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Home My WebLink About20193751.tiffPRIVILEGED AND CONFIDENTIAL 0...)241-"Ct MEMORANDUM =1p it9 Co9 I DATE: April 20, 2021 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement Amendment with Shiloh Home Inc, DBA Shiloh House Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Agreement Amendment with Shiloh Home Inc, DBA Shiloh House, The Department entered into a Child Protection Agreement for Services with Shiloh Home Inc, DBA Shiloh House, identified as Tyler ID 2019-3751 on August 19, 2019. The Agreement was amended on June 15, 2020 to extend the term date through May 31, 2021 and amend the Rate Schedule. The Agreement is now being amended to renew for a third and final year, for the period of June 1, 2021 through May 31, 2022, and to make changes to the Rate Schedule as noted below. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Rate Schedule Changes: Day Treatment Services: $2.0252,125.00/Month (Day Treatment Services) Foster Care/Adoption Services: $7479.00/Hour (Foster Parent Consultation — Coaching) $444120.00/Hour (Foster Parent Consultation — In -Home Therapy) $14095.00/Hour (Foster Parent Consultation — In -Home Therapy) $41,I150.00/Episode (Foster Parent Education — 11 hour class) $440505.00/Episode (Foster Parent Education -- 3 hour class) $.579.00/Hour (Kinship Services — Coaching) $4 4120.00/Hour (Kinship Services — In -Home Therapy) $402100/Hour (Kinship Services — In -Office Therapy) Home Based Services: $7479.00/Hour (Aftercare In -Home Coaching) $115120.00/Hour (Aftercare In -Home Therapy) Mental Health Services: $115120.00/Hour (Mental Health Therapy, In -Home) Pass -Around Memorandum; April 20, 2021- ID 4691 Page 1 eense,n+ A.3 -016L 0019-'3-151 HB0090 ot- agral PRIVILEGED AND CONFIDENTIAL. $3995.00/Hour (Mental Health Therapy, Office) $4-f-5173.00/Hour (Psychological Testing) $3,3503,515.00/Episode (Psychological Testing) Sexual Abuse Treatment: P579.00/Hour (Problematic Sexual Conduct (PSC) Coaching, In -Home) $125131.00/Hour (Sexual Abuse Therapy, In -Home) I do not recommend a Work Session. I recommend approval of this Agreement Amendment. Perry L. Buck Mike Freeman Scott K. James, Pro-Tem Steve Moreno, Chair Lori Saine Approve Recommerxlation Schedule Work Session Other/Comments: Pass -Around Memorandum; April 20, 2021- ID 4691 Page 2 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SHILOH HOME, INC. DBA SHILOH HOUSE -+ h This Agreement Amendment, made and entered into 00 day of Apr ` i 2021 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Shiloh Home, Inc. DBA Shiloh House, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment Services, Foster Care/Adoption Services, Home Based Services, Life Skills, Mental Health Services, and Sexual Abuse Treatment, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2019- 3751, approved on August 19, 2019. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2020. • The Original Agreement was amended on: June 15, 2020 to extend the term date through May 31, 2021 and amend the Rate Schedule. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2019-3751. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Term This agreement is being renewed for a third and final year, for the period of June 1, 2021 through May 31, 2022. 2. Exhibit D, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST. ! JeitO;ti Weld you Clerk to By: Deputy Cler BOARD OF COUNTY COMMISSIONERS WELD BOUNTY, COLORADO Steve Moreno, Chair ONTRACTOR: APR 2 8 2021 Shiloh Home, Inc. DBA Shiloh House 6588 West Ottawa Avenue Littleton, Colorado 80128 By: Date: fte�ehrati`ez Steven Ramirez, Chief Executive Officer Apr 8, 2021 o2t)/9r c375/ EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2022. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Day Treatment Services Rate Unit Type Service Name $2,125.00 Month Day Treatment Services Foster Care/Adoption Services Rate Unit Type Service Name $79.00 Hour Foster Parent Consultation — Coaching $120.00 Hour Foster Parent Consultation — In Home Therapy $95.00 Hour Foster Parent Consultation — Office Therapy $1,850.00 Episode Foster Parent Education — 11 -hour class $505.00 Episode Foster Parent Education — 3 -hour class $79.00 Hour Kinship Services — Coaching $120.00 Hour Kinship Services — In -Home Therapy $95.00 Hour Kinship Services — In -Office Therapy Home Based Services Rate Unit Type Service Name $79.00 Hour Aftercare In -Home Coaching $120.00 Hour Aftercare In -Home Therapy Life Skills Rate Unit Type Service Name $1,100.00 Month Beyond the Walls Program — Aftercare $79.00 Hour Life Skills Coaching, In -Home $79.00 Hour Supervised Visitation, In -Home Mental Health Services Rate Unit Type Service Name $120.00 Hour Mental Health Therapy, In -Home $95.00 Hour Mental Health Therapy, Office $173.00 Hour Psychological Testing $3,515.00 Episode Psychological Testing Sexual Abuse Treatment Rate Unit Type I Service Name $79.00 $131.00 Hour Hour 3. Submittal of Vouchers Problematic Sexual Conduct (PSC) Coaching, In -Home Sexual Abuse Therapy, In -Home Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7"' day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. New Contract Request Entity Information Entity Name* SHILOH HOUSE, INC Entity ID* X00035732 ❑ New Entity? Contract Name* Contract ID SHILOH HOME, INC. DBA SHILOH HOUSE (AGREEMENT 4691 AMENDMENT) Contract Status CTB REVIEW Contract Description* BID #B1904025 TERM: 6 1 (21-5,31:22 Contract Lead* APEGG Contract Lead Email apeggwreidgov.com;cobbx xlkg weidgov.com Contract Description 2 CONSENT. PA IS BEING ROUTED THROUGH THE NORMAL PROCESS. ETA TO CTB 4 22'21. Contract Type* AMENDMENT Amount* 50.0+ Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Ernail CM- HumanServices,T tveidgov.co m Department Head Email CM-HumanServices- De-tHead weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email C:M - COU NTY.ATTO RN E4'=PNELDG OV.C:OM Requested ROCC Agenda Date* 05:26;2021 Parent Contract ID 20193751 Requires Board Approval YES Department Project # Due Date 05.22 '2021 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 MISA enter MSA Contract ID Note. the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date* 04;01 '2022 Renewal Date Termination Notice Period Contact Information Contact Info Contact Name Purchasing Committed Delivery Date. Contact Type Contact Email Expiration Date* 05:31,2022 Contact Phone 1 Contact Phone 2 Purchasing Approver Purchasing Approved Date CONSENT 04; 19r 2021 Approval Process Department Head JAMIE ULRICH DH Approved Date 04:19,2021 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 04;'28 2021 Originator APEGG Finance Approver CONSENT Legal Counsel CONSENT Finance Approved Date Legal Counsel Approved Date 04.19 20.21 04;'19`2021 Tyler Ref # AG 042821 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: April 2, 2020 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Child Welfare 2020-21 Service Provider Agreement Amendments 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 Child Welfare 2020-21 Service Provider Agreement Amendments. The Department entered into agreements with various Child Welfare service providers through the 2019-20 Request for Proposal (RFP), identified as Tyler ID 2019-0707). These agreements were issued for a period of three years with the option to renew annually. The attached list reflects the providers, services and rates, including minor rate changes, the Department wishes to enter into for the period of June 1, 2020 through May 31, 2021. The Human Services Advisory Commission (HSAC) has reviewed and approved this information. Upon Board approval of this pass -around, signed agreement amendments will be obtained from providers and submitted to the Board for approval and Chair signature. I do not recommend a Work Session. I recommend approval of these Agreement Amendments. Mike Freeman, Chair Scott James Barbara Kirkmeyer Steve Moreno, Pro-Tem Kevin Ross Approve Recommendation Work Session Schedule Other/Comments: Pass -Around Memorandum; April 2, 2020 — Not in CMS Page 1 ,i6-01-0 6,-/5-020 37,;1 /4 -zoo O VENDOR RENEWALS Service Name Funding Rate Unit Type Vendor Program Area Life Skills Mentoring Low Level (4hrs/wk), Inside Catchment Core $ 1,015.00 Month Life Skills Mentoring Low Level (4hrs/wk), Outside Catchment Core $ 1,515.00 Month Life Skills Mentoring Moderate Inside Catchment Level (6.5hrs/wk), Core $ 1,650.00 Month Life Skills Mentoring Moderate Level (6.5hrs/wk), Outside Catchment Core $ 2,150.00 Month Supervised Visitation Core $ 75.00 Hour Therapeutic Visitation Core $ 120.00 Hour Transportation Core $ 40.00 Hour _Mental Health Services Aftercare Services -Inside Catchment Core $ 1,150.50 Month Aftercare Services -Outside Catchment Core $ 1,650.50 Month Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT)-Inside Catchment Core $ 1,082.00 Month Alternatives for Families: A Cognitive Therapy (AF-CBT)-Outside Catchment Behavioral Core $ 1,582.00 Month Trauma -Focused Cognitive Behavioral Therapy (TF- CBT)-Inside Catchment Core $ 1,082.00 Month Trauma CBT)-Outside -Focused Cognitive Catchment Behavioral Therapy (TF- Core $ 1,582.00 Month Multisystemic Therapy Multisystemic Therapy (MST) -Inside Catchment Core $ 1,794.00 Month Multisystemic Therapy (MST) -Outside Catchment Core $ 2,294.00 Month Sexual Abuse Treatment Informed Supervision -Inside Catchment Core $ 250.00 Hour Informed Supervision -Outside Catchment Core $ 500.00 Hour MST Problem Sexual Behavior -Inside Catchment Core $ 2,737.00 Month MST Problem Sexual Behavior -Outside Catchment Core $ 3,237.00 Month SAI Child Protection -Inside Catchment Core $ 1,933.00 Month SAI Child Protection -Outside Catchment Core $ 2,433.00 Month Sexual Abuse Intervention (SAI)-Inside Catchment Core $ 1,933.00 Month Sexual Abuse Intervention (SAI)-Outside Catchment Core $ 2,433.00 Month Substance Abuse Treatment Core $ 1,300.00 Month FFT Contingency Management -Inside Catchment FFT Contingency Management -Outside Catchment Core $ 1,800.00 Month MST Contingency Management -Inside Catchment Core $ 2,094.00 Month MST Contingency Management -Outside Catchment Core $ 2,594.00 Month Shiloh Home Day Treatment Services Day Treatment Services Core $ 2,025.00 Month Foster Care/Adoption Support Foster Parent Consultation - Coaching Core $ 75.00 Hour Foster Parent Consultation - In Home Therapy Core $ 115.00 Hour Foster Parent Consultation - In Office Therapy Core $ 90.00 Hour Foster Parent Education - 11 hour class Core $ 1,760.00 Episode Foster Parent Education - 3 hour class Core $ 480.00 Episode Kinship Services - Coaching Core $ 75.00 Hour Kinship Services - In Home Therapy Core $ 115.00 Hour Kinship Services - In Office Therapy Core $ 90.00 Hour WELD COUNTY DEPT. OF HUMAN SERVICES - CHILD WELFARE DIVISION 2020-21 SERVICE VENDORS (CORE/NON-CORE) BID NO.: B2000037 11 VENDOR RENEWALS Program Area Service Name Funding Rate Unit Type Vendor Home Based Services Aftercare In Home Coaching Core $ 75.00 Hour Aftercare In Home Therapy Core $ 115.0O Hour Beyond the Walls Program (Aftercare) Core $ 1,050.00 Month Life Skills Life Skills Coaching, In Home Core $ 75.00 Hour Supervised Visitation, In Home Core $ 75.00 Hour Mental Health Services Mental Health Therapy, In Home Core $ 115.00 Hour Mental Health Therapy, Office Core $ 90.00 Hour Psychological Testing (Episode) Core $ 3,350.00 Episode Psychological Testing (HR) Core $ 165.00 Hour Sexual Abuse Treatment Problematic Sexual Conduct (PSC) Coaching, In Home Core $ 75.00 Hour Sexual Abuse Treatment/Therapy Core $ 125.00 Hour Specialized Alternatives for Families and Youth Home Based Services Multigenerational Treatment Services -High Intensity - No Medicaid Core $ 2,520.00 Month Multigenerational Treatment Services -Low Intensity - No Medicaid Core $ 1,575.00 Month Multigenerational Treatment Services -Medicaid - Inside Catchment Core $ 40.72 Day Multigenerational Treatment Services -Medicaid - Outside Catchment Core $ 54.97 Day Mental Health Services Psychotherapy Core $ 92.00 Hour Staffing, FTM, TDM, etc. Core $ 92.00 Hour Trauma Informed Care/Services Foster Parent Consultation 2nd Clinician Core $ 88.80 Hour Foster Parent Consultation Case Collaboration Core $ 74.00 Hour Foster Parent Consultation Daily Rate Core $ 22.50 Day Foster Parent Consultation Family Support Management Assistance Core $ 74.00 Hour Foster Parent Consultation High Intensity - No Medicaid Core $ 2,400.00 Month Foster Parent Consultation Low Intensity - No Medicaid Core $ 1,500.00 Month Foster Parent Consultation Mileage Core $ 0.56 Month _ Staffing, FTM, TDM, etc. Core $ 74.00 Hour Strong Foundations Home Studies Additional Fee per Adult, Beyond Two Adults CW Block/Child Welfare Services $ 250.00 Each Cancellation Fee CW Block/Child Welfare Services $ 225.00 Episode Full Home Study CW Block/Child Welfare Services $ 950.00 Episode Interpretive Services for Family Home Study CW Block/Child Welfare Services $ 300.00 Episode Interpretive Services for Individual Home Study CW Block/Child Welfare Services $ 150.00 Episode Updated Home Study CW Block/Child Welfare Services $ 425.00 Episode The Daisy Center Child Mentoring and Family Support Coaching Core $ 65.00 Hour Coaching, Step-down Core $ 35.00 Hour The Jacob Center Life Skills Intake Cancellation Core $ 25.00 Hour Intake-Larimer County Core $ 25.00 Hour Intake -Outside Larimer County Core $ 115.00 Hour Staffing, FTM, TDM, etc. - Outside Larimer County Core $ 175.00 Hour Staffing, FTM, TDM, etc. - Phone or Larimer County Core $ 85.00 Hour WELD COUNTY DEPT- OF HUMAN SERVICES - CHILD WELFARE DIVISION 2020-21 SERVICE VENDORS (CORE/NON-CORE) BID NO.: B2000037 12 W.litrAw Je AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SHILOH/HOME, INC. This Agreement Amendment, made and entered into N day of, 2020 by and between the Board of Weld County Commissioners, on behalf of the Weld County Departme f Human Services, hereinafter referred to as the "Department", and Shiloh Home, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment Services and Foster Care/Adoption Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2019-3751, approved on August 19, 2019. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2020. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement: 1. Term This agreement is being renewed for a second full year term, for the period June 1, 2020 through May 31, 2021. 2. Exhibit D, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: Weld Cogr►ty Clerk to the Board, COUNTY: BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Deputy Clerk to the Board Mike Freeman, Chair CONTRACTOR: Shiloh Home, Inc 6588 West Ottawa Avenue Littleton, CO 80128 By: Steven Ramirez, CEO Date: 5/14/2020 JUN 15 2020 oZo /%- 03 / EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2021. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2 Fees for Services Day Treatment Services: $2,025.00/Month (Day Treatment Services) Foster Care/Adoption Services: $75.00/Hour (Foster Parent Consultation — Coaching) $115.00/Hour (Foster Parent Consultation — In -Home Therapy) $90.00/Hour (Foster Parent Consultation — In -Home Therapy) $1,760.00/Episode (Foster Parent Education — 11 hour class) $480.00/Episode (Foster Parent Education — 3 hour class) $75.00/Hour (Kinship Services — Coaching) $115.00/Hour (Kinship Services — In -Home Therapy) $90.00/Hour (Kinship Services — In -Office Therapy) Home Based Services: $75.00/Hour (Aftercare In -Home Coaching) $115.00/Hour (Aftercare In -Home Therapy) Life Skills: $1,050.00/Month (Beyond the Walls Program -Aftercare) $75.00/Hour (Life Skills Coaching, In -Home) $75.00/Hour (Supervised Visitation, In -Home) Mental Health Services: $115.00/Hour (Mental Health Therapy, In -Home) $90.00/Hour (Mental Health Therapy, Office) $165.00/Hour (Psychological Testing) $3,350.00/Episode (Psychological Testing) Sexual Abuse Treatment: $75.00/Hour (Problematic Sexual Conduct (PSC) Coaching, In -Home) $125.00/Hour (Sexual Abuse Therapy, In -Home) 3 Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the Th day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. New Contrac._ Request Entity lniormatton `lt.it' Name* HILOH HOUSE: INC Contract Name* H l L H HOME, INC. DBA S 1LOH H U E AMENDMENT) contra Status CTB REVIEW Entity * @00035732 Contract F REME l~ T 3573 Contract Lead* C -U LLI TA Contract Lead Email cull n aeco_wei _c . s New Erti Pareo, Contract ID rca57, : ..Z€,z e T P S.; Board Approval Departrnent Project # Contract Description-" / 4, 0 0002 5.1 CONSENT. BIER N0_• 4_� BOC 411512C CHILD PROTECTION AGREEMENT AMENDMENT. TERM: 06/01/20 THROUGH 05/31121_ FUNDING: CORE/OTHER.. Contract Description 2 Contract Type* AGREEMENT Amount - 0-00. Renewable :- f (Th. All tomat ic Renewal Grant A Department HUMAN SERVICES Department Email HumanSe ces-� time dgov_ Department Head Email CM-HumanServices- DeptHead@weidgov.com County y Attorney GE.NERAL COUNTY ATTORNEY EMAIL unty! Attorney Email CM- OUNTY:A i I ORNEYW EL GOV.COM f this is a. renewal enter previous Contract 1D r if this ic Dart of a MSA en Pr NASA Contract ILA Requested BOCC Agenda Date u41512020 [ate ate 04/1/2020 Will a wow session ► it.h A CC be required?* Does Contract require Purchasing Dept, to be included? Note: the Previous Contract Number and Master Services Agreement Number- should be left blank if those contracts are not in OnBase Contract Fates Effective Date ermination Notice Period Review Date 04/01/2021 Committed IX1ivery Date Renewal Date Expiration Date 05/31/2021 ContactInformation ,rorttatc. Info Contact Name •Porcha.sing Purchasing Approver Approval Process Department H JAMIE ULRI H DH Approved Date 06/0912020 Final Approval ROCC Approved ROCC Signed Date °CC Agenda Date Originator S NY f Y Legal Counsel Legal Counsel Approved Date 06/1012020 Contact Type Contact rimai i nano Approver B.ARB N LLY Contact Phone 1 Contact Phone 2 Purchasing Approved Date Finance Approved Dade 0611 012020 Tr Ref CONSENT CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SHILOH HOME, INC. DBA SILOH HOUSE i This Agreement, made and entered into the day of ; 2019, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of man Services, hereinafter referred to as the "Department' and Shiloh Home, Inc. dba Shiloh House, hereinafter referred to as the Contractor'. The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Response to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule. Exhibit B, C, and D are attached hereto and incorporated herein by this reference. Exhibit A is Weld County's Request for Proposal Number B1900025, which is incorporated into this agreement by reference and will be provided upon request to the Department. W ITN ESSETH WHEREAS, required approval, clearance, and coordination have been accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Core Services or other funding to the Department for Day Treatment Services, Foster Care/Adoption Services, Home Based Services, Life Skills, Mental Health Services, and Sexual Abuse Treatment. