home. By utilizing a partial or day hospitalization model specific therapeutic interventions can be implemented within the family system or with the child' s problem behavior while they continue to reside at home. 2 . POPULATION TO BE SERVED Youth Passages serves clients aged 12-1€ from diverse ethnic and socioeconomic backgrounds . Both males and females are treated at Youth Passages . A wide range of diagnostic categories , dysfunctions, and problem behaviors are served. Many of our clients are experiencing severe emotional , behavioral, interpersonal , educational , and family problems . A large number are classified as special education students , many are clients of Department of Social Services , and a fair number have criminal histories . North Colorado PsychCare is a 27-10 designated facility. Program capacity is slated to be 14 clients once the program is fully implemented. Length of stay is contingent upon severity of pathology and clinical progress. Thus, while the mean stay has been approximately 21 treatment days, the client' s length of treatment could vary from a few weeks to several months . Client referrals begin with a phone call to Youth Passages Program Coordinator . A brief sketch of the client and presenting issues are gathered. If the client appears to be an appropriate candidate for Youth Passages an intake session is scheduled. In depth assessment occurs in the intake. If the client appears appropriate, an admission date is set. We propose using PAC funds for those clients with insufficient resources who meet the following guidelines for out-of-home placements : CRITERIA fll (at 1E t one of the below) a . The child is in need of protection b. There is a finding of mental illness c. The child' s behavior constitutes danger to the community CRITERIA 2 : a. Appropriate community resources are absent/exhausted CRITERIA ;=3 : a . Out-of-home placement is most likely to remedy the dysfunction. 3 . PROGRAM IMPLEMENTATION The primary overall goals of Youth Passages include: 1 . Stabilization and treatment of the presenting problems 2 . Improving family dynamics and level of functioning 3 . Preventing more restrictive treatment placements 4 . Maintaining the patient in the community and within the family system and home school district 5 . Addressing and resolving educational problems Each client is thoroughly assessed with regards to individual and family systems dynamics as part of our intake process. An individualized treatment plan based on this and other relevant data will be implemented within 3 program days . Individual, milieu, group, and experiential therapy will be implemented on the first day of attendance. Family Therapy will be initiated within 5 program days from admission. See attachment B for specific measurable outcome-based goals . 4 . PROGRAM COMPONENTS Each client will receive individual , milieu, group, experiential and family therapy, as well as state certified education (via our BOCES school program) . Routine psychological evaluation, provided to all clients in the initial stage of treatment may, include a brief screening/assessment for psychopathology via standardized psychological tests such as the Minnesota Multiphasic Personality Inventory or the Millon Adolescent Personality Inventory. Further psychological testing/evaluation and psychotropic medications will be administered on an as needed basis . In addition, psychoeduational classes covering a wide variety of issues and skills ( ie: assertiveness training, drug and alcohol use, problem solving, relaxation training , etc) are offered. See attached sample schedule. All clients are admitted to the program and attended by a North Colorado Medical Center staff physician and case managed by a Master' s or Doctoral Level mental health professional . The therapeutic community is strengthened by daily community meetings and a behavior modification system. By addressing client' s individual and family needs with this intensive multi-modal approach, it is believed that those clients at risk for out-of-home placement and/or placement in increasingly restrictive and costly facilities can be prevented. 