HomeMy WebLinkAboutC10-281 CORE Services Program Three Year Plan CORE SERVICES PROGRAM THREE YEAR PLAN S FY 2010 - 2011 S FY 2011 - 2012 S FY 2012 - 2013 FOR EAGLE COUNTY ao ut REQUEST FOR STATE APPROVAL OF PLAN Since this is the first of a the three year Core Services Plan, this page needs to be signed by required signatures. This Core Services Plan is hereby submitted for Eagle County, for the period contract years June 1, 2010, through May 31, 2013, fiscal years July 1, 2010, through June 30, 2013. The Plan includes the following: ➢ Completed "Statement of Assurances "; ➢ Completed Statement of the eight (8) required Core services to be provided or purchased; a list of county optional services, County Designed Program Services (indicate Evidenced Based Services to Adolescents Awarded County Designed Programs), to be provided or purchased; ➢ Completed program description of each proposed "County Designed Service"; ➢ Completed "Information on Fees" form; ➢ Completed "Reunification Issues" form; ➢ Completed "Direct Service Delivery" form; ➢ Completed "Purchase of Service Delivery" form; ➢ Completed "Projected Outcomes" form; ➢ Completed "Overhead Cost" form; ➢ Completed "Final Budget Page" form; ➢ r and, Com leted "State Board Summary"; a P N. ➢ Completed "100% Funding Summary' form. This Core Services Program Plan has been developed in accordance with State Department of Human Services rules and is hereby submitted to the Colorado Department of Human Services, Division of Child Welfare Services for approval. If the enclosed proposed Core Services Program Plan is approved, the Plan will be administered in conformity with its provisions and the provisions of State Department rules. The person who will act as primary contact person for the Core Services Plan is Sherri Almond and she can be reached at telephone number 970- 328 -8852 and e-mail at sherri.almond(aeaglecountv.us If two or more counties propose this plan, the required signatures below are to be completed by each county, as appropriate. Please attach an additional signature page as needed. Signature, DIRECTOR, COUNTY DEPARTMENT OF HUMAN /SOCIAL SERVICES DATE Signature, CHAIR, PLACEMENT ALTERNATIVES COMMISSION DATE keZ allc� Signature, CHAIR, B ARD OF COUNTY COMMISSIONERS DATE Please check here if your county does not have a Placement Alternative Commission: X 2 CORE SERVICES STATEMENT OF ASSURANCES Eagle County(ies) assures that, upon approval of the Core Services Program Plan the following will be adhered to in the implementation of the Plan: Core Services Assurances: • Operation will conform to the provisions of the Plan; • Operation will conform to State rules; • Core Services Program Services, provided or purchased, will be accessible to children and their families who meet the eligibility criteria set forth in Rule Volume 7, at 7.303.13; • Operation will not discriminate against any individual on the basis of race, sex, national origin, religion, age or mental /physical disability who applies for or receives services through the Core Services