HomeMy WebLinkAbout20191244.tiffPRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: March 19, 2019
TO: Board of County Commissioners — Pass -Around
FR: Judy A. Griego, Director, Human Services
RE: Core Services Family Preservation/Placement Alternative
Commission Report
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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 Submission of the Department's Core Services Family
Preservation/Placement Alternative Commission Report (Attachment 1). The Core Services Family
Preservation/Placement Alternative Commission Report is required of each county annually according to the
requirements of C.R.S. 26-5.5-104 (6), which mandates that the Colorado Department of Human Services
annually provide "... an evaluation of the overall effectiveness and cost efficiency of the program and any
recommended changes to such program."
The service and delivery information is being collected and reported based on a calendar year from the Trails
system. The attached report reflects the period of January 1, 2018, through December 31, 2018, for Weld
County. The evaluator, Colorado State University -Social Work Research Center, compiles a final report from
all counties and distributes it to the Governor and counties later this year.
The report, which outlines gaps in service and areas that need improvement within the Core Services Program,
was reviewed by Child Welfare leadership, the Department Director and the Deputy Director. A signature from
the Human Services Advisory Commission (HSAC) Chair will be obtained before submission. The report must
be submitted online to the State by Friday, March 29, 2019.
I do not recommend a Work Session. I recommend approval for the HSAC Chair to sign and the Department to
submit the Report online.
Sean P. Conway
Mike Freeman, Pro-Tem
Scott James
Barbara Kirkmeyer, Chair
Steve Moreno
Approve Schedule
Recommendation Work Session
Other/Comments:
2019-1244
Pass -Around Memorandum; March 19, 2019 - Not in CMS
AgpAcia„
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1-1-Rl/ V t
Core Services Family Preservation/PAC Report
Membership List and Signature Page
You may choose to either mail the original signature page to: Marc Winokur at Colorado State
University, A107 Behavioral Sciences Building, Fort Collins, CO 80523-1586 or send a scanned
PDF of the signature page via email to Marc Winokur at marc. winokur(cJcolostate.edu
Please list all members of your local Family Preservation Commission/Placement Alternative
Commission (PAC).
County/Tribe Name: Weld County
Family Preservation Commission/PAC Members:
1. Barber, Elizabeth
2. Falvo, Melanie (Secretary)
3. Gausch, Stephanie
4. Graffis, Stanley
5. Hartmann, Jodi
6. Horn, Cynthia
7. James, Scott
8. Kearns -Rout, Enita (Chair)
9. Lorenz, Rebecca
10.Mathews, Michael
11.Montoya, Pres
12.Munoz, Meredith
13.Taylor, Lisa
14.Teixeira, Tom
15.Turk, Adam (Co -Chair)
Enita Kearns-Hout
Name of Commission Chair
Signature of the'Commission Chair
Colorado State University
COLORADO
Office of Children,
Youth & Families
Division of Child Welfare
Core Services Family Preservation/Placement Alternative
Commission Report
January 1, 2018 — December 31, 2018
OVERVIEW
The Social Work Research Center at Colorado State University is partnering with the Colorado
Department of Human Services to conduct the evaluation of the Core Services Program, and to
prepare the Department's Core Services Program Evaluation Annual Report.
Each year, counties/tribes are required to complete a report on the status of your Core Services
Program. The information you provide through this web -based report will be combined with
other sources of information including the Colorado Trails database to form the content for the
required annual report.
This report should be completed in conjunction with your Family Preservation
Commission/Placement Alternative Commission (PAC). If your county/tribe does not have a
Family Preservation Commission/PAC, then a designated county/tribal representative who has
knowledge of the Core Services program (e.g., Core Services Coordinator, Child Welfare
Director, DHS Director) should complete the report. Input from local Family Preservation
Commissions/PACs provides a context for the quantitative data elements and represents an
opportunity for your county/tribe to tell the story behind the numbers.
INSTRUCTIONS
1. In preparing your responses, please reflect on the time period from January 1, 2018 to
December 31, 2018, as the report is now based on the calendar year.
2. Your responses will be automatically saved. If you do not complete the report in one
sitting, you can return to the partially completed report by clicking on the survey link
included in the email. Furthermore, you can forward the email with the survey link to a
member of your Family Preservation Commission/PAC for review and/or completion
before submitting the report.
3. You can print or save your responses before submitting the report by downloading and
saving the PDF attachment located at the top of the Report Summary Page.
4. Once you submit the report, the link included in the email will be deactivated and you
will be unable to change your responses.
Colorado County/Tribe
Name:
Weld County
Contact Person for Questions about the Report:
Name:
Phone:
E-mail:
Tobi A. Cullins
(970) 400-6392
cullinta@weldgov.com
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Availability and Capacity of Core Services
Please complete the following questions about the availability (i.e., does the service exist) and
capacity (e.g., is there a lack of providers for the service) of services in your county/tribe.
1. Indicate your level of agreement with the following statements that best describes overall
Core Service availability and capacity.
a. Overall, the availability of Core Services in our county/tribe is adequate to address the
needs of children, youth, and families.