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2019, upon proper execution of this Agreement and shall expire May 31, 2020, unless sooner terminated as provided herein. The agreement is for a period of three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit B, Contractor's Response to Request for Proposal and Exhibit C, Scope of Services. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e- mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Quality Assurance Team Supervisor (hainlejd@weldgov.com, 970-400-6210). No other Department staff or other party to the case may authorize services or modifications to services. 1 cc -% pneyis.e H5D O€rt t ci l 19 2019-3751 /--feoO 90 c. Contractor agrees to submit a complete Request for Reimbursement and supporting documentation by the 7th of the month, following the month of service, utilizing billing forms required by the Department. Contractor agrees to utilize the Client Verification Form for all scheduled and unscheduled face-to-face services with the exception of home studies and monitored sobriety testing. Contractor agrees that original complete Client Verification Forms are to be submitted with the Request for Reimbursement. Requests for Reimbursement and Client Verification Forms received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet 60 -day deadline may result in termination of the Agreement. d. Contractor agrees to submit a monthly report by the 7th of the month, following the month of service, for each client receiving ongoing services. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Date and time of service b. Where the service took place c. Clinician/therapist name d. Clients participating e. What interventions were used, recommendations and/or goals discussed f. Any and all safety concerns One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation, home study). Verification of Monitored Sobriety Services will be the test result. A completed home study may be a full, partial or denied study, as determined by the Department. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: i. The service being provided by the contractor is not a Medicaid eligible service; ii. The service is not deemed medically necessary; iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; iv. A Medicaid provider is not available to provide the needed service; v. Medicaid is exhausted for the needed service; or vi. Medicaid denied service. vii. The client is not eligible for Medicaid. b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Response to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule, attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent upon, the continuing availability of said funds for the purposes hereof. 2 d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule: a. If services are funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit an, which will be provided by the Department, with a voided check. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement, Contractor will strictly adhere to all applicable Federal and State laws, order, and applicable standards, regulations, interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations, including, but not limited to the following: - Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and - the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and 3 - Title VII of the Civil Rights Act of 1964; and - the Age Discrimination in Employment Act of 1967; and - the Equal Pay Act of 1963; and - the Education Amendments of 1972; and - Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race, color, national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973, as amended, cited above. If necessary, Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken to assure that small and minority businesses are utilized, when possible, as sources of supplies, equipment, construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks for all employees, contractors and sub -contractors. b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services, Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is determined by the Department. d. Contractor assures and certifies that it and its principals: - Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not, within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. 4 e. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor and the Department within three (3) days that Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to the Department, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., the Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. f. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24- 76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5- 103 prior to the effective date of the contract. 8. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 5 9. Insurance Requirements Contractor and the Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide the liability insurances (including professional liability insurances where necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal, and required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement. At a minimum, Contractor shall procure, either personally or through its employer as applicable to the Contractor's business, at its own expense, and maintain for the duration of the work, the following insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements: Contractors must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, the Department must be notified by the Contractor. Contractor shall be responsible for the payment of any deductible or self -insured retention. The Department reserves the right to require Contractor to provide a bond, at no cost to the Department, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: i.Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 0110/93 6 or equivalent, covering premises operations, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: - $1,000,000 each occurrence; $2,000,000 general aggregate; $50,000 any one fire; and - $500,000 errors and omissions. iii.Automobile Liability: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: If any aggregate limit is reduced by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify the Department within ten (10) days and reinstate the aggregates required; Unlimited defense costs in excess of policy limits; Contractual liability covering the indemnification provisions of this Agreement; A severability of interests provision; Waiver of exclusion for lawsuits by one insured against another; A provision that coverage is primary; and A provision that coverage is non-contributory with other coverage or self-insurance provided by the Department. v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to the Department, whichever is earlier. c. Contractors shall secure and deliver to County's Risk Administrator ("Administrator") at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor shall provide a copy of this information to its insurance agent or broker and shall have its agent or broker provide proof of Contractor's required insurance. The Department reserves the right to require Contractor to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor's insurer shall name County as an additional insured as follows f. Waiver of Subrogation: For all coverages, Contractor's insurer shall waive subrogation rights against County. B. Subcontractors: All subcontractors, independent contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor. Contractor shall include all such subcontractors, independent contractors, sub -vendors, suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors, suppliers or other entities upon request by the Department. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contractor shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 10. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at 970-400-6503 and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any 8 program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables, which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker, Child Welfare Division Head Austin Topolnicki, Chief Operating Officer 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s) or address to whom such notices shall be sent. For Department: Judy A. Griego, Director P.O. Box A Greeley, CO 80632 (970)400-6510 9 For Contractor: Austin Topolnicki, Chief Operating Officer 6588 West Ottawa Avenue Littleton, CO 80128 (303)932-9599 18. Litigation Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department, or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third -Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act of §§24-10-101 et. seq., as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall 10 not enter into any third -party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. A conflict of interest or appearance of a conflict of interest may also apply to personal relationships between providers and clients. If a provider has a personal relationship with a client to whom the Contractor may provide services for, the Contractor must disclose that relationship to the Department. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during business hours, have access to inspect and copy records, and shall be allowed to monitor and review through on -site visits, all activities related to this Agreement, supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records, documents, communications, and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request, for a period of seven (7) years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven (7) year period, or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of, all such information, in any form, including social networks. Contractor shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 11 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contractor agrees that it is an independent Contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contractor shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit A provide proof thereof when requested to do so by County. 28. Entire Agreement This Agreement, together with all attachments hereto, constitutes the entire understanding between the parties with respect to the subject matter hereof, and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work, nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A, B, C, and D. 12 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to the Department originals of all tests and results, reports, etc., generated during completion of this work. Acceptance by the Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement, the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contractor acknowledges that the Department has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this project without the Department's prior written consent, which may be withheld in the Department's sole discretion. 13 36. Attorney's Fees/Legal Costs In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of the Department. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the Department. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of the Department. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 14 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: datif.„,) f -f ict4 Ci BOARD OF COUNTY COMMISSIONERS Weld County Clerk to the Board _;- a ', (fA /J�; WELD COUNTY, COLORADO By: Depu y Clerk to the Board 15 rbara Kirkmeyer, Ch. r CONTRACTOR: Shiloh Home, Inc. dba Shiloh House 6588 West Ottawa Avenue Littleton, CO 80128 (303)932-9599 Date: Steven Ramirez, Chief Executive,Officer - l O { 0&/ 0 7o-1 EXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page intentionally left blank. EXHIBIT B CONTRACTOR'S RESPONSE TO REQUEST FOR PROPOSAL I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 January 28, 2019 Weld County, CO Shiloh House 6588 W. Ottawa Ave Littleton, CO 80128 Steven and Vicki Ramirez founded Shiloh Home, Inc. (d.b.a. Shiloh House), in January 1985. Today Shiloh House treats both boys and girls and operates 13 separate facilities, including five Colorado Department of Education approved schools. Shiloh Home is a preferred provider of services for the counties of Adams, Arapahoe, Denver, Douglas, Jefferson, and Weld. Shiloh House primarily serves Colorado youth and families, by providing office -based, in -home, and residential treatment services that include life skills services; sexual abuse treatment; family and individual therapy; mental health services; educational programming; and day treatment services. Truama Informed Care is a cornerstone of every service provided by Shiloh House. We strongly believe in building a circle of support around each youth in our care while working closely with families and social services personnel. Our approach is based on over 30 years of experience creating an environment where wounds begin to heal, relationships are built or restored, and new possibilities are created. Mission Statement: Shiloh House offers nurturing, therapeutic and educational services to empower youth and families to overcome the impact of abuse, neglect and trauma. Through guidance, clinical intervention and advocacy, Shiloh House meets the needs of the community while respecting the diversity of youth and families. Shiloh House offers employment to skilled, educated men and women from diverse professional backgrounds. Each department serves a unique and important purpose, yet departments are interdependent. No one role is more valuable than another and every employee is expected to maintain focus on the agency wide goal of providing the highest standard of service for clients; responding to requests for services quickly and efficiently. All licensed employees of Shiloh Home, Inc. are registered under the Department of Regulatory Affairs (DORA). Qualifications for employees providing services outlined in this bid are listed with the service description. Administrators at Shiloh House specialize in their fields of practice including residential services, human resource management, clinical, educational and financial services. Each position has specific educational and experiential requirements depending on the particular department or service. Shiloh House Administrators also serve as liaisons to the community and to other professionals in the field. The scope of services provided for the current Weld County bid, number B1900025 will include After Care, Day Treatment, Sex Abuse Treatment, Foster Parent Consultation, Foster Parent Education, Kinship Services, Home Based Intensive Services, Life Skills, Mental Health Services, Beyond the Walls, Group Counseling, and Psychological Testing. At this time, all services are provided in English only. 1 EXHIBIT B PROVIDER INFORMATION FORM Weld County Department of Human Services Shiloh Home, Inc. (DBA Shiloh House) 1539982 AGENCY OR PRNATE PRACTICE TRAILS PROVIDER ID RI Known) Austin Topolnicki Chief Operating Officer PRIMARY CONTACT -FULL NAME 303 ) 932-9599 328 PHONE NUMBER atopoiruckie hiiohh©use_net _ PRIMARY CONTACT -EMAIL ADDRESS 6588 W. Ottawa Avenue AGENCY MM WIG ADDRESS PNMART CONTACT • TITLE L303_1973-1269 EXT. FAR NUMBER nfoLshilohhouse.ori AGENCY/PRACTICE WEB ADDRESS RE APPUCABEE) Littleton tm 80128 IIP REFERRAL CONTACT Daniel Venman REFFERAL CONTACT- FULL NAME 1303 32-9599 604 _ REFERRAL CONTACT -PHONE NUMBER EXT. Clinical Director of Offense Specific Services REFERRAL CONTACT• TTLE civenn-a! y Si ' iii Utie net REFERRAL CONTACT -E-MAIL ADDRESS BILLING CONTACT Andy Tucker Chief Financial Officer BRLNG CONTACT -FULL NAME 303-1932-9599 SUMS 03NTACT-PHONE NUMBER NUING CONTACT. TITLE 144 atucker@shilohhouse.net DtT. SLUNG CONTACT -E•MAN ADDRESS T certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it has so indicated in this bid form. 1 further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded. The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are cpetiti+e.iePrice and quality. Signature of Authorized Representative: Date of Signature: \ C 1 Bid No.: B 1900025 Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Aftercare Shiloh House will provide individual and family therapy and support services to allow for the reunification of the child with his or her family where feasible. These services will promote the successful transition of children to their home (or another permanent placement) from a higher level of care and are aimed at preventing out of home placements. Aftercare services are especially appropriate when the child is transitioning from a Shiloh House residential program to home or another permanent placement, as Shiloh House providers can communicate with each other and work together to facilitate a seamless transition. The anticipated length of services is 3 to 6 months but is flexible and depends on the specific needs of the child and his or her family. Target Population of Aftercare Services: The target population of Aftercare Services is children and adolescents in the process of reunifying with their families or transitioning to another permanent placement. The target population often includes children, adolescents, and families who are struggling with issues related to mental health, trauma, and difficult family dynamics that compromise individual and family functioning and lead to placement