HomeMy WebLinkAbout950962.tiffRESOLUTION
RE: APPROVE REQUEST FOR STATE APPROVAL OF FAMILY PRESERVATION
PROGRAM PLAN FOR 80/20 FUNDING AND FAMILY ISSUES CASH FUND TO
COLORADO DEPARTMENT OF HUMAN SERVICES, DIVISION OF CHILD WELFARE
SERVICES, 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 Request for State Approval of Family
Preservation Program Plan for 80/20 Funding and Family Issues Cash Fund from 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, to the Colorado Department of Human Services,
Division of Child Welfare Services, commencing June 1, 1995, and ending May 31, 1996, with
further terms and conditions being as stated in said request, and
WHEREAS, after review, the Board deems it advisable to approve said request, 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 Request for State Approval of Family
Preservation Program Plan for 80/20 Funding and Family Issues Cash Fund from 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, to the Colorado Department of Human Services,
Division of Child Welfare Services, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is, authorized
to sign said request.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 8th day of May, A.D., 1995.
ATTEST:
Weld Co
BY.
eputy Cler @• the Board
APPRQVED AS TO
dunty Attokney
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLO DO
J. Kirkmeyer, ro-Tem
George I Baxter
Constance L. Harped
W. H. Webster
950962
SS0021
FAMILY PRESERVATION PROGRAM PLAN
FOR
WELD
COUNTY(S)
950962
REQUEST FOR STATE APPROVAL P
FAMILY PRESERVATION P ROGRAMLAN
(80/20 Funding)
This Family Preservation Program Plan (FPP) is hereby submitted for
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
(Indicate county(ies) name(s) and lead county if this is a multi -county plan),
for the period June 1, 1995 through May 31, 1996 The Plan includes the
following:
• "Statement of Assurances";
• - Statement of which of the five (5) required FPP services will be
provided or purchased and a list of county optional services to be
provided or purchased; i.e., County Designed and/or Transition
Service;
• Completed program description of each proposed "County Designed
Service";
• Completed program description of each proposed "Transition Service;"
• Completed "Information on Fees" form;
• completed "Direct Service Delivery" form;
• Completed "Purchase of Service Delivery" form;
• Completed "Overhead Cost" form;
• Completed "Summary Sheet By Individual Service" form;
• Completed "Final Budget Page" form.
• State Board Summary.
This Family Preservation Program Plan has been developed in accordance with State Department of Human Services rules and Colora
Department of Human Services, is submitted
Division of Child Welfare Services for e approval
If the enclosed proposed FPP Plan is approved, the plan will be administered in
conformity with its provisions and the provisions of State Department rules.
The person who will act as primary contact person o
FOWLER, and who can be reached at telephone number (970) 352-1551 ext. 6IEL M.
210.
If this plan is proposed by two or more counties, the required signatures below
are to be completed by each county, as appropriate. Attach an additional
signature page as needed.
Signature
Signat e, CHAIR, PL CEMENT ALTERNATIVES COMMISSION
Signature, CHAIR, BO
OF COUNTY COMMISSIONERS
PAGE 1
/4
c/r/9DE
51?/q5
DATE
950962
REQUEST FOR STATE APPROVAL OF
FAMILY PRESERVATION PROGRAM PLAN
Family Issues Cash Fund (FICF)
This Family Preservation Program Plan (FPP) is hereby submitted for
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
(Indicate county(ies) name(s) and lead county if this is a multi -county plan),
for the period June 1, 1995 through May 31, 1996. The Plan includes the
following:
• "Statement of Assurances";
• Statement that the five (5) required FPP services will be provided
or purchased and a list of county optional services to be provided
or purchased; i.e., County Designed and/or Transition Service;
• Completed program description of each proposed "County Designed
Service";
• Completed program description of each proposed "Transition Service;"
• Completed "Information on Fees" form;
• Completed "Direct Service Delivery" form;
• Completed "Purchase of Service Delivery" form;
• Completed "Overhead Coat" form;
• Completed "Summary Sheet By Individual Service" form;
• Completed "Final Budget Page" form.
• 100% FICF Summary Form.
This Family Preservation Program Plan has been developed in accordance with State
Department of Human Services rules and is hereby submitted to the Colorado
Department of Human Services, Division of Child Welfare Services for approval.