program; • Services will recognize and support cultural and religious background and customs of children and their families; • Out -of -state travel will not be paid for with Core Services funds; • All forms used in the completion of the Core Services Plan will be State prescribed or State approved forms; • Core FTE /Personal Services costs authorized for reimbursement by the State Department will be used only to provide Core Services authorized in the county(ies)' approved Core Services Plan; • The purchase of services will be in conformity with State purchase of service rules including contract form, content, and monitoring requirements; and • Information regarding services purchased or provided will be reported to the State Department for program, statistical and financial purposes. 3 CORE SERVICES TO BE PROVIDED /PURCHASED Place an "X" to indicate which of the following Core Services Program Services will be provided /purchased in accordance with State Department rules: X Home Based Intervention X Intensive Family Therapy X Sexual Abuse Treatment Services X Day Treatment Life Skills X Special Economic Assistance X Mental Health Services (Regional Contract) X Substance Abuse Treatment Services (Regional Contract) List below "County Designed Service" that will be provided /purchased in accordance with State Department rules. Please indicate which, if any, of the County Designed Service are provided through the Evidenced Based Services to Adolescents earmarked funding: 4 FAMILY STABILITY SERVICES TO BE PROVIDED /PURCHASED Due to budget reallocations for state fiscal year 2010 -2011, funding is not available for the Family Stability Services (FSS) based on Senate Bill 01 -012. If a county would like to provide Family Stability Services as outlined in Colorado Department of Human Services Rule Staff Manual Volume 7, at 7.310, with Child Welfare Block, Temporary Assistance to Needy Families (TANF), or county only funds, please contact Melinda Cox at 303.866.5962 for details and plan requirements. A. Respite Care: a service to provide temporary care to children who are not in an out -of -home placement through the county departments of social /human services and to their families who request a short break in parenting in order to stabilize family environment. Respite may occur outside of the home and in the home settings for Tess than 24 hours. The family may choose appropriate respite care providers including, but not limited to, kin, friends and licensed providers depending on the needs of the family and available resources. B. In -home Services: short -term, solution- focused services provided to children who are not in an out -of- home placement through the county departments and to their families, based on their unique needs in order to strengthen the home environment so that children do not need a higher level of intervention or out - of -home placement. C. Reintegration Services: transition services to assist children and families to reintegrate following an out - of -home placement. Service elements would prepare children and their families for successful reunification. 