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HomeMy WebLinkAbout20213152.tiffRESOLUTION RE: APPROVE BUSINESS PROPOSAL FOR COUNTY BEHAVIORAL HEALTH GRANT PROGRAM FOR HIGH-FIDELITY WRAPAROUND PROJECT AND AUTHORIZE CHAIR PRO-TEM TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Business Proposal for the County Behavioral Health Grant Program for the High -Fidelity Wraparound Project from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Human Services, Office of Behavioral Health, with further terms and conditions being as stated in said business proposal, and WHEREAS, after review, the Board deems it advisable to approve said business proposal, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Business Proposal for the County Behavioral Health Grant Program for the High -Fidelity Wraparound Project from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Human Services, Office of Behavioral Health, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair Pro-Tem be, and hereby is, authorized to sign said business proposal. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 10th day of November, A.D., 2021. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: them) Weld County Clerk to the Board Deputy Clerk APP ED ount Attorney `Date of signature: t l /Z3 /2( cc: HSD,(cv) 12/c, /21 2021-3152 HR0093 Cn4tO\Cd 1153t PRIVILEGED AND CO ME FIDENTIAL DATE: October 25, 2021 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Colorado Department of Human Services (CDHS) County Behavioral Health Grant Program Application Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request o;,sd A sproval of the Department's C lorado Department of Human Services (CDHS) Cunty Behavioral Health Grant Program Appiicatiom The Weld County Department of Human Services (WCDHS) is requesting submission approval for an application for funding for the Colorado Department of Human Services (CDIJS) County Behavioral Health Grant Program. This Request for Application (RFA) seeks to provide grants to County Departments of Human Services through the Office of Behavioral Health (OBH) for the expansion or improvement of local or regional behavioral health programs. The total amount that WCDHS would be applying for would be $680,165.00. If awarded, the grant would be used to create a High -Fidelity Wraparound (HFW) team to work directly with children and families working with Child Welfare, Family Resource and Area Agency on Aging who have complex behavioral/mental health needs and who may be involved in multiple systems. The HFW team would be housed within the Family Resource Division at Human Services. This grant application must be submitted by Monday, November 8, 2021. If grant money is awarded the anticipated contract start date is January 1, 2021 and would run for two terms ending June 30, 2023. I do not recommend a Work Session. I recommend approval of this Application and authorize the Chair to sign the required signature page for submission. Perry L. Buck Mike Freeman Scott K. James, Pro-Tem Steve Moreno, Chair Lori Same Approve Schedule Recommendation Work Session Other/Comments: Pass -Around Memorandum; October 25, 2021 -- CMS 5353 2021-3152 Page 1 Karla Ford From: Sent: To: Subject: Attachments: I approve Perry Buck Perry Buck Monday, October 25, 2021 11:07 AM Karla Ford Re: Please Reply -PA FOR ROUTING: FR Behavioral Health Grant Application (CMS 5353) image002.jpg; image001 jpg; 102521 FR Behavioral Health Grant Application (CMS 5353).pdf Sent from my 'Phone On Oct 25, 2021, at 10:55 AM, Karla Ford <kford@weldgov.com>wrote: Please reply and let me know if you approve recommendation. Thanks! Karla Ford X Office Manager, Board of Weld County Commissioners 1150 0 Street, P.O. Box 758, Greeley, Colorado 80632 :: 970.330-7204 :: ktord www.weldgov.com **Please note my working hours are Monday -Thursday 7:00a.m.-5:00p.m.** Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Alison Pegg <apegg@weldgov.com> Sent: Monday, October 25, 2021 10:23 AM To: Karla Ford <kford@weldgov.com> Cc: Barb Connolly <bconnolly@weldgov.com>; Bruce Barker <bbarker@weldgov.com>; Chris D'Ovidio <cdovidio@weldgov.com>; Esther Gesick <egesick@weldgov.com>; HS -Contract Management <HS- ContractManagement@co.weld.co.us>; Lennie Bottorff <bottorll@weldgov.com> Subject: PA FOR ROUTING: FR Behavioral Health Grant Application (CMS 5353) Good morning Karla, Please see the attached PA that has been approved by Jamie for routing to the BoCC: FR Behavioral Health Grant Application (CMS 5353). Thank you, Alison Pegg Contract Management and Compliance Coordinator 1 BUSINESS PROPOSAL RFA#: RFP IHJA 2022000092 COUNTY BEHAVIORAL HEATH GRANT PROGRAM WELD COUNTY DEPARTMENT OF HUMAN SERVICES 315 NORTH 11th AVENUE P.O. BOX A GREELEY, CO 80632 a. Executive Summary Weld County is requesting $680,165.00 to create a High -Fidelity Wraparound (HFW) team. HFW