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MEMORANDUM
DAM: June 26,2015
TO: Board of County Commissioners— Pass-Around
FR: Judy A. Griego, Director, Human Services
RE: Weld County Department of Human Services' Child
Protection Agreement Extension/Renewal with North Range
Behavioral Health (Core)
Please review and indicate if you would like a work session prior to placing this item on the
Board's agenda.
Request Board Approval for the Departments'Child Protection Agreement
Extension/Renewal with North Range Behavioral Health (Core). The parties agree to extend
the term and rate structure of their original agreement(2014-3107), under the standard form for
renewals. The standard form was approved as new business on March 9, 2015. The renewal
term is for June 1, 2015 to May 31, 2016.
Under this renewal,the parties agree to changes in the Contract Documents. These changes are
as tullows:
I. EXH)BIT C-SCOPE OF SERVICE, Paragraph 3-Mental Health Services:
vii. Intensive In-Home Program (II-H): Intensive in-home mental health services for
children who are at risk of out of home placement due to severe emotional disturbance.
11-H is intended to provide hospital diversion and step-down services in cases that
present with a significant instability and impairment to the extent that without intensive
therapeutic supports, mental health deterioration would result. Services include in-home
behavioral supports, psychotherapy and respite organized into tour(4) phases:
• Phase I (Week I): Assessments(3)and up to 12 hours, Level 2 individual assessment,
family system assessment, and behavior evaluation. Individual, family, dyadic
psychotherapy,as indicated. Behavioral supports, including parent mentoring,
behavioral coaching,de-escalation, resources/education regarding behavioral principles,
conflict resolution, problem solving, and communication. Brief in-home respite(up to 2
hours). Pre-treatment symptoms/issues/behavioral inventories-Outcomes Questionnaire
(OQ), Youth Outcomes Questionnaire(YOQ), Youth Outcomes Questionnaire-Self
Report (YOQ-SR)-Child/youth self-report, Assessment--Treatment Flowchart. Services
may occur in the home, school,community, and other settings. Service times are
determined by the needs of the child/youth,such as when behavioral challenges are
anticipated.
• Phase 2 (Weeks 2-4): 15-20 hours/week. Psychotherapies, behavioral supports, brief
in-home respite(up to 2 hours/week). Assessment-"Treatment Flowchart. Inclusive of
coordination with the Department processes and meetings.
• Phase 3 (Weeks 5-6): 10-15 hours/week. Psychotherapies, behavioral supports, brief
in-home respite(up to 2 hours/week). Assessment-Treatment Flowchart. Inclusive of
coordination with the Department processes and meetings.
Pass-Around Memorandum; June 26, 2015
��% ikk4L(''u> 2015-2205
• Phase 4(Weeks 7-8): Up to 10 hours/week. Psychotherapies, behavioral supports,brief
in-home respite(up to 2 hours/week). Assessment-Treatment Flowchart. Inclusive of
coordination with the Department processes and meetings. Post-treatment
symptoms/issues/behavioral inventories(Outcomes Questionnaire(OQ), Youth
Outcomes Questionnaire(YOQ), Youth Outcomes Questionnaire-Self Report(YOQ-
SR)-child/youth self report).
•Aftercare: Three(3) months. In-home family session once per month.
Phases may be repeated or skipped as indicated by progress with Department approval.
Contractor will report any deviation from the I I-H treatment model to the caseworker
and the Department's Contract and Services Coordinator.
2. EXHIBIT D-PAYMENT SCIIEDULE, Paragraph 2-Fees for Services:
Mental Health Services:
$930.00/Week(Phase I and Phase 2, pro-rated for partial week of service at beginning or end of
service)
$720.00/Week(Phase 3, pro-rated for partial week of service at beginning or end of service)
$420.00/Week(Phase 4, pro-rated for partial week of service at beginning or end of service)
$75.00/Hour(Aftercare. Discontinued Phase I-Assessment Only.)
I do not recommend a Work Session. I recommend approval of this Renewal.
Approve Request
BOCC A Benda Work Session
Sean Conway
Steve Moreno
Barbara Kirkmeyer
Mike Freeman
Julie Cozad
Pass-Around Memorandum;June 26, 2015 Page 2
D /19'
AGREEMENT EXTENSION/RENEWAL BETWEEN
THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND NORTH RANGE BEHAVIORAL HEALTH (CORE)
This Agreement Extension/Renewal("Renewal"),made and entered inter day of -TILL ,2015,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 North Range Behavioral Health,hereinafter referred to as the"Contractor".