If the enclosed proposed FPP Plan is approved, the plan will be administered in
conformity with its provisions and the provisions of State Department rules.
The person who will act as primary contact person for the FPP Plan is Daniel M.
Fowler, and who can be reached at telephone number (970) 352-1551 ext. 6210.
If this plan is proposed by two or more counties, the required signatures below
are to be completed by each county, as appropriate. Attach an additional
signature page as needed.
S igna
DtECTOR,
DEPARTMENT OF SOCIAL SERVICES
Signature, , BOARD OF COUNTY COMMISSIONERS
PAGE 2
5/3}q5
DATE
950962
FAMILY PRESERVATION PROGRAM PLAN
STATEMENT OF ASSURANCES
WELD County assures that, upon approval of the Family Preservation Program Plan
(FPP), the following will be adhered to in the implementation of the Plan:
1. Operation will be in conformity with the provisions of the Plan;
2. Operation will be in conformity with the provisions of State rules;
3. Family Preservation Program Services, provided or purchased, will be
accessible to children and their families who meet the eligibility
criteria;
4. Operation will not discriminate against any individual on the basis of
race, sex, national origin, religion, age or handicap who applies for or
receives services through the Family Preservation Program;
S. Services will recognize and support cultural and religious background and
customs of children and their families;
6. Services will be provided under the Family Preservation Program only to
eligible children and their families;
7. No out-of-state travel will be paid for with FPP funds;
8. All forms used will be State prescribed or State approved forms;
9. FPP FTE/Personal Services costs authorized for reimbursement by the State
Department will be used only to provide FPP Services authorized in the
county(ies) approved FPP Plan;
10. The purchase of services will be in conformity with State purchase of
service rules including contract form, content, and monitoring
requirements; and
11. Information regarding services purchased or provided will be reported to
the State Department for program statistical and financial purposes in
conformity with State rules.
PAGE 3
950962
FAMILY PRESERVATION
PROGRAM SERVICES
TO BE PROVIDED/PURCHASED
Place an (A) or a (P) to indicate which of the following Family Preservation
Program Services will be provided/purchased in accordance with State Department
rules: "A" indicates currently available to clients, "P" indicates county plans
to purchase/provide in 95-96.
P Home Based Intensive Family Intervention Service (Staff Manual
Volume 7, 7.503.61)
P Intensive Family Therapy Service (Staff Manual, Volume 7, 7.503.62)
P Sexual Abuse Treatment Service (Staff Manual, Volume 7, 7.503.63)
P Day Treatment Service (Staff Manual, Volume 7, 7.503.64)
P Life Skills Service (Staff Manual, Volume 7, 7.503.65)
List county optional services of "County Designed Service" and/or "Transition
Service" which will be provided/purchased in accordance with State Department
rules:
♦ List County Designed Service(s) (Staff Manual, Volume 7, 7.503.66)
None
♦ List Transition Service(s) (Staff Manual, Volume 7, 7.503.67)
Only those transition services approved in FY 94-95 can be listed.
None
PAGE 4
950962
I NFO RMAT I ON ON FEES
Please check the following which apply:
X Fees will not be assessed for Family Preservation Program Services.
(STOP. Remainder of information does not need to be completed.)
Fees will be assessed for the following services: Check those that
apply:
Home Based Intensive Family Intervention
Intensive Family Therapy
Sexual Abuse Treatment
Day Treatment
Life Skills
County Designed Service (List Services Below)
Transition Service (List Services Below)
Fee assessment formula is the same for all services. State the
formula here (attach sheet if needed).
Fee assessment formula varies with service. State formula used for
each service.
PAGE 5
950962
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SERVICE
N
COUNTY NUMBER
CO
ACCOUNT CODE:
Indicate information for each CWEST provider from whom FPP services are proposed to be purchased.