services will be available to children and families throughout Weld County who have complex behavioral/mental health needs and who may be involved with or need access to a variety of systems, such as out -of -home placement, the Regional Accountable Entity (RAE), special education services, Medicaid Waivers such as Children's Habilitation Residential Program (CHRP) and Children's Extensive Support (CES), Community Centered Boards (CCB), the juvenile justice system or local community mental health. The HFW team will be housed in the Family Resource Division within WCDHS. The primary contact for this project will be Julie Witkowski, the Family Resource Division Head for Weld County Department of Human Services (WCDHS). The proposed project is specifically targeted to serve five (5) out of the eight (8) identified priority populations: children and youth with complex behavioral needs, individuals with intellectual and developmental disabilities, individuals with aggression as a component of behavioral health, individuals experiencing homelessness, and individuals with criminal justice involvement. Since individuals from these priority populations are frequently served by one (1) or more programs of WCDHS, the HFW project will allow WCDHS to serve in a "no wrong door" capacity for these targeted high needs populations within Weld County. The primary goal of the project is to enhance engagement and convene representatives from various systems to effectively and efficiently meet the mental/behavioral health needs of participants with an objective of decreasing a persons need or lessening the length of time for formal Child Welfare, Youth Services/Juvenile Justice, and Adult Protection intervention. b. Local funding •r in -kind county resources OR a plan for regional collaboration The HFW project will rely on dedicated local funding to support the salary of the Division Head who will provide general oversight and direct supervision to the HFW Supervisor. It is estimated that 6% of the Division Head's time will be spent on this project and paid via other resources. In addition, the project will be supported by internal resources of the Human Services Fiscal team and general operating expenses, such as mileage for Wraparound Facilitators to meet with customers and stakeholders in the field. c. Project Description The HFW process is a way to improve the lives of children and adults with complex needs and high acuity by developing individualized plans of care. WCDHS has been working closely with the local community mental health center, RAE, CCB and juvenile justice entities to solve system navigation challenges faced by Weld County residents seeking behavioral/mental health support. HFW is a desired program because it is evidence based, developed by a family centered team, individualized, and is based on needs rather than service driven. This means that systems and supports are brought together with the intent to "wrap" around the family with interventions specifically targeted to address their unique needs. There are four (4) phases to the wraparound process. Phase one (1) is engagement. During this phase the groundwork is established for trust and shared vision among the family and the wraparound team. This phase is initiated via conversation and engagement between the family, the HFW Facilitator and any other formal or informal supports already involved. It is important to note that formal supports may or may not be involved at this point. The HFW Facilitator will be working on a discovery of strengths, needs, and cultural practices, which will set the tone for the teamwork and team interactions. Phase two (2) is the initial plan development. The initial plan is created using a structured planning process which incorporates the wraparound principles. The participant and family should guide the process and ultimately feel heard and respected as the plan is developed. During this phase the HFW Facilitator is focused on building team trust, cohesion, and mutual respect through responsive, open, and respectful communication. This phase usually takes one (1) to two (2) meetings and is important to incorporate shared responsibilities which sets the stage for goal attainment and individual success. During this phase, formal supports are typically incorporated with the team involved in developing the plan according to the wraparound principles. Phase three (3) is implementation. During this phase, the initial wraparound plan is implemented and progress is continually reviewed with an emphasis on identifying successes and challenges, and incorporating new elements as needed. Ongoing HFW team meetings are held to support the participant and family in achieving their goals for improved well-being and stability. This phase is repeated until the team's mission is achieved and formal wraparound is no longer needed. While