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HomeMy WebLinkAbout20222386.tiffRESOLUTION RE: APPROVE 2022-2023 PLAN FOR CORE SERVICES PROGRAM AND AUTHORIZE CHAIR AND DIRECTOR OF DEPARTMENT OF HUMAN SERVICES TO SIGN AND SUBMIT ELECTRONICALLY WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with the 2022-2023 Plan for the Core Services Program from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Human Services, commencing July 1, 2022, and ending June 30, 2023, with further terms and conditions being as stated in said plan, and WHEREAS, after review, the Board deems it advisable to approve said plan, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the 2022-2023 Plan for the Core Services Program from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Human Services, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair and Director of the Department of Human Services be, and hereby are, authorized to electronically sign and submit said plan. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 17th day of August, A.D., 2022, nunc pro tunc July 1, 2022. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: ditArAl ..do;&k. Weld County Clerk to the Board BY: Deputy Clerk to the Boar APP ED A County A torney Date of signature: /22 Scott K. James , Chair cc: HSD q /i f Kz2 2022-2386 HR0094 CkJLqL PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: August 9, 2022 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Core Services Program Plan — First Year of a Three -Year Plan (SFY 2022-23) 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 Core Services Program Plan — First Year of a Three - Year Plan (SFY 2022-23). The Core Services Program Plan has been developed in accordance with State Department of Human Services rules governing Core Services funding. This Plan is for year one of a three-year Core Plan cycle and is effective for the fiscal year July 1, 2022, through June 30, 2023. The Department's allocation for year 2022-23 is $4,425,936.00 which is an increase of $270,206.00 over 2021-22. The High -Fidelity Wraparound program is the only new service that has been added for this Core Service Year. If the proposed Core Services Program Plan is approved by the State, the Plan will be administered in conformity with its provisions and the provisions of State Department rules. I do not recommend a Work Session. I recommend approval of this Plan and authorize the Chair and Director to sign. Approve Recommendation Perry L. Buck Mike Freeman, Pro -Tern Scott K. James. Chair Steve Moreno Lori Saine (i)s Schedule Work Session Other/Comments: Pass -Around Memorandum; August 9, 2022 - CMS ID 6192 Pace 2022-2386 0-P_OOclq DocuSign Envelope ID: C93C41C6-85FB 4907-92C1-BFA81335FF5E COLORADO Department of Human Services CORE SERVICES PROGRAM FIRST YEAR OF A THREE-YEAR PLAN SFY 2022 - 2023 SFY 2023 - 2024 SFY 2024 - 2025 FOR Weld COUNTY(IES): Please complete this plan template and budget pages. Upload a copy of this plan into Docusign to route for signatures. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs. colorado. gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E REQUEST FOR STATE APPROVAL OF PLAN All signatures from the County Director(s), Boards of Commissions, and Placement Alternatives Commission are required. Weld This Core Services Plan is hereby submitted for [Indicate county name(s) and lead county if this is a multi -county plan], for the period contract years June 1, 2022, through May 31, 2023 fiscal years July 1, 2022, through June 30, 2023. The Plan includes the following: • Completed "Statement of Assurances"; • Completed program description of each proposed "County Designed Service"; • Completed "Information on Fees" form; • Completed "Overhead Cost" form (Optional); • Completed "State Board Summary"; • Completed "100% Funding Summary" form; and • Completed "Final Budget Page". This Core Services Program Plan has been developed in accordance with State Department of Human Services rules and is hereby submitted to the Colorado Department of Human Services, Division of Child Welfare for approval. If the enclosed proposed Core Services Program Plan is approved, the Plan will be administered in conformity with its provisions and the provisions of State Department rules. The person who will act as primary contact person for the Core Services Plan is, 970-400-6545 can be reached at telephone numbe , and e-mail at If two or more counties propose this plan, the required signatures below are to be completed by each county, as appropriate. Please attach an additional signature page as needed. Denise Suniga and Please check here if your county has a Core II Plan: x sunigadk@weldgov.com Please check here if your county does not have a Placement Alternative Commission: DocuSigned by: 1C1020$047 401 Signature, DIRECTOR, COUNTY DEPARTMENT OF HUMAN/SOCIAL SERVICES DocuSigned by: Scoff ja*t,s E74B8DB083D44A1... 8/4/2022 DATE 8/17/2022 Signature, CHAIR, PLACEMENT ALTERNATIVES COMMISSION DocuSigned by: \kr— 14.3.31 UZbbbbU4Ub DATE 8/6/2022 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado. gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Signature, CHAIR, BOARD OF COUNTY COMMISSIONERS CORE SERVICES STATEMENT OF ASSURANCES Weld DATE County assures that, upon approval of the Core Services Program Plan the following will be adhered to in the implementation of the Program: Core Services Assurances: Operation will conform to the provisions of the Plan; Operation will conform to State rules; Core Services Program Services, provided or purchased, will be accessible to children and their families who meet the eligibility criteria set forth in Rule Manual Volume 7, at 7.303; Operation will not discriminate against any individual on the basis of race, sex, national origin, religion, age or mental/physical disability who applies for or receives services through the Core Services program; Services will recognize and support cultural and religious background and customs of children and their families; Out-of-state travel will not be paid for with Core Services funds; All forms used in the completion of the Core Services Plan will be State prescribed or State approved forms; Core FTE/Personal Services costs authorized for reimbursement by the State Department will be used only to provide the direct delivery of Core Services; The purchase of services will be in conformity with State purchase of service rules including contract form, content, and monitoring requirements; Core Services Program expenditures will not be reimbursed when the expenditures may be reimbursed by some other source. (Set forth in Rule Manual Volume 7, at 7.414,B); Information regarding services purchased or provided will be reported to the State Department for program, statistical and financial purposes; All providers of Core Services (through purchase of service contracts) must be registered with the Colorado Department of Regulatory Agencies (DORA). The provision of Life Skills is the only exception to this mandate; County staff are responsible for monitoring their Program provider payments and for ensuring the county and providers are following all statutory and regulatory requirements; All Core Services are made available, based on need of each child/youth/family; and 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E • All contracts for services using Core Services Program funding will include all of the required language of the attached contract template. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES TO BE PROVIDED/PURCHASED List below "County Designed Service" that will be provided/purchased. Please indicate which, if any, of the County Designed Service are provided through the Evidenced Based Services to Adolescents earmarked funding: • Prevention Services Program • Crisis Intervention and Stabilization Services (Various providers) • Mental Health in Schools • Functional Family Therapy (FFT) (Various providers) (Evidenced Based Services to Adolescents) • Foster Parent Consultation (Various providers) • High Fidelity Wraparound Services • Kinship Consultation and Support (Therapeutic Kinship Services) • Mediation (Various providers) • Mentoring (Various providers) • Mental Health Navigator Program • Multi -Systemic Therapy (MST) (Various providers) (Evidenced Based Services to Adolescents) • Nurse Consultation (Nurturing Program) • Post Permanency Services • Role Model Mentoring (Child Mentoring and Family Support) • Teamwork, Innovation, Growth, Hope and Training (TIGHT) (Evidenced Based Services to Program Area Three - PA3 Services - Prevention/Intervention Services If your county submitted a Program Area Three (PA3) Plan last fiscal year, and you wish to continue providing PA3 services using Core Services Program funding, please check the box below; ® Yes, our county wishes to continue offering PA3 services using Core Services Program funding. If your county has not submitted a Program Area Three (PA3) Plan, and you wish to provide PA3 services, please complete and submit the PA3 Plan Addendum attached. Funding for Evidenced Based Services to Adolescents If the county received funding for evidenced based services to adolescents, and is requesting the funding to continue to receive the same funding for the same expansion or created of the evidenced based county designed program to adolescents, please indicate that above, as well as on the Core Plan under County Designed. 1575 Sherman St., Denver, Co 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Prevention Services Program Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. The Prevention Services Program is a county -wide intensive case management system to meet the needs of families at risk of involvement with child welfare or youth services. Specific Family Services are developed to incorporate access to existing community services and the development of new service alternatives to address Drug and alcohol concerns Mental and behavioral health needs Mediation and/or mentoring needs Educational and employment concerns Truancy concerns Juvenile delinquency behavior Parenting education and support Developmental needs Barriers to stable income and housing Services include comprehensive and individualized case management and may include psychosocial groups that focus on preventive education and support. