HomeMy WebLinkAbout991274.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR CORE
SERVICES FUNDS AND AUTHORIZE CHAIR TO SIGN -WELD COUNTY
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
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 Core Services 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 County Department of Public Health and Environment, commencing
June 1, 1999, and ending May 31, 2000, with further terms and conditions being as stated in
said award, and
WHEREAS, after review, the Board deems it advisable to approve said award, 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 Core Services 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 County Department of Public Health and Environment be, and
hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said award.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 2nd day of June, A.D., 1999, nunc pro tunc June 1, 1999.
BOARD OF COUNTY COMMISSIONERS
y(d€lp COUNTY, COL AD
ATTEST: I�,���j� r=.:F. )'
' ' Dale K. Hall, Chair
Weld County Clerk to tg; . t&'� 1 �1
1 fG � kuy EXCUSED DATE OF SIGNING (AYE)
? • Barbara J. Kirkmeyer, Pro-Tem
Deputy Clerk to the BAtJWV EXCUSED TE OF SIGNING (AYE)
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991274
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DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY, CO 80632
Administration and Public Assistance(970) 352-1551
C. Child Services
(970)352-69331
Protective and Youth Services (970)352-1923
COLORADO MEMORANDUM
TO: Dale K. Hall, Chair Date: May 24, 1999
Board of County Commissioners /
FR: Judy A. Griego, Director, and Social Services aI, t
RE: Core Services Notification of Financial Assistance Award /
between the Weld County Department of Social Services
and the Weld County Health Department
Enclosed for Board approval is a Core Services Notification of Financial Assistance
Award (NOFAA) between the Weld County Department of Social Services and the Weld
County Health Department. The purpose of the NOFAA is to conclude our Request for
Proposal Process for vendors under the Core Services Funds. The Families, Youth, and
Children (FYC) Commission has recommended approval of the NOFAA.
1. The term of the NOFAA is from June 1, 1999 through May 31, 2000.
2. The source of funds is Core Services, Family Issues Cash Fund. Social Services
agrees to pay the Weld County Health Department a unit cost as outlined in this
Memorandum.
3. The Weld County Health Department will provide a Life Skills Program entitled,
"Attachment Program", as follows:
A. Description: The program will identify twelve children(ages infant to
eight) with an attachment disorder. The Attachment Center will complete
an evaluation and recommend intervention strategies by the Health
Department's nurse. The nurse will provide services at the family's home
for two to three hours per week for six to eight months.
B. Cost Per Unit of Service: $103.00 per hour.
If you have any questions, please telephone me at extension 6510.
991274
Weld County Department of Social Services
Notification of Financial Assistance Award
for Families,Youth and Children Commission (FYC)Funds
Type of Action Contract Award No.
X Initial Award FY99-PAC-8000
Revision (RFP-FYC-99005)
Contract Award Period Name and Address of Contractor
Beginning 06/01/1999 and Weld County Department of Health
Ending 05/31/2000 Life Skills - Attachment Program
1555 N 17 Avenue
Greeley, CO 80631
Computation of Awards Description
Unit of Service The issuance of the Notification of Financial Assistance
Award is based upon your Request for Proposal (RFP).
Identify 12 children (0-8) per year who screen The RFP specifies the scope of services and conditions
positive with an attachment disorder. Children of award. Except where it is in conflict with this
who screen positive, a complete evaluation would NOFAA in which case the NOFAA governs, the RFP
be done by a therapist from the Attachment upon which this award is based is an integral part of the
Center. Therapist would make specific action.
recommendations for intervention by WCHD Special conditions
nurse in the family's home, two to three hours per 1) Reimbursement for the Unit of Services will be based
week for six to eight months. on an hourly rate per child or per family.
2) The hourly rate will be paid for only direct face to face
cost Per Unit of Service contact with the child and/or family, as evidenced by
client-signed verification form, and as specified in the
Hourly Rate Per S 103.00 unit of cost computation.