5 CORE SERVICES COUNTY DESIGNED SERVICE Service Name: Optional services approved as a part of the county's Core Services Plan are approved on an annual basis. For a County Designed Service to be extended beyond one year, this portion of the plan must be submitted and approved annually by the State Department. Given that County Designed programs are not standardized across counties, it is important to provide detailed information as outlined below. This information can be use to justify continued funding of the program with the legislature. The information listed below is to be completed for each County Designed Service to be included in the County(ies)' Core Services Program Plan. 1. Describe the service and components of the service; define the goals of the program. 2. Indicate if a new Trails service detail is necessary for this County Designed Program or that the service detail is already an option in Trials. 3. Define the eligible population to be served. 4. Define the time frame of the service. 5. Define the workload standard for the program: • number of cases per worker, • number of workers for the program, and • worker to supervisor ratio. 6. Define the staff qualifications for the service, e.g., minimum caseworker III or equivalent, see 7.303.17 for guidelines. 7. Define the performance indicators that will be achieved by the service, see 7.303.18. 8 Identify the service provider. 9. Define the rate of payment (e.g., $250.00 per month). 6 INFORMATION ON CORE SERVICE FEES Please check all that apply: X Fees will not be assessed for Core Services Program Services. If above line is checked, STOP. Remainder of information does not need to be completed. Fees will be assessed for the following services: Check those that apply: Home Based Intervention Intensive Family Therapy Sexual Abuse Treatment Day Treatment Life Skills Special Economic Assistance Mental Health Services Substance Abuse Treatment Services County Designed Service (List Services Below) Fee assessment formula is the same for all services. State the formula here (attach additional sheets as needed). Fee assessment formula varies with service. State formula used for each service (attach additional sheets as needed). 7 t d w ' a C� > ca E O 0 r c � > 4.., c1.- al �a Ts a � 15 C c c c� _ m m >, C� 0 c - 0 d V . 3 r c O d -0 v) 6 Q) ;W - G 0 -0 2 3 r c •0 t w+ O O Q C , 0. - .0 C N . N) a> O , c d V d U t) m L O E L N m d V Q R v) IE .c o N 4-, >+ d a) 4- N . c L N • cow Q . i > - E 4.- W 0 4 3 0D c .N 0 la N 0 C c 0 00 0 c ca Q c N • N 0- Q O V t L gs as •E N O• :c a = _ al o m . a N i a v ) ° co) = X • 0 C c °230 0 L V Ce 0-EE� ?' gay = �� so > O CD +0. a s_ i s ' E . �, 2 , o d E +... E U ,,,9 a) 3 ui co d oa N us .N �'" NLi v )m L L c 0 V 0 LL r d C l W. N N c N S O L CU p N co C = E c � W Rf • d N f.. Y t 0' D N -0 2 N . 3 d N d d -0 2 6 ca 13) v 3 c a � 0 �� c o s � a 0).c V 0" U) N O 3 - .> 2 ca a m E V c d , ca N c 0 c�OE 00 E >N c cc a) : c r oVz >, N 3ea0N oV 7 cC o a 0 V ?'