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. 3. This service detail is currently available through existing Program Area 3 Prevention Services. Define the eligible population to be served. The eligible population for these services will include - Families who are not involved with an open PA4 Youth Services, PA5 Child Protection or PA6 Youth In Transition Case with children or youth currently in school if 18who are at 1575 Sherman St., Denver, Co 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E risk of child welfare or youth services involvement and who agree to intervention that focuses on the family unit, as well as the needs and aspirations of the family. - Families who meet the rules and requirements specific funding stream utilized. 4. Define the time frame of the service. - Individual participation time frames will vary based on the family's level of involvement with Weld County and their specific needs. 5. Define the workload standard for the program: • number of cases per worker, up to 35 active cases • number of workers for the program, There are currently six (6) Community Case Managers, and • worker to supervisor ratio. 8:1 is the current ratio 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. - At a minimum, Qualified Full Time Employees (FTEs) must have a Bachelor's degree or higher, complete and maintain CDHS caseworker certification, and complete the Strengthening Families' Protective Factors Framework training. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. At a minimum, The Prevention Services Program will Whenever possible, prevent families who are at risk of child welfare involvement who are willing and open to services from penetrating the child welfare system or having a youth become adjudicated through the juvenile justice system. Successfully reduce high cost services, such as out -of -home placement, detention, or Division of Youth Services (DYS) commitment. Keep families together through a better utilization of existing community resources to avoid the opening of a case in the child welfare or juvenile justice system. Increase families' protective factors. 8 Identify the service provider. - Weld County Staff 9. Define the rate of payment (e.g., $100.00 per session/episode). - $7085.00/Month per FTE - $7567.21 /Month per FTE (Weld County Public Health Department) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Service Name: Crisis Intervention and Stabilization Services Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Crisis Intervention and Stabilization Services will provide immediate in-person/in-home response to families, youth and children, in crisis, 24 hours a day, seven (7) days a week. A "crisis" is further defined as a situation or circumstance, usually acute (recent) in nature, which breaks down the normal functioning of an individual and/or family, and results in the inability of the individual and/or family to resolve the crisis through normal coping behaviors, or without immediate intervention. The primary goal of the services is to prevent out -of -home placement of youth and/or child(ren) and provide families with the services they need to maintain their youth and/or child(ren) in their home. Services may also be used for crises occurring during reunification. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails ("Crisis Intervention"). 3. Define the eligible population to be served. The eligible population for these services will include: Families with open Program Area 3, 4, 5 or 6 cases with Weld County. Children (and their families) identified as eligible for Core Services based on their imminent risk of out -of -home placement due to one or more factors as defined in Volume 7. 4. Define the time frame of the service. Individual participation off amities will vary based on the referred family's level of involvement with Weld County, and their specific needs. Initial services will be immediate with follow-up occurring for 45-60 days. 5. Define the workload standard for the program: • number of cases per worker, five (5)- seven (7) cases per clinician at any one time • number of workers for the program, and Number of workers varies as needed 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E • worker to supervisor ratio. <6:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Qualified Crisis Intervention staff will have a Bachelor's degree or higher and demonstrate the knowledge, training and expertise to conduct Crisis Intervention and Stabilization Services. Service provider will also be familiar with Trauma Informed Care principles and practices. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. At a minimum, Crisis Intervention and Stabilization Services will: - Help prevent out -of -home placement of youth and/or child(ren) - Provide families with the services they need to maintain their youth and/or child(ren) in their home. - Provide families with the services they need to continue the reunification process with their youth and/or child(ren) in their home. 8. Identify the service provider. - Various Providers 9. Define the rate of payment (e.g., $100.00 per session/episode). $55/Hour 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Mental Health in Schools Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Mental Health in School services students with emotional disabilities and students on the autism spectrum in grades 6-12. Students with emotional disabilities and students on the autism spectrum will receive services in separate classrooms set up specifically for their needs. Each student shall: Receive individual or dyad -based "tutorial" sessions in English/Language Arts, Math and Reading based upon their skill level, as well as their individual learning pace and style. Receive a minimum of three (3) sessions daily with the student, teacher and/or teaching assistant to provide direct instruction, review material, reinforce skill development, and prepare for an exhibition, test or mastery -of -material assessment. Rotate through independent work, teacher -directed tutorials, technology -based activities and small group reinforcement sessions. Receive curriculum aligned with the Common Core Standards. Receive individual and/or group counseling as prescribed by the student's Individualized Education Program (IEP). Model for Students with Autism. Each student shall participate in: Discrete Trail Training (DTT): An intensive 1:1 where students are engaged in trails of demands which focus on expanding the repertoire of language development. Social Skills Lab: A small group opportunity for social skills application utilizing an interactive activity that requires them to use greetings, requesting, and sharing skills in order to complete the activity. Independent Play and Leisure: An independent station that allows students to engage in an age -appropriate item for a set duration of time to increase their ability to learn a variety of functionalities and maintain independence. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Natural Environment Teaching (NET): A small group setting in which students have an opportunity to practice their greetings, requesting, sharing, play, and leisure skills to use in a less contrived setting. Activity Schedules: An activity that requires students to independently complete visual performance and fine motor tasks when guided by a visual schedule in order to prepare students for an academic or workplace setting. Life Skills: An individualized plan of skills that focuses on everyday functional activities to increase successful home and community generalization. Motor Lab: A sequence of progressive skills, which increase fine and gross motor abilities. Services Shall also include: Development, implementation and tracking of Individualized Education Plan 9. Personalized, tutorial -based target and interactive instructional approaches to meet all student IEP goals provided by one certified teacher and instructional aide per classroom. Classroom utilization of technology to supplement teacher -guided instruction. Classroom desktop computers are equipped with word recognition and speech -to -text software, and AlphaSmart keyboards. iPads and large screen calculators are provided as necessary. An intensive behavior modification system designed to minimize classroom disruptions and maximize learning is implemented, supported by positive reinforcement techniques and student incentives. Social skills' training is infused throughout the school day, to teach students the aptitudes and self-confidence needed to function well interpersonally and interpersonally. A flexible curriculum, focused on holistically educating challenging students while conforming to the home district's unique curriculum and instruction standards, is utilized. Renaissance Learning STAR Assessments are used to both monitor progress and inform daily instruction. An expansive array of transition services is provided, including the use of a Transition Planning Inventory; training in financial independence/management and the use of transportation resources; the development of good work habits; community involvement for the purposes of career readiness, exposure to occupations/industries, and volunteer activities; and exploration of and preparation for postsecondary educational opportunities. End -of -year outcome measurements relating to pre -and post -text academic achievement, attendance, behavioral level summary, standardized test scores, and positive trends working LRE and IEP progress are provided to referral entity. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. This service detail already exists in Trails (Mental Health Services) 3. Define the eligible population to be served. Students in grades 6-12, with emotional disabilities and/or students on the autism spectrum, who are at risk of out -of -home placement. 