WHEREAS the parties entered into an agreement(the"Original Agreement")identified by the Weld County Clerk to the
Board of County Commissioners as Document Number 2014-3107,approved on 10/13/2014.
WHEREAS the parties hereby agree to extend the term of the Original Agreement in accordance with the terms of the
Original Agreement,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 31,2015.
• The parties agree to extend the Original Agreement for an additional one(1)year period,which will begin June 1,2015,and
will end on May 31,2016.
• The Renewal,together with the Original Agreement,constitutes the entire understanding between the parties. The
following change is hereby made to the Contract Documents:
1. EXHIBIT C-SCOPE OF SERVICE, Paragraph 3-Mental Health Services:
vii. Intensive In-Home Program(II-H): Intensive in-home mental health services for children who are at risk of
out of home placement due to severe emotional disturbance. II-H is intended to provide hospital diversion
and step-down services in cases that present with a significant instability and impairment to the extent that
without intensive therapeutic supports,mental health deterioration would result. Services include in-
home behavioral supports,psychotherapy and respite organized into four(4)phases:
• Phase 1(Week 1): Assessments(3)and up to 12 hours,Level 2 individual assessment,family system
assessment,and behavior evaluation. Individual,family,dyadic psychotherapy,as indicated.
Behavioral supports,including parent mentoring,behavioral coaching, de-escalation,
resources/education regarding behavioral principles,conflict resolution,problem solving,and
communication. Brief in-home respite(up to 2 hours). Pre-treatment symptoms/issues/behavioral
inventories-Outcomes Questionnaire(OQ),Youth Outcomes Questionnaire(YOQ),Youth Outcomes
Questionnaire-Self Report(YOQ-SR)-Child/youth self-report,Assessment-Treatment Flowchart.
Services may occur in the home,school,community,and other settings. Service times are determined
by the needs of the child/youth,such as when behavioral challenges are anticipated.
• Phase 2(Weeks 2-4): 15-20 hours/week. Psychotherapies,behavioral supports,brief in-home respite
(up to 2 hours/week). Assessment-Treatment Flowchart. Inclusive of coordination with the
Department processes and meetings.
• Phase 3(Weeks 5-6): 10-15 hours/week. Psychotherapies, behavioral supports,brief in-home respite
(up to 2 hours/week). Assessment-Treatment Flowchart. Inclusive of coordination with the
Department processes and meetings.
• Phase 4(Weeks 7-8): Up to 10 hours/week. Psychotherapies,behavioral supports,brief in-home
respite(up to 2 hours/week). Assessment-Treatment Flowchart. Inclusive of coordination with the
Department processes and meetings. Post-treatment symptoms/issues/behavioral inventories
(Outcomes Questionnaire(OO),Youth Outcomes Questionnaire(YOQ),Youth Outcomes
Questionnaire-Self Report(YOQ-SR)-child/youth self report).
• Aftercare: Three(3)months. In-home family session once per month.
020 1,�- 5
AGREEMENT EXTENSION/RENEWAL BETWEEN
THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND NORTH RANGE BEHAVIORAL HEALTH (CORE)
Phases may be repeated or skipped as indicated by progress with Department approval.
Contractor will report any deviation from the II-H treatment model to the caseworker and •he
Department's Contract and Services Coordinator.
2. EXHIBIT D-PAYMENT SCHEDULE, Paragraph 2-Fees for Services:
Mental Health Services:
$930.00/Week(Phase 1 and Phase 2, pro-rated for partial week of service at beginning or end of service)
$720.00/Week(Phase 3, pro-rated for partial week of service at beginning or end of service)
$420.00/Week(Phase 4, pro-rated for partial week of service at beginning or end of service)
$75.00/Hour(Aftercare. Discontinued Phase 1-Assessment Only.)
• 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: BOARD OF COUNTY COMMISSIONERS
Weld Coun ler to the Board ��4 s ' 4 % WELD COUNTY,COLORADO
BY: �.� �� i�
Deputy Clerk o the Boa 361f O . Barbara Kirkmeyer, air
►`'� r,"L ' 0 2015
� 1 • , APPROVED AS TO SUBSTANCE:
44-th1LController Elect Official oDepartme Head
APPROVED AS TO FORM
Director of General Services
County Attorney NORT RANGE BEHAVIORAL HEALTH
t/v"
ry D.P orff, Executive Dir r
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