in this phase, it is not mandatory for formal supports to attend all family meetings, however, when updates are needed or changes need to be made, it is the responsibility of the HFW Facilitator to ensure that all necessary supports are present. Phase four (4) is transition. During this phase, plans are made for a purposeful transition out of formal wraparound to a mix of formal and natural supports in the community. The focus on transition is continuous during the wraparound process. The goal of this phase is to advance the family away from utilizing formal support systems and shift them to use more natural support systems. HFW has standardized ten (10) guiding principles which including: 1. Family voice and choice — Family and participant perspectives are intentionally elicited and prioritized during all phases of the wraparound process. 2. Team based — The wraparound team consists of mutually agreed upon individuals who are committed to the individual and family as natural, formal, and community supports. 3. Natural supports — The team actively seeks out and encourages the full participation of team members drawn from the family members network of interpersonal and community relationships. 4. Collaboration — Team members work cooperatively and share responsibility for developing, implementing, monitoring, and evaluating a single wraparound plan. 5. Community based — The HFW team implements services and support strategies that take place in the most inclusive, most responsive, most accessible, and least restrictive settings possible. 6. Culturally competent — The wraparound process demonstrates respect for and builds on the values, preferences, beliefs, culture, and identity of the child/youth, family and their community. 7. Individualized — Utilizing the family's culture and strengths, the HFW team will create a prioritized plan to address their needs. 8. Strengths based — The wraparound process uses the strengths of the family to address the needs of the family. 9. Persistence (unconditional care) — Despite challenges the team continues to work toward the goals included in the wraparound plan until the team reaches an agreement that the wraparound process is no longer needed. 10. Outcomes based — The team ties the goals and strategies of the wraparound plan to observable or measurable indicators of success, monitors progress in terms of these indicators and revises the plan accordingly. 1. Describe what are the current barriers and gaps that exist that the project will help solve. The current barrier identified is a lack of HFW providers in the area. Currently there is only one (1) provider in Weld County with the ability to provide this service who only has the capacity to serve a few participants at a time and who mostly works with individuals enrolled in Medicaid Waivers. In the past, Weld County has had two (2) other agencies providing the HFW program, however, both of those agencies have since stopped providing this service. It has been a pattern in Weld County for non-profit agencies to start HFW, but unfortunately, they have not historically been able to sustain it due to turnover or lack of funding. WCDHS believes that bringing this program in-house will assist in making the program sustainable in Weld County as well as greatly increase the community's access to wraparound services which will effectively meet the behavioral/mental health needs of individuals with complex needs and high acuity. 2. List the counties/area you have identified as most in need of enhancements in priority order as identified by community input and local planning efforts. Weld County is considered a rural county and is a part of Region 2 which was identified within the 2020 Behavioral Health Needs Assessment (Exhibit F) as having high behavioral health needs and poor behavioral health outcomes. Within Region 2 there are more individuals who fit the safety net population criteria than the state average. In addition, the percentage of behavioral health providers is lower than the state's overall, making access to and coordination with providers a priority. This project encompasses the Six Pillars of Strong Behavioral Health Systems as outlined in Exhibit G: 1) Guided by the consumer 2) Intended to improve access 3) Aimed at streamlining funding resources and therefor increasing affordability 4) Focused on the whole person 5) Driven by accountability 6) Designed to build family support. 