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HomeMy WebLinkAbout20140722.tiff • MEMORANDUM 1861 txl :47„, DATE: January 30,2014 OUNTY C Q- TO: Board of County Commissioners-Pass-Around FR: Judy A. Griego, Director, Human Services RE: Weld County Department of Human Services Various Items This Memorandum provides the summary of the following: • Chronic Disease Self-Management Education(CDSME)License Holder Agreement • Non-Financial Partnership Member Agreement for the Statewide Chronic Disease Self- Management Program Collaborative • Purchase of Services Agreements with Various Providers • The Department's 2014-2015 Victim Assistance Law Enforcement(VALE)Grant Application • Weld County PA-3 Addendum to the 2013-2014 Core Plan • Complete the Community Response Grant Application with the State of Colorado Department of Human Services' Office of Early Childhood These do not represent new activities. Please review and indicate if you would like a work session prior to placing these on the Board's agenda. 1. Request Board Approval of a Chronic Disease Self-Management Education(CDSME) License Holder Agreement between the Department's Area Agency on Aging and the Central Colorado Area Health Education Center. This agreement allows the Area Agency on Aging to implement the Stanford's Chronic Disease Self-management Education series under a grant from the Department of Human Services,Division of Aging and Adult Services to older adults 60 years and older and adults with disabilities age 18 and older in Weld County. We will receive reimbursement for each participant that has completed the class at a rate of$160.00 per person. This agreement will be effective as of the date of signing and shall be effective until August 31, 2014, for year 2 and renewal for year 3 based on funding availability. This is the second year of the grant. I do not recommend a work session. I recommend approval of this License Holder Agreement. Approve Request BOCC Agenda Work Session Sean Conway t __ Bill Garcia W6 Barbara Kirkmeyer Mike Freeman Doug Rademacher Pass-Around Memorandum;January 30, 2014 2014-0722 earnnuAn i 3/1 O/ZA q 2. Request Board Approval of a Non-Financial Partnering Member Agreement for the Statewide Chronic Disease Self-Management Program Collaborative. The Weld County Area Agency on Aging has been a member of the Statewide Chronic Disease Self-management Collaborative(currently have a non-financial agreement that has expired December 31,2013). This non-financial partnering member agreement outlines that we will work collaborative with other agencies in Colorado that provide the Stanford Chronic Disease Self-Management Education series. This agreement will be effective as of the date of signing and will remain effective until it is revoked in writing by the Statewide Collaborative or the Department. I do not recommend a work session. I recommend approval of this Non-Financial Member Agreement. Approve Request BOCC Agenda Work Session Sean Conway Bill Garcia Barbara Kirkmeyer _ Mike Freeman Doug Rademacher 3. Request Board Approval of Purchase of Services Agreements between the Department and Various Providers. Each of the centers listed below face financial hardship in terms of keeping their centers open due to their limited funds. All of these sites are part of our Senior Nutrition Program and play a vital role in senior services in their rural communities. The centers will utilize the grants to help pay for heat,lights, telephone, supplies,water and other operational expenses. The funds for the Operational grants were approved by the Area Agency on Aging Advisory Board and the Weld County Board of Commissioners in June 2013 for FY14. • Pierce Senior Center- $375 • Hill N Park Senior Center- $375 • Lochbuie Senior Center- $375 • Nunn Senior Center-$375 I do not recommend a work session. I recommend approval of these Agreements. Approve Request BOCC Agenda Work Session Sean Conway Bill Garcia u� Barbara Kirkmeyer Mike Freeman Doug Rademacher 4. Request Board Approval of the Department's 2014-2015 Victim Assistance Law Enforcement(VALE)Grant Application. The Ombudsman Program has received the VALE grant for the past 17 years since 1997. We are requesting $12,000 for the July 2014 through June 2015 funding cycle. The VALE grant has allowed the Ombudsman Program to increase staff time to keep up with the increasing demand for advocacy on behalf of this very vulnerable population. Since the last grant application,2 new assisted living facilities and 1 nursing home have opened in Weld County. The funds have enabled the Program to maintain an abuse Pass-Around Memorandum;January 30, 2014 Page 2 education and awareness program aimed at educating direct caregivers who work in long term care settings. The grant has also allowed the opportunity for the Ombudsman Program to educate residents and staff about the Ombudsman Program,abuse issues and resident rights. Continued funding will make it possible for the Ombudsman Program to serve the increasing number of vulnerable long term care residents, and allow for the continuation of the long term care friendly visitor program. We believe that our request for the continuation of funding relates to the mandate of early crisis intervention and to provide assistance and support to victims and their families. I do not recommend a work session. I recommend approval of this Grant Application. Approve Request BOCC Agenda Work Session Sean Conway Bill Garcia kit Barbara Kirkmeyer Mike Freeman F Doug Rademacher 5. Request Board Approval of a Weld County PA-3 Addendum