Unit of Service Based on Approved Plan 3) Unit of service costs cannot exceed the hourly and
yearly cost per child and/or family.
4) Payment will only be remitted on cases open with, and
referrals made by the Weld County Department of
n losur Social Services.
igned RFP:Exhibit A 5) Requests for payment must be an original submitted to
Supplemental Narrative to RFP: Exhibit B the Weld County Depaitinent of Social Services by the
Recommendation(s) end of the 25th calendar day following the end of the
month of service. The provider must submit requests
Conditions of Approval for payment on forms approved by Weld County
Department of Social Services.
Ap als: Program Official:
By By
Dale K. Hall, Chair Judy Grie , Direct
Board of Weld County Commissioners Weld ounty Department of Social Services
Date: OyD�/ Date:—_ q --
Qa -a 7�
INVITATION TO BID
RFP-FYC 99005
DATE: February 26, 1999 BID NO: RFP-FYC-99005
RETURN BID TO: Pat Persichino, Director of General Services
915 10th Street, P.O. Box 758, Greeley, CO 80632
SUMMARY
Request for Proposal (RFP-FYC-99005) for: Family n tion Program i ife Skills Program Family
Issues Cash Fund or Family Preservationlrogam Funds
Deadline: March 23, 1999, Tuesday, 10:00 a.m.
The Families, Youth and Children Commission, an advisory commission to the Weld County Department of
Social Services, announces that applications will be accepted for approved vendors 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 Families, Youth and Children Commission wishes to approve services targeted to
run from June 1, 1999, through May 31, 2000, at specific rates for different types of service, the county will
authorize approved vendors and rates for services only. The Life Skills Program must provide services that
•
focus on teaching life skills which are designed to improve household management competency, parental
competency, family conflict management and effectively accessing community resources. This program
announcement consists of five parts, as follows:
PART A...Administrative Information PART D..Bidder Response Format
PART B...Background, Overview and Goals PART E...Bid Evaluation Process
PART C...Statement of Work
Delivery Date March 22, 1999
(After receipt of order) B ST BE SIGNED IN INK
John Pickle
TYPED OR PRINTED SIGNATURE
Weld County Department of
VENDOR Health and Environment
(Name) dwritten Signature By Authorized
Officer or Agent of Vender
Director of Weld County Departme
ADDRESS 1551 N 17th Avenue TITLE of Health and Environment
Greeley, CO 80631 DATE 3V ✓Y
PHONE # (970)304-6420
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
Page 1 of 35
RFP-FYC-99005 Attached A
LIFE SKILLS PROGRAM BID PROPOSAL AND
REQUEST FOR CONTINUATION OF AWARD UNDER FPP CORE SERVICES FUNDING
FAMILY PRESERVATION PROGRAM
1999/2000 BID PROPOSAL APPLICATION
PROGRAM FUNDS YEAR 1999-2000
BID #RFP-FYC-99005
NAME OF AGENCY: WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ADDRESS: 1555 N 17TH AVENUE; GREELEY, CO 80631
PHONE:(970 ) 304-6420
CONTACT PERSON: BECKY MCMAHAN TITLE: REGISTERED NURSE
DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Life Skills Program Category mustpmvidr
services that focus on teaching life skills designed to facilitate implementation of the case plan by improving household
management competency.parental competency.family conflict management and effectively accessing community resources
12-Month approximate Project Dates: _ 12-month contract with actual time lines of:
Start June 1. 1999 Start JUNE 1, 1999
End Mar 31.2000 End MAY 31, 2000
TITLE OF PROJECT: Identification & Case management of families with Attachment and Bonding issue:
AMOUNT REQUESTED:
d LC a�a��99
Linda Carlson BSN MA Prevenative Health Services
Name and Signature of Person aring Document Date
ohn S Pickle, R.S., M.S.E.H. , Director 371--J—/l�
ame and Signature Chief Administrative Officer Applicant Agency Da e
MANDATORY PROPOSAL REOUI$,EMENTS
For both new bids and renewal bids,please initial to indicate that the following required sections are included in this Proposal for
Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund Year 1999-2000 to
Program Fund year 1999-2000.
