The URL can be used to link to this page

Browse Search

Home My WebLink About20180814.tiffPRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: March 13, 2018 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Core Services Family Preservation/Placement Alternative Commission Report 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, 2017, through December 31, 2017, 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 Fridsv1 March 23, 2018. I do not recommend a Work Session. I recommend approval for the HSAC Chair to sign and the Department to submit the Family Preservation Report online. Approve Recommendation Sean P. Conway Julie A. Cozad Mike Freeman rC Barbara Kirkmeyer, Pro -Tern Steve Moreno, Chair Schedule Work Session Other/Comments: 2018-0814 Pass -Around Memorandum; March 13, 2018 — Not in CMS &/1≤� -024-i , .00$79 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@colostate.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: • Barber, Elizabeth • Falvo, Melanie (Secretary) • Freeman, Mike • Gausch, Stephanie • Graffis, Stanley • Hartmann, Jodi • Horn, Cynthia • Kearns-Hout, Enita (Chair) • Lorenz, Rebecca • Matthews, Michael • McConnell, Lucas • Munoz, Meredith • Taylor, Lisa • Teixeira, Tom • Turk, Adam (Co -Chair) Enita Kearns-Hout Name -of Commission Chair <Ylz _Gel Signature o th Commission Chair 3/O.1//cf Date Colorado State University COLORADO Office of Children, Youth & Families Division of Child Welfare Core Services Family Preservation/PAC Report January 1, 2017 - December 31, 2017 OVERVIEW The Social Work Research Center in the School of Social Work 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 their 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, County DHS Director) should complete the report. Input from the local Family Preservation Commission/PAC 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, 2017 to December 31, 2017, 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 Contact Person for Questions about the Report: Name Phone Email Availability and Capacity of Core Services Tobi Vegter 970-400-6392 vegterta@weldgov.com 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 Core Services in your county/tribe. Indicate your level of agreement with the following statements that best describes overall Core Services availability and capacity. Overall, the availability of Core Services in our county/tribe is adequate to address the needs of children, youth, and families. Overall, the capacity of Core Services in our county/tribe is adequate to address the Strongly Strongly Disagree Disagree Agree Agree ❑ El ❑ needs of children, youth, and families. Indicate your level of agreement with the following statement that best describes specific Core Services availability. Strongly Strongly Disagree Disagree Agree Agree There are specific Core Services needed in our county/tribe that are not currently available. ❑ ❑ ❑ Indicate your level of agreement with the following statement that best describes overall Core Services capacity. All needed Core Services are available in our county/tribe, but not at adequate capacity. Strongly Strongly Disagree Disagree Agree Agree ❑ ❑ ❑ For which Core Services are there inadequate capacity? (select all that apply) Q Substance Abuse Treatment © Mental Health Services 0 Home -based Interventions 0 Life Skills © Intensive Family Therapy ❑ Special Economic Assistance © Sexual Abuse Treatment © Day Treatment © Trauma -informed Services © County Designed Services (specify) Bilingual Services- Multiple Langauges (All areas) What steps have been/are being taken to address these capacity issues? Weld County continually researches service options in and around Weld County. Staff meet with potential providers on a regular basis. As potential providers are identified that meet Weld County standards and provide a needed service, services are pursued through our contracting process. Towards the end of 2017, Weld County began having ongoing conversations with our BHO, Colorado Access, regarding accessibility of services, available services, service authorizations and creative solutions to meet client needs. The current outcomes of those conversations have resulted in Weld having a better understanding of the authorization process for some services, such as psychological evaluations, and Weld has been able to open lines of communication between the client and their BHO Care Manager. This has helped keep families out of the Child Welfare system. The unknown factors surrounding the upcoming BHO changes continue to create a barrier to services with regard to timely delivery of services. Specifically, Colorado Access has indicated they do not know who the contact points will be going forward, especially when it comes to appeals and helping families navigate that system. Additionally, Colorado Access has noted that there will be a "warm hand-off" but is not able to articulate what that looks like between them, and the new Regional Accountability Entity (RAE) and our current providers. Weld County is concerned that if this happens to close to the end of the time with our current BHO, it will that impact providers in the area of reimbursement rates. Weld County continues to develop strong relationships