to the 2013-2014 Core Plan. In 2013, Program Area(PA-3)was added to State rule allowing counties to provide prevention and intervention services with existing funding sources. The Addendum to the 2013-2014 Core Plan that has been submitted for your approval reflects the addition of Program Area 3 (PA-3)in order for Weld County to utilize this new area. By amending our current Core plan and adding PA-3,it will allow Weld County; 1)the flexibility to creatively design and deliver prevention and intervention strategies in our community to prevent children from entering or being more deeply involved in child welfare, 2)the ability to collect and analyze outcome data for services delivered, 3)the ability to track funding used for prevention and intervention service delivery. I do not recommend a work session. I recommend approval of this Addendum. Approve Request BOCC Agenda Work Session Sean Conway Bill Garcia Barbara Kirkmeyer Mike Freeman yr, Doug Rademacher yf 6. Request Board Approval for the Department to Complete the Community Response Grant Application. The Weld County Department of Human Services is submitting a grant to apply for the Colorado Community Response grant that is funded through the State of Colorado Department of Human Services' Office of Early Childhood. We are requesting$75,000 for the first year and $150,000 for the second year. These funds will support: 1)An additional Community Case Manager FTE,we currently have two(2)in our Prevention Unit and this FTE will assist with the current waitlist. These FTEs are taking the families who are screened out when a community member calls in a concern of abuse/neglect. 2) An FTE for a Family Engagement Facilitator, as a part of the grant it requires a Family Engagement meeting with each family. 3) We will contract with North Range Behavioral Health through Project Launch to provide groups that are required through the grant to assist families with parenting and life Pass-Around Memorandum;January 30,2014 Page 3 skills. The preferred population is those families with children age 5 and under, refugees, undocumented persons, teen parents and single parents. However, we can continue to offer this to all families who have been screened out in the system. This grant assists us with our vision in prevention and with our continued working relationship with North Range to assist in the prevention of abuse and neglect. There is no local match. I do not recommend a work session. I recommend approval of this Grant Application. Approve Request BOCC Agenda Work Session Sean Conway oafs, Bill Garcia to Barbara Kirkmeyer Mike Freeman to Doug Rademacher Pass-Around Memorandum;January 30, 2014 Page 4 Section I —Applicant Qualifications Weld County has maintained a community case management program to field screened out referrals in a prevention capacity for the past four years. The Community Case Managers who currently work in this unit are seasoned case workers who have been trained through the state and have experience in the department also as intake workers, case aides, screeners, and parent educators. The unit is supervised by a Prevention Programs Supervisor who has been trained through the CDHS Academy as well. All Community Case Managers will hold a bachelor's degree; complete all training through the academy including courses on case management, family engagement, and the Center for the Study of Social Policies Strengthening Family Protective Factors Framework. Additionally, the Community Case Managers will be all obtain the Infant Mental Health Specialist II endorsement from the Colorado Association for Infant Mental Health. These positions will be supervised by the Prevention Programs Supervisor as well as receive reflective clinical supervision through our partnership with Project Launch at North Range Behavioral Health. Since 2013 the Community Case Managers have been assigned to work with 228 families within Weld County. Section II. Target Population Currently the Community Case Managers Program is working with any family with children ages 18 and younger who are in need of prevention services within Weld County. One of the current case managers is fluent in Spanish and able to assist families who are monolingual Spanish speaking. In addition, due to an influx of Somalian and Burmese refugees, the department also works closely with refugee services such as Lutheran Family Services, the Global Refugee Center and Catholic Charities to provide cultural competent services to those populations. Additionally, the department contracts with the Language Line to provide interpreter services in over 200 additional languages. Historically the department has screened out approximately 48% of referrals to the department and closed approximately 87% of assigned assessments as either unfounded or inconclusive. Of those assessments about a third of the families had children between the ages of 0-5 years old. These families would be the primary pool of clients for the voluntary free prevention services of the community case managers. Section III. Program Services and Activities Over the past 1-2 years, the Weld County DHS Child Welfare Prevention Community Case Manager Program has been developing and implementing the following response to screened out referrals. Weld County DHS Child Welfare Prevention Community Case Manager Program The Community Case Manager program aims to: • keep children in a safe, stable and nurturing family environment • improve parenting capacity and family functioning • improve children's well-being • prevent families