Indicate No Change from FY 1998-1999
- Project Description NO
_ Target/Eligibility Populations NO
- Types of services Provided NO
_ Measurable Outcomes NO
- Service Objectives NO
- Workload Standards NO
- Staff Qualifications NO
- Unit of Service Rate Computation YES
- Program Capacity per Month NO
Certificate of Insurance
Page 29 of 3 5
RFP-FYC-99005 Attached A
Date of Meeting(s)with Social Services Division Su,ervisor: 3- ._ CT 9
C en by SSD Supervisor: U-Q YCo--,-,-1-QQ 3 1:5-)
tO C.e (3-'2-ci? 6
G/obi a Rovv\an5 I. K -
. Q-.5-v=10, 4 G . -P / - g - 9 9
Name and Signature of SSD Supervisor Date
Page 30 of 35
ATTACHMENT AND BONDING PROGRAM
I. Project Description
Definition:
An Attachment Disorder (AD) is a condition in which individuals have
difficulty forming loving, lasting relationships in most severe situations, due
to interferencs at birth and early childhood. These children fail to develop
a conscience and do not learn to trust others. These are the babies who
resist cuddling, the children who are disruptive in day care and classrooms,
and the teenagers who are found in juvenile halls.
Precipitating Factors:
Children who experience separation from the biological mother from
conception through age two are at high risk for some degree of AD.
Situations which contribute to this are prenatal interference, premature
birth, hospitalization, abuse, neglect, and poor parenting skills.
Intervention:
The purpose of this program is to provide support and information to
parents to assist them in rebuilding a broken bond. Early intervention is an
important factor in assisting parent/child relationships with rebonding
experiences. The goal of this program is to keep children with their
biological parents or with a current parent figure to prevent failed
placements and frequent moves, which further disturb the bonding
relationship.
Evaluation:
Families who are referred to this program will be evaluated by the
public health nurse for behaviors which would indicate the presence of some
degree of AD. Attachment Disorder symptoms occur on a continuum from
mild to severe. Children who have a severe degree of problems will be
further evaluated by a community therapist with further consultation from
the Attachment Center in Evergreen on a case by case basis. Dr. Marilee
Smith, a family therapist in our community who has been working with AD
children, will provide an evaluation and determine appropriate therapy for
families referred to her by a public health nurse. Becky McMahan, a public
health nurse with extensive experience in pediatric health care, will
Page 2
work closely with families redirecting the parenting process through weekly
home visits. Margaret Menecke, a therapist from the Attachment Center in
Evergreen, will provide a consultation evaluation as referred by the public
health nurse and/or the community therapist as needed. This family
centered, collaborative model has been an effective program over the past
three years.
Direction and Closure:
An important part of the public health nurse evaluation is to identify
the degree of attachment issues, level of frustration, and the strength and
commitment of the family. The public health nurse will work with the family
in the home for a predetermined period of time. This will include providing
the parents with support and information they will need to take care of
themselves and their children with AD. Weekly sessions will provide
direction and closure around the attachment issues. Ultimate closure is
reached when the parent/child relationship is reestablished, fears and
insecurities diminish, and outside assistance is no longer needed.
II. TARGET AND ELIGIBILITY POPULATION
Identification:
Services will be provided upon referral from the Department of Social
Services (D55) for families who are experiencing difficulty with attachment
and bonding issues. Children must be at risk for being removed from the
current home environment or at risk for continued placement outside of the
home. History of poor health, parental abuse, neglect, lack of parenting
skills, substance abuse and domestic violence all place children at high risk
for attachment and bonding problems. Infants born prematurely or
separated from their biological mother are also at high risk for bonding
issues.
focus and Limitation:
A total of twelve family units will be served, with children's ages from
birth to age eight. These family units would include all family members who
Page 3
have a relationship with the identified child. The family must be willing to
invest in an ongoing relationship with the public health nurse and be
committed to improving the home environment for the safety of the child.