with existing providers that allow for communication of needs and flexibility in services options and delivery. Our network of providers helps us creatively meet the needs of our children, youth and families, while also assisting us in identifying potential providers. Weld County also works closely with community members and State staff to brainstorm ways to overcome services barriers, including the lack of adequate capacity among providers in our area. Indicate your level of agreement with the following statement that best describes overall Core Services accessibility (e.g., is it a challenge for clients to receive the service). Strongly Strongly Disagree Disagree Agree Agree All needed Core Services in our county/tribe are available and have adequate capacity, but there are barriers to accessing them. Delivery of Core Services El El El Please complete the following questions about the delivery of Core Services in your county/tribe. What is working well for Core Services delivery in your county/tribe? In early 2017, Weld County restructured it's staff to include a Core Services Practitioner whose role is to focus on provider recruitment and service engagement, while other staff have been moved into Fiscal and Contract Management to refocus those needs. Weld County also continues to extend collaborative efforts with community partners including our local mental health provider, homeless coalition, medical staff and other individuals and agencies to meet the needs of Weld County clients through the delivery of Core Services. Through those efforts Weld has been able to expand its service menu and options, and work creatively with available resources in our communities. What is not working well for Core Services delivery in your county/tribe? In the last year (2017), Weld County has faced significant struggles in utilizing Core Services and Medicaid appropriately, as have many counties, due to the conflicting nature of guiding information from CDHS and the general understanding among systems that counties must access in order to access Medicaid funding for services. This is further exacerbated by a lack of understanding at the County judicial level around the governing rules of both Core and Medicaid, and when each can be accessed. Weld has responded by attempting to bring all parties to the table, including the State, providers, and judicial, so that learning and resolution can occur across all systems in the best interests of the children, youth and families served by Weld County. The end result of this conflict is a delay' in service delivery for some services, such as Intensive In -Home Services. Transportation ;continues to be one of the largest barriers to the delivery of Core Services in Weld County. ;Greeley/Evans area is one of the most unique in the North Front Range with regard to transportation. 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. The Weld County Department of Human Services attempts to address these barriers through issuance of public transportation passes, gas vouchers, working with clients and contractors to identify individuals with vehicles who can assist with 'transportation to and from services, when services are not available in the home, and utilizing available funding to assist with car repairs. When applicable, Medicaid transport is utilized for eligible clients. Weld County further utilizes caseworkers for transport, as well as other creative solutions such as Greyhound. The need for qualified bilingual providers in ;multiple languages for all program areas continues to be an area of need in Weld County. ;Weld has attempted to address the lack of bilingual providers in all program areas through to Request for Bid (RFB), word-of-mouth recruitment, and continually attempting to engage new bilingual providers whom the County becomes aware of. Weld communicates :regularly with contracted providers regarding the need for bilingual services, but providers ,report that they struggle similarly to identify and engage qualified bilingual providers. How is your county/tribe supporting a multi -generational approach in your delivery of Core Services? Weld practices and encourages a philosophy among its staff, vendors and other professionals that looks at the family holistically, not just individual family members or needs. Family engagement is sought and encouraged throughout the process and the majority of the services are geared toward the family, both immediate and extended, rather than individual members. What is your county/tribe process for identifying LGBTQ children/youth who are eligible for Core Services? Weld does not have a specific process at this time for identifying children and youth other than self -disclosure by the child or youth. Once a child or youth discloses, every effort is made to match them with services and providers that understand their special needs and have expertise or experience working with LGBTQ population. Additionally, Weld works with and consults the few organizations in our area that have expertise with this specific population and works with the State's Youth Development Specialist, under the Child Welfare Division of the Office of Children, Youth and Families. The Youth Development Specialist