from re-entering the child protection system and prevent unnecessary placement. The primary intended outcome of the community case manager program is that a family can receive services and resources for overcoming challenges that, if left unaddressed, could result in further involvement with the child welfare system. Family and Child outcomes will depend on include a combination o f any of the the goals identified for each child and their family and may following: • improved family functioning including: o increased social support for family o improved parenting skills o improved skills in problem solving, financial management/budgeting o improved household living conditions o more sustainable household routines o crisis situation stabilized o maintain and strengthen family bonds and reduce family conflict o independently access supports needed to effectively manage stressful or crisis situations • reduction in concern for risk for the child • other related needs of particular family members are recognized and addressed • improved child safety and wellbeing Colorado Practice Model —Standards of Practice that Apply to Weld County's Prevention Service Unit The following overarching standards are valued and demonstrated at every stage of service through the Weld County Prevention Service Unit's involvement with a family. • Family engagement is an overarching theme of practice throughout service assessment, planning, and delivery. Family engagement is demonstrated by staff joining the family, involving the family and youth in decisions that affect them, and establishing common goals concerning safety, well-being and permanency, with emphasis on identified family protective factors. Family engagement is culturally responsive and results in meaningful family involvement. • Through mutual dialogue with children, youth and families and extended family, supportive relationships are identified and promoted. • Consistent and meaningful contact with children, youth and families include continuous assessment of all family members in regard to safety, risk and the family service plan. • Documentation is factual, accurate, clear, concise, timely and understandable. • Integrated human services is part of an overall philosophy to enhance the family condition by improving services, increasing prevention, collaborating with communities and creating improved client outcomes. • When multiple service systems are involved with a family, all efforts will be made on the part of the child welfare system to collaborate with those systems and to coordinate and integrate service planning and delivery whenever possible. These efforts will include engaging in two way communication with other service providers, linking plan elements to meet families' needs, minimizing duplication of services, and monitoring plan progress in a team oriented fashion, with the family participating as an equal team member. This will result in a shared meaning of strengths, needs and outcomes. • Supervisors will guide casework practices and decisions that promote the values and principles of the practice model while ensuring compliance with applicable laws and regulations. • Supervisors will support staff in developing skills through proactive performance management and feedback and provide quality clinical supervision, supportive coaching, and effective mentoring consistently across the child welfare system. • Leadership at all levels of the Colorado child welfare system will be responsive to how staff experience their job and work concerns, specifically related to worker safety. n resources necessary to staff will beprovided with the tools, training and Casework promote their own physical and emotional safety. • Services are monitored and evaluated for impact on child safety, permanency and well- being, as well as lessons learned through the delivery of the service by the agency and community service providers. • Case transition include the relevant/appropriate participants and are transparent, planned, timely, clearly communicated and documented. Case transitions may include stages of a case, case transfers or changes of services and involved participants. • Information sharing should occur through an active exchange of information to benefit assessments, case planning, and service delivery while ensuring confidentiality and protecting private information. • Agency staff have a thorough knowledge of and are able to refer children, youth, and families to community and/or agency resources • Decision-making is objective, culturally responsive, builds upon information gathered, and collective whenever possible. Practice Standards that are valued and achieved as specific tasks related to service delivery during a family's involvement with Weld County's Prevention Services Unit, as they are applicable. • Assessment is dynamic and on-going throughout the life of the case. Assessment includes interviewing all relevant parties in a culturally responsive manner, obtaining and sharing information regarding what is current dynamics within the family that is of concern, identifying the strengths of the children, youth and families, and recognizing underlying safety, risk and protective factors. • Child safety is paramount. Ongoing safety and risk assessment for children, youth and families drives decision making, service planning and delivery. • Community and agency services and supports will be made available with a goal of keeping the children and youth in their home and sustaining success after the case is closed. • Agency staff helps families