�c c L O ca C> > N Of E L f ° — ' c.0 `a' xc) EE L C C C C> or WLL O W to E WL� 0 N 0 c E G d W 'C i 0 U 0 V 7,, W o0 C 0) 0 0 C V c N O ea ea ea '0 E .N a) d d A >, N _ y c a) c V c o CD 0 N 0 ._ v al G . d co G C m d 0 - C .N . N C) . c i C) c _ 3 0 > >, a) '3 F'— = ea CO c � � ;c a) C 03 ca > D. c L N -o ca i r _ V N N c N ::+ CO ) 0 d E N m c a) E = CD � 'c • E E E D. d (I) U) •C C OW0 N0 0 Z C.) CU t N L N 3 .. L . ch -p ca c o c c 0 . ea 0 t E N al N L > . = co wr d .N y - >.2....- G1 o " CU C CD = v E - � o - S 99 ° E N >• CD `m O2 .2a 0= E L ca a CU a) 0 u) >% > � N c a) U) -C a0 . 0) C.) v Al w cC • .c 0 c • � '� Q Q a) - 0 t co . .o i 0 s *E C E W 0 r J 3 0 0 O Q t V N G. C) = c co a) N O co U a) O c co H� U) _ L E N o O O • O u O w C Q. a) U co a) co N N N -5 co N O .- N- c- Et 0 O. o U c • Z -c U O D N U �4 d L . T E a ��c�Z n co 0 v N `1 •E ° O o '.- a) o + cc) • M a) U C N C I F -20InU 69- ER b9 0 5- Z (TS C D a) O o c of co ° > Q r 2 2 O c 0 >+ V• O 2 Q N N Q a) m° >, O O O a/ ��� a0n LL _a 0 a E C9 > ° >, I- o O c a -o - v� °-' O > , a) ` COO -0_ o >, (6 �� v ) •z� rn� °Z`o� L u) a a W a) o m ` c �Q�` a �V �a)� a.cnLL1 O�co E yo m E� cn W a) fn W 0 - U o �' � a) o ° -0 Z N 0 U 0 E >, co cu 0 0 >+ OW a) ,.. c o 0 0 0 0 co 2 a) c ,� , o co N o HOC L —o, (0 L() ZO - oa o c `a 8 ° a 0 ' ) >V0 E c ° oa) w � -0 � �o a)a ~ 2 CD c N o a � v _ a)- ca ° >0ti Z W c S °? a. ov)LLmco 0 > = .0 N w m W J I �''c co a) >. w < o n E ca c o ° ( 0 0 .c m W V O. E c MO 3 rc Es W V ate) a)) : 2 > 70 •Z o v co >, O Ce o ° Q- w T15 _o = W Q tr (0c E N N t6 o ". 2I - `� ccn F- a) • N O •Z c rn c0 0 co C Q 0 0 c 3 ° C co _f) �_ __ U 2 L L . b 69- E{ 3 3 Z N Z U N a 12 N o >, :=. c a) a) co v) L o 'O U .E-0 N c co O co C 0) ) U U ` 0 To (71 LO co cp o. co co al m E O E •L L0 - a) N hi 2 ca i a) O O 0 O co U ` N' p .• N N a ) > d E° ° E Lu �� E - u) �- o U)0 UU) < U 0 cQ Zm g.- a) c cn , :EM 2 ° my ac E c a) o '- Dc: 5 ca °_ Uc v) E o = a. Z N co f ,kk /0 \ co a. o , ¥if i ƒ 0 7 2 f $ k \ / k > = k/ -o � 2 2 Q Ce C .8 \ %k% 3 / j k ƒ 2 s£ ro E % / o f � 2 o - E • �3 �kkI- \ \ \ o dd w 26 m0 � a a ) • G E d 7 // _ m o. u) 0_ => < > 2 E § / f £ ± t co 2 0) a) = \ fƒ I / u /a k( \ 8 > � \ 0 m $ % % g� 2 & • G o f & f m a _ f / ƒ %2 § � \ >- o o t o � amLwLO�� f g � � a » 2 w � / o > � \ / / ƒ2 ® �� g $§ I %� _0 °$ \ ƒ E >"2p = o0 n • v / § 2 £ -0 - 2 } % ® 2 = S / f = o % lam 6 � � k 0- o / LL .0 /� / > > § 2 \ ° (/) _J U c I• > 2 f Z W a e e WI �2 k § / �\k k 2 W 0 \ / f O CL / � � ^ a) W \ ƒ � r /ƒ ƒ I- • 7/ 2 # . \ T. U cv ® 2 2 & o CL 0 . « \ »� .4- - 5 \ m — f2 / Ea / f / o G Q S $ E k \ �@f CO _ ® k / / / /ƒ e3 69 \ c ° o 2 7 k E § og ® 3 0) 7 § 2 $ - 5 ,_ 2 @ @ o I \ �� / \ �f 2 .0 . o • c- 0 0 o p k/ k f 0 < 0/ / 3 • J m k h k2 \m /\ 0 = a2 .- cv CO 3 �� 7 o 0.