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Home My WebLink About20221631.tiffCor cxc-k- BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Professional Services Agreement Amendments for Core/Non-Core Contracted Services Bid # B22000040 DEPARTMENT: Human Services DATE: April 2, 2024 PERSON REQUESTING: Jamie Ulrich, Director, Human Services Brief description of the problem/issue: The Department entered into Agreements with various Child Welfare Service Providers through Request for Proposal (RFP) Bid #B2200040, identified as Tyler ID 2022-0410. These Agreements were issued for a period of three (3) years with the option to renew annually. The Department is now requesting to renew the current agreements for eight (8) of these providers with minor changes. The attached list indicates the minor changes in red for each provider. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. What options exist for the Board? Approval of the eight (8) Child Welfare Core/Non-Core Services Agreement Amendments. Deny approval of the eight (8) Child Welfare Core/Non-Core Services Agreement Amendments. Consequences: Child Welfare Core/Non-Core Service Agreement Amendments will not be executed. Impacts: Weld County clients will not continue to receive needed services. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): Total Cost = Various depending on services provided. Funded through Child Welfare Core/Non-Core Service funding. Pass -Around Memorandum; April 2, 2024 - CMS I Vari 4(6,/,6-0) Conte jr- 5/.2A/0217/- 5/n / t{VZoOa ll Recommendation: • Approval of the Agreement Amendments and authorize the Chair to sign. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro-Tem Mike Freeman Scott K. James Kevin D. Ross, Chair Lori Saine fp Mf Via Lire Pass -Around Memorandum; April 2, 2024 - CMS ID Various Karla Ford From: Sent: To: Subject: yes Lori Saine Weld County Commissioner, District 3 1150 O Street PO Box 758 Greeley CO 80632 Phone: 970-400-4205 Fax: 970-336-7233 Email: Isdine@weldgov.com Website: www.co.weld.co.us In God We Trust Lori Saine Tuesday, April 2, 2024 2:06 PM Karla Ford RE: 9 _ Please Reply - PA FOR ROUTING: Core/Non-Core 2022-23 Minor Changes (CMS Various) Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Karla Ford <kford@weld.gov> Sent: Tuesday, April 2, 2024 1:26 PM To: Lori Saine <Isaine@weld.gov> Subject: 9 - Please Reply - PA FOR ROUTING: Core/Non-Core 2022-23 Minor Changes (CMS Various) Importance: High Please advise if you support recommendation and to have department place on the agenda. Karla Ford Via, 1 Minor Core Bid Services Changes Year 2022-23 Providers for 2024-25 riffith Centers, Inc Ga Program Area Service ______.......w..nwn Name Rate II Unit Type Other Day Treatment Day Treatment $ 1,648.00 Month Address Change Day Treatment Mileage: Day Treatment $ 300.00 Month Address Change Home -Based Services Family Community Preservation: In -Home or $ 120.00 Hour Address Change Home -Based Services Family Preservation: In-Office/Video $ 105.00 Hour Address Change Life Skills Life Skills: Mileage $ 0.65 Mile Address Change Life Skills Life Skills: No Show $ 55.00 Each Address Change Mental Health Services Mental Professional Health Staffing Services: FTM, TDM, $ 75.00 Hour Address Change Mental Health Services Mental Health Services: No Show $ 55.00 Each Address Change Mentoring Mentoring: Mileage S 0.65 Mile Address Change Mentoring Mentoring: No Show $ 55.00 Each Address Change Life Skills Parenting Community Skills: In -Home or $ 105.00 Hour Address Change Life Skills Parenting Skills: with Transportation $ 110.00 Hour Address Change Life Skills Parenting Skills: In-Office/Video $ 90.00 Hour Address Change Life Skills Supervised Community Visitation: In -Home or $ 110.00 Hour Address Change Life Skills Supervised Transportation Visitation: with $ 115.00 Hour Address Change Program Area Service Name en it • Rate is Unit Type ether Life Skills Supervised Visitation: In-Office/Video 100.00 Hour Address Change Life Skills Therapeutic Community Visitation: In -Home or $ 120.00 Hour Address Change Life Skills Therapeutic Transportation Visitation: with $ 125.00 Hour Address Change Life Skills Therapeutic Office/Video Visitation: In - $ 105.00 Hour Address Change Mental Health Services Family Community Therapy: In -Home or $ 130.00 Hour Address Change Mental Health Services Family Therapy: In-Office/Video $ 125.00 Hour Address Change Mental Health Services Group In -Home Therapy: or Community In-Office/Video AND S 45.00 Hour Address Change Mental Health Services Individual Community Therapy: In -Home or $ 130.00 Hour Address Change Mental Health Services Individual Therapy: In-Office/Video $ 125.00 Hour Address Change Home -Based Services Family Professional Preservation: Staffing FTM, TDM, $ 75.00 Hour Address Change Home -Based Services Family Preservation: Mileage 0.65 Mile Address Change Mental Health Services Mental Health Services: Mileage $ 0.65 Mile Address Change Mental Health Services Therapeutic Community Intake: In -Home or $ 100.00 Hour Address Change Mental Health Services Therapeutic Intake: In-Office/Video $ 90.00 Hour Address Change Mentoring Mentoring/Behavior Home or Community Coaching: In- $ 93.00 Hour Address Change Mentoring Mentoring/Behavior Transportation Coaching: with $ 103.00 Hour Address Change Mentoring Mentoring/Behavior Office/Video Coaching: In- $ 88.00 Hour Address Change Mentoring Mentoring: Staffing FTM, TDM, Professional $ 75.00 Hour Address Change Home -Based Services Family Preservation: No Show $ 55.00 Each Address Change Program Area Service Name Rate Unit Type Other Life Skills Life Staffing Skills: TDM, Professional S 75.00 Hour Address Change FTM, Foster Support Care/Adoption Foster Professional Parent Staffing Education: FTM, TDM, $ 35.00 Hour Address Change Foster Support Care/Adoption Foster Community Parent Education: In -Home or $ 92.00 Hour Address Change Foster Support Care/Adoption Foster office/Video Parent Education: In - $ 64.00 Hour Address Change Foster Support Care/Adoption Foster Parent Education: No Show $ 30.00 Each Address Change Foster Support Care/Adoption Relinquishment TDM, Professional Counseling: Staffing FTM, $ 75.00 Hour Address Change Foster Support Care/Adoption Relinquishment or Community Counseling: In -Home $ 130.00 Hour Address Change Foster Support Care/Adoption Relinquishment Office/Video Counseling: In - $ 125.00 Hour Address Change Foster Support Care/Adoption Relinquishment Counseling: Mileage $ 0.65 Mile Address Change Foster Support Care/Adoption Relinquishment Counseling: No -Show $ 55.00 Each Address Change Lutheran Family Services Rocky Mountains Program Area Service Name Rate Unit Type Other Life Skills Supervised Community Family Time: In -Home or $ 101.00 Hour Name Change Life Skills Supervised Office/Video Family Time: In - $ 90.00 Hour Name Change Life Skills Therapeutic Office/Video Family Time: In - $ 101.00 Hour Name Change Life Skills (Therapeutic Therapeutic Community) Homebased Visitation: Services In -Home or $ 140.00 Hour Name Change Maple Star Colorado Program Area Service Name Rate Unit Type Other Home -Based Services Aftercare Engagement Support Team Services (ASSET) and $ 2,300.00 Month Name Address Change Change & Program Area lir Service Name Rate • i ill Unit Type Other Home -Based Services Stabilizing (STAY): At Risk Teens and Youth in Home $ 1,300.00 Month Name Address Change Change & Home -Based Services Stabilizing (STAY): High Teens Risk and Youth in Home $ 2,600.00 Month Name Address Change Change & Home -Based Services Stabilizing (STAY): Teens Imminent and Risk Youth in Home $ 4,000.00 Month Name Address Change Change & Life Skills Life Staffing Skills: FTM, TDM, Professional $ 93.00 Hour Name Address Change Change & Life Skills Life Skills: Mileage $ 0.65 Mile Name Address Change Change & Life Skills Life Skills: No Show $ 65.00 Each Name Address Change Change & Life Skills RAP Training or Community I - Resilient, (Parent Attuned Coaching): Parent In -Home $ 105.00 Hour Name Address Change Change & Life Skills RAPT Training Office/Video - Resilient, (Parent Attuned Coaching): Parent In- $ 89.00 Hour Name Address Change Change & Life Skills Supervised Community Family AND with Time: In Transportation -Home or $ 120.00 Hour Name Address Change Change & Life Skills Supervised Office/Video Family Time: In- $ 89.00 Hour Name Address Change Change & Life Skills Therapeutic Community AND Family with Time: Transportation In -Home or $ 168.00 Hour Name Address Change Change & Life Skills Therapeutic Office/Video Family Time: In- $ 118.00 Hour Name Address Change Change & Mental Health Services Mental Office/Video Community Health AND Services: In -Home In- or $ 130.00 Hour Name Address Change Change & Mental Health Services Mental Health Services: No Show $ 65.00 Each Name Address Change Change & Mental Health Services Mental Professional Health: Staffing FTM, TDM, $ 93.00 Hour Name Address Change Change & Mental Health Services Mental Health Services: Mileage $ 0.65 Mile Name Address Change Change & Martinez, Tim dba Assurance Therapeutic TM Program Area °- - Service Name Rate Unit Type Other Sex Abuse Treatment Offense with Abel Specific Juvenile Assessment Evaluation $ 1,200.00 Episode Program Area Service Name Rate Unit Type Other Sex Abuse Treatment Offense Without Specific Abel Juvenile Assessment Evaluation $ 1,000.00 Episode Sex Abuse Treatment Therapy Offense Specific Treatment: Family $ 100.00 Hour Rate Change Sex Abuse Treatment Therapy Offense Specific Treatment: Individual S 100.00 Hour Rate Change Sex Abuse Treatment Sex Professional Abuse Treatment: Staffing FTM, TDM, $ 75.00 Hour Sex Abuse Treatment Sex Abuse Treatment: Mileage $ 0.33 Mile Northern Colorado Youth for Christ dba Rebalance Program Area Service Name Rate Unit Type Other Mental Health Services Rebalance $ 45.00 Hour Mental Health Services Rebalance: No Show $ 20.00 Each Mentoring Mentoring $ 80.00 Hour Rate Change David Kalis, Inc. dba Parker Personal Care Homes Program Area llir Service Name Unit Rate � Type Other Foster Support Care/Adoption Foster Masters: Staffing Care/Adoption FTM, TDM, Support Professional - $ 200.00 Hour Rate Change Foster Support Care/Adoption Foster Masters: Care/Adoption No Show Support - $ 150.00 Each Rate Change Foster Support Care/Adoption Foster Mileage Care/Adoption Support: $ 0.50 Mile Foster Support Care/Adoption In-Office/Video Foster Community Parent Consultation AND In -Home - Masters: or $ 200.00 Hour Rate Change Foster Support Care/Adoption Foster Office/Video Community Parent In -Home - Masters: or In - $ 200.00 Hour Rate Change Training AND Home -Based Services In Aftercare Masters -Home Therapy Level: or Community In-Office/Video & Consultation AND - $ 200.00 Hour Rate Change Home -Based Services In-Office/Video Home Community Based Intervention AND In -Home - Masters: or $ 200.00 Hour Rate Change Home -Based Services Home FTM, TDM, Based Intervention Professional Staffing - Masters: $ 200.00 Hour Rate Change Program Area Service Name Rate Typ-, Uni ; ,Other Home -Based Services Home No Show Based Intervention - Masters: $ 150.00 Each Rate Change Home -Based Services Home -Based Services: Mileage $ 0.50 Mile Life Skills Life Professional Skills - Masters: Staffing FTM, TDM, $ 200.00 Hour Rate Change Life Skills Life Skills - Masters: No Show $ 150.00 Each Rate Change Life Skills Life Skills: Mileage $ 0.50 Mile Life Skills Parent Office/Video Community Coaching AND - Masters: In -Home In- or $ 200.00 Hour Rate Change Life Skills Supervised Office/Video Community Family AND Time In -Home - Masters: In or $ 200.00 Hour Rate Change Life Skills Therapeutic In-Office/Video Community Family AND Time In -Home - Masters: or $ 200.00 Hour Rate Change Mental Health Services Consultation Office/Video Community - AND Masters: In -Home In- or $ 200.00 Hour Rate Change Mental Health Services Consultation AND In -Home - or PhD: Community In-Office/Video $ 250.00 Hour Rate Change Mental Health Services Counseling/Psychotherapy FTM, TDM, Professional Staffing - Masters: $ 200.00 Hour Rate Change Mental Health Services In-Office/Video Counseling/Psychotherapy Community AND In -Home -Masters: or $ 200.00 Hour Rate Change Mental Health Services Counseling/Psychotherapy Office/Video Community AND In -Home -PhD: or In- $ 250.00 Hour Rate Change Mental Health Services Evaluation & Assessment: No Show $ 500.00 Each Rate Change Mental Health Services In-Office/Video Functional Community Family AND Therapy In -Home - Masters: or $ 200.00 Hour Rate Change Mental Health Services Functional Office/Video Community Family AND Therapy In -Home - or PhD: In- $ 250.00 Hour Rate Change Mental Health Services Mental FTM, TDM, Health Professional Services - Staffing Masters: $ 200.00 Hour Rate Change Program Area Service Name Rate Unit Type Other Mental Health Services Show Mental Health Services - Masters: No $ 150.00 Each Rate Change Mental Health Services Mental TDM, Professional Health Services Staffing - PhD: FTM, $ 250.00 Hour Rate Change Mental Health Services Mental Show Health Services - PhD: No $ 250.00 Each Rate Change Mental Health Services Mental Health Services: Mileage $ 0.50 Mile Mental Health Services Multisystemic Office/Video Community AND Therapy In -Home - Masters: or In- $ 200.00 Hour Rate Change Mental Health Services Parent In-Office/Video Community -Child Interactional AND In -Home Evaluation: or $ 500.00 Hour Rate Change Mental Health Services Psychological Office/Video Community AND Evaluation: In -Home In- or $ 500.00 Hour Rate Change Mental Health Services Trauma AND In -Home Assessment: or Community In-Office/Video $ 500.00 Hour Rate Change N/A Anger Prevention AND In Management -Home - Masters: or Community Treatment/DV In-Office/Video $ 200.00 Hour Rate Change N/A Child FTM, Welfare TDM, Block Professional funded Staffing - Masters: $ 200.00 Hour Rate Change N/A Child No Show Welfare Block Funded - Masters: 5 150.00 Each Rate Change N/A Child Welfare Block Funded: Mileage $ 0.50 Mile N/A Mediation AND In -Home - Masters: or In-Office/Video Community $ 200.00 Hour Rate Change N/A In-Office/Video Relinquishment Community Counseling AND In -Home - Masters: or $ 200.00 Hour Rate Change Sex Abuse Treatment Psychosexual/Sex Evaluation - Masters: Offender In-Office/Video Specific $ 400.00 Hour Rate Change Sex Abuse Treatment Psychosexual/Sex Evaluation: PhD Offender Level testing Specific $ 500.00 Hour Rate Change Sex Abuse Treatment Sexual FTM, TDM, Abuse Treatment Professional - Staffing Masters: $ 200.00 Hour Rate Change Sex Abuse Treatment Sexual No Show Abuse Treatment - Masters: $ 150.00 Each Rate Change Program Area Service Name Rate Unit Type Other Sex Abuse Treatment Sexual Consultation Office/Video Community Abuse Treatment - AND Masters: In -Home Therapy In- or and $ 200.00 Hour Rate Change Sex Abuse Treatment Sexual Abuse Treatment: Mileage $ 0.50 Mile Substance Treatment Abuse Substance Masters: Home In-Office/Video Community Abuse Evaluation AND In - $ 400.00 Hour Rate Change Substance Treatment Abuse Substance Level Testing Abuse Evaluation: PhD $ 500.00 hour Rate Change Substance Treatment Abuse Substance Masters: No Abuse Show Treatment - $ 150.00 Each Rate Change Substance Treatment Abuse Substance Consultation Office/Video Community Abuse - AND Masters: Treatment In -Home In - and or $ 200.00 Hour Rate Change Substance Treatment Abuse Substance FTM, TDM, Abuse Professional Treatment- Staffing Masters: $ 200.00 Hour Rate Change Substance Treatment Abuse Substance Abuse Treatment: Mileage $ 0.50 Mile Services Therapeutic Kinship Therapeutic Masters: Staffing FTM, Kinship TDM, Services Professional - $ 200.00 Hour Rate Change Therapeutic Services Kinship Therapeutic Masters: Home or In-Office/Video Community Kinship Services AND - In - $ 200.00 Hour Rate Change Therapeutic Services Kinship Therapeutic Masters: No Kinship Show Services - S 150.00 Each Rate Change Therapeutic Services Kinship Therapeutic Kinship Services: Mileage $ 0.50 Mile Shiloh Home Program Area �_ Service Name Ra Unit Type Other Day Treatment Day Treatment $ 2,125.00 Month Day Treatment Evening Reporting Center $ 98.50 Day Foster Support Care/Adoption Foster Mileage Care/Adoption Support: $ 0.59 Mile Foster Support Care/Adoption Foster FTM, TDM, Parent Professional Consultation Staffing Coaching: $ 80.00 Hour r Program Area Service Name Rate Unit Type Other Foster Support Care/Adoption Foster In -Home Parent or Community Consultation Coaching: $ 80.00 Hour Foster Support Care/Adoption Foster In-Office/Video Parent Consultation Coaching: $ 65.00 Hour Foster Support Care/Adoption Foster No Show Parent Consultation Coaching: $ 60.00 Each Foster Support Care/Adoption Foster FTM, TDM, Parent Professional Consultation Staffing Therapy: $ 95.00 Hour Foster Support Care/Adoption Foster In -Home Parent or Community Consultation Therapy: $ 120.00 Hour Foster Support Care/Adoption Foster In-Office/Video Parent Consultation Therapy: $ 95.00 Hour Foster Support Care/Adoption Foster No Show Parent Consultation Therapy: $ 75.00 Each Foster Support Care/Adoption Foster with Transportation Parent Consultation Therapy: $ 120.00 Hour Home -Based Services Aftercare FTM, TDM, Individual/Family Prof Staffing Therapy: $ 85.00 Hour Home -Based Services Aftercare In Transportation -Home Individual/Family or Community AND Therapy: with $ 115.00 Hour Home -Based Services In-Office/Video Aftercare Individual/Family Therapy: $ 85.00 Hour Home -Based Services Aftercare No Show Individual/Family Therapy: $ 75.00 Each Home -Based Services Aftercare Based TDM, Family Professional In -Home Support and Staffing Services: Community FTM, $ 85.00 Hour Home -Based Services Aftercare Based Office/Video Family In -Home Support and Services: Community In - $ 85.00 Hour Home -Based Services Aftercare Based Show Family In -Home Support and Community Services: No $ 60.00 Each Home -Based Services Home -Based Services: Mileage $ 0.59 Mile Home -Based Services Rapid Staffing Response: FTM, TDM, Prof. $ 95.00 Hour Home -Based Services Rapid Community Response: AND In -Home with or Transportation $ 140.00 Hour Home -Based Services Rapid Response: In-Office/Video $ 95.00 Hour Home -Based Services Rapid Response: No Show $ 75.00 Each Program Area Service Name Rate Unit Type Other - Home -Based Services Youth FTM, Intervention TDM, Prof.Staffing Family Coaching: $ 65.00 Hour Home -Based Services Youth In -Home Transportation Intervention or Community Family AND Coaching: with $ 80.00 Hour Home -Based Services Youth In-Office/Video Intervention Family Coaching: $ 65.00 Hour Home -Based Services Youth No Show Intervention Family Coaching: $ 60.00 Each Home -Based Services Youth FTM, TDM, Interventions Prof.Staffing Therapy Services: $ 95.00 Hour Home -Based Services Youth In -Home Transportation Interventions or Community Therapy AND Services: with $ 125.00 Hour Home -Based Services Youth In-Office/Video Interventions Therapy Services: $ 95.00 Hour Home -Based Services Youth No Show Interventions Therapy Services: $ 75.00 Each Life Skills Beyond the Walls $ 1,115.00 Month Life Skills Comprehensive TDM, Prof.Staffing Parenting Time: FTM, $ 80.00 Hour Name Change Life Skills Comprehensive Home Transportation or Community Parenting AND Time: with In - $ 85.00 Hour Name Change Life Skills Comprehensive Office/Video Parenting Time: In $ 80.00 Hour Name Change Life Skills Comprehensive Show Parenting Time: No S 70.00 Each Name Change Life Skills Life Skills: FTM, TDM, Prof.Staffing $ 85.00 Hour Life Skills Life Skills: In -Home or Community $ 85.00 Hour Life Skills Life Skills: In-Office/Video $ 65.00 Hour Life Skills Life Skills: Mileage $ 0.59 Mile Life Skills Life Skills: No Show $ 60.00 Each Life Skills Parents as Teachers $ 600.00 Month Life Skills Therapeutic Prof.Staffing Family Time: FTM, TDM, $ 95.00 Hour Name Change Life Skills Therapeutic Community Family AND with Time: Transportation In -Home or $ 120.00 Hour Name Change Program Area Service Name Rate Unit Type Other Life Skills Therapeutic Office/Video Parenting Time: In - $ 95.00 Hour Name Change Life Skills Therapeutic Parenting Time: No Show $ 75.00 Each Name Change Mental Health Services Individual TDM, Prof.Staffing and Family Therapy: $ 95.00 Hour FTM, Mental Health Services Individual Home Transportation or and Community Family AND Therapy: with In - $ 120.00 Hour Mental Health Services Individual Office/Video and Family Therapy: In - $ 95.00 Hour Mental Health Services Individual Show and Family Therapy: No $ 75.00 Each Mental Health Services Mental Health Services: Mileage $ 0.59 Mile N/A FP & KP Training - 11 -hour class $ 1,760.00 Each N/A FP & KP Training - 3 -hour class $ 480.00 Each N/A FP Sexually Reactive & KP Training Abusive Youth - The and Truth Sexually about $ 480.00 Each Sex Abuse Treatment Community Youth Conduct Community with Coaching: Problematic Based AND Treatment with In -Home Sexual Transportation or for $ 130.00 Hour Sex Abuse Treatment Community Youth Conduct with Coaching: Problematic Based Treatment In-Office/Video Sexual for $ 95.00 Hour Sex Abuse Treatment Individual Home Transportation or and Community Family Treatment: AND with In - $ 130.00 Hour Sex Abuse Treatment Individual Office/Video and Family Treatment: In - $ 130.00 Hour Sex Abuse Treatment Informed Supervision $ 300.00 Each Sex Abuse Treatment Sex Professional Abuse Treatment: Staffing FTM, TDM, $ 95.00 Hour Sex Abuse Treatment Sex Abuse Treatment: Mileage i $ 0.59 Mile Sex Abuse Treatment Sex Abuse Treatment: No Show $ 75.00 Each Transitions Psychology Group Program Area Service Name Rate Unit Type Other Foster Support Care/Adoption Foster Therapeutic TDM, Prof. Parent Staffing Kinship Consultation and Services: FTM, $ 140.00 Hour Foster Support Care/Adoption Foster Therapeutic or Transportation Community Parent Consultation Kinship AND Services: with and In Home $ 188.00 Hour Rate Change Foster Support Care/Adoption Foster Therapeutic Office/Video Parent Consultation Kinship Services: and In $ 125.00 Hour Rate Change Foster Support Care/Adoption Foster Therapeutic Parent Consultation Kinship Services: and Mileage $ 0.58 Mile Foster Support Care/Adoption Foster Therapeutic Show Parent Consultation Kinship Services: and No $ 90.00 Each Life Skills In -Home In Transportation Home Family or Community Prevention AND Program: with $ 188.00 Hour Rate Change Life Skills In In -Home Office/Video Family Prevention Program: 5; 125.00 Hour Rate Change Life Skills LIFE Staffing SKILLS: FTM, TDM, Professional $ 140.00 Hour Life Skills LIFE SKILLS: Mileage $ 0.58 Mile Life Skills LIFE SKILLS: No Show $ 90.00 Each Life Skills Therapeutic Community Visitation: AND with Transportation In Home or $ 188.00 Hour Rate Change Life Skills Therapeutic Office/Video Visitation: In- $ 125.00 Hour Rate Change N/A Additional Adult $ 300.00 Each N/A Child TDM, Welfare Professional Block Staffing Funded: FTM, $ 140.00 Hour N/A Full Home Study $ 1,350.00 Episode N/A Home Studies: Mileage $ 0.58 Mile N/A Partial Home Study $ 300.00 Episode I N/A Relinquishment or Community Counseling: In Home $ 180.00 Hour N/A Relinquishment Office/Video Counseling: In $ 140.00 Hour N/A Updated Home Study $ 700.00 Episode AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SHILOH HOME, INC. Q This Agreement Amendment made and entered into ,7 CI day of M , 2024 by and between the Board of Weld County Commissioners, on behalf of the Weld unty Department of Human Services, hereinafter referred to as the "Department", and Shiloh Home, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Aftercare Services, Day Treatment, Foster Parent Consultation, Life Skills, Mental Health Services, Sexual Abuse Treatment, and Home -Based Intervention, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1631, approved on June 13, 2022. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2022. • The Original Agreement was amended on: • May 24, 2023 to extend the term date through May 31, 2024, to amend Exhibit A, Scope of Services, and Exhibit B, Rate Schedule. • The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2022-1631. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement as of June 1, 2024: 1. Term This agreement is being renewed for the third and final year, for the period June 1, 2024 through May 31, 2025. 2. Exhibit A, Scope of Services, is hereby amended as attached. 3. Exhibit B, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: BY: lerk to the Boar Deputy CI BOARD OF COUNTY COMMISSIONERS WELD COU L �C---� 0 vin D. Ross, Chair MAY 2 2 2024 TRACTOR: Shiloh Home, Inc. 6588 West Ottawa Avenue Littleton, Colorado 80218 Steven Ravri'ez By: Steven Ramirez lMay 15, 2024 23:10 MDT) Steven Ramirez, Chief Executive Officer May 15,2024 Date: OC(/41 %.5J EXHIBIT A SCOPE OF SERVICES Contractor will provide Aftercare Services, Day Treatment, Foster Parent Consultation, Life Skills, Mental Health Services, Sexual Abuse Treatment, and Home -Based Intervention, as referred by the Department. Aftercare Services 1. Aftercare Services a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide individual and family therapy and support services to allow for the reunification of the child with his or her family where feasible. These services will promote the successful transition of children to their home (or another permanent placement) from a higher level of care and are aimed at preventing out of home placements. ii. Contractor offers the following Aftercare Services: 1. Office -Based Family Therapy. 2. Community -Based Family Therapy. 3. In -Home Family Therapy. 4. Office -Based Individual Therapy. 5. Community -Based Individual Therapy. 6. In -Home Individual Therapy. 7. Community -Based Family Support Services (i.e., Life Skills and/or Parent Coaching). 8. In -Home Family Support Services. iii. Assessments Utilized for Aftercare Services: 1. Contractor will implement assessments to determine the focus of Aftercare Services. 2. A mental health assessment will be used to evaluate therapeutic needs for the individual and family and assist in creating an effective treatment plan. Other assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.) to further establish treatment objectives and to measure outcomes. b. Anticipated Frequency of Services: i. Therapy services: One (1) hour weekly unless the need for more frequent intervention is identified through the assessment process. ii. Intensive Family Therapy: up to three (3) hours per week. iii. Four Life Skills treatment packages are available: 1 1. Intensive, ten (10) to fifteen (15) hours per week. 2. High, seven (7) to nine (9) hours per week. 3. Moderate, four (4) to six (6) hours per week. 4. Low, three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: I. Treating emotional and behavioral symptoms associated with trauma and mental health disorders. ii. Educating families about trauma and mental health issues. iii. Helping children, adolescents, and their families develop healthy coping tools. iv. Equipping caretakers with knowledge and methods to provide trauma - informed parenting. v. Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences. vi. Providing intensive psychoeducation that increases each family member's understanding of their own unhealthy interaction patterns and how to change them. vii. Reducing conflict between family members by teaching them positive communication skills that foster empathy between them. viii. Facilitating communication between family members about emotional, behavioral, and relational issues. ix. Assisting caretakers in creating a nurturing and healthy home environment which will enable the children to successfully progress in their development and academic achievement. Practical implementation of parenting skills learned in therapy (e.g., creating chore charts, homework charts). xi. Practical implementation of life skills. e. Outcomes of Services: i. Improved individual and family functioning. ii. Alleviation or reduction of mental health symptoms. iii. Completion of treatment goals. f. Target Population: i. Children and adolescents in the process of reunifying with their families or transitioning to another permanent placement. ii. The target population often includes children, adolescents, and families who are struggling with issues related to mental health, trauma, and 2 difficult family dynamics that compromise individual and family functioning and lead to placement disruptions. g. Language: i. English. h. Medicaid Eligibility: i. This service is partially eligible for Medicaid. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -office. iii. In the community when appropriate. Day Treatment 1. Day Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's Shiloh Academy offers educational services at on -site locations. Components of the program include: 1. Educational and clinical assessment services. 2. Offense specific treatment services. 3. Individual, family, group and milieu therapies (offered on a weekly basis). 4. Case management. 5. Academic curriculum -credits transferable to public school. 6. Special education services. 7. Transportation to/from school within a fifteen (15) mile radius. 8. In -home service/per case need (Not included in the listed rate). 9. Community activities. 10. 24/hour on -call assistance. 11. Monthly progress reports. 12. On -going assessment of family Transitional services/staffing to public school. b. Anticipated Frequency of Services: i. Educational services are offered daily, Monday through Friday when school is in session. ii. Groups are offered daily, Monday through Friday when school is in session. iii. Individual therapy is offered weekly. 3 c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. The student will experience improved emotional and behavioral function through engagement in group and individual therapy. ii. The student will have support from educational staff to learn techniques to gain physical and emotional safety. iii. The student will have opportunities for improved academic success. iv. The student will have opportunities to learn healthy decision -making skills in a smaller classroom setting. e. Outcomes of Services: i. Credit recovery. ii. Improved school emotional and behavioral functioning. iii. Prepared for academic and interpersonal success upon return to home school. iv. Maintain positive home and community relationships. f. Target Population: i. Contractor's Day Treatment services are available to youth between seven (7) to eighteen (18) years of age who are proficient in speaking English; and who present with behavioral disorders, mental health issues, or problematic sexual behaviors. ii. Clients with the following issues are generally considered not appropriate for the program: 1. Severely limited cognitive abilities (IQ below 65). 2. Ongoing medical issues that cannot be supervised/managed by staff. 3. The inability or significantly impaired ability to understand and/or communicate in English. 4. Is actively psychotic. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In Office, on site at Shiloh Academy locations. ii. In Weld County at Shiloh Academy located at 2700 E. Ken Pratt Boulevard, Longmont, Colorado 80504. 4 2. Evening Reporting Center a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Students participating in the program receive academic counseling and tutoring, truancy counseling, substance abuse counseling, therapeutic recreation, and resource development. b. Anticipated Frequency of Services: i. Four (4) to five (5) hours per day. Services only take place on business days and are not available on weekends and holidays. c. Anticipated Duration of Services: i. Ten (10) to forty-five (45) days. d. Goals of Services: i. The student will experience improved pro -social engagement. ii. The student will have improved school attendance. iii. Completion of court ordered community service. iv. The student will have opportunities to explore options for continuing education or career path development. e. Outcomes of Services: i. Youth appearance at all scheduled judicial hearings. ii. Creation and maintenance of positive behavior at home and in the community. iii. Performance of community service. iv. Promote legal behaviors to prevent new delinquent acts. v. Improved school attendance and performance, vocational or college planning. vi. Improved healthy relationships, social activity, and family functioning. f. Target Population: i. Youth between the ages of twelve (12) and eighteen (18) years who: 1. Require pro -social activity engagement during evening hours. 2. Have truancy issues at school. 3. Participate in a pre-trial release and supervision program. 4. On probation for the first time. ii. Have minimum system involvement and could benefit from intervention to prevent additional charges or delinquent behaviors. g. Language: i. English. 5 h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. Foster Parent Consultation 1. Foster Parent and Kinship Provider Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide psychoeducation for foster parents regarding the impact of trauma and abuse and neglect. This training will include 8 hours of instruction and practice. The instruction will include the following curriculum topics: 1. It's all about the brain, not the behaviors. 2. The teenage brain is unique, and the teenage traumatized brain can be healed. 3. Understanding the impact of trauma "it's not defiance, it's learned survival". 4. Effective consequences for teenagers impacted by abuse and neglect. 5. Skills rather than punishment or consequences. 6. Developmental age vs chronological age and reasonable expectations. 7. Resiliency: how to identify the strengths that already exist, and how to build resiliency in every child. Foster parents are the key. ii. Contractor will provide support services to assist the foster family with child specific consultation. iii. Contractor will provide families with assistance with household family functioning through on -site family support from the Shiloh House Family Support Professionals. iv. Contractor will provide phone consultation in crisis situations. v. Contractor will provide a supportive and non -judgmental relationship for the foster child and foster parents. vi. Contractor will assist families with skill development to ensure that families can establish appropriate relationship development, structure, boundaries and limits, with the goal of proactively preventing family conflict, and/or to decrease conflict that may already exist. vii. Contractor will provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. 6 viii. Contractor will support the development of foster parent/child relationships. ix. The goal of Contractor Home's home -based Foster Parent Consultation services is to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, providing information for community resources, and providing effective parenting training. b. Anticipated Frequency of Services: i. One (1) to two (2) hours per week. c. Anticipated Duration of Services: i. Eight (8) hours total. d. Goals of Services: i. Increase the level of family functioning. ii. Eliminate placement disruption. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase foster parents' understanding of the impact of trauma. v. Help foster parents to have realistic child expectations. vi. Improve foster parenting, relationship, and social skills. vii. Provide rapid crisis consultation and support for foster parents experiencing challenges with their foster child. viii. Role modeling positive interaction with children - The Home -Based family support professional will use a wide variety of interaction and education - based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. ix. Increase foster parent confidence - As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. x. Teach value of daily routine and consistency with children - Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age -appropriate chore charts to help parents with consistency. xi. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Contractor's services are provided from a family engagement, strength based, trauma informed basis. xii. Return children in placement to their own home: Contractor's home - based and foster parent consultation services are provided as either a 7 prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. xiii. Unite children with their permanent families: Contractor's home -based services strive to ensure the permanency of children with their families. xiv. Provide services that protect the child: Contractor's in -home services ensure that children are protected, and that the well-being of every child is our first priority. e. Outcomes of Services: i. Placement preservation. ii. Increased supports and community -based resources. iii. Reduced risks for additional child protection or delinquency concerns. f. Target Population: i. Foster parents and Kinship providers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: ii. In -office. 2. Foster Parent and Kinship Provider Training: The Truth about Sexually Abusive and Sexually Reactive Youth a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provide education about juvenile sexual abuse and sexual reactivity to increase care provider efficacy, promote retention of foster care providers, and increase the potential for juveniles to experience success in their treatment plans by contributing to stability of the foster or kinship placement and minimizing the risk for placement in a higher level of care. b. Anticipated Frequency of Services: i. One (1) time training. c. Anticipated Duration of Services: i. Three (3) hours. 8 d. Goals of Services: i. Provide information about normative, concerning, and problematic sexual behavior. ii. Dispel the "myths" that many people often believe in regard to sexually abusive and sexually reactive youth. iii. Provide accurate information about what is actually required when providing care for sexually abusive and/or sexually reactive youth. e. Outcomes of Services: i. Community Safety. ii. Preserve foster placement to minimize disruption for children and families. iii. Increase willingness and ability of foster parents to care for sexually abusive or sexually reactive youth. iv. Divert entry into residential placement, or support step-down from residential placement into foster care. f. Target Population: i. Kinship providers and foster parents caring for juveniles who have engaged in sexually abusive behaviors or exhibit sexual reactivity. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. 3. Foster Parent and Kinship Provider Training: Psycho Education a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide psychoeducation for foster parents and kinship providers regarding the impact of trauma, abuse and neglect, transitions impact to foster children, navigation of the mental health system, biological family reunification and developmental expectations. ii. This training will include eleven (11) hours of instruction and practice. The instruction will include the following curriculum topics: 1. It's all about the brain, not the behaviors. 2. The teenage brain is unique, and the teenage traumatized brain can be healed. 9 3. Understanding the impact of trauma "it's not defiance, it's learned survival". 4. Effective consequences for teenagers impacted by abuse and neglect. 5. Skills rather than punishment or consequences. 6. Developmental age versus chronological age and reasonable expectations. 7. Resiliency: how to identify the strengths that already exist, and how to build resiliency in every child. Foster parents are the key. 8. Transitions Impact on Foster Children: includes a review of the grief and loss that occurs in transitions, viewing and discussion of dramatic videos that portray the impact, and teaching foster parents how to support foster children in transitions. 9. Navigation of the Mental Health system: our instructors will provide a step by step guide of navigating the mental health system, including accessing services, counseling and psychiatric services, initial assessments and first contacts, making appointments, how to support the child before and after mental health appointments and/or hospitalizations, communication with the therapist, and problem solving real life roadblocks. 10. Family Reunification: our instructors will provide a thorough review of children's complex feelings toward their families and the best strategies for support the child in all steps of the family reunification process. Real life examples of reunification challenges related to past trauma, and abuse and neglect experiences, as well as positive family experiences, memories, and the ambivalence that children experience. The foster parents will be provided the opportunity to explore their own feelings about family reunification. b. Anticipated Frequency of Services: i. One (1) hour session weekly. c. Anticipated Duration of Services: i. A minimum of three (3) hours will be provided. ii. Contractor has an eleven (11) hour package also available. iii. Additional sessions may be available depending on needs of the client and the complexity of issues. d. Goals of Services: i. Enable the family to function in a safe manner. ii. Address safety concerns through education, and role modeling. iii. Provide information for community resources. 