make connections to community partners and teach, advocate and mentor families so they can work to utilize resources on their own. • Service planning is a dynamic, ongoing and culturally responsive process based on continuous assessment of the children, youth and family situation. • Families will participate, as team members, in decision making regarding the choice of resources. Resources must be appropriately matched to the needs of the family and their ability to use the resource effectively. Services must be relevant and consistent with evidence about effective practice. • Setting goals and developing plans will be done with families. The plan should be realistic, clearly articulated and written in a language the family understands. The plan should include specific goals that obtain outcomes of measurable, behavior change. • Families and case workers will work together to develop family service plans which contain a mix of traditional and non-traditional services for families and youth that result in meaningful change. A comprehensive, coordinated and integrated family service plan across multiple children and family serving agencies will address child and youth well- being. • Service delivery follows the terms of the plan and is adjusted as indicated by ongoing assessment of the family's needs by the team. When multiple service systems are involved with a family, successful delivery requires linking and coordinating systems, both formal and informal, to meet the family's needs, minimize duplication of activities and support continuous movement toward agreed upon goals. • Agency staff members have a clear understanding of their professional agency's role as a service provider in the community. Case management facilitates the achievement of client wellness and autonomy through advocacy, mentorship, assessment, planning, communication, education, resource management, and service facilitation. Based on the needs and values of the client, and in collaboration with all service providers, the case manager links clients with appropriate providers and resources throughout the continuum of health and human services and care settings, while ensuring that the care provided is safe, effective, client-centered, timely, efficient, and equitable. The program incorporates strengths-based case management that requires the intentional process and a clear purpose for both the family being served and the case manager. Key elements to strengths-based case management include building a relationship, completion of a strengths-based assessment, goal identification and prioritization, development of a family service plan with action steps and ways to overcome obstacles and to celebrate achievements. Functions include: • Conducting a comprehensive assessment of the family's needs, including risk and protective factors, and develop family service plan collaboratively with the family. • Planning with the family how to maximize resources in the community to garner the most effective outcomes. • Facilitating communication and coordination between the systems of care involving the family and involving the family in the decision-making process in order to minimize fragmentation of the services. • Educating the family regarding issues facing the family so that timely and informed decisions regarding case management can be made. • Empowering the family to problem-solve by exploring options and alternative plans, when necessary, to achieve desired outcomes. • Encouraging the appropriate use of community resources and strives to improve quality of care. • Assist the family, when necessary, to transition to the next level of most appropriate care. • Strive to promote family self-advocacy and self-determination. Effectiveness of a case management program is demonstrated in the positive impact that it has on the target population. Individuals will have met the general expectations of case management services when they can be effectively maintained by community supports that have been established without further assistance of the case manager. Eligibility Criteria Human services shall be responsible for identifying and referring children and their families who are eligible for the program. Cases that are screened out by RED Team or a Child Protection Supervisor may be eligible to be reviewed by the Prevention Services Unit Supervisor and assigned to a Community Case Manager. Appropriate Referrals Guidelines for Referrals to Consider for the Community Case Management Program 1. Families with children, age 5 or under 2. Expecting and parenting teens; single, incarcerated immigrant and refugee parents and/or parents facing multiple challenges that increase risk of child abuse and neglect. 3. Abuse or neglect is likely to occur(threatened harm) 4. A lack of identified PRESENT danger threats 5. Lack of necessary care due to poverty 6. Parent fails to provide necessary care for religious reasons 7. Possible medical neglect of a disabled infant 8. Possible impending danger 9. Lack of supervision 10. Lack of necessary medical care 11. Food, clothing, and shelter needs are inconsistently met by parents/caregivers 12. Untreated physical injuries, illnesses or impairments 13. Emotional damage 14. Situational or"one time" non-accidental injuries 15. Long history of involvement with child welfare with multiple referrals/screen outs/unfounded Initial Contact and Engagement After a referral has been assigned, Community Case Managers will first attempt to contact the family by telephone to engage the family in the program. If we are