disruptions. Assessments Utilized for Aftercare Services: Shiloh House will implement assessments to determine the focus of Aftercare Services. A mental health assessment will be used to evaluate therapeutic needs for the individual and family and assist in creating an effective treatment plan. Other assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.) to further establish treatment objectives and to measure outcomes. Goals of Aftercare Services Areas targeted by Shiloh House Aftercare services may include: • Treating emotional and behavioral symptoms associated with trauma and mental health disorders • Educating families about trauma and mental health issues • Helping children, adolescents, and their families develop healthy coping tools • Equipping caretakers with knowledge and methods to provide trauma -informed parenting • Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences • Providing intensive psycho -education that increases each family member's understanding of their own unhealthy interaction patterns and how to change them • Reducing conflict between family members by teaching them positive communication skills that foster empathy between them • Facilitating communication between family members about emotional, behavioral, and relational issues • Assisting caretakers in creating a nurturing and healthy home environment which will enable the children to successfully progress in their development and academic achievement 1 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 • Practical implementation of parenting skills learned in therapy (e.g., creating chore charts, homework charts) • Practical implementation of life skills Interventions Used to Accomplish Goals of Aftercare Services: Shiloh Home, Inc. utilizes interventions that are trauma informed, evidence -based, and focus on the strengths of the child and family. These may include: Behavior Therapy principles/interventions (including communication skills training), Motivational Interviewing, Parenting Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and DBT techniques. Outcomes of Aftercare Services: Shiloh House will measure outcomes through observation and/or structured assessment. Indicators of success include improved individual and family functioning, alleviation or reduction of mental health symptoms, and completion of treatment goals. Providers of Aftercare Services: Aftercare therapy services are provided by a Shiloh House Master's level clinician; licensed, provisionally licensed, or under the supervision of a licensed supervisor. Other Aftercare support services such as life skills and parent coaching may be recommended. These will be provided by a Shiloh House Family Support Professional who is a bachelor's level employee. Shiloh House providers collaborate with each other and with outside providers to help families navigate systems of care and to ensure that they are offered comprehensive support for their needs. This includes the participation of Shiloh House providers in multi -disciplinary family team meetings. Aftercare Services List Shiloh House offers the following Aftercare Services: • Office -Based Family Therapy • Community -Based Family Therapy • In -Home Family Therapy • Office -Based Individual Therapy • Community -Based Individual Therapy • In -Home Individual Therapy • Community -Based Family Support Services (i.e., Life Skills and/or Parent Coaching) • In -Home Family Support Services 2 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) After Care Services 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Individual and family therapy, assessment tools include mental health assessment, trauma symptom checklists, and family relationship questionnaire. 4. Capacity to Provide Services (ex. 4 hours/week). Individual and Family therapy occur one hour per week unless otherwise clinically indicated. Up to 12 hours per week of Coaching services can be available, depending on the needs of the family. Shiloh House has the capacity to provide up to 25 hours per week of therapy. Services are typically provided from 3 to 6 months. 5. Goals of the service. Support placement stability in the home by continuing services for mental health, providing education about trauma and mental health issues, assisting the family in development of healthy coping tools, providing trauma -informed parenting skills, reducing conflict through intensive psycho -education and increased communication skills, life -skills, and assisting in the creating of a nurturing, healthy home environment. 6. Outcomes of service. Indicators of suocess include improved individual and family functioning, alleviation or reduction of mental health symptoms, and completion of treatment goals. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Youth, ages 7-18 who have transitioned home, or into kinship or foster care from a higher level of care. 8. Service access. Note: Bidder must indicate capacity for video conferencing, phone conferencing and in person. If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. In -home services can be provided to families within Weld County. In -office services are available 2700 E. Ken Pratt Blvd Longmont, CO 80504 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE month, episode). Approximate rates or a range of rates for a service will not be accepted. In -home therapy: $115.00/hour In -home coaching: $75.00/hour Bid No.: 1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the MiliblslaTcl4ervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: BIDDER LEGAL ENTITY NAME: Aftercare Services Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR SUPERVISOR INFORMATION INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA #��.; (If applicable) Last Name First Name Work ft a. Work Ernail�y�.` 1 Venman Daniel 303-772-1802 x 6C dvanman@shiloh Masters Fischer 303-772-1802 pfischer@shilohh O'Hayre Bridget 303-932-9599 bohayre@shilohh 6 7 8 9 10 11 Moseley 303-932-9599 Nathlich Aguilar Amy Laura Donnie 303-932-9599 tmosley@shilohh anathlich@shilohf 303-932-9599 laguilar@shilohho 303-932-9599 dhill@shilohhous 13 14 16 17 18 19 20 22 23 24 25 26 27 Masters BA BA BBS BA JD, BS, BA Clinical Counsel LPC Forensic Psychc Psychology Sociology LPC N/A Psychology N/A English Educatid N/A Justice Studies, N/A LPC.0011841 Miller Beth LPC.0013350 Venman Daniel Larcom O'Hayre O'Hayre ,'O'Hayre O'Hayre Melissa Bridget Bridget Bridget Bridget 303-932-9599 x 3; 303-772-1802 x 61 bmiller@shilohhot dvenman@shilohr 303-932-9599 303-932-9500 303-932-9599 303-932-9599 303-932-9599 mlarcom@shilohh bohayre@shilohho bohayre@shilohh( bohayre@shilohho bohayre@shilohh( 81800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the iftWiAgd3ervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) Jse.net muse.net ouse.net >use.net >use.net >use.net >use.net B1800058 Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Day Treatment Services: Shiloh House Day Treatment services are available to youth between 7 to 18 years of age who are proficient in speaking English; and who present with behavioral disorders, mental health issues, and problematic sexual behaviors. The program is specifically designed for those youth who demonstrate a pattern of maladaptive behaviors that interfere with their adaptive community functioning and who are not at greater risk for out - of -home removal. The program focuses on skills development where the youth recognizes his or her maladaptive behaviors and associated thinking errors and where the use of a greater repertoire of positive social skills and adaptive coping skills is supported. Significant considerations for admission include but are not limited to: level of risk to family, victim and community, typology of juvenile, level of denial, intellectual functioning, secondary diagnostic features and substance abuse issues. Clients with the following issues are generally considered not appropriate for the program: • Severely limited cognitive abilities (IQ below 65) • Ongoing medical issues that cannot be supervised/managed by staff • The inability or significantly impaired ability to understand and/or communicate in English. • Is actively psychotic Delivery Methods: Shiloh Academy offers educational services at five on -site locations. Components of the program include: • Educational, psychological and clinical assessment services • Offense specific treatment services • Individual, family, group and milieu therapies (offered on a weekly basis) • Case management • Academic curriculum -credits transferable to public school • Special education services • Transportation to/from school (within 15 -mile radius) • In -home service/per case need • Community activities • 24/hour on -call assistance • Monthly progress reports • On -going assessment of family Transitional services/staffing to public school Engagement Techniques: The referred student practices new cognitive and behavioral skills with peers and teachers in the Shiloh Academy program, in group therapy, with their family at home, and in the community at large. Progression though the program is assisted by a feedback system in which the student's behavior and quality of work on phase projects at Shiloh Academy and at home is tied to student's program privileges. Forward movement through the program also involves successful completion of written and behavioral assignments and the development of a relapse prevention plan. The focus of treatment sessions is both cognitive (teaching new, healthy, empathic and reality -based way of thinking) and behavioral (teaching and rehearsing healthy ways to behave when overwhelmed by feeling and perceived needs). Staff Credentials: Clinicians are master's level licensed, provisionally licensed, or under the supervision of a licensed supervisor. Education staff - Minimum BA level under the supervision of CDE approved supervisor. There are currently 20 teaching staff and 15 paraprofessional staff. 1 Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Outcome Goals: • Credit recovery • Improved school emotional and behavioral functioning • Return to home school prepared for academic and interpersonal success • Maintain positive home and community relationships Fee Schedule: All services are billed monthly Category Day Treatment Service Rate Unit Group $1,675.00 Monthly This rate does not include therapeutic services. Therapeutic services are billed directly to Medicaid. 2 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Day Treatment Services 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Therapeutic modalities include TF-CBT, DBT techniques, and sexual abuse treatment. Special Education services are offered, and the academic curriculum is transferrable to public schools. 4. Capacity to Provide Services (ex. 4 hours/week). Day Treatment services are provided until transition back to a public school setting is appropriate. Shiloh Academy has the capacity to serve 4 Day Treatment students at any given time. 5. Goals of the service. Address academic needs to help the student achieve academic success, provide mental health services to support emotional and behavioral stability, and teach the student coping strategies and social skills that will improve the ability to communicate needs and interact with peers and adults in ways that promote healthy relationships so that long term stability can be achieved. 6. Outcomes of service. Credit recovery, improved school emotional and behavioral functioning, maintain positive home and community relationships, and return to home school prepared for academic and interpersonal success. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Shiloh House Day Treatment services are available to male youth between 7 to 18 years of age who are proficient in speaking English; and who present with behavioral disorders, mental health issues, and problematic sexual behaviors. Exclusions include youth with severely limited cognitive abilities (IQ below 65), ongoing medical issues that cannot be managed/supervised by staff, active psychosis, and inability or significantly impaired ability to understand and/or communicate in English. 8. Service access. Note: Bidder must indicate capacity for video conferencing, phone conferencing and in person. If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. Day Treatment services are provided on -site. 2700 E. Ken Pratt Blvd Longmont, CO 80504 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, Bid No.: 1900025 EXHIBIT C PROPOSAL TEMPLATE month, episode). Approximate rates or a range of rates for a service will not be accepted. $1675/Month. This fee does not include therapy. Therapy services are billed directly to Medicaid. Bid No.: 1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the paititligcl4ervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: Day Treatment BIDDER LEGAL ENTITY NAME: Shiloh Home, Inc. (DBA Shiloh House APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name Work # Work Email enman ante -iiz-18UL x 6(dvanman@shilohl Masters Clinical Counsel LPC LPC.0011841 Miller Beth 303-932-9599 x 3: bmiller@shilohhoc 2 3 4 5 6 7 Fischer Green Gernant Feller Taylor Odiorne Page Lawrence Kerry Ashleigh Jessica Shane 303-772-1802 303-932-9599 303-772-1802 303-772-1802 303-932-9599 303-772-1802 pfischer@shilohhc Igreen@shilohhou kgernant@shiloit afeller@shilohhoi. Itaylor@shilohhou sodiorne@shilohh Masters Masters BA BA Masters BA Forensic Psychc Special Education - Severe Affective Needs Special Education Generalist Applied Human Sciences in Social Work Curriculum and Instruction LPC LPC.0013350 Psychology Psychology Venman Tracy Feller Taylor Tracy Feller Daniel Kevin Ashleigh Jessica Kevin Ashleigh Ashleigh 303-772-1802 x 6( 303-932-9599 303-772-1802 303-932-9599 303-932-9599 303-772-1802 dvenman@shilohP ktracv@shilohhou. afeller@shilohhou jtaylor@shilohhou ktracv@shilohhou. afeller@shilohhou 8 Campbell -Martin Maggie 303-772-1802 mcampbellmartin BA Feller 303-772-1802 afeller@shilohhou 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the FirlilialVdiervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) ase.net iouse.net se.net se.net se.net se.net se.net se.net 61800058 IShiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Foster Parent Consultation 1. Shiloh will provide psycho -education for foster parents regarding the impact of trauma and abuse and neglect. This training will include 8 hours of instruction and practise. The instruction will include the following curriculum topics: a. It's all about the brain, not the behaviors! b. The teenage brain is unique...the teenage traumatized brain can be healed c. Understanding the impact of trauma "its not defiance, it's learned survival" d. Effective consequences for teenagers impacted by abuse and neglect e. Skills rather than punishment or consequences! f. Developmental age vs chronological age and reasonable expectations g. Resiliency — how to identify the strengths that already exist, and how to build resiliency in every child - foster parents are the key!! 2. Shiloh will provide support services to assist the foster family with child specific consultation. 3. Shiloh will provide families with assistance with household family functioning through on - site family support from the Shiloh House Family Support Professionals. 4. Shiloh will provide phone consultation in crisis situations. 5. Shiloh will provide a supportive and non -judgmental relationship for the foster child and foster parents. 6. Shiloh will assist families with skill development to ensure that families can establish appropriate relationship development, structure, boundaries and limits, with the goal of proactivly preventing family conflict, and/or to decrease conflict that may already exist. 7. Shiloh will provide tools to improve family functioning, including behavior management, conflict management, communication, and problem solving tools. 8. Shiloh will support the development of foster parent/child relationships. 9. The goal of Shiloh Home's home based Foster Parent Consultation services is to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, providing information for community resources, and providing effective parenting training. Outcome Foster Parent Consultation goals are to: 1. Increase the level of family functioning 2. Eliminate placement disruption 3. Increase formal and informal supports such as community, family, and friends 4. Increase foster parents understanding of the impact of trauma 5. Help foster parents to have realistic child expectations 6. Improve foster parenting, relationship, and social skills 1 IShiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 7. Provide rapid crisis consultation and support for foster parents experienceing challenges with their foster child. 8. Role modeling positive interaction with children - The Home Based family support professional will use a wide variaty of interaction and education based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. 9. Increase foster parent confidence -As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. 10. Teach value of daily routine and consistency with children -Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age appropriate chore charts to help parents with consistency. 11. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Shiloh Home services are provided from a family engagement, strength based, trauma informed basis. 12. Return children in placement to their own home: Shiloh Home's home based and foster parent consultation services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. 13. Unite children with their permanent families: Shiloh Home home based services strive to ensure the permanency of children with their families. 14. Provide services that protect the child: Shiloh Home in -home services ensure that children are protected and that the well-being of every child is our first priority. Shiloh Home has over 30 years experience working with traumatized children and families in Colorado. Shiloh Home works to collaborate with the families in meeting all cultural needs. Language translation needs are provided through our staff when possible or translation services. Shiloh Home will collaborate with all members of the team, and will remain flexible in it's service delivery in order to meet the presenting needs and reinforce the foster families strengths. 