8
TOTAL
COST
PER PLAN
(6 x 7)
0
0
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4,4
7
NO. OF
MONTHS
OF
COST
r,
6
PER MONTH
COST
(4 x 5)
$3,163.42
5
PAYMENT
RATE PER
UNIT OF
SERVICE
$28.54
4
NO. OF
UNITS OF
SERVICE
PER MONTH
110.842
3
UNIT OF
SERVICE*
C4
0
W
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2
CWEST
PROVIDER
NO.
rn
0
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CO
1
PROVIDER NAME
WELD MENTAL HEALTH
CENTER
$37,961.00
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ti
6
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COST
(4 x 5)
a,
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5
RATHEHER
UNIT OF
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$24.97
4
NO. OF
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H
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PROVIDER NAME
ISLAND GROVE REGIONAL
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$33,816.90
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COUNTY NAME
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SERVICE NAME:
a
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ACCOUNT CODE:
9
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$44,008.04
7
NO. OF
MONTHS
OF
COST
N
ti
6
PER MONTH
COST
(4 x 5)
$3,667.34
5
PAYMENT
RATE PER
UNIT OF
SERVICE
$30.98
4
NO. OF
UNITS OF
SERVICE
PER MONTH
co
In
H
H
H
3
UNIT OF
SERVICE*
5
0
2
CWEST
PROVIDER
NO.
1
PROVIDER NAME
ISLAND GROVE REGIONAL
TREATMENT CENTER, INC.
$44,008.04
H
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* - Identification of units is:
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COUNTY NAME
INTENSIVE FAMILY THERAPY
SERVICE
N
tD
COUNTY NUMBER
ACCOUNT CODE:
Indicate information for each
8
TOTAL
COST
PER PLAN
(6 x 7)
$73,234.00
7
NO. OF
MONTHS
OF
COST
N
6
PER MONTH
COST
(4 x 5)
$6,102.83
5
PAYMENT
RATE PER
UNIT OF
SERVICE
$26.93
4
NO. OF
UNITS OF
SERVICE
PER MONTH
N
N
N
3
UNIT OF
SERVICE*
a
O
1 2
PROVIDER NAME CWEST
PROVIDER
NO.
m
O
0
OD
WELD MENTAL HEALTH
CENTER. INC.
I
0
O
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a
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M = Month
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COUNTY NUMBER
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4-4
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8
TOTAL
COST
PER PLAN
(6 x 7)
$30,312.00
a_1J_L�I
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COUNTY NAME
LIFE SKILLS
SERVICE
N
COUNTY NUMBER
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0
0
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in
Indicate information for each
8
TOTAL
COST
PER PLAN
I (6 x 7)
CO
ON
.c
In
N
LCl
art
7
NO. OF
MONTHS
OF
COST
N
H
6
PER MONTH
COST
(4 x 5)
$4,378.75
5
PAYMENT
RATE PER
UNIT OF
SERVICE
CO
00
ri
ri
We
4
NO. OF
UNITS OF
SERVICE
PER MONTH
320.083
I 2 3
PROVIDER NAME CWEST UNIT OF
PROVIDER SERVICE*
NO.
O
M
Ln
O
N
'.O
ICHILD ADVOCATE RESOURCE
AND EDUCATION, INC.
$52,544.98
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COUNTY NAME
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LIFE SKILLS
SERVICE NAME:
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COUNTY NAME
LIFE SKILLS
SERVICE
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COUNTY NUMBER
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ACCOUNT CODE:
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47
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TOTAL
COST
PER PLAN
(6 x 7)
$26,250.00
7
NO. OF
MONTHS
OF
COST
N
6
PER MONTH
COST
` (4 x 5)
$2,187.50
5
PAYMENT
RATE PER
UNIT OF
SERVICE
0
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NO. OF
UNITS OF
SERVICE
PER MONTH
In
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3
UNIT OF
SERVICE*
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2
CWEST
PROVIDER
NO.
1
PROVIDER NAME
IWELD COUNTY DEPARTMENT
I flF HEALTH
1
$26,250.00
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2
CWEST
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NO.
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PROVIDER NAME
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414
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COUNTY NAME
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SERVICE NAME:
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Indicate information for each
B
TOTAL
COST
PER PLAN
(6 x 7)
O
0
0
O
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7
NO. OF
MONTHS
OF
COST
N
6
PER MONTH
COST
(4 x 5)
O
O
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CO
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5
PAYMENT
RATE PER
UNIT OF
SERVICE
4
NO. OF
UNITS OF
SERVICE
PER MONTH
3
UNIT OF
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2
CWEST
PROVIDER
NO.