If the children are in foster placement, efforts will be made to work with
foster parents and biological parents to assist in reunification of families.
We will assist fost-adopt and adoptive parents through an adjustment period
to ensure that the adoption will work.
Time Line Expectations:
Referrals for all Weld County families, regardless of demographic
location, will be served. Weld County's population includes a high number of
monolingual Hispanic families. Children in these families will be served
through provision of an interpreter. Families would remain in the program
for six to eight months initially based on D55 case worker's referral. The
average hours per week per family would be two to three hours. The
monthly maximum number of families receiving intervention through home
visitation will be five. The monthly average home visitation capacity would
be three to four families. A family could conceivably complete the program
or be terminated early, depending on the individual circumstances. A
particular referral could be renewed for another six to eight months if the
family is working successfully toward reconciliation and more time is needed
to secure the family unit. This would be up to the discretion of the public
health nurse, the therapist, the D55 case worker and the family.
III. SERVICES TO BE PROVIDED
Action Plan:
This program is designed to provide home visitation by a public health
nurse, to assist the family with identification of their needs and to develop a
plan with successful outcomes. Intervention includes providing information
and supporting the parents to improve their own self esteem and to enable
them to parent successfully. Through the parent's increased knowledge and
awareness of AD, they will begin to understand their child's behavior and
their parent-child relationship. The emotional status of parents is a key
component to the success or failure of this program.
Page 4
Skill Level Objectives:
The public health nurse during the home visits will model good
parenting techniques which include positive interaction, like cuddling,
rocking, eye to eye contact, reading and talking appropriately to their child.
These interactions are basic to rebuild the broken bond between the child
with AD and the parent. Parents are also taught the types of discipline
which are effective for a child with AD. This is implemented by
demonstration and positive coaching techniques given by the public health
nurse.
Goals:
Every day living skills are addressed per family assessment. Emphasis
on providing a routine, safe and stable environment is important for families
with AD children. Assistance to meeting household management goals is
provided through the public health nurse by information on appropriate
every day living skills. This stable home life is needed for the AD child to
develop a sense of trust and security.
Support Network:
Families are assisted with referrals to other community agencies as
the need arises. Referrals range from medical issues to social concerns.
Once knowledgeable about community services, families may continue to
access these agencies as needed. Plans for resuming a support group for
parents of attachment disordered children are in process.
An Understanding:
Families receive an ongoing evaluation to support and acknowledge
their progress and identify problem areas. A mutual agreement is set
between the nurse and the family to work together to provide a positive plan
that serves the family's situation. Both the nurse and the family will
mutually agree when the goals of the plan are met.
Page 5
IV. EXPECTED MEASURABLE OUTCOMES
Screening the Child::
All families will be screened with a tool designed to indicate the
presence and degree of AD. This screening identifies the problem behaviors
of the child and gives a starting measure of parents' emotional status and
degree of involvement with their child. (Copy attached)
By discussing the results of this screening, we will assist families in
identifying the needs of their child. This discussion is helpful to the
screener in determining the degree of commitment the parent has toward
the parent-child relationship; giving the Public Health Nurse (PHNJ insight
into how best to work with parents to improve parenting skills. The
discussion may also open insights, improved understanding and reassurance
for the parent regarding their child's needs. This assessment will be
completed periodically through the referral period to measure the status of
the family.
Screening the Family:
We will utilize the Home Visit Risking tool to identify problems in the
home which relate to safety, social and health concerns. This tool focuses
on a wide variety of risk factors in every day living. (Copy attached) The
tool allows the public health nurse to develop a working measurable plan with
the family.
We will share with the family the concerns arising from this
assessment and include their own perception of difficult areas. This tool will
be used to identify strengths in the family and to develop a plan with them
for working to improve problem areas. We will re-evaluate periodically with
parents to review progress and reappraise their concerns.