3. Describe how your project will address equity, diversity, and inclusion in your community. Community based — The wraparound team implements services and supports strategies that take place in the most inclusive, most responsive, most accessible, and least restrictive settings possible. Culturally competent — The wraparound process demonstrates respect for and builds on the values, preferences, beliefs, culture, and identity of the child/youth, family and their community. Individualized — Utilizing the family's culture and strengths, the HFW team will create a prioritized plan to address their needs. d. Service Area 1. List the associated counties and municipalities where the project will expand or improve local or regional behavioral health disorder treatment programs. Weld County is geographically the third (3rd) largest county and one (1) of the top ten (10) by population, having over 328,000 residents (2020 Census). By enhancing the engagement and coordination between local behavioral health systems within Weld County, the proposed HFW team will strive to improve local behavioral health outcomes for Weld County residents who have acute and complex behavioral health needs. 2. Describe the population to be served, including any subpopulations and your organization's experience working with them. As discussed previously, the populations to be served include children and youth with complex behavioral needs, individuals with Intellectual and Developmental Disabilities (IDD), individuals with aggression as a component of behavioral health, individuals experiencing homelessness, and individuals with criminal justice involvement. These populations are often served by the Family Resource, Child Welfare or Area Agency on Aging Divisions at WCDHS and participants will be identified by caseworkers and case managers in each of these Divisions. In addition, WCDHS will accept referrals for wraparound services from our local partners such as the community mental health center, RAE, CCB, local school districts and other community stakeholders for children who are not involved in Child Welfare as long as their families are interested and willing to engage in voluntary case management through the Prevention team within the Family Resource Division. e. Quality Assurance 1. Describe how your organization will identify and establish deliverables (client count, quality of service). The HFW team will consist of a supervisor and four (4) HFW Facilitators. All team members will complete the training and practice elements required to become credentialed in Colorado for their respective roles. Within six (6) months of hire, HFW Facilitators are required to participate in at least twenty (20) hours of coaching from a State of Colorado approved coach and within twelve (12) months, they must receive another twenty (20) hours of coaching. Facilitators are assessed at three (3), six (6) and twelve (12) -month intervals and must pass required competencies at 85% or higher. The WCDHS HFW team will implement the wraparound process to fidelity. Each facilitator will carry a caseload of eight (8) to ten (10) families and will be required to meet with their supervisor at least twice a month. In addition to their coach, supervisor and Division Head, Facilitators will have access to our two (2) Mental Health Professionals for clinical consultation. Facilitators will utilize the Child and Adolescent Needs and Strengths (CANS) assessment to prioritize participants. Facilitators will use the Colorado Wraparound Fidelity Tool to gather data from at least 75% of participants. 2. Describe your organization's quality assurance plan to monitor project performance, improvement, timelines, and quality of services. In 2019, Colorado conducted an independent systematic review of HFW and has found it to meet evidence standards of a promising practice. At the time of the review, HFW was being implemented in thirteen (13) counties. Between October 1, 2016, and September 30, 2018, a total of 290 individuals participated in HFW. Subsequently, children and youth involved in HFW saw a 63% reduction in the total number of nights spent in out -of -home care. WCDHS HFW Facilitators will track required data and the Supervisor will be expected to provide annual reports on the following performance outcomes: 1) 90% of families will be connected to applicable public benefits within forty-eight (48) business hours. 2) 75% of participants will remain in a home type, non -institutional setting. 3) Children and youth will attend school at least 85% of the time. 4) 80% of families will report satisfaction of at least a four (4) out of five (5) on a Likert scale. 5) For children in out -of -home placement, the number of days spent out of the home will be reduced by 50%. 