® I- 5 Cl) 0 . (3) § f / E \ c k / \ /P / 7 / o NE -E. 0 [t \ .8 k5k% 3 co o @ _c 2 j k / ° r « \ ƒ ƒ 2 E 2� ƒE ƒ/� § \ \2 R c o / _ S f C. S /£ $� / 0 �� § § 0 \ . ƒ /u02 ¢ E g 4- ® fi 2 % a .0 W � \ / / / / � ƒ ff I /u_ / ƒ �- c 00 _ / U) k § E0 = / _o � § E ,- /5LL _c/k co _1 O -0 ) 9 - § U o m = 2 U) � / ƒ / ¥7 / f c 7 — \ E f m 5 § >/ o. -.1 �c / 2 2 Qom == - § > z c w /_ �k \ m o @ a = c t o L k/ �� - > / E f 8 > o W ' ƒ mk$ — o @ o @ E sc v 2e / E o L.) � f � § > .0 7 / // . -E- c '\ � k� \ \ \ %7 G @J � $ / 2 - CO ƒ CL) al _ ■ § C @ a /$ // oƒ/ x \ / / E o @ �/ = 0 c2 ƒ E @ o . m oa 9 .0 = m // /\ k � / q q. � $ k / kb k. ./2 CL Z ° o co E§ �k / k Lo m ® CD E \ • E > • Cti k / 2 2 2 . • 2 ct Q �� z %k � • / / 2 – ,_ + _a E .c - + // �fOL \ \ _/ w 69- 69. ( E 2 co _ � e // >, ( 0 1:3 \ a �\ / k c ± t c = ƒ f �d�f3 § o 0 n Ce § 9- E % i — 0 n o 2 / /� � k /k ° �� \ U - / O$LL1-LL /.k . to ILI / C rm / 0 f £ / a) f o > _ § $ k K $ >' iii W @ \\ a %LLID / 1- \ ƒ CO O � 5 // § Q 10 2 §% 2 = N ce >- o _c 2 $ § f \ 2 We n k f I /LLJo /, \ c § 2 \ . o D J k k% >o / W n e = 2 \ 2 E\ co "5 c . W Q o Ec 2O $ U t • 3 - -o > 2 /® > § 7 o ILI . /t � E ) m �w \ W ) § > - Ce E 2 2 # k / / (0 c p $ / / o - g @ 2 L ® E d k R @R > / \ )o 2 / \ « m @ oaf q 2 a) / \/ 0 2 R $ 7 \ � / % o a E q R 7 ® 2 o / / m k = k \— c- o f/ /f /7 // /� / qR F2 f // k b / _o / \ P § a2 - q « R _ o = x oƒ / / /ƒ/ CO CO m m o c = S § g f 2 > > / \� / / \ 2 ( ° 2 \ �2 = 0/ c > v Z o o = ° �� / a) .0 2 c To $/ _C t / ? x : CO � k\ f§\ 7 k / $ 2 w2 a m ( 0 CO G / 2 5 _o 0) / £ 2 / . ƒ k / k 5 o 2 @ E_ 1 f0 / /3 E C3 c 0 2 I- > re > 2 E o _a -> _a 2 0 @ £ ® k = W � k 2 2 Q± 2 ° m m U _ • e@ r c E o f o § «e £ 5 @ c tY - $ /f / $ �mLwLO— E > W m R 7 o \ o 0 @ 0 ? / 2 / Z U) v. n$ k- =§7= /o 1.11 W § \k 0 I / U _0 ƒ ƒ co w I -a — b 0 0 / j k ? _ co $ ( / / § 2 / k 2 k W W � / \/ ƒ % / LL .0\� / U) > § 2 0) = r � = 2 & % >m / 2 / E / of k < 00 2a - u 3o f X> �% c � = o > § U) t o � \ r// oIP _ I— gf c co ° ® 2 W c E $ >, C CC // � ƒ #fƒ 0 _ - %2 S k � ® 42 . 0 2 c /§ a) > $° 2 2 �@f� o m k m E = o e o m \ R 0. 77 S/ ohm a a § 0 0 o E == k2 ° % / v o a) 2 � E o a § f q Q ... co k / 0 e\ 2� f • c � m k� kfc 0 < 0/ / / / q0k �$ 3/ k b k // /\ 0 = a2 ,- m N - _ a) U >rn E p ( 6 a co N = EI O ` > ER = Et 43 2 C — .0 p O p U p Z 2 N +. a) a) t d .- L ai = 00 CO X _ O a) U a) L .Q 69 O 0 c ° te a) o E o co cu io 2 a) o a n. 69. ~ 0 N r N o CO -0w U-' -0 O (0 E o • E o Lo Q E >- Z Z o cn c6 ~O 1 LG V O w >, U W50 0 ° ., _0 u) ` a) E I-a'Q E � c L_ ��V �� o a) W° 2 p C c Z r a • w d �rAa 3 E° =Q• -a w 71- J LL co E QULLHO a co I C M Q W o w a) QW 1- 4- >, >; x L- N > - ° v o v a a) =W o ° c 2 c Z N II 0 W � <0L ,-- W Ce 1T2 v �G.Q I` o >, >; a) Y N Z V t r = CO O = N C (6 N a) a) co =b- o CD ° C N 4 O QULL z; 11 C > E O co L E 7 ° °c 0 _ E > p 6- 11 .� N 0_ _o 0 0 a) N 'c0 7 U I- 2 _ w .p =O Z O O v) 2 a) c W 11 0. 2 E E w C 0) = L Q N a w Z a) ° a et 7 o 0 w > .1-70 Em • a) 5 d w co — O co a) d . CC O a) O w a •c 2 U co co r; N - • o a) a) o •U o °o c 2 X O ;t aco ~ a °' CL a a� r w -c cm E • O O O V o Z a� u) 0 co a U 2 CO .. . 4a• 0 X 0 O . a " U 2T N a) . L O o a) O a) a O .c? O O C >, o a) co co . fl U -.a. J o z • U 0 E D O L o Q E Z o (1) 0 W in a� o 0 vS co 5 C) 0 0 .0 - °' E IX ...