Outside Agency Support
Parents are encouraged to work with community agencies to assist
with their needs. The public health nurse serves as a liaison between the
family and the agency involved to facilitate a positive experience and
outcome. This is measured by a family's commitment in keeping
Page 6
appointments, providing the necessary paperwork, and being responsible to
the agencies requirements.
If at the end of the referral time, the PHN does not see improvement
in the family situation, she will request a renewal of the referral to the
program. The PHN will also explore with the case worker and other involved
professionals, other avenues of service which might be helpful to the family.
The PHN will make one phone contact with the family six months after
completion of the program to determine their current status.
V. SERVICE OBJECTIVES
Periodic Review:
We would expect that parents would first come to understand the
need to provide a safe, healthy home environment for their children.
Through direct parent modeling, providing information, improved home
interaction and, in some cases, referral to other community resources, we
would expect to see positive changes in the home.
We expect parents to reach a better understanding of their nurturing
parent role through reading educational literature and experiencing
repeated parent demonstrations. We would expect to see an improved
ability to provide a physically safe home environment with an emotionally
secure parent/child connection. We anticipate improvement in the parents'
ability to provide age appropriate interactive activities, with limit setting,
and healthy discipline measures appropriate for the age of the child.
Using Resources:
Once we have introduced parents to available resources, we would
expect parents to access these resources to meet their needs. Experiencing
trust and support through community resources is a healthy step toward
establishing family connectedness. After being assisted initially through
this program, the families may continue to access services independently as
needed. Learning the right phone calls to make and the necessary paper
work to be filled out are steps down the road to parent competence.
Page 7
Empowerment:
An important part of this program is enabling parents. Many parents who
have children with AD feel isolated and angry. They tend to doubt their own
ability to parent. By offering the tools of this program with its positive support,
we expect to see a parent with heightened self-esteem and a family with vibrant
signs of life and well-being.
VI. WORKLOAD STANDARDS
A. Public health 48 hours per month of nurse time will be provided. Four hours
per month will be provided by community therapist. Twenty-four hours of
consultation time will be provided over the course of a year by a therapist from
Evergreen.
B. The services will be provided by three individuals, a public health nurse, a
community therapist, and a consultant from Evergreen.
C. The public health nurse will be providing a maximum of 4-5 clients in a month's
duration.
D. The modality of treatment will be home visits provided by the public health
nurse 1-3 times per week. Office visits will be modality of treatment for families
referred to therapist. The consultation from Evergreen will be available for the
public health nurse, community therapist, and family as the need arises.
E. As A-D above.
F. As A-D above.
G. Covered by county insurance--no copy attached.
•
Page 8
VII. STAFF QUALIFICATIONS
Becky McMahan R.N., B.S.N.
Becky meets the educational requirements for nurses at the Weld
County Health Department with a Bachelor's degree in nursing. She has
previous experience of fourteen years working in pediatric nursing in the
hospital setting. Becky has been with the Health Department for three and
a half years with her primary program focused in Attachment Disorder. She
works as program charge nurse for the Well Child Clinic held once a week
and home visitation to high risk infants. Becky has received training through
the Attachment Center at Evergreen, and continues to keep abreast on
current developments related to the field.
Cheryl Weinmeister, R.N., B.S.N.
Cheryl is the Child Health Supervisor since 1998, and has been at the
Health Department since 1992. Cheryl's experience includes six years
working with children who have special needs. Cheryl is committed to the
programs goals and objectives, and is aware of the time allotted to assure
success.
Becky Cervantes, Interpreter
Becky is the interpreter and office technician for the program. She
is bilingual and works on the Child Health Team. Currently Becky is being
trained in developmental screenings and assists Becky McMahan with clerical
duties.
Dr. Marilee Smith Psy.D.
Marilee is a psychologist working in Weld County. In 1997, she
received specialized training in the treatment of children with Attachment
Disorders.
Margaret Meinecke L.C.S.W.
Margaret is a therapist from the Attachment Disorder Treatment
center in Evergreen. She has 10 years experience as a private practice
clinician working with families.