6) If placed out of the home, 75% of participants will experience no more than two (2) placements by the time they achieve permanency. f. Organizational Capacity 1. Describe the positions within your organization who will be working on the project and their roles. WCDHS will have four (4) full-time HFW Facilitators and a full-time supervisor. Facilitators will be available to meet with families in conjunction with Caseworkers and Case Managers from the Family Resource, Area Agency on Aging and Child Welfare Divisions. In addition to being a HFW Supervisor, the supervisor will be a high-level systems navigator, familiar with the local continuum of care for individuals experiencing behavioral and mental health crisis. They will be tasked with developing a deep understanding of and relationships with representatives from each of these systems in order to advocate for more responsive, effective and efficient delivery of behavioral health support. We often see these systems play "hot potato" with individuals who have complex needs and have recognized the need for increased systems navigation knowledge and accountability. 2. Describe your organization's experience with, and approach to working in, underserved communities that need behavioral health treatment. The Family Resource Division (FRD) of WCDHS works with underserved and vulnerable populations throughout the community and across all other human services departments to reduce programmatic and community "silo"ing. Oftentimes the most vulnerable have unmet behavioral health needs that require immediate access to services. FRD encompasses the Community Outreach, Child Abuse Prevention, Specialized TANF Case Management, Post Adoption Support, Human Services Funds Distribution and SOAR Social Security programs. All programs of FRD approach families in a wholistic, strengths -based manner, partnering with community agencies to ensure families receive the services they need to be successful and contributing members of the community. The HFW program is a natural fit for the FRD. 3. Identify any partnering agencies and their roles in the implementation of this project. Our local community mental health agency, North Range Behavioral Health, will provide individual, family and group based behavioral health treatment to adults and children referred to them by the HFW Facilitators. As mentioned previously, WCDHS will accept HFW referrals from community entities, including but not limited to: North Range Behavioral Health, RAE 2 (Northeast Health Partners), the local CCB (Envision), local school districts, faith -based organizations, the Nineteenth Judicial District and United Way of Weld County. In order to collect and track required data, families referred for HFW must be willing to open a voluntary case management case if not already being served by Child Welfare or Area Agency on Aging. 4. Describe your organization's plan to rapidly distribute the grant money into the community and how the project will be monitored. WCDHS relies on strong community relationships to wholistically serve residents of Weld County and because of these relationships, FRD can rapidly create and implement a HFW program. Many individuals in need of intensive behavioraUmental health support are already participating in one (1) or more programs offered by WCDHS, making the initial delivery of services to those at highest need possible. In addition, as a component of the HFW process, a portion of the funding provided by this grant will be set aside to provide flexible funding directly to HFW participants and their families to address emergent financial needs. Access to these funds will reviewed, approved and monitored by the Human Services Funds Distribution Committee which is tasked with managing all emergency supportive services throughout WCDHS. g. Sustainability Plan 1. If any grant money is used for capital projects, please demonstrate how you will continue those services past the grant cycle for at least an additional five years. This project will not include any capital expenses. 2. Describe how services initiated with this grant funding will be sustained beyond the grant period. The staff and services initiated with this grant funding will be sustained utilizing various funding streams which are currently available or will be available in the future. Counties and community agencies across the state have successfully implemented HFW as a Medicaid billable service. WCDHS will explore the option of becoming a Medicaid provider and can provide funding through the Core Services budget in the interim. In addition, HFW is on the Colorado service array in the Family First Prevention Plan as a promising practice based on an independent systematic review and will soon be reviewed by the Title IVE Prevention Services Clearinghouse. We will continue to monitor the progress of this federal review and consult with the Colorado Department of Human Services as more services are added to our Family First Prevention Plan. If HFW becomes a supported or well supported program on the Clearinghouse, the program will be eligible for drawdown of Federal funds as part of the Family First Prevention Services Act. h. Additional Requirements 1. Innovation & Collaboration OR services to Rural/Frontier Counties (CRS 27-60-111 (6)) Weld County is home to thirty-two (32) rural incorporated municipalities. These include