unable to connect on the phone the case manager will try to reach the family at their home. At this time a letter will be mailed out to the family indicating they have been referred to the program and they are eligible for additional resources. An initial meeting will be scheduled and at that meeting a Family Engagement meeting will be discussed. If the Community Case Manager has not heard from the family within five business days of the second phone call, they may make an unannounced visit to the family's home. The idea is to provide a universal access for this service to address fair and equitable access. Intake An intake and Stressors and Strengths Tracking Device are completed in the initial meetings with the client during which the case manager gathers information to address the family's immediate needs to encourage their engagement and retention of services. Releases of information are signed as needed to refer to outside agencies. Using a comprehensive case management model, the intake allows initiation of case management activities while the assessment can be completed. During the intake, the family with the guidance of the case manager will assess what, if any, are immediate needs that should be addressed promptly. In addition to exploring immediate needs, all families will explore the ongoing issues in regards to their children including parenting needs and support. Families will also complete the Protective Factors Survey pre-evaluation that measures protective factors in five areas: family functioning/resiliency, social networks, concrete support, nurturing and attachment and knowledge of parenting/child development. Additional screens related to developmental screening and mental health supports will be determined. A protocol will be developed to collect pre/post data. A mandatory Family Engagement meeting will be held with all families after the assessment is complete and thereafter every 60-90 days until completion of the CCR program. Family Service Plan During the intake or the first subsequent visit after the intake, a family service plan will be developed. A family service plan includes: • Goal(s) • Activities (work plan, action to be taken, follow-up tasks) • Individuals responsible for the activity (case manager or team member, client, family member, agency representative) • Anticipated time frame for each activity • Protective Factors • Client signature and date, signifying agreement • Supervisor's signature and date and will be reviewed by the supervisor every 30-days with the case manager. • All other related team members Documentation includes: • Family service plan format developed by the program that includes the above information • Progress notes recording activities on behalf of the client to implement the family service plan • Actual outcomes of case management goals and activities The program will monitor to assess the client's ability and motivation to complete the family service plan activities and address any other barriers to achieving the plan. (For example, if a client is unable to perform specific activities alternative approaches to meet the goal will be explored such as skills development or navigation of activity by case manager). All family service plans will be developed during face-to-face meetings between the client/family and case manager to encourage a client's active participation and empowerment. A copy of the plan is also offered to the client to emphasize the partnership. Measurable goals and activities, taking into consideration cognitive and physical abilities, available resources, support networks, and client interest, result in a more realistic, client- specific plan. Although client signature denotes acceptance of a plan, a client may decline all or any portion of the family service plan as well as request changes. The bulk of case management work occurs in the implementation of the family service plan. Implementation involves carrying out tasks listed in the plan, including the following activities: • provider contact in person, by phone or in writing • assistance to client and family in applications for services • assistance in arranging services, making appointments, confirming service delivery dates • encouragement to client/family to carry out tasks they agreed to • direct education to the client/family as needed • support to enable client/family to overcome barriers and access services • advocacy and mentorship as needed • other case management activities as needed by client, and as expected and permissible by program initiative. In the comprehensive case management model, client contact and monitoring are expected to be frequent and proactive in order to anticipate problems, stabilize the status, prevent crises, and support the client in achieving service goals. Expectations include face-to-face contact, home visits (when appropriate), and accompaniment of clients to providers where necessary to ensure services. 1. Oversight of the case plan implementation is the responsibility of the case manager. 2. Progress notes in the case management record detail the advancement of the case management effort for client/family and record actual outcomes of activities. 3. Evidence is documented in the client's file that the case manager and/or team members contact the client and/or providers by a means and frequency appropriate to the family's needs. 