• E C -O IL (.0 0 y V) W W 0 o �2Z � -- a co w JN E o -- a. w 15 tr) JLLN E < 1-O co II c N OW O uJ a LLI U _ ,- >, >, a W(A o 0 .0 w c U E a 'd 't O E o o w �= N 2 O E C D 2 c c4 W (0 QU�i° 11 3 d- O H o >, > a) U O c 7 a as a) c�a.L E O ` C N Q Uu_co Q) C 0 O .0 `- >, O fo c E •> 0 — C OL II 3 0 0 a) c•I E >; a) as f ` = L W 0 'O O Z o c c to 2 0 11 O Ct = 0 E N (B w c O Q O a Z O N Z O U • w - Z O U W v > u) O w 'V' a P. U io o o � / � = ± ±\ 0 > / ' m E9 5 _ W b W � k � k � k / Z 2 o \ 5 \ 't .c . ) I S q — o o o. . / /� o 2 69 .c 2 ƒ - o 2 t a) E o w E //ƒ 0 0 q o �� vo. . _ 2 " K 2 / 3 /£ 2 E • - c W Q o � § � °§ ° f o w \ 2 0 m 0 / o c > W W CX ° ® E Q o = / f E CO < 0 m c \ 2 / z // = .0 o. W $ Eo,< - -0 f F. 111 > f <UL@02@ § • « i x Lu % ® o Q m $ ? t = - / CI ce ® = $c f® o 0 o E G m c O co / /LL° 11 $ ° \ 2 -o w % _ .0 2 § t 2q� 0 $ 2 o n f 0 _ . E o k J / � / 11 .0 c 2 / 2 c O o \ ii % - 2±/ O § / %E _ \ w 2 — = Z = e - 2 ƒ c CL 11 / & k k / ,- ƒ 2 a % E / U % / $ 0 /'- # m u) / k/ > N , o 0o ( . 5 1/ 0 $ /b 0 0 11 2 5 ± . m : 43 v) 7 _c f o 0 k \ I a / °_� 2 ate¥ 0 e co 0 x 0 0. Gk � / (0 2 Co / 2 2 2& 4_ o E m 0_ o ; o k ~ \$f r > \ co as ta 0 / ' � o 2/ 7 2 Z 2 § c c ®• - 2 « E W W § / °§° . w / 2 0 \ z o m2 # 0 / Ce U) 0 0 « .0 \ ° E • m\f 0 2 W O W -c ° c 2 U R Eon < / e E «U�eL� 11 § f w E 3 0 § < ce W k � \ £ x w a O 0 / k 0 o 11 � c f \ w % > E £ \ 2 a) n = , _ / o 0 E ƒ E o § / co 11 <UL= a m o _ E 7 0 = \ 11 / / q ƒ // § f 0 0 c £ CO I o I 11 ƒ ¥ § w \ / Z r 11 % a) ± . f c / • b a m 2 co // 5 ® k 2• ƒ c / / > b N ok /� . ( 7 &\ o $ / ƒ� 2 m J /� /. 7 \ c§o§ %/ / Z # •0 / Zr) .c ) 0_ —w 0 c° In' x o a §/� R cn 0 7 \ o $ $ £ 9_ o E o co ® k$ /� o > 2 > C $ o .0 a �� 64 2 2 % m e < § c / /% k / I— 0 / Z 0 / — b \ >0 co ,, U) 0 / 3 « =�/ . f E 2 0 W E 0k a \ O R Eon < L / 2 O W <OLwOo@ 2 11 E E L o O « o _ / CO o q W W / \k / k £ - EL 0 & E o § 0 c O «U±,- 11 _c U U / I R CO ��_ 0 / ) no // 0 / ƒ / E o § / \ 11 / C CD o 9 .0 E f 5 / c & \ ii \ 0 § / C E § \ w e Z 0 5 ƒ 0 0 c cL 11 0 ¥ § / = i E a %. w U 2 2 ca /� # CL \ 0 / > - ui 43 0 °2x a) - co > o m ° J I c _� 7 k o§o§ %/ 2 z m u) a) ) u) = /f 0 J §/= n 2 0 _c a) a _ £ & @ E 2 ° o. o. 2 o ~ k3f� .0 a. 2 co co '0 / § m 2 § = - / 9- kf < ƒ 0 W 0 E o o 0 \ 5 , 0 m 2 0 m m ° _ o (0 � � f o .0 � g � = n m E \@ 2 L g 0 E I— p W % °222 2 $ a 2 0 W - E ƒfu- /E�£ \ 2 < k 4- _ / 1 I III 45 — U «% f 1- W W • # \ Z re / ƒku_/ f k 5 o / _ I— % > § �R \/ -0 ) / k J /u/ \ c . 2 o 3 / 0 — - 2 $ t II k \ o f§ W E 0 $ . I-= M 5 § @ CO 0 c - f k - 11 x I m § § / / _ W 0 ). W f E_ 5 k u) \ ± y e I 0) / \ m • N. o E 20 co 7 / ƒ @ C 0 E / 4- 3 7 k o§ . 2 2 2 a a � CL£ = ai \ o 7 o * o a / 2 T R £ / a) o £ b ® o E CO ° °°® 0 LLI \ �ƒ$ � U 0. a�� . $ in W % = -° E .2 -I / o E= o E o « E Z ° ) k% / . b / W » 0 m - . _ O r o > cri Ts Q a ' 3 « %mo _ 0 co W p m E k f f / 7 E ° _�& = 0 1 Ill / ƒ�� / 3\/ / M M I W % ® / CO U m / o = £ ) < C4 W 5 # = Q o a 0 0 2 Eo c 2 U a 4UL.- II f $ I- 1- ' a> = 2 co n \ / /q / E C/) $ E o = a 11 \ E «Qu= 0 / $ 0 q 0 f § II \ % q /� � § 5 8 = D § ® D 2 = 5 ƒ 0 0 0 0 II / ¥ § / / 0 < , *.