10 iv. Provide effective parenting training. e. Outcomes of Services: i. Provide foster children with the best possible family environment that responds in a developmentally and trauma informed manner. ii. Provide foster children with stable and successful life experiences. iii. Increase the level of foster family functioning. iv. Increase foster parent competency and confidence. v. Significantly reduce placement disruption. vi. Increase formal and informal supports such as community, family, and friends. vii. Increase foster parents understanding of the impact of trauma. viii. Help foster parents to have realistic child expectations. ix. Improve foster parenting, relationship, and social skills. x. Role modeling positive interaction with children - The Home -Based family support professional will use a wide variety of interaction and education based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. xi. Increase foster parent confidence: As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. xii. Teach the value of developmentally appropriate daily routine and consistency with children - Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age -appropriate chore charts to help parents with consistency. xiii. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Contractor's services are provided from a family engagement, strength based, trauma informed basis. xiv. Return children in placement to their own home: Contractor's home - based and foster parent training services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. xv. Unite children with their permanent families: Contractor's home -based services strive to ensure the permanency of children with their families. xvi. Provide services that protect the child: Contractor's in -home services ensure that children are protected, and that the well-being of every child is our first priority. f. Target Population: 11 i. Foster parents and kinship providers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. Life Skills 1. Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Life Skills Coaching is an in -home service. Treatment Packages include 75% face to face with family and 25% other duties including but not limited to Team Decision Meetings, Administrative Review Conferences, Case Management, and Court related activities. ii. The Life Skills coach will provide the family with tools to move toward self-confidence and independence. These tools may include but are not limited to the following: 1. Provide information regarding community resources, employment, occupational training, education, and health care options. 2. Provide support services to assist families with accessing resources and employment. 3. Provide families with assistance with household budgeting. 4. Provide help with household management. 5. Provide a non -judgmental relationship. 6. Help families identify and establish appropriate boundaries and limits. 7. Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. 8. Support development of parent/child relationships. 9. Teach appropriate discipline techniques: Life Skills coaches utilize a variety of techniques with parents to increase awareness, skill, and management of child behavior. 10. Role modeling positive interaction with children: Life Skills coaches use activities to model how to positively interact with children. The Life Skills coach will use books, games, crafts, and 12 creative play to teach clients. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. 11. Increase parent confidence. As the parent begins to gain new skills and control in the home, confidence is naturally increased. Providing parents with resources to help them with supporting their family also gives the parent a feeling of accomplishment and instills a sense of pride. 12. Teach the value of daily routine and consistency with children. Life Skills coaches will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards, and consequences and are given resources such as age -appropriate chore charts to help parents with consistency. 13. Increase parental awareness of children's basic and emotional needs- Life Skills coaches will assist parents in learning to recognize child healthcare needs, make doctor appointments, and at times, accompany the family to a doctor's appointment. Coaches will help parents plan and prepare nutritious meals, in addition to providing resources for housing, food, clothing and shelter. Coaches help teach parents to recognize what feelings are expressed in their child's behaviors and how to respond in a way that nurtures the child. 14. Provide parents with information regarding age -appropriate child development- Life Skills coaches teach parents about child development. Coaches use a variety of assessments to help determine a child's developmental growth as well as providing parents with activities to utilize with their child in order to stimulate development of fine and gross motor skills as well as adaptive and communication skills. Coaches will help a parent recognize what is age -appropriate behavior and how to manage any inappropriate behavior. b. Anticipated Frequency of Services: i. Four (4) Life Skills treatment packages are available: 1. Intensive, ten (10) to fifteen (15) hours per week. 2. High, seven (7) to nine (9) hours per week. 3. Moderate, four (4) to six (6) hours per week. 4. Low, three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. 13 d. Goals of Services: i. Children will remain in the care of their parents while parents resolve child protection concerns. ii. Parents will learn skills to prevent new or repeated child protection concerns. iii. Parents will be able to recognize the emotional, physical, and developmental needs of their children. iv. Parents will learn to use resources available within the community to help meet the needs of their children. e. 0itcomes of Services: i. Increase level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. f. Target Population: i. Families involved with the Department, where one or more children may be at risk for placement disruption that may be prevented if parents have the opportunity to develop stronger skills. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. Community -based. 2. Beyond the Walls. a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Transitional coaching for youth. Each month Beyond the Walls sponsors Workshops such as financial literacy, Reality Tours at local colleges and businesses, and mentoring relationships on a 1:1 level or in Circles of support. Each learning and support opportunity focuses on the areas of education, housing, job skills, faith -based connections, business engagement, and community skills. 14 1. Youth are motivated to participate through exposure to a network of activities and hands-on assistance that are proven tools to assist young people in gaining vital confidence and support as they transition into young adulthood. 2. The combination of action learning, mentoring, coaching and peer mentoring provides young people with a wider source of support and inspiration for idea generation and greater creativity in problem solving during critical times in a young person's life. 3. Specially trained community partners guide each personal growth opportunity which gives young people the chance for experiential learning, and a chance to discuss individual plans. Peer support is offered from community partners acting as a sounding board for young people to bounce ideas and potential solutions to problems. 4. Beyond the Walls also leverages and builds links to existing resources in the community to ensure young people are able to find what they need to become vibrant members of their local community. b. Anticipated Frequency of Services: i. Each month, twenty-five (25) hours of learning opportunities are available to participating youth. c. Anticipated Duration of Services: i. Services may be provided for many years as needed. d. Goals of Services: i. This program works to ensure that every young person is: 1. Attached to nurturing adults. 2. Linked with educational supports that lead to career readiness. 3. Engaged in community, school and/or extracurricular activities. 4. Career ready with positive attitudes about the world of work. 5. Productive and equipped to reach financial self-sufficiency. 6. Aware of, appreciates and demonstrates behaviors of personal and social responsibility. 7. Demonstrating healthy decisions that lead to well-being. e. Outcomes of Services: i. Transition from out of home care to independence. ii. Develop circles of support to increase opportunities for success in young adult life. iii. Achieve goals outlined in an individual plan. 15 f. Target Population: i. Youth, ages sixteen (16) to twenty-six (26). g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. ii. In the community. 3. Parents as Teachers a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evidence -Based Home Visiting Model is the comprehensive home - visiting, parent education model used by Parents as Teachers Affiliates. This model has been identified as a well -supported practice by the Title IV -E Prevention Services Clearinghouse. The program provides a resource network, and child screening. b. Anticipated Frequency of Services: i. Personal Visits — one (1) to two (2) visits per month. ii. Group Connections — One (1) per month. c. Anticipated Duration of Services: i. While the child is in the age range of birth to five (5) years. d. Goals of Services: i. Increase parent knowledge of early childhood development and improve parent practices. ii. Provide early detection of developmental delays and health issues. iii. Prevent child abuse and neglect. iv. Increase children's school readiness and success. e. Outcomes of Services: i. Increase parent knowledge of early childhood development. ii. Improve parenting practices, increasing children's school readiness and success. iii. Provide early detection of developmental delays and health issues. f. Target Population: 16 i. Families with children from birth through kindergarten. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. 4. Comprehensive Family Time and Sibling Family Time a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Family Time may occur in community -based locations such as parks, libraries, restaurants, museums and many other approved and appropriate locations, including the client's home. This flexibility allows families to meet in environments that promote bonding and child development. The decision to provide community based, Family Time is determined by feedback from the multi -disciplinary team. Family Time includes parent education regarding the developmental needs of the children, and parent skill development. All parties in attendance for Family Time must be pre -approved by the multi -disciplinary team. ii. The Family Time supervisor will meet with the visiting parent 15 minutes before and after each visit to discuss goals and provide feedback, making it easier for parents to identify progress and areas for continued support or growth. Family Time services typically lasts between one (1) to three (3) months. The need for Family Time visits will be reevaluated every sixty (60) days. Family Time visitation appointments can occur between the hours of 8:30 AM and 8:30 PM, Sunday through Saturday. Each visit will last at least one (1) hour unless safety concerns require ending the visit. When the referral is for Family Time visits between siblings only, Family Time visitation will include age -appropriate guidance and interventions by the Family Time supervisor during the visit to foster healthy sibling bonds. The primary purpose of the Family Time supervisor is to ensure the safety of the children. Family Time supervisors will remain in sight and hearing of siblings and will engage with children using trauma informed, culturally responsive, age -appropriate techniques to minimize risk and maximize the potential for healthy sibling relationships. iii. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, activities will be planned ahead of time and 17 explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. iv. Family Time visits may occur in community -based locations such as parks, libraries, restaurants, museums and many other approved and appropriate locations. This flexibility allows siblings to interact in environments that promote bonding and provide normalized childhood experiences. The decision to provide community based, supervised sibling Family Time visits is determined by feedback from the multi- disciplinary team. All parties in attendance must be pre -approved by the multi -disciplinary teams. If needed, transportation for sibling Family Time visits can be provided. If the sibling group is comprised of three (3) or more children, a second Family Time supervisor must be present. When visits are scheduled for sibling groups, the Family Time supervisors will be trained in Informed Supervision. b. Anticipated Frequency of Services: i. Typically, one (1) hour per week. c. Anticipated Duration of Services: i. One (1) to three (3) months. d. Goals of Services: i. Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting. ii. Ensure the safety of children. iii. Strengthen the protective capacity of parents. iv. Help parents identify the child's cues and respond appropriately so that needs are met. v. Help parents communicate with their children in ways that are appropriate to age and cognition. e. Outcomes of Services: i. Increased bonding between parents and children. ii. Increased understanding of age -appropriate parent/child interactions. iii. Demonstration of safe parenting techniques that will help parents in the goal of reunification. f. Target Population: i. Parents with children in out of home care in cases where the goal is reunification or a permanent connection. g. Language: 18 i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. iii. Community -based locations. 5. Therapeutic Family Time and Therapeutic Sibling Family Time a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provides a goal focused therapeutic time for the parent and child within the supervision and therapeutic intervention, training, and skill building of the bachelor (BA) or Masters (MA) level parenting therapist. For those parents and families that would benefit from a more intensive Family Time training and experience the Therapeutic Family Time program is appropriate. ii. Delivery Methods: Following an initial assessment meeting, and observation, the parent, and parenting therapist collaborate to identify specific skill building areas, as well as develop the goals and tasks for each of the parenting times. Therapeutic Family Time will be scheduled in advance, and staff will coordinate with all necessary parties for effective service delivery. iii. Engagement Techniques: In each therapeutic Family Time session, the therapist and the parent will review the skills, discuss the goals of the session, plan the specific tasks and then engage in a natural interaction time between the parent and child. During the session if the therapist believes a short helpful intervention or role modeling would be beneficial, they will engage the parent in this learning process. Following the parent -child time together, the therapist and the parent will meet to review the session, provide feedback, discuss frustrations or skills that the parent has identified as needing and establish a plan for the next session. iv. Provides a clinically guided; goal focused therapeutic Family Time for siblings within the supervision and therapeutic intervention of the master's level therapist, or a qualified Family Time supervisor who works under the direct supervision of a master's level therapist. All staff will be trained in Informed Supervision. When one (1) or more siblings struggle with the impact of mental health issues, sexual abuse, or other forms of trauma, a therapeutic model may be appropriate to establish a safe, 19 constructive environment where sibling bonds can be repaired, and healthy relationships can grow. v. An assessment may be required prior to scheduling Family Time visits to assist in establishing culturally responsive, age -appropriate visitation goals; identify areas for skill building; and create an initial Family Time plan. Therapeutic Sibling Family Time supervisors utilize a trauma informed approach. Therapeutic Sibling Family Time can occur at one of Contractor's facility, or another approved, community -based location that provides a calm, neutral environment suitable for therapeutic interactions. Contractor will collaborate with the Department on an ongoing basis so that the need for this level of supervised Family Time can be frequently reevaluated based on progress toward Therapeutic Family Time goals and the needs of each client involved. vi. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, activities will be planned ahead of time and explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. b. Anticipated Frequency of Services: i. Two (2) to four (4) hours per week. c. Anticipated Duration of Services: i. Eight (8) to sixteen (16) weeks. d. Goals of Services: i. Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting. ii. Ensure the safety of children. iii. Strengthen the protective capacity of parents. iv. Help parents identify the child's cues and respond appropriately so that needs are met. v. Help parents communicate with their children in ways that are appropriate to age and cognition. e. Outcomes of Services: i. Improvement of a healthy parent -child relationship. ii. Child safety, and increased ability by the parent to recognize cues provided by the child. iii. Step-down to a lower level of parent -child supervision. f. Target Population: 20 i. Parents with children in out of home care in cases where the goal is reunification or a permanent connection, and relationship dynamics or child protection concerns merit therapeutic support during Family Time. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. iii. Community -based locations. Mental Health Services 1. Mental Health Services: Individual, and Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Outpatient or in -home individual and family therapy services provided to children, adolescents, and families who are struggling with mental health issues (often related to trauma) and difficult family dynamics. ii. Assessments Utilized: A mental health assessment is used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, and family relationship questionnaires.). iii. Focus of Mental Health Services: Areas targeted by therapy services include: 1. Reducing problematic symptoms and behaviors associated with mental health disorders and trauma. 2. Educating children, adolescents, and families about issues associated with trauma and mental health, including identifying how they impact functioning. 3. Helping children, adolescents, and their families develop healthy coping tools to manage their unpleasant thoughts and emotions. 4. Equipping caretakers with knowledge and methods to provide trauma -informed parenting and meet the unique needs of their children. 5. Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences. 21 6. Increasing each family member's understanding of their own unhealthy interaction patterns and how to change them. 7. Reducing conflict within families by teaching and guiding family members in the use of positive communication skills that foster empathy between them. 8. Facilitating communication between family members to address therapy issues. iv. Mental Health Services Methodologies: All treatment interventions used by Contractor are trauma -informed, evidence -based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and Dialectical Behavior Therapy (DBT) techniques. v. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Therapeutic services are trauma informed, strength -based and are designed to meet the needs of each client. vi. Mental Health Services Providers: Therapy services are provided by a master's level clinician; licensed, provisionally licensed, or under the supervision of a licensed supervisor. b. Anticipated Frequency of Services: i. Individual Therapy: One (1) hour per week. ii. Family Therapy: One (1) hour per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Increase functioning and overall wellbeing. ii. Increase coping skills. iii. Physical and emotional safety. iv. Improve interpersonal skills, including healthy communication and self - advocacy. e. Outcomes of Services: i. Improved Mental Health. ii. Improved Individual Functioning. iii. Improved Family Functioning. iv. Completion of Treatment Goals. 22 f. Target Population: i. Youth, adults, and families. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. 2. Intensive Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Short-term, family -centered therapeutic process used to focus on the destructive familial relationship patterns and define new healthy patterns for interaction between family members. Family therapy is a solution - based treatment concentrating on resolving presenting problems identified by the Department reason for involvement. Treatment may include individual therapy or a combination of two or more members of the family in the office with the therapist at one time or as an in -home service. Intensive Family Therapy should be individualized to each individual and family and should incorporate measurable goals/anticipated outcomes that are consistent with the Human Services Family Service Plan. ii. Delivery Methods: Therapeutic services can be provided in the office or in the home. Evidence based services include Trauma Focused -Cognitive Behavioral Therapy (TF-CBT). iii. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Therapeutic services are strength -based and are designed to meet the needs of each client. iv. Staff Credentials: Master's level clinician licensed, provisionally licensed or under the supervision of a licensed supervisor. b. Anticipated Frequency of Services: i. Up to three (3) hours per week. c. Anticipated Duration of Services: 23 i. Three (3) to six (6) months. d. Goals of Services: i. Gain effective communication skills. ii. Learn to resolve conflict in non -abusive ways. iii. Identify and replace destructive familial relationship patterns. e. Outcomes of Services: i. Improved family dynamics. ii. Completion of treatment goals. iii. Family continues to demonstrate safety and stability in the home environment, reducing the risk for out of home placement or future Human Services involvement. f. Target Population: i. Parents and children who will benefit from short term therapeutic supports. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. Sexual Abuse Treatment 1. Community Based Treatment for Youth with Problematic Sexual Conduct a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. This outpatient program is designed for family and youth verbalizing a strong commitment to actively participate in a combination of home - based offense specific therapy and coaching services. These families may not fully grasp the seriousness of the sexual offending or the contributing family dynamics, but the family and the youth have demonstrated a willingness to engage in the treatment process. This program can help youth and families address issues including sexual reactivity due to abuse and trauma; unhealthy behaviors including inappropriate touching, bullying, gesturing, and threatening verbalizations; youth who have engaged in family -based incest; and youth who have engaged in 24 community based sexual assault. Participating youth maybe adjudicated, or non -adjudicated. ii. Delivery Methods: This Community Based Treatment for Problematic Sexual Conduct includes two (2) to three (3) hours per week of in -home Sex Offender Management Board (SOMB) masters level treatment and additional bachelors (BA) level in -home training, coaching and accountability targeting safe and healthy sexual behavior life skills. Coaches and therapists build on strengths that exist within the family and help family members address safety concerns in a realistic, non- judgmental way. iii. Engagement Techniques: The offense specific life skills coaches will reinforce the parents in the skill areas necessary for ensuring the care and wellbeing of their children, as well as treatment success for the youth with Problematic Sexual Conduct. Master's level clinicians actively listed with the Colorado SOMB as approved providers will provide offense specific treatment that is tailored to meet the needs of the youth and the family. Case management services and communication are also provided by Contractor staff to ensure multi -disciplinary team (MDT) member collaboration. Following an initial assessment, an individualized treatment plan will be completed for each youth and family and will be modified as needed during services with approval by the MDT. b. Anticipated Frequency of Services: i. Two (2) to three (3) hours per week. c. Anticipated Duration of Services: i. Six (6) to eight (8) months. d. Goals of Services: i. To successfully integrate SOMB guided home based offender treatment with evidence -based treatment principles including Trauma Focused CBT and High Fidelity Wrap Around. ii. To support the following High -Fidelity Wrap Around principals: 1. To be strength based and to value all members of the team focusing on family and youth needs rather than deficits. 2. To engage natural support systems for the youth and family and provide the natural support with informed supervision training and accountability skills to ensure that the youth and family have supportive resources. 3. To ensure that the family and youth voice are valued in all discussions. 4. To be culturally competent and respectful in all services. 5. To individually tailor all treatment and offense specific life skills. 25 6. To collaborate and communicate effectively with all multi- disciplinary team members. 7. To be dedicated to progressing through inevitable challenges and barriers. 8. To be outcome based with observable and measurable indicators of success. iii. To address complex and overlapping needs. iv. To successfully address family and offending youth denial of sexual offending problems. v. To reduce future Problematic Sexual Conduct. vi. To strengthen protective and resiliency factors for the youth and family vii. To provide effective coordination with all community partners including development of a school safety plan. viii. To provide offense specific assessments including Juvenile Sex Offender Assessment Protocol (J -SOAP), Psychosexual evaluations and polygraphs. ix. To successfully integrate mental health treatment with offense specific treatment. x. To provide well -coordinated treatment with victim therapists and support systems. xi. To provide services within SOMB guiding principles. e. Outcomes of Services: i. Prevent out of home placement. ii. Promote safety for persons victimized, the youth and family, and for the community through the successful completion of a treatment plan. iii. Increase the personal health of the offending youth. f. Target Population: i. Youth ages eight (8) to eighteen (18) and their families who are struggling with a wide variety of Problematic Sexual Conduct. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. 2. Sex Abuse Individual and Family Treatment 26 a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization. Delivery Methods: Contractor practices the best standards of care and emphasizes implementation of evidence -based treatment practices. Sex abuse individual and family treatment provides strength based, family focused, accountable, relationship -oriented service which respects the family while ensuring that the goals of treatment are achieved. ii. Contractor adheres to the Sex Offender Management Board (BOMB) Guidelines and Standards. Risk assessment will be addressed through empirically guided risk evaluations and clinical insight, ongoing team and family collaboration, treatment progress and team members input, behavioral observation within all arenas of the client's life (home, school, job, social, community). Adjunct referral for polygraphs, arousal measurement, psychological services and psychiatric services are made as deemed necessary and appropriate. Therapy adheres to the Colorado Sex Offender Management Board's Standards and Guidelines for the Evaluation, Assessment, Treatment and Supervision of Juveniles. iii. Contractor utilizes Trauma -Focused Cognitive Behavioral Therapy (TF- CBT), Cognitive Behavioral Therapy (CBT), Psychoeducation and Family Systems Therapy, risk assessment and safety planning, Informed Supervision training, and relapse prevention planning. These services help youth and families increase pro -social behaviors and protective factors; develop a nurturing, healthy home environment; eliminate all illegal behaviors by family members; and provide participants with an understanding of their family and personal cycle of abuse, while increasing their ability to interrupt this cycle. iv. Engagement Techniques: Contractor's SOMB therapists provide interactive educational and therapeutic tools to help clients identify and address safety concerns for all family members; promote disclosure of abusive behaviors and address any victimization the client has experienced; assist in the development of empathy for persons victimized; and establish healthy coping skills and tools (self-control, and rehearsal of corrected cognitions). Whenever possible and appropriate, SOMB therapists work directly with the victim therapist(s) to assist the youth and person(s) victimized in the clarification process. b. Anticipated Frequency of Services: i. Individual therapy: One (1) hour per week. ii. Family Therapy: One (1) hour per week. 27 c. Anticipated Duration of Services: i. Six (6) to eight (8) months. d. Goals of Services: i. To successfully address family and offending youth denial of sexual offending problems. ii. To reduce future Problematic Sexual Conduct. iii. To strengthen protective and resiliency factors for the youth and family. e. Outcomes of Services: i. Community Safety. ii. Parent/Caregiver will gain understanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. iii. Decreased risk and improved personal health. f. Target Population: i. Youth eight (8) to eighteen (18) years of age who have had sexually abusive behaviors, and their families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. 3. Informed Supervision a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor offers Informed Supervision training consistent with SOMB Standards and Guidelines. ii. The Informed supervision training is provided by a Contractor staff who is trained in Informed Supervision and supervised by an SOMB qualified supervisor. iii. The Informed supervision training includes at a minimum the following topics: iv. History of SOMB. 28 v. Principals of SOMB treatment with emphasis on community safety. vi. Why Informed Supervision is necessary. vii. Victim Confidentiality. viii. Sexual Offending Behaviors overview. ix. Current laws that relate to juvenile sexual offending. x. Seriousness of Juvenile Offending, impact, and priorities. xi. Dynamic patterns (cycles) associated with abusive behavior. xii. The role of the MDT in all decisions. xiii. Safety Plans. xiv. High Risk patterns. xv. Community Supervision and Treatment. b. Anticipated Frequency of Services: i. Three (3) hour training during a single appointment. c. Anticipated Duration of Services: i. One (1) time appointment. d. Goals of Services: i. Prepare parents, guardians, and family supports to provide Informed Supervision. ii. Ensure that parents, guardians, and family supports understand the requirements of informed supervision, and that they are willing and able to provide that supervision. iii. Increase community safety by helping the supervising adult understand the risks and needs of the youth in treatment. e. Outcomes of Services: i. Community Safety. ii. Parent/Caregiver will gain understanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. iii. Decreased risk and improved personal health. f. Target Population: i. Parents and other adult caregivers of youth with problematic sexual conduct g. Language: i. English. 29 h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office. Home -Based Intervention 1. Rapid Response a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provides short-term, preventative mental health assessment and intervention services to youth and families with the intentions of bridging access to care and reducing further need for intervention by county social services. ii. Interventions Used: 1. Immediate screening/contact (phone or in person) — A discussion with the family members regarding their perspective of the challenges that they are facing. In the initial contact the Assessment Clinician will offer the following: a. A crisis assessment is completed, and immediate safety planning will be offered. b. A Family and individual Biopsychosocial screening will be offered. c. The Assessment Clinician will review the broad range of possible. services in an effort to assist the family in understanding the wide range of hopeful opportunities. d. The Assessment Clinician will offer a home or office based. comprehensive assessment to assist in the service planning. e. The Assessment Clinician will offer an individual child - based assessment to assist in the service planning. 2. Immediate Safety planning. 3. Immediate home -based family visit. 4. Immediate home or office -based crisis intervention. 5. Comprehensive Assessment. 6. Consistent phone and email follow up to check in and offer additional services as the family and/or individual situation changes. iii. On -going services: 1. Individual therapy (home or office based): six (6) to eight (8) solution focused sessions aimed at stabilization, improved emotional regulation and problem solving. 30 2. Family therapy, home and office based, focusing on immediate crisis resolution, improved communication, and relationship restoration. 3. Coaching: two (2) to six (6) hours per week of home -based family support - with funding approval. 4. Family Assessment — This assessment is completed at the home unless the family prefers the confidentiality of an office setting. a. Twenty (20) point family assessment. b. Screening for mental health concerns. c. Assessment and recommendations for additional supports and services. iv. When deemed appropriate access to: 1. Child Behavior Checklist (CBCL). 2. Conner's 3 (ADHD screening) 3. Scales of Independent Behavior— Revised (SIB -R) developmental assessment. 4. Beck Depression Inventory (BDI-II). 5. Beck Combination Youth Inventory. 6. Ansell — Casey Life Skills Assessment. 7. Mental Status checklist for Adolescents. 8. Trauma Symptom Checklist. 9. Behavior Assessment System for Children (BASC-3). 10. Resiliency Scales for Children and Adolescents (Strengths profile). v. b. Anticipated Frequency of Services: i. Coaching: Two (2) to six (6) hours per week. ii. Therapy: Six (6) to eight (8) sessions. c. Anticipated Duration of Services: i. Four (4) weeks. d. Goals of Services: i. With supports in place to maintain family functioning, the youth will remain at home successfully. ii. Provide information regarding community resources, mental health, education, and health care options. iii. Provide services to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, and providing information for community resources. iv. Help families create and implement safety plans. v. Help families create short term goals to transition to appropriate on- going providers to support maintenance of goals. 31 vi. Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem - solving tools. vii. Support development of parent/child relationships. viii. Teaching appropriate discipline techniques. e. Outcomes of Services: i. Increase the level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. vii. Youth will maintain or be reconnected with educational services or employment at the time of discharge. f. Target Population: i. Families with children birth to eighteen (18) years of age, who will benefit from short term preventative interventions services to prevent further human services involvement. . Language: i. English. h. Medicaid Eligibility: i. This service may be eligible for Medicaid. i. Service Access and Transportation: i. Home based. ii. Office -based. 2. Youth Intervention a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor offers in -home and out -patient services to reduce risks of out of home placement and increase stability in the home environment. Youth Intervention to divert entry into the child welfare system will provide in -home, office -based, and community -based services to youth twelve (12) to eighteen (18) years of age and their families when lower levels of intervention are not sufficient, and the family is willing to participate in services to prevent the need for child welfare involvement. 32 ii. Diversion From Entry Into the Child Welfare System: Preventative services are provided to avoid the need for child welfare involvement by establishing stability within the family so that all members of the family are safe and adequately supported through the use of community based resources. Many families recognize the need for help but are not sure where to find needed supports or cannot afford the available services. Contractor offers evidence -based tools and techniques that strengthen the connection between children and parents and address mental health and behavioral issues in the family that may place them at risk for child welfare involvement. iii. Delivery Methods: 1. Therapeutic and Family Coaching services can be provided in the home, office or in the community. For therapeutic services, mental health assessments can be used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, and family relationship questionnaires). 2. All treatment interventions used by Contractor are trauma - informed, evidence -based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF- CBT), play therapy, Family Systems interventions, and Dialectical Behavior Therapy (DBT) techniques. 3. The therapist and Family Coach will provide monthly documentation to the Department and will collaborate throughout the service period with the Department to ensure that service goals are being met. iv. Engagement Techniques: Clinicians and Family Coaches work as closely as possible with the family to schedule services for times and locations that are most convenient for the family. v. Crisis Intervention Program Description: The goal of crisis intervention is to provide short-term, preventative mental health assessment and intervention services to youth and families, with the intentions of bridging access to care and reducing further need for intervention by county social services. vi. Timeline for Services: vii. Once a referral is accepted, the family is contacted within 24 hours. The referral is screened to determine the need and level of appropriateness for services. If the level of need is higher than what can be managed within the parameters of the program, the youth and family will receive tailored referrals to community providers that may better address their specific circumstances. 33 viii. A Youth Intervention Program clinician will meet with the family to provide an assessment to identify the family's needs, risks, and strengths, and create an appropriate intervention plan for the level of crisis and needs. Crisis Intervention services can be provided for up to four months. Extension of services can be available if requested by the County and supported by the Service Plan. b. Anticipated Frequency of Services: i. Coaching: Two (2) to six (6) hours per week. ii. Therapy: Six (6) to eight (8) sessions. c. Anticipated Duration of Services: i. Four (4) months. d. Goals of Services: i. Prevent out of home placement. ii. Divert entry into the child welfare system. iii. Enhance stability so that all members of the family are safe and adequately supported through the use of community -based resources. e. Outcomes of Services: i. Increase the level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. vii. Youth will maintain or be reconnected with educational services or employment at the time of discharge. f. Target Population: i. Youth ages twelve (12) to eighteen (18) and their families. g. Language: i. English. h. Medicaid Eligibility: i. This service may be Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. 34 iii. Community based. Terms 1. Contractor will respond to the Mental Health and Support Services Team 11.:CWServiceReferral@weldgov.com) within three (3) business days regarding the ability to accept the received referral. 2. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team (HS- CWServiceReferral@weldgov.com) . 3. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understands that the Department will not reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 -hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team (HS- CWServiceReferral@weldgov.com) within three (3) days of when the client is placed on a behavioral plan or discharged. 4. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team (HS-CWServiceReferral@weldgov.com) immediately via email, to discuss service continuation. 35 5. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 6. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported to the caseworker and the Mental Health and Support Services Team (HS-CWServiceReferral@weldgov.com) immediately AND on the required monthly report. 7. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 8. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 9. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department. 10. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team (HS-CWServiceReferral@weldgov.com) of new staff who will manage and/or administer the services with the following information: 36 a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 37 EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Aftercare Services Aftercare Individual and Family Therapy Rate Unit Type Service Name $85.00 Hour In-office/Video $115.00 Hour In -Office with Transportation $115.00 Hour In -Home or Community $85.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Aftercare In -Home and Community Based Family Support Services Rate Unit Type Service Name $85.00 Hour In -Home or Community $85.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Rate Unit Type Day Treatment Service Name $2,125.00 Month Day Treatment $98.50 Day Evening Reporting Center, includes four (4) to five (5) hours Foster Parent Consultation Foster Parent Consultation Therapy Rate Unit Type Service Name $95.00 Hour In-office/Video $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Foster Parent Consultation Coaching Rate Unit Type Service Name $65.00 Hour In-office/Video $80.00 Hour In -Home or Community $80.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Foster Parent and Kinship Provider Training Rate Unit Type Service Name $480.00 Month Foster Parent and Kinship Provider Training: The Truth About Sexually Abusive and Sexually Reactive Youth $480.00 Month Foster Parent and Kinship Provider Training: Psycho -Education —Three (3) hour class $1,760.00 Month Foster Parent and Kinship Provider Training: Psycho -Education — Eleven (11) hour class Life Skills Rate Unit Type Service Name $65.00 Hour In-office/Video $85.00 Hour In -Home or Community $85.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Beyond the Walls Rate Unit Type Service Name $1,115.00 Month Beyond the Walls Parents as Teachers Rate Unit Type Service Name $600.00 Month Parents as Teachers Comprehensive Family Time and Sibling Family Time Rate Unit Type Service Name $80.00 Hour In-office/Video $85.00 Hour In -Office with Transportation $85.00 Hour In -Home or Community $80.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $70.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Therapeutic Family Time Rate Unit Type Service Name $95.00 Hour In-office/Video $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Mental Health Services Mental Health Services: Individual and Family Therapy Rate Unit Type Service Name $95.00 Hour In-office/Video $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Intensive Family Therapy Rate Unit Type Service Name $95.00 Hour In-office/Video $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Sexual Abuse Treatment Community Based Treatment for Youth with Problematic Sexual Conduct Coaching Rate Unit Type Service Name $95.00 Hour In-office/Video $130.00 Hour In -Office with Transportation $130.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TOM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Sex Abuse Individual and Family Treatment Rate Unit Type Service Name $95.00 Hour In-office/Video $130.00 Hour In -Office with Transportation $130.00 Hour In -Home or Community $95.00 Hour Sexual Abuse Treatment Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Informed Supervision Rate Unit Type Service Name $300.00 Each Informed Supervision Home -Based Interventions Rapid Response Rate Unit Type Service Name $95.00 Hour In-office/Video $140.00 Hour In -Office with Transportation $140.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Youth Intervention (Therapy Services) Rate Unit Type Service Name $ 95.00 Hour In-office/Video $125.00 Hour In -Office with Transportation $125.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Youth Intervention (Family Coaching) Rate Unit Type Service Name $65.00 Hour In-office/Video $80.00 Hour In -Office with Transportation $80.00 Hour In -Home or Community $65.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. When submitting a request for payment for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. SIGNATURE REQUESTED: Weld/Shiloh Amendment #2 Final Audit Report 2024-05-16 Created: 2024-05-08 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAWIIkNL8D6XikSV7DEhZHI66-r_fwf7-I "SIGNATURE REQUESTED: Weld/Shiloh Amendment #2" Histo rY t Document created by Windy Luna (wluna@weld.gov) 2024-05-08 - 10:56:43 PM GMT- IP address: 204.133.39.9 El Document emailed to sramirez@shilohhouse.net for signature 2024-05-08 - 10:57:17 PM GMT ▪ Email viewed by sramirez@shilohhouse.net 2024-05-08 - 10:57:24 PM GMT- IP address: 74.125.151.67 .5 Email viewed by sramirez@shilohhouse.net 2024-05-11 - 11:44:57 PM GMT- IP address: 74.125.215.69 t Email viewed by sramirez@shilohhouse.net 2024-05-15 - 1:47:35 AM GMT- IP address: 74.125.215.70 A0 Signer sramirez@shilohhouse.net entered name at signing as Steven Ramirez 2024-05-16 - 5:10:51 AM GMT- IP address: 73.243.168.92 6o Document e -signed by Steven Ramirez (sramirez@shilohhouse.net) Signature Date: 2024-05-16 - 5:10:53 AM GMT - Time Source: server- IP address: 73.243.168.92 O Agreement completed. 2024-05-16 - 5:10:53 AM GMT Powered by Adobe Acrobat Sign Contract Form Entity Information Entity Name* SHILOH, INC Entity ID* @00015512 Contract Name* SHILOH HOME, INC. (PROFESSIONAL SERVICES AGREEMENT AMENDMENT #2) Contract Status CTB REVIEW Contract ID 8226 Contract Lead * WLUNA ❑ New Entity? Parent Contract ID 20221631 Requires Board Approval YES Contract Lead Email Department Project # wluna@weldgov.com;cob bxxlk@weldgov.com Contract Description* (CONSENT) SHILOH HOME, INC - PROFESSIONAL SERVICES AGREEMENT AMENDMENT #2 - RELATED TO BID #B2200040. TERM: 06/01 /2024 THROUGH 05/31 /2025. Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESENTED TO THE BOCC ON 06/1 3/2022. Contract Type* AMENDMENT Amount" $0.00 Renewable * NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServices@weldgov. com Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL DGOV.COM Requested BOCC Agenda Date * 05/22/2024 Due Date 05/18/2024 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Review Date* 03/31/2025 Committed Delivery Date Renewal Date Expiration Date* 05/31/2025 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 05/16/2024 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 05/16/2024 05/16/2024 05/16/2024 Final Approval BOCC Approved Tyler Ref # AG 052224 BOCC Signed Date Originator WLUNA BOCC Agenda Date 05/22/2024 CoM-vooi- ([#7013 Cvnatn+- 0/ze-vzs PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: May 16, 2023 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement Amendment #1 with Shiloh Home, Inc. Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Agreement Amendment #1 with Shiloh Home, Inc. The Department has an Agreement with Shiloh Home, Inc. for Aftercare, Day "Treatment, Foster Parent Consultation, Life Skills, Mental Health, Sexual Abuse Treatment, and Home -Based Intervention Services. This Agreement is known to the Board as Tyler ID# 2022-1631. The agreement is now being amended to renew for a second year, for the period June I, 2023 through May 31, 2024, and to make changes to the Scope of Services and Rate Schedule as noted below. The Human Services Advisory Commission (FISAC) has reviewed and approved this information, Scope of Services Changes: • Updates to the terms as requested by the Department. Rate Schedule Changes: • Updates to the terms as requested by the Department. • Updates to the rates as requested by the Contractor. I I O _r,IIll Arca I1 IIc Unit Sct ice Name vl,�• Home Based Intervention $95.00 $95.00 Hour $120.00 Hour $75,00 $85.00 $85.00 $60.00 Hour Hour Each Hour Hour Each Aftercare Individual and Family Therapy: In- Office/Video Aftercare Individual and Family Therapy: In - O ffice with Transportation Aftercare Individual and Family Therapy: In - Home or Community Aftercare Individual and Family Therapy: Team Meeting (Emil), Team Decision Making (TDM) Meeting, Professional Staffing Aftercare Individual and Family Therapy: No Show (Max of 2 no shows or 2 hours/month/client) Aftercare In -Home and Community Based Family Support Services Aftercare In -Home and Community Based Family Support Services: Team Meeting (FTM). Team Decision Making (TDM) Meeting, Professional Staffing Aftercare In -Home and Community Based Family Support Services: No Show (Max of 2 j no shows or 2 hours/month/client) Pass -Around Memorandum; May 16, 2023 - CMS ID 7013 01.64Ca4th1)) j/O2 )3/42 3 Page 1 2,0221(o3\ Hi2606N- PRIVILEGED AND CONFIDENTIAL Program Area Day Treatment R.tl. $2.125.00 Unit SM.:Name Ivpc 'I ' Month Day Treatment $98.50 Day Evening Reporting Center (Includes 4-5 hours) Foster Parent Consultation $95.00 Hour Foster Parent Consultation Therapy: In- Office/Video $120.00 Hour Foster Parent Consultation Therapy: In -Office with Transportation $120.00 Hour Foster Parent Consultation Therapy: In -Home or Community $95.00 Hour Foster Parent Consultation Therapy, FTM, TDM, Prof. Staffing $75.00 Each Foster Parent Consultation Therapy: No Show (Max o€2 no shows or 2 hours/month/client) $65.00 Hour Foster Parent Consultation Coaching: In- OfficciViCico $80.00 Hour Foster Parent Consultation Coaching: In -Home or Community $80.00 Hour Foster Parent Consultation Coaching: Team Meeting (FTM), Team Decision Making (-rpm) Meeting, Professional Staffing $60.00 Each Foster Parent Consultation Coaching: No Show (Max of 2 no shows or 2 hours/month/client) - $480,00 Each I Foster Parent & Kinship Provider Training - The Truth about Sexually Abusive and Sexually Reactive Youth $480.00 Each 1 Foster Parent & Kinship Provider Training - 3- hour class $1,760.00 Each Foster Parent & Kinship Provider Training - l 1 -hour class Life Skills $65.00 Hour Life Skills: In-Office/Video $85.00 Hour Life Skills: In -Home or Community $85.00 Hour Life Skills: Team Meeting (FTM), Team Decision Making (TDM) Meeting,, Professional Staffing - $60.00 Each Life Skills: No Show (Max of 2 no shows or 2 hours/month/client) $1,115.00 Month Beyond the Walls $600.00 Month Parents as Teachers $80.00 Hour Comprehensive Parenting Time: In- Offie/Video $85.00 Hour Comprehensive Parenting Time: In -Office with Transportation $85.00 Hour Comprehensive Parenting Time: In -Home or Community $80.00 Hour Comprehensive Parenting Time: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $70.00 Each Comprehensive Parenting Time: No Show (Max of 2 no shows or 2 hours/month/client) $95.00 Hour_ Therapeutic Parenting Time: In-Office/Video $120.00 Hour Therapeutic Parenting Time: In -Office with Transportation Pass -Around Memorandum; May 16, 2023 — CMS ID 7013 Page 2 PRIVILEGED AND CONFIDENTIAL Life Skills Mental Health Services $95.00 1 Hour Sexual Abuse Treatment $ 120.00 Therapeutic Parenting Time: Team Meeting $95.00 Hour # (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each § Therapeutic Parenting Time: No Show (Max $120.00 ; Hour $120.00 Hour $95.00 I Hour of2 no shows or 2 hours/month/client) Mental Health Services Individual and Family Therapy: In-OfficeNideo (Also for Intensive Family Therapy) Mental Health Services Individual and Family Therapy: In -Office with Transportation (Also for Intensive Family Therapy) Mental Health Services Individual and Family Therapy: In -Home or Community (Also for Intensive,Family Therapy) Mental Health Services Individual and Family Therapy: "Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing (Also for Intensive Famil Them. ) Mental Health Services Individual and Family $75.00 Each Therapy: No Show (Also for Intensive Family Therapy; Max of 2 no shows or 2 hours/month/client Community Based Treatment for Youth with $95.00 Hour Problematic Sexual Conduct Coaching: In- Office/Video Community Based Treatment for Youth with $130.00 = Hour Problematic Sexual Conduct Coaching: In- , Office with Transportation Community Based Treatment for Youth with $130.00 Flour h Problematic Sexual Conduct Coaching: In - Home or Community $95.00 Hour ' Individual and Family Treatment: In Office/Video $130.00 Hour Individual and Family Treatment: In -Office with Trans+ortation $130.00 $95,00 Hour Individual and Family Treatment: In -Home or Commune Abuse Treatment: Team Meeting (FTM Hour € Team Decision Making (TDM) Meeting, Professional Staffin $75.00 Each Sex Abuse Treatment: No Show (Max of 2 no shows or 2 hours/month/client) $300.00 Each Informed Supervision me Based Intervention $95.00 Hour ' Rapid Response: In-OfficeNideo $140.00 Hour Rapid Response: In -Office with Transportatio $140 Q0 Hour Rapid Response' In -Home or Community._, Rapid Response: Team Meeting (FTM), Team $95,00 Hour Decision Making (TDM) Meeting, Professional Staffing $75.00 Each Rapid Response: No Show (Max of 2 no shows or 2 hours/month/client) Pass -Around Memorandum; May 16, 2023 - CMS ID 7013 Page 3 PRIVILEGED AND CONFIDENTIAL l'I'ti2rain 5ry , Rut,' limit lypc ,T,icl' Name Home Based Intervention $95.00 Hour Youth Interventions Therapy Services: In- Office/Video $125.00 Hour Youth Interventions Therapy Services: In - office with. Transportation $ 125.00 Hour Youth Interventions Therapy Services: In - Home or Community $95.00 Hour Youth Interventions Therapy Services: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each Youth Interventions Therapy Services: No Show (Max of 2 no shows or 2 hours/month/client) $65.00 Hour Youth Intervention Family Coaching: In- Office/Video $80.00 Hour Youth Intervention} Family Coaching: In - Office with Transportation $80.00 Hour Youth Intervention Family Coaching: In - Home or Community $65.00 Hour Youth Intervention Family Coaching: Team Meeting (FTM), Team Decision Making (TDM) Meeting. Professional Staffing $60.00 Each '' Youth Intervention Family Coaching: No Show (Max of 2 no shows or 2 hours/month/client) All Program Areas $0.59 Mile Mileage* I do not recommend a Work Session. I recommend approval of this Agreement Amendment # I and authorize the Chair to sign. Schedule Work Session Perry L. Buck, Pro-Tem Mike Freeman, Chair Scott K. James Kevin D. Ross Lori Saine Other/Comments: Pass -Around Memorandum; May 16, 2023 - CMS ID 7013 Page 4 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SHILOH HOME, INC. This Agreement Amendment, made and entered into 2.14n1MaL-I, 2023, b g day of Yand between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Se ces, hereinafter referred to as the "Department", and Shiloh Home, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Aftercare Services, Day Treatment, Foster Parent Consultation, Life Skills, Mental Health Services, Sexual Abuse Treatment, and Home -Based Intervention, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2022-1631, approved on June 13, 2022. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2023. • This Amendment, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Child Protection Agreement as of June 1, 2023: 1. Term This Agreement is being renewed for the second year, for the period of June 1, 2023 through May 31, 2024. 2. Exhibit A, Scope of Services, is hereby amended as attached. 3. Exhibit B, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: �� /• Je::&40;ok, BY: ay/ -4.dirarSet* 4uty Cler'! o th; tent ,t� etc:. rr�JAi COUNTY: BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair a. ONTRACTOR: MAY 2 4 2323 Shiloh Home, Inc. 6588 West Ottawa Avenue Littleton, Colorado 8012$ steven ramirez By: steven ramirez (May 17, 2023 09:06 MDT) Steven Ramirez, Chief Executive Officer May 17, 2023 Date: o1o.0 - iG S EXHIBIT A SCOPE OF SERVICES Contractor will provide Aftercare Services, Day Treatment, Foster Parent Consultation, Life Skills, Mental Health Services, Sexual Abuse Treatment, and Home -Based Intervention, as referred by the Department. Program Area: Home -Based Intervention 1. Aftercare Services a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide individual and family therapy and support services to allow for the reunification of the child with his or her family where feasible. These services will promote the successful transition of children to their home (or another permanent placement) from a higher level of care and are aimed at preventing out of home placements. ii. Contractor offers the following Aftercare Services: 1. Office -Based Family Therapy. 2. Community -Based Family Therapy. 3. In -Home Family Therapy. 4. Office -Based Individual Therapy. 5. Community -Based Individual Therapy. 6. In -Home Individual Therapy. 7. Community -Based Family Support Services (i.e., Life Skills and/or Parent Coaching). 8. In -Home Family Support Services. iii. Assessments Utilized for Aftercare Services: 1. Contractor will implement assessments to determine the focus of Aftercare Services. 2. A mental health assessment will be used to evaluate therapeutic needs for the individual and family and assist in creating an effective treatment plan. Other assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.) to further establish treatment objectives and to measure outcomes. b. Anticipated Frequency of Services: i. Therapy services: One (1) hour weekly unless the need for more frequent intervention is identified through the assessment process. ii. Intensive Family Therapy: up to three (3) hours per week. iii. Four Life Skills treatment packages are available: 1. Intensive, ten (10) to fifteen (15) hours per week. 2. High, seven (7) to nine (9) hours per week. 3. Moderate, four (4) to six (6) hours per week. 4. Low, three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Treating emotional and behavioral symptoms associated with trauma and mental health disorders. ii. Educating families about trauma and mental health issues. iii. Helping children, adolescents, and their families develop healthy coping tools. 1 iv. Equipping caretakers with knowledge and methods to provide trauma -informed parenting. v. Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences. vi. Providing intensive psychoeducation that increases each family member's understanding of their own unhealthy interaction patterns and how to change them. vii. Reducing conflict between family members by teaching them positive communication skills that foster empathy between them. viii. Facilitating communication between family members about emotional, behavioral, and relational issues. ix. Assisting caretakers in creating a nurturing and healthy home environment which will enable the children to successfully progress in their development and academic achievement. Practical implementation of parenting skills learned in therapy (e.g., creating chore charts, homework charts). xi. Practical implementation of life skills. e. Outcomes of Services: i. Improved individual and family functioning. ii. Alleviation or reduction of mental health symptoms. iii. Completion of treatment goals. f. Target Population: i. Children and adolescents in the process of reunifying with their families or transitioning to another permanent placement. ii. The target population often includes children, adolescents, and families who are struggling with issues related to mental health, trauma, and difficult family dynamics that compromise individual and family functioning and lead to placement disruptions. g. Language: i. English. h. Medicaid Eligibility: i. This service is partially eligible for Medicaid. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -office. iii. In the community when appropriate. Program Area: Day Treatment 1. Day Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's Shiloh Academy offers educational services at on -site locations. Components of the program include: 1. Educational and clinical assessment services. 2. Offense specific treatment services. 3. Individual, family, group and milieu therapies (offered on a weekly basis). 4. Case management. 5. Academic curriculum -credits transferable to public school. 6. Special education services. 7. Transportation to/from school within a fifteen (15) mile radius. 8. In -home service/per case need (Not included in the listed rate). 9. Community activities. 2 10. 24/hour on -call assistance. 11. Monthly progress reports. 12. On -going assessment of family Transitional services/staffing to public school. b. Anticipated Frequency of Services: i. Educational services are offered daily, Monday through Friday when school is in session. ii. Groups are offered daily, Monday through Friday when school is in session. iii. Individual therapy is offered weekly. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. The student will experience improved emotional and behavioral function through engagement in group and individual therapy. ii. The student will have support from educational staff to learn techniques to gain physical and emotional safety. iii. The student will have opportunities for improved academic success. iv. The student will have opportunities to learn healthy decision -making skills in a smaller classroom setting. e. Outcomes of Services: i. Credit recovery. ii. Improved school emotional and behavioral functioning. iii. Prepared for academic and interpersonal success upon return to home school. iv. Maintain positive home and community relationships. f. Target Population: i. Contractor's Day Treatment services are available to youth between seven (7) to eighteen (18) years of age who are proficient in speaking English; and who present with behavioral disorders, mental health issues, or problematic sexual behaviors. ii. Clients with the following issues are generally considered not appropriate for the program: 1. Severely limited cognitive abilities (IQ below 65). 2. Ongoing medical issues that cannot be supervised/managed by staff. 3. The inability or significantly impaired ability to understand and/or communicate in English. 4. Is actively psychotic. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In Office, on site at Shiloh Academy locations. ii. In Weld County at Shiloh Academy located at 2700 E. Ken Pratt Boulevard, Longmont, Colorado 80504. 2. Evening Reporting Center a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: 3 i. Students participating in the program receive academic counseling and tutoring, truancy counseling, substance abuse counseling, therapeutic recreation, and resource development. b. Anticipated Frequency of Services: i. Four (4) to five (5) hours per day. Services only take place on business days and are not available on weekends and holidays. c. Anticipated Duration of Services: i. Ten (10) to forty-five (45) days. d. Goals of Services: i. The student will experience improved pro -social engagement. ii. The student will have improved school attendance. iii. Completion of court ordered community service. iv. The student will have opportunities to explore options for continuing education or career path development. e. Outcomes of Services: i. Youth appearance at all scheduled judicial hearings. ii. Creation and maintenance of positive behavior at home and in the community. iii. Performance of community service. iv. Promote legal behaviors to prevent new delinquent acts. v. Improved school attendance and performance, vocational or college planning. vi. Improved healthy relationships, social activity, and family functioning. f. Target Population: i. Youth between the ages of twelve (12) and eighteen (18) years who: 1. Require pro -social activity engagement during evening hours. 2. Have truancy issues at school. 3. Participate in a pm -trial release and supervision program. 4. On probation for the first time. ii. Have minimum system involvement and could benefit from intervention to prevent additional charges or delinquent behaviors. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. Program Area: Foster Parent Consultation 1. Foster Parent and Kinship Provider Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide psychoeducation for foster parents regarding the impact of trauma and abuse and neglect. This training will include 8 hours of instruction and practice. The instruction will include the following curriculum topics: 1. It's all about the brain, not the behaviors. 2. The teenage brain is unique, and the teenage traumatized brain can be healed. 3. Understanding the impact of trauma "it's not defiance, it's learned survival". 4 4. Effective consequences for teenagers impacted by abuse and neglect. 5. Skills rather than punishment or consequences. 6. Developmental age vs chronological age and reasonable expectations. 7. Resiliency: how to identify the strengths that already exist, and how to build resiliency in every child. Foster parents are the key. ii. Contractor will provide support services to assist the foster family with child specific consultation. iii. Contractor will provide families with assistance with household family functioning through on -site family support from the Shiloh House Family Support Professionals. iv. Contractor will provide phone consultation in crisis situations. v. Contractor will provide a supportive and non judgmental relationship for the foster child and foster parents. vi. Contractor will assist families with skill development to ensure that families can establish appropriate relationship development, structure, boundaries and limits, with the goal of proactively preventing family conflict, and/or to decrease conflict that may already exist. vii. Contractor will provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. viii. Contractor will support the development of foster parent/child relationships. ix. The goal of Contractor Home's home -based Foster Parent Consultation services is to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, providing information for community resources, and providing effective parenting training. b. Anticipated Frequency of Services: i. One (1) to two (2) hours per week. c. Anticipated Duration of Services: i. Eight (8) hours total. d. Goals of Services: i. Increase the level of family functioning. ii. Eliminate placement disruption. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase foster parents' understanding of the impact of trauma. v. Help foster parents to have realistic child expectations. vi. Improve foster parenting, relationship, and social skills. vii. Provide rapid crisis consultation and support for foster parents experiencing challenges with their foster child. viii. Role modeling positive interaction with children - The Home -Based family support professional will use a wide variety of interaction and education -based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. ix. Increase foster parent confidence - As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. Teach value of daily routine and consistency with children - Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age -appropriate chore charts to help parents with consistency. xi. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Contractor's services are provided from a family engagement, strength based, trauma informed basis. xii. Return children in placement to their own home: Contractor's home -based and foster parent consultation services are provided as either a prevention of out of home placement, 5 or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. xiii. Unite children with their permanent families: Contractor's home -based services strive to ensure the permanency of children with their families. xiv. Provide services that protect the child: Contractor's in -home services ensure that children are protected, and that the well-being of every child is our first priority. e. Outcomes of Services: i. Placement preservation. ii. Increased supports and community -based resources. iii. Reduced risks for additional child protection or delinquency concerns. f. Target Population: i. Foster parents and Kinship providers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: ii. In -office. 2. Foster Parent and Kinship Provider Training: The Truth about Sexually Abusive and Sexually Reactive Youth a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provide education about juvenile sexual abuse and sexual reactivity to increase care provider efficacy, promote retention of foster care providers, and increase the potential for juveniles to experience success in their treatment plans by contributing to stability of the foster or kinship placement and minimizing the risk for placement in a higher level of care. b. Anticipated Frequency of Services: i. One (1) time training. c. Anticipated Duration of Services: i. Three (3) hours. d. Goals of Services: i. Provide information about normative, concerning, and problematic sexual behavior. ii. Dispel the "myths" that many people often believe in regard to sexually abusive and sexually reactive youth. iii. Provide accurate information about what is actually required when providing care for sexually abusive and/or sexually reactive youth. e. Outcomes of Services: i. Community Safety. ii. Preserve foster placement to minimize disruption for children and families. iii. Increase willingness and ability of foster parents to care for sexually abusive or sexually reactive youth. iv. Divert entry into residential placement, or support step-down from residential placement into foster care. 6 f. Target Population: i. Kinship providers and foster parents caring for juveniles who have engaged in sexually abusive behaviors or exhibit sexual reactivity. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. 3. Foster Parent and Kinship Provider Training: Psycho Education a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide psychoeducation for foster parents and kinship providers regarding the impact of trauma, abuse and neglect, transitions impact to foster children, navigation of the mental health system, biological family reunification and developmental expectations. ii. This training will include eleven (11) hours of instruction and practice. The instruction will include the following curriculum topics: 1. It's all about the brain, not the behaviors. 2. The teenage brain is unique, and the teenage traumatized brain can be healed. 3. Understanding the impact of trauma "it's not defiance, it's learned survival". 4. Effective consequences for teenagers impacted by abuse and neglect. 5. Skills rather than punishment or consequences. 6. Developmental age versus chronological age and reasonable expectations. 7. Resiliency: how to identify the strengths that already exist, and how to build resiliency in every child. Foster parents are the key. 8. Transitions Impact on Foster Children: includes a review of the grief and loss that occurs in transitions, viewing and discussion of dramatic videos that portray the impact, and teaching foster parents how to support foster children in transitions. 9. Navigation of the Mental Health system: our instructors will provide a step by step guide of navigating the mental health system, including accessing services, counseling and psychiatric services, initial assessments and first contacts, making appointments, how to support the child before and after mental health appointments and/or hospitalizations, communication with the therapist, and problem solving real life roadblocks. 10. Family Reunification: our instructors will provide a thorough review of children's complex feelings toward their families and the best strategies for support the child in all steps of the family reunification process. Real life examples of reunification challenges related to past trauma, and abuse and neglect experiences, as well as positive family experiences, memories, and the ambivalence that children experience. The foster parents will be provided the opportunity to explore their own feelings about family reunification. b. Anticipated Frequency of Services: i. One (1) hour session weekly. c. Anticipated Duration of Services: i. A minimum of three (3) hours will be provided. ii. Contractor has an eleven (11) hour package also available. 7 iii. Additional sessions may be available depending on needs of the client and the complexity of issues. d. Goals of Services: i. Enable the family to function in a safe manner. ii. Address safety concerns through education, and role modeling. iii. Provide information for community resources. iv. Provide effective parenting training. e. Outcomes of Services: i. Provide foster children with the best possible family environment that responds in a developmentally and trauma informed manner. ii. Provide foster children with stable and successful life experiences. iii. Increase the level of foster family functioning. iv. Increase foster parent competency and confidence. v. Significantly reduce placement disruption. vi. Increase formal and informal supports such as community, family, and friends. vii. Increase foster parents understanding of the impact of trauma. viii. Help foster parents to have realistic child expectations. ix. Improve foster parenting, relationship, and social skills. x. Role modeling positive interaction with children - The Home -Based family support professional will use a wide variety of interaction and education -based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. xi. Increase foster parent confidence: As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. xii. Teach the value of developmentally appropriate daily routine and consistency with children - Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age - appropriate chore charts to help parents with consistency. xiii. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Contractor's services are provided from a family engagement, strength based, trauma informed basis. xiv. Return children in placement to their own home: Contractor's home -based and foster parent training services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. xv. Unite children with their permanent families: Contractor's home -based services strive to ensure the permanency of children with their families. xvi. Provide services that protect the child: Contractor's in -home services ensure that children are protected and that the well-being of every child is our first priority. f. Target Population: i. Foster parents and kinship providers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. 8 Program Area: Life Skills 1. Life Skills Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Life Skills Coaching is an in -home service. Treatment Packages include 75% face to face with family and 25% other duties including but not limited to Team Decision Meetings, Administrative Review Conferences, Case Management, and Court related activities. ii. The Life Skills coach will provide the family with tools to move toward self-confidence and independence. These tools may include but are not limited to the following: 1. Provide information regarding community resources, employment, occupational training, education, and health care options. 2. Provide support services to assist families with accessing resources and employment. 3. Provide families with assistance with household budgeting. 4. Provide help with household management. 5. Provide a non judgmental relationship. 6. Help families identify and establish appropriate boundaries and limits. 7. Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. 8. Support development of parent/child relationships. 9. Teach appropriate discipline techniques: Life Skills coaches utilize a variety of techniques with parents to increase awareness, skill, and management of child behavior. 10. Role modeling positive interaction with children: Life Skills coaches use activities to model how to positively interact with children. The Life Skills coach will use books, games, crafts, and creative play to teach clients. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. 11. Increase parent confidence. As the parent begins to gain new skills and control in the home, confidence is naturally increased. Providing parents with resources to help them with supporting their family also gives the parent a feeling of accomplishment and instills a sense of pride. 12. Teach the value of daily routine and consistency with children. Life Skills coaches will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards, and consequences and are given resources such as age -appropriate chore charts to help parents with consistency. 13. Increase parental awareness of children's basic and emotional needs- Life Skills coaches will assist parents in learning to recognize child healthcare needs, make doctor appointments, and at times, accompany the family to a doctor's appointment. Coaches will help parents plan and prepare nutritious meals, in addition to providing resources for housing, food, clothing and shelter. Coaches help teach parents to recognize what feelings are expressed in their child's behaviors and how to respond in a way that nurtures the child. 14. Provide parents with information regarding age -appropriate child development - Life Skills coaches teach parents about child development. Coaches use a variety of assessments to help determine a child's developmental growth as well as providing parents with activities to utilize with their child in order to stimulate development of fine and gross motor skills as well as adaptive and communication skills. Coaches will help a parent recognize what is age - appropriate behavior and how to manage any inappropriate behavior. b. Anticipated Frequency of Services: 9 i. Four (4) Life Skills treatment packages are available: 1. Intensive, ten (10) to fifteen (15) hours per week. 2. High, seven (7) to nine (9) hours per week. 3. Moderate, four (4) to six (6) hours per week. 4. Low, three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Children will remain in the care of their parents while parents resolve child protection concerns. ii. Parents will learn skills to prevent new or repeated child protection concerns. iii. Parents will be able to recognize the emotional, physical, and developmental needs of their children. iv. Parents will learn to use resources available within the community to help meet the needs of their children. e. Outcomes of Services: i. Increase level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. f. Target Population: i. Families involved with the Department, where one or more children may be at risk for placement disruption that may be prevented if parents have the opportunity to develop stronger skills. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. Community -based. 2. Beyond the Walls a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Transitional coaching for youth. Each month Beyond the Walls sponsors Workshops such as financial literacy, Reality Tours at local colleges and businesses, and mentoring relationships on a 1:1 level or in Circles of support. Each learning and support opportunity focuses on the areas of education, housing, job skills, faith -based connections, business engagement, and community skills. 1. Youth are motivated to participate through exposure to a network of activities and hands-on assistance that are proven tools to assist young people in gaining vital confidence and support as they transition into young adulthood. 2. The combination of action learning, mentoring, coaching and peer mentoring provides young people with a wider source of support and inspiration for idea 10 generation and greater creativity in problem solving during critical times in a young person's life. 3. Specially trained community partners guide each personal growth opportunity which gives young people the chance for experiential learning, and a chance to discuss individual plans. Peer support is offered from community partners acting as a sounding board for young people to bounce ideas and potential solutions to problems. 4. Beyond the Walls also leverages and builds links to existing resources in the community to ensure young people are able to find what they need to become vibrant members of their local community. b. Anticipated Frequency of Services: i. Each month, twenty-five (25) hours of learning opportunities are available to participating youth. c. Anticipated Duration of Services: i. Services may be provided for many years as needed. d. Goals of Services: i. This program works to ensure that every young person is: 1. Attached to nurturing adults. 2. Linked with educational supports that lead to career readiness. 3. Engaged in community, school and/or extracurricular activities. 4. Career ready with positive attitudes about the world of work. 5. Productive and equipped to reach financial self-sufficiency. 6. Aware of, appreciates and demonstrates behaviors of personal and social responsibility. 7. Demonstrating healthy decisions that lead to well-being. e. Outcomes of Services: i. Transition from out of home care to independence. ii. Develop circles of support to increase opportunities for success in young adult life. iii. Achieve goals outlined in an individual plan. f. Target Population: i. Youth, ages sixteen (16) to twenty-six (26). g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. ii. In the community. 