45062
1
PROVIDER NAME
WELD COUNTY DEPARTMENT
nF' SnrTAT. SERVICES
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$93,600.00
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SEX ABUSE TREATMENT
SERVICE NAME:
V
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F
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8
TOTAL
COST
PER PLAN
(6 x 7)
$54,926.00 II
7
NO. OF
MONTHS
OP
COST
N
6
PER MONTH
COST
(4 x 5)
4,577.17
1 2 3 4 5
PROVIDER NAME CWEST UNIT OF NO. OF PAYMENT
PROVIDER SERVICE* UNITS OF RATE PER
NO. SERVICE UNIT OF
PER MONTH SERVICE
$26.93
N
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WELD MENTAL HEALTH
I ',rumen Tull_
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•
0
0
N
0
N
* - Identification of units is:
m
w
4
a
950962
SUMMARY SHEET BY
INDIVIDUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME WMHC - OPTION A
• Account Code 82
• Program Code 1782
♦ Total Children To Be Served 16
• Average Monthly Children To Be Served 1.5
♦ Total Families To Be Served 16
Average Monthly Families To Be Served 1.5
♦ Employee FTE Number
♦ Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
Purchased (Contractor) Cost Per Child
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
$37,961.00 + 0.00 = $37,961.00 -
CONTRACTOR COST DSS OVERHEAD COST COST OF PURCHASED SER.
16
NO. OF
CHILD
TO BE SERVED
_ $2,372.56
12 = $197.71
PURCHASED SERVICE NUMBER OF MONTHLY COST
COST PER CHILD MONTHS PER CHILD
OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost
$2,372.56
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 26,049.27
Total 100% Plan Cost of Purchased Service $ 11,911.73
TOTAL PLAN COST OF SERVICE DELIVERY $ 37,961.00
PAGE 20
950962
SUMMARY SHEET SY
I ND I V I DUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME ISLAND GROVE - OPTION B
• Account Code 83
• Program Code 1783
• Total Children To Be Served 16
• Average Monthly Children To Be Served 2
• Total Families To Be Served 16
Average Monthly Families To Be Served 2
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
• Purchased (Contractor) Cost Per Child
$33,816.90 + 0.00 = $33,816.90 T
CONTRACTOR COST DSS OVERHEAD COST COST OF PURCHASED SER.
16
NO. OF
CHILD
TO BE SERVED
$2,113.56 • 12 = $176.13
PURCHASED SERVICE NUMBER OF MONTHLY COST
COST PER CHILD MONTHS PER CHILD
OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2)
Purchased Service Cost $2,113.56
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 23,205.54
Total 100% Plan Cost of Purchased Service $ 10,611.36
TOTAL PLAN COST OF SERVICE DELIVERY $ 33,816.90
PAGE 21
95(;962
SUMMARY SHEET Sr
= ND = V= DUAL SERVICE
(To be completed for each service -- including county optional services)
SERVICE NAME WMHC - OPTION B
• Account Code 83
• Program Code 1783
• Total Children To Be Served 32
• Average Monthly Children To Be Served 3
• Total Families To Be Served 32
Average Monthly Families To Be Served 3
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
COST OF PROVIDED SERVICE
• Purchased (Contractor) Cost Per Child
$37,961.00 -F 0.00
NUMBER OF
MONTHS OF
SERVICE
CONTRACTOR COST DSS OVERHEAD COST
32 = $1,186.28
NO. OF PURCHASED SERVICE
CHILD COST PER CHILD
TO BE SERVED
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost
MONTHLY COST
PER CHILD
$37,961.00
COST OF PURCHASED SER.
12 = $98.86
NUMBER OF
MONTHS PER CHILD
OF SERVICE
MONTHLY COST
$1,186.28
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service
Total 100% Plan Cost of Purchased Service
$
26,049.27
11,911.73
TOTAL PLAN COST OF SERVICE DELIVERY $ 37,961.00
PAGE 22
SUMMARY SHEET BY
I ND I V I DUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME ISLAND GROVE - INTENSIVE FAMILY THERAPY
• Account Code 84
• Program Code 1784
• Total Children To Be Served 30
• Average Monthly Children To Be Served 10
• Total Families To Be Served 30
• , Average Monthly Families To Be Served 10
• Employee FTE Number
Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE NUMBER OF MONTHLY COST
CHILDREN COST PER CHILD MONTHS OF PER CHILD
TO BE SERVED SERVICE
• Purchased (Contractor) Cost Per Child
$44,008.04 + 0.00 = $44,008.04
CONTRACTOR COST DSS OVERHEAD COST COST OF PURCHASED SER.