- a_ , 2 co W o . W .17) Em @ ƒ/ �¥ 0_ / /\ ~ oo. k 2 1\ \ / ƒ� o ce _�/ 7 - § ° o / / 2 2 a a / /k 0 a 02 ( o o . -o 2 o E CD a o. 0 o o /k k a a± m % ( § uj ot ° °E ono \ 5 U it § 2 0 m n O 2 W re 0 E > CO C3 CO 0 t 7 w E WI u_ u) E r\ og / § k §§k$% W 2 E <ULwu • CV �� c f E. 0 I W p E § ® £ C c @ o £ o = Z o ak\ 2 c 0 O <0L II ƒ 0 0 / I- % > > 7 £ / 2 \ � / k k E o Eo ii E «UL= m g 5, -0 E a c 0 `0" 11 2 a- .c 0 § k C E E e _ - = 2 = e c 0 1 § CL 11 / 4 2 w c < z % n ± c /_ b E _ / / e� w / 5 / /7 4 O U U c6 o o o _c L ' . �O 4) o a' .- O 2 }; c 'E O Cl) a s L U C V CD v.) c W U L O 4-, U •W C. U . D O U E O U O p C O N m r a) U c c T 33 al 40)0 7 oca > o .5 CD E. E 2 m ca • L L . L 0 0) w a 10 CO c n } • O -, - o O = E 0 0 N N CtS Ce r + c L a) N (Q a) w O1 L a _c .o 13 c 0 U o - o) O W (A cQ moo., 0 C O 'v cc N 0 a) O 'O L 0 X ,� +-' — "� U O ) C C.) Q N (a (6 • � O d 8 � 0 iii V) 0 ..G 2 � a 4-,r o L O c� ca o � o ,� N �- RS V U y^, C 0) O _ O c6 a L E O -C ✓ r C L (6 V o = -0 U O Q -6 •N a. a� o O Z a 2_ w U a U c6 E (/) C'' O L. N it ..... ... C O L Q U O CD a) a) w - a) a) a) t 0 � a)a�o�a a}, 0 o v mcc 4_, tf n a) � - v ci2200000.c .• OCcvcv0 8o x = Z a)i �AAAAAA wa 67 2 2 PROJECTED CORE SERVICES OUTCOMES FOR PERFORMANCE INDICATORS FOR FY 2010 - 2011 Service :' Over 85% ' ` :85% -25 % Under 25 % Total Clients Served 15 3 2 20 Home Base 15 3 2 20 Intensive Family Therapy Life Skills 1 1 2 Day Treatment 2 1 1 4 Sexual Abuse Treatment Mental Health Treatment Substance Abuse Treatment 2 1 1 4 Special Economic Assistance County Design (List) 1- Client meets 86% or more of the treatment goals 2- Client meets between 85 % -25% of the treatment goals 3- Client meets 24% or less of the treatment goals 23 CORE SERVICES PROGRAM OVERHEAD COST 1. DIRECT SERVICE A. Total Salary/Fringe/Travel /Operating Costs of Line Service Workers and their Immediate Supervisors $74,904 B. Formula Percentage Allowed for Overhead Costs 15% C. Provided Service Overhead Costs (A X B) $11,236 2. PURCHASED SERVICE A. Purchased Service Dollar Amount $34,823 B. Formula Percentage Allowed for Overhead Costs 5% $0 - 50,000 = 5% $50,001 - 100,000 = 4.9% For each $50,000 (in total expenditure) increase the overhead decreases by .1 °A°. C. Allowed Amount for Overhead Costs (A X B) $1741.00 D. Base Overhead Cost Allowed $500.00 E. Purchased Service Overhead Costs (C + D) $2241.00 3. TOTAL OVERHEAD COSTS (1C + 2E) $13,477 DISTRIBUTION OF OVERHEAD COSTS AMONG SERVICES* SERVICE Provided Service Purchased Total Overhead Overhead Costs Service Overhead Costs Costs 1. Home Based Intervention $2809 $560 $3369 2. Intensive Family Therapy $2809 $561 $3370 3. Sexual Abuse Treatment $2809 $560 $3369 4. Day Treatment $2809 $560 $3369 5. Life Skills 6. County Designed Service COLUMN TOTALS $11,236 $2241 $13,477 * Formula to determine overhead cost by service: Step 1: total provided service cost (by service) x 15% = provided service overhead cost Step 2: total purchased service cost (by service) x % listed in 2B = Y $500 divided by the