5 . PROVISION OF SERVICES AND ADMINISTRATIVE CAPABILITY Youth Passages utilizes a medical model approach with a multi- disciplinary staff . Currently, Youth Passages is staffed with a board certified child/adolescent psychiatrist, acting as the program medical director, a Doctoral level psychologist (Program Coordinator) , a Master' s level affective needs teacher, a Master' s level mental • health therapist, a Certified Therapeutic Recreation Specialist, and a Psychiatric Team As- istant. Program hours arP 2 am to 4 pm Monday through Friday wit. family therapy scheduled c an individual basis. A case management system is utilized. The Program Coordinator will be responsible for all client tracking and reporting requirements. Clinical and educational staffings are held at least once every two weeks to coordinate treatment and discharge planning. All agencies involved in the adolescent' s care are invited to attend and participate in these staffings . There is no risk of duplication of services , given that Youth Passages is currently the sole county provider of adolescent partial hospitalization programming. Fiscal accountability for funding received through this grant shall be the responsibility of the Manager of North Colorado PsychCare. Funds shall be allocated to meet individual client needs . North Colorado PsychCare will document for all patients charges incurred, 3rd party payment resources obtained, if any, and PAC funding offset. PAC funds will be accounted for separately from all other reimbursement sources. 6 . PAST PERFORMANCE Youth Passages is a program offered by North Colorado PsychCare which is , in turn, a division of North Colorado Medical Center. Because we have been in operation since March 10 , 1992 , we can only provide a brief baseline of program outcomes . Judging from patient satisfaction surveys , informal feedback, and outside agency contact it appears that cur program has been extremely successful in stabilizing family dynamics , addressing individual and family dysfunction, and improving school performance. We have successfully intervened with children slated for State hospitalization and or residential care outside of Weld County. During and following treatment at Youth Passages , clients have been maintained in their home or in foster care within Weld County . We have also successfully prevented numerous potential inpatient admissions to our inpatient psychiatric unit, PsychCare, thereby realizing great cost savings and avoiding further family disruption. Since the inception of Youth Passage' s PAC program on 9 /1/92 we have received four (4 ) referrals and have treated two (2 ) of these referrals . Our first two referrals did not result in admission due to: ( 1) geographical distance precluding attendance or (2) the refusal of the family system and client to engage in the process . Regarding the two referrals we have treated, the first we met Objectives #2 and #3 but were unable to meet #1 (maintaining client in the home) . The second client we met all three objectives (see attached C) . We believe that as our program becomes more familiar and accessible to Weld County Department of Social Services where all referrals originate, that utilization of our program will increase. It is difficult to extrapolate efficacy trends from a sample of two. However, when considering our identified objectives with respect to our larger client population (those not in the PAC program vet frequently presenting similar dynamics) we believe we will nave great success in meeting our objectives with future Youth Passages PAC fund clients . 7 . EVALUATION RESULTS (See attached D) r . sasec. on 9 months) TIME PERIOD: 1 J1 ' 93 - 31 May ' 94 a. Total amount of budget : b. Maximum number of clients served: $37 ' '40 . 86 1 . 5 c. Average number of clients served: 1. 5 d. Annual cost of client or family served: $ 4 , 080 (30 program days @ $136) e. (1) Monthly cost of client or family served : $ 2 , 720 (20 program days @ $136) f. Average number of hours served per client/ family per week: g. Hourly cost 40 per client/family: $ 16 . 