4. Define the time frame of the service. Monday through Friday, 8:30 a.m. - 3 p.m. 5. Define the workload standard for the program: • number of cases per worker, Teacher to Student Ratio = 1:2.5 • number of workers for the program, and Varies on need • worker to supervisor ratio. <6:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Bachelor's Degree or higher in a related field with demonstrated teaching experience and credentialing. 7 Define the performance indicators that will be achieved by the service, see 7.303.18. A minimum of 93% of students will transition successfully to their mainstream home school environment (if applicable). All Students will: Acquire academic skills in reading and writing. Acquire skills in obtaining and managing information, solving problems, thinking critically, and communicating effectively. Acquire specific information concerning the principles of the physical and biological sciences. Understand specific events and the broader context of social studies, the historical record of human achievements and failures, and current social issues. Become effective and responsible contributors to the political decision -making processes of the community, state, country and world. Play a greater role in his/her educational environment. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Acquire awareness of career opportunities and to acquire knowledge necessary for further education. Acquire an understanding of and the ability to form responsible relationships with a wide range of people. Acquire the capacities for playing satisfying and responsible roles in family life. Acquire the knowledge, habits, and attitudes that promote personal and public health, both physical and mental. Acquire the ability and the desire to express himself/herself creatively in one or more of the arts, as well as in other education disciplines, and to appreciate the creative expressions of other people. Develop an understanding his/her own worth, abilities, potential, and limitations. Enjoy the process of learning and acquire skills necessary for a lifetime of continuous learning and adaptation to change. 8. Identify the service provider. Centennial BOCES DBA Sierra School of Weld County 9. Define the rate of payment (e.g., $100.00 per session/episode). $73.00/Day (Therapeutic Costs) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID. C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Functional Family Therapy (FFT) Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Functional Family Therapy (FFT) is an intensive family -based treatment that addresses the pervasive patterns of relational dysfunction known to be determinants of conduct disorder, violent acting out, and substance abuse among youth 10-18 years of age. FFT address the multiple factors known to be related to delinquency and therefore strives to enhance both the safety of the youth and family directly receiving FFT services as well as the safety of the greater community in which the youth resides. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails (Functional Family Therapy). 3. Define the eligible population to be served. The target population for this service is youth ages 10-18 who are conduct disordered, violent or have issues with substance abuse, and are a risk of out -of -home placement. Youth must meet Core Services criteria as identified in Volume 7. 4. Define the time frame of the service. The average length of services is two (2) to five (5) months which can be lengthened for youth deemed appropriate for extended services. 5. Define the workload standard for the program: number of cases per worker, North Range Behavioral Health (NRBH): 16, Savio :8-10 number of workers for the program, and NRBH: 4, Savio: 3 (FT), 2 (PT) worker to supervisor ratio. NRBH: 4:1, Savio: 7:1 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. FFT therapists are Master's level clinicians or equivalent. All therapists have completed the nationally recognized FFT training program and strictly adhere to the accepted program model. 7 Define the performance indicators that will be achieved by the service, see 7.303.18. "Family Conflict Management". The family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment, running away, status offenses and delinquent behavior. "Parental Competency". "Caregivers/parents will show ability to maintain sound relationships with the children placed in the home and provider care, nutrition, hygiene, discipline, protection, instructions, and supervision. "Personal and Individual Competency". Families will show awareness in terms of self- esteem, victim awareness, peer relationships enhancement, establishing appropriate physical and emotional boundaries, demonstrating assertive behavior and assuming responsibility for one's own behavior. 8. Identify the service provider. North Range Behavioral Health Savio 9. Define the rate of payment (e.g., $100.00 per session/episode). NRBH: $700/Month (FFT) $1200/Month (FFT-CW) Savio $1,000-1,300/Month (FFT-Various Levels) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Foster Parent Consultation (Foster Care/Adoption Support) Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. This program provides foster care consultative services in the areas of (1) consultation and foster parent support specific to a child placed in the home, (2) mandated corrective action consultation specific to a child placed in the home, and (3) mandated critical care consultation specific to a child placed in the home. Through consultation, foster care children are being maintained in the lowest level of care and least restrictive setting when out -of -home placement is necessary. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails. 3. Define the eligible population to be served. These services are open to any child placed in a Weld County foster home. 4. Define the time frame of the service. Foster children are referred for the service through the assigned County Foster Care Coordinator. Duration is initially three (3) months with the option to review the service for renewal through the staffing team. 5. Define the workload standard for the program: • number of cases per worker, The number of cares per worker varies and is dependent upon the availability of the provider and the need for services at any given time. • number of workers for the program, and Varies on Need • worker to supervisor ratio. 1:1 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C4106-85FB-4907-92C1-BFA81335FF5E 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Master's level clinician, or higher, with extensive experience and training in the area of foster care and Child Welfare. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. "Family Conflict Management". The foster family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment, running away, status offenses and delinquent behavior. "Parental Competency". Foster parents will show ability to maintain sound relationships with the children placed in the home and provider care, nutrition, hygiene, discipline, protection, instructions, and supervision. "Academic, Behavioral and Emotional Competency". Children involved in school or day treatment settings will demonstrate ability to meet school requirements, to control behavior, and to control and communicate feelings. 8. Identify the service provider. Various Providers 9. Define the rate of payment (e.g., $100.00 per session/episode). Varies $100-$150 an hour 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: High -Fidelity Wraparound Services Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. Describe the service and components of the service; define the goals of the program. The High -Fidelity Wraparound (HFW) Program is an intensive, team -based, person -centered service that provides coordinated, family -driven care to meet the complex needs of children and adolescents who are involved with multiple systems who have mental and behavioral health, neurobiological, and/or substance use problems and may be at risk for high levels of care and/or out -of -home placement. HFW is a service that; facilitates care planning and coordination of services for children and adolescents, provides access to support to promote engagement and completion of services, engages youth and families to establish an individualized child and family team that develops and monitors a strengths -based plan of care, and addresses youth and family needs across domains of physical and behavioral health, social determinants of health, and natural supports. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. This service detail is currently available through existing Program Area 3 Prevention Services, Program Area 4 Youth in Conflict, Program Area 5 Children in Need of Protection, or Program Area 6 Adoption Cases. 3. Define the eligible population to be served. Children and adolescents who are involved with multiple systems (e.g. mental health, child welfare, juvenile/criminal justice, education, community centered boards), who have mental and behavioral health, neurobiological, and/or substance use problems and may be at risk for high levels of care and/or out -of -home placement, or are aging out of DHS care. 4. Define the time frame of the service. Participation in the HFW Program is voluntary and can be accessed as many times as necessary throughout the lifetime of the child(ren). 5. Define the workload standard for the program: 1575 Sherman St., Denver, Co 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E • number of cases per worker, Wraparound Facilitators can be assigned up to 10 families. • number of workers for the program, and Four (4) FTE • worker to supervisor ratio. 4:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Wraparound Facilitators must have successful completion of a bachelor's degree in a human behavioral science field or other appropriately related field. They must possess Colorado Caseworker Certification or obtain it within first 12 months of employment, and they must possess Colorado Wraparound Facilitator Credentialing or obtain it within first 12 months of employment. 