number of purchased service = Z, then Y + Z = overhead cost Step 3: Provided service overhead cost plus purchased service overhead cost equals total overhead cost. 24 GENERIC COST SUMMARY SHEET 1. Account Code 2. Total number of children to be served by provided services 3. Total number of children to be served by purchased services 4. Average number of children (total 2 +3 =12) to be served monthly 5. Total number of families to be served 6. Average number of families to be served monthly 7. Employee FTE number (should be the total staff listed on Direct Service Delivery Page) 8. Provided cost Overhead cost (From Overhead cost summary sheet) • Total provided cost 9. Monthly provided cost per child [this is determined by dividing the total provided cost by the number of children to be served from provided services and then dividing that total by the number of months the service will be provided.] 10. Purchased cost Overhead cost (From Overhead cost summary sheet) Total purchased cost 11. Monthly purchased cost per child [this is determined by dividing the total purchased cost by the number of children to be served from purchased services and then dividing that total by the number of months the service will be provided.] 12. TOTAL COST REQUESTED [Total provided cost plus Total purchased cost] 13. Total 80/20 service cost requested 14. Total 100% service cost requested 25 X 0 0 Cu J 10 Q p c O D a) O I— M 0 0 O N 0 O 0 d o0 ' O 0 1 C 1•-: C In 0 CO CO O O � CO 0) C7) 0) r 0 b3 b} 69 63 69 69 H3 69 69 a) N CC 0) Y. w 0) _ c - 0 m 7 C 0 w LL ~ >, C 7 0 o 0)^ 0 c :S Y w �v a)2 Tra 0 _ n `S c ,- 0 T m w U v a c i co v v d" 0) 0 a) ct 0i U) 6 b E W - 0 0 0 LE 0 c N 0 0 O CL ii. LL N co O 0 O 0.) U 0 a 0 0) 0 (••••• C CO z NZ 6 W N (1 ) 0 c') T- r 0 ( © W 64 69 o CO a) ` - o 0 2 0 > , Q W O � (j fn LL- 0 - 0 0) 0 Z W . 1e a) N 0 u) � � a) C : >,L cn�� tu a 0 `0 0'3 O 0_ 0 0 co te ) aa) .0 a 0- a) ym 4 — cn m E N _c iii a) ~ 0 . Z co as al Ca N Cn Ca >, a) r N 2 (/) O O . �+ c Z E m N p a) d • '? a a E is ca to >, 1 2 1 E �° 7:1 2 C — < v E a) < a) a) 0 X X o O (n -o v LL E E v N c a) 0 • v) N Cn > O N a) c6 y a) " Q O CO CO a) C () 7 c E C 1--' 7 ' I — • U 0 0 0 E Ca (/) 0_ 0 o coi o c n ccC2 O O 0 N 0 ccc c IlLL U...00 u_, 0 0 O 0 0 0 0 0 u) a) or) 7 U 0 ULL_ ' - co co co - O UU % 0 / 0 7 \ k 7 .- 0 \ ® ® 0 q N CO C) EA- IL 0 N- 0 % \ MI a\ q 2 0 O /� 0 N 0 CO 2 k 2 . 1- -0 \ O Z k c W u _ ‘.- ,-- R 02� CO a Ce U _ % % f cq I- as " » Li_ 7 k O ce 4 5 ( 53 k w co � . I- CN I 'a O 0 u_ q / co to co 2 < co cO 6 / \ 6 0 k � a _ 16 e 45 a) a k k \ / ± 1 2 2 2 ° e§ a a a s W a § § § 0 0 > > > > W > @ @ LLJ w / k 7 \ 8 E 0 ' o > 7 7 n Z ƒ \U 7 e /S E & 2 § > § 7 / / / % 0 M. / 0 Cr) a) L a) o rn U 1.6 co co co .ct rn rn 0) Ea Ea 69- Ea L L ° C.) "'E" co a� 2 co co co co ° co N a U 1:) �- co O Q c4 m 2 0 201- la y. • CL r' U ° ° u) a. N * o w� Z V ° N ZW _ a te = w� E c N� U. ,T0o o *� oU 0 co ° 1E 0 N 45 w co cn rn ° co ° a o o C) id LL r o 0 w w w co o w w N O N 7 0 cv E N E so a m co c a w c a) in o o 0 c 0 2 c U) a 6 co F-