30 = $1,466.93 ▪ 12 = $122.24
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2)
Purchased Service Cost $1,466.93
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service
Total 100% Plan Cost of Purchased Service
$
30,198.82
13,809.22
TOTAL PLAN COST OF SERVICE DELIVERY $ 44,008.04
PAGE 23
950962
SUMMARY SHEET BY
I ND I V I DUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME WMHC - INTENSIVE FAMILY THERAPY
• Account Code 84
• Program Code 1784
• Total Children To Be Served 32
• Average Monthly Children To Be Served 12
• Total Families To Be Served 32
Average Monthly Families To Be Served 12
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
• Purchased (Contractor) Cost Per Child
$73,234.00 -t- 0.00 = $73,234.00
CONTRACTOR COST
DSS OVERHEAD COST COST OF PURCHASED SER.
32 = $2,288.56 - 12 = $190.71
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2)
Purchased Service Cost $2,288.56
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 50,254.00
Total 100% Plan Cost of Purchased Service $ 22,980.00
TOTAL PLAN COST OF SERVICE DELIVERY $ 73,234.00
PAGE 24
950962
SUMMARY SHEET BY
I ND I V I DUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME ACKERMAN & ASSOC. INTENSIVE FAMILY THERAPY
• Account Code 84
• Program Code 1784
• Total Children To Be Served
• Average Monthly Children To Be Served
• Total Families To Be Served 24
• ; Average Monthly Families To Be Served 2
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
COST OF PROVIDED SERVICE
• Purchased (Contractor) Cost Per Child
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
$30,312.00 + 0.00 = $30,312.00
CONTRACTOR COST
DSS OVERHEAD COST COST OF PURCHASED SER.
24 = $1,263.00
NO. OF PURCHASED SERVICE
CHILD COST PER CHILD
TO BE SERVED
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost
• Total
12 = $105.25
NUMBER OF
MONTHS PER CHILD
OF SERVICE
MONTHLY COST
$1,263.00
FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service
Total 100% Plan Cost of Purchased Service
$
$
20,800.44
9,511.56
TOTAL PLAN COST OF SERVICE DELIVERY $ 30,312.00
PAGE 25
950962
SUMMARY SHEET BY
MNI13][17]:I3112122k1:. SERVICE
(To be completed for each service -- including county optional services)
SERVICE NAME A WOMAN'S PLACE - LIFE SKILLS
• Account Code 85
• Program Code 1785
• Total Children To Be Served 0
• Average Monthly Children To Be Served 6
• Total Families To Be Served 20
♦ Average Monthly Families To Be Served 6
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE NUMBER OF MONTHLY COST
CHILDREN COST PER CHILD MONTHS OF PER CHILD
TO BE SERVED SERVICE
• Purchased (Contractor) Cost Per Child
$29,035.80 -F- 0.00 = $29,035.80 r
CONTRACTOR COST DSS OVERHEAD COST COST OF PURCHASED SER.
20 = $1,451.79 - 12 = $120.98
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2)
Purchased Service Cost $1,451.79
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 19,924.70
Total 100% Plan Cost of Purchased Service $ 9,111.10
TOTAL PLAN COST OF SERVICE DELIVERY $ 29,035.80
PAGE 26
950962
SUMMARY SHEET BY
INDIVIDUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME CARE - LIFE SKILLS
♦ Account Code 85
• Program Code 1785
♦ Total Children To Be
Served 8
♦ Average Monthly Children To Be Served 9.25
♦ Total Families To Be Served 8
♦ Average Monthly Families To Be Served 9.25
♦ Employee FTE Number
♦ Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
NUMBER OF
MONTHS OF
SERVICE
• Purchased (Contractor) Cost Per Child
$52,544.98
CONTRACTOR COST
+ 0.00 =
MONTHLY COST
PER CHILD
$52,544.98
DSS OVERHEAD COST COST OF PURCHASED SER.