2 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Foster Parent Consultation 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Psycho -education Capacity to Provide Services (ex. 4 hours/week). Masters level observation and consultation is weekly is 2 hours per week - anticipated duration 6 weeks. Masters level therapy services as clinically indicated - anticipated duration 4 months Coaching (if therapeutically indicated) is 2-4 hours per week - anticipated duration 6 months Shiloh House has the capacity to provide up to 60 hours of coaching per week. 4. Goals of the service. Increased placement stability, diversion from a higher level of out of home placement, increased foster parent understanding of the impact of trauma, and the risks associated with further institutional systems involvement. 5. Outcomes of service. Prevent placement disruption, increase family functioning, increase formal and information supports (i.e. community resources, family, and friends). 6. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Foster parents of male and female youth between birth -18 years of age who are at risk for institutional systems involvement. 7. Service access. Note: If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. Services can be provided in -office, or in -home for families who are involved with the Weld County Department of Human Services. 2700 E. Ken Pratt Blvd Longmont, CO 80504 8. Languages service is available in. Note: Bidder should note the language and level of proficiency. English 9. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (Le., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. Bid No.: B1900025 EXHIBIT C PROPOSAL TEMPLATE In -home Therapy: $115.00/hour In -office Therapy: $90.00/hour Coaching: $75.00/hour Bid No.: B1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the Ifiitidi Tdilervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: Foster Parent Consultation BIDDER LEGAL ENTITY NAME: Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name Work # Work Email 1 Venman Daniel 303-772-1802 x 6( dvanman@shilohi Masters Clinical Counsel LPC LPC.0011841 Miller Beth 303-932-9599 x 3: bmiller@shilohhoi 2 Fischer Page 303-772-1802 pfischer@shilohhc Masters Forensic Psychc LPC LPC.0013350 Venman Daniel 303-772-1802 x 6( dvenman@shilohl- 4 O'Hayre Bridget 303-932-9599 bohayre@shilohh( BA Psychology N/A N/A Larcom Melissa 303-932-9599 mlarcom@shilohh 5 Moseley Taejah 303-932-9599 tmosley@shilohhc BA Sociology N/A N/A O'Hayre Bridget 303-932-9500 bohayre@shilohhc 6 Nathlich Amy 303-932-9599 anathlich@shilohh BBS Psychology N/A N/A O'Hayre Bridget 303-932-9599 bohayre@shilohhc 7 Aguilar Laura 303-932-9599 laguilar@shilohho BA English Educatic N/A N/A O'Hayre Bridget 303-932-9599 bohayre@shilohhc 8 Hill Donnie 303-932-9599 dhill@shilohhousEJD, BS, BA Justice Studies, N/A N/A O'Hayre Bridget 303-932-9599 bohayre@shilohhc 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the iftlitlaWd3ervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) ase.net muse.net ouse.net )use.net )use.net )use.net )use.net B1800058 Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Shiloh House will offer Foster Parent Training focused on two primary areas: Psycho -education regarding the impact of trauma, abuse, and neglect; and SOMB focused training regarding the truth about sexually abusive and sexually reactive youth. Foster Parent Training: Psycho -education 1. Shiloh will provide psycho -education for foster parents regarding the impact of trauma, abuse and neglect, transitions impact to foster children, navigation of the mental health system,biological family reunification and developmental expectations. This training will include 11 hours of instruction and practise. The instruction will include the following curriculum topics: a. It's all about the brain, not the behaviors! b. The teenage brain is unique...the teenage traumatized brain can be healed c. Understanding the impact of trauma "its not defiance, it's learned survival" d. Effective consequences for teenagers impacted by abuse and neglect e. Skills rather than punishment or consequences! f. Developmental age vs chronological age and reasonable expectations g. Resiliency — how to identify the strengths that already exist, and how to build resiliency in every child - foster parents are the key!! h. Transitions Impact on Foster Children — includes a review of the grief and loss that occurs in transitions, viewing and discussion of dramatic videos that protray the impact, and teaching foster parents how to support foster children in transitions. i. Navigation of the Mental Health system — our instructuors will provide a step by step guide of navigating the mental health system, including accessing services, counseling and psychiatic services, initial assessments and first contacts, making appointments, how to support the child befor and after mental health appointments and/or hospitalizations, communication with the therapist, and problem solving real life road blocks. j. Family Reunification — our instructors will provide a thorough review of childlren's complex feelings toward their families and the best strategies for support the child in all steps of the family reunification process. Real life examples of reunification challenges related to past trauma,and abuse and neglec experiences, as well as positive family experiences, memories, and the ambivolence that children experience. The foster parents will be provided the opportunity to explore their own feelings about family reunification. The goal of Shiloh Home's home -based Foster Parent Training services is to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, providing information for community resources, and providing effective parenting training. Outcome Foster Parent Training goals are to: 1. Provide foster children with the best possible family environment that responds in a developmentally and trauma informed manner 2. Provide foster children with stable and successful life experiences 3. Increase the level of foster family functioning 4. Increase foster parent competency and confidence 1 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 5. Signficantly reduce placement disruption 6. Increase formal and informal supports such as community, family, and friends 7. Increase foster parents understanding of the impact of trauma 8. Help foster parents to have realistic child expectations 9. Improve foster parenting, relationship, and social skills 10. Role modeling positive interaction with children - The Home Based family support professional will use a wide variaty of interaction and education based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. 11. Increase foster parent confidence -As the foster parent begins to gain new skills and control in the home, confidence is naturally increased. 12. Teach the value of develoopmentally apprpriate daily routine and consistency with children - Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age appropriate chore charts to help parents with consistency. 13. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Shiloh Home services are provided from a family engagement, strength based, trauma informed basis. 14. Return children in placement to their own home: Shiloh Home's home based and foster parent training services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. 15. Unite children with their permanent families: Shiloh Home home based services strive to ensure the permanency of children with their families. 16. Provide services that protect the child: Shiloh Home in -home services ensure that children are protected and that the well-being of every child is our first priority. 2 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Foster Parent Training: The Truth about Sexually Abusive and Sexually Reactive Youth Counties throughout the State of Colorado face challenges in recruiting and retaining foster families for youth who have committed a sexual offense, or who have engaged in unsafe sexualized behaviors due to sexual reactivity resulting from trauma. These youth are often labeled, misunderstood, and stigmatized. Like all children, juveniles who have committed a sexual offense need care, guidance, and unconditional positive regard from adults in the least restrictive environment where safety can be maintained. Shiloh House would be pleased to work with Weld County Department of Human Services to provide foster parents and individuals seeking foster parent certification with 1.5 hours of training entitled "The Truth about Sexually Abusive and Sexually Reactive Youth". Training Objectives: 1. Provide information about normative, concerning, and problematic sexual behavior. 2. Dispel the "myths" that many people often believe in regards to sexually abusive and sexually reactive youth. 3. Provide accurate information about what is actually required when providing care for sexually abusive and/or sexually reactive youth. Providing education about juvenile sexual abuse and sexual reactivity can increase care provider efficacy, promote retention of foster care providers, and increase the potential for juveniles to experience success in their treatment plans by contributing to stability of the foster placement and minimizing the risk for placement in a higher level of care. Outcome Goals: 1. Community Safety 2. Preserve foster placement to minimize disruption for children and families. 3. Increase willingness and ability of foster parents to care for sexually abusive or sexually reactive youth. 4. Divert entry into residential placement, or support step-down from residential placement into foster care. Credentials: Licensed, master's level Clinicians, with associate or fully operating approval from the SOMB. Shiloh Home has over 30 years experience working with traumatized children and families in Colorado. Shiloh Home works to collaborate with the families in meeting all cultural needs. Language translation needs are provided through our staff when possible or translation services. Shiloh Home will collaborate with all members of the team, and will remain flexible in it's service delivery in order to meet the presenting needs and reinforce the foster families strengths. 3 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Foster Parent Education 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Psycho -education, SOMB education 4. Capacity to Provide Services (ex. 4 hours/week). Shiloh House has the capacity to provide up to 20 hours of Foster Parent Education per month. 3 hour training is a one-time event. 11 hour training is scheduled over two days. 5. Goals of the service. Psycho -education can improve resiliency; increase placement stability; support the reunification process; and provide a step by step guide of navigating the mental health system, including accessing services. SOMB education provides information about normative, concerning, and problematic sexual behavior; dispel "myths" that many people believe in regards to sexually abusive and sexually reactive youth; and provide accurate information about what is actually required when providing care for sexually abusive and/or sexually reactive youth. 6. Outcomes of service. Promote community safety; preserve foster placement to minimize disruption to children and families; support the parent/child reunification goal; and divert entry into residential placement, or support successful step-down from residential into foster care. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Foster parents of male and female youth between birth and18 years of age who are placed in foster care in Weld County. 8. Service access. Note: If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. This is an office -based service 2700 E. Ken Pratt Blvd Longmont, CO 80504 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English Bid No.: B1900025 EXHIBIT C PROPOSAL TEMPLATE 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. $1760.00/11 hour class $480.00/3 hour class Bid No.: B1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the preifigdriervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: Foster Parent Training BIDDER LEGAL ENTITY NAME: Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name Work # Work Email 1 Venman Daniel 303-772-1802 x 6( dvanman@shilohl Masters Clinical Counsel LPC LPC.0011841 Miller Beth 303-932-9599 x 3: bmiller@shilohhoi 2 Fischer Page 303-772-1802 pfischer@shilohhc Masters Forensic Psychc LPC LPC.0013350 Venman Daniel 303-772-1802 x 6( dvenman@shilohl 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the pratiiiigdgervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) ase.net iouse.net B1800058 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Home Based Interventions Shiloh House Community Based Treatment Serving Youth with Problematic Sexual Conduct Shiloh House will provide home and community -based services for youth ages 8-18 and their families who are struggling with a wide variety of Problematic Sexual Conduct. This home -based program is designed for family and youth verbalizing a strong commitment to actively participate in a combination of home -based offense specific therapy and coaching services. These families may not fully grasp the seriousness of the sexual offending or the contributing family dynamics, but the family and the youth have demonstrated a willingness to engage in the treatment process. This program can help youth and families address issues including sexual reactivity due to abuse and trauma; unhealthy behaviors including inappropriate touching, bullying, gesturing, and threatening verbalizations; youth who have engaged in family -based incest; and youth who have engaged in community based sexual assault. Participating youth may be adjudicated, or non -adjudicated. Delivery Methods: This Community Based Treatment for Problematic Sexual Conduct includes 2-3 hours per week of in -home SOMB Masters level treatment and a minimum of 4 hours per week of BA level in - home training, coaching and accountability targeting safe and healthy sexual behavior life skills. Coaches and therapists build on strengths that exist within the family and help family members address safety concerns in a realistic, non -judgmental way. Goals related to service delivery are: • To successfully integrate SOMB guided home based offender treatment with evidence -based treatment principals including Trauma Focused CBT and High Fidelity Wrap Around • To support the following High -Fidelity Wrap Around principals: o To be strength based and to value all members of the team focusing on family and youth needs rather than deficits o To engage natural support systems for the youth and family and provide the natural support with informed supervision training and accountability skills to ensure that the youth and family have supportive resources o To ensure that the family and youth voice are valued in all discussions o To be culturally competent and respectful in all services o To individually tailor all treatment and offense specific life skills o To collaborate and communicate effectively with all multi -disciplinary team members o To be dedicated to progressing through inevitable challenges and barriers o To be outcome based with observable and measurable indicators of success o To address complex and overlapping needs • To successfully address family and offending youth denial of sexual offending problems • To reduce future Problematic Sexual Conduct • To strengthen protective and resiliency factors for the youth and family • To provide effective coordination with all community partners including development of a school safety plan. • To provide offense specific assessments including J -SOAP, Psychosexual evaluations and polygraphs. • To successfully integrate mental health treatment with offense specific treatment • To provide well -coordinated treatment with victim therapists and support systems • To provide services within SOMB guiding principles Engagement Techniques: The offense specific life skills coaches will reinforce the parents in the skill areas necessary for ensuring the care and wellbeing of their children, as well as treatment success for the youth with Problematic Sexual Conduct. The offending youth will also participate in weekly offense specific group 1 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 therapy with peers who share similar Problematic Sexual Conduct. Offense specific assessment will be provided including psychosexual, and polygraph services. Case management services and communication are also provided by Shiloh House staff to ensure MDT member collaboration. Following an initial assessment, an individualized treatment plan will be completed for each youth and family and will be modified as needed during services with approval by the MDT. Length of service is 6-8 months. Staff Credentials: BA level coaches, Masters level therapists (SOMB providers). Outcome Goals: • Prevent out of home placement Promote safety for persons victimized, the youth and family, and for the community through the successful completion of a treatment plan 2 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Sex Abuse Individual and Family Treatment: Trauma Informed Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization. Delivery Methods: Shiloh House practices the best standards of care and emphasizes implementation of evidence -based treatment practices. Sex abuse individual and family treatment provides strength based, family focused, accountable, relationship oriented service which respects the family while ensuring that the goals of treatment are achieved. Shiloh House adheres to the SOMB Guidelines and Standards. Risk assessment will be addressed through the Juvenile Sex Offender Assessment Protocol (JSOAP), ongoing team and family collaboration, treatment progress and team members input, behavioral observation within all arenas of the client's life (home, school, job, social, community). Adjunct referral for polygraphs, arousal measurement, psychological services and psychiatric services are made as deemed necessary and appropriate. Therapy adheres to the Colorado Sex Offender Management Board's Standards and Guidelines for the Evaluation, Assessment, Treatment and Supervision of Juveniles. Shiloh House utilizes TF-CBT, CBT, Psycho -education and Family Systems Therapy, risk assessment and safety planning, Informed Supervision training, and relapse prevention planning. These services help youth and families increase pro -social behaviors and protective factors; develop a nurturing, healthy home environment; eliminate all illegal behaviors by family members; and provide participants with an understanding of their family and personal cycle of abuse, while increasing their ability to interrupt this cycle. Engagement Techniques: Shiloh House SOMB therapists provide interactive educational and therapeutic tools to help clients identify and address safety concerns for all family members; promote disclosure of abusive behaviors, and address any victimization the client has experienced; assist in the development of empathy for persons victimized; and establish healthy coping skills and tools (self-control, and rehearsal of corrected cognitions). When clinically appropriate, SOMB therapists can work with the victim therapist(s) to assist the youth and person(s) victimized in the clarification process. Staff Credentials: SOMB approved, and master's level clinician licensed, provisionally licensed or under the supervision of a licensed supervisor. Outcome Goals: • Completion of the treatment plan • The youth contributes to community safety by maintaining healthy boundaries and accountability • Prevent out of home placement • Reduced risk of offending as measured by JSOAP • Demonstration of improved mental health as demonstrated by observation and assessments 3 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Mental Health Services Individual and Family Therapy: As a component of the after -care plan for youth stepping down from RCCF care, Shiloh Home provides individual and family therapy services to ensure a successful transition for youth who are returning home. In addition, Shiloh Home provides clinical services to individuals and families to address clinical presenting issues which provide challenges to the individual or family with the goal of preventing out of home placements. With early intervention with complex mental health presenting areas, we believe that the individual and/or family system can be strengthened and as a component of a larger plan will be helped to successfully and safely remain in the community and within the family system. Delivery Methods: Therapeutic services can be provided in the office or in the home. Evidence based services include TF-CBT, and EMDR. Engagement Techniques: Clinicians work as closely as possible with the family to schedule services for times and locations that are most convenient for the family to ensure ongoing success after a youth returns home. Staff Credentials: Masters level clinician licensed, provisionally licensed or under the supervision of a licensed supervisor. Outcome Goals: • Improved mental health as assessed by observation and structured assessments • Completion of treatment goals • Client continues to demonstrate safety and stability in the home environment, reducing the risk for further out of home placement 4 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 In -Home Life Skills The mission of Shiloh House Life Skills services is to provide supports that can strengthen the family. Life Skills Coaches provide guidance and information to allow self-sufficiency, and create a safe, nurturing environment for children, thereby increasing the likelihood of long-term family preservation. Shiloh House Life Skills coaches focus on the individual needs of the family and the goals set forth in the treatment plan. Delivery Method: Life Skills Coaching is an in -home service. Treatment Packages include 75% face to face with family and 25% other duties including but not limited to Team Decision Meetings, Administrative Review Conferences, Case Management, and Court related activities. Four treatment packages are available: Intensive, 10-15 hours per week; High, 7-9 hours per week; Moderate, 4-6 hours per week; and low, 3 hours per week. Engagement Techniques: Life Skills coaches seek direct input from clients on the needs they identify for their families. The Life Skills coach will keep the family's County case worker and all other involved professionals updated on objectives, progress, and issues in the case on a regular basis. The in -home life skills coaches are available on a very flexible schedule including evenings and weekends. The BA level Life Skills coach will provide the family with tools to move toward self-confidence and independence. These tools may include but are not limited to the following: • Provide information regarding community resources, employment, occupational training, education, and health care options. • Provide support services to assist families with accessing resources and employment. • Provide families with assistance with household budgeting. • Provide help with household management. • Provide a non -judgmental relationship. • Help families identify and establish appropriate boundaries and limits. • Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. • Support development of parent/child relationships. • Teach appropriate discipline techniques: Life Skills coaches utilize a variety of techniques with parents to increase awareness, skill, and management of child behavior. • Role modeling positive interaction with children: Life Skills coaches use activities to model how to positively interact with children. The Life Skills coach will use books, games, crafts, and creative play to teach clients. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. • Increase parent confidence. As the parent begins to gain new skills and control in the home, confidence is naturally increased. Providing parents with resources to help them with supporting their family also gives the parent a feeling of accomplishment and instills a sense of pride. 5 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 • Teach the value of daily routine and consistency with children. Life Skills coaches will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards, and consequences and are given resources such as age appropriate chore charts to help parents with consistency. • Increase parental awareness of children's basic and emotional needs- Life Skills coaches will assist parents in learning to recognize child healthcare needs, make doctor appointments, and at times, accompany the family to a doctor's appointment. Coaches will help parents plan and prepare nutritious meals, in addition to providing resources for housing, food, clothing and shelter. Coaches help teach parents to recognize what feelings are expressed in their child's behaviors and how to respond in a way that nurtures the child. • Provide parents with information regarding age appropriate child development- Life Skills coaches teach parents about child development. Coaches use a variety of assessments to help determine a child's developmental growth as well as providing parents with activities to utilize with their child in order to stimulate development of fine and gross motor skills as well as adaptive and communication skills. Coaches will help a parent recognize what is age appropriate behavior and how to manage any inappropriate behavior. Staff Credentials: BA level. There are currently two full time and two part-time Life Skills coaches. Outcome Goals: • Increase level of family functioning • Eliminate child protection issues in the home • Increase formal and informal supports such as community, family, and friends • Increase parents understanding of their parenting role • Help parents have realistic child expectations • Improve parenting, relationship, and social skills 6 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Supervised Visitation: Supervised Visitation services provided by Shiloh House to Weld County families include a parenting assessment which highlights strengths, needs, and risks of each parent. The results of the parenting assessment are used to guide the visitation supervisor in designing a service plan to provide the level of support and supervision needed by the parent. Supervised Visitation includes feedback and interventions by the visitation supervisor during the visit to role model and assist the family in developing improved parenting skills. The primary purpose of the visitation supervisor is to ensure the safety of the child, and strengthen the protective capacity of parents. Supervised visits may occur in community based locations such as parks, libraries, restaurants, museums and many other approved and appropriate locations, including the client's home. This flexibility allows families to meet in environments that promote bonding and child development. The decision to provide community based, supervised visits is determined by feedback from the multi -disciplinary team. Supervised Visitation includes parent education regarding the developmental needs of the children, and parent skill development. All parties in attendance for visits must be pre -approved by the multi -disciplinary team. The visitation supervisor will meet with the visiting parent 15 minutes before and after each visit to discuss goals and provide feedback, making it easier for parents to identify progress and areas for continued support or growth. Supervised visitation typically lasts between one to three months. The need for supervised visits will be reevaluated every 60 days. Supervised visitation appointments can occur between the hours of 8:30 AM and 8:30 PM, Sunday through Saturday. Each visit will last at least one hour unless safety concerns require ending the visit. Staff Credentials: BA level staff Outcome Goals: • Increased bonding between parents and children • Increased understanding of age appropriate parent/child interactions 7 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Home Based Services 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Problematic Sexual Conduct uses SOMB guidelines, trauma -focused CBT, and the High Fidelity Wrap - Around model. Home -based Mental Health services are evidence based, and include the use trauma -focused CBT, and EMDR. Life Skills provides parents skills in areas necessary for ensuring the care and well-being of their children, including age appropriate discipline and interaction techniques, and tools to ensure safety in the home. Life Skills offers Coaching and Supervised Visitation in -home or in the community. 4. Capacity to Provide Services (ex. 4 hours/week). Frequency of each in -home services is determined with the Multi -Disciplinary team and is based on the needs of the family. Four treatment packages are available for Life Skills coaching: Intensive, 10-15 hours per week; High, 7-9 hours per week; Moderate, 4-6 hours per week; and low, 3 hours per week. Individual and Family therapy occurs for 1 hour weekly, unless otherwise clinically indicated. Problematic Sexual Conduct consists of up to 4 hours of therapy services and up to 10 hours of Coaching. Shiloh House has the capacity to provide up to 20 hours of SOMB therapy per week. Shiloh House has the capacity to provide up to 25 hours of Mental Health therapy per week. Shiloh House has the capacity to provide up to 40 hours of coaching, and up to 40 hours of supervised visitation per week. 5. Goals of the service. Promote placement stability and permanency, minimize risks for sexual abuse, strengthen parenting skills, improve overall mental health, increase bonds between parents and children. 6. Outcomes of service. Preserve placement, increase community safety, increase level of family functioning, improved mental health, and improve parenting relationships and social skills. Specific outcome goals are listed in the outcome section of each service. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Problematic Sexual Conduct: youth ages 8-18 and their families who are struggling with a wide variety of Problematic Sexual Conduct. Life Skills and Supervised Visits: Families with children who have involvement with Weld County Department of Human Services. Mental Health services: Youth ages 8-18 and their families emotional, or behavioral problems and mental health diagnoses. 8. Service access. Note: If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is Bid No.: B1900025 EXHIBIT C PROPOSAL TEMPLATE willing to travel to. Services are provided in -home for families working with the Weld County Department of Human Services. 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. Life Skills and PSC Coaching: $75.00/hour Supervised Visitation: $75.00/hour In -home Mental Health Therapy: $115.00/hour Sexual Abuse Therapy: $125.00/hour Bid No.: B1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the rirXpfblVdilervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: Home Based Interventions BIDDER LEGAL ENTITY NAME: Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name Work # Work Email 1 Venman 2 4 5 6 7 8 8 Fischer O'Hayre Moseley Nathlich Aguilar Hill Daniel Page Bridget Taejah Amy Laura Donnie 303-772-1802 x 6( dvanman@shilohl Masters 303-772-1802 303-932-9599 303-932-9599 303-932-9599 303-932-9599 303-932-9599 pfischer@shilohhc bohayre@shilohh tmosleY@shilohhc anathlich@shilohl IaRuilar@shilohho Masters BA BA BBS BA dhill@shilohhousEp, BS, BA Clinical Counsel LPC Forensic Psychc Psychology Sociology Psychology English Educatic Justice Studies, LPC N/A N/A N/A N/A N/A LPC.0011841 LPC.0013350 N/A N/A N/A N/A N/A Miller Venman Larcom O'Hayre O'Hayre O'Hayre O'Hayre Beth Daniel Melissa Bridget Bridget Bridget Bridget 303-932-9599 x 3: bmiller@shilohhoc 303-772-1802 x 6( 303-932-9599 303-932-9500 303-932-9599 303-932-9599 303-932-9599 dvenman@shilohh mlarcom@shilohh bohayre@shilohhc bohayre@shilohhc bohayre@shilohhc bohayre@shilohhc 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the FrAllifigd3ervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) ase.net iouse.net ouse.net )use.net )use.net )use.net )use.net B1800058 IShiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Kinship Services 1. Shiloh will provide psycho -education for kinship providers regarding the impact of trauma and abuse and neglect. This training will include 8 hours of instruction and practise. The instruction will include the following curriculum topics: a. It's all about the brain, not the behaviors! b. The teenage brain is unique...the teenage traumatized brain can be healed c. Understanding the impact of trauma "its not defiance, it's learned survival" d. Effective consequences for teenagers impacted by abuse and neglect e. Skills rather than punishment or consequences! f. Developmental age vs chronological age and reasonable expectations g. Resiliency — how to identify the strengths that already exist, and how to build resiliency in every child - kinship providers are the key!! 2. Shiloh will provide support services to assist the family with child specific consultation. 3. Shiloh will provide families with assistance with household family functioning through on - site family support from the Shiloh House Family Support Professionals. 4. Shiloh will provide phone consultation in crisis situations. 5. Shiloh will provide a supportive and non -judgmental relationship for the child and kinship providers. 6. Shiloh will assist families with skill development to ensure that families can establish appropriate relationship development, structure, boundaries and limits, with the goal of proactivly preventing family conflict, and/or to decrease conflict that may already exist. 7. Shiloh will provide tools to improve family functioning, including behavior management, conflict management, communication, and problem solving tools. 8. Shiloh will support the development of kinship provider/child relationships. 9. The goal of Shiloh Home's home based Kinship provider Consultation services is to enable the family to function in a safe manner, by addressing the concerns through education, role modeling, providing information for community resources, and providing effective parenting training. Outcome Kinship provider Consultation goals are to: 1. Increase the level of family functioning 2. Eliminate placement disruption 3. Increase formal and informal supports such as community, family, and friends 4. Increase kinship providers understanding of the impact of trauma 5. Help kinship providers to have realistic child expectations 6. Improve kinship providering, relationship, and social skills 7. Provide rapid crisis consultation and support for kinship providers experienceing challenges with their child. 1 IShiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 8. Role modeling positive interaction with children - The Home Based family support professional will use a wide variaty of interaction and education based tools to help the family build skills, relationships and have fun together. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. 9. Increase kinship provider confidence -As the kinship provider begins to gain new skills and control in the home, confidence is naturally increased. 10. Teach value of daily routine and consistency with children -Home Based family support professionals will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with household rules, rewards and consequences and are given resources such as age appropriate chore charts to help parents with consistency. 11. Focus on the family strengths by directing intensive services that support and strengthen the family and protect the child: All of Shiloh Home services are provided from a family engagement, strength based, trauma informed basis. 12. Return children in placement to their own home: Shiloh Home's home based and kinship provider consultation services are provided as either a prevention of out of home placement, or to facilitate the successful return of youth to the home and community ensuring that the family has the support needed to help the youth be successful post placement. 