towns that lack behavioral health services within their town limits which results in residents traveling to receive services. This program would offer in -home, community -based, or in -office services and, as well as a virtual option when requested or required. Whenever possible, HFW Facilitators will meet with the family in their own home. 2. Demonstrates a need as identified by community input and local planning efforts (such as number of available providers, distance to services, etc.) (CRS 27-60-111 (6)) In 2020, Weld County's local Department of Public Health and Environment (WCDPHE) conducted a Community Health Assessment which identified access to mental health resources as one (1) of the top ten (10) health issues. In fact, nearly 30% of residents reported the need for mental health services (an uptrend from 2019) and only 55% percent indicated they had sought care. Of the remaining 45%, 56% reported not feeling like they could afford care, 51% didn't believe mental health care was covered by insurance, and 51% reported not knowing how or where to seek mental health assistance. In addition, leadership within the local community mental health center as well as local juvenile justice entities have indicated a recognition of a lack of service navigation and high intensity care coordination for individuals with acute behavioral/mental health needs as well as those involved in multiple systems. 3. Demonstrates the ability to rapidly distribute the grant money into the community (CRS 27- 60-111 (6)) WCDHS currently has one (1) staff member who is certified as a Trainer and Coach for High Fidelity Wraparound Program. There are also options for training through the Colorado Cross Systems Training Institute in partnership with Colorado's Trauma Informed System of Care (COACT).. Training and certification for the HFW team would begin immediately following the hiring of staff. Weld County intends to hire a supervisor within the first six (6) weeks of receiving funding and then to hire facilitators within the following six (6) weeks, allowing the supervisor to be instrumental in building their team. Once training is completed, the goal would be to have twenty (20) to twenty-five (25) families identified and be able to begin the wraparound process within two (2) weeks of training completion. Solicitation Terms WCDHS respectfully requests modification to the following three (3) documents: 1. Exhibit A: CDHS Personal Services Contract Template a. Section 19.C., Governmental Immunity, addition to clearly state that this clause applies to public entities as well. 2. Exhibit C: Miscellaneous Provisions a. Remove the final sentence in section II.B, Corrective Action, and to completely remove section II.C., Liquidated Damages, as liquid damages are not typical for a State contract with another public entity. 3. Exhibit D: HIPAA Business Associate Agreement a. Remove section 7, Limitation of Liability. EXHIBIT B COLORADO Office of Behavioral Health Department of Human Services EXHIBIT B, FY22 ANNUAL BUDGET OBH Program Count,/ Behavioral Health Agency Name Weld County DE partment of Human Sery ces Budget Period January 2022 - June 30, 2022 Project Name High F delity Wraparound Program Contact Name, Title Phone Email Julie Witkowski, Family Resource Division Head 970-400-6777 witkowjx@weldgov.com Fiscal Contract Name, Title Tammy Maurer, Fiscal Manager Phone 970-400-6533 Email maurertk@weldgov.com Date Completed November 8, 2021 All budget numbers are estimates. Contract billing will be on a cost reimbursement basis for actual expenses incurred. EXPENDITURE CATEGORIES Personnel: Salary/Benefits Annual Budget Position Title Description of Work Gross or Annual Salary Fringe Percent of Time on Project Total Amount Requested from OBH Wraparound Supervisor High Fidelity Wrapa -ound Supervisor who will serve as a systems $ 76,923.43 $ 31,136.00 50% 54,029.72 Wraparound Coordinator Wraparound Coordinator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 25% 23,959.78 Wraparound Coordinator Wraparound Coordinator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 25% 23,959.78 Wraparound Coordinator Wraparound Coordinator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 25% 23,959.78 Wraparound Coordinator Wraparound Coordinator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 25% 23,959.78 Division Head Provide general oversight for the HFW program and direct supervision $ 2,923.91 $ 1,143.14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Personnel Services -Hourly Employees Annual Budget Position Title Description of Work Hourly Wage Hourly Fringe Total # of Hours on Project Total Amount Requested from OBH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 (including Total Personnel Services fringe benefits) 149,869,00 Client Costs Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH Page 1 of 8 Last update 10_06_2021 EXHIBIT B Flex Funding Flex funding can be used to address concrete economic needs which support family 1,500.00 3 4,500.