8 = $6,568.12
NO. OF PURCHASED SERVICE
CHILD COST PER CHILD
TO BE SERVED
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost
12 = $547.34
NUMBER OF
MONTHS PER CHILD
OF SERVICE
MONTHLY COST
$6,568.12
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 36,056.96
Total 100% Plan Cost of Purchased Service $ 16,488.02
TOTAL PLAN COST OF SERVICE DELIVERY $ 52,544.98
PAGE 27
950962
SUMMARY SHEET BY
I ND I V I DUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME 1ST STEPS - LIFE SKILLS
• Account Code 85
• Program Code 1785
• Total Children To Be Served 6
• Average Monthly Children To Be Served 3
• Total Families To Be Served 6
• Average Monthly Families To Be Served 3
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
COST OF PROVIDED SERVICE
NUMBER OF
MONTHS OF
SERVICE
• Purchased (Contractor) Cost Per Child
MONTHLY COST
PER CHILD
$24,699.27 HI- 0.00 = $24,699.27
CONTRACTOR COST
DSS OVERHEAD COST COST OF PURCHASED SER.
6 = $4,116.55
NO. OF PURCHASED SERVICE
CHILD COST PER CHILD
TO BE SERVED
• Average Cost Per Child
1) Provided Service Cost
2)
• Total
12 = $343.05
NUMBER OF
MONTHS PER CHILD
OF SERVICE
MONTHLY COST
Purchased Service Cost $4,116.55
FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service
Total 100% Plan Cost of Purchased Service
$
16,948.92
7,750.35
TOTAL PLAN COST OF SERVICE DELIVERY $ 24,699.27
PAGE 28
950962
SUMMARY SHEET BY
INDIVIDUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME WCDH - LIFE SKILLS
• Account Code 85
• Program Code 1785
• Total Children To Be Served 9
• Average Monthly Children To Be Served 7
• Total Families To Be Served 9
• ' Average Monthly Families To Be Served 7
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDEDSERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
• Purchased (Contractor) Cost Per Child
$26,250.00 + 0.00 = $26,250.00
CONTRACTOR COST DSS OVERHEAD COST COST OF PURCHASED SER.
9 = $2,916.67 12 = $243.05
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost $2,916.67
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 18,013.05
Total 100% Plan Cost of Purchased Service $ 8,236.95
TOTAL PLAN COST OF SERVICE DELIVERY $ 26,250.00
PAGE 29
950962
SSAJMINLPLFZIC SHEET BY
I ND I V I DUAL SERVICE
(To be completed for each service -- including county optional services)
SERVICE NAME ALTERNATIVE HOMES - DAY TREATMENT
• Account Code 86
• Program Code 1786
• -Total Children To Be Served 16
• Average Monthly Children To Be Served 5.33
• Total Families To Be Served 16
Average Monthly Families To Be Served 5.33
• Employee FTE Number
• Provided (Employee) Cost Per Child
f
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
• Purchased (Contractor) Cost Per Child
$97,909.00 + 0.00
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
$97,909.00
CONTRACTOR COST DSS OVERHEAD COST COST OF PURCHASED SER.
16 = $6,119.31 12 • $509.94
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost
$6,119.31
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 67,186.27
Total 100% Plan Cost of Purchased Service $ 30,722.73
TOTAL PLAN COST OF SERVICE DELIVERY $ 97,909.00
PAGE 30
950962
SUMMARY S HE E T BY
I ND I V I DUAL SERVICE
(To be completed for each service -- including county optional services)
SERVICE NAME NCD YOUTH PASSAGES - DAY TREATMENT
• Account Code 86
• Program Code 1786
• Total Children To Be Served 36
• Average Monthly Children To Be Served 2
• Total Families To Be Served 36
Average Monthly Families To Be Served 2
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE NUMBER OF MONTHLY COST
CHILDREN COST PER CHILD MONTHS OF PER CHILD
TO BE SERVED SERVICE
• Purchased (Contractor) Cost Per Child
$66,777.60 + 0.00 = $66,777.60 T
CONTRACTOR COST DSS OVERHEAD COST COST OF PURCHASED SER.
36 = $1,854.93 : 12 = $154.58
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost $1,854.93
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 45,823.55
Total 100% Plan Cost of Purchased Service $ 20,954.05
TOTAL PLAN COST OF SERVICE DELIVERY $ 66,777.60
PAGE 31
95G962
SUMMARY SHEET SW
I ND I V I DUAL S E RV I C E
(To be completed for each service -- including county optional services)
SERVICE NAME WCDSS - DAY.TREATMENT
♦ Account Code 86
♦ Program Code 1786
♦ Total Children To Be Served 6
• Average Monthly Children To Be Served 6
• Total Families To Be Served 6
Average Monthly Families To Be Served 6
• Employee FTE Number
• Provided (Employee) Cost Per Child
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
♦ Purchased (Contractor) Cost Per Child
$93,600.00 -I- 0.00
CONTRACTOR COST
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
$93,600.00
DSS OVERHEAD COST COST OF PURCHASED SER.