13. Unite children with their permanent families: Shiloh Home home based services strive to ensure the permanency of children with their families. 14. Provide services that protect the child: Shiloh Home in -home services ensure that children are protected and that the well-being of every child is our first priority. Shiloh Home has over 30 years experience working with traumatized children and families in Colorado. Shiloh Home works to collaborate with the families in meeting all cultural needs. Language translation needs are provided through our staff when possible or translation services. Shiloh Home will collaborate with all members of the team, and will remain flexible in it's service delivery in order to meet the presenting needs and reinforce the families strengths. 2 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Kinship Services 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Psycho -education 4. Capacity to Provide Services (ex. 4 hours/week). Masters level observation and consultation is weekly is 2 hours per week - anticipated duration 6 weeks Masters level therapy services as clinically indicated - anticipated duration 4 months Coaching (if therapeutically indicated) is 2-4 hours per week - anticipated duration 6 months. Shiloh House has the capacity to provide up to 60 hours of coaching per week. 5. Goals of the service. Increased placement stability, diversion from a higher level of out of home placement, increased foster parent understanding of the impact of trauma, and the risks associated with further institutional systems involvement. 6. Outcomes of service. Prevent placement disruption, increase family functioning, increase formal and information supports (i.e. community resources, family, and friends). 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Foster parents of male and female youth between birth and 18 years of age who are at risk for institutional systems involvement. 8. Service access. Note: If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. Services can be provided in -office, or in -home for families who are involved with the Weld County Department of Human Services. 2700 E. Ken Pratt Blvd Longmont, CO 80504 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English Bid No.: B1900025 EXHIBIT C PROPOSAL TEMPLATE 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. In -home Therapy: $115.00/hour In -office Therapy: $90.00/hour Coaching: $75.00/hour Bid No.: B1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the iiiiklifigd9ervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: Kinship Services BIDDER LEGAL ENTITY NAME: Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name. Work # Work Email 1 Venman 2 4 5 6 7 8 8 Fischer O'Hayre Moseley Nathlich Aguilar Hill Daniel Page Bridget Taejah Amy Laura Donnie 303-772-1802 x 6( dvanman@shilohl. Masters 303-772-1802 303-932-9599 303-932-9599 303-932-9599 303-932-9599 303-932-9599 pfischer@shilohhc bohavre@shilohh( tmoslev@shilohhc anathlich@shilohl- IaRuilar@shilohho dhill@shilohhous€ Masters BA BA BBS BA JD, BS, BA Clinical Counsel LPC Forensic Psychc Psychology Sociology Psychology English Educatic Justice Studies, LPC N/A N/A N/A N/A N/A LPC.0011841 LPC.0013350 N/A N/A N/A N/A N/A Miller Venman Larcom O'Hayre O'Hayre O'Hayre O'Hayre Beth Daniel Melissa Bridget Bridget Bridget Bridget 303-932-9599 x 3: bmiller@shilohhoc 303-772-1802 x 6( 303-932-9599 303-932-9500 303-932-9599 303-932-9599 303-932-9599 dvenman@shilohl. mlarcom@shilohh bohavre@shilohhc bohavre@shilohhc bohavre@shilohhc bohavre@shilohhc 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SH EET(Bidder must list all applicable staff who will manage and/or administer the Fiiiilliild3ervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) Jse.net iouse.net ouse.net )use.net )use.net )use.net )use.net B1800058 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 In -Home Life Skills The mission of Shiloh House Life Skills services is to provide supports that can strengthen the family. Life Skills Coaches provide guidance and information to allow self-sufficiency, and create a safe, nurturing environment for children, thereby increasing the likelihood of long-term family preservation. Shiloh House Life Skills coaches focus on the individual needs of the family and the goals set forth in the treatment plan. Delivery Method: Life Skills Coaching is an in -home service. Treatment Packages include 75% face to face with family and 25% other duties including but not limited to Team Decision Meetings, Administrative Review Conferences, Case Management, and Court related activities. Four treatment packages are available: Intensive, 10-15 hours per week; High, 7-9 hours per week; Moderate, 4-6 hours per week; and low, 3 hours per week. Engagement Techniques: Life Skills coaches seek direct input from clients on the needs they identify for their families. The Life Skills coach will keep the family's County case worker and all other involved professionals updated on objectives, progress, and issues in the case on a regular basis. The in -home life skills coaches are available on a very flexible schedule including evenings and weekends. The BA level Life Skills coach will provide the family with tools to move toward self-confidence and independence. These tools may include but are not limited to the following: • Provide information regarding community resources, employment, occupational training, education, and health care options. • Provide support services to assist families with accessing resources and employment. • Provide families with assistance with household budgeting. • Provide help with household management. • Provide a non -judgmental relationship. • Help families identify and establish appropriate boundaries and limits. • Provide tools to improve family functioning, including behavior management, conflict management, communication, and problem -solving tools. • Support development of parent/child relationships. • Teach appropriate discipline techniques: Life Skills coaches utilize a variety of techniques with parents to increase awareness, skill, and management of child behavior. • Role modeling positive interaction with children: Life Skills coaches use activities to model how to positively interact with children. The Life Skills coach will use books, games, crafts, and creative play to teach clients. This includes recognition of children's needs, nurturing interactions, appropriate responses to the child's cues, as well as stepping in to model age appropriate discipline and consequences. • Increase parent confidence. As the parent begins to gain new skills and control in the home, confidence is naturally increased. Providing parents with resources to help them with supporting their family also gives the parent a feeling of accomplishment and instills a sense of pride. • Teach the value of daily routine and consistency with children. Life Skills coaches will help parents establish a daily routine by using schedules and meal planning menus. Parents are assisted with 1 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 household rules, rewards, and consequences and are given resources such as age appropriate chore charts to help parents with consistency. • Increase parental awareness of children's basic and emotional needs- Life Skills coaches will assist parents in learning to recognize child healthcare needs, make doctor appointments, and at times, accompany the family to a doctor's appointment. Coaches will help parents plan and prepare nutritious meals, in addition to providing resources for housing, food, clothing and shelter. Coaches help teach parents to recognize what feelings are expressed in their child's behaviors and how to respond in a way that nurtures the child. • Provide parents with information regarding age appropriate child development- Life Skills coaches teach parents about child development. Coaches use a variety of assessments to help determine a child's developmental growth as well as providing parents with activities to utilize with their child in order to stimulate development of fine and gross motor skills as well as adaptive and communication skills. Coaches will help a parent recognize what is age appropriate behavior and how to manage any inappropriate behavior. Staff Credentials: BA level. There are currently two full time and two part-time Life Skills coaches. Outcome Goals: • Increase level of family functioning • Eliminate child protection issues in the home • Increase formal and informal supports such as community, family, and friends • Increase parents understanding of their parenting role • Help parents have realistic child expectations • Improve parenting, relationship, and social skills 2 Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Beyond the Walls - Life skills Transitional Resource Network: Transitional coaching for youth ages 14-26 - Beyond the Walls assembles the circle of support, and network of resources that exists naturally in local communities. Young people build a plan by assessing where they are currently and their goals for the future. The youth that participate in Beyond the Walls will have the opportunity to work with a Life Transitions Coach to identify their needs, set goals, and connect them with our Community Partners Network. Our Community Resource Network then links young people to opportunities and experience to help them in reach their goals. Each month 25 hours of learning opportunities are available to the youth. This integrated system of resources and connections amplify the ability for each youth to have caring adults working along side as they journey towards their future. Each month Beyond the Walls sponsors; Work Shops such as financial literacy, Reality Tours such as college tours, business tours, Mentoring relationships on a 1: 1 level or in Circles of support; Each learning and support opportunity focus on the areas of education, housing, job skills, faith -based connections, business engagement, and community skills. The network of activities and support are proven tools that support young people in gaining vital confidence and support during times of change in their life. The combination of action learning, mentoring, coaching and peer mentoring provides young people with a wider source of support and inspiration for idea generation and greater creativity in problem solving during critical times in a young persons life. Specially trained community partners guide each learning opportunity which give young people the chance for experiential learning, a chance to discuss individual plans, followed by peer support with community partners acting as a sounding board for young people to bounce ideas and potential solutions to problems. Beyond the Walls also leverages and builds links to existing resources in the community to ensure young people are able to find what they need to become a vibrant member of their local community. Credentials: BA level Outcomes: 1. Percentage of participation 2. Successful completion of goals 3 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Life Skills and Beyond the Walls 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Life Skills provides parents skills in areas necessary for ensuring the care and well-being of their children, including age appropriate discipline and interaction techniques, and tools to ensure safety in the home. Beyond the Walls teaches independent living skills (ex: college enrollment; application and job seeking skills; and budgeting), and connects youth to mentors who can be long term connections. Capacity to Provide Services (ex. 4 hours/week). Four treatment packages are available for Life Skills coaching: Intensive, 10-15 hours per week; High, 7-9 hours per week; Moderate, 4-6 hours per week; and low, 3 hours per week. Beyond the Walls offers up to 28 hours of services per month, including Monthly workshops, monthly reality tours, twice monthly groups, and an available four hours per week of drop -in support. Individual services can also be provided as needed. Shiloh House has the capacity to provide up to 60 hours of Coaching per week. 4. Goals of the service. Life Skills -promote placement stability and permanency, strengthen parenting skills, and increase bonds between parents and children. Beyond the Walls -prepares adolescents who have been involved in the Human Services system to transition into young adulthood and live independently through the creation of long term supports and teaching adult life -skills. 5. Outcomes of service. Life Skills -preserve placement, increase level of family functioning, improved mental health, and improve parenting relationships and social skills. Specific outcome goals are listed in the outcome section of each service. 6. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Life Skills and Supervised Visits: Families with children who have involvement with Weld County Department of Human Services. Beyond the Walls: Youth ages 14-26 who have an independent living/emancipation goal because return home is not a viable plan. 7. Service access. Note: If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. Life Skills services are provided in -home for families working with the Weld County Department of Human Services. Beyond the Walls services are provided in -office and in the community. 2700 E. Ken Pratt Blvd Longmont, CO 80504 Bid No.: B1900025 EXHIBIT C PROPOSAL TEMPLATE 8. Languages service is available in. Note: Bidder should note the language and level of proficiency. English 9. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. Life Skills Coaching and supervised visitation: $75.00/hour Beyond the Walls: $1,050.00/month Bid No.: B1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the IfrlibiiiFTdgervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: Life Skills and Beyond the Walls (BTW) BIDDER LEGAL ENTITY NAME: Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name Work # Work Email 1 Venman 2 4 5 6 7 8 9 10 11 12 13 14 15 Fischer O'Hayre Moseley Nathlich Aguilar Hill Coy Davis Killian Murther Elwood Inskeep-Sugar Daniel Venman 303-772-1802 x 6(dvanman@shilohl Masters Page Fischer Bridget Taejah Amy Laura Donnie Amy Mary Matt Katrina William Dylan 303-772-1802 303-932-9599 303-932-9599 303-932-9599 303-932-9599 303-932-9599 720-213-1400 720-213-1400 720-213-1400 720-213-1400 303-772-1802 303-772-1802 pfischer@shilohhc bohayre@shilohh( tmosley@shilohhc anathlich@shilohl IaRuilar@shilohho dhill@shilohhousE JD, BS, BA acoy@shilohhousf mdavis@shilohho mkillian@shilohhc kmurther@shilohl welwood@shilohl dinskeep@shilohl- Masters BA BA BBS BA AA BS BSW BA CSC BA Clinical Counsel LPC Forensic Psychc Psychology Sociology Psychology English Educatic Justice Studies, Social Work Social Work Psychology and Culinary Arts Sociology LPC N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A LPC.0011841 LPC.0013350 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Miller Venman Larcom O'Hayre O'Hayre O'Hayre O'Hayre Ramirez Coy Coy Coy Coy Coy Beth Daniel Melissa Bridget Bridget Bridget Bridget Molly Amy Amy Amy Amy Amy 303-932-9599 x 3: bmiller@shilohhoc 303-772-1802 x 6( 303-932-9599 303-932-9500 303-932-9599 303-932-9599 303-932-9599 720-213-1400 720-213-1400 720-213-1400 720-213-1400 720-213-1400 720213-1400 dvenman@shilohl- mlarcom@shilohh bohayre@shilohhc bohayre@shilohhc bohayre@shilohhc bohavre@shilohhc mollvramirez@shit acoy@shilohhousE acoy@shilohhousE acoy@shilohhousE acoy@shilohhousE acoy@shilohhousE 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the rftlitlifWdilervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) lohhouse.net 81800058 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Mental Health Services Outpatient individual and family therapy services provided to children, adolescents, and families who are struggling with mental health issues (often related to trauma) and difficult family dynamics. Assessments Utilized A mental health assessment is used to determine the therapeutic needs of the individual and family. Further assessments may be administered if indicated (e.g., trauma symptom checklists, family relationship questionnaires, etc.). Focus of Mental Health Services Areas targeted by therapy services include: • Reducing problematic symptoms and behaviors associated with mental health disorders and trauma • Educating children, adolescents, and families about issues associated with trauma and mental health, including identifying how they impact functioning • Helping children, adolescents, and their families develop healthy coping tools to manage their unpleasant thoughts and emotions • Equipping caretakers with knowledge and methods to provide trauma -informed parenting and meet the unique needs of their children • Improving parenting skills including the ability to develop, implement, and reinforce appropriate behavior expectations and consequences • Increasing each family member's understanding of their own unhealthy interaction patterns and how to change them • Reducing conflict within families by teaching and guiding family members in the use of positive communication skills that foster empathy between them • Facilitating communication between family members to address therapy issues Mental Health Services Methodologies All treatment interventions used by Shiloh Home, Inc. are trauma -informed, evidence -based, and focus on individual and family strengths. Mental Health Treatment services may include: Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused -Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and DBT techniques. Mental Health Services Providers Therapy services are provided by a master's level clinician; licensed, provisionally licensed, or under the supervision of a licensed supervisor. Mental Health Services Outcomes Outcomes are measured through observation and/or structured assessment. Indicators of success include: • Improved Mental Health • Improved Individual Functioning • Improved Family Functioning • Completion of Treatment Goals 1 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Psychological Evaluation Shiloh House offers psychological testing to assess the cognitive, emotional, and interpersonal functioning of individual children and adolescents. Psychological testing is often used to clarify diagnoses (particularly when providers are unable to verify diagnoses using other methods) and to aid in treatment planning and clinical decision making. It is often utilized when there is limited progress in therapy, as multiple case -specific treatment recommendations are provided. All comprehensive psychological evaluations include a written report and can be completed in 12 to 15 business hours. Providers Psychological testing is provided by a licensed psychologist, who is registered with DORA. Psychological Assessments Utilized The tests used in a comprehensive psychological evaluation depends on the referral questions and the age of the child. In addition to a clinical interview and review of records, assessments may include: • Wechsler Intelligence Scale for Children -Fifth Edition (WISC-V) • Rorschach Inkblot Test (Exner's Comprehensive System) • Minnesota Multiphasic Personality Inventory -Adolescent Restructured Form (MMPI-A RF) • Millon Pre -Adolescent Clinical Inventory (M -PACT) • Millon Adolescent Clinical Inventory (MACI) • Trauma Symptom Checklist for Children (TSCC) • UCLA PTSD Reaction Index for Children/Adolescents — DSM-5 • Behavior Assessment System for Children -Adolescent, Third Edition (BASC-3) Self -Report, Teacher Rating Scales, Parent Rating Scales • Incomplete Sentences Blank - High School Form • Children's Sentence Completion Test (Conger) • Projective Drawings (e.g., House -Tree -Person, Kinetic Family Drawing) 2 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Mental Health Services 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Mental Health Treatment services may include: Assessment, Behavior Therapy principles/interventions (including communication skills training), Parent Management Training techniques, Trauma Focused - Cognitive Behavioral Therapy (TF-CBT), play therapy, Family Systems interventions, and DBT techniques. 