3. Parents as Teachers a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evidence -Based Home Visiting Model is the comprehensive home -visiting, parent education model used by Parents as Teachers Affiliates. This model has been identified as a well -supported practice by the Title IV -E Prevention Services Clearinghouse. The program provides a resource network, and child screening. 11 b. Anticipated Frequency of Services: i. Personal Visits — one (1) to two (2) visits per month. ii. Group Connections — One (1) per month. c. Anticipated Duration of Services: i. While the child is in the age range of birth to five (5) years. d. Goals of Services: i. Increase parent knowledge of early childhood development and improve parent practices. ii. Provide early detection of developmental delays and health issues. iii. Prevent child abuse and neglect. iv. Increase children's school readiness and success. e. Outcomes of Services: i. Increase parent knowledge of early childhood development. ii. Improve parenting practices, increasing children's school readiness and success. iii. Provide early detection of developmental delays and health issues. f. Target Population: i. Families with children from birth through kindergarten. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. 4. Comprehensive Parenting Time and Sibling Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Supervised visits may occur in community -based locations such as parks, libraries, restaurants, museums and many other approved and appropriate locations, including the client's home. This flexibility allows families to meet in environments that promote bonding and child development. The decision to provide community based, supervised visits is determined by feedback from the multi -disciplinary team. Supervised Visitation includes parent education regarding the developmental needs of the children, and parent skill development. All parties in attendance for visits must be pre -approved by the multi- disciplinary team. ii. The visitation supervisor will meet with the visiting parent 15 minutes before and after each visit to discuss goals and provide feedback, making it easier for parents to identify progress and areas for continued support or growth. Supervised visitation typically lasts between one (1) to three (3) months. The need for supervised visits will be reevaluated every sixty (60) days. Supervised visitation appointments can occur between the hours of 8:30 AM and 8:30 PM, Sunday through Saturday. Each visit will last at least one (1) hour unless safety concerns require ending the visit. When the referral is for visits between siblings only, visitation will include age -appropriate guidance and interventions by the visitation supervisor during the visit to foster healthy sibling bonds. The primary purpose of the visitation supervisor is to ensure the safety of the children. Visitation supervisors will remain in sight and hearing of siblings and will engage with children using trauma informed, culturally responsive, age -appropriate techniques to minimize risk and maximize the potential for healthy sibling relationships. 12 iii. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, activities will be planned ahead of time and explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. iv. Supervised visits may occur in community -based locations such as parks, libraries, restaurants, museums, and many other approved and appropriate locations. This flexibility allows siblings to interact in environments that promote bonding and provide normalized childhood experiences. The decision to provide community based, supervised sibling visits is determined by feedback from the multi -disciplinary team. All parties in attendance must be pre -approved by the multi -disciplinary teams. If needed, transportation for sibling visits can be provided. If the sibling group is comprised of three (3) or more children, a second visitation supervisor must be present. When visits are scheduled for sibling groups, the visitation supervisors will be trained in Informed Supervision. b. Anticipated Frequency of Services: i. Typically, one (1) hour per week. c. Anticipated Duration of Services: i. One (1) to three (3) months. d. Goals of Services: i. Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting. ii. Ensure the safety of children. iii. Strengthen the protective capacity of parents. iv. Help parents identify the child's cues and respond appropriately so that needs are met. v. Help parents communicate with their children in ways that are appropriate to age and cognition. e. Outcomes of Services: i. Increased bonding between parents and children. ii. Increased understanding of age -appropriate parent/child interactions. iii. Demonstration of safe parenting techniques that will help parents in the goal of reunification. f. Target Population: i. Parents with children in out of home care in cases where the goal is reunification or a permanent connection. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. In -home. ii. In -office. iii. Community -based locations. 5. Therapeutic Parenting Time and Therapeutic Sibling Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: 13 i. Provides a goal focused therapeutic time for the parent and child within the supervision and therapeutic intervention, training, and skill building of the bachelor (BA) or Masters (MA) level parenting therapist. For those parents and families that would benefit from a more intensive parenting time training and experience the Therapeutic Parenting Time program is appropriate. ii. Delivery Methods: Following an initial assessment meeting, and observation, the parent, and parenting therapist collaborate to identify specific skill building areas, as well as develop the goals and tasks for each of the parenting times. Therapeutic Parenting Time will be scheduled in advance, and staff will coordinate with all necessary parties for effective service delivery. iii. Engagement Techniques: In each therapeutic parenting session, the therapist and the parent will review the skills, discuss the goals of the session, plan the specific tasks and then engage in a natural interaction time between the parent and child. During the session if the therapist believes a short helpful intervention or role modeling would be beneficial, they will engage the parent in this learning process. Following the parent -child time together, the therapist and the parent will meet to review the session, provide feedback, discuss frustrations or skills that the parent has identified as needing and establish a plan for the next session. iv. Provides a clinically guided; goal focused therapeutic time for siblings within the supervision and therapeutic intervention of the master's level therapist, or a qualified visitation supervisor who works under the direct supervision of a master's level therapist. All staff will be trained in Informed Supervision. When one (1) or more siblings struggle with the impact of mental health issues, sexual abuse, or other forms of trauma, a therapeutic model may be appropriate to establish a safe, constructive environment where sibling bonds can be repaired, and healthy relationships can grow. v. An assessment may be required prior to scheduling visits to assist in establishing culturally responsive, age -appropriate visitation goals; identify areas for skill building; and create an initial visitation plan. Therapeutic sibling visitation supervisors utilize a trauma informed approach. Therapeutic sibling visits can occur at one of Contractor's facility, or another approved, community -based location that provides a calm, neutral environment suitable for therapeutic interactions. Contractor will collaborate with the Department on an ongoing basis so that the need for this level of supervised visitation can be frequently reevaluated based on progress toward therapeutic visitation goals and the needs of each client involved. vi. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, activities will be planned ahead of time and explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. b. Anticipated Frequency of Services: i. Two (2) to four (4) hours per week. c. Anticipated Duration of Services: i. Eight (8) to sixteen (16) weeks. d. Goals of Services: i. Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting. ii. Ensure the safety of children. iii. Strengthen the protective capacity of parents. iv. Help parents identify the child's cues and respond appropriately so that needs are met. v. Help parents communicate with their children in ways that are appropriate to age and cognition. e. Outcomes of Services: 14 i. Improvement of a healthy parent -child relationship. ii. Child safety, and increased ability by the parent to recognize cues provided by the child. iii. Step-down to a lower level of parent -child supervision. f. Target Population: i. Parents with children in out of home care in cases where the goal is reunification or a permanent connection, and relationship dynamics or child protection concerns merit therapeutic support during parenting time. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. Service Access and Transportation: i. In -home. ii. In -office. iii. Community -based locations. Program Area: Mental Health Services 1. Mental Health Services: Individual, and Family Therapy Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Outpatient or in -home individual and family therapy services provided to children, adolescents, and families who are struggling with mental health issues (often related to trauma) and difficult family dynamics. ii. Assessments Utilized: A mental health assessment is used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, and family relationship questionnaires.). iii. Focus of Mental Health Services: Areas targeted by therapy services include: 1. Reducing problematic symptoms and behaviors associated with mental health disorders and trauma. 2. Educating children, adolescents, and families about issues associated with trauma and mental health, including identifying how they impact functioning. 3. Helping children, adolescents, and their families develop healthy coping tools to manage their unpleasant thoughts and emotions. 4. Equipping caretakers with knowledge and methods to provide trauma -informed parenting and meet the unique needs of their children. 5. Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences. 6. Increasing each family member's understanding of their own unhealthy interaction patterns and how to change them. 7. Reducing conflict within families by teaching and guiding family members in the use of positive communication skills that foster empathy between them. 8. Facilitating communication between family members to address therapy issues. iv. Mental Health Services Methodologies: All treatment interventions used by Contractor are trauma -informed, evidence -based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and Dialectical Behavior Therapy (DBT) techniques. 15 v. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Therapeutic services are trauma informed, strength -based and are designed to meet the needs of each client. vi. Mental Health Services Providers: Therapy services are provided by a master's level clinician; licensed, provisionally licensed, or under the supervision of a licensed supervisor. b. Anticipated Frequency of Services: i. Individual Therapy: One (1) hour per week. ii. Family Therapy: One (1) hour per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Increase functioning and overall wellbeing. ii. Increase coping skills. iii. Physical and emotional safety. iv. Improve interpersonal skills, including healthy communication and self -advocacy. e. Outcomes of Services: i. Improved Mental Health. ii. Improved Individual Functioning. iii. Improved Family Functioning. iv. Completion of Treatment Goals. f. Target Population: i. Youth, adults, and families. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. 2. Intensive Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Short-term, family -centered therapeutic process used to focus on the destructive familial relationship patterns and define new healthy patterns for interaction between family members. Family therapy is a solution -based treatment concentrating on resolving presenting problems identified by the Department reason for involvement. Treatment may include individual therapy or a combination of two or more members of the family in the office with the therapist at one time or as an in -home service. Intensive Family Therapy should be individualized to each individual and family and should incorporate measurable goals/anticipated outcomes that are consistent with the Human Services Family Service Plan. ii. Delivery Methods: Therapeutic services can be provided in the office or in the home. Evidence based services include Trauma Focused -Cognitive Behavioral Therapy (TF- CBT). 16 iii. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Therapeutic services are strength - based and are designed to meet the needs of each client. iv. Staff Credentials: Masters level clinician licensed, provisionally licensed or under the supervision of a licensed supervisor. b. Anticipated Frequency of Services: i. Up to three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Gain effective communication skills. ii. Learn to resolve conflict in non -abusive ways. iii. Identify and replace destructive familial relationship patterns. e. Outcomes of Services: i. Improved family dynamics. ii. Completion of treatment goals. iii. Family continues to demonstrate safety and stability in the home environment, reducing the risk for out of home placement or future Human Services involvement. f. Target Population: i. Parents and children who will benefit from short term therapeutic supports. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. Program Area: Sexual Abuse Treatment 1. Community Based Treatment for Youth with Problematic Sexual Conduct Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. This outpatient program is designed for family and youth verbalizing a strong commitment to actively participate in a combination of home -based offense specific therapy and coaching services. These families may not fully grasp the seriousness of the sexual offending or the contributing family dynamics, but the family and the youth have demonstrated a willingness to engage in the treatment process. This program can help youth and families address issues including sexual reactivity due to abuse and trauma; unhealthy behaviors including inappropriate touching, bullying, gesturing, and threatening verbalizations; youth who have engaged in family -based incest; and youth who have engaged in community based sexual assault. Participating youth may be adjudicated, or non -adjudicated. ii. Delivery Methods: This Community Based Treatment for Problematic Sexual Conduct includes two (2) to three (3) hours per week of in -home Sex Offender Management Board (SOMB) masters level treatment and additional bachelors (BA) level in -home 17 training, coaching and accountability targeting safe and healthy sexual behavior life skills. Coaches and therapists build on strengths that exist within the family and help family members address safety concerns in a realistic, non judgmental way. iii. Engagement Techniques: The offense specific life skills coaches will reinforce the parents in the skill areas necessary for ensuring the care and wellbeing of their children, as well as treatment success for the youth with Problematic Sexual Conduct. Masters level clinicians actively listed with the Colorado SOMB as approved providers will provide offense specific treatment that is tailored to meet the needs of the youth and the family. Case management services and communication are also provided by Contractor staff to ensure multi -disciplinary team (MDT) member collaboration. Following an initial assessment, an individualized treatment plan will be completed for each youth and family and will be modified as needed during services with approval by the MDT. b. Anticipated Frequency of Services: i. Two (2) to three (3) hours per week. c. Anticipated Duration of Services: i. Six (6) to eight (8) months. d. Goals of Services: i. To successfully integrate SOMB guided home based offender treatment with evidence - based treatment principles including Trauma Focused CBT and High Fidelity Wrap Around. ii. To support the following High -Fidelity Wrap Around principals: 1. To be strength based and to value all members of the team focusing on family and youth needs rather than deficits. 2. To engage natural support systems for the youth and family and provide the natural support with informed supervision training and accountability skills to ensure that the youth and family have supportive resources. 3. To ensure that the family and youth voice are valued in all discussions. 4. To be culturally competent and respectful in all services. 5. To individually tailor all treatment and offense specific life skills. 6. To collaborate and communicate effectively with all multi -disciplinary team members. 7. To be dedicated to progressing through inevitable challenges and barriers. 8. To be outcome based with observable and measurable indicators of success. iii. To address complex and overlapping needs. iv. To successfully address family and offending youth denial of sexual offending problems. v. To reduce future Problematic Sexual Conduct. vi. To strengthen protective and resiliency factors for the youth and family vii. To provide effective coordination with all community partners including development of a school safety plan. viii. To provide offense specific assessments including Juvenile Sex Offender Assessment Protocol (J -SOAP), Psychosexual evaluations and polygraphs. ix. To successfully integrate mental health treatment with offense specific treatment. x. To provide well -coordinated treatment with victim therapists and support systems. xi. To provide services within SOMB guiding principles. e. Outcomes of Services: i. Prevent out of home placement. ii. Promote safety for persons victimized, the youth and family, and for the community through the successful completion of a treatment plan. iii. Increase the personal health of the offending youth. f. Target Population: 18 i. Youth ages eight (8) to eighteen (18) and their families who are struggling with a wide variety of Problematic Sexual Conduct. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. 2. Sex Abuse Individual and Family Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization. Delivery Methods: Contractor practices the best standards of care and emphasizes implementation of evidence -based treatment practices. Sex abuse individual and family treatment provides strength based, family focused, accountable, relationship -oriented service which respects the family while ensuring that the goals of treatment are achieved. ii. Contractor adheres to the Sex Offender Management Board (SOMB) Guidelines and Standards. Risk assessment will be addressed through empirically guided risk evaluations and clinical insight, ongoing team and family collaboration, treatment progress and team members input, behavioral observation within all arenas of the client's life (home, school, job, social, community). Adjunct referral for polygraphs, arousal measurement, psychological services and psychiatric services are made as deemed necessary and appropriate. Therapy adheres to the Colorado Sex Offender Management Board's Standards and Guidelines for the Evaluation, Assessment, Treatment and Supervision of Juveniles. iii. Contractor utilizes Trauma -Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Behavioral Therapy (CBT), Psychoeducation and Family Systems Therapy, risk assessment and safety planning, Informed Supervision training, and relapse prevention planning. These services help youth and families increase pro -social behaviors and protective factors; develop a nurturing, healthy home environment; eliminate all illegal behaviors by family members; and provide participants with an understanding of their family and personal cycle of abuse, while increasing their ability to interrupt this cycle. iv. Engagement Techniques: Contractor's SOMB therapists provide interactive educational and therapeutic tools to help clients identify and address safety concerns for all family members; promote disclosure of abusive behaviors and address any victimization the client has experienced; assist in the development of empathy for persons victimized; and establish healthy coping skills and tools (self-control, and rehearsal of corrected cognitions). Whenever possible and appropriate, SOMB therapists work directly with the victim therapist(s) to assist the youth and person(s) victimized in the clarification process. b. Anticipated Frequency of Services: i. Individual therapy: One (1) hour per week. ii. Family Therapy: One (1) hour per week. c. Anticipated Duration of Services: i. Six (6) to eight (8) months. d. Goals of Services: 19 i. To successfully address family and offending youth denial of sexual offending problems. ii. To reduce future Problematic Sexual Conduct. iii. To strengthen protective and resiliency factors for the youth and family. e. Outcomes of Services: i. Community Safety. ii. Parent/Caregiver will gain understanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. iii. Decreased risk and improved personal health. f. Target Population: i. Youth eight (8) to eighteen (18) years of age who have had sexually abusive behaviors, and their families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. 3. Informed Supervision a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor offers Informed Supervision training consistent with SOMB Standards and Guidelines. ii. The Informed supervision training is provided by a Contractor staff who is trained in Informed Supervision and supervised by an SOMB qualified supervisor. iii. The Informed supervision training includes at a minimum the following topics: iv. History of SOMB. v. Principals of SOMB treatment with emphasis on community safety. vi. Why Informed Supervision is necessary. vii. Victim Confidentiality. viii. Sexual Offending Behaviors overview. ix. Current laws that relate to juvenile sexual offending. x. Seriousness of Juvenile Offending, impact, and priorities. xi. Dynamic patterns (cycles) associated with abusive behavior. xii. The role of the MDT in all decisions. xiii. Safety Plans. xiv. High Risk patterns. xv. Community Supervision and Treatment. b. Anticipated Frequency of Services: i. Three (3) hour training during a single appointment. c. Anticipated Duration of Services: i. One (1) time appointment. d. Goals of Services: i. Prepare parents, guardians, and family supports to provide Informed Supervision. 20 ii. Ensure that parents, guardians, and family supports understand the requirements of informed supervision, and that they are willing and able to provide that supervision. iii. Increase community safety by helping the supervising adult understand the risks and needs of the youth in treatment. e. Outcomes of Services: i. Community Safety. ii. Parent/Caregiver will gain understanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. iii. Decreased risk and improved personal health. f. Target Population: i. Parents and other adult caregivers of youth with problematic sexual conduct g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office. Program Area: Home -Based Intervention 1. Rapid Response a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provides short-term, preventative mental health assessment and intervention services to youth and families with the intentions of bridging access to care and reducing further need for intervention by county social services. ii. Interventions Used: 1. Immediate screening/contact (phone or in person) — A discussion with the family members regarding their perspective of the challenges that they are facing. In the initial contact the Assessment Clinician will offer the following: a. A crisis assessment is completed, and immediate safety planning will be offered. b. A Family and individual Biopsychosocial screening will be offered. c. The Assessment Clinician will review the broad range of possible. services in an effort to assist the family in understanding the wide range of hopeful opportunities. d. The Assessment Clinician will offer a home or office based. comprehensive assessment to assist in the service planning. e. The Assessment Clinician will offer an individual child -based assessment to assist in the service planning. 2. Immediate Safety planning. 3. Immediate home -based family visit. 4. Immediate home or office -based crisis intervention. 5. Comprehensive Assessment. 6. Consistent phone and email follow up to check in and offer additional services as the family and/or individual situation changes. iii. On -going services: 21 1. Individual therapy (home or office based): six (6) to eight (8) solution focused sessions aimed at stabilization, improved emotional regulation and problem solving. 2. Family therapy, home and office based, focusing on immediate crisis resolution, improved communication, and relationship restoration. 3. Coaching: two (2) to six (6) hours per week of home -based family support - with funding approval. 4. Family Assessment — This assessment is completed at the home unless the family prefers the confidentiality of an office setting. a. Twenty (20) point family assessment. b. Screening for mental health concerns. c. Assessment and recommendations for additional supports and services. iv. When deemed appropriate access to: 1. Child Behavior Checklist (CBCL). 2. Conner's 3 (ADHD screening) 3. Scales of Independent Behavior — Revised (SIB -R) developmental assessment. 4. Beck Depression Inventory (BDI-II). 5. Beck Combination Youth Inventory. 6. Ansell — Casey Life Skills Assessment. 7. Mental Status checklist for Adolescents. 8. Trauma Symptom Checklist. 9. Behavior Assessment System for Children (BASC-3). 10. Resiliency Scales for Children and Adolescents (Strengths profile). b. Anticipated Frequency of Services: i. Coaching: Two (2) to six (6) hours per week. ii. Therapy: Six (6) to eight (8) sessions. c. Anticipated Duration of Services: i. Four (4) weeks. d. Goals of Services: i. With supports in place to maintain family functioning, the youth will remain at home successfully. ii. Provide information regarding community resources, mental health, education, and health care options. iii. Provide services to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, and providing information for community resources. iv. Help families create and implement safety plans. v. Help families create short term goals to transition to appropriate on -going providers to support maintenance of goals. vi. Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. vii. Support development of parent/child relationships. viii. Teaching appropriate discipline techniques. e. Outcomes of Services: i. Increase the level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. vii. Youth will maintain or be reconnected with educational services or employment at the time of discharge. 22 Target Population: i. Families with children birth to eighteen (18) years of age, who will benefit from short term preventative interventions services to prevent further human services involvement. g. Language: i. English. h. Medicaid Eligibility: i. This service may be eligible for Medicaid. i. Service Access and Transportation: i. Home based. ii. Office -based. 2. Youth Intervention a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor offers in -home and out -patient services to reduce risks of out of home placement and increase stability in the home environment. Youth Intervention to divert entry into the child welfare system will provide in -home, office -based, and community - based services to youth twelve (12) to eighteen (18) years of age and their families when lower levels of intervention are not sufficient, and the family is willing to participate in services to prevent the need for child welfare involvement. ii. Diversion From Entry Into the Child Welfare System: Preventative services are provided to avoid the need for child welfare involvement by establishing stability within the family so that all members of the family are safe and adequately supported through the use of community based resources. Many families recognize the need for help but are not sure where to find needed supports or cannot afford the available services. Contractor offers evidence -based tools and techniques that strengthen the connection between children and parents and address mental health and behavioral issues in the family that may place them at risk for child welfare involvement. iii. Delivery Methods: 1. Therapeutic and Family Coaching services can be provided in the home, office or in the community. For therapeutic services, mental health assessments can be used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, and family relationship questionnaires). 2. All treatment interventions used by Contractor are trauma -informed, evidence - based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and Dialectical Behavior Therapy (DBT) techniques. 3. The therapist and Family Coach will provide monthly documentation to the Department and will collaborate throughout the service period with the Department to ensure that service goals are being met. iv. Engagement Techniques: Clinicians and Family Coaches work as closely as possible with the family to schedule services for times and locations that are most convenient for the family. v. Crisis Intervention Program Description: The goal of crisis intervention is to provide short-term, preventative mental health assessment and intervention services to youth and families, with the intentions of bridging access to care and reducing further need for intervention by county social services. vi. Timeline for Services: 23 vii. Once a referral is accepted, the family is contacted within 24 hours. The referral is screened to determine the need and level of appropriateness for services. If the level of need is higher than what can be managed within the parameters of the program, the youth and family will receive tailored referrals to community providers that may better address their specific circumstances. viii. A Youth Intervention Program clinician will meet with the family to provide an assessment to identify the family's needs, risks, and strengths, and create an appropriate intervention plan for the level of crisis and needs. Crisis Intervention services can be provided for up to four months. Extension of services can be available if requested by the County and supported by the Service Plan. b. Anticipated Frequency of Services: i. Coaching: Two (2) to six (6) hours per week. ii. Therapy: Six (6) to eight (8) sessions. c. Anticipated Duration of Services: i. Four (4) months. d. Goals of Services: i. Prevent out of home placement. ii. Divert entry into the child welfare system. iii. Enhance stability so that all members of the family are safe and adequately supported through the use of community -based resources. e. Outcomes of Services: i. Increase the level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. vii. Youth will maintain or be reconnected with educational services or employment at the time of discharge. f. Target Population: i. Youth ages twelve (12) to eighteen (18) and their families. g. Language: i. English. h. Medicaid Eligibility: i. This service may be Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. iii. Community based. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 24 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team CWServiceReferral(a,weldgov.com within three (3) business days regarding the ability to accept the received referral. 4. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team (HS - C WServiceReferral(ai/weldeov.com). 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team (HS-CWServiceReferral(a/weldgov.com). No other Department staff or other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understands that the Department will not reimburse for "no-shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 -hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team (HS- CWServiceReferral(ai/weldgov.com) within three (3) days of when the client is placed on a behavioral plan or discharged 7. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team(HS-CWServieeReferralna,weldgov.com) immediately via email, to discuss service continuation. 8. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported to the 25 caseworker and the Mental Health and Support Services Team(HS-CWServiceReferral(a,weldeov.com) immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Stuffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Stuffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team (HS- CWServieeReferral(a)weldeov.com) of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 9 of this Exhibit. 15. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 26 16. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 17. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 18. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department, and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients to sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement 27 EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate(s) specified below in Paragraph 2, Fees for Services. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services. Program Area H omy Based Tratervex on Rate 595.00 Unit .hype i,our Service Name After are Individual and Family Therapy: In ffice /Vi deo $120.00 Hour Aftercare Individual and Family Therapy: In - Office with Transportation 120.00 Hour Aftercare lndividual a d ly Therapy: In- Hame'or Corrianunity $95.00 Hour Aftercare Individual and Family Therapy: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing 75.00 Each Aftercare lndividual and rr'amil_._ Therapy: Jo f 2 no shorts or 2 ho�zrs,'ratontI' client) $85.00 Hour Aftercare In -Home and Community Based Family Support Services j $5,00 flour Aftercare lit- me and Community Based I atnily Support Services Team Meeting Decisioo Making (TDlvi) ileeting9 Professional Staffing $60.00 Each Aftercare In -Home and Community Based Family Support Services: No Show (Max of 2 no shows or 2 hours/month/client) I7ay Tr $2,125.00 Month"Day Treatment $98.50 Day Evening Reporting Center (Includes 4-5 hours) Program Area Foster Parent Consultation Rate $95.00 Unit Type Hour Service Name Foster Parent Consultation Therapy: In- Office/Video $120.00 Hour Foster Parent Consultation Therapy: In -Office with Transportation $120.00 Hour Foster Parent Consultation Therapy: In -Home or Community $95.00 Hour Foster Parent Consultation Therapy, FTM, TDM, Prof. Staffing $75.00 Each Foster Parent Consultation Therapy: No Show (Max of 2 no shows or 2 hours/month/client) $65.00 Hour Foster Parent Consultation Coaching: In- Office/Video $80.00 Hour Foster Parent Consultation Coaching: In -Home or Community $80.00 Hour Foster Parent Consultation Coaching: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each Foster Parent Consultation Coaching: No Show (Max of 2 no shows or 2 hours/month/client) $480.00 Each Foster Parent & Kinship Provider Training - The Truth about Sexually Abusive and Sexually Reactive Youth $480.00 Each Foster Parent & Kinship Provider Training - 3- hour class $1,760.00 Each Foster Parent & Kinship Provider Training - 11 -hour class Life Skills $65.00 Hour Life Skills: In-Office/Video $85.00 Hour Life Skills: In -Home or Community $85.00 Hour Life Skills: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each Life Skills: No Show (Max of 2 no shows or 2 hours/month/client) $1,115.00 Month Beyond the Walls $600.00 Month Parents as Teachers $80.00 Hour Comprehensive Parenting Time: In- Office/Video $85.00 Hour Comprehensive Parenting Time: In -Office with Transportation $85.00 Hour Comprehensive Parenting Time: In -Home or Community $80.00 Hour Comprehensive Parenting Time: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $70.00 Each Comprehensive Parenting Time: No Show (Max of 2 no shows or 2 hours/month/client) $95.00 Hour Therapeutic Parenting Time: In-Office/Video $120.00 Hour Therapeutic Parenting Time: In -Office with Transportation Program ,Area Life Skills Rate $120.00 Unit Type Hour Service Name Therapeutic Parenting Time: In -Home or Community $95.00 Hour Therapeutic Parenting Time: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each Therapeutic Parenting Time: No Show (Max of 2 no shows or 2 hours/month/client) Mental Health Services $95.00 Hour Mental Health Services Individual and Family Therapy: In-Office/Video (Also for Intensive Family Therapy) $120.00 Hour Mental Health Services Individual and Family Therapy: In -Office with Transportation (Also for Intensive Family Therapy) $120.00 Hour Mental Health Services Individual and Family Therapy: In -Home or Community (Also for Intensive Family Therapy) $95.00 Hour Mental Health Services Individual and Family Therapy: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing (Also for Intensive Family Therapy) $75.00 Each Mental Health Services Individual and Family Therapy: No Show (Also for Intensive Family Therapy; Max of 2 no shows or 2 hours/month/client) Sexual Abuse Treatment $95.00 Hour Community Based Treatment for Youth with Problematic Sexual Conduct Coaching: In- Office/Video $130.00 Hour Community Based Treatment for Youth with Problematic Sexual Conduct Coaching: In - Office with Transportation $130.00 Hour Community Based Treatment for Youth with Problematic Sexual Conduct Coaching: In - Home or Community $95.00 Hour Individual and Family Treatment: In Office/Video $130.00 Hour Individual and Family Treatment: In -Office with Transportation $130.00 Hour Individual and Family Treatment: In-I-Iome or Community $95.00 Hour Sex Abuse Treatment: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each Sex Abuse Treatment: No Show (Max of 2 no shows or 2 hours/month/client) $300.00 Each Informed Supervision Home Based Intervention $95.00 Hour Rapid. Response: In-Office/Video $140.00 Hour Rapid Response: In -Office with Transportation $140.00 Hour Rapid Response: In -Home or Community Program Area Home Based Intervention Rate $95.00 Unit Type Hour Service Name Rapid Response: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each Rapid Response: No Show (Max of 2 no shows or 2 hours/month/client) $95.00 Hour Youth Interventions Therapy Services: In- Office/Video $125.00 Hour Youth Interventions Therapy Services: In - office with Transportation $125.00 Hour Youth Interventions Therapy Services: In - Home or Community $95.00 Hour Youth Interventions Therapy Services: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each Youth Interventions Therapy Services: No Show (Max of 2 no shows or 2 hours/month/client) $65.00 Hour Youth Intervention Family Coaching: In- Office/Video $80.00 Hour Youth Intervention Family Coaching: In - Office with Transportation $50.00 Hour Youth Intervention Family Coaching: In - Home or Community $65.00 Hour Youth Intervention Family Coaching: Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each Youth Intervention Family Coaching: No Show (Max of 2 no shows or 2 hours/month/client) All Program Areas $0.59 Mile Mileage* a For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. 3. Request for Reimbursement and Sunnortint Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Time(s) of service (i.e. 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Requests for Reimbursement and/or supporting documentation received after the 7° day of the month may delay payment. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. 4. Payment The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions areas follows: a. Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. b. Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 6. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. SIGNATURE REQUESTED: Weld/Shiloh Amendment #1 - 2023-24 Final Audit Report 2023-05-17 Created: 2023-04-21 By: Lesley Cobb (cobbxxlk@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAAbn6LZM8NdHXK5McCni2U-dFyll5fmw4L "SIGNATURE REQUESTED: Weld/Shiloh Amendment #1 - 202 3-24" History t Document created by Lesley Cobb (cobbxxlk@co.weld.co.us) 2023-04-21 - 6:15:28 PM GMT- IP address: 204.133.39.9 E7-1, Document emailed to shilohramirez@gmail.com for signature 2023-04-21 - 6:16:38 PM GMT ,t Email viewed by shilohramirez@gmail.com 2023-04-21 - 6:16:47 PM GMT- IP address: 74.125.214.74 t Email viewed by shilohramirez@gmail.com 2023-05-03 - 7:18:35 PM GMT- IP address: 66.102.7.124 ,e Email viewed by shilohramirez@gmail.com 2023-05-06 - 6:21:09 PM GMT- IP address: 64.233.172.253 t Email viewed by shilohramirez@gmail.com 2023-05-09 - 6:53:02 PM GMT- IP address: 64.233.172.234 'n Email viewed by shilohramirez@gmail.com 2023-05-12 - 7:06:25 PM GMT- IP address: 64.233.172.252 'n Email viewed by shilohramirez@gmail.com 2023-05-13 - 1:24:08 AM GMT- IP address: 64.233.172.251 t Email viewed by shilohramirez@gmail.com 2023-05-14 - 10:13:09 PM GMT- IP address: 64.233.172.236 t Email viewed by shilohramirez@gmail.com 2023-05-15 - 7:37:55 PM GMT- IP address: 64.233.172.236 Powered by Adobe Acrobat Sign t Email viewed by shilohramirez@gmail.com 2023-05-16 - 2:02:36 PM GMT- IP address: 74.125.214.16 t Email viewed by shilohramirez@gmail.com 2023-05-17 - 3:05:01 PM GMT- IP address: 66.102.7.124 dp Signer shilohramirez@gmail.com entered name at signing as steven ramirez 2023-05-17 - 3:06:42 PM GMT- IP address: 40.130.222.122 dS© Document e -signed by steven ramirez (shilohramirez@gmail.com) Signature Date: 2023-05-17 - 3:06:44 PM GMT - Time Source: server- IP address: 40.130.222.122 Q Agreement completed. 