SIGNS OF ATTACHMENT DISORDER ATTACHMENT A
ONE TO EIGHT YEARS OF AGE
CHILD'S NAME BIRTH DATE
PERSON SCORING:
SIGNS PROBLEM SEVERITY
NONE MILD MODERATE ' SEVERE
(never) (25%of the time) (50%of the time) (75%or more)
Lack of ability to give and receive affection.
(demands affection in a controlling way: abrupt neutral.
unenthusiastic exchanges: absence of warm physical
contact demanding and dingy)
Extreme control problems.
(persistent frequent tantrums: hyperactivity evident)
Self-destructive behavior.
High threshold of discomfort.
(will-rot seek comfort if in pain)
Cruelty to others or animals.
(sadistic violent bullies.threatens,or intimidates: initiates
physical fights: has used a weapon)
•
Counterfeit emotionality.
(phoniness)
Stealing, hoarding,or gorging.
(has broken into someone else's home,care,etc.: has stolen
items of non-trivial value: has stolen while confronting a
person.i.e.,mugging) .
Speech pathology.
(problems of speech development)
Lack of long-term childhood friends. ----
Abnormalities in eye contact.
Sexual obsession.
(Has forced someone into sexual activity)
Preoccupied with blood,fire, and gore_
(deliberatelyengaged in fire setting)
Superficial attractiveness and friendliness with
strangers_
(indiscriminatedisplays of affection)
Destruction of property.
Compulsive lying.
(devious: manipulative)
Defective conscience
(no remorse) Difficult to observe — — —
Learning disorders — —------ --
Problems with motor coordination
(may appear accident prone) ---- -
Oppositional, resistant defiant. and controlling
behavior
WINGS Attachments;
HOME VISITING - RISKING TOOL
u.ild's Name D.O.B.
Score and date administered, please score on scale of 1-5 with 5 being the highest risk.
I HEALTH VII COMMUNICATION
A.NO PRIMARY PHYSICIAN A. LITERACY
B. UNINSURED B. PRIMARY LANGUAGE
C. UNDERINSURED . C. HEARING IMPAIRED
D.NO. OF HOSPITALIZATION D.HEARING
E .NO. OF DR. VISITS(over or under use)
F. VISITS TO OTHER PROVIDERS (over or under use) ASSISSTANCE WITH ACTIVITIES OF
G. E.R. VISITS (for acute care non emergency.) IX
OF DALIY LIVING _
II ECONOMIC RISKS A. RESPITE
A. UNEMPLOYED B. REHABILATION
B. HOMELESS 1. OCCUPATIONAL
C. INADEQUATE HOUSING (UNSAFE) 2. PHYSICAL
D. LOW INCOME 3. SPEECH
E. NUTRITION
F. CLOTHING X MEDICATION REVIEW
G. CHILD CARE
III VIOLENCE RISK XI LEGAL ISSUES
A. DOMESTIC VIOLENCE
B. ELDER VIOLENCE
C. CHILD ABUSE/NEGLECT XII EDUCATIOAL LEVEL
D. SEXUAL ASSAULT
F. GANG INVOLVEMENT
XII FAMILY STRUCRURE
IV MENTAL HEALTH CONCERNS A. SINGLE PARENT
A. GRIEF ASSISTANCE B. RUNAWAYS
B. VICTIM ASSISTANCE C. LIVING WITH NO PARENTS
C. ADDICTIONS D. TEEN PARENT
D. SUICIDE(PREVENTION/POSTVENTION)
E. DEPRESSION XIV DIAGNOSTIC CODE
V ISOLATION-GEOGRAPHIC
VI ENVIRONMENTAL RISKS
A POTTERY
13 WATER
C LEAD
D RAW MILK
I_ AIR
P_ CLUTTER - UNSANITARY CON ITIONS
RF -FYC-99005 Attached A
VIII. COMPUTATION OF DIRECT SERVICE RATE
This form is to be used to provide detailed explanation of the hourly rate your
organization will charge the Core Services 'Program for the services offered in
this Request for Proposal. This rate may only be used to bill the Weld County
Department of Social Services for direct, face-to-face services provided to
clients referred for these services by the Department. Requests for payment based
on units of service such as telephone calls, no shows, travel time, mileage
reimbursement, preparation, documentation, and other costs not involving direct
face-to-face services will not be honored. Likewise, billings must be for hours
of direct service to the client, regardless of the number of staff involved in
providing those services. Therefore, it is imperative that this rate be
sufficient to cover all costs associated with this client, regardless of the
number of staff involved in providing these services.