7 Define the performance indicators that will be achieved by the service, see 7.303.18. Throughout this process, the child(ren) or adolescents and their parent(s)/caregiver(s) develop skills in the following: "Family Conflict Management": The family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment and delinquent behavior. "Parental Competency": Parents will show ability to provide appropriate care and maintain sound relationships with their children. "Resources Access Competency": Parents will demonstrate ability to obtain help when needed. "Personal and Individual Competency": Families will show awareness in terms of self- esteem, victim awareness, management of one's own history and assuming responsibility for one's own behavior. "Competence in Maintaining Sobriety": Household members will be able to maintain sobriety and/or develop relapse prevention planning 8. Identify the service provider. Family Resource Division's Wraparound Facilitators 9. Define the rate of payment (e.g., $100.00 per session/episode). $491,416/Year (Four (4) Wraparound Facilitators and one Supervisor). 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Kinship Consultation and Support Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. This program provides kinship consultative services in the areas of (1) consultation and kinship parent support specific to a child placed in a kinship home, (2) corrective consultation specific to a child placed in a kinship home, and (3) critical care consultation specific to a child placed in a kinship home. Through consultation, children placed in kinship care are being maintained in the lowest level of care and the least restrictive setting when out of home placement is necessary. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails (Therapeutic Kinship Services) 3. Define the eligible population to be served. The population served is any child placed in a Weld County kinship home. 4. Define the time frame of the service. Kinship children are referred for the service through the assigned Kinship Care Coordinator. Duration is initially three (3) months with the option to review the service for renewal through the staff Ing team. 5. Define the workload standard for the program: • number of cases per worker, 40-50 Cases • number of workers for the program, and Four (4) Kinship Coordinators One (1) FTE Supervisor • worker to supervisor ratio. • 4:1 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. The Kinship Care Coordinators must have a Bachelor's degree in Social Work and one year of professional casework experience acquired after the degree in a public or private social services agency or a Master's degree in Social Work. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. Family Conflict Management: The kinship family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment, running away, status offenses and delinquent behavior. Parental Competency: Kinship parents will show the ability to maintain sound relationships with the children placed in the home and provide care, nutrition, hygiene, discipline, protection, instructions and supervision. Academic, Behavioral and Emotional Competency: By supporting kinship providers, children will remain in a stable placement and therefore be able to demonstrate the ability to meet school requirements, to control behavior and to control and communicate feelings. 8. Identify the service provider. Weld County Kinship Coordinators 9. Define the rate of payment (e.g., $100.00 per session/episode). $472, 800.00/Year - Supervisor ($110,900.00) - Four (4) Kinship Care Coordinators ($361,900.00) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Mediation Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Mediation serves as a means to assist parties in reaching successful agreements on various issues that will help progress their case and limit litigation. When possible, mediation will assist parties to reach agreements that can advance the case and reduce litigation. If full agreements cannot be reached by the participating parties, mediation will aid in bringing the parties closer to resolution, which can limit the issues in Court and provide the foundation for a better working relationship among the parties. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails ("Mediation"). 3. Define the eligible population to be served. Families with open Program Area 3, 4, 5 or 6 cases with Weld County. Children (and their families) identified as eligible for Core Services based on their imminent risk of out -of -home placement due to one or more factors as defined in Volume 7. Collaterals within the community for the purpose of developing effective treatment and prevention plans for children and/or families. 4. Define the time frame of the service. Individual participation of families will vary based on the referred family's level of involvement with Weld County, and their specific needs. Potential timeframes may range from two (2) to four (4) hours per scheduled mediation session. 5. Define the workload standard for the program: • number of cases per worker, 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Up to six (6) mediations per month • number of workers for the program, and • worker to supervisor ratio. 1:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Service provider must be an attorney -at -law in good standing with extensive experience and/or training in mediation, Dependency and Neglect and Family Law. Service provider must agree to accept calls directly from the Court to schedule mediations as needed. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. - Mediation will assist parties to reach agreements that can advance the case and reduce litigation. - Mediation will aid in bringing the parties closer to resolution, which can limit the issues in Court and provide the foundation for a better working relationship among the parties. 8. Identify the service provider. Julie A. Scroggins, Attorney -at -Law 9. Define the rate of payment (e.g., $100.00 per session/episode). $250.00 per hour 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Mentoring Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. One-on-one mentoring to guide and teach youth to make positive choices, support goals as defined by the referral source, and prevent out -of -home placement or involvement/further involvement in the juvenile justice system. Services will include: Connecting youth and family with resources in the area of parenting, pregnancy, mental health concerns, drug and alcohol treatment, and alternative educational opportunities. Advocating for youth ad teaching youth accountability and responsibility for behaviors. Teaching youth skills which foster independence such as job skills, goal setting, and development. Assisting youth in identifying alternative outlets for self-destructive behavior, as well as assessing risks and developing plans to make positive choices in difficult situations. Engaging the youth in pro -social activities, interests and plans which promote a positive self- image and expand upon those experiences to increase positive peer associations. Assisting youth with compliance of system expectations including probation, community service, electronic home monitoring, court appearances, school attendance, and other requirements. Encouraging youth to participate in recommended programs, such as therapy, as well as processing any barriers to participation. Providing youth with opportunities and discussion to strengthen self-esteem, communication skills, and coping strategies while building hope and intermediary steps towards long-term goals. Guiding youth to increase communication with parents and adult supports through utilization of positive resources. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails ("Mentoring"). 3. Define the eligible population to be served. Children and youth, age five (5) to 18, who are at risk of out -of -home placement. 4. Define the time frame of the service. A minimum of one (1) time per week for up to six (6) months. 5. Define the workload standard for the program: • number of cases per worker, Two (2) to Three (3) cases at any given time • number of workers for the program, and One (1) • worker to supervisor ratio. 1:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Bachelor's Degree or higher in a related field with demonstrated youth mentoring experience and/or credentialing and complete the Strengthening Families "Protective Factors Framework. 7 Define the performance indicators that will be achieved by the service, see 7.303.18. Youth will demonstrate progress towards goals as defined by the referral source. This may include increased attendance at school, improved personal hygiene, securing employment, or other demonstrated progress as it relates to the specific goals of the referred youth. 85% of the youth who successfully discharge from services will continue to reside at home, or in a least restrictive setting, and will have not entered the juvenile justice system at the time of discharge. 8. Identify the service provider. Various Providers 9. Define the rate of payment (e.g., $100.00 per session/episode). $65-70/Hour 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID. C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Mental Health Navigator Program Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Mental Health Navigators are highly trained and licensed staff who assist families and caseworkers in navigating through the Mental Health System and Medicaid process. They provide mental health clinical expertise and oversight to assist caseworkers in accurately assessing factors contributing to intrapsychic, social and/or family dysfunction of children/ youth and their families. They complete mental health assessments and written reports on children in the custody of Weld County using standardized assessment instruments including the CANS on youth at risk of out -of -home placement to determine the appropriate level of care. The Navigators meet with families in person when possible or via phone call to best understand their needs and determine where in the process their services might be within the Medicaid system. They then coordinate with the Regional Accountable Entities (RAE) to work on best service options for those families. They also appeal decisions if the county disagrees with a determination or if the family disagrees and walks them through the process working in the best interest of the child. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. A new Trails Service Detail needs to be created. 3. Define the eligible population to be served. The population served are all families who are either entering the child welfare system or who have been in the child welfare system with an open case and who have need of assistance for navigation of the mental health system. There are also times the Navigators assist with PA 3 prevention cases to prevent a family from coming into the child welfare system. 4. Define the time frame of the service. Services may be provided up to 18 months. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 5. Define the workload standard for the program: • number of cases per worker, 15-20 Cases • number of workers for the program, and Two (2) Mental Health Navigators .3 FTE Supervisor • worker to supervisor ratio. 3:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. The Mental Health Navigators must have a Master's level degree in Social Work, Psychology or a related field. In addition, the Mental Health Professional must be a Licensed Professional Counselor, Licensed Clinical Social Worker, Licensed Marriage and Family Therapist or Licensed Psychologist and have five years full-time work experience as a Social Worker, Case Worker or Mental Health Counselor. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. The Mental Health Navigators enhance the ability for parents and children to access mental health services in a timely manner by helping them to navigate the mental health system, assisting with the Medicaid process and assessing the type of mental health service that is most appropriate to meet the needs of the parents and children. Parental Competency: Appropriate mental health services will increase parental competency and personal and individual competency. As parents access treatment to address their mental health concerns, they will be more likely to build and maintain sound relationships with their children and provide appropriate care. Personal and Individual Competency: As parents engage in mental health services to address trauma, prior victimization and self-esteem issues, they are better equipped to establish physical and emotional boundaries for themselves and their children and assume responsibility for their behavior. Children who access mental health treatment will develop healthy self-esteem and the skills necessary to positively interact with family and peers while maintaining physical and emotional safety for themselves. 8. Identify the service provider. Weld County Mental Health Navigators 9. Define the rate of payment (e.g., $100.00 per session/episode). 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E $213,580.00/Year - 20% Supervisor ($19,980.00/Year) - Three (3) FT Mental Health Navigators ($290,400.00/Year) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Multisystemic Therapy (MST) Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Multisystemic Therapy (MST) is a nationally recognized evidence, family and community -based program model that focuses on chronic juvenile offenders, ages 12 and 17, who have extensive criminal histories. MST therapists work closely with families in their home to assist the youth and family in controlling the youth's behaviors, maintaining focus on school, engaging in pro - social activities, and obtaining job skills. The program utilizes Cognitive Behavioral Therapy, behavior management training, family therapy and community -based resources. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails ("Multisystemic Therapy"). 3. Define the eligible population to be served. The target population for this service is youth ages 12-17 with antisocial behavior and who have extensive criminal histories. Youth must meet Core Services criteria as identified in Volume 7. 4. Define the time frame of the service. The average length of services is two (2) to five (5) months which can be extended for youth deemed appropriate for extended services. 5. Define the workload standard for the program: • number of cases per worker, NRBH: 6, Savio: 4-5 • number of workers for the program, and NRBH:4, Savio 4 • worker to supervisor ratio. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E NRBH: 4-1, Savio: 4-1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. MST therapists are Master's level clinicians or equivalent. All therapist have completed the nationally recognized MST training program and strictly adhere to the accepted program model. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. - The family shall demonstrate capacity to resolve conflicts and disagreements and show awareness and responsibility for one's behavior. - Parents will show ability to maintain sound relationships with their children. 8. Identify the service provider. North Range Behavioral Health (NRBH) Savio 9. Define the rate of payment (e.g., $100.00 per session/episode). NRBH: $1,8000.00/Month (Multisystemic Therapy) Savio: $1,794.00-3,237.00/Month (Multisystemic Therapy - Various Levels) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Nurse Consultation Program Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. As part of the Nurse Consultation Program, the nurse will: Be available to accompany caseworkers on home visits to assess medical, environmental and psychosocial needs as appropriate Provide care management, monitoring, education, basic nursing interventions such as medication administration, setting up medication boxes and other needed interventions Provide services in -home as applicable and promptly and appropriately respond to any medical issues that arise during the provision of services Provide education and training for caregivers to include, but not limited to, basic daily care skills, medical equipment usage and maintenance, medical/behavioral health monitoring and other areas specific to the medical needs of the child Continually assess foster parents' or caregivers' capacity to appropriately care for the child's needs to keep the child safe and enhance child's well-being Participate in Family Team Meetings to provide medical expertise as requested Assist in the development of the treatment plan goals and services for medically fragile children and their families 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. Nurturing Program 3. Define the eligible population to be served. The population served are high risk infants and children who have high medical needs and their families who have an open Child Welfare case. 4. Define the time frame of the service. Services may range from a one-time intervention up to 6 months of intensive services. 5. Define the workload standard for the program: 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E • number of cases per worker, One (1) FTE Nurse, 15-20 Cases • number of workers for the program, and One (1) FTE Nurse • worker to supervisor ratio. 1:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. The Nurse will have a minimum of a bachelor's degree. Specialized training will include child abuse and neglect, motivational interviewing, counseling regarding risk reduction for use of alcohol, drugs and tobacco and knowledge of early childhood development and other emotional and health related needs. 7 Define the performance indicators that will be achieved by the service, see 7.303.18. This service will be provided by Nurses from community partners. The Nurse will help families to achieve elements A through G set forth in 7.303.18. In addition to these elements, this service will help children achieve permanency more quickly, shorten length of stay in placement and prevent out of home placement. The Nurse Consultation Program will be evaluated on the following measure: At least 95% of children who are in home with nurse involvement should remain home At least 90% of the children in Weld County Foster homes who have nurse involvement should maintain placement or return home 100% of the prevention cases the nurse is involved with will not enter child welfare anytime during the nurse engagements 90% of children in Weld County Foster homes who returned home and had nurse involvement will not re-enter placements 8. Identify the service provider. This service will be provided by Nurses from community partners. 9. Define the rate of payment (e.g., $100.00 per session/episode). Payment is made based on the number of hours provided each month as a fee for service contract or one (1) FTE nurse salary. Total amount not to exceed $140,000. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Post Permanency Services Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 6. Describe the service and components of the service; define the goals of the program. The Weld County Department of Human Services (WCDHS) Family Resource Division's (FRD) Post Permanency Support Program provides ongoing outreach, one on one consultation, community resource referral and case management services for adoptive, allocation of parental responsibilities (APR) and guardianship families. The main goal of the program is to support families in remaining intact and healthy. Using a strengths -based approach, the Adoption Support and Resource Coordinators develop and maintain supportive relationships with families from the time they are matched with children and through the child's 18th birthday as long as they remain the legal responsibility of the participant guardian. Through implementation of the evidenced based Trust Based Relational Intervention model, the Adoption Support and Resource Coordinators provide training and individualized support to ensure families have the skills and tools needed to successfully parent children who may have experienced trauma and loss. In addition, they assist families in maneuvering systems and accessing resources which are necessary to ensure safety and meet the specific needs of each child. This often includes advocacy and assistance in obtaining specialized educational, physical and mental health services, behavioral and social skills interventions, therapeutic services and specialized parent coaching. 7. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. This service detail is currently available through existing Program Area 6 Adoption Cases or Program Area 3 Prevention Services. 8. Define the eligible population to be served. Families who are adopting, have APR/guardianship or who have adopted from WCDHS (whether they reside in Weld County or elsewhere), and families who have adopted elsewhere who currently reside in Weld County are eligible to participate in the program. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92O1-BFA81335FF5E Participation in the Post Permanency Support Program is voluntary and can be accessed as many times as necessary throughout the lifetime of the child(ren). 9. Define the time frame of the service. This service is available to all adoption and APR/Guardianship cases until the child reaches the age of 18. 10. Define the workload standard for the program: • number of cases per worker, Adoption Support and Resource Coordinators are available as a resource for all adoptive families and can work with up to 20 active families at a time. • number of workers for the program, and Two (2) FTE • worker to supervisor ratio. 8:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Adoption Support and Resource Coordinators must meet the minimum professional and educational requirements for Colorado Social Caseworker outlined in Volume 7. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. The Post Adoption Support Program works with families to design individualized Family Service Plans which assist families in building skills in the following: - "Family Conflict Management": The family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment, running away, status offenses and delinquent behavior. - "Parental Competency": Parents will show ability to maintain sound relationships with their children and provide care, nutrition, hygiene, discipline, protection, instructions, and supervision. - "Resources Access Competency": Parents will demonstrate ability to obtain help from the community and within the local, state, and federal governments. 8. Identify the service provider. Family Resource Division's Adoption Support and Resource Coordinators 9. Define the rate of payment (e.g., $100.00 per session/episode). $151,576.00/Year (Two (2) FT Adoption Support and Resource Coordinators) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Role Model Mentoring (Child Mentoring and Family Support) Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Rote Model Mentoring (RMM) works with youth who have lost or been abandoned by a parent. Youth involved in the program progress through a level system that incorporates activities, interactions, and events that build self-esteem, explore the youth's interests, and build leadership skills. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail does exist in Trails at this time (Child Mentoring and Family Support). 3. Define the eligible population to be served. Any youth who has lost or been abandoned by a parent, including youth in foster or kin placement. 4. Define the time frame of the service. Individual participation of families will vary based on the referred family's level of Involvement with Weld County, and their specific needs. 5. Define the workload standard for the program: • number of cases per worker, Up to seventy-five (75) youth per year; unduplicated. • number of workers for the program, and One (1) • worker to supervisor ratio. 1:1 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Bachelor's degree or higher in a related filed with demonstrated youth mentoring experience and/or credentialing and complete the Strengthening Families'' Protective Factors. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. Better utilization of strengths within the family to promote protective factors Increased attendance rates of children and youth in school 85% of the youth who successfully discharge from the program will continue to reside at home, in a least restrictive setting, and will have not entered the juvenile justice system at the time of discharge. 8. Identify the service provider. Paid in Full, Inc. 9. Define the rate of payment (e.g., $100.00 per session/episode). $95.00/Episode (One-time fee/client. Level 1 - Intro to Best Effort) $195.00/Episode (One-time fee/client. Level 1 - Intro to Camaraderie) $195.00/Episode (One-time fee/client. Level 1 - Intro to Work as a Team) $195.00/Episode (One-time fee/client. Level 1 n- Prep and Test for Level 2) $100.00/Episode (One-time fee/client. Level 2 - R.M.M. Family Club, Up to 12 Sessions) $100.00/Episode (Level 3 - Club Captains, up to 4 Times) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Teamwork, Innovation, Growth, Hope and Training- TIGHT (Reconnecting Youth) Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. The information listed below is to be completed for each County Designed Service and included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. Teamwork, Innovation, Growth, Home and Training (TIGHT) is a collaborative effort involving Youth Services in the Child Welfare Division and the Employment Services Division. The goal of TIGHT is to delay or eliminate the need for out -of -home placement by exposing participating youth to a variety of projects within their community. These include educational opportunities, pro -social activities, and exposure to life skills topics such as financial literacy, job readiness, soft skills, and other information to help them be successful independent young adults. These projects promote a healthy growth in self-esteem and a sense of community, with the hope that participating youth identify and choose positive alternatives in their community. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trails. The service detail already exists in Trails ("Reconnecting Youth"). 3. Define the eligible population to be served. The target population for this service is youth ages 15-17 who are at risk of out -of -home placement and who exhibit delinquent/maladaptive behaviors, primarily truancy issues and expulsion from school. 4. Define the time frame of the service. Youth participate in the program for various lengths of time; each individuals situation is different. 5. Define the workload standard for the program: • number of cases per worker, TIGHT Crew, 8:1 • number of workers for the program, and Two (2)-FTE (Crew Leaders) 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92O1-BFA81335FF5E .5 FTE (Team Leader) • worker to supervisor ratio. 1:3 (FT/PT) 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. Team Leader has a Bachelor's degree in Human Services, six (6) years of experience working with youth and two (2) years supervisory experience. Crew Leaders have high school diploma or GED and two (2) years Human Services experience working with youth. Define the performance indicators that will be achieved by the service, see 7.303.18. "Family Conflict Management". The family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment, running away, status offenses and delinquent behavior. "Parental Competency". Parents will be supported in developing household structure, increased monitoring and supervision of their youth, and the development of clear rules and consequences. Furthermore, parents will be empowered with skills and resources needed to independently address the difficulties that arise with their youth. "Personal and Individual Competency". Families will show awareness in terms of self- esteem, victim awareness, peer relationships enhancement, establishing appropriate physical and emotional boundaries, demonstrating assertive behavior and assuming responsibility for one's own behavior. Youth will demonstrate an ability to seek positive alternatives and positive choices. 8. Identify the service provider. Collaborative effort between Child Welfare and Employment Services Divisions in Weld County DHS. 9. Define the rate of payment (e.g., $100.00 per session/episode). Youth Programs Crew Leader (1 FTE) $64,100.00 Youth Programs Crew Leader (1 FTE) WCYCC Supervisor (.5 FTE) $68,800.00 $43,100.00 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E INFORMATION ON CORE SERVICE FEES Please check all that apply: ®Fees will not be assessed for Core Services Program Services. If above line is checked, STOP. Remainder of information does not need to be completed. ❑Fees will be assessed for the following services: Check those that apply: 0 Home Based Intervention ❑ Intensive Family Therapy 0 Life Skills ❑ Day Treatment 0 Sexual Abuse Treatment 0 County Designed Service (List Services Below) O Special Economic Assistance ❑ Mental Health Services 0 Substance Abuse Treatment Services ❑ Fee assessment formula is the same for all services. State the formula here (attach additional sheets as needed). 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E ❑ Fee assessment formula varies with service. State formula used for each service (attach additional sheets as needed). 