2023-05-17 - 3:06:44 PM GMT Powered bn Adobe Acrobat Sign Entity Name. SHILOH HOUSE, INC Entity ID* OO0035732 ❑ New Entity? Contract Name. Contract ID SHILOH HOME, INC (AGREEMENT AMENDMENT #1 PY 2023- 7013 24) Contract Status CTB REVIEW Contract Lead* COBBXXLK Contract Lead Email cobbxxik@co.weld.co.us Parent Contract ID 20221631 Requires Board Approval YES Department Project # Contract Description* CONSENT BID# 82200040. MINOR SCOPE, RATE AND TERM CHANGES. TERM 6:1 23-5;°31 124. Contract Description 2 CONSENT: PA ROUTING THROUGH NORMAL APPROVAL PROCESS. ETA TO CTB 05/18,2023. Contract Type AMENDMENT Amount* $0.00 Renewat>i NO Automatic Renewal HUMAN SERVICES Department Email CM - H umanServicesOweldgov.co CM-Hurnan 5ervices- DeptHeadoveldgay.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY/ELDG OV.COM Requested BOCC Agenda Date* 05!24,x2023 Due Date 05/20/2023 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a NSA enter NSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Effective Date Renewal Date 03,`28/2024 Termination Notice Period Committed Delivery Date Expiration Date 05/31/2024 Purchasing Approved Date 05,19/2023 Purchasing Approver CONSENT Approval De tH JAMIE ULRICH DH Approved Date 05,19/2023 Final App 1 BOCC Approved BOCC Signed Date BOCC Agenda Date 05/24/2023 Originator COSBXXLK Finance Approver CONSENT Finance Approved Date 05/19/2023 Tyler Ref # AG 052423 Legal Counsel CONSENT Legal Counsel Approved Date 05 19,2023 Con/act- It4sd1 (QS' CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SHILOH HOME, INC. This Agreement, made and entered into the I J day of JUJU , 2022, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department" and Shiloh Home, Inc., hereinafter referred to as the "Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Scope of Services, Exhibit B, Rate Schedule, Exhibit C, Weld County's Request for Proposal, and Exhibit D, Contractor's Response to Request for Proposal. Exhibit A, B, and D are attached hereto and incorporated herein by this reference. Exhibit C is Weld County's Request for Proposal Number B220040 which is incorporated into this agreement by reference and will be provided upon request to the Department. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Core Services or other funding to the Department for Aftercare Services, Day Treatment, Foster Parent Consultation, Life Skills, Mental Health Services, Sexual Abuse Treatment, and Home -Based Intervention. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2022, upon proper execution of this Agreement and shall expire May 31, 2023, unless sooner terminated as provided herein. This agreement may be renewed for 2 additional terms by written agreement of both parties. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit A Scope of Services, and Exhibit D, Contractor's Response to Request for Proposal. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Quality Assurance Team (HS-CWQualitvAssurance(a,weldgov.com). No other Department staff or other party to the case may authorize services or modifications to services. c. Contractor agrees to submit a complete Request for Reimbursement and supporting documentation by the 7t" of the month, following the month of service, utilizing billing forms required by the Department. Requests for Reimbursement Forms received after 45 days from the date of service may Cm/0191-0a- CAP/612Z CO: CIk2) D‘o/i8/ate 2022-1631 4120094 result in delay or forfeiture of payment. Consistent failure to. meet 45 -day deadline may result in termination of the Agreement. d. Contractor agrees to submit a monthly report by the 7th of the month, following the month of service, for each client receiving ongoing services. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Date and time(s) of service (i.e. two hours or 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. Clients participating e. What interventions were used, recommendations and/or goals discussed f. Any and all safety concerns One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation, home study). Verification of Monitored Sobriety Services will be the test result. A completed home study may be a full, partial or denied study, as determined by the Department. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: i. The service being provided by the contractor is not a Medicaid eligible service; ii. The service is not deemed medically necessary; iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; iv. A Medicaid provider is not available to provide the needed service; v. Medicaid is exhausted for the needed service; or vi. Medicaid denied service. vii. The client is not eligible for Medicaid. b. Payment shall be made in accordance with Exhibit A, Scope of Services , Exhibit B, Rate Schedule, Exhibit C, Weld County's Request for Proposal, and Exhibit D, Contractor's Response to Request for Proposal., attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 2 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit A, Scope of Services, Exhibit B, Rate Schedule, and Exhibit D, Contractor's Proposal: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and - Title VII of the Civil Rights Act of 1964; and - the Age Discrimination in Employment Act of 1967; and - the Equal Pay Act of 1963; and the Education Amendments of 1972; and - Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and 3 all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is determined by the Department. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. e. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E - Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien toperform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor and the Department within three (3) days that Contractor has actual knowledge that a subcontractor is 4 employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to the Department, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., the Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24- 76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5- 103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and the Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect prior to execution of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, insurance coverage 5 listed in this agreement. The Board of County Commissioners of Weld County and its Officers/Employees shall be named as additional insured. a. General Requirements: Contractors must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, the Department must be notified by the Contractor. Contractor shall be responsible for the payment of any deductible or self -insured retention. The Department reserves the right to require Contractor to provide a bond, at no cost to the Department, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: - $1,000,000 each occurrence; - $2,000,000 general aggregate; - $50,000 any one fire; and - $500,000 errors and omissions. iii.Automobile Liability: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: If any aggregate limit is reduced by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify the Department within ten (10) days and reinstate the aggregates required; Unlimited defense costs in excess of policy limits; Contractual liability covering the indemnification provisions of this Agreement; A severability of interests provision; Waiver of exclusion for lawsuits by one insured against another; 6 - A provision that coverage is primary; and - A provision that coverage is non-contributory with other coverage or self-insurance provided by the Department. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to the Department, whichever is earlier. c. Contractors shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor shall provide a copy of this information to its insurance agent or broker and shall have its agent or broker provide proof of Contractor's required insurance. The Department reserves the right to require Contractor to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor's insurer shall name County as an additional insured. f. Waiver of Subrogation: For all coverages, Contractor's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors, independent contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor. Contractor shall include all such subcontractors, independent contractors, sub -vendors, suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors, suppliers or other entities upon request by the Department. A provider of Professional Services shall provide the following coverage: Professional Liability: Contractor shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 7 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives 8 of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker, Child Welfare Division Head Austin Topolnicki, Consultant 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Jamie Ulrich, Director P.O. Box A Greeley, CO 80632 (970) 400-6510 18. Litigation For Contractor: Austin Topolnicki, Consultant 6588 West Ottawa Avenue Littleton, Colorado 80128 (303) 932-9599 Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third -Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq., as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The 9 parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third -party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. A conflict of interest or appearance of a conflict of interest may also apply to personal relationships between providers and clients. If a provider has a personal relationship with a client to whom the Contractor may provide services for, the Contractor must disclose that relationship to the Department. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall 10 be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contractor shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit C, provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner 11 consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to the Department originals of all tests and results, reports, and other similar items, generated during completion of this work. Acceptance by the Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. 24-18-201 et seq. and .*24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contractor acknowledges that the Department has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this project without the Department's prior written consent, which may be withheld in the Department's sole discretion. 36. Attorney's Fees/Legal Costs 12 In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of the Department. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the Department. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of the Department. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST:. �I•�K• By: Id County Clerk to e Board Deputy Cler 13 BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO JUN 1 3 2022 CONTRACTOR: Shiloh Home, Inc. 6588 West Ottawa Avenue Littleton, Colorado 80128 (303) 933-1393 By: Steven Ramirez (Jun 6, 2022 07:49 PDT) Steven Ramirez, Chief Executive Officer Date: Jun 6, 2022 049. 02,91 EXHIBIT A SCOPE OF SERVICES Contractor will provide Aftercare Services, Day Treatment, Foster Parent Consultation, Life Skills, Mental Health Services, Sexual Abuse Treatment, and Home -Based Intervention, as referred by the Department. Aftercare Services 1. Aftercare Services a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide individual and family therapy and support services to allow for the reunification of the child with his or her family where feasible. These services will promote the successful transition of children to their home (or another permanent placement) from a higher level of care and are aimed at preventing out of home placements. ii. Contractor offers the following Aftercare Services: 1. Office -Based Family Therapy. 2. Community -Based Family Therapy. 3. In -Home Family Therapy. 4. Office -Based Individual Therapy. 5. Community -Based Individual Therapy. 6. In -Home Individual Therapy. 7. Community -Based Family Support Services (i.e., Life Skills and/or Parent Coaching). 8. In -Home Family Support Services. iii. Assessments Utilized for Aftercare Services: 1. Contractor will implement assessments to determine the focus of Aftercare Services. 2. A mental health assessment will be used to evaluate therapeutic needs for the individual and family and assist in creating an effective treatment plan. Other assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.) to further establish treatment objectives and to measure outcomes. b. Anticipated Frequency of Services: i. Therapy services: One (1) hour weekly unless the need for more frequent intervention is identified through the assessment process. ii. Intensive Family Therapy: up to three (3) hours per week. iii. Four Life Skills treatment packages are available: 1. Intensive, ten (10) to fifteen (15) hours per week. 2. High, seven (7) to nine (9) hours per week. 3. Moderate, four (4) to six (6) hours per week. 4. Low, three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Treating emotional and behavioral symptoms associated with trauma and mental health disorders. ii. Educating families about trauma and mental health issues. iii. Helping children, adolescents, and their families develop healthy coping tools. 1 iv. Equipping caretakers with knowledge and methods to provide trauma -informed parenting. v. Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences. vi. Providing intensive psycho -education that increases each family member's understanding of their own unhealthy interaction patterns and how to change them. vii. Reducing conflict between family members by teaching them positive communication skills that foster empathy between them. viii. Facilitating communication between family members about emotional, behavioral, and relational issues. ix. Assisting caretakers in creating a nurturing and healthy home environment which will enable the children to successfully progress in their development and academic achievement. x. Practical implementation of parenting skills learned in therapy (e.g., creating chore charts, homework charts). xi. Practical implementation of life skills. e. Outcomes of Services: i. Improved individual and family functioning. ii. Alleviation or reduction of mental health symptoms. iii. Completion of treatment goals. f. Target Population: i. Children and adolescents in the process of reunifying with their families or transitioning to another permanent placement. ii. The target population often includes children, adolescents, and families who are struggling with issues related to mental health, trauma, and difficult family dynamics that compromise individual and family functioning and lead to placement disruptions. g. Language: i. English. h. Medicaid Eligibility: i. This service is partially eligible for Medicaid. i. Service Access and Transportation: i. Services can be provided in -home. ii. In -office. iii. In the community when appropriate. Day Treatment 2. Day Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor's Shiloh Academy offers educational services at on -site locations. Components of the program include: 1. Educational and clinical assessment services. 2. Offense specific treatment services. 3. Individual, family, group and milieu therapies (offered on a weekly basis). 4. Case management. 5. Academic curriculum -credits transferable to public school. 6. Special education services. 7. Transportation to/from school within a fifteen (15) mile radius. 8. In -home service/per case need (Not included in the listed rate). 9. Community activities. 2 10. 24/hour on -call assistance. 11. Monthly progress reports. 12. On -going assessment of family Transitional services/staffing to public school. b. Anticipated Frequency of Services: i. Educational services are offered daily, Monday through Friday when school is in session. ii. Groups are offered daily, Monday through Friday when school is in session. iii. Individual therapy is offered weekly. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. The student will experience improved emotional and behavioral function through engagement in group and individual therapy. ii. The student will have support from educational staff to learn techniques to gain physical and emotional safety. iii. The student will have opportunities for improved academic success. iv. The student will have opportunities to learn healthy decision making skills in a smaller classroom setting. e. Outcomes of Services: i. Credit recovery. ii. Improved school emotional and behavioral functioning. iii. Prepared for academic and interpersonal success upon return to home school. iv. Maintain positive home and community relationships. f. Target Population: i. Contractor's Day Treatment services are available to youth between seven (7) to eighteen (18) years of age who are proficient in speaking English; and who present with behavioral disorders, mental health issues, or problematic sexual behaviors. ii. Clients with the following issues are generally considered not appropriate for the program: 1. Severely limited cognitive abilities (IQ below 65). 2. Ongoing medical issues that cannot be supervised/managed by staff. 3. The inability or significantly impaired ability to understand and/or communicate in English. 4. Is actively psychotic. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In Office, on site at Shiloh Academy locations. ii. In Weld County at Shiloh Academy located at 2700 E. Ken Pratt Boulevard, Longmont, Colorado 80504. 3. Evening Reporting Center a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: 3 i. Students participating in the program receive academic counseling and tutoring, truancy counseling, substance abuse counseling, therapeutic recreation, and resource development. b. Anticipated Frequency of Services: i. Four (4) to five (5) hours per day. Services only take place on business days and are not available on weekends and holidays. c. Anticipated Duration of Services: i. Ten (10) to forty-five (45) days. d. Goals of Services: i. The student will experience improved pro -social engagement. ii. The student will have improved school attendance. iii. Completion of court ordered community service. iv. The student will have opportunities to explore options for continuing education or career path development. e. Outcomes of Services: i. Youth appearance at all scheduled judicial hearings. ii. Creation and maintenance of positive behavior at home and in the community. iii. Performance of community service. iv. Promote legal behaviors to prevent new delinquent acts. v. Improved school attendance and performance, vocational or college planning. vi. Improved healthy relationships, social activity, and family functioning. f. Target Population: i. Youth between the ages of twelve (12) and eighteen (18) years who: 1. Require pro -social activity engagement during evening hours. 2. Have truancy issues at school. 3. Participate in a pre-trial release and supervision program. 4. On probation for the first time. ii. Have minimum system involvement and could benefit from intervention to prevent additional charges or delinquent behaviors. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. Foster Parent Consultation 4. Foster Parent and Kinship Provider Consultation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide psycho -education for foster parents regarding the impact of trauma and abuse and neglect. This training will include 8 hours of instruction and practice. The instruction will include the following curriculum topics: 1. It's all about the brain, not the behaviors. 2. The teenage brain is unique, and the teenage traumatized brain can be healed. 3. Understanding the impact of trauma "it's not defiance, it's learned survival". 4 4. Effective consequences for teenagers impacted by abuse and neglect. 5. Skills rather than punishment or consequences. 6. Developmental age vs chronological age and reasonable expectations. 7. Resiliency: how to identify the strengths that already exist, and how to build resiliency in every child. Foster parents are the key. ii. Contractor will provide support services to assist the foster family with child specific consultation. iii. Contractor will provide families with assistance with household family functioning through on -site family support from the Shiloh House Family Support Professionals. iv. Contractor will provide phone consultation in crisis situations. v. Contractor will provide a supportive and non judgmental relationship for the foster child and foster parents. vi. Contractor will assist families with skill development to ensure that families can establish appropriate relationship development, structure, boundaries and limits, with the goal of proactively preventing family conflict, and/or to decrease conflict that may already exist. vii. Contractor will provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. viii. Contractor will support the development of foster parent/child relationships. ix. The goal of Contractor Home's home -based Foster Parent Consultation services is to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, providing information for community resources, and providing effective parenting training. b. Anticipated Frequency of Services: i. One (1) to two (2) hours per week. c. Anticipated Duration of Services: i. Eight (8) hours total. d. Goals of Services: i. Increase the level of family functioning. ii. Eliminate placement disruption. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase foster parents' understanding of the impact of trauma. v. Help foster parents to have realistic child expectations. vi. Improve foster parenting, relationship, and social skills. vii. Provide rapid crisis consultation and support for foster parents experiencing challenges with their foster child. viii. Role modeling positive interaction with children - The Home -Based family support professional will use a wide variety of interaction and education based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. ix. Increase foster parent confidence - As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. x. Teach value of daily routine and consistency with children - Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age -appropriate chore charts to help parents with consistency. xi. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Contractor's services are provided from a family engagement, strength based, trauma informed basis. xii. Return children in placement to their own home: Contractor's home -based and foster parent consultation services are provided as either a prevention of out of home placement, 5 or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. xiii. Unite children with their permanent families: Contractor's home -based services strive to ensure the permanency of children with their families. xiv. Provide services that protect the child: Contractor's in -home services ensure that children are protected and that the well-being of every child is our first priority. e. Outcomes of Services: i. Placement preservation. ii. Increased supports and community -based resources. iii. Reduced risks for additional child protection or delinquency concerns. f. Target Population: i. Foster parents and Kinship providers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: ii. In -office. 5. Foster Parent and Kinship Provider Training: The Truth about Sexually Abusive and Sexually Reactive Youth a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provide education about juvenile sexual abuse and sexual reactivity to increase care provider efficacy, promote retention of foster care providers, and increase the potential for juveniles to experience success in their treatment plans by contributing to stability of the foster or kinship placement and minimizing the risk for placement in a higher level of care. b. Anticipated Frequency of Services: i. One (1) time training. c. Anticipated Duration of Services: i. Three (3) hours. d. Goals of Services: i. Provide information about normative, concerning, and problematic sexual behavior. ii. Dispel the "myths" that many people often believe in regards to sexually abusive and sexually reactive youth. iii. Provide accurate information about what is actually required when providing care for sexually abusive and/or sexually reactive youth. e. Outcomes of Services: i. Community Safety. ii. Preserve foster placement to minimize disruption for children and families. iii. Increase willingness and ability of foster parents to care for sexually abusive or sexually reactive youth. iv. Divert entry into residential placement, or support step-down from residential placement into foster care. 6 f. Target Population: i. Kinship providers and foster parents caring for juveniles who have engaged in sexually abusive behaviors or exhibit sexual reactivity. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. 6. Foster Parent and Kinship Provider Training: Psycho Education a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor will provide psycho -education for foster parents and kinship providers regarding the impact of trauma, abuse and neglect, transitions impact to foster children, navigation of the mental health system, biological family reunification and developmental expectations. ii. This training will include eleven (11) hours of instruction and practice. The instruction will include the following curriculum topics: 1. It's all about the brain, not the behaviors. 2. The teenage brain is unique, and the teenage traumatized brain can be healed. 3. Understanding the impact of trauma "it's not defiance, it's learned survival". 4. Effective consequences for teenagers impacted by abuse and neglect. 5. Skills rather than punishment or consequences. 6. Developmental age versus chronological age and reasonable expectations. 7. Resiliency: how to identify the strengths that already exist, and how to build resiliency in every child. Foster parents are the key. 8. Transitions Impact on Foster Children: includes a review of the grief and loss that occurs in transitions, viewing and discussion of dramatic videos that portray the impact, and teaching foster parents how to support foster children in transitions. 9. Navigation of the Mental Health system: our instructors will provide a step by step guide of navigating the mental health system, including accessing services, counseling and psychiatric services, initial assessments and first contacts, making appointments, how to support the child before and after mental health appointments and/or hospitalizations, communication with the therapist, and problem solving real life roadblocks. 10. Family Reunification: our instructors will provide a thorough review of children's complex feelings toward their families and the best strategies for support the child in all steps of the family reunification process. Real life examples of reunification challenges related to past trauma, and abuse and neglect experiences, as well as positive family experiences, memories, and the ambivalence that children experience. The foster parents will be provided the opportunity to explore their own feelings about family reunification. b. Anticipated Frequency of Services: i. One (1) hour session weekly. c. Anticipated Duration of Services: i. A minimum of three (3) hours will be provided. ii. Contractor has an eleven (11) hour package also available. 7 iii. Additional sessions may be available depending on needs of the client and the complexity of issues. d. Goals of Services: i. Enable the family to function in a safe manner. ii. Address safety concerns through education, and role modeling. iii. Provide information for community resources. iv. Provide effective parenting training. e. Outcomes of Services: i. Provide foster children with the best possible family environment that responds in a developmentally and trauma informed manner. ii. Provide foster children with stable and successful life experiences. iii. Increase the level of foster family functioning. iv. Increase foster parent competency and confidence. v. Significantly reduce placement disruption. vi. Increase formal and informal supports such as community, family, and friends. vii. Increase foster parents understanding of the impact of trauma. viii. Help foster parents to have realistic child expectations. ix. Improve foster parenting, relationship, and social skills. x. Role modeling positive interaction with children - The Home -Based family support professional will use a wide variety of interaction and education based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. xi. Increase foster parent confidence: As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. xii. Teach the value of developmentally appropriate daily routine and consistency with children - Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age - appropriate chore charts to help parents with consistency. xiii. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Contractor's services are provided from a family engagement, strength based, trauma informed basis. xiv. Return children in placement to their own home: Contractor's home -based and foster parent training services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. xv. Unite children with their permanent families: Contractor's home -based services strive to ensure the permanency of children with their families. xvi. Provide services that protect the child: Contractor's in -home services ensure that children are protected and that the well-being of every child is our first priority. f. Target Population: i. Foster parents and kinship providers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. 8 Life Skills 7. Life Skills a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Life Skills Coaching is an in -home service. Treatment Packages include 75% face to face with family and 25% other duties including but not limited to Team Decision Meetings, Administrative Review Conferences, Case Management, and Court related activities. ii. The Life Skills coach will provide the family with tools to move toward self-confidence and independence. These tools may include but are not limited to the following: 1. Provide information regarding community resources, employment, occupational training, education, and health care options. 2. Provide support services to assist families with accessing resources and employment. 3. Provide families with assistance with household budgeting. 4. Provide help with household management. 5. Provide a non judgmental relationship. 6. Help families identify and establish appropriate boundaries and limits. 7. Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. 8. Support development of parent/child relationships. 9. Teach appropriate discipline techniques: Life Skills coaches utilize a variety of techniques with parents to increase awareness, skill, and management of child behavior. 10. Role modeling positive interaction with children: Life Skills coaches use activities to model how to positively interact with children. The Life Skills coach will use books, games, crafts, and creative play to teach clients. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age -appropriate discipline and consequences. 11. Increase parent confidence. As the parent begins to gain new skills and control in the home, confidence is naturally increased. Providing parents with resources to help them with supporting their family also gives the parent a feeling of accomplishment and instills a sense of pride. 12. Teach the value of daily routine and consistency with children. Life Skills coaches will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards, and consequences and are given resources such as age -appropriate chore charts to help parents with consistency. 13. Increase parental awareness of children's basic and emotional needs- Life Skills coaches will assist parents in learning to recognize child healthcare needs, make doctor appointments, and at times, accompany the family to a doctor's appointment. Coaches will help parents plan and prepare nutritious meals, in addition to providing resources for housing, food, clothing and shelter. Coaches help teach parents to recognize what feelings are expressed in their child's behaviors and how to respond in a way that nurtures the child. 14. Provide parents with information regarding age -appropriate child development - Life Skills coaches teach parents about child development. Coaches use a variety of assessments to help determine a child's developmental growth as well as providing parents with activities to utilize with their child in order to stimulate development of fine and gross motor skills as well as adaptive and communication skills. Coaches will help a parent recognize what is age - appropriate behavior and how to manage any inappropriate behavior. b. Anticipated Frequency of Services: i. Four (4) Life Skills treatment packages are available: 9 1. Intensive, ten (10) to fifteen (15) hours per week. 2. High, seven (7) to nine (9) hours per week. 3. Moderate, four (4) to six (6) hours per week. 4. Low, three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Children will remain in the care of their parents while parents resolve child protection concerns. ii. Parents will learn skills to prevent new or repeated child protection concerns. iii. Parents will be able to recognize the emotional, physical, and developmental needs of their children. iv. Parents will learn to use resources available within the community to help meet the needs of their children. e. Outcomes of Services: i. Increase level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. f. Target Population: i. Families involved with the Department, where one or more children may be at risk for placement disruption that may be prevented if parents have the opportunity to develop stronger skills. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. Community -based. 8. Beyond the Walls. a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Transitional coaching for youth. Each month Beyond the Walls sponsors Workshops such as financial literacy, Reality Tours at local colleges and businesses, and mentoring relationships on a 1:1 level or in Circles of support. Each learning and support opportunity focuses on the areas of education, housing, job skills, faith -based connections, business engagement, and community skills. 1. Youth are motivated to participate through exposure to a network of activities and hands-on assistance that are proven tools to assist young people in gaining vital confidence and support as they transition into young adulthood. 2. The combination of action learning, mentoring, coaching and peer mentoring provides young people with a wider source of support and inspiration for idea generation and greater creativity in problem solving during critical times in a young person's life. 10 3. Specially trained community partners guide each personal growth opportunity which gives young people the chance for experiential learning, and a chance to discuss individual plans. Peer support is offered from community partners acting as a sounding board for young people to bounce ideas and potential solutions to problems. 4. Beyond the Walls also leverages and builds links to existing resources in the community to ensure young people are able to find what they need to become vibrant members of their local community. b. Anticipated Frequency of Services: i. Each month, twenty-five (25) hours of learning opportunities are available to participating youth. c. Anticipated Duration of Services: i. Services may be provided for many years as needed. d. Goals of Services: i. This program works to ensure that every young person is: 1. Attached to nurturing adults. 2. Linked with educational supports that lead to career readiness. 3. Engaged in community, school and/or extracurricular activities. 4. Career ready with positive attitudes about the world of work. 5. Productive and equipped to reach financial self-sufficiency. 6. Aware of, appreciates and demonstrates behaviors of personal and social responsibility. 7. Demonstrating healthy decisions that lead to well-being. e. Outcomes of Services: i. Transition from out of home care to independence. ii. Develop circles of support to increase opportunities for success in young adult life. iii. Achieve goals outlined in an individual plan. f. Target Population: i. Youth, ages sixteen (16) to twenty-six (26). g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -office. ii. In the community. 9. Parents as Teachers a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Evidence -Based Home Visiting Model is the comprehensive home -visiting, parent education model used by Parents as Teachers Affiliates. This model has been identified as a well -supported practice by the Title IV -E Prevention Services Clearinghouse. The program provides a resource network, and child screening. b. Anticipated Frequency of Services: i. Personal Visits — one (1) to two (2) visits per month. 11 ii. Group Connections — One (1) per month. c. Anticipated Duration of Services: i. While the child is in the age range of birth to five (5) years. d. Goals of Services: i. Increase parent knowledge of early childhood development and improve parent practices. ii. Provide early detection of developmental delays and health issues. iii. Prevent child abuse and neglect. iv. Increase children's school readiness and success. e. Outcomes of Services: i. Increase parent knowledge of early childhood development. ii. Improve parenting practices, increasing children's school readiness and success. iii. Provide early detection of developmental delays and health issues. f. Target Population: i. Families with children from birth through kindergarten. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. 10. Comprehensive Parenting Time and Sibling Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Supervised visits may occur in community -based locations such as parks, libraries, restaurants, museums and many other approved and appropriate locations, including the client's home. This flexibility allows families to meet in environments that promote bonding and child development. The decision to provide community based, supervised visits is determined by feedback from the multi -disciplinary team. Supervised Visitation includes parent education regarding the developmental needs of the children, and parent skill development. All parties in attendance for visits must be pre -approved by the multi- disciplinary team. ii. The visitation supervisor will meet with the visiting parent 15 minutes before and after each visit to discuss goals and provide feedback, making it easier for parents to identify progress and areas for continued support or growth. Supervised visitation typically lasts between one (1) to three (3) months. The need for supervised visits will be reevaluated every sixty (60) days. Supervised visitation appointments can occur between the hours of 8:30 AM and 8:30 PM, Sunday through Saturday. Each visit will last at least one (1) hour unless safety concerns require ending the visit. When the referral is for visits between siblings only, visitation will include age -appropriate guidance and interventions by the visitation supervisor during the visit to foster healthy sibling bonds. The primary purpose of the visitation supervisor is to ensure the safety of the children. Visitation supervisors will remain in sight and hearing of siblings and will engage with children using trauma informed, culturally responsive, age -appropriate techniques to minimize risk and maximize the potential for healthy sibling relationships. iii. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, 12 activities will be planned ahead of time and explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. iv. Supervised visits may occur in community -based locations such as parks, libraries, restaurants, museums and many other approved and appropriate locations. This flexibility allows siblings to interact in environments that promote bonding and provide normalized childhood experiences. The decision to provide community based, supervised sibling visits is determined by feedback from the multi -disciplinary team. All parties in attendance must be pre -approved by the multi -disciplinary teams. If needed, transportation for sibling visits can be provided. If the sibling group is comprised of three (3) or more children, a second visitation supervisor must be present. When visits are scheduled for sibling groups, the visitation supervisors will be trained in Informed Supervision. b. Anticipated Frequency of Services: i. Typically, one (1) hour per week. c. Anticipated Duration of Services: i. One (1) to three (3) months. d. Goals of Services: i. Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting. ii. Ensure the safety of children. iii. Strengthen the protective capacity of parents. iv. Help parents identify the child's cues and respond appropriately so that needs are met. v. Help parents communicate with their children in ways that are appropriate to age and cognition. e. Outcomes of Services: i. Increased bonding between parents and children. ii. Increased understanding of age -appropriate parent/child interactions. iii. Demonstration of safe parenting techniques that will help parents in the goal of reunification. f. Target Population: i. Parents with children in out of home care in cases where the goal is reunification or a permanent connection. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. iii. Community -based locations. 11. Therapeutic Parenting Time and Therapeutic Sibling Visitation a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provides a goal focused therapeutic time for the parent and child within the supervision and therapeutic intervention, training, and skill building of the bachelor (BA) or Masters 13 (MA) level parenting therapist. For those parents and families that would benefit from a more intensive parenting time training and experience the Therapeutic Parenting Time program is appropriate. ii. Delivery Methods: Following an initial assessment meeting, and observation, the parent, and parenting therapist collaborate to identify specific skill building areas, as well as develop the goals and tasks for each of the parenting times. Therapeutic Parenting Time will be scheduled in advance, and staff will coordinate with all necessary parties for effective service delivery. iii. Engagement Techniques: In each therapeutic parenting session, the therapist and the parent will review the skills, discuss the goals of the session, plan the specific tasks and then engage in a natural interaction time between the parent and child. During the session if the therapist believes a short helpful intervention or role modeling would be beneficial, they will engage the parent in this learning process. Following the parent -child time together, the therapist and the parent will meet to review the session, provide feedback, discuss frustrations or skills that the parent has identified as needing and establish a plan for the next session. iv. Provides a clinically guided; goal focused therapeutic time for siblings within the supervision and therapeutic intervention of the master's level therapist, or a qualified visitation supervisor who works under the direct supervision of a master's level therapist. All staff will be trained in Informed Supervision. When one (1) or more siblings struggle with the impact of mental health issues, sexual abuse, or other forms of trauma, a therapeutic model may be appropriate to establish a safe, constructive environment where sibling bonds can be repaired, and healthy relationships can grow. v. An assessment may be required prior to scheduling visits to assist in establishing culturally responsive, age -appropriate visitation goals; identify areas for skill building; and create an initial visitation plan. Therapeutic sibling visitation supervisors utilize a trauma informed approach. Therapeutic sibling visits can occur at one of Contractor's facility, or another approved, community -based location that provides a calm, neutral environment suitable for therapeutic interactions. Contractor will collaborate with the Department on an ongoing basis so that the need for this level of supervised visitation can be frequently reevaluated based on progress toward therapeutic visitation goals and the needs of each client involved. vi. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, activities will be planned ahead of time and explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. b. Anticipated Frequency of Services: i. Two (2) to four (4) hours per week. c. Anticipated Duration of Services: i. Eight (8) to sixteen (16) weeks. d. Goals of Services: i. Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting. ii. Ensure the safety of children. iii. Strengthen the protective capacity of parents. iv. Help parents identify the child's cues and respond appropriately so that needs are met. v. Help parents communicate with their children in ways that are appropriate to age and cognition. e. Outcomes of Services: i. Improvement of a healthy parent -child relationship. ii. Child safety, and increased ability by the parent to recognize cues provided by the child. 14 iii. Step-down to a lower level of parent -child supervision. f. Target Population: i. Parents with children in out of home care in cases where the goal is reunification or a permanent connection, and relationship dynamics or child protection concerns merit therapeutic support during parenting time. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. iii. Community -based locations. Mental Health Services 12. Mental Health Services: Individual, and Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Outpatient or in -home individual and family therapy services provided to children, adolescents, and families who are struggling with mental health issues (often related to trauma) and difficult family dynamics. ii. Assessments Utilized: A mental health assessment is used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, and family relationship questionnaires.). iii. Focus of Mental Health Services: Areas targeted by therapy services include: 1. Reducing problematic symptoms and behaviors associated with mental health disorders and trauma. 2. Educating children, adolescents, and families about issues associated with trauma and mental health, including identifying how they impact functioning. 3. Helping children, adolescents, and their families develop healthy coping tools to manage their unpleasant thoughts and emotions. 4. Equipping caretakers with knowledge and methods to provide trauma -informed parenting and meet the unique needs of their children. 5. Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences. 6. Increasing each family member's understanding of their own unhealthy interaction patterns and how to change them. 7. Reducing conflict within families by teaching and guiding family members in the use of positive communication skills that foster empathy between them. 8. Facilitating communication between family members to address therapy issues. iv. Mental Health Services Methodologies: All treatment interventions used by Contractor are trauma -informed, evidence -based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and Dialectical Behavior Therapy (DBT) techniques. v. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Therapeutic services are trauma informed, strength -based and are designed to meet the needs of each client. 15 vi. Mental Health Services Providers: Therapy services are provided by a master's level clinician; licensed, provisionally licensed, or under the supervision of a licensed supervisor. b. Anticipated Frequency of Services: i. Individual Therapy: One (1) hour per week. ii. Family Therapy: One (1) hour per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Increase functioning and overall wellbeing. ii. Increase coping skills. iii. Physical and emotional safety. iv. Improve interpersonal skills, including healthy communication and self -advocacy. e. Outcomes of Services: i. Improved Mental Health. ii. Improved Individual Functioning. iii. Improved Family Functioning. iv. Completion of Treatment Goals. f. Target Population: i. Youth, adults, and families. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. 13. Intensive Family Therapy a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Short-term, family -centered therapeutic process used to focus on the destructive familial relationship patterns and define new healthy patterns for interaction between family members. Family therapy is a solution -based treatment concentrating on resolving presenting problems identified by the Department reason for involvement. Treatment may include individual therapy or a combination of two or more members of the family in the office with the therapist at one time or as an in -home service. Intensive Family Therapy should be individualized to each individual and family and should incorporate measurable goals/anticipated outcomes that are consistent with the Human Services Family Service Plan. ii. Delivery Methods: Therapeutic services can be provided in the office or in the home. Evidence based services include Trauma Focused -Cognitive Behavioral Therapy (TF- CBT). iii. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Therapeutic services are strength - based and are designed to meet the needs of each client. 16 iv. Staff Credentials: Masters level clinician licensed, provisionally licensed or under the supervision of a licensed supervisor. b. Anticipated Frequency of Services: i. Up to three (3) hours per week. c. Anticipated Duration of Services: i. Three (3) to six (6) months. d. Goals of Services: i. Gain effective communication skills. ii. Learn to resolve conflict in non -abusive ways. iii. Identify and replace destructive familial relationship patterns. e. Outcomes of Services: i. Improved family dynamics. ii. Completion of treatment goals. iii. Family continues to demonstrate safety and stability in the home environment, reducing the risk for out of home placement or future Human Services involvement. f. Target Population: i. Parents and children who will benefit from short term therapeutic supports. g. Language: i. English. h. Medicaid Eligibility: i. This service is Medicaid eligible. i. Service Access and Transportation: i. In office. ii. In the client's home. Sexual Abuse Treatment 14. Community Based Treatment for Youth with Problematic Sexual Conduct a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. This outpatient program is designed for family and youth verbalizing a strong commitment to actively participate in a combination of home -based offense specific therapy and coaching services. These families may not fully grasp the seriousness of the sexual offending or the contributing family dynamics, but the family and the youth have demonstrated a willingness to engage in the treatment process. This program can help youth and families address issues including sexual reactivity due to abuse and trauma; unhealthy behaviors including inappropriate touching, bullying, gesturing, and threatening verbalizations; youth who have engaged in family -based incest; and youth who have engaged in community based sexual assault. Participating youth may be adjudicated, or non -adjudicated. ii. Delivery Methods: This Community Based Treatment for Problematic Sexual Conduct includes two (2) to three (3) hours per week of in -home Sex Offender Management Board (SOMB) masters level treatment and additional bachelors (BA) level in -home training, coaching and accountability targeting safe and healthy sexual behavior life skills. Coaches and therapists build on strengths that exist within the family and help family members address safety concerns in a realistic, non judgmental way. 17 iii. Engagement Techniques: The offense specific life skills coaches will reinforce the parents in the skill areas necessary for ensuring the care and wellbeing of their children, as well as treatment success for the youth with Problematic Sexual Conduct. Masters level clinicians actively listed with the Colorado SOMB as approved providers will provide offense specific treatment that is tailored to meet the needs of the youth and the family. Case management services and communication are also provided by Contractor staff to ensure multi -disciplinary team (MDT) member collaboration. Following an initial assessment, an individualized treatment plan will be completed for each youth and family and will be modified as needed during services with approval by the MDT. b. Anticipated Frequency of Services: i. Two (2) to three (3) hours per week. c. Anticipated Duration of Services: i. Six (6) to eight (8) months. d. Goals of Services: i. To successfully integrate SOMB guided home based offender treatment with evidence - based treatment principles including Trauma Focused CBT and High Fidelity Wrap Around. ii. To support the following High -Fidelity Wrap Around principals: 1. To be strength based and to value all members of the team focusing on family and youth needs rather than deficits. 2. To engage natural support systems for the youth and family and provide the natural support with informed supervision training and accountability skills to ensure that the youth and family have supportive resources. 3. To ensure that the family and youth voice are valued in all discussions. 4. To be culturally competent and respectful in all services. 5. To individually tailor all treatment and offense specific life skills. 6. To collaborate and communicate effectively with all multi -disciplinary team members. 7. To be dedicated to progressing through inevitable challenges and barriers. 8. To be outcome based with observable and measurable indicators of success. iii. To address complex and overlapping needs. iv. To successfully address family and offending youth denial of sexual offending problems. v. To reduce future Problematic Sexual Conduct. vi. To strengthen protective and resiliency factors for the youth and family vii. To provide effective coordination with all community partners including development of a school safety plan. viii. To provide offense specific assessments including Juvenile Sex Offender Assessment Protocol (J -SOAP), Psychosexual evaluations and polygraphs. ix. To successfully integrate mental health treatment with offense specific treatment. x. To provide well -coordinated treatment with victim therapists and support systems. xi. To provide services within SOMB guiding principles. e. Outcomes of Services: i. Prevent out of home placement. ii. Promote safety for persons victimized, the youth and family, and for the community through the successful completion of a treatment plan. iii. Increase the personal health of the offending youth. f. Target Population: i. Youth ages eight (8) to eighteen (18) and their families who are struggling with a wide variety of Problematic Sexual Conduct. g. Language: 18 i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. 15. Sex Abuse Individual and Family Treatment a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization. Delivery Methods: Contractor practices the best standards of care and emphasizes implementation of evidence -based treatment practices. Sex abuse individual and family treatment provides strength based, family focused, accountable, relationship oriented service which respects the family while ensuring that the goals of treatment are achieved. ii. Contractor adheres to the Sex Offender Management Board (SOMB) Guidelines and Standards. Risk assessment will be addressed through empirically guided risk evaluations and clinical insight, ongoing team and family collaboration, treatment progress and team members input, behavioral observation within all arenas of the client's life (home, school, job, social, community). Adjunct referral for polygraphs, arousal measurement, psychological services and psychiatric services are made as deemed necessary and appropriate. Therapy adheres to the Colorado Sex Offender Management Board's Standards and Guidelines for the Evaluation, Assessment, Treatment and Supervision of Juveniles. iii. Contractor utilizes Trauma -Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Behavioral Therapy (CBT), Psycho -education and Family Systems Therapy, risk assessment and safety planning, Informed Supervision training, and relapse prevention planning. These services help youth and families increase pro -social behaviors and protective factors; develop a nurturing, healthy home environment; eliminate all illegal behaviors by family members; and provide participants with an understanding of their family and personal cycle of abuse, while increasing their ability to interrupt this cycle. iv. Engagement Techniques: Contractor's SOMB therapists provide interactive educational and therapeutic tools to help clients identify and address safety concerns for all family members; promote disclosure of abusive behaviors, and address any victimization the client has experienced; assist in the development of empathy for persons victimized; and establish healthy coping skills and tools (self-control, and rehearsal of corrected cognitions). Whenever possible and appropriate, SOMB therapists work directly with the victim therapist(s) to assist the youth and person(s) victimized in the clarification process. b. Anticipated Frequency of Services: i. Individual therapy: One (1) hour per week. ii. Family Therapy: One (1) hour per week. c. Anticipated Duration of Services: i. Six (6) to eight (8) months. d. Goals of Services: i. To successfully address family and offending youth denial of sexual offending problems. ii. To reduce future Problematic Sexual Conduct. iii. To strengthen protective and resiliency factors for the youth and family. 19 e. Outcomes of Services: i. Community Safety. ii. Parent/Caregiver will gain understanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. iii. Decreased risk and improved personal health. f. Target Population: i. Youth eight (8) to eighteen (18) years of age who have had sexually abusive behaviors, and their families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. 16. Informed Supervision a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor offers Informed Supervision training consistent with SOMB Standards and Guidelines. ii. The Informed supervision training is provided by a Contractor staff who is trained in Informed Supervision and supervised by an SOMB qualified supervisor. iii. The Informed supervision training includes at a minimum the following topics: iv. History of SOMB. v. Principals of SOMB treatment with emphasis on community safety. vi. Why Informed Supervision is necessary. vii. Victim Confidentiality. viii. Sexual Offending Behaviors overview. ix. Current laws that relate to juvenile sexual offending. x. Seriousness of Juvenile Offending, impact, and priorities. xi. Dynamic patterns (cycles) associated with abusive behavior. xii. The role of the MDT in all decisions. xiii. Safety Plans. xiv. High Risk patterns. xv. Community Supervision and Treatment. b. Anticipated Frequency of Services: i. Three (3) hour training during a single appointment. c. Anticipated Duration of Services: i. One (1) time appointment. d. Goals of Services: i. Prepare parents, guardians, and family supports to provide Informed Supervision. ii. Ensure that parents, guardians, and family supports understand the requirements of informed supervision, and that they are willing and able to provide that supervision. iii. Increase community safety by helping the supervising adult understand the risks and needs of the youth in treatment. 20 e. Outcomes of Services: i. Community Safety. ii. Parent/Caregiver will gain understanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. iii. Decreased risk and improved personal health. f. Target Population: i. Parents and other adult caregivers of youth with problematic sexual conduct g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. In contractor's office. Home -Based Intervention 1. Rapid Response a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Provides short-term, preventative mental health assessment and intervention services to youth and families with the intentions of bridging access to care and reducing further need for intervention by county social services. ii. Interventions Used: 1. Immediate screening/contact (phone or in person) — A discussion with the family members regarding their perspective of the challenges that they are facing. In the initial contact the Assessment Clinician will offer the following: a. A crisis assessment is completed, and immediate safety planning will be offered. b. A Family and individual Biopsychosocial screening will be offered. c. The Assessment Clinician will review the broad range of possible. services in an effort to assist the family in understanding the wide range of hopeful opportunities. d. The Assessment Clinician will offer a home or office based. comprehensive assessment to assist in the service planning. e. The Assessment Clinician will offer an individual child -based assessment to assist in the service planning. 2. Immediate Safety planning. 3. Immediate home -based family visit. 4. Immediate home or office -based crisis intervention. 5. Comprehensive Assessment. 6. Consistent phone and email follow up to check in and offer additional services as the family and/or individual situation changes. iii. On -going services: 1. Individual therapy (home or office based): six (6) to eight (8) solution focused sessions aimed at stabilization, improved emotional regulation and problem solving. 2. Family therapy, home and office based, focusing on immediate crisis resolution, improved communication, and relationship restoration. 21 3. Coaching: two (2) to six (6) hours per week of home -based family support - with funding approval. 4. Family Assessment — This assessment is completed at the home unless the family prefers the confidentiality of an office setting. a. Twenty (20) point family assessment. b. Screening for mental health concerns. c. Assessment and recommendations for additional supports and services. iv. When deemed appropriate access to: 1. Child Behavior Checklist (CBCL). 2. Conner's 3 (ADHD screening) 3. Scales of Independent Behavior — Revised (SIB -R) developmental assessment. 4. Beck Depression Inventory (BDI-II). 5. Beck Combination Youth Inventory. 6. Ansell — Casey Life Skills Assessment. 7. Mental Status checklist for Adolescents. 8. Trauma Symptom Checklist. 9. Behavior Assessment System for Children (BASC-3). 10. Resiliency Scales for Children and Adolescents (Strengths profile). v. b. Anticipated Frequency of Services: i. Coaching: Two (2) to six (6) hours per week. ii. Therapy: Six (6) to eight (8) sessions. c. Anticipated Duration of Services: i. Four (4) weeks. d. Goals of Services: i. With supports in place to maintain family functioning, the youth will remain at home successfully. ii. Provide information regarding community resources, mental health, education, and health care options. iii. Provide services to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, and providing information for community resources. iv. Help families create and implement safety plans. v. Help families create short term goals to transition to appropriate on -going providers to support maintenance of goals. vi. Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. vii. Support development of parent/child relationships. viii. Teaching appropriate discipline techniques. e. Outcomes of Services: i. Increase the level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. vii. Youth will maintain or be reconnected with educational services or employment at the time of discharge. f. Target Population: i. Families with children birth to eighteen (18) years of age, who will benefit from short term preventative interventions services to prevent further human services involvement. 22 g. Language: i. English. h. Medicaid Eligibility: i. This service may be eligible for Medicaid. i. Service Access and Transportation: i. Home based. ii. Office -based. 17. Youth Intervention a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Contractor offers in -home and out -patient services to reduce risks of out of home placement and increase stability in the home environment. Youth Intervention to divert entry into the child welfare system will provide in -home, office -based, and community - based services to youth twelve (12) to eighteen (18) years of age and their families when lower levels of intervention are not sufficient, and the family is willing to participate in services to prevent the need for child welfare involvement. ii. Diversion From Entry Into the Child Welfare System: Preventative services are provided to avoid the need for child welfare involvement by establishing stability within the family so that all members of the family are safe and adequately supported through the use of community based resources. Many families recognize the need for help but are not sure where to find needed supports or cannot afford the available services. Contractor offers evidence -based tools and techniques that strengthen the connection between children and parents, and address mental health and behavioral issues in the family that may place them at risk for child welfare involvement. iii. Delivery Methods: 1. Therapeutic and Family Coaching services can be provided in the home, office or in the community. For therapeutic services, mental health assessments can be used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, and family relationship questionnaires). 2. All treatment interventions used by Contractor are trauma -informed, evidence - based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and Dialectical Behavior Therapy (DBT) techniques. 3. The therapist and Family Coach will provide monthly documentation to the Department and will collaborate throughout the service period with the Department to ensure that service goals are being met. iv. Engagement Techniques: Clinicians and Family Coaches work as closely as possible with the family to schedule services for times and locations that are most convenient for the family. v. Crisis Intervention Program Description: The goal of crisis intervention is to provide short-term, preventative mental health assessment and intervention services to youth and families, with the intentions of bridging access to care and reducing further need for intervention by county social services. vi. Timeline for Services: vii. Once a referral is accepted, the family is contacted within 24 hours. The referral is screened to determine the need and level of appropriateness for services. If the level of need is higher than what can be managed within the parameters of the program, the youth and family will receive tailored referrals to community providers that may better address their specific circumstances. 23 viii. A Youth Intervention Program clinician will meet with the family to provide an assessment to identify the family's needs, risks, and strengths, and create an appropriate intervention plan for the level of crisis and needs. Crisis Intervention services can be provided for up to four months. Extension of services can be available if requested by the County and supported by the Service Plan. b. Anticipated Frequency of Services: i. Coaching: Two (2) to six (6) hours per week. ii. Therapy: Six (6) to eight (8) sessions. c. Anticipated Duration of Services: i. Four (4) months. d. Goals of Services: i. Prevent out of home placement. ii. Divert entry into the child welfare system. iii. Enhance stability so that all members of the family are safe and adequately supported through the use of community -based resources. e. Outcomes of Services: i. Increase the level of family functioning. ii. Eliminate child protection issues in the home. iii. Increase formal and informal supports such as community, family, and friends. iv. Increase parents understanding of their parenting role. v. Help parents have realistic child expectations. vi. Improve parenting, relationship, and social skills. vii. Youth will maintain or be reconnected with educational services or employment at the time of discharge. f. Target Population: i. Youth ages twelve (12) to eighteen (18) and their families. g. Language: i. English. h. Medicaid Eligibility: i. This service may be Medicaid eligible. i. Service Access and Transportation: i. In -home. ii. In -office. iii. Community based. Terms 1. Contractor will respond to the Quality Assurance Team(HS-CWOualitvAssurance(&weld2ov.com within three (3) business days regarding the ability to accept the received referral. 2. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral 24 period, the Contractor will notify the caseworker and the Quality Assurance Team HS CWQualityAssurance(a�weldgov co►n. 3. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understands that the Department will not reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Quality Assurance Team HS-CWQualitvAssurancenaa,weldgov.com within three (3) days of when the client is placed on a behavioral plan or discharged. 4. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Quality Assurance Team HS-CWQualityAssurance(&,weldgov.com immediately via email, to discuss service continuation. 5. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 6. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported to the caseworker and the Quality Assurance Team HS-CWQualityAssurance(a,weldgov.com immediately AND on the required monthly report. 7. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 8. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Quality Assurance Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 9. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Quality Assurance Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department. 25 10. On a monthly basis, the Contractor will notify the Quality Assurance Team HS- CWQualityAssurance(a�weldgov.com of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 26 EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Aftercare Services Aftercare Individual and Family Therapy Rate Unit Type Service Name $85.00 Hour In-officeNideo $115.00 Hour In -Office with Transportation $115.00 Hour In -Home or Community $85.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Aftercare In -Home and Community Based Family Support Services Rate Unit Type Service Name $85.0 Hout In -Home or Community $85.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Da) Treatment Rate $2,125.00 $98.50 Unit Type Service Name Month Day Day Treatment Evening Reporting Center, includes four (4) to five (5) hours Foster Parent Consultation Foster Parent Consultation Therapy Rate Unit Type Service Name $95.00 Hour In-officeNideo $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Foster Parent Consultation Coaching Rate Unit Type Service. Name $65.00 Hour In —offs Nideo $80.00 Hour — to I -lo m or Community $80.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Foster Parent and Kinship Provider Training Rate Unit Type Service Name $480.00 Month Foster Parent and Kinship Provider Training: The Truth About Sexually Abusive and Sexually Reactive Youth $480.00 Month Foster Parent and Kinship Provider Training: Psycho -Education — Three (3) hour class $1,760.00 Month Foster Parent and Kinship Provider Training: Psycho -Education — Eleven (11) hour class Life Skills Life Skills Rate Unit Type Service Name $65.00 Hour In-officeNideo $85.00 Hour In -Home or Community $85.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Beyond the Walls Rate Unit Type Service Name $1,115.00 Month Beyond the Walls Parents as Teachers Rate Unit Type Service Name $600.00 Month Parents as Teachers Comprehensive Parenting Time Rate Unit Type Service Name $80.00 Hour In-officeNideo $85.00 Hour In -Office with Transportation $85.00 Hour In -Home or Community $80.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $70.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 Boulevard, Longmont, Colorado 80504. East Ken Pratt Therapeutic Parenting Time Rate Unit Type Service Name $95.00 Hour In-officeNideo $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show 0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Nlental I lealth Services Mental Health Services: Individual and Family Therapy Rater Unit Type Service Name $95.00 Hour In-officeNideo $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Intensive Family Therapy Rate Unit Type Service Name $95.00 Hour In-office/Video $120.00 Hour In -Office with Transportation $120.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. sexual \Buse Treatment Community Based Treatment for Youth with Problematic Sexual Conduct Coaching Rate Unit Type Service Name $95.00 Hour In-officeNideo $130.00 Hour In -Office with Transportation $130.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Sex Abuse Individual and Family Treatment Rate Unit Type Service Name $95.00 Hour In-officeNideo $130.00 Hour In -Office with Transportation $130.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Informed Supervision Rate Unit Type Service Name $300.00 Each Informed Supervision l-ome-Based Interventions Rapid Response Rate Unit Type Service Name $95.00 Hour In-office/Video $140.00 Hour In -Office with Transportation $140.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show `" $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Youth Intervention (Therapy Services) Rate Unit Type Service Name $ 95.00 Hour In-office/Video $125.00 Hour In -Office with Transportation $ 125.00 Hour In -Home or Community $95.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $75.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. Youth Intervention (Family Coaching) Rate Unit Type Service Name $ 65.00 Hour In-office/Video $80.00 Hour In -Office with Transportation $80.00 Hour In -Home or Community $65.00 Hour Family Team Meeting (FTM), Team Decision Making (TDM) Meeting, Professional Staffing $60.00 Each No Show $0.59 Mile For distances exceeding thirty (30) roundtrip miles from 2700 East Ken Pratt Boulevard, Longmont, Colorado 80504. 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement . Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service. Requests for Reimbursement and/or supporting documentation received ater 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. When submitting a request for payment for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Exhibit C WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page is intentionally left blank Exhibit D Contractor's response to the Request for Proposal Exhibit D contains the following documents: • Attachment B — Provider Information Form (PIF) • Attachment C — Proposal • Attachment D — Staff Data Sheet • Certificate of Insurance (COI) ATTACHMENT B WELD COUNTY DEPARTMENT OF HUMAN SERVICES - PROVIDER INFORMATION FORM (PIF) AGENCY INFORMATION Agency Name: Shiloh Home, Inc. Provider Contact Full Name:Austin Topolnicki Primary Phone Number (10 -digit): 303-932-9599 Trails Provider ID (if known): Title: Consultant 1539982 Ext.: 1328 Fax Number (10 -digit): Primary Contact Email: atopolnicki@shilohhouse.net Agency Location Address (Street, city, state, zip): Agency Mailing Address (Street, city, state, zip): Agency Type (pick one): Public Company Web Address: 303-973-1269 www.shilohhouse.org 6588 W. Ottawa Avenue Littleton, CO 80128 6588 W. Ottawa Avenue Littleton, CO 80128 Private Non -Profit Private for Profit Send Referrals for Service to: Referral Contact Name: Daniel Venman Title: Senior Clinical Director Referral Phone Number (10 -digit): 303-932-9599 1604 dvenman@shilohhouse,net Ext.: Email: Billing Contact Name: Billing Contact Rebecca Lynch Billing Phone Number (10 -digit): 303-933-1393 Ext.: Title: Finance Coordinator 1105 billing@shilohhouse.net Email: r I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it Ihas so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded. I The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept Ithe bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are competitive in price and quality. CERTIFICATION WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. Authorized Rep. Full Name: Steven Ramirez shilohramirez@gmail.com 303-933-1393 1303 Authorized Rep. Email: Phone (10 -digit): Ext.: Chief Executive Officer Authorized Rep. Address (Street, ci Signature of Authorized Rep.r� _ state, zips Title: 6588 W. Ottawa Avenue Littleton, CO 80128 i Date: M ,f. REV. DECEMBER 2021 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment Cif you have more than 5. for Proposal starting on page 13. Shiloh Home, Inc. (DBA Shiloh House) Aftercare Services Number of services offered on this Attachment C (max 5): SECTION 2 - Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Aftercare Services 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Shiloh House will provide individual and family therapy and support services to allow for the reunification of the child with his or her family where feasible. These services will promote the successful transition of children to their home (or another permanent placement) from a higher level of care and are aimed at preventing out of home placements. Shiloh House offers the following Aftercare Services: • Office -Based Family Therapy • Community -Based Family Therapy • In -Home Family Therapy • Office -Based Individual Therapy Community -Based Individual Therapy In -Home Individual Therapy Community -Based Family Support Services (i.e., Life Skills and/or Parent Coaching) • In -Home Family Support Services Assessments Utilized for Aftercare Services: Shiloh House will implement assessments to determine the focus of Aftercare Services. A mental health assessment will be used to evaluate therapeutic needs for the individual and family and assist in creating an effective treatment plan. Other assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.) to further establish treatment objectives and to measure outcomes • • 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Therapy services are 1 hour weekly, unless the need for more frequent intervention is identified through the assessment process. Intensive Family Therapy is up to 3 hours per week. Four Life Skills treatment packages are available: Intensive, 10.15 hours per week; High, 7-9 hours per week; Moderate, 4-6 hours per week; and low, 3 hours per week. 2.1c Anticipated duration of service (i.e. 3-4 months): 3-6 months 2.1d Three (3), or more, specific goals of the service (DO use bullet points): Areas targeted by Shiloh House Aftercare services may include: • Treating emotional and behavioral symptoms associated with trauma and mental health disorders • Educating families about trauma and mental health issues • Helping children, adolescents, and their families develop healthy coping tools • Equipping caretakers with knowledge and methods to provide trauma -informed parenting • Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences • Providing intensive psycho -education that increases each family member's understanding of their own unhealthy interaction patterns and how to change them • Reducing conflict between family members by teaching them positive communication skills that foster empathy between them REV. OCT 2021 1 ATTACHMENT C - PROPOSAL Facilitating communication, between family members about emotional, behavioral,; and relational issues Assisting caretakers in`creating anurturing and healthy home environmentWhich will enable the children to. successfully progress in their development and academic achievement • Practical implementation of parenting skills learned in therapy (e.g., creating chore charts, homework charts) Practical implementation of life skills 2.1e Three (3), or more, specific outcomes of service: • Improved individual and family functioning • Alleviation or reduction of mental health symptoms Completion of treatment goals. 2.1f Target population of the service, including age and gender: Children and adolescents in the process of reunifying with their families or transitioning to another permanent placement. The target population often includes children, adolescents, and families who are struggling with issues related to mental health, trauma, and difficult family dynamics that compromise individual and family functioning and lead to placement disruptions. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Shiloh House can bill Medicaid for those services that are Medicaid eligible. Some services offered through the Aftercare program may be Medicaid eligible. 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Services can be provided in -home, or in -office, and in the community when appropriate. Service #2 Name: 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.2c Anticipated duration of service (i.e. 3-4 months): 2.2d Three (3), or more, specific goals of the service (DO use bullet points): 2.2e Three (3), or more, specific outcomes of service: 2.2f Target population of the service: 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.3e 2.3f 2.3g 2.3h 2.3i Service 2.4a 2.4b 2.4c 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a 2.5b Three (3), or more, specffic outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Anticipated duration of service (i.e. 3-4 months): Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing tine, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check one: ® YES ❑ NO REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 3.2 Will you conduct services in a client's home or in the community? Check one: El, YES 3.3 Will you transport clients to and/or from services? Check one: Z YES .O NO 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? 