4. Capacity to Provide Services (ex. 4 hours/week). Individual therapy is 1 hour per week unless otherwise clinically indicated. Family therapy is 1 hour per week unless otherwise clinically indicated. All comprehensive psychological evaluations include a written report and can be completed in 12 to 15 business hours. Shiloh House has the capacity to provide up to 25 hours per week of mental health therapy, and up to 15 hours per week for psychological testing. 5. Goals of the service. Improved mental health, increased individual and increased family functioning. 6. Outcomes of service. Improved mental health, increased individual, increased family functioning, and completion of the treatment plan. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Youth ages 8-18 and their families emotional, or behavioral problems and mental health diagnoses. 8. Service access. Note: If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. Services are provided in -home or in -office. 2700 E. Ken Pratt Blvd Longmont, CO 80504 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. In -home Mental Health Therapy: $115.00/hour In -office Mental Health Therapy: $9O.OO/hour Bid No.: B1900025 EXHIBIT C PROPOSAL TEMPLATE Psychological Testing: $3350.00/test, $165.00/hour Bid No.: B1900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the drStIiligdllervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: Mental Health Services BIDDER LEGAL ENTITY NAME: Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISOR INFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name Work # Work Email 1 Venman Daniel Venman 303-772-1802 x 6( dvanman@shilohi Masters Clinical Counsel LPC LPC.0011841 Miller Beth 303-932-9599 x 3: bmiller@shilohhoi 2 Fischer Page Fischer 303-772-1802 pfischer@shilohhc Masters Forensic Psychc LPC LPC.0013350 Venman Daniel 303-772-1802 x 6( dvenman@shilohl- 3 Dr. Laurie Tonelli 303-932-9599 Itonelli@shilohho PhD Counseling Psyc Licensed Psyc PSY.0004245 Miller Beth 303-932-9599 x 3: bmiller@shilohhot 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the rirliklifiVdilervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) ase.net muse.net ise.net B1800058 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Sex Abuse Individual and FamilyTreatment: Therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization. Shiloh Home practices the best standards of care and emphasizes implementation of evidence -based treatment practices. Shiloh Home adheres to the SOMB Guidelines and Standards. Risk assessment will be addressed through the Juvenile Sex Offender Assessment Protocol (JSOAP), on -going team and family collaboration, treatment progress and team members input, behavioral observation within all arenas of the client's life (home, school, job, social, community). Adjunct referral for polygraphs, arousal measurement, psychological services and psychiatric services are made as deemed necessary and appropriate. Therapy adheres to the Colorado Sex Offender Management Board's Standards and Guidelines for the Evaluation, Assessment, Treatment and Supervision of Juveniles. Shiloh Home utilizes the following evidence -based treatments in conjunction with a trauma informed approach: 1. Cognitive -Behavioral Therapy — Correcting thinking errors, linking thoughts, feelings and behaviors, teaching new, healthy, empathic, and reality based ways of thinking. a) Trauma Focused Cognitive Behavioral Therapy b) Offense Specific Cognitive Behavioral Therapy 2. Behavioral Therapy —teaching and rehearsing healthy ways to behave when overwhelmed by feelings and perceived needs. 3. Psycho -education and Family Systems Theory 4. Dialectical Behavior Therapy (DBT) 5. Eye Movement Desensitization and Reprocessing (EMDR) 6. Aggression Replacement 7. Animal Assisted Therapy 8. Play Therapy 9. Brief Strategic Family Therapy 10. Visiting Coaching Model 11. School — Core Knowledge 12. School — Positive Behavior Supports (PBS) The goals of the Sex Abuse Treatment are as follows: 1. To ensure community safety. 2. To asses risks, ensure that all family members are safe within the family. 3. To provide strength based, accountable, relationship oriented service which respects the family while ensuring that the goals of treatment are achieved. 4. To provide intensive psycho -educational treatment that increases the client and families understanding of abusive interaction patterns and enables the family to eliminate abusive patterns with in the family. 5. Disclosure of abusive behaviors as well as own victimization 6. To provide the client and family with an understanding of their family and personal cycle of abuse and to ensure their ability to interrupt this cycle. 7. Correction of abusive patterns of behavior, and creation of an abuse -free home and family life 8. Development of victim empathy 9. Mental health stabilization 10. Development of healthy coping skills and tools (self-control, rehearsal of corrected cognitions) 11. Increased pro -social behaviors and increased protective factors 1 IShiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 12. To provide all caregivers with an understanding of Informed Supervision, and the essential nature of being vigilant in providing a safe environment. 13. To complete clarification work depending upon the individual family circumstances and stages in treatment. 14. To provide a strong emphasis on identifying the contributing risk factors and aiding the family in remediating these risks. 15. To develop a strong relapse prevention plan. 16. To facilitate family reunification and/or establish healthy family dynamics if they are unable to live together. 17. To assist the family in development of a nurturing and healthy home environment which will enable the children to successful progress in their development, and academic achievement. 18. To eliminate illegal behaviors by all members of the identified family unit. Qualifications: SOMB approved, and Master's level clinician licensed, provisionally licensed or under the supervision of a licensed supervisor. Outcomes: 1. Completion of Treatment Plan goals 2. Prioritize Community Safety 3. Reduce risk of out of home placement 4. Reduce offending risk as measured by JSOAP 5. Demonstrate improved mental health per observation and assessments 2 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Shiloh House Community Based Treatment Serving Youth with Problematic Sexual Conduct Shiloh House will provide home and community -based services for youth ages 8-18 and their families who are struggling with a wide variety of Problematic Sexual Conduct. This home -based program is designed for family and youth verbalizing a strong commitment to actively participate in a combination of home -based offense specific therapy and coaching services. These families may not fully grasp the seriousness of the sexual offending or the contributing family dynamics, but the family and the youth have demonstrated a willingness to engage in the treatment process. This program can help youth and families address issues including sexual reactivity due to abuse and trauma; unhealthy behaviors including inappropriate touching, bullying, gesturing, and threatening verbalizations; youth who have engaged in family -based incest; and youth who have engaged in community based sexual assault. Participating youth may be adjudicated, or non -adjudicated. Delivery Methods: This Community Based Treatment for Problematic Sexual Conduct includes 2-3 hours per week of in -home SOMB Masters level treatment and a minimum of 4 hours per week of BA level in - home training, coaching and accountability targeting safe and healthy sexual behavior life skills. Coaches and therapists build on strengths that exist within the family and help family members address safety concerns in a realistic, non -judgmental way. Goals related to service delivery are: • To successfully integrate SOMB guided home based offender treatment with evidence -based treatment principals including Trauma Focused CBT and High Fidelity Wrap Around • To support the following High -Fidelity Wrap Around principals: o To be strength based and to value all members of the team focusing on family and youth needs rather than deficits o To engage natural support systems for the youth and family and provide the natural support with informed supervision training and accountability skills to ensure that the youth and family have supportive resources o To ensure that the family and youth voice are valued in all discussions o To be culturally competent and respectful in all services o To individually tailor all treatment and offense specific life skills o To collaborate and communicate effectively with all multi -disciplinary team members o To be dedicated to progressing through inevitable challenges and barriers o To be outcome based with observable and measurable indicators of success o To address complex and overlapping needs • To successfully address family and offending youth denial of sexual offending problems • To reduce future Problematic Sexual Conduct • To strengthen protective and resiliency factors for the youth and family • To provide effective coordination with all community partners including development of a school safety plan. • To provide offense specific assessments including J -SOAP, Psychosexual evaluations and polygraphs. • To successfully integrate mental health treatment with offense specific treatment • To provide well -coordinated treatment with victim therapists and support systems • To provide services within SOMB guiding principles Engagement Techniques: The offense specific life skills coaches will reinforce the parents in the skill areas necessary for ensuring the care and wellbeing of their children, as well as treatment success for the youth with Problematic Sexual Conduct. The offending youth will also participate in weekly offense specific group therapy with peers who share similar Problematic Sexual Conduct. Offense specific assessment will be provided including psychosexual, and polygraph services. Case management services and communication 3 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 are also provided by Shiloh House staff to ensure MDT member collaboration. Following an initial assessment, an individualized treatment plan will be completed for each youth and family and will be modified as needed during services with approval by the MDT. Length of service is 6-8 months. Staff Credentials: BA level coaches, Masters level therapists (SOMB providers). Outcome Goals: • Prevent out of home placement • Promote safety for persons victimized, the youth and family, and for the community through the successful completion of a treatment plan 4 I Shiloh Home, Inc. Response to Request for Child Welfare -Bid Number B1900025 Informed Supervision Training: Informed supervision training is consistent with SOMB standards by a Shiloh staff who is trained in Informed Supervision and supervised by an SOMB qualified supervisor. Informed Supervision Education is a 3 hour class provided to parents and caregivers. The Informed supervision training includes at a minimum the following topics: • History of SOMB • 20- Principals of SOMB treatment with emphasis on community safety • Why Informed Supervision is necessary • Victim Confidentiality • Sexual Offending Behaviors overview • Current laws that relate to juvenile sexual offending • Seriousness of Juvenile Offending, impact, and priorities • Dynamic patterns (cycles) associated with abusive behavior • The role of the MDT in all decisions • Safety Plans • High Risk patterns • Community Supervision and Treatment Credentials: Informed Supervision Trained BA or MA level staff with SOME supervision Outcomes: 1. Community Safety 2. Parent/Care Giver successful completion of Informed Supervision training as demonstrated by observation, participation, and post test resulsts. 5 EXHIBIT C PROPOSAL TEMPLATE 1. Bidder's legal entity name: 2. Program name or service type being proposed: Shiloh Home, Inc. (DBA Shiloh House) Sexual Abuse Treatment 3. Modalities, curriculum or tools that will be utilized in the delivery of the service. Juvenile Sex Offender Assessment Protocol (JSOAP), Trauma -focused CBT, Offense Specific CBT, Behavoiral Therapy, Psycho -education, Family Systems Therapy, DBT, EMDR, Aggression Replacement, Play Therapy, and Brief Strategic Family Therapy. 4. Capacity to Provide Services (ex. 4 hours/week). Individual therapy is 1 hour per week unless otherwise clinically indicated. Family therapy is 1 hour per week unless otherwise clinically indicated. Shiloh House has the capacity to provide up to 20 hours per week of Sexual Abuse Treatment. 5. Goals of the service. Goals include ensuring community safety, assessing risks, ensuring that all family members are safe within the family, increase understanding of abusive interaction patterns, and enable clients to eliminate abusive patterns within the family, disclosure of abusive behaviors as well as own victimization, development of healthy coping skills, and increased pro -social behaviors. 6. Outcomes of service. Complete treatment plan, prioritize community safety, reduce risk of out of home placement, Reduce offending risk as measured by JSOAP, and demonstrate improved mental health. 7. Target population for service. Note: Please include age range, applicable genders, and any specific characteristics/traits/needs. Youth age 7-17 who have committed a sexual offense, or who have sexually reactive behaviors and their families. 8. Service access. Note: If office -based, bidder should provide full physical addresses for all locations. If provided outside the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is willing to travel to. Services are provided in -home or in -office. 2700 E. Ken Pratt Blvd Longmont, CO 80504 9. Languages service is available in. Note: Bidder should note the language and level of proficiency. English 10. Rates of service. Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day, month, episode). Approximate rates or a range of rates for a service will not be accepted. Sexual Abuse Treatment: $125.00/hour Bid No.: 81900025 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the FirStlifigdllervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) PROPOSED SERVICE OR SERVICE TYPE: BIDDER LEGAL ENTITY NAME: Sexual Abuse Treatment Shiloh Home, Inc. (DBA Shiloh House) APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION SUPERVISORINFORMATION No. Last Name First Name Work# Work Email Education Level Degree Focus Licensure/ Credentials DORA # (If applicable) Last Name First Name Work# Work Email enman ante 303-772-1802 x 6( dvanman@shilohl Masters Clinical Counsel LPC LPC.0011841 Miller Beth 303-932-9599 x 3: bmiller@shilohhoc 2 4 Fischer O'Hayre Moseley Nathlich Page Bridget Taejah Amy Laura 303-772-1802 303-932-9599 pfischer@shilohhc bohayre@shilohhc Masters BA Forensic Psychc Psychology Sociology Psychology English Educatic Justice Studies, LPC N/A N/A N/A N/A N/A LPC.0013350 N/A N/A N/A N/A N/A Venman Larcom Daniel Melissa 303-772-1802 x 6( 303-932-9599 dvenman@shilohl- mlarcom@shilohh 5 303-932-9599 tmosley@shilohhc BA O'Hayre O'Hayre O'Hayre O'Hayre Bridget Bridget Bridget Bridget 303-932-9500 bohayre@shilohhc 6 7 Aguilar Hill 303-932-9599 303-932-9599 anathlich@shilohl- IaRuilar@shilohho BBS BA 303-932-9599 303-932-9599 bohayre@shilohhc bohayre@shilohhc 8 8 Donnie 303-932-9599 dhill@shilohhousE JD, BS, BA 303-932-9599 bohayre@shilohhc 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B1800058 STAFF DATA SHEET(Bidder must list all applicable staff who will manage and/or administer the drlitliPArdgervice. One Staff Data Sheet per proposed service. Bidder should not combine services.) ase.net iouse.net ouse.net )use.net )use.net )use.net )use.net 81800058 EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Day Treatment Services, Foster Care/Adoption Services (Foster Parent Consultation, Foster Parent Education, and Kinship Services), Home Based Services (Aftercare), Life Skills, Mental Health Services, and Sexual Abuse Treatment (Problematic Sexual Conduct Coaching), as referred by the Department. 