Strongly Disagree
Disagree 'Agree Strongly Agree
b. Overall, the capacity of Core Services in our county/tribe is adequate to address the
needs of children, youth, and families.
'Strongly Disagree'
Disagree Agree Strongly Agree
2. Indicate your level of agreement with the following statements that best describes specific
Core Service availability.
a. There are specific services needed in our county/tribe that are not currently available.
Strongly Disagree
Disagree 'Agree' Strongly Agree
If you answer "strongly disagree" or "disagree" to 2a then skip to 3
b. Which Core Services are not currently available (select all that apply)?
X Substance Abuse Treatment (Very limited availability)
Mental Health Services
Home -based Interventions
Life Skills
Intensive Family Therapy
Special Economic Assistance
Sexual Abuse Treatment (Very limited availability)
X Day Treatment (Very limited availability)
Trauma -informed Services
County Designed Services (specify)
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3. Indicate your level of agreement with the following statement that best describes specific
Core Service capacity.
a. All needed services are available in our county/tribe, but not at adequate capacity.
Strongly Disagree
Disagree Agree
If you answer "strongly disagree" or "disagree" to 3a then skip to 4
[Strongly Agree!
b. For which Core Services are there inadequate capacity (select all that apply)?
X Substance Abuse Treatment
Mental Health Services
X Home -based Interventions
X Life Skills
Intensive Family Therapy
X Special Economic Assistance
X Sexual Abuse Treatment
X Day Treatment
X Trauma -informed Services
County Designed Services (specify)
c. What steps have been/are being taken to address these capacity issues?
Weld County continually explores service options in and around Weld County. As
service options that meet Weld County standards and provide a needed service are
identified, they are pursued through our contracting process. Weld County
continues to develop strong relationships with existing providers that allow for
communication of needs and flexibility in service options and delivery. Our network
of providers helps us creatively meet the needs of our children, youth and families,
and assists us in identifying additional potential providers. Weld County also works
closely with community members and State staff to brainstorm ways to overcome
service barriers, including the lack of adequate capacity among providers in our
area.
At the end of 2018, Weld County began exploring the implementation of hard
timeframes for all services, which would result in referrals only being authorized for
90 days, with the option to review for continuation/extension of the service if
needed. The goal is to encourage providers to address service needs quicker, thus
generating openings and somewhat addressing capacity issues.
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4. Indicate your level of agreement with the following statements that best describes Core
Service accessibility (e.g., is it a challenge for clients to receive the service).
a. All needed services in our county/tribe are available and have adequate capacity, but
there are barriers to accessing them.
Strongly Disagree
Disagree
Agree Strongly Agree
If you answer "strongly disagree" or "disagree" to 4a then skip to 5
b. For which Core Services are there barriers to access (select all that apply)?
Substance Abuse Treatment
Mental Health Services
Home -based Interventions
Life Skills
Intensive Family Therapy
Special Economic Assistance
Sexual Abuse Treatment
Day Treatment
Trauma -informed Services
County Designed Services (specify)
b. Which of the following are barriers to accessing Core Services in your county/tribe?
Transportation
Medicaid coverage
Clinician/Therapist turnover
Bilingual providers
Service costs
family engagement
Other:
c. What steps have been/are being taken to address the barriers you have identified?
Delivery of Core Services
Please complete the following questions about the delivery of services in your county/tribe.
5. What is working well for Core Services delivery in your county/tribe?
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• Core Referral Staffing: Staffings provide an opportunity for caseworkers and
Quality Assurance staff to review cases, articulate service needs and better
monitor progress.
• Open Communication with Providers: Continued open communication with
providers has allowed for increased relationship building and has allowed Weld
County to address issues quickly.
• Provider Pool/Menu of Services: An increased provider pool and a menu of
services has allowed Weld County to better meet client needs; although, capacity
continues to be an issue.
• Medicaid Application Assistance: Assisting families to apply to Medicaid. Families
are identified through a Core referral staffing as needing to apply for Medicaid and
assistance is provided.
6. What is not working well for Core Services delivery in your county/tribe?
Transportation, as in the past, continues to be one of the largest (if not the largest),
barriers to the delivery of Core Services in Weld County. The Greeley/Evans area is one of
the most unique, with regard to transportation, in the North Front Range. Weld County
covers 3,996 miles; however, public transit systems are centralized in metro areas, such as
Greeley and Evans. Rural communities, even those near metro areas, do not offer any
form of public transit. Other transportation options are limited by the availability of
multi -use off street trails, marked bicycle routes, and adequate, safe pedestrian routes.
While Weld County attempts to address these barriers through a variety of means,
including but not limited to: issuing public transportation passes and gas vouchers,
identifying individuals with vehicles who can assist with transportation to and from
services, utilizing Medicaid transport, and utilizing available funding to assist with car
repairs. These barriers continue to be one of the most challenging aspects of delivering
Core Services. In 2O18, Weld County began negotiations with an alternative
transportation vendor to assist with the transportation needs of foster care children and
youth, ages 6 and up.