80 Miles NO 2700 E. Ken Pratt Blvd Longmont, CO 80504 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Aftercare Individual and Family therapy $ Amount Unit Type 4.1a In-Office/Video: $ 85.00 per Hour 4.1b In -Office with Transportation: $115.00 per Hour No. of roundtrip miles included in rate: 30 miles In -Home or Community: $115.00 per Hour No. of roundtrip miles included in rate: 30 miles 4.1c FTM, TDM, Prof. Staffing: $85.00 per Hour 4.1d No show: $75.00 per No Show 4.1e Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Aftercare In -Home and Community Based Family Support Services $ Amount Unit Type 4.2a In-Office/Video: N/A per Hour 4.2b In -Office with Transportation: N/A per Hour No. of roundtrip miles included it rate: 30 miles 4.2c In -Home or Community: $80.00 per Hour No. of roundtrip miles included m rate: 30 miles 4.2d FTM, TDM, Prof. Staffing: $80.00 per Hour 4.2e No show: $60.00 per No Show 4.2f Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included ii rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included 'n rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4..3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included n rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.5 Hourly 4.5a 4.5b 4.5c 4.5d 4.5e 4.5f Service #5 Name: In-Office/Video: In -Office with Transportation: In -Home or Community: FTM, TDM, Prof. Staffing: No show: Mileage rate: $ Amount Unit Type per Hour per Hour No. of roundtrip miles included in rate: per Hour No. of roundtrip miles included in rate: per Hour per No Show per Mile This is paid after the miles listed above. miles miles 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item Xl of the Request for Proposal starting on page 13. Shiloh Home, Inc. (DBA Shiloh House) Day Treatment Number of services offered on this Attachment C (max 5): You may complete another Attachment C if you have more than 5. 2 SECTION 2 - Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Day Treatment 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Shiloh Academy offers educational services at on -site locations. Components of the program include: • Educational and clinical assessment services • Offense specific treatment services • Individual, family, group and milieu therapies (offered on a weekly basis) • Case management • Academic curriculum -credits transferable to public school • Special education services • Transportation to/from school (within 15 -mile radius) • In -home service/per case need (Not included in the listed rate) • Community activities • 24/hour on -call assistance • Monthly progress reports • On -going assessment of family Transitional services/staffing to public school 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: • Educational services are offered daily, Monday through Friday when school is in session • Groups are offered daily, Monday through Friday when school is in session • Individual therapy is offered weekly 2.1c Anticipated duration of service (i.e. 3-4 months): 3-6 months 2.1d Three (3), or more, specific goals of the service (DO use bullet points): • The student will experience improved emotional and behavioral function through engagement in group and individual therapy. • The student will have support from educational staff to learn techniques to gain physical and emotional safety • The student will have opportunities for improved academic success • The student will have opportunities to learn healthy decision making skills in a smaller classroom setting 2.1e Three (3), or more, specific outcomes of service: • Credit recovery • Improved school emotional and behavioral functioning • Prepared for academic and interpersonal success upon return to home school • Maintain positive home and community relationships 2.1f Target population of the service, including age and gender: REV. OCT 2021 1 ATTACHMENT C - PROPOSAL Shiloh House Day Treatment services are available to youth between 7 to 18 years of age who are proficient in speaking English; and who present with behavioral disorders, mental health issues, or problematic sexual behaviors. Clients with the following issues are generally considered not appropriate for the program: • Severely limited cognitive abilities (IQ below 65) Ongoing medical issues that cannot be supervised/managed by staff • The inability or significantly impaired ability to understand and/or communicate in English. • Is actively psychotic 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English 2.1h Medicaid eligibility - list whether the service is eligible for Medicaid in whole or in part: Day treatment services are not typically funded by Medicaid 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) In Office: Day Treatment services are provided on site at Shiloh Academy locations. In Weld County, there is a Shiloh Academy located at 2700 E. Ken Pratt Blvd, Longmont, CO 80504. Service #2 Name: Evening Reporting Center 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Students participating in the program receive academic counseling and tutoring, truancy counseling, substance abuse counseling, therapeutic recreation, and resource development. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 4-5 hours per day (not available on weekends and holidays) 2.2c Anticipated duration of service (i.e. 3-4 months): 10-45 days 2.2d Three (3), or more, specific goals of the service (DO use bullet points): The student will experience improved pro -social engagement The student will have improved school attendance Completion of court ordered community service The student will have opportunities to explore options for continuing education or career path development 2.2e Three (3), or more, specific outcomes of service: Youth appearance at all scheduled judicial hearings Creation and maintenance of positive behavior at home and in the community Performance of community service Promote legal behaviors to prevent new delinquent acts Improved school attendance and performance, vocational or college planning Improved healthy relationships, social activity, and family functioning 2.2f Target population of the service: Youth between the ages of 12 and 18 years who: • Require pro -social activity engagement during evening hours • Have truancy issues at school • Participate in a pre-trial release and supervision program • On probation for the first time Have minimum system involvement and could benefit from intervention to prevent additional charges or delinquent behaviors. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.2g Languages service is available in (please list proficiency and if interpreter services are available): 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: • ►5 NO Will you conduct services in a client's home or in the community? Check one: • CI NO Miles Will you transport clients to and/or from services? Check one: 0 YES • How many miles are you willing to travel round trip? List a specific number of miles. 30 When you calculate mileage, what is your starting point address? 2700 E. Ken Pratt Blvd Longmont, CO 80504 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Day Treatment 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount Monthly rate Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 30 30 This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Dvening Reporting Center 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount Daily rate Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 30 30 This is paid after the miles listed above. miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.3 Hourly Service #3 Name: $ Amount Unit Type 4.3a In-Office/Video: per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included ii rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a Day Treatment $ 2,125.00 Meets or exceeds CDE requirement 4.6b Evening Reporting Center $98.50 per day 4-5 hours per day 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers - List your rates in the box below. 4.8 Monitored Sobriety Providers - List your rates in the box below. Provider special notes: REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the Request for Proposal starting on page 13. Shiloh Home, Inc. (DBA Shiloh House) Foster Parent Consultation Number of services offered on this Attachment C (max 5): You may complete another Attachment C if you have more than 5. 3 If Service 2.1a 2.1b 2.1c 2.1d SECTION 2 - Service Name(s) and Information the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. #1 Name: Foster Parent and Kinship Provider Consultation Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): • Shiloh wil neglect: This following o It's o The o Understanding o Effective o Skills o Developmental o Resiliency: child. • Shilohwill • Shiloh will support from • Shiloh will • Shiloh will • Shiloh will relationship conflict, and/or • Shiloh will management, • Shiloh will • The goal of function iri information provide psycho -education for foster parents regarding the impact of trauma and abuse and training will include 8 hours of instruction and practice. The instruction will include the curriculum topics: all about the brain, not the behaviors.: teenage brain is unique, and the teenage traumatized brain can be healed. the impact of trauma "it's not defiance, it's learned survival". consequences for teenagers impacted by abuse and neglect. rather than punishment or consequences. age vs chronological age and reasonable expectations. how to identify the strengths that already exist, and how to build resiliency in every Foster parents are the key. provide support services to assist the foster family with child specific consultation: provide families with assistance with household family functioning through on -site family the Shiloh House Family Support Professionals, provide phone consultation in crisis situations. provide a supportive and non -judgmental relationship for the foster child and foster parents: assist families with skill development to ensure that families can establish appropriate development; structure, boundaries and limits, with the goal of proactively preventing family to decrease conflict that may already exist. provide tools to improve family functioning, including behavior management, conflict communication, and problem solving tools: support the development of foster parent/child relationships. Shiloh Home's home based Foster Parent Consultation services is to enable the family to a safe manner, by addressing the concerns through education, role modeling, providing for community resources, and providing effective parenting training. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1 hour weekly. If coaching is included, the total may be 2 hours weekly Anticipated duration of service (i.e. 3-4 months): This training includes 8 hours of instruction and practice Three (3), or more, specific goals of the service (DO use bullet points): • Increase the level of family functioning REV. OCT 2021 1 ATTACHMENT C - PROPOSAL Eliminate placement disruption Increase formal and informal supports such as community, family, and friends Increase foster parents' understanding of the impact of trauma Help foster parents to have realistic child expectations Improve foster parenting, relationship, and social skills Provide rapid crisis consultation and support for foster parents experiencing challenges with their foster child. Role modeling positive interaction with children - The Home Based family support professional will use a wide variety of interaction and education based tools to help the family build skills, relationships, and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. Increase foster parent confidence -As the foster parent begins to gain new skills and control, in the home, confidence is naturally increased. Teach value of daily routine and consistency with children -Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age appropriatechore charts to help parents with consistency. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Shiloh Home services are provided from a family engagement, strength based, trauma informed basis. Return children in placement to their own home: Shiloh Home's home based and foster parent consultation services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. Unite children with their permanent families: Shiloh Home home based services strive to ensure the permanency of children with their families. Provide services that protect the child: Shiloh Home in -home services ensure that children are protected and that the well-being of every child is our first priority. 2.1e Three (3), or more, specific outcomes of service: Placement preservation Increased supports and community based resources Reduced risks for additional child protection or delinquency concerns 2.1f Target population of the service, including age and gender: Foster parents and Kinship providers 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: N/A 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office Service #2 Name: Foster Parent and Kinship Provider Training: The Truth about Sexually Abusive and Sexually Reactive Youth 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL Providing education, about juvenile sexual abuse and sexual reactivity can increase care provider efficacy, promote retention of foster care providers, and increase the potential for juveniles to experience success in their treatment plans by contributing to stability of the foster or kinship placement and minimizing the risk for placement in a higher level of care. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: One time training 2.2c Anticipated duration of service (i.e. 3-4 months): 3 hours 2.2d Three (3), or more, specific goals of the service (DO use bullet points): • Provide information about normative, concerning, and problematic sexual behavior. • Dispel the "myths" that many people often believe in regards to sexually abusive and sexually reactive youth. • Provide accurate information about what is actually required when providing care for sexually abusive and/or sexually reactive youth. 2.2e Three (3), or more, specific outcomes of service: • Community Safety • Preserve foster placement to minimize disruption for children and families. • Increase willingness and ability of foster parents to care for sexually abusive or sexually reactive youth. • Divert entry into residential placement, or support step-down from residential placement into foster care. 2.2f Target population of the service: Kinship providers and foster parents caring for juveniles who have engaged in sexually abusive behaviors, or. exhibit sexual reactivity. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: N/A 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Office based Service #3 Name: Foster Parent and Kinship Provider Training: Psycho Education 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Shiloh will provide psycho -education for foster parents and kinship providers regarding the impact of trauma, abuse. and neglect, transitions impact to foster children, navigation of the mental health system,biological family reunification and developmental expectations. This training will include 11 hours of instruction and practice. The instruction will include the following curriculum topics: • It's all about the brain, not the behaviors. • The teenage brain is unique, and the teenage traumatized brain can be healed. • Understanding the impact of trauma "it's not defiance, it's learned survival". • Effective consequences for teenagers impacted by abuse and neglect. Skills rather than punishment or consequences. Developmental age versus chronological age and reasonable expectations. Resiliency: how to identify the strengths that already exist, and how to build resiliency in every child. Foster parents are the key. • Transitions Impact on Foster Children: includes a review of the grief and loss that occurs in transitions, viewing and discussion of dramatic videos that portray the impact, and teaching foster parents how to support foster children in transitions. • Navigation of the Mental Health system: our instructors will provide a step by step guide of navigating the mental health system, including accessing services, counseling and psychiatric services, initial assessments and • • REV. OCT 2021 3 ATTACHMENT C - PROPOSAL first contacts, making appointments, how to support the child before and after mental health appointments and/or hospitalizations, communication with the therapist, and problem solving real life roadblocks. Family Reunification: ,our instructors will provide a thorough review of children's complex feelings toward their families and the best strategies for support the child in all steps of the family reunification process. Real life examples of reunification challenges related to past trauma,and abuse and neglect experiences, as well as positive family experiences, memories, and the ambivalence that children experience. The foster parents will be provided the opportunity to explore their own feelings about family reunification. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Weekly one hour sessions 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d 2.3e A minimum of 3 hours will be provided. An 11 hour package is also available. Additional sessions may be available depending on needs of the client and the complexity of issues. Three (3), or more, specific goals of the service (DO use bullet points): • Enable the family to function in a safe manner • Address safety concerns through education, and role modeling • Provide information for community resources • Provide effective parenting training Three (3), or more, specific outcomes of service: • Provide foster children with the best possible family environment that responds in a developmentally and trauma informed manner • Provide foster children with stable and successful life experiences • Increase the level of foster family functioning • Increase foster parent competency and confidence • Significantly reduce placement disruption • Increase formal and informal supports such as community, family, and friends • Increase foster parents understanding of the impact of trauma • Help foster parents to have realistic child expectations • Improve foster parenting, relationship, and social skills • Role modeling positive interaction with children - The Home Based family support professional will use a wide variety of interaction and education based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. • Increase foster parent confidence: As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. • Teach the value of developmentally appropriate daily routine and consistency with children -Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such h as age appropriate chore charts to help parents with consistency. • Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Shiloh Home services are provided from a family engagement, strength based, trauma informed basis. • Return children in placement to their own home: Shiloh Home's home based and foster parent training services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to -help the youth be successful post placement. • Unite children with their permanent families: Shiloh Home home based services strive to ensure the permanency of children with their families. REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 2.3f 2.3g 2.3h 2.3i Service 2.4a 2.4b 2.4c 2.4d 2.4e 2.4f 2.4g 2.4h 2.4i Service 2.5a 2.5b • Provide services that protect the child: Shiloh Home in -home services ensure that children are protected and that the well-being of every child is our first priority. Target population of the service: Foster parents and kinship providers Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: N/A Service location — list where the service will take place (i.e. client's home, in -office, other) Office based service #4 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Anticipated duration of service (i.e. 3-4 months): Three (3), or more, specific goals of the service (DO use bullet points): Three (3), or more, specific outcomes of service: Target population of the service: Languages service is available in (please list proficiency and if interpreter services are available): Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Service location — list where the service will take place (i.e. client's home, in -office, other) #5 Name: Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation REV. OCT 2021 s ATTACHMENT C - PROPOSAL 3.1 Will you charge Weld County for transporting clients or mileage? Check one: 3.2 Will you conduct services in a client's home or in the community? Check one: 3.3 Will you transport clients to and/or from services? Check one: Z YES 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? E YES ❑ NO ® YES E NO ® NO 80 Miles 2700 E. Ken Pratt Blvd Longmont, CO 80504 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Foster Parent Consultation Therapy $ Amount Unit Type 4.1a In-Office/Video: $95.00 per Hour 4.1b In -Office with Transportation: $120.00 per Hour No. of roundtrip miles included in rate: 30 miles In -Home or Community: $120.00 per Hour No. of roundtrip miles included in rate: 30 miles 4.1c FTM, TDM, Prof. Staffing: $95.00 per Hour 4.1d No show: $75.00 per No Show 4.1e Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Foster Parent Consultation Coaching $ Amount Unit Type 4.2a In-Office/Video: $65.00 per Hour 4.2b In -Office with Transportation: N/A per Hour No. of roundtrip miles included in rate: 30 miles 4.2c In -Home or Community: $80.00 per Hour No. of roundtrip miles included in rate: 30 miles 4.2d FTM, TDM, Prof. Staffing: $80.00 per Hour 4.2e No show: $60.00 " per No Show 4.2f Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: Foster Parent Reactive Youth and Kinship Provider Training: The Truth about Sexually Abusive and Sexually $ Amount Unit Type 4.3a In-Office/Video: single unit rate per Hour 4.3b In -Office with Transportation: N/A per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: N/A per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: N/A per Hour 4.3e No show: per No Show 4.3f Mileage rate: N/A per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: Foster Parent and Kinship Provider Training: Psycho Education $ Amount Unit Type 4.4a In-Office/Video: Single unit rates per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: 30 miles In -Home or Community: N/A per Hour No. of roundtrip miles included in rate: 30 miles 4.4c FTM, TDM, Prof. Staffing: N/A per Hour REV. OCT 2021 6 ATTACHMENT C - PROPOSAL 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: I miles 4.5d FTM, TOM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a Foster Parent and Kinship Provider Training: The Truth About Sexually Abusive and Sexually Reactive Youth $480.00 One 3 hour class 4.6b Foster Parent and Kinship Provider Training: Psycho- Education $480.00 3 hours 4.6c Foster Parent and Kinship Provider Training: Psycho - Education $1760.00 11 hours 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: REV. OCT 2021 7 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Shiloh Home, Inc. (DBA Shiloh House) Home -Based Intervention Number of services offered on this Attachment C (max 5): 2 SECTION 2 — Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Rapid Response 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): The Rapid Response Program provides short-term, preventative mental health assessment and intervention services to youth and families with the intentions of bridging access to care and reducing further need for intervention by county social services. Interventions Used • Immediate screening/contact (phone or in person) - A discussion with the family members regarding their perspective of the challenges that they are facing. In the initial contact the Assessment Clinician will offer the following: o A crisis assessment is completed, and immediate safety planning will be offered. o A Family and individual Biopsychosocial screening will be offered. o The Assessment Clinician will review the broad range of possible services in an effort to assist the family in understanding the wide range of hopeful opportunities, o The Assessment Clinician will offer a home or office based comprehensive assessment to assist in the service planning. o The Assessment Clinician will offer an individual child based assessment to assist in the service planning: Immediate Safety planning • Immediate home based family visit • Immediate home or office based crisis intervention • Comprehensive. Assessment • Consistent phone and email follow up to check in and offer additional services as the family and/or individual situation changes. On -going services: • Individual therapy (home or office based): 6-8 solution focused sessions aimed at stabilization, improved emotional regulation and problem solving. • Family theiapy, home and office based, focusing on immediate crisis resolution, improved communication, and relationship restoration. • Coaching: 2-6 hours per week of home based family support - with funding approval • Family Assessment —This assessment is completed at the home unless the family prefers the confidentiality of an office setting. o 20 point family assessment o Screening for mental health concerns o Assessment and recommendations for additional supports and services • When deemed appropriate access to: o Child Behavior Checklist (CBCL) o Conner's 3 (ADHD screening) o SlB-R developmental assessment REV. OCT 2021 1 ATTACHMENT C - PROPOSAL o Beck Depression Inventory (BDI-ll) o Beck Combination Youth Inventory o Ansell — Casey Life Skills Assessment o Mental Status checklist for Adolescents o Trauma Symptom Checklist o Behavior Assessment System for Children (BASC-3) o Resiliency Scales for Children and Adolescents (Strengths profile) 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Coaching: 2-6 hours per week Therapy: 6-8 sessions 2.1c Anticipated duration of service (i.e. 3-4 months): 4 weeks - 2.1d Three (3), or more, specific goals of the service (DO use bullet points): With supports in place to maintain family functioning, the youth will remain at home successfully Provide information regarding community resources, mental health, education, and health care options. Provide services to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, and providing information for community resources. Help families create and implement safety plans Help families create short term goals to transition to appropriate on going providers to support maintenance of goals Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem solving tools: Support development of parent/child relationships: Teaching appropriate discipline techniques 2.1e Three (3), or more, specific outcomes of service: • Increase the level of family functioning • Eliminate child protection issues in the home • Increase formal and informal supports such as community, family, and friends • Increase parents understanding of their parenting role • Help parents have realistic child expectations • Improve parenting, relationship, and social skills • Youth will maintain or be reconnected with educational services or employment at the time of discharge. 2.1f Target population of the service, including age and gender: Families with children birth to 18 years of age, who will benefit from short term preventative interventions services to prevent furtherhuman services involvement. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English 2.1h Medicaid eligibility— list whether the service is eligible for Medicaid in whole or in part: Therapy services may be covered by Medicaid 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) Home based and office based services Service #2 Name: Youth Intervention 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Shiloh House offers in -home and out -patient services to reduce risks of out of home placement, and increase stability in the home environment. Youth Intervention to divert entry into the child welfare system will provide in -home, office -based, and community -based services to youth 12-18 years of age and their families when lower levels of intervention are not sufficient, and the family is willing to participate in services to prevent the need for child welfare involvement. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL Diversion From Entry Into the Child Welfare System: Preventative services are provided to avoid the need for child welfare involvement by establishing stability within the family so that all members of the family 'are safe and adequately supported through the use of community based resources. Many families recognize the need for help, but are not sure where to find needed supports or cannot afford the available services. Shiloh House offers evidence -based tools and techniques that strengthen the connection between children .and parents, and address mental health and behavioral issues in the family that may place them at risk for child welfare involvement. Delivery Methods: Therapeutic and Family Coaching services can be provided in the home, office or in the community. For therapeutic services, mental health assessments can be used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.). All treatment interventions used by Shiloh Home, Inc. are trauma -informed, evidence -based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF- CBT), play therapy, Family Systems interventions, and DBTtechniques. The therapist and Family Coach will provide monthly documentation to the Department of Human Services, and will collaborate throughout the service period with the Department to ensure that service goals are being met. Engagement Techniques: Clinicians and Family Coaches work as closely as possible with the e_familyto schedule services for times and locations that are most convenient for the family. Crisis Intervention Program Description The goal of crisis intervention is to provide short-term, preventative mental health assessment and intervention services to youth and families, with the intentions of bridging access to care and reducing further need for intervention by county social services. Timeline for Services Once a referral is accepted, the family is contacted within 24 hours. The referral is screened to determine the need and level of appropriateness for services. If the level of need is higher than what can be managed within the parameters of the program, the youth and family will receive tailored referrals to community providers that may better address their specific circumstances. A Youth Intervention Program clinician will meet with the family to provide an assessment to identify the family's needs, risks, and strengths, and create an appropriate intervention plan for the level of crisis and needs. Crisis Intervention services can be provided for up to four months. Extension of services can be available if requested by the County and supported by the Service Plan. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Coaching: 2-6 hours per week Therapy: 6-8 sessions 2.2c Anticipated duration of service (i.e. 3-4 months): 4 months 2.2d Three (3), or more, specific goals of the service (DO use bullet points): Prevent out of home placement Divert entry into the child welfare system Enhance stability so that all members of the family are safe and adequately supported through the use of community based resources. 2.2e Three (3), or more, specific outcomes of service: Increase the level of family functioning Eliminate child protection issues in the home • Increase formal and informal supports such as community, family, and friends • Increase parents understanding of their parenting role • Help parents have realistic child expectations • Improve parenting, relationship, and social skills • Youth will maintain or be reconnected with educational services or employment at the time of discharge. 2.2f Target population of the service: REV. OCT 2021 3 ATTACHMENT C - PROPOSAL Youth 12-18, and their families 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Therapy services may be Medicaid eligible 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) In -home, in -office, and community based Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: 0 ■ NO Will you conduct services in a client's home or in the community? Check one: 0 • NO Miles Will you transport clients to and/or from services? Check one: 0 YES ■ How many miles are you willing to travel round trip? List a specific number of miles. 80 When you calculate mileage, what is your starting point address? 2700 E. Ken Pratt Blvd Longmont, CO 80504 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Rapid Response 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $95.00 $140.00 $140.00 $95.00 $75.00 0.59 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 30 30 This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Youth Intervention (Therapy Services) 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount $ 95.00 $125.00 $ 125.00 $95.00 $75.00 0.59 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 30 30 This is paid after the miles listed above. miles miles REV. OCT 2021 5 ATTACHMENT C - PROPOSAL 4.3 Hourly Service #3 Name: Youth Intervention (Family Coaching) $ Amount Unit Type 4.3a In-Office/Video: $ 65.00 per Hour 4.3b In -Office with Transportation: $80.00 per Hour No. of roundtrip miles included in rate: 30 • miles 4.3c In -Home or Community: $80.00 per Hour No. of roundtrip miles included in rate: -30 miles 4.3d FTM, TDM, Prof. Staffing: $65.00 per Hour 4.3e No show: $60.00 per No Show 4.3f Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Therapy services are typically billed under Medicaid. Services that do not qualify for Medicaid funding are billed through Core services. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column I of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Shiloh Home, Inc. (DBA Shiloh House) Life Skills Number of services offered on this Attachment C (max 5): 5 SECTION 2 - Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Life. Skills 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Life Skills Coaching is an in -home service. Treatment Packages include 75%face to face with family and 25% other duties including but not limited to Team Decision Meetings, Administrative Review Conferences, Case Management, and Court related activities. The Life Skills coach will provide the family with tools to move toward self-confidence and independence. These tools may include but are not limited to the following: • Provide information regarding community resources, employment, occupational training, education, and health care options, • Provide support services to assist families with accessing resources and employment. • Provide families with assistance with household budgeting. • Provide help with household management: • Provide a non -judgmental relationship. • Help families identify and establish appropriate boundaries and limits. • Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. • Support development of parent/child relationships. • Teach appropriate discipline techniques: Life Skills coaches utilize a variety of techniqueswith parents to increase awareness, skill, and management of child behavior. •` Role modeling positive interaction with children: Life Skills coaches use activities to model how to positively interact with children. The Life Skills coach will use books, games, crafts, and creative play to teach clients. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. • Increase parent confidence. As the parent begins to gain new skills and control in the home, confidence is naturally increased. Providing parents with resources to help them with supporting their family also gives the parent a feeling of accomplishment and instills a sense of pride. • Teach the value of daily routine and consistency with children. Life Skills coaches will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards, and consequences and are given resourcessuch as age appropriate chore charts to help parents with consistency. • Increase parental awareness of children's basic and emotional needs- Life Skills coaches will assist parents in learning to recognize child healthcare needs, make doctor appointments, and at times, accompany the family to a doctor's appointment. Coaches will help parents plan and prepare nutritious meals, in addition to providing REV. OCT 2021 1 ATTACHMENT C - PROPOSAL resources for housing, food, clothing and shelter. Coaches help teach parents to recognize what feelings are expressed in their child's behaviors and how to respond in a way that nurtures the child. • Provide parents with information regarding age appropriate child development- Life Skills coaches teach parents about child development. Coaches use a variety of assessments to help determine a child's developmental growth as well as providing parents with activities to utilize with their child in order to stimulate development of fine and gross motor skills as well as adaptive and communication skills. Coaches will help a parent recognize what is age appropriate behavior and how to manage any inappropriate behavior. 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Four treatment packages are available: • Intensive'; 10-15 hours per week • High, 7-9 hours per week • Moderate, 4-6 hours per week • Low, 3 hours per week. 2.1c Anticipated duration of service (i.e. 3-4 months): 3-6 months 2.1d Three (3), or more, specific goals of the service (DO use bullet points): • Children will remain in the care of their parents while parents resolve child protection concerns. • Parents will learn skills to prevent new or repeated child protection concerns. • Parents will be able to recognize the emotional, physical, and developmental needs of their children. • Parents will learn to use resources available within the community to help meet the needs of their children. 2.1e Three (3), or more, specific outcomes of service: • Increase level of family functioning • Eliminate child protection issues in the home • Increase formal and informal supports such as community, family, and friends • Increase parents understanding of their parenting role • Help parents have realistic child expectations • Improve parenting, relationship, and social skills 2.1f Target population of the service, including age and gender: Families involved with the Department of Human Services, where one or more children may be at risk for placement disruption that may be prevented if parents have the opportunity to develop stronger skills. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English _ 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: N/A 2.11 Service location — list where the service will take place (i.e. client's home, in -office, other) Home and community based services Service #2 Name: Beyond the Walls 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Transitional coaching for youth. Each month Beyond the Walls sponsors Workshops such as financial literacy, Reality Tours at local colleges and businesses, and mentoring relationships on a 1: 1 level or in Circles of support. Each learning and support opportunity focuses on the areas of education, housing, job skills, faith -based connections, business engagement, and community skills. • Youth are motivated to participate through exposure to a network of activities and hands-on assistance that are proven tools to assist young people in gaining vital confidence and support as they transition into young adulthood. REV. OCT 2021 2 ATTACHMENT C - PROPOSAL The combination of action learning, mentoring, coaching and peer mentoring provides youngpeople with a wider source of support and inspiration for idea generation and greater creativity in problem solving during critical times in a young person's life. Specially trained community partners guide each personal growth opportunity which gives young people the chance for experiential learning, and a chance to discuss individual plans. Peer support is offered from community partners acting as a sounding board for young people to bounce ideas and potential solutions to problems. Beyond the Walls also leverages and builds links to existing resources in the community to ensureyoung people are able to find what they need to become vibrant members of their local community. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Each month 25 hours of learning opportunities are available to participating youth. 2.2c Anticipated duration of service (i.e. 3-4 months): Up to 12 years 2.2d Three (3), or more, specific goals of the service (DO use bullet points): Beyond the Walls at Shiloh House works to ensure that every young person is • Attached to nurturing adults • Linked with educational supports that lead to career readiness • Engaged in community, school and/or extracurricular activities • Career ready with positive attitudes about the world of work • Productive and equipped to reach financial self-sufficiency • Aware of, appreciates and demonstrates behaviors of personal and social responsibility • Demonstrating healthy decisions that lead to well-being 2.2e Three (3), or more, specific outcomes of service: Transition from out of home care to independence. Develop circles of support to increase opportunities for success in young adult life. Achieve goals outlined in an individual plan 2.2f Target population of the service: Youth 16-26 years of age 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: N/A 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office, and community based locations Service #3 Name: Parents as Teachers 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): The Parents as Teachers Evidence -Based Home Visiting Model is the comprehensive home -visiting, parent education model used by Parents as Teachers Affiliates. This model has been identified as a well -supported practice by the Title IV -E Prevention Services Clearinghouse. The program provides a resource network, and child screening. 