2. Day Treatment Services: Therapeutic modalities include TF-CBT, DBT techniques, and sexual abuse treatment. Special Education services are offered, and the academic curriculum is transferrable to public schools. a. Capacity for Services: Day Treatment services are provided until transition back to a public - school setting is appropriate. Shiloh Academy has the capacity to serve 4 Day Treatment students at any given time. b. Goals of Service: i. Address academic needs to help the student achieve academic success. ii. Provide mental health services to support emotional and behavioral stability and teach the student coping strategies and social skills that will improve the ability to communicate needs and interact with peers and adults in ways that promote healthy relationships so that long term stability can be achieved. c. Outcomes of Service: i. Credit recovery. ii. Improved school emotional and behavioral functioning. iii. Maintain positive home and community relationships. iv. Return to home school prepared for academic and interpersonal success. d. Target Population: i. Male youth between 7 to 18 years of age who are proficient in speaking English; and who present with behavioral disorders, mental health issues, and problematic sexual behaviors. ii. Exclusions include youth with severely limited cognitive abilities (IQ below 65), ongoing medical issues that cannot be managed/supervised by staff, active psychosis, and inability or significantly impaired ability to understand and/or communicate in English. e. Service Access: 2700 E. Ken Pratt Blvd, Longmont, CO 80504. f. Language: English only. 3. Foster Care/Adoption Services a. Foster Parent Consultation: Pscyho-education. i. Capacity for Services: 1. Masters level observation and consultation is weekly is 2 hours per week - anticipated duration 6 weeks. 2. Masters level therapy services as clinically indicated - anticipated duration 4 months 3. Coaching (if therapeutically indicated) is 2-4 hours per week - anticipated duration 6 months. 4. Contractor has the capacity to provide up to 60 hours of coaching per week. ii. Goals of Service: 1. Increased placement stability. 2. Diversion from a higher level of out of home placement. 3. Increased foster parent understanding of the impact of trauma. 1 4. Understanding of the risks associated with further institutional systems involvement. iii. Outcomes of Service: 1. Prevent placement disruption. 2. Increase family functioning. 3. Increase formal and information supports (i.e. community resources, family, and friends). iv. Target Population: Foster parents of male and female youth between birth and 18 years of age who are at risk for institutional systems involvement. v. Service Access: 2700 E. Ken Pratt Blvd, Longmont, CO 80504. vi. Language: English only. b. Foster Parent Education: Psycho -education, SOMB education. i. Capacity for Services: \ 1. Contractor has the capacity to provide up to 20 hours of Foster Parent Education per month. a. 3 -hour training is a one-time event. b. 11 -hour training is scheduled over two days. ii. Goals of Service: 1. Psycho -education: a. Improve resiliency. b. Increase placement stability. c. Support the reunification process. d. Provide a step by step guide of navigating the mental health system, including accessing services. 2. SOMB education: a. Provide information about normative, concerning, and problematic sexual behavior. b. Dispel "myths" that many people believe regarding sexually abusive and sexually reactive youth. c. Provide accurate information about what is actually required when providing care for sexually abusive and/or sexually reactive youth. iii. Outcomes of Service: 1. Promote community safety. 2. Preserve foster placement to minimize disruption to children and families; support the parent/child reunification goal. 3. Divert entry into residential placement or support successful step-down from residential into foster care. iv. Target Population: Foster parents of male and female youth between birth and 18 years of age who are placed in foster care in Weld County. v. Service Access: 2700 E. Ken Pratt Blvd, Longmont, CO 80504. vi. Language: English only. c. Kinship Services: Psycho -education. i. Capacity for Services: 1. Masters level observation and consultation is weekly is 2 hours per week - anticipated duration 6 weeks. 2. Masters level therapy services as clinically indicated - anticipated duration 4 months. 2 3. Coaching (if therapeutically indicated) is 2-4 hours per week - anticipated duration 6 months. Shiloh House has the capacity to provide up to 60 hours of coaching per week. ii. Goals of Service: 1. Increased placement stability. 2. Diversion from a higher level of out of home placement. 3. Increased foster parent understanding of the impact of trauma, and the risks associated with further institutional systems involvement. iii. Outcomes of Service: Prevent placement disruption, increase family functioning, increase formal and information supports (i.e. community resources, family, and friends). iv. Target Population: Foster parents of male and female youth between birth and 18 years of age who are at risk for institutional systems involvement. v. Service Access: 2700 E. Ken Pratt Blvd, Longmont, CO 80504. vi. Language: English only. 4. Home Based Services (Aftercare): Individual and family therapy, assessment tools include mental health assessment, trauma symptom checklists, and family relationship questionnaire. a. Capacity for Services: i. Individual and Family therapy occur one hour per week unless otherwise clinically indicated. ii. Up to 12 hours per week of Coaching services can be available, depending on the needs of the family. Shiloh House has the capacity to provide up to 25 hours per week of therapy. iii. Services are typically provided from 3 to 6 months. b. Goals of Service: i. Support placement stability in the home by continuing services for mental health. ii. Provide education about trauma and mental health issues. iii. Assist the family in development of healthy coping tools. iv. Provide trauma -informed parenting skills. v. Reduce conflict through intensive psycho -education and increased communication skills, life -skills. vi. Assist in the creating of a nurturing, healthy home environment. c. Outcomes of Service: i. Improved individual and family functioning. ii. Alleviation or reduction of mental health symptoms. iii. Completion of treatment goals. d. Target Population: Youth, ages 7-18 who have transitioned home, or into kinship or foster care from a higher level of care. e. Service Access: 2700 E. Ken Pratt Blvd, Longmont, CO 80504. 5. Life Skills a. Services available under this agreement include: i. Life Skills: Provides parents skills in areas necessary for ensuring the care and well-being of their children, including age appropriate discipline and interaction techniques, and tools to ensure safety in the home. ii. Beyond the Walls: b. Capacity for Services: i. Life Skills 3 g• 1. Intensive, 10-15 hours per week. 2. High, 7-9 hours per week. 3. Moderate, 4-6 hours per week. 4. Low, 3 hours per week. ii. Beyond the Walls 1. Up to 28 hours of services per month. 2. Includes monthly workshops, monthly reality tours, twice monthly groups, and an available four hours per week of drop -in support. 3. Contractor can provide up to 60 hours per week. c. Goals of Service: i. Life Skills: Promote placement stability and permanency, strengthen parenting skills, and increase bonds between parents and children. ii. Beyond the Walls: Prepare adolescents who have been involved in the Human Services system to transition into young adulthood and live independently through the creation of long term supports and teaching adult life -skills. d. Outcomes of Service: i. Preserve placement. ii. Increase level of family functioning. iii. Improved mental health. iv. Improved parenting relationships and social skills. e. Target Population: i. Life Skills and Supervised Visitation: Families with children who are involved with the Department. ii. Beyond the Walls: Youth ages 14-26 who have an independent living/emancipation goal because return home is not a viable plan. f. Services Access: i. Life Skills: Life Skills services are provided in -home for families working with the Department. ii. Beyond the Walls: In -office, 2700 E. Ken Pratt Blvd, Longmont, CO 80504, and in the community. Language: English only. 6. Mental Health Services a. Services available under this agreement include: i. Assessment. ii. Behavior Therapy principles/interventions, including communication skills training. iii. Parent Management Training techniques. iv. Trauma Focused -Cognitive Behavioral Therapy (TF-CBT). v. Play therapy. vi. Family Systems interventions. vii. DBT techniques. b. Capacity for Services: i. Individual therapy is 1 hour per week unless otherwise clinically indicated. ii. Family therapy is 1 hour per week unless otherwise clinically indicated. iii. All comprehensive psychological evaluations include a written report and can be completed in 12 to 15 business hours. iv. Contractor will provide up to 25 hours per week of mental health therapy, and up to 15 hours per week for psychological testing. 4 c. Goals of Service: i. Improved mental health. ii. Increased individual and increased family functioning. d. Outcomes of Service: i. Improved mental health. ii. Increased individual. iii. Increased family functioning. iv. Completion of the treatment plan. e. Target Population: Youth ages 8-18 and their families emotional, or behavioral problems and mental health diagnoses. f. Service Access: In -home or in -office, 2700 E. Ken Pratt Blvd, Longmont, CO 80504. g. Language: English only. 7. Sexual Abuse Treatment: Contractor will utilize Juvenile Sex Offender Assessment Protocol (JSOAP), Trauma -focused CBT, Offense Specific CBT, Behavioral Therapy, Psycho -education, Family Systems Therapy, DBT, EMDR, Aggression Replacement, Play Therapy, and Brief Strategic Family Therapy. a. Service available under this agreement include: i. Problematic Sexual Conduct (PSC). ii. Sexual Abuse Therapy. b. Capacity for Services: i. Problematic Sexual Conduct (PSC): Up to 4 hours of therapy services and up to 10 hours of Coaching. ii. Sexual Abuse Therapy 1. Individual therapy is 1 hour per week unless otherwise clinically indicated. 2. Family therapy is 1 hour per week unless otherwise clinically indicated. 3. Contractor will provide up to 20 hours per week. c. Goals of Service: i. Problematic Sexual Conduct (PSC): 1. Promote placement stability and permanency. 2. Minimize risks for sexual abuse/ 3. Strengthen parenting skills. 4. Improve overall mental health. 5. Increase bonds between parents and children. ii. Sexual Abuse Therapy: 1. Ensure community safety. 2. Assess risks. 3. Ensure that all family members are safe within the family. 4. Increase understanding of abusive interaction patterns. 5. Enable clients to eliminate abusive patterns within the family. 6. Disclosure of abusive behaviors as well as own victimization. 7. Development of healthy coping skills and increased pro -social behaviors. d. Outcomes of Service: i. Problematic Sexual Conduct 1. Preserve placement. 2. Increase community safety. 3. Increase level of family functioning. 4. Improved mental health. 5. Improve parenting relationships and social skills. ii. Sexual Abuse Therapy: 5 1. Completion of treatment plan. 2. Prioritization of community safety. 3. Reduced risk of out of home placement. 4. Reduced offending risk as measured by JSOAP. 5. Demonstration of improved mental health. e. Target Population: i. Problematic Sexual Conduct: Youth ages 8-18 and their families who are struggling with a wide variety of Problematic Sexual Conduct. ii. Sexual Abuse Therapy: Youth age 7-17 who have committed a sexual offense, or who have sexually reactive behaviors and their families. f. Service Access: i. Problematic Sexual Conduct: in -home for families working with the Weld County Department. ii. Sexual Abuse Therapy: Services are provided in -home or in -office, 2700 E. Ken Pratt Blvd, Longmont, CO 80504. g. Language: English only. 8. Contractor will respond to the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400- 6210) within three (3) business days regarding the ability to accept the received referral. 9. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). 10. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for visitation services. If a rate for "no shows" is not specifically stated in Exhibit D, Rate Schedule, then Contractor understand that the Department will no reimburse for "no shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows" on the part of the client per month. After three (3) "no-shows, "Contractor will place client on a behavioral plan requiring attendance or discharged client from services. Contractor must inform the caseworker and the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). 11. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Quality Assurance Team Supervisor (hainleid@weldgov.com) immediately via email, to discuss service continuation. 12. Contractor will identify in detail areas of continued concern and make recommendations to the Department regarding continuation of services and/or the need for additional services. 13. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited 6 to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately AND on the required monthly report. 14. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 15. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Contract and Services Coordinator, a Department -facilitated Team Decision Making (TDM) or Family Team Meeting (FTM), or by court order. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 16. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Court Staffings, Family Team Meetings and/or Team Decision Making meetings. Contractor may participate by phone, if approved by the Department. 17. Contractor will notify the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210) of new staff who will manage and/or administer the services with the following information: a. b. c. d. e. Staff member name and contact information Education level/degree (if applicable) Licensure/credentials (if applicable) Department of Regulatory Authority (DORA) number (if applicable) Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 7 EXHIBIT D RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department after May 31, 2020. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Day Treatment Services: $1,675.00/Month (Day Treatment Services) Foster Care/Adoption Services: $75.00/Hour (Foster Parent Consultation — Coaching) $115.00/Hour (Foster Parent Consultation — In -Home Therapy) $90.00/Hour (Foster Parent Consultation — In -Home Therapy) $1,760.00/Episode (Foster Parent Education —11 hour class) $480.00/Episode (Foster Parent Education — 3 hour class) $75.00/Hour (Kinship Services — Coaching) $115.00/Hour (Kinship Services — In -Home Therapy) $90.00/Hour (Kinship Services — In -Office Therapy) Home Based Services: $75.00/Hour (Aftercare In -Home Coaching) $115.00/Hour (Aftercare In -Home Therapy) Life Skills: $1,050.00/Month (Beyond the Walls Program -Aftercare) $75.00/Hour (Life Skills Coaching, In -Home) $75.00/Hour (Supervised Visitation, In -Home) Mental Health Services: $115.00/Hour (Mental Health Therapy, In -Home) $90.00/Hour (Mental Health Therapy, Office) $165.00/Hour (Psychological Testing) $3,350.00/Episode (Psychological Testing) Sexual Abuse Treatment: $75.00/Hour (Problematic Sexual Conduct (PSC) Coaching, In -Home) $125.00/Hour (Sexual Abuse Therapy, In -Home) 3. Submittal of Vouchers Contractor shall prepare and submit monthly a Request for Reimbursement, Client Verification Form, other supporting documentation, and monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 60 days from the date of service. Requests for Reimbursement and/or supporting documentation received after 60 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in termination of the Agreement. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement. For one-time services, proof of services rendered shall be receipt of a Client Verification Form and the completed product. For Monitored Sobriety services, proof of services rendered shall be the test result. Contract Farm New Contract Request Entity Information Entity Name* SHILOH HOUSE, INC Entity ID* D03 732 Contract Name* SHILOH HOME. INC DBA SHILOH HOUSE (CHILD PROTECTION AGREEMENT FOR SERVICES) Contract Status CTB REVIEW ❑ New Entity? Contract ID 2596 Contract Lead* CULLINTA Contract Lead Email cullmta[a-co weld.co.us Parent Contract ID 20190707 Requires Board Approval YES Department Project # Contract Description " CONSENT. NEW AGREEMENT FOR SERVICES. FUNDING: CORE OTHER. TERM: 06101/19-05/31/20 Contract Description 2 BID NO. B1900025. Contract Type* AGREEMENT Amount* S0 00 Renewable* YES Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanSer:/lces@weldgov.com Department Head Email CM-HumanSer../ic es- DeptHead@welcigov.com County Attomey GENERAL COUNTY ATTORNEY EMAIL County Attorney Entail CM- COUNTYA I ORNEY@WELD GOV COM Requested BOCC Agenda Date* 05.'2212019 Due Date 0511812019 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 Ik4SA enter &ISA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date lc 04101/2020 Termination Notice Period Committed Delivery Date Renewal Date* 0hs+01x`2020 Expiration Date Contact Information Contact Info Contact Name Purchasing Purchasing Approver CONSENT Approval Process Department Head JUDY GRIEGC DH Approved Date D8/13/2019 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date D8419/2019 Originator CULLINTA Contact Type Contact Email Finance Approver CONSENT Contact Phone 1 Purchasing Approved Date 08/13/2019 Finance Approved Date 081 1312019 Tyler Ref* AG 081919 Legal Counsel CONSENT Contact Phone 2 Legal Counsel Approved Date 081112019 Submit Hello