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E CORE SERVICES PROGRAM OVERHEAD/PROGRAM ADMINISTRATION COST for CORE SERVICES STAFF ***OPTIONAL PAGE - ONLY USE IF YOUR COUNTY WISHES TO CLAIM OVERHEAD/PROGRAM ADMINISTRATION COSTS*** 1. DIRECT SERVICE A. Total Core Services salary/Fringe/Travel/Operating Costs of Line Core Service Workers and their Immediate Supervisors _$2,179,378 B. Formula Percentage Allowed for Overhead/Program Administration Costs 15% C. Provided Service Overhead/Program Administration Costs (A X B) _$326,906.00 2. PURCHASED SERVICE A. Purchased Service Dollar Amount $2,246,5572 B. Formula Percentage Allowed for Overhead/Program Administration Costs $0 - 50,000 = 5%; $50,001 -100,000 = 4.9% For each $50,000 (in total expenditure) increase the Overhead/ Program Administration decreases by .1 %. C. Allowed Amount for Overhead/Program Administration Costs (A X B) -0- D. Base Overhead/Program Administration Cost Allowed E. Purchased Service Overhead/Program Administration Costs (C + D) 3. TOTAL OVERHEAD?PROGRAM ADMINISTRATION COSTS (1C + 2E) $500.00__ $500 _$327,406.00 DISTRIBUTION OF OVERHEAD/PROGRAM ADMINISTRATION COSTS AMONG SERVICES* SERVICE Overhead/Program Administration Provided Service Costs Overhead/Program Administration Purchased Service Costs Total Overhead Administration Costs /Program 1. Home Based Intervention $26,476.15 $26,476.15 2. Intensive Family Therapy 3. Sexual Abuse Treatment $17,304.65 4. Day Treatment $2,480.40 5. Life Skills $159,342.40 $139,057.35 6. County Designed Service $141,087.45 $141,087.45 r $500.00 $500.00 COLUMN TOTALS $326,906.00 $500.00 $327.406.00 * Formula to determine overhead/program administration cost by service: Step 1: total provided service cost (by service) x 15% = provided service overhead/program administration cost Step 2: total purchased service cost (by service) x % listed in 2B = Y $500 divided by the number of purchased service = Z, then Y + Z = overhead/program administration cost Step 3: Provided service overhead/program administration cost plus purchased service overhead cost equals total overhead/program administration cost 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 80/20 FUNDING SUMMARY CORE SERVICES PROGRAM FY 2022-2023 County(ies): Weld Services Resource/Provider or Number of FTE Age of Child # of Families Served Per Month # Children Served Per Month Cost per Child Per Month Cost per Year Home Based Intervention Various Providers 0-21 See Trails See Trails See Trails $ 300,000.00 Intensive Family Therapy Various Providers 0-21 See Trails See Trails See Trails $ 3,000.00 Life Skills Various Providers 0-21 See Trails See Trails See Trails $ 1,227,000.00 Mental Health in Schools Various Providers 0-21 See Trails See Trails See Trails $ 10,000.00 Sex Abuse Treatment Various Providers 0-21 See Trails See Trails See Trails $ 90,000.00 Special Economic Assistance Various Providers 0-21 See Trails See Trails See Trails Substance Abuse Treatment Services Various Providers 0-21 See Trails See Trails See Trails County Design Services - Purchased Services (Community Based Family Support Services - Compass; Child Mentoring and Family Support-RMM; Foster Care/Adoption Support -Foster Parent Consultation; Therapeutic Kinship Services -Kinship Parent Consultation; Mediation; Mentoring) Various Providers 0-21 See Trails See Trails See Trails $ 869,776.00 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E County Design Services - Evidenced Based Services for Adolescents (Functional Family Therapy; High Fidelity Wraparound Services; Multisystemic Therapy; Reconnecting Youth-T.I.G.H.T.) Various Providers 0-21 See Trails See Trails See Trails $ 200,000.00 Total 80/20 CORE: $ 2,699,776.00 100% FUNDING SUMMARY CORE SERVICE PROGRAM FY 2022-2023 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E County(ies): Weld Services Resource/Provider or Number of FTE Age of Child # of Families Served Per S Month # Children Served Per e Month Cost per Child per Month Cost per Year Home Based Intervention Various Providers 0-21 See Trails See Trails See Trails $ 150,000.00 Intensive Family Therapy Various Providers 0-21 See Trails See Trails See Trails $- Life Skills Various Providers 0-21 See Trails See Trails See Trails $ 600,000.00 Mental Health in .Schools Various Providers 0-21 See Trails See Trails See Trails $ 0 Sex Abuse Treatment Various Providers 0-21 See Trails See Trails See Trails $ 60,000.00 Special Economic Assistance Various Providers 0-21 See Trails See Trails See Trails $ 64,014.00 Substance Abuse Treatment Services Various Providers 0-21 See Trails See Trails See Trails $ 445,000.00 County Design Services - Purchased Services (Community Based Family Support Services - Compass; Child Mentoring and Family Support- RMM; Foster Care/Adoption Support -Foster Parent Various Providers 0-21 See Trails See Trails See Trails $ 150,000.00 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Consultation; Therapeutic Kinship Services - Kinship Parent Consultation; Mediation; Mentoring) County Design Services - Evidenced Based Services for Adolescents (Functional Family Therapy; High Fidelity Wraparound Services; Multisystemic Therapy; Reconnecting Youth -T. I. G. H.T. ) Various Providers 0-21 See Trails See Trails See Trails Total 100% CORE: $ 1,726,159.00 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E FINAL BUDGET PAGE FY 2021-2022 CORE SERVICES PROGRAM CFMS Function Code Service Name Other DSS Funds (Specify fund source) Other Source Funds (Specify Fund source) Total Funds 80/20 1700 Total Funds 100% (Core, SEA, Substance Abuse, Mental Health) 1800 Total FSS Funds TOTAL FUNDS 1700/1800 Home Based Intervention $ 300,000.00 $ 150,000.00 $450,000.00 1710/1810 Intensive Family Therapy $ 3,000.00 $3,000.00 1720/1820 Life Skills $ 1,227,000.00 $ 600,000.00 $1,827,000.00 1730/1830 Day Treatment $ 10,000.00 $ $10,000.00 1740/1840 Sexual Abuse Treatment $ 90,000.00 $ 60,000.00 $150,000.00 1855 Special Economic Assistance $ 64,014.00 $64,014.00 1845 Mental Health Services $ 445,000.00 $445,000.00 1850 Substance Abuse Treatment Services $ 150,000.00 $150,000.00 1747 County Design Services - Purchased Services (Community Based Family Support Services - Compass; Child Mentoring and Family Support- RMM; Foster Care/Adoption $ 869,776.00 $ 257,145.00 $1,126,921.00 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Support -Foster Parent Consultation; Therapeutic Kinship Services - Kinship Parent Consultation; Mediation; Mentoring) 1725 County Design Services - Evidenced Based Services for Adolescents (Functional Family Therapy; High Fidelity Wraparound Services; Multisystemic Therapy; Reconnecting Youth-T.I.G.H.T.) $ 200,000.00 $200,000.00 TOTALS $2,699,776.00 $1,726,195.00 $ $4,425,935.00 CFMS Function Codes 17xx denotes 80/20 funded Core Service CFMS Function Codes 18xx denotes 100% funded Core Service CFMS Function Codes for Family Stability Services will be determined by funding source. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E PURCHASE OF SERVICE CONTRACT Core Services Program 1. THIS CONTRACT, made this day of , 21 by and between the County Department of Human/Social Services at , hereinafter called "County" and (address) , (name) , (address) , hereinafter called "Contractor". (Tax I.D. or Social Security Number) 2. This contract will be effective from until 3. County agrees to purchase and Contractor agrees to provide (Core Service) • To at at other such (population to be served) (location service is to be provided)_ location as shall facilitate the provision of such services. This service is described in Rule Manual Volume 7, Section 7.303.1 , and, if appropriate, the State approved County Core Service Plan. 4. County agrees to purchase and contractor agrees to furnish units of service at the cost of per unit of service for a maximum amount of this contract of $ . 5. The parties agree that the Contractor's relationship to the county is that of an independent Contractor. 6. The parties agree that payment pursuant to this Contract is subject to and contingent upon the continuing availability of funds for the purpose thereof. 7. County agrees: a) To determine child eligibility and as appropriate, to provide information regarding rights to fair hearings. b) To provide Contractor with written prior authorization on a child or family basis for services to be purchased. c) To provide Contractor with referral information including name and address of family, social, medical, and educational information as appropriate to the referral. d) To monitor the provision of contracted service. e) To pay Contractor after receipt of billing statements for services rendered satisfactorily and in accordance with this Contract. 8. Contractor agrees: a) Not to assign any provision of this Contract to a subcontractor. b) Not to charge clients any fees related to services provided under this contract. c) To hold the necessary license(s) which permits the performance of the service to be purchased, and/or to meet applicable Colorado Department of Human Services qualification requirements. d) To comply with the requirements of the Civil Rights Act of 1964 and Section 504, Rehabilitation Act of 1973 concerning discrimination on the basis of race, color, sex, age, religion, political beliefs, national origin, or handicap. e) To provide the service described herein at cost not greater than that charged to other persons in the same community. f) To submit a billing statement in a timely manner, no later than forty-five (45) days after services. failure to do so may result in nonpayment. g) To safe guard information and confidentiality of the child and the child's family in accordance with rules of the Colorado Department of Human Services and the County Department of Human/Social Services. h) To provide County with reports on the provision of services as follows: • Within weeks of enrollment/participation, submission of a treatment plan for the child/child's family with specific objectives and target dates. The treatment plan is subject to county approval. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Potts, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E • At intervals of months, from the time of enrollment/participation, submit reports that include progress and barriers in achieving provisions of the treatment plan. i) To provide access for any duly authorized representative of the County or the Colorado Department of Human Services until the expiration of five (5) years after the final payment under this Contract, involving transactions related to this Contract. j) Indemnify the County and the Colorado Department of Human Services from the action based upon or arising out of damage or injury, including death, to persons or property caused or sustained in connection with the performance of this contract or by conditions created thereby, or based upon any violation of any statue, regulation, and the defense of any such claims or actions. 9. In addition to the foregoing, the County and Contractor also agree: 10. Termination: Either party may terminate this Contract by thirty (30) days prior notification in writing. 11. All payments will be paid through the State's approved automated system, as appropriate. o Core Services Program expenditures will not be reimbursed when the expenditures may be reimbursed by some other source. (As set forth in Rule Manual Volume 7, at 7.414, B (12 CCR 2509-5). ADDITIONAL PROVISIONS: County Director's Signature Contractor's Signature Date Contractor's Title Date Original to Contractor Copy to the Case File Copy to County Bookkeeping Copy to State Accounting 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Bames, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Program Area Three PA3 - Prevention and Intervention Services Plan Please submit if applying for CDHS funding sources per Volume 7.200.1, 7.200.11 and 7.200.12. COUNTY(IES) Prevention Intervention Service Delivery using: Please check all that apply: ❑ Child Welfare Block Funding ❑ Collaborative Management Funding ❑ Core Services Program Funding ❑ County Only Funds ❑ Promoting Safe and Stable Families Program Funding (if your county is an approved PSSF site) ❑ Parental Fee Funding ❑ SSA/SSI Trust Funds ❑ TANF Block Grant Funding 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E For Core Services Funding Only: Program Area Three (PA3): Prevention and Intervention Services TO BE PROVIDED/PURCHASED Place an "X" to indicate which of the following Services will be provided/purchased in accordance with State Department rules: Home Based Intervention Intensive Family Therapy Sexual Abuse Treatment Services Day Treatment Life Skills Special Economic Assistance Mental Health Services Substance Abuse Treatment Services List below "County Designed Service" that will be provided/purchased in accordance with State Department rules. The Prevention Services Program is a county -wide intensive case management system to meet the needs of families at risk of involvement with child welfare/youth services. Prevention is also available to support families who are transitioning out of child welfare/youth services when there are no longer any child protection concerns. The information below is a simplified breakdown of the salary expenses associated with the prevention case managers. No Core Services funds are currently used to pay prevention salaries; however, other Core Services are available to families involved with prevention when other sources are not available. 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Program Area Three (PA3): Prevention and Intervention Services COUNTY DIRECTLY PROVIDED SERVICES SUMMARY SFY 2022-2023 County(ies): Weld Services Position Number of FTE Age Range of Children Child(ren) Number of Families Served Per Month Number of Children Served Per Month Cost per Child Per Month Cost per Year Prevention Case Manager 7 0-18 113 204 $245.00 $600,826.52 Total: $600,826.52 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polls, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E Program Area Three (PA3): Prevention and Intervention Services FINAL BUDGET PAGE - SFY 2022-2023 County(ies): Weld Service Name Service Provider PA3 Funding PA3 Funding Source: PA3 Funding Source: Total Funds 80/20 CWB: Total Funds 100% CWB: TOTAL FUNDS Core: Core: Prevention Case Management Weld County PSSF 85,832.36 Prevention Case Management Weld County CCR 85,832.36 Prevention Case Management Weld County 80/20 85,832.36 Prevention Case Management Weld County CSBG 128,748.54 Prevention Case Management Weld County TANF 214,580.90 Total: 600,826.52 1575 Sherman St., Denver, CO 80203 P 303.866.5700 cdhs.colorado.gov Jared Polis, Governor I Michelle Barnes, Executive Director DocuSign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FF5E 100% Funding Summary Core Service Program FY 2022-23 (Core II Plan) County (ies) Weld Services Resource/Provider or Number of FTE Age of Child # of Families Served Per Month . # Children . Served Per Mont Cost per Child Per Month Cost per Year Home Based Intervention Various Providers 0-21 See Trails See Trails See Trails $ 250,000.00 Life Skills Various Providers 0-21 See Trails See Trails See Trails $ 274,000.00 Supervised Visitation Various Providers 0-21 See Trails See Trails See Trails Day Treatment Various Providers 0-21 See Trails See Trails See Trails $ 30,000.00 Sexual Abuse Treatment Various Providers 0-21 See Trails See Trails See Trails $ Special Economic Assistance Various Providers 0-21 See Trails See Trails See Trails $ 10,000.00 Mental Health Services Various Providers 0-21 See Trails See Trails See Trails $ Substance Abuse Treatment Services Various Providers 0-21 See Trails See Trails See Trails $ Total 100% CORE $ 564,000.00 DocuSign Envelope ID: C93C41C6-85FB-4907-9201-BFA81335FFSE State Board Summary Core Service Program FY 2022-23 80/20 Funding (Core II Plan) County (ies) Weld ;,Services Bee I1^ider er N,00ber Rr$ TP ����9f 'h #� d " y 3 � rr Pee , n Mee--„ Home Based Intervention Various Providers 0-21 See Trails See Trails See Trails $ Intensive Family Therapy Various Providers 0-21 See Trails See Trails See Trails $ Life Skills Various Providers 0-21 See Trails See Trails See Trails $ Mental Health Services Various Providers 0-21 See Trails See Trails See Trails $ Supervised Visitation Various Providers 0-21 See Trails See Trails See Trails $ Day Treatment Various Providers 0-21 See Trails See Trails See Trails $ Sexual Abuse Treatment Various Providers 0-21 See Trails See Trails See Trails $ County Design Services - Purchased Services (Community Based Family Support Servcies - Compass; Child Mentoring and Family Support-RMM; Foster Care/Adoption Support -Foster Parent Consultation; Therapeutic Kinship Services -Kinship Parent Consultation; Mediation; Mentoring) Various Providers 0-21 See Trails See Trails See Trails $ 88,000.00 County Design Services - Evidenced Based Services for Adolescents (Functional Family Therapy; Multisystemic Therapy; Reconnecting Youth-T.I.G.H.T.) Various Providers 0-21 See Trails See Trails See Trails $ DocuSign Envelope ID: C93C41C6-85F6-4907-92C1-BFA81335FF5E Total 80/20 Core $ 88,000.00 Docu5ign Envelope ID: C93C41C6-85FB-4907-92C1-BFA81335FFSE Final Budget Page FY 2022-23 (Core II Plan) CORE SERVICES PROGRAM CFMS Function Code Service Name Other DSS Funds (Speeifiy fund source) Other Source Funds (Specify fund source) Total Funds 80/20 1700 Total Funds 100% (Core, ACM, SEA, Substance Abuse, Mental Health) 1800 Total FSS 100% TOTAL FUNDS 1700/1800 Home Based Intervention 8 250,000 00 $250,000 1710/1810 Intensive Family Therapy $ 1720/1820 Life Skills $ 274,000.00 $274,000 1730/1830 Day Treatment $ $ 1740/1840 Sexual Abuse Treatment $ 30,000.00 $30,000 1855 Special Economic Assistance $ 10,000.00 $10,000 1845 Mental Health Services $ 1850 Substance Abuse Treatment Services $ 1747 County Design Services - Purchased Services (Community Based Family Support Serviies - Compass; Child Mentoring and Family Support-RMM; Foster Care/Adoption Support - Foster Parent Consultation; Therapeutic Kinship Services - Kinship Parent Consultation; Mediation; Mentoring) $ 88,000.00 $ $88,000 1725 County Design Services - Evidenced Based Services for Adolescents (Functional Funnily Therapy; Multisystemic Therapy; Reconnecting Youth- T.I.G.H.T.) $ TOTALS $ $ $88,000 $564,000 $ $652,000 CFMS functional Codes 18. denotes 100% funded Core Service CFMS functional Codes 17xx denotes 80/20 funded Core Service CFMS Functional Codes for Family Stability Services will be determined by funding source: Child Welfare Block or County Funds. Please Contact Melinda Cox at 303.866.5962 for more information. Contract Form New Contract Request Entity Information Entity Name' Entity ID' COLORADO DEPARTMENT OF HUMAN OO0003650 SERVICES Contract Name* COLORADO DEPARTMENT OF HUMAN SERVICES (CORE SERVICES PROGRAM PLAN SFY 2022-23) Contract Status CTB RESIEW Contract ID 6192 Contract Lead' APEGG ❑ New Entity? Parent Contract ID Requires Board Approval YES Contract Lead Email Department Project # apeggigweldgov.com;cobbx xlk@weldgov.com Contract Description' NEW CORE SERVICES PROGRAM PLAN FOR SFY 2022-23 AS PREPARED BY THE DHS DIVISION OF CHILD WELFARE. PLAN WILL BE SIGNED AND SUBMITTED TO CDHS VIA DOCUSIGN. THE DEPARTMENT'S ALLOCATION FOR YEAR 2022-23 IS 54,425,936.00. Contract Description 2 PA IS BEING ROUTED THROUGH THE NORMAL PROCESS. ETA TO CTB: 8 11 2022. Contract Type' APPLICATION Amount' 54,425,936.00 Renewable' NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServices0,weldgov.co Department Head Email CM-HumanServices- DeptHeatht'weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COU NTYATTO RN EY UFWELDG OV.COM Requested BOCC Agenda Date' 08,17=2022 Due Date 08,'13;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 On Base Contract Dates Effective Date Termination Notice Period Contact Information Contact Info Contact Name Purchasing Review Date 05 01;2023 Committed Delivery Date Renewal Date Expiration Date 06,'30:2023 Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Approver Purchasing Approved Date Approval Process Department Head JAMIE ULRICH DH Approved Date 08.'09:2022 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 08 1, 2022 Originator APEGG Finance Approver CHERYL PATTELLI Legal Counsel CAITLIN PERRY Finance Approved Date Legal Counsel Approved Date 08!09,2022 08 12'2022 Tyler Ref # AG 081 722 Hello