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: • Personal Visits (1-2 visits monthly) • Group Connections (1 per month) 2.3c Anticipated duration of service (i.e. 3-4 months): Birth to 5 years 2.3d Three (3), or more, specific goals of the service (DO use bullet points): • Increase parent knowledge of early childhood development and improve parent practices • Provide early detection of developmental delays and health issues • Prevent child abuse and neglect • Increase children's school readiness and success REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 2.3e Three (3), or more, specific outcomes of service: • Increase parent knowledge of early childhood development. • Improve parenting practices, increasing children's school readiness and success. • Provide early detection of developmental delays and health issues. 2.3f Target population of the service: The model provides services to families with children from prenatal through kindergarten. 2.3g Languages service is available in (please list proficiency and if interpreter services are available): r English 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: N/A 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) The program has both in -office and in -home components. Service #4 Name: Comprehensive Parenting Time and Sibling Visitation 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Supervised visits may occur in community based locations such as parks, libraries, restaurants, museums and many other approvedand appropriate locations, including the client's home. This flexibility allows families to meet in environments that promote bonding and child development. The decision to provide community based, supervised visits is determined by feedback from the multi -disciplinary team. Supervised Visitation includes parent education regarding the developmental needs of the children, and parent skill development. All parties in attendance for visits must be pre -approved by the multi -disciplinary team. The visitation supervisor will meet with the visiting parent 15 minutes before and after each visit to discuss goals and provide feedback, making ii easier for parents to identify progress and areas for continued support or growth. Supervised visitation typically lasts between one to three months. The need for supervised visits will be reevaluated every 60 days: Supervised visitation appointments can occur between the hours of 8:30 AM and 8:30 PM, Sunday through Saturday. Each visit will last at least one hour unless safety concerns require ending the visit. When the referral is for visits between siblings only, visitation will include age appropriate guidance and interventions by the visitation supervisor during the visit to foster healthy sibling bonds. The primary purpose of the visitation supervisor is to ensure the safety of the children. Visitation supervisors will remain in sight and hearing of siblings and will engage with children using trauma informed, culturally responsive, age appropriate techniques to minimize risk and maximize the potential for healthy sibling relationships. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, activities will be planned ahead of time and explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. Supervised visits may occur in community based locations such as parks, libraries,, restaurants, museums and many other approved and appropriate locations. This flexibility allows siblings to interact in environments that promote bonding and provide normalized childhood experiences: The decision to provide community based, supervised sibling visits is determined by feedback from the multi -disciplinary team. All parties in attendance must be pre -approved by the multi -disciplinary teams. If needed, transportation for sibling visits can be provided. If the sibling group is comprised of three or more children, a second visitation supervisor must be present. When visits are scheduled for sibling groups, the visitation supervisors will be trained in Informed Supervision. 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: REV. OCT 2021 4 ATTACHMENT C - PROPOSAL Typically, parenting time is weekly for one hour, unless otherwise determined by the MDT 2.4c Anticipated duration of service (i.e. 3-4 months): • 1-3 months 2.4d Three (3), or more, specific goals of the service (DO use bullet points): • Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting • . Ensure the safety of children • Strengthen the protective capacity of parents • Help parents identify the child's cues, and respond appropriately so that needs are met • Help parents communicate with their children in ways that are appropriate to age and cognition 2.4e Three (3), or more, specific outcomes of service: • Increased bonding between parents and children • Increased understanding of age appropriate parent/child interactions • Demonstration of safe parenting techniques that will help parents in the goal of reunification 2.4f Target population of the service: Parents with children in out of home care in cases where the goal is reunification or a permanent connection 2.4g Languages service is available in (please list proficiency and if interpreter services are available): English 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: N/A 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) In -home, in -office, and community based locations Service #5 Name: Therapeutic Parenting Time and Therapeutic Sibling Visitation 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Therapeutic Parenting Time provides a goal focused therapeutic time for the parent and child within the supervision and therapeutic intervention, training, and skill building of the BA or MA level parenting therapist. For those parents and families that would benefit from a more intensive parenting time training and experience the Therapeutic Parenting Time program is appropriate. Delivery Methods: Following an initial assessment meeting, and observation, the parent, and parenting therapist collaborate to identify specific skill building areas, as well as develop the goals and tasks for each of the parenting times. Therapeutic Parenting Time will be scheduled in advance, and staff will coordinate with all necessary parties for effective service delivery. Engagement Techniques: In each therapeutic parenting session, the therapist and the parent will review the skills, discuss the goals of the session, plan the specific tasks and then engage in a natural interaction time between the parent and child. During the session if the therapist believes a short helpful intervention or role modeling would be beneficial, they will engage the parent in this learning process. Following the parent -child time together, the therapist and the parent will meet to review the session, provide feedback, discuss frustrations or skills that the parent has identified as needing and establish a plan for the next session. Therapeutic sibling visitation provides a clinically guided; goal focused therapeutic time for siblings within the supervision and therapeutic intervention of the master's level therapist, or a qualified visitation supervisor who works under the direct supervision of a master's level therapist. All staff will be trained in Informed Supervision. When one or more siblings struggle with the impact of mental health issues, sexual abuse, or other forms of trauma, a therapeutic model may be appropriate to establish a safe, constructive environment where sibling bonds can be repaired, and healthy relationships can grow. An assessment may be required prior to scheduling visits to assist in establishing culturally responsive, age appropriate visitation goals; identify areas for skill building; and create an initial visitation plan. Therapeutic sibling visitation supervisors utilize a trauma informed approach. Therapeutic sibling visits can occur at a Shiloh House REV. OCT 2021. 5 ATTACHMENT C - PROPOSAL 2.5b 2.5c 2.5d 2.5e 2.5f 2.5g 2.5h 2.6i facility, or another approved, community based location that provides a calm, neutral environment suitable for therapeutic interactions. Shiloh House will collaborate with the Department of Human Services on an ongoing basis so that the need for this level of supervised visitation can be frequently reevaluated based on progress toward therapeutic visitation goals and the needs of each client involved. Expectations for the visit will be established with the participants at the beginning of each visit, so that each child or youth is aware of what will happen. Whenever possible, activities will be planned ahead of time and explained to the child or youth to reduce anxiety and increase the potential for a successful visit. If conflict between siblings occurs during the visit, staff will intervene to resolve conflict and maintain safety. Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2-4 hours per week Anticipated duration of service (i.e. 3-4 months): 8-16 weeks Three (3), or more, specific goals of the service (DO use bullet points): • Provide opportunities for parents and children to spend time together in a comfortable atmosphere to promote natural parenting • Ensure the safety of children • Strengthen the protective capacity of parents • . Help parents identify the child's cues, and respond appropriately so that needs are met • Help parents communicate with their children in ways that are appropriate to age and cognition Three (3), or more, specific outcomes of service: • Improvement of a healthy parent -child relationship • Child safety, and increased ability by the parent to recognize cues provided by the child • Step-down to a lower level of parent -child supervision Target population of the service: Parents with children in out of home care in cases where the goal is reunification or a permanent connection, and relationship dynamics or child protection concerns merit therapeutic support during parenting time. Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part N/A Service location — list where the service will take place (i.e. client's home, in -office, other) In -home, In the community, or in -office Section 3 — Service Access and Transportation 3.1 Will you charge Weld County for transporting clients or mileage? Check one: 3.2 Will you conduct services in a client's home or in the community? Check one: 3.3 Will you transport clients to and/or from services? Check one: El YES ® YES ® YES ❑ NO 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 3.5 When you calculate mileage, what is your starting point address? 80 O Miles NO NO 2700 E. Ken Pratt Blvd Longmont, CO 80504 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. REV. OCT 2021 6 ATTACHMENT C - PROPOSAL • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Life Skills $ Amount Unit Type 4.1a In-Office/Video: $65.00 - per Hour 4.1b In -Office with Transportation: N/A per Hour No. of roundtrip miles included in rate: 30 miles In -Home or Community: $85.00 per Hour No. of roundtrip miles included in rate: 30 miles 4.1c FTM, TDM, Prof. Staffing: $85.00 per Hour 4.1d No show: $60.00 per No Show 4.1e Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.2 Hourly Service #2 Name: Beyond the Walls $ Amount Unit Type 4.2a In-Office/Video: Monthly rate per Hour 4.2b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.2c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.2d FTM, TDM, Prof. Staffing: per Hour 4.2e No show: per No Show 4.2f Mileage rate: per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: Parents as Teachers $ Amount Unit Type 4.3a In-Office/Video: Monthly rate per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.3c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 43f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: Comprehensive Parenting Time $ Amount Unit Type 4.4a In-Office/Video: $ 80.00 per Hour 4.4b In -Office with Transportation: $ 85.00 per Hour No. of roundtrip miles included in rate: 30 miles In -Home or Community: $ 85.00 per Hour No. of roundtrip miles included in rate: 30 miles 4.4c FTM, TDM, Prof. Staffing: $80.00 per Hour 4.4d No show: $70.00 per No Show 4.4e Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: Therapeutic Parenting Time $ Amount Unit Type 4.5a In-Office/Video: $95.00 per Hour 4.5b In -Office with Transportation: $120.00 per Hour No. of roundtrip miles included in rate: 30 miles 4.5c In -Home or Community: $120.00 per Hour No. of roundtrip miles included in rate: 30 miles 4.5d FTM, TDM, Prof. Staffing: $95.00 per Hour 4.5e No show: $75.00 per No Show 45f Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a Beyond the Walls $1,115.-- 25 hours of learning opportunities 4.6b Parents as Teachers $600.00 REV. OCT 2021 7 ATTACHMENT C - PROPOSAL 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Transportation is not provided for Parents as Teachers REV. OCT 2021 8 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Program Areas are listed in column 1 of the table located in Item XI of the Request You may complete another Attachment C if you have more than 5. for Proposal starting on page 13. Shiloh Home, Inc. Mental Health Services Number of services offered on this Attachment C (max 5): 2 SECTION 2 - Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Mental Health Services: Individual, and Family Therapy 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Outpatient or in -home individual and family therapy services provided to children, adolescents, and families who are struggling with mental health issues (often related to trauma) and difficult family dynamics. Assessments Utilized A mental health assessment is used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.). Focus of Mental Health Services Areas targeted by therapy services include: • Reducing problematic symptoms and behaviors associated with mental health disorders and trauma • Educating children, adolescents, and families about issues associated with trauma and mental health, including identifying how they impact functioning Helping children, adolescents, and their families develop healthy coping tools to manage their unpleasant thoughts and emotions • Equipping caretakers with knowledge and methods to provide trauma -informed parenting and meet the unique needs of their children Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences Increasing each family member's understanding of their own unhealthy interaction patterns and how to change them Reducing conflict within families by teaching and guiding family members in the use of positive communication skills that foster empathy between them • Facilitating communication between family members to address therapy issues Mental Health Services Methodologies All treatment interventions used by Shiloh Home, Inc. are trauma -informed, evidence -based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including. communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF- CBT), play therapy, Family Systems interventions, and DBT techniques. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Therapeutic services are traumainformed, strength -based and are designed to meet the needs of each client. Mental Health Services Providers Therapy services are provided by a master's level clinician; licensed, provisionally licensed, or under the supervision of a licensed supervisor. 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Individual Therapy: 1 hour weekly Family Therapy: 1 hour weekly REV. OCT 2021 1 ATTACHMENT C - PROPOSAL 2.1c Anticipated duration of service (i.e. 3-4 months): 3-6 months. 2.1d Three (3), or more, specific goals of the service (DO use bullet points): Increase functioning and overall wellbeing Increase coping skills Physical and emotional safety •, Improve interpersonal skills, including healthy communication and self -advocacy 2.1e Three (3), or more, specific outcomes of service: Improved Mental Health Improved Individual Functioning Improved Family Functioning Completion of Treatment Goals 2.1f Target population of the service, including age and gender: Youth, adults, and family groups 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Individual and Family therapy are Medicaid eligible services 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office or in -home Service #2 Name: Intensive Family Therapy 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Intensive Family Therapy is short-term, family -centered therapeutic process used to focus on the destructive familial relationship patterns and define new healthy patterns for interaction between family members. Family therapy is a solution based treatment concentrating on resolving presenting problems identified by the Department of Human Services reason for involvement. Treatment may include individual therapy or a combination of two or more members of the family in the office with the. therapist at one time or as an in -home service. Intensive Family Therapy should be individualized to each individual and family and should incorporate measurable goals/anticipated outcomes that are consistent with the Human Services Family Service Plan, Delivery. Methods: Therapeutic services can be provided in the office or in the home. Evidence based services include TF-CBT. Services are offered up to 3 hours per week. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenientfor the family to ensure ongoing success after a youth returns home. Therapeutic services are strength -based and are designed to meet the needs of each client; Staff Credentials: Masters level clinician licensed, provisionally licensed or under the supervision of a licensed supervisor. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Up to 3hours per week 2.2c Anticipated duration of service (i.e. 3-4 months): 3-6 months 2.2d Three (3), or more, specific goals of the service (DO use bullet points): Gain effective communication skills Learn to resolve conflict in non -abusive ways Identify and replace destructive familial relationship patterns 2.2e Three (3), or more, specific outcomes of service: Improved family dynamics Completion of treatment goals REV. OCT 2021 2 ATTACHMENT C - PROPOSAL • Family continues to demonstrate safety and stability in the home environment, reducing the risk for out of home placement or future Human Services involvement. 2.2f Target population of the service: Parents and children who will benefit from short term therapeutic supports 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Family therapy is a Medicaid eligible service 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office and in -home Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) 3.1 3.2 3.3 3.4 3.5 Section 3 — Service Access and Transportation YES YES NO Will you charge Weld County for transporting clients or mileage? Check one: ►.4 ■ NO Will you conduct services in a client's home or in the community? Check one: e • NO Miles Will you transport clients to and/or from services? Check one: @ YES • How many miles are you willing to travel round trip? List a specific number of miles. 80 When you calculate mileage, what is your starting point address? 2700 E. Ken Pratt Blvd Longmont, CO 80504 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Mental Health Services: Individual and Family Therapy 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $95.00 $120.00 $120.00 $95.00 $75.00 0.59 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 30 30 This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Intensive Family Therapy 4.2a In-Office/Video: 4.2b In -Office with Transportation: $ Amount $95.00 $120.00 Unit Type per Hour per Hour No. of roundtrip miles included in rate: 30 miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.2c In -Home or Community: $120.00 per Hour No. of roundtrip miles included ii rate: 30 miles 4.2d FTM, TDM, Prof. Staffing: $95:00 per Hour 41e No show: $75.00 per No Show 4..2f Mileage rate: 0.59 per Mile This is paid after the miles listed above. 4.3 Hourly Service #3 Name: $ Amount Unit Type 4..3a In-Office/Video: per Hour 4.3b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 43c In -Home or Community: per Hour No. of roundtrip miles included ii rate: miles 4.3d FTM, TDM, Prof. Staffing: per Hour 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 4.5c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: REV. OCT 2021 5 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Shiloh Home, Inc. (DBA Shiloh House) Sexual Abuse Treatment Program Areas are listed in column 1 of the table located in Item XI of the Request for Proposal starting on page 13. Number of services offered on this Attachment C (max 5): You may complete another Attachment Cif you have more than 5. 3 SECTION 2 — Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Community Based Treatment for Youth with Problematic Sexual Conduct 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): This outpatient program is designed for family and youth verbalizing a strong commitment to actively participate in a combination of home -based offense specific therapy and coaching services. These families may not fully grasp the seriousness of the sexual offending or the contributing family dynamics, but the family and the youth have demonstrated a willingness to engage in the treatment process. This program can help youth and families address issues; including sexual reactivity due to abuse and trauma; unhealthy behaviors including inappropriate touching, bullying, gesturing, and threatening verbalizations; youth who have engaged in family -based incest; and youth who have engaged in community based sexual assault. Participating youth may be adjudicated, or non -adjudicated: Delivery Methods: This Community Based Treatment for Problematic Sexual Conduct includes 2-3 hours per week of in -home SOMB masters level treatment and additional BA level in -home training, coaching and accountability targeting safe and healthy sexual behavior life skills. Coaches and therapists build on strengths that exist within the family and help family members address safety concerns in a realistic, non judgmental way. Engagement Techniques: The offense specific life skills coaches will reinforce the parents in the skill areas necessary for ensuring the care and wellbeing of their children, as well as treatment success for the youth with Problematic Sexual Conduct. Masters level clinicians actively listed with the Colorado SOMB as approved providers will provide offense specific treatment that is tailored to meet the needs of the youth and the family. Case management services and communication are also provided by Shiloh House staff to ensure MDT member collaboration, following an initial assessment, an individualized treatment plan will be completed for each youth and family and will be modified as needed during services with approval by the MDT. 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2-3 hours per week far therapy 2.1c Anticipated duration of service (i.e. 3-4 months): 6-8 months 2.1d Three (3), or more, specific goals of the service (DO use bullet points): To successfully integrate SOMB guided home based offender treatment with evidence -based treatment principles including Trauma Focused CBT and High Fidelity Wrap Around To support the following High -Fidelity Wrap Around principals: o To be strength based and to value all members of the team focusing on family and youth needsrather than deficits o To engage natural support systems for the youth and family and provide the natural support with informed supervision training and accountability skills to ensure that the youth and family have supportive resources o To ensure that the family and youth voice are valued in all discussions o To be culturally competent and respectful in all services o To individually tailor all treatment and offense specific life skills o To collaborate and communicate effectively with all multi -disciplinary team members REV. OCT 2021 1 ATTACHMENT C - PROPOSAL o To be dedicated to progressing through inevitable challenges and barriers o . To be outcome based with observable and measurable indicators of success o To address complex and overlapping needs • To successfully address family and offending youth denial of sexual offending problems • To reduce future Problematic Sexual Conduct • To strengthen protective and resiliency factors for the youth and family • To provide effective coordination with all community partners including development of a school safety plan. • To provide offense specific assessments including J -SOAP, Psychosexual evaluations and polygraphs. • To successfully integrate mental health treatment with offense specific treatment • To provide well -coordinated treatment with victim therapists and support systems • To provide services within SOMB guiding principles 2.1e Three (3), or more, specific outcomes of service: • Prevent out of home placement • Promote safety for persons victimized, the youth and family, and for the community through the successful completion of a treatment plan. • Increase the personal health of the offending youth 2.1f Target population of the service, including age and gender: youth ages 8-18 and their families who are struggling with a wide variety of Problematic Sexual Conduct. 2.1g Languages service is available in (please list proficiency and if interpreter services are available): English 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Not eligible for Medicaid 2.1i Service location — list where the service will take place (i.e. client's home, in -office, other) In -home, in -office Service #2 Name: Sex Abuse Individual and Family Treatment 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Trauma Informed Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization. Delivery Methods: Shiloh House practices the best standards of care and emphasizes implementation of evidence -based treatment practices. Sex abuse individual and family treatment provides strength based, family focused, accountable, relationship oriented service which respects the family while ensuring that the goals of treatment are achieved. Shiloh House adheres to the SOMB Guidelines and Standards. Risk assessment will be addressed through empirically guided risk evaluations and clinical insight, ongoing team and family collaboration, treatment progress and team members input, behavioral observation within all arenas of the client's life (home, school, job, social, community). Adjunct referral for polygraphs, arousal measurement, psychological services and psychiatric services are made as deemed necessary and appropriate. Therapy adheres to the Colorado Sex Offender Management Board's Standards and Guidelines for the Evaluation, Assessment, Treatment and Supervision of Juveniles. Shiloh House utilizes TF-CBT, CBT, Psycho -education and Family Systems Therapy, risk assessment and safety planning, Informed Supervision training, and relapse prevention planning. These services help youth and families increase pro -social behaviors and protective factors; develop a nurturing, healthy home environment; eliminate all illegal behaviorsby family members; and provide participants with an understanding of their family and personal cycle of abuse, while increasing their ability to interrupt this cycle. Engagement Techniques: Shiloh House SOMB therapists provide interactive educational and therapeutic tools to help clients identify and address safety concerns for all family members; promote disclosure of abusive behaviors, and address any victimization the client has experienced; assist in the development of empathy for persons victimized; and establish healthy coping skills and tools (self-control, and rehearsal of corrected cognitions). Whenever possible and appropriate, SOMB therapists work directly with the victim therapist(s) to assist the youth and person(s) victimized in the clarification process. 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: Individual therapy: 1 hour weekly Family therapy: 1 hour weekly REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.2c Anticipated duration of service (i.e. 3-4 months): 6-8 months 2.2d Three (3), or more, specific goals of the service (DO use bullet points): • To successfully address family and offending youth denial of sexual offending problems • To reduce future Problematic Sexual Conduct • To strengthen protective and resiliency factors for the youth and family 2.2e Three (3), or more, specific outcomes of service: Community Safety Parent/Caregiver will gain understanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. Decreased risk, and improved personal health 2.2f Target population of the service: Youth 8-18 years of age who have had sexually abusive behaviors, and their families. 2.2g Languages service is available in (please list proficiency and if interpreter services are available): English 2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Not eligible for Medicaid 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) In -home, and in -office Service #3 Name: Informed Supervision 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Shiloh Home offers Informed Supervision training consistent with SOMB Standards and Guidelines. The Informed supervision training is provided by a Shiloh staff who is trained in Informed Supervision and supervised by an SOMB qualified supervisor. The Informed supervision training includes at a minimum the following topics: • History of SOMB • Principals of SOMB treatment with emphasis on community safety • Why Informed Supervision is necessary • Victim Confidentiality • Sexual Offending Behaviors overview • Current laws that relate to juvenile sexual offending Seriousness of Juvenile Offending, impact, and priorities Dynamic patterns (cycles) associated with abusive behavior The role of the MDT in all decisions • Safety Plans • High Risk patterns • Community Supervision and Treatment 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: This is a three hour training provided in a single appointment 2.3c Anticipated duration of service (i.e. 3-4 months): One time training 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e • Prepare parents, guardians, and family supports to provide Informed Supervision • Ensure that parents, guardians, and family supports understand the requirements of informed supervision, and that they are willing and able to provide that supervision • Increase community safety by helping the supervising adult understand the risks and needs of the youth in treatment Three (3), or more, specific outcomes of service: REV. OCT 2021 3 ATTACHMENT C - PROPOSAL Community Safety, Parent/Caregiver will gainunderstanding of Informed Supervision standards and guidelines; and will demonstrate both willingness and ability to provide Informed Supervision as evidenced by participation in the class, acknowledgement of the impact of abusive behavior, and demonstration of knowledge through completion of a post test. Decreased risk, and improved personal health 2.3f Target population of the service: Parents and other adult caregivers of youth with problematic sexual conduct 2.3g Languages service is available in (please list proficiency and if interpreter services are available): English 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: Not eligible for Medicaid 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) In -office Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.5b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access and Transportation 3.1 3.2 3.3 3.4 3.5 When you calculate mileage, what is your starting point address? Will you charge Weld County for transporting clients or mileage? Check one: Will you conduct services in a client's home or in the community? Check one: Will you transport clients to and/or from services? Check one: ® YES ® YES ® YES ❑ NO How many miles are you willing to travel round trip? List a specific number of miles. 80 0 Miles NO NO 2700 E. Ken Pratt Blvd Longmont, CO 80504 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Community Based Treatment for Youth with Problematic Sexual Conduct 4.1a In-Office/Video: 4.1b In -Office with Transportation: In -Home or Community: 4.1c FTM, TDM, Prof. Staffing: 4.1d No show: 4.1e Mileage rate: $ Amount $95.00 $130.00 $130.00 $95.00 $75.00 0.59 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 30 30 This is paid after the miles listed above. miles miles 4.2 Hourly Service #2 Name: Sex Abuse Individual and Family Treatment 4.2a In-Office/Video: 4.2b In -Office with Transportation: 4.2c In -Home or Community: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount $95.00 $130.00 $130.00 $95.00 $75.00 0.59 Unit Type per Hour per Hour per Hour per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 30 30 This is paid after the miles listed above. miles miles 4.3 Hourly Service #3 Name: Informed Supervision 4.3a In-Office/Video: 4.3b In -Office with Transportation: 4.3c In -Home or Community: 4.3d FTM, TDM, Prof. Staffing: $ Amount Per unit rate No Transportation Unit Type per Hour per Hour per Hour per Hour No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles REV. OCT 2021 s ATTACHMENT C - PROPOSAL 4.3e No show: per No Show 4.3f Mileage rate: per Mile This is paid after the miles listed above. 4.4 Hourly Service #4 Name: $ Amount Unit Type 4.4a In-Office/Video: per Hour 4.4b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.4c FTM, TDM, Prof. Staffing: per Hour 4.4d No show: per No Show 4.4e Mileage rate: per Mile This is paid after the miles listed above. 4.5 Hourly Service #5 Name: $ Amount Unit Type 4.5a In-Office/Video: per Hour 4.5b In -Office with Transportation: per Hour No. of roundtrip miles included in rate: miles 45c In -Home or Community: per Hour No. of roundtrip miles included in rate: miles 4.5d FTM, TDM, Prof. Staffing: per Hour 4.5e No show: per No Show 4.5f Mileage rate: per Mile This is paid after the miles listed above. 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate per Month No. of Direct Service Hours: 4.6a Informed Supervision (single service) $300.00 per unit 3 hours 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Transportation is not available for Informed Supervision. REV. OCT 2021 6 ATTACHMENT D - STAFF DATA SHEET Bidder Must List All Staff Who Will Administer the Proposed Service(s) BIDDER'S LEGAL NAME (As it appears on the W-9): AGENCY CONTACT: Austin. Topolnicki Shiloh Home, Inc. PHONE NUMBER: 303-932-9599 x1328 EMAIL: atopolnicki@shilohhouse.net PROPOSED SERVICE(S): Venman T Daniel Clinical Director, SOMB LPC LPC.0011841 Feller C Fischer Page Clinician LPC LPC.00 13350 Coy C Amy Beyond the Walls Davis E Mary Beyond the Walls Elwood. A William Beyond the Walls Essique G Austin Beyond the Walls Judd S Carmen Beyond the Walls Kearns M Madysen Beyond the Walls Cunningham F Bridget Parents as Teachers Haro A Eunice Parents as Teachers Hashimoto S Ashley Parents as Teachers Lucero L Jeni Parents as Teachers Sailer R Kendall Day Treatment Warren n/a Dana Clinician LPP/LPC LPP.0001605, LPCC.0018404 White E Katie Clinician LPP Soto M Maria Cultural Navigator Richardson L Jennifer Clinical Director LPC LPC.0001311 Ramirez W Molly Deputy CEO LCSW CSW.09924481 Moore J Yazmine Clinician Provisional Social Worker SWP.0001387, SWC.0000000041 Martinez S Rafilita Pt. time PARA Martinez A Lauren Director of Community Services CSW.09925319 CHILD WELFARE REQUEST FOR PROPOSAL 2022-23 - VARIOUS SERVICES ATTACHMENT D - STAFF DATA SHEET Bidder Must List All Staff Who Will Administer the Proposed Service(s) BIDDER'S LEGAL NAME (As it appears on the W-9): AGENCY CONTACT:Austin Topolnicki Shiloh Home, Inc. PHONE NUMBER:303-932-9599 x1328 EMAIL:atopolnicki@shilohhouse.net PROPOSED SERVICE(S): Mental Health Services, Life Skills, Day Treatment, Sex Abuse Treatment, Foster Parent and Kinship Consultation, Foster Parent and Kinship Training, Aftercare Services, Home -Based Intervention Knight S Jamara Prevention Supervisor LPCC Goodman R Jill Clinician LPCC LPCC.0018235 Glenday L Colin Clinician MSW/SWP SWP.0001392 Straley G Sarah Clinician LPCC LPCC.0019177 Feller Ashleigh Lead Teacher Flanigan C Brianna Teacher Finn K Keighley Lead Family Support Professional Green Lawrence Director of Special Education CHILD WELFARE REQUEST FOR PROPOSAL 2022-23 - VARIOUS SERVICES RCONTE SHILHOM-01 ACORO® CERTIFICATE OF LIABILITY INSURANCE `..►� DATD/YYYY) /4/2 /4/2022 1/4/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER BOKF Insurance Risk Management CONTACT Ruth Conte NAME: PHONE (A/c, No, Ext): (720) 264-5351 FAX (A/C, No): E-MAILhconte@bokf.com INSURER(S) AFFORDING COVERAGE NAIC f1 INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED Shiloh House, Inc. 6588 W. Ottawa Avenue Littleton, CO 80128 INSURER B : Pinnacol Assurance Company 41190 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR wVD POLICY NUMBER POLICY EFF IMM/DD/YYYYI POLICY EXP (MM/DD/YYYY) UNITS A X COMMERCIAL GENERAL LIABILITY X PHPK2359882 1/1/2022 1/1/2023 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 1,000,000 S CLAIMS -MADE X OCCUR MED EXP (Any one person) S 20,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECTLOC PER: PRODUCTS - COMP/OP AGG S 3,000,000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED PHPK2359882 1/1/2022 1/1/2023 COMBINED SINGLE LIMIT (Ea accident 1,000,000 S BODILY INJURY (Per person) 5 BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) S S A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PHUB796559 1/1/2022 1/1/2023 EACH OCCURRENCE S 9,000,000 AGGREGATE 9,000,000 S DED X RETENTIONS 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR'PARTNER!EXECUTI?JE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below Y/N N NIA 1705662 1/1/2022 1/1/2023 X PER 12TH - STATUTE ER E.L. EACH ACCIDENT 500,000 S E.L. DISEASE - EA EMPLOYEE 500,000 E.L. DISEASE - POLICY LIMIT 500,000 S A A Professional Liab Professional Liab PHPK2359882 PHPK2359882 1/1/2022 1/1/2022 1/1/2023 1/1/2023 Per Prof Incident Aggregate 1,000,000 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) Sexual Abuse & Molestation Liability - Policy PHPK2359882 effective 01/01/2022 to 01/01/2023 written with Philadelphia Indemnity Insurance Company. Limits of $1,000,000 Per Occurrence and $3,000,000 Policy Aggregate. Fidelity Liability - Policy PHSD1680757 effective 01/01/2022 to 01/01/2023 written with Philadelphia Indemnity Insurance Company. Limit of $1,000,000 subject to a $5,000 Retention. Cyber Liability - Policy 660364002 effective 01/01/2022 to 01/01/2023 written with HSB Specialty Insurance Company. Limit of $2,000,00 Per Occurrence/ SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION Weld County, Colorado PO Box A (Greeley. CO 80632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ICI ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: SHILHOM-01 RCONTE LOC #: 0 ACOREE ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY BOKF Insurance Risk Management g NAMED INSURED Shiloh House, Inc. 6588 Ottawa W. Ottawa Avenue Littleton, CO 80128 POLICY NUMBER SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: $2,000,000 Aggregate subject to a $10,000 Retention. Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, are included as an Additional Insured with respect to General Liability as required by written contract or agreement per the attached form. 60 day Notice of Cancellation is provided for Weld County. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Contract Form New Contract Request Entity Name* SHILOH HOUSE, INC Entity ID* z00035732 732 Contract Name* Contract ID ❑ New Entity? Parent Contract ID SHILOH HOUSE, INC (NEW CHILD PROTECTION AGREEMENT) 5968 20220410 Contract Status CTB REVIEW Contract Lead* APEGG Contract Lead Email apeggweldgov. com;cobbx xlkc 3weldgov.corn Contract Description* CONSENT BID B2200040 TERM: JUNE 1, 2022 THROUGH MAY 31, 2023 Requires Board Approval YES Department Project # Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESNEFED TO THE BOCC ON 04 x'06. 22 AND AS A COMMUNICATION ITEM. PA SENT TO CTB ON 05 a` 10.2022. Contract Type AGREEMENT Amount $0.00 Renewable* YES Automatic Renewal Grant Department HUMAN SERVICES Department Email CM- HumanServices@weldgov.co m De ent Head Email CM-HumanServices- DeptHeadg weldgov.com County Attorney GENERAL COUNTY Al I ORNEY EMAIL County Attorney Email CM- COUNTYA I I ORNEY 2WELDG OV.COM Requested BOCC nda Due Date Date* 06,E 11 /2022 06:'15,=`2022 Will a work session with BOCC be required? NO Does Contract require Purchasing Dept_ to be included? if this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in Onaase Contract Dates Effective Date Termination Notice Period Contact Intor nati n Purchasing Purchasing AF CONSENT Approval Pr De entl JAMIE ULRICH OH Approved Date 06;07;2022 Ilatkp prlral BOCC Approved BOCC Signed Date BOCC Agenda Date 06/13/2022 Originator APEGG Review Date * 03'31 2023 Committed Delivery Date Finance Approver CONSENT Renewal Date* 05, 31 ,''' 2023 Expiration Date Contact Phone 1 Contact Phone 2 Purchasing •, d' 06,'07`2022 Legal Counsel CONSENT Finance Approved Date Legal Counsel Approved Date 06/07x2022 06,07'2022 Tyler Ref If AC 061322 Hello