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Client Costs 4,500.00 Contractors/Consultants Services (Subcontracts) Annual Budget Name Description of Work Rate Quantity Total Amount Requested from OBH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Contract Services 0.00 Occupancy Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH 0.00 0.00 0.00 0.00 Total Occupancy 0.00 Operating Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH Technology -purchase Equipment: Laptop, docking station, dual monitors, mouse, keyboard, cell phone and $ 2,472.37 2 4,944.74 Telephones -monthly Ongoing expenses for cell and desk phones -77.98 monthly x 5 sets x 6 months $ 389.90 6 2,339.40 Mileage Mileage to and from client homes and community locations will be paid via other $ 216.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Operating 7,284.00 Depreciation/Amortization Annual Budget Page 2 of 8 Last update 10_06_2021 EXHIBIT B Item Description of Item Total Amount Requested from OBH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Depreciation/Amortization 0.00 Professional Fees Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH 0.00 0.00 0.00 0.00 0.00 Total Professional Fees 0.00 (TDC) 161,653.00 TOTAL DIRECT COSTS Less: Expenses per OMB 2CFR § 200 Subcontracts in excess of $25,000 0.00 Rent 0.00 Equipment 0.00 Other Unallowable Expenses 0.00 Total Expenses per OMB 2CFR § 200 0.00 MODIFIED TOTAL DIRECT COSTS (MTDC) 161,653.00 Indirect Costs Annual Budget Item Description of Item Percentage Total Amount Requested from OBH Drop Down Box Describe what the cost includes and the use of allowance 0% 0.00 Total Indirect 0.00 Total Amount Requested 161,653.00 Matching Funds Annual Budget Matching Funds Non -Governmental Contracts 0.00 Other State Revenue/Accrual 0.00 Federal Grant Funds/Accrual 0.00 Local Funds -Match 0.00 Private Grant Funds/Accrual 0.00 Public Support 0.00 Private Support 0.00 In -Kind Donations 0.00 In -Kind County Resources 0.00 Local Funds/Accrual 0.00 Other Funds (Specify below) 0.00 0.00 Page 3 of 8 Last update 10_06_2021 EXHIBIT B i, A - a Total Match i 0 00 r ,, xBudget - Total Request (Requested Amount & Match) ,, _, , ; - - -161,653 00 - The Parties may mutually agree, in writing, to modify the Budget administratively using an OBH Budget Reallocation form Page 4 of 8 Last update 10_06_2021 EXHIBIT B COLOR ADO Office of Behavioral Health Department of Hunan Services EXHIBIT B, FY23 ANNUAL BUDGET OBH Program County Behavioral Health Agency Name Weld County Department of Human Services Budget Period July 1, ;022 - June 30, 2023 Project Name High Fidelity Wraparound Program Contact Name, Title Phone Email Julie Witkowski, Family Resource Division Head 970-400-6777 witkowjx@weldgov.com Fiscal Contract Name, Title Tammy Maurer, Fiscal Manager Phone 970-400-6533 Email maurertk@weldgov.com Date Completed November 8, 2021 All budget numbers are estimates. Contract billing will be on a cost reimbursement basis for actual expenses incurred. EXPENDITURE CATEGORIES Personnel: Salary/Benefits Annual Budget Position Title Description of Work Gross or Annual Salary Fringe Percent of Time on Project Total Amount Requested from OBH Wraparound Coordinator Wraparound Coordi iator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 100% 95,839.11 Wraparound Coordinator Wraparound Coordinator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 100% 95,839.11 Wraparound Coordinator Wraparound Coordinator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 100% 95,839.11 Wraparound Coordinator Wraparound Coordi iator will work to preserve and rehabilitate $ 67,379.11 $ 28,460.00 100% 95,839.11 Wraparound Supervisor High Fidelity Wraparound Supervisor who will serve as a systems $ 76,923.43 $ 31,136.00 100% 108,059.43 Division Head Provide general ove sight for the HFW program and direct supervision $ 5,847.81 $ 2,286.28 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Personnel Services -Hourly Employees Annual Budget Position Title Description of Work Hourly Wage Hourly Fringe Total 4* of Hours on Project Total Amount Requested from OBH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Personnel Services (including fringe benefits) 491,416.00 Client Costs Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH Page 5 of 8 Last update 10_06_2021 EXHIBIT B Flex Funding Flex funding can be used to address concrete economic needs which support family 1,500.00 10 15,000.