Locating and accessing qualified bilingual providers, for a variety of languages for all
program areas, is another ongoing barrier to the delivery of Core Services. Weld County
continually seeks out providers through recruitment efforts such as Requests for Bid (RFB),
word-of-mouth, and recurrently following up on entities that Weld County becomes aware
of. Furthermore, Weld County communicates regularly with contracted
providers regarding the need for bilingual services, but providers continue to report that
they struggle similarly to identify and engage qualified bilingual providers.
The loss of local providers due to business closure or other reasons has resulted in Weld
County having to seek alternative services outside of the county due to inadequate
resources.
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7. In the past year, what has changed for your county/tribe in supporting a multi -generational
approach in your delivery of Core Services?
Weld County practices and encourages a philosophy among its staff, vendors and other
professionals which looks at the family holistically, not just at individual family members'
needs. Family engagement is sought and encouraged throughout the process, and most
of the services are geared toward the family, both immediate and extended, rather than
individual members.
8. What strategies has your county/tribe implemented to create a welcoming environment for
LGBTQ children/youth?
Weld County works with local and State resources such as the State's Youth Development
Specialist, and Parents, Families and Friends of Lesbians and Gays (PFLAG). While Weld
County does not have a specific process for identifying children and youth who identify as
LGBTQ, upon disclosure by a child or youth, every effort is made to match them with
services and providers that understand their specific needs. Many of Weld County's
providers now specifically identify services within their scope of work that are specific to
the LGBTQ population.
Collaboration
Please complete the following question related to Core Services collaboration in your
county/tribe.
9. In the past year, what new collaborative efforts has your county/tribe been engaged in to
better serve children, youth, and families in your Core Services Program?
• School Districts: Weld County has developed and/or pursued Memorandums of
Understanding (MOU) with school districts regarding the Every Student Succeeds
Act (ESSA). Weld County continues efforts to bring all county school districts under
executed MOUs.
• Local Community Mental Health: Weld County holds quarterly meetings with the
local mental health provider both in north and south Weld County to address
service needs, communication and collaborative efforts.
• Foster and Kinship Parent Training: Weld County has worked, and continues to
work with, expert providers to bring topic -specific training to foster and kinship
parents. This has included, but is not limited to, offense -specific needs of children
and youth, child development and Applied Behavior Analysis (ABA).
• Regional Accountable Entity (RAE): Weld County continues to meet with Northeast
Behavioral Health and BEACON to identify Weld County needs, population and
barriers to Medicaid access. Weld County also works closely with RAE
representatives on an ongoing basis.
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Core Services Allocation
Please complete the following question related to the Core Services allocation in your
county/tribe.
10. If you could change one thing about how Core Services funding is allocated, what would it
be and why?
Weld County agrees with the basic formula used to calculate the allocation but believes
the CWAC and the State should be moving toward an allocation split between the Ten
Large Counties and the Balance of State Counties, which reflects the actual caseload split
between those clusters.
11. Has your county/tribe participated in any of the Family First Prevention Services Act (FFPSA)
committees, subcommittees, or task groups?
Yes — Family First Prevention Services Act Implementation Team. Weld County has also
participated in FFPSA trainings.
11a. How prepared is your country/tribe to implement the requirements of the FFPSA
for your Core Services Program?
1 2
3
4 5
Not Prepared A Little Prepared Somewhat Prepared' Very Prepared Extremely Prepared
12. What is the biggest barrier for families in your county/tribe to access Medicaid covered
services?
Families in Weld County struggle to access services under Medicaid due to a variety of
factors, including but not limited to:
• Lack of Medicaid providers in many areas of Weld County.
• Lack of acknowledgement by Medicaid regarding the need to certify more
providers.
• Insufficient capacity of current Medicaid providers. Wait lists are common and
often appointments are weeks out.
• Providers are unwilling to engage as Medicaid providers due to the level of
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paperwork, the difficulty of the process, and the low reimbursement rates for
services, thus further limiting the pool of Medicaid providers.
• Medicaid does not always authorize the level of service needed for Child Welfare
clients.
• Medicaid providers lack Child Welfare knowledge and understanding of the court
requirements for Child Welfare cases, with regard to, recommendations and
treatment plans. While this has improved from 2017, there is still room for
improvement. Specifically, in the provision of more detail regarding what is being
worked on with the client, identified next steps and more succinct information
regarding therapeutic progress.
Recommendations
13. If you could make one change to the Core Services Programs, what would it be and why?
Weld County would continue to request greater flexibility to utilize Core Services funding
for transportation only, when the transportation is specifically for getting a client to
and/or from Core funded services. The ability to contract with a transportation specific
service for this purpose under Core Services would alleviate an enormous barrier to service
delivery and client participation in services.
Additionally, Weld County would like the ability to reimburse a provider for professional
time lost in travel to in -home services in rural areas. Often, a provider is unwilling to
conduct services in rural areas or in locations that require extensive travel because of the
loss of billable hours.
14. If you could make one change to this survey, what would it be and why?
This survey continues to be somewhat redundant across questions. Weld County would
request that the survey continue to be reviewed and adjusted for redundancy.
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