has been particularly helpful in providing research and resources that directly pertain to how best to serve the LGBTQ population. How does your county/tribe assure that inclusive services are available for this population? Weld continues to seek education in this area and works to recruit expertise in providers and community resources for LGBTQ children and youth. What inclusive outreach efforts have been made by your county/tribe to reach this population? Weld County has made efforts to seek input from this specific population as to its specific needs and working with those with expertise in this area to develop and implement applicable services and programming. Collaboration Please complete the following question related to Core Services collaboration in your county/tribe. Please describe how collaborative efforts help your county/tribe to better serve children, youth, and families in your Core Services Program. Weld County continues to work collaboratively with many providers and community partners in an effort to move toward permanency, safety and well-being for Weld children Wand youth. Our collaborations include, but are not limited to: - Promoting Safe and Stable Families (PSSF) - The Collaborative Management Program (CMP) - Nurse -Family Partnership - Colorado Community Response (CCR) - SafeCare Colorado - Colorado Works - Bags of Love Project - Realities for Children Charities - Project 1.27 - Tower 21 - Foster Source - Royal Family Kids - Finally Home Foundation. Weld County works diligently with providers and community partners to focus their services to align with the needs of our community. Weld County has also worked closely with our providers and community partners to increase the overall knowledge base with regard to 2Gen Approach, Trauma Informed Care, etc., thus shifting the approach taken with families to engage them at a deeper level, help them identify what occurred and what the next steps are for their family. Weld County also has placed a greater emphasis on prevention, thus keeping families out of the Child Welfare system. Overall, the County has been able to increase the continuum of services, both Core and non -Core funded, through flexible funding and ongoing collaborative efforts. Core Services Allocation Please complete the following questions related to the Core Services allocation for your county/tribe. 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 believe 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. Has your county/tribe aligned/or are you considering aligning Core Services program rates with Medicaid rates? Yes El No What is the biggest barrier to families in your county/tribe accessing Medicaid covered services? Families in Weld County struggle to access services under Medicaid due to a variety of factors, including but not limited to: 1) Lack of Medicaid providers in many areas of Weld County. 2) Lack of acknowledgement by Medicaid regarding the need to certify more providers. 3) The insufficient capacity of current Medicaid providers. Wait lists are common and often times appointments are months out. 4) Providers not being willing to engage as Medicaid providers due to the level paperwork and difficulty of the process and the low reimbursement rates for services, thus further limiting the pool of Medicaid providers. 5) Medicaid not authorizing the level of service needed for Child Welfare clients. 6) Medicaid providers lack of Child Welfare knowledge and understanding of the court requirements for Child Welfare cases with regard to recommendations and treatment plans. Recommendations Please complete the following questions related to your recommendations for the Core Services Program and Evaluation. If you could make one change to the Core Services Program, what would it be and why? Weld County would request greater flexibility to utilize Core Services funding for transportation only, when the transportation is specifically for the purpose of 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. If you could make one change to this survey, what would it be and why? No changes requested at this time. Powered by Qualtrics Submit CORE SERVICES FAMILY PRESERVATION/PAC REPORT January 1, 2017 -December 31, 2017 (Questions/Responses Not Fully Visible on PDF) QUESTION RESPONSE What steps have been/are being taken to address Weld County continually researches service options in and around Weld County. Staff these capacity issues? meet with potential providers on a regular basis. As potential providers are identified that meet Weld County standards and provide a needed service, services are pursued through our contracting process. Towards the end of 2017, Weld County began having ongoing conversations with our BHO, Colorado Access, regarding accessibility of services, available services, service authorizations and creative solutions to meet client needs. The current outcomes of those conversations have resulted in Weld having a better understanding of the authorization process for some services, such as psychological evaluations, and Weld has been able to open lines of communication between the client and their BHO Care Manager. This has helped keep families out of the Child Welfare system. The unknown factors surrounding