6 = $15,600.00 12 = $1,300.00
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost $15,600.00
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service
Total 100% Plan Cost of Purchased Service
$
$
64,229.38
29,370.62
TOTAL PLAN COST OF SERVICE DELIVERY $ 93,600.00
PAGE 32
950962 .1
SIMI:MARY SHEET Sr
3:P4I3JENTJEI3IJAIL. S E RC7 I C E
(To be completed for each service -- including county optional services)
SERVICE NAME WMHC - SEX ABUSE TREATMENT
• Account Code 87
• Program Code 1787
• Total Children To Be Served 24
• Average Monthly Children To Be Served 9
• Total Families To Be Served 24
Average Monthly Families To Be Served 9
• Employee FTE Number
• Provided (Employee) Cost Per Child
-t-
PER. SER. COST DSS OVERHEAD COST COST OF PROVIDED SERVICE
NO. OF PROVIDED SERVICE
CHILDREN COST PER CHILD
TO BE SERVED
• Purchased (Contractor) Cost Per Child
$54,926.00 + 0.00
CONTRACTOR COST
NUMBER OF
MONTHS OF
SERVICE
MONTHLY COST
PER CHILD
$54,926.00
DSS OVERHEAD COST COST OF PURCHASED SER.
24 = $2,288.58 - 12 = $190.72
NO. OF PURCHASED SERVICE NUMBER OF MONTHLY COST
CHILD COST PER CHILD MONTHS PER CHILD
TO BE SERVED OF SERVICE
• Average Cost Per Child
1) Provided Service Cost
2) Purchased Service Cost
$2,288.58
• Total FPP Funds Proposed For This Service:
Total 80/20 Plan Cost of Provided Service $ 37,690.84
Total 100% Plan Cost of Purchased Service $ 17,235.16
TOTAL PLAN COST OF SERVICE DELIVERY $ 54,926.00
PAGE 33
95 962
TOTAL FUNDS
100%
C')
I.
.I
.-I
01
N
.-I
44
to
Cl
.-I
.i
to
O
.-I
K
M
N
.-1
w
01
r4
.-I
(R
$ 13,809.22
$ 22,980.00
to
in
.-1
.4
In
01
d!
O
.-I
.-I
.-I
.-I
01
44
$ 16,488.02
$ 7,750.35
to
01
to
Cl
N
CO
V}
$ 30,722.73
$ 20,954.05
$ 29,370.62
$ 17,235.16
$220,604.59
TOTAL FUNDS
80/20
$ 26,049.27
$ 23,205.54
$ 26,049.27
N
CO
•
co
01
r1
o
M
64
$ 50,254.00
$ 20,800.44
$ 19,924.70
to
al
to
In
0
t0
f7
64
$ 16,948.92
In
o
r1
.-i
0
co
.--I
4*
$ 67,186.27
$ 45,823.55
$ 64,229.38
$ 37,690.84
$482,431.00
OTHER SOURCE
FUNDS
OTHER DSS
FUNDS
m
Q
Z
W
O.
w
W
0
o
.
.-I
I.0
01
N
re)
.4
$ 33,816.00
0
0
.-1
ID
01
N
r)
yr
$ 44,008.04
$ 73,234.00
$30,312.00
$ 29,035.80
$ 52,544.98
$ 24,699.27
$ 26,250.00
0
0
01
0
01
N
01
dr
$ 66,777.60
0
0
0
0
to
In
0)
w
$ 54,926.00
$703,035.59
SERVICE NAME
WMHC - OPTION A
ISLAND GROVE -
OPTION B
WMHC - OPTION B
ISLAND GROVE -
INT. FAM. THER.
WMHC - INT. FAM.
THER.
ACKERMAN & ASSO.
INT. FAM. THER.