4. Families can always contact the case manager and request updates, 5. Documentation indicates contact with client and/or providers occurs after arranging services to determine if services are: a. delivered as expected b. utilized by the family c. satisfactory to the family d. continue to be appropriate to the family's needs e. result in positive outcomes This is referred to in this community as "Closing the Loop" and has been identified by a variety of community partners involved with Project LAUNCH in a recent Sustainability Planning meeting, as a needed service. 6. Case management provider follows up on problems with service delivery Case Planning The Community Case Manager will engage in regular home visits. These visits should begin as weekly visits for the first 30 days. Visits may decrease thereafter, depending on the needs of the family. This service is designed to enhance the bonding between the parents and their children, and increase the knowledge of child development and effective parenting techniques. The service is primarily in the family's home and tailored to each family's unique needs. Components of the home visit include: • Parent training using "Making Parenting a Pleasure" curriculum or Parenting Wisely • Referrals to North Range Behavioral Health (Project Launch), Northeast Behavioral Health/Family CONNECTS, or Lutheran Family Services Rocky Mountain programs that incorporate Nurturing Parenting Program, Parents as Teachers or the Incredible Years for parents/caregivers who need more in-depth parenting instruction, and infant and early mental health consultant • Referrals will be made to the ongoing Circle of Parents groups that will allow parents to connect with one another and reinforce informal supports in the community. • Parent-to parent-mentoring, when available • Parent support: focusing on the strengths of parents and providing reinforcements for those behaviors • Coaching: structured communication that results in indentifying and solving problems and building on strengths • Assessment/Parent Involvement in goal setting • Monitoring and evaluating the goals with families • Advocating on behalf of the family • Referrals and follow-ups: reviewing progress and revising goals in a partnership relationship between families and staff • Respite care: temporary alternative care for the child or children during stressful or crisis situations • Assess if the families financial picture has been determined and consult on needs to assist with budgeting and social capital Financial Decision Making In addition to addressing other basic immediate needs as well as ongoing support, the ability for the family to address their financial needs will be explored. Each family will be asked to complete a financial literacy program certified by the National Endowment for Financial Education. NEFE is the leading non-profit foundation dedicated to inspiring empowered financial decision making for individuals and families through every stage of life. Tools from NEFE will assist case managers on the financial aspects of the financial challenges facing clients to include basic money management and ability for case managers to coach families on their financial assets. Flex Funding In addition to the use of the CSBG funds, the Community Case Managers will have access to flex funding provide families with limited, one-time requests to cover to expenses associated q with rent, utilities, clothing, child safety equipment, transportation and one-time emergency mer enc funding will be made through the Community . Applications for such e assistance emergency 9 pp Case Manager, approved by the Prevention Services Program Supervisor and, if over$500, reviewed/approved by the Child Welfare Administrator. Other avenues of funding such as LEAP, community assistance, and charitable donations will be accessed first before applying for flexible funding through the program. Case Evaluation —Outcomes and Indicators Check List Clients who complete the program successfully will be asked to participate in an evaluation of knowledge and skills prior to closing. This evaluation will be based on the 21 targeted outcomes for every case. It is not a test to whether or not the clients retained the knowledge but if the knowledge was imparted to them within their case management program. Not all targeted outcomes are appropriate for every family and adjustments to the evaluation may be made to reflect that. In addition, a follow up Protective Factors survey and any other related surveys will be completed. Case Closure Clients who are no longer engaged in active case management services should have their cases closed based on the criteria and protocol outlined below. A closure summary in the case file will outline the progress towards meeting identified goals and case disposition. Common reasons for case closure include: • Client does not engage in service. • Client chooses to terminate service. • Client relocates outside of service area. • Agency terminates. • Mutual agreement. • Client is no longer in need of service. • Client completed case management goals. Follow-Up Contact Outcome The Community Case Management program will be reviewed at the end of each fiscal year. The following outcomes will be reported: 1) If the program successfully reduced the number of open cases in child welfare system 2) If the program successfully reduced high cost services such as out-of-home placement or further involvement by Human Services. 3) If the program successfully re-focused resources within social services. 