56 [Note: Total program cost per client/family member of alternative placement targeted at $4 , 080, assuming 30 treatment days] 9 . PROGRAM EVALUATION AND CONTINUATION The effectiveness of utilizing PAC funds to cover patients care at Youth Passages will be evaluated by measuring compliance with the following outlined objectives : Objective #1: 75% of clients will actively engage and participate in Youth Passages' on-site school and at time of discharge will continue education in a state approved school Objective #2 : By the time of discharge 75% of clients will not be dangerous to themselves or others thereby enabling them to function within the community at large Objective #3 : 75% of clients families/foster families will consistently and actively engage in treatment planning, family therapy and program activities . Data for Objective #1 will be gathered from review of educational section of medical record and from case manager's discharge summary. Data for Objective #2 will be gathered from discharge summaries . Data for Objective #3 will be gathered from patient' s medical record. Data for all the objectives will be collated into one report. Cost effectiveness will be demonstrated via utilization of Attachment C (Cost Saving Analysis) . Youth Passages will continue our commitment to serve individual clients once these funds have been exhausted. This commitment has been demonstrated already by both Youth Passages and PsychCare. Of course, growing market financial pressures will continue to impact our ability to provide this care. . : "'.0'1'4 PAC =2;tip ..___.._:me::_ Hourly butt 2a ',osc 2 Computation Sheet Program. Name: youth Passages PAC Proorait youth Passages of North Colorado PsvchCare The project willprovide n..a_ eyoeof veada _____ .' _ . -h__ de--rice ..___ be provided for a 40 .-a..:mum) hour_ sec week for -. to E .ma-__mcO 3 lay _. the cram) The hourly Unit Rate as based on: Theck cne is A. whoaged l An iadtvi^ua1 client i 0 through p • l 3. A farm_}' unit as described as -`c--ows : 'Program Statistics ** - tea'_ :;umber clients to be serves in the _2 mono grogram is i0 The month'_, maximum program capacity is n The monthly average cao __ _ • Average stay the Program is c 6 we"° ' _verse hours per week in the program is _7d. Descr1odon _ unit of service cost be_peen c_--" end ind'er- services ._ * unit of service based Rase _.._ ccmnu[ador. on the hourly rate per on the average capacity -he .hourly rate per unit cost -.. The portion of .._sect services to � _ _ per hour. (only based on averase capacity � -• _ face-to--ace contact ..y_.. the __---.- far services) _o hourly rate per unit cost portion c* _nd_r___ ser:_�__ -- ` hour. ��- - is or per based on average capacity - .,. Total hourly .at._ per unit oT: service based on ayerago cost , -- S 1"6, udg for sarYiees S.3 740 RE—Total proposed yearly*All clients receive a minimum of 40 hours ner week of direct service . Any indirect services occur simultaneously . In ae_neral , we estimate that as an es I am unsure organization 25` of our time is dedicated to indirect services of how to reflect this withinthis format as these is res appear to be_ mutually exclusive given the layout . ** (It is estimated that we will have funds to serve 10 clients . Should each full treatment, 9 . 25 . Thus client recui_e the 6 weeks of �_ , we could serve depending upon length of treatment this number could vary .) rz •'_f h..:v- Attac Pen= G COUNT! PLACEMENT ALTERNATIVES ?LAN FINAL BUDGET PAGE FY 1993 - 1994 (2) (2) (4) (5) - RJGR."O-. PAC FOSTE:. =HER 7CT.:... . -...... BLS ...7i♦`. =.. Vl(F.:�. REQUESTED _,,.t1:__ FRO - ;E: FOR PROJECT FOR ?RO Youth Passages Program $37 , 740 .86 ----- ---- $37, 740 . 86 TOTALS $37 , 740 .86 How will ?AC money be accounted for separately from o er a2ertcy money? See Page 3 , Section V • j ( DEPARTMENT OF SOCIAL SERVICES P O BOX 806 2 GREELEY,COLORADO 80632 ■ Administration and Public Assistance(303)352-1551 Will Child Support(303)352-6933 C Protective and Youth Services(303)352-1923 Food Stamps(303)356-3850 FAX(303)353-5215 COLORADO MEMORANDUM TO: Constance Harbert:, Chairman Board of County Commissioners FROM: Judy Griego, Director, Social. Services DATE: July 29, 1993 SUBJECT: Notification of Financial Assistance Award between North Colorado Psychcare and the Weld County Department of Social Services Enclosed for Board approval is a Notification of Financial Assistance Award between the North Colorado Psychcare and the Weld County Department of Social Services for Placement Alternatives Commission (PAC) finds. The Placement Alternatives Commission (PAC) reviewed proposals wider a Request for Proposal process and are recommending approval of this bid. 1. Total award would be $37,740.88. 2 . The period of the award is June 1 . 1993 through May 31, 1994. 3. The Psychcare program would provide one hour of direct services to the client by staff of Youth Passages for 40 hours per week up to 6 weeks. If you have any questions, please telephone me at extension 6200. JAG:jac 7 Hello