A WOMAN'S PLACE
LIFE SKILLS
CARE - LIFE SKILLS
1ST STEPS - LIFE
SKILLS
WCHD - LIFE SKILLS
ALTERNATIVE HOME
DAY TREATMENT
YOUTH PASSAGE
DAY TREATMENT
WCDSS - DAY
TREATMENT
WMHC - SEX ABUSE
TREATMENT
2Q03
'DOUd
N
CO
N
.i
1783
1783
1784
1784
1784
In
CO
N
_I
In
CO
N
..I
1785
1785
to
W
N
.i
CO
CO
N
.i
t0
CO
N
.i
1787
•
0 O
0 0
co
N
co
en
co
en
co
of
co
d'
CO
d'
CO
In
CO
in
CO
In
CO
In
W
to
CO
to
CO
to
CO
N
CO
U,
a
H
0
E
In
v
0
to
O
N
N
a
a
0
a
E
0
E
M
C
a
950962
ca
COUNTY(IES)
COST PER
YEAR
$ 26,049.27
$ 23,205.54
$ 26,049.27
$ 30,198.82
$ 50,254.00
Tr
o
O
CO
0
N
V}
$ 19,924.70
$ 36,056.96
N
01
CO
c
01
0 1
N
V}
$ 18,013.05
$ 67,186.27
$ 45,823.55
$ 64,229.38
$ 37,690.84
COST,,
PER CHILD
PER MONTH
r'-
N
N
01
N
V}
$ 176.13
10
co
co
01
V}
$ 122.24
r-i
N
O
01
.-1
d}
$ 105.25
CO
01
O
N
.-1
V}
$ 547.34
Ui
O
m
d'
M
V}
$ 243.05
$ 509.94
$ 154.58
a
O
0
0
M
V}
$ 190.72
NO.
CHILD
PER MO.
U,
.--I
N
3
0
H
N
.-I
N
10
U,
N
01
M
n
5.33
N
1O
01
AGE OF
CHILD
PROVIDER
OR NO.
FTE
SERVICES DESCRIPTION
OPTION A
OPTION B
OPTION B
a
Cu
x
E
x
w
•
z
M
INT. FAM. THER.
INT. FAM. THER.
LIFE SKILLS
LIFE SKILLS
LIFE SKILLS
LIFE SKILLS
DAY TREATMENT
DAY TREATMENT
DAY TREATMENT
SEX ABUSE TREATMENT
SERVICES
WMHC
ISLAND GROVE
WMHC
ISLAND GROVE I
U
s
ACKERMAN &
ASSOC.
A WOMAN'S
PLACE
CARE
1ST STEPS I
WCHD
ALTERNATIVE
HOMES
YOUTH L
PASSAGES
WCDSS
U
x
$482,431.00
O
N
0
CO
TOTAL PAC
950962
go)
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2
g
0riaW.
O
Vo
zoo
]zo
wo°
<>a
;co
H
44:1H
ww
a
a
COUNTY(IES)
COST PER
YEAR
en
N
H
-
01
.-I
N
d!
I$ 10,611.36
th
N
N
.-I
01
.-I
.--I
Vt
N
N
O1
a
CO
M
..-I
Vt
0
a
a
co
01
N
N
Vt.
10
Ln
.-I
.-I
N
01
VP
0
N
.-i
N
.-I
0%
H
N
a
0
CO
d'
10
N
V!
N
M
a
in
N
N
VI
u1
01
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$ 30,727.73
$ 20,954.05
$ 29,370.62
$ 17,235.16
COST
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PER MONTH
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$ 176.13
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$ 122.24
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$ 105.25
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$ 547.34
$ 343.05
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SERVICES DESCRIPTION
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DAY TREATMENT
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SEX ABUSE TREATMENT
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COLORADO
MEMORANDUM
DEPARTMENT OF SOCIAL SERVICES
P.O. BOX A
GREELEY, COLORADO 80632
Administration and Public Assistance (303) 352-1551
Child Support (303) 352-6933
Protective and Youth Services (303) 352-1923
Food Stamps (303) 356-3850
FAX (303) 353.5215
TO: Jackie Sinnett, Program Administrator
Family Preservation Program
FROM: Dan Fowler, Social Services Administrator VI
DATE: May 5, 1995
SUBJECT: 1995-96 Family Preservation Program Plan
Enclosed please find the original and eight copies of Weld County's 1995-96
Family Preservation Program Plan.
If you need further information or have any questions, please do not hesitate
to call me. Thank you.
DF:cm
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