4) If the program successfully developed a better system of design to meet the needs of child/youth and families in regard to: a. Keep families together through a better utilization of existing community resources to avoid opening a case in the child welfare b. Improve the ability of families to access and maintain services as documented by outcomes in the case plan 5) If the program reduced the recidivism rate of additional welfare calls. 6) If the program increased protective factors for the family. The Community Case Manager assigned to a particular family will be responsible to conduct follow-up contacts upon completion of the agreed upon course of intervention. The follow-up contact is to occur at 1 month, and 6 months post discharge. The 1-month follow-up will be face-to-face whenever possible. The subsequent follow-ups can be phone contacts. At the 1-month follow-up face-to-face appointment, all families who originally complete a Protective Factors Survey at the beginning of their case, and are open with a case manager for more than 60 days, will be asked to complete a post-survey as well. If they originally declined to fill out a pre-survey, they are not requested to fill out at the 1-month follow-up visit. Evaluation & Measurement In order to properly evaluate the outcome of prevention in the cases assigned to Community Case Managers, the following procedure will be put in place: All cases in which they have completed the entire program voluntarily will be re-examined after 6-months. Dependent Variable 6-months after case closure Successful No referrals or re-entry, including less than 2 screen outs Partially Success Referrals but findings were either unfounded or inconclusive Unsuccessful Re-entry with founded assessment A report will be generated each quarter to assess the success of the program and precipitate any adjustments to service delivery. The quarterly review will be submitted to the Child Welfare Administrator and the Director of Human Services. Supervision The Community Case Manager and their supervisor will meet weekly to discuss progress on open cases and address challenges facing successful completion of the program. In addition, reflective supervision and clinical case conferencing will be made available through North Range Behavioral Health as part of the local Project LAUNCH. Section IV. Evaluation Weld County currently has employed two FTE who gather data from similar cases in which this grant is requiring and places the data into a spreadsheet. Weld would have the case managers enter the data and if needed they would have the assistance from their supervisor. All employees have a laptop with access to an air-card to assist with the inputting of data in the field. Since the case managers are Weld County employees access to Trails will be seamless. Evaluation will be completed as per the requirements of this grant. Section V. Community Resources Within the Prevention Unit there are several collaborative relationships working together to help promote the well-being of families. Weld County receives Promoting Safe and Stable Families (PSSF) funding which the local homeless shelter receives. A current contract exists that fund Community Case managers who primarily work with families when homelessness is a concern. This case manager also provides child protection knowledge and direction to the shelter staff and helps with a parenting class as well for the residents. North Range Behavioral Health is our mental health provider. A team of infant and early mental health prevention providers partner with Weld Department of Human Services prevention unit to provide workforce development related to infant and early mental health, evidence base practices, and activities to support infant mental health endorsement, such as reflective supervision. Weld just completed its' 3rd year as a Project LAUNCH .grantee —Weld Systems Navigation Project. Department of Human Services representatives participated in the original grant application, the community needs assessment, and strategic planning for this grant. Currently, they are an active LAUNCH partner and participate in activities related to social marketing, workforce development for the prevention unit and strategic planning and implementation of evidence based early mental health practices in an effort to increase their response to the needs of the families they serve. An emphasis has been placed on shifting from an intervention to prevention framework. Finally, the development of a systems' navigation component, in which families with multiple needs across multiple systems, are provided advocacy, mentorship and education, serves to inform the Colorado Community Response Model, with respect to pre/post data collected related to parent knowledge, motivation, closing the loop, access to community services and program satisfaction. Weld County has a Faith Council where the non-profit organizations including some of the churches meet monthly to discuss resources and share information about what the needs in the community may be for any given month. This has proven to be a great resource to our community. Weld County DHS has a program called Compass that employs 6 different individuals who are shared between their organization and Weld County DHS under yearly contracts that has been in existence for over 11 years. This community organization works as a team with a set structure that assists families through systems and offers varied strategies to best assist families to succeed. A plan is created with the family and action steps are implemented for the best outcomes. Weld also has a great working relationship with the Youth and Family Connections organization which assists youth with an assessment and referral process. Hello