the upcoming BHO changes continue to create a barrier to services with regard to timely delivery of services. Specifically, Colorado Access has indicated they do not know who the contact points will be going forward, especially when it comes to appeals and helping families navigate that system. Additionally, Colorado Access has noted that there will be a "warm hand-off" but is not able to articulate what that looks like between them, and the new Regional Accountability Entity (RAE) and our current providers. Weld County is concerned that if this happens to close to the end of the time with our current BHO, it will that impact providers in the area of reimbursement rates. Weld County continues to develop strong relationships with existing providers that allow for communication of needs and flexibility in services options and delivery. Our network of providers helps us creatively meet the needs of our children, youth and families, while also assisting us in identifying potential providers. Weld County also works closely with community members and State staff to brainstorm ways to overcome services barriers, including the lack of adequate capacity among providers in our area. CORE SERVICES FAMILY PRESERVATION/PAC REPORT January 1, 2017 -December 31, 2017 (Questions/Responses Not Fully Visible on PDF) What is not working well for Core Services delivery in your county/tribe? In the last year (2017), Weld County has faced significant struggles in utilizing Core Services and Medicaid appropriately, as have many counties, due to the conflicting nature of guiding information from CDHS and the general understanding among systems that counties must access in order to access Medicaid funding for services. This is further exacerbated by a lack of understanding at the County judicial level around the governing rules of both Core and Medicaid, and when each can be accessed. Weld has responded by attempting to bring all parties to the table, including the State, providers, and judicial, so that learning and resolution can occur across all systems in the best interests of the children, youth and families served by Weld County. The end result of this conflict is a delay in service delivery for some services, such as Intensive In -Home Services. Transportation continues to be one of the largest barriers to the delivery of Core Services in Weld County. Greeley/Evans area is one of the most unique in the North Front Range with regard to transportation. 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. The Weld County Department of Human Services attempts to address these barriers through issuance of public transportation passes, gas vouchers, working with clients and contractors to identify individuals with vehicles who can assist with transportation to and from services, when services are not available in the home, and utilizing available funding to assist with car repairs. When applicable, Medicaid transport is utilized for eligible clients. Weld County further utilizes caseworkers for transport, as well as other creative solutions such as Greyhound. The need for qualified bilingual providers in multiple languages for all program areas continues to be an area of need in Weld County. Weld has attempted to address the lack of bilingual providers in all program areas through a Request for Bid (RFB), word-of- mouth recruitment, and continually attempting to engage new bilingual providers whom the County becomes aware of. Weld communicates regularly with contracted providers regarding the need for bilingual services, but providers report that they struggle similarly to identify and engage qualified bilingual providers. CORE SERVICES FAMILY PRESERVATION/PAC REPORT January 1, 2017 -December 31, 2017 (Questions/Responses Not Fully Visible on PDF) Please describe how collaborative efforts help your county/tribe to better serve children, youth, and families in your Core Services Program. Weld County continues to work collaboratively with many providers and community partners in an effort to move toward permanency, safety and well-being for Weld children and youth. Our collaborations include, but are not limited to: - Promoting Safe and Stable Families (PSSF) - The Collaborative Management Program (CMP) - Nurse -Family Partnership - Colorado Community Response (CCR) - SafeCare Colorado - Colorado Works - Bags of Love Project - Realities for Children Charities - Project 1.27 - Tower 21 - Foster Source - Royal Family Kids - Finally Home Foundation. Weld County works diligently with providers and community partners to focus their services to align with the needs of our community. Weld County has also worked closely with our providers and community partners to increase the overall knowledge base with regard to 2Gen Approach, Trauma Informed Care, etc., thus shifting the approach taken with families to engage them at a deeper level, help them identify what occurred and what the next steps are for their family. Weld County also has placed a greater emphasis on prevention, thus keeping families out of the Child Welfare system. Overall, the County has been able to increase the continuum of services, both Core and non -Core funded, through flexible funding and ongoing collaborative efforts. Hello