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Client Costs 15,000.00 Contractors/Consultants Services (Subcontracts) Annual Budget Name Description of Work Rate Quantity Total Amount Requested from OBH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Contract Services 0.00 Occupancy Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH _ 0.00 0.00 0.00 0.00 Total Occupancy 0.00 Operating Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH Technology -purchase Equipment: Laptop, docking station, dual monitors, mouse, keyboard, cell phone and $ 2,472.37 3 7,417.11 Telephones -monthly Ongoing expenses for cell and desk phones -77.98 monthly x 5 sets x 12 months $ 389.90 12 4,678.80 Mileage Mileage to and from client homes and community locations will be paid via other $ 216.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Operating 12,096.00 Depreciation/Amortization Annual Budget Page 6 of 8 Last update 10_06_2021 EXHIBIT B Item Description of Item Total Amount Requested from OBH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Depreciation/Amortization 0.00 Professional Fees Annual Budget Item Description of Item Rate Quantity Total Amount Requested from OBH 0.00 0.00 0.00 I 0.00 0.00 Total Professional Fees 0.00 518,512.00 TOTAL DIRECT COSTS (TDC) Less: Expenses per OMB 2CFR § 200 Subcontracts in excess of $25,000 0.00 Rent 0.00 Equipment 0.00 Other Unallowable Expenses 0.00 Total Expenses per OMB 2CFR § 200 0.00 MODIFIED TOTAL DIRECT COSTS (MTDC) 518,512.00 Indirect Costs Annual Budget Item Description of Item Percentage Total Amount Requested from OBH Drop Down Box Describe what the cost includes and the use of allowance 0% 0.00 Total Indirect 0.00 Total Amount Requested 518,512.00 Matching Funds Annual Budget Matching Funds Non -Governmental Contracts 0.00 Other State Revenue/Accrual 0.00 Federal Grant Funds/Accrual 0.00 Local Funds -Match 0.00 Private Grant Funds/Accrual 0.00 Public Support 0.00 Private Support 0.00 In -Kind Donations 0.00 In -Kind County Resources 0.00 Local Funds/Accrual 0.00 Other Funds (Specify below) 0.00 0.00 Page 7 of 8 Last update 10_06_2021 EXHIBIT B Total Match 0.00 Total Budget Request (Requested Amount & Match) 518,512.00 The Parties may mutually agree, in writing, to modify the Budget administratively using an OBH Budget Reallocation form Page 8 of 8 Last update 10_06_2021 J. Signature Page The Vendor must complete and submit the Signature Page along with the application. Vendor Name Weld County Department of Human Services Vendor Address 315 North 11th Avenue, PO Box A, Greeley, CO 80632 Vendor Contact Name Julie Witkowski Vendor Contact Email WITKOWJX@weldgov.com Vendor Contact Phone (970) 400-6777 Does the Vendor have any perceived, potential, or apparent conflicts of interest? If so, please disclose them. No Is the Vendor a Service -Disabled Veteran Owned Small Business pursuant to C.R.S. §24- 103-905? No Is the Vendor currently on any debarred list? No Name of person authorized to submit this application Julie Witkowski Signature from an authorized individual. Signatures may be physical or electronic as defined by the Uniform Electronic Transactions Act. Some examples of acceptable signatures are DocuSign, Adobe, or scanned physical copies. Scott K. James Pro —Tern, Board of County Commissioners NOV 1 0 2021 Colorado Department of Human Services Solicitation Number: RFP IHJA 2022000092 Division of Contracts and Procurement Page 12 of 12 Contract Form New Contract Request Entity Information Entity Name* Entity ID* COLORADO DEPARTMENT OF HUMAN p00003650 SERVICES Contract Name* COLORADO DEPARTMENT OF HUMAN SERVICES (COUNTY BEHAVIORAL HEALTH GRANT PROGRAM APPLICATION) Contract Status CTB REVIEW ❑ New Entity? Contract ID 5353 Contract Lead* APEGG Contract Lead Email apegg@weldgov.com;cobbx xIkToweldgov.corn Parent Contract ID Requires Board Approval YES Department Project # Contract Description* COLORADO DEPARTMENT OF HUMAN SERVICES; RFA#: RFP IHJA 2022000032; COUNTY BEHAVIORAL HEALTH GRANT PROGRAM. IF AWARDED, A CONTRACT WILL BE EXECUTED WITH SPECIFIC BUDGET AND TERM DATES. Contract Description 2 PA IS BEING ROUTED THROUGH THE NORMAL PROCESS. ETA TO CTB: 10,)27,+21. Contract Type* APPLICATION Amount* 50.00 Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- HumanServiceslPweldgov.co m Department Head Email CM-HumanServices- DeptHeadveldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email C M- COUNTYATTORNEYg WELDG OV.COM Requested BOCC Agenda Date* 11:03;2021 Due Date 10;30;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 MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Contact Info Contact Name Purchasing Review Date* 05"02/2022 Committed Delivery Date Renewal Date Expiration Date* 06 30 fi 2022 Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Approver Purchasing Approved Date Approval Process Department Head JAMIE ULRICH DH Approved Date 11;01,{2021 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda. Date 1 1 10 2021 Originator APEGG Finance Approver BARB CONNOLLY Legal Counsel KARIN MCDOUGAL Finance Approved Date Legal Counsel Approved Date 11;01/2021 11/03/2021 Tyler Ref # AG 111021 Hello