(Explanations for these Lines are Provided on the Following Page)
Total Hours of Direct Service per Client 54 Hours [Al
Total Clients to be Served 12 Clients [B]
Total Hours of Direct Service for Year 648 Hours [C]
(Line [Al Multiplied by Line [B]
• Cost per Hour of Direct Services $ 50.96 Per Hour [D]
Total Direct Service Costs ' $ 33,022 [E]
(Line [C) Multiplied by Line [D] )
Administration Costs Allocable to Program $ 26,299 [F)
Overhead Costs Allocable to Program $ 7,425 [G]
Total Cost, Direct and Allocated, of Program$ 66,746 [H]
Line (E] Plus Line [F] Plus Line [G] )
Anticipated Profits Contributed by this Program $ -0- [I]
Total Costs and Profits to be Covered
by this Program(Line [H] Plus Line [I) ) $ 66,746 [J]
Total Hours of Direct Service for Year 648 [K]
(Must Equal Line (C] )
Rate per Hour of Direct, Face-to-Face Service
to be Charged to Weld County Department of
Social services $ 103.00 [L]
Day Treatment Programs Only:
Direct Service House Per Client Per Month [M]
Monthly Direct. Service Rate $ [N]
Page 34 of35
RFP-FYC-99005 Attached A
[A] This is an estimate of the total hours of direct, face-to-face service each
client will receive from the time he or she enters the program until completing
the program.
[B] This is an estimate of the number of clients who will be served during the period
from June 1, 1999, through May 31, 2000.
[D] This represents the average hourly salary and benefits that your organization
pays its direct service providers plus any costs which are directly attributable
to the face-to-face session with the client.
[F] This represents the salary and benefits of direct service, supervisory, and
clerical personnel which are not incurred in providing direct, face-to-face
service to the client, but can be allocated to this program for time spent on the
program for activities such as travel, phone conversations, "no-shows,"
discussions with involved parties, meeting preparation, and report completion.
[G] This represents the Agency overhead costs, such as Rent, Utilities, Supplies,
Postage, Travel Reimbursement, Telephone Charges, Equipment, and Data Processing
which are not incurred in providing direct, face-to-face service to the client,
but can be allocated to this program for time spent on the program for activities
such as travel, phone conversations, "no-shows," discussions with involved
parties, meeting preparation, and report completion.
[HI This represents the Grand Total Costs directly attributable or allocable to this
program. It should be a reasonable assumption that if you decided to discontinue
this program, your agency would realize a reduction in costs approximately equal
to this amount.
[I] This represents the total amount of profit your firm expects to realize as a
result of operating this program. Any difference between Lines [H] and [J] must
be substantiated by an amount indicated on this line.
[L] This is the actual direct, face-to-face hourly service rate at which you will be
requesting payment for the services provided under the conditions of this Request
for Proposal.
[M] To be completed by prospective providers of the Day Treatment Program only, this
line represents the estimated number of hours per month your organization will
provide direct, face-to-face services per client.
[N] To be completed by prospective providers of the Day Treatment Program services
only, this line represents the actual direct, face-to-face monthly service rate
at which you will be requesting payment for the services provided under the
conditions of this Request for Proposal. calculated by multiplying Line [L] by
Line [M] .
Page 35 of 35
Page 9
IX. Program Capacity by Month
To support the program the public health nurse would need to work with a
minimum of three families per month over a six month time period. The maximum
client capacity per month would be six families over the six month time period.
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