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HomeMy WebLinkAboutC12-339 Core Services Program 3 Year PlanCORE SERVICES PROGRAM THIRD OF A THREE YEAR PLAN SFY 2010 -2011 SFY 2011 -2012 SFY 2012-2013 FOR EAGLE COUNTYQES) All Counties:Entire Plan Modifications —Budget and/or County Designed Programs have changed. (Please proceed to complete signature page,all corresponding Core Services Plan and budget pages,and then submit for approval.) REQUEST FOR STATE APPROVAL OF PLAN Since this is the second of a the three year Core Services Plan,this page needs to be signed by a Core Service Program county representative. This Core Services Plan is hereby submitted for Eagle County Child,Family and Adult Services [Indicate county name(s) and lead county if this is a multi-county plan],for the period contract years June 1,2010,through May 31,2013,fiscal years July 1,2010,through June 30,3013.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; r Completed “Information on Fees form; >Completed “Reunification Issues”form; >Completed Direct Service Delivery form; ..-Completed Purchase of Service Delivery form; >Completed “Projected Outcomes”form; r Completed Overhead Cost form; -Completed Final Budget Page form; >Completed “State Board Summary”;and, -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,Holly Kasper-Blank and can be reached at telephone number 970-328-8812 and e-mail at holly.kasper@eaglecounty.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. 1 Signature,DIRECTOR,COUNTY DEPARTMENT OF HUMAN/SOCIAL SERVICES DA E Signature,CHAIR,PLACEMENT ALTERNATIVES COMWSSlON DATE Signature,CHAIR,BOARD OF COUNTY COMMIJNRS DkrE Please check here it your county does not have a Placement Alternative Commission: 7 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 Manual Volume 7,at 7303.13; •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 Day Treatment X Life Skills X Special Economic Assistance X Mental Health Services (Regional) X Substance Abuse Treatment Services (Regional and Local-No AFS match) 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 EvidencedBased Services to Adolescents earmarked funding County Designed Direct Service-Family Group Decision Making-Evidenced Based Services to Adolescents Eagle County Children and Family Services is requesting $10,860 in Evidenced Based Services to Adolescents funding to provide family group decision making service for 25 adolescents and their families in the 2012-2013 state fiscal year.The goal of the family group decision making program is to prevent out of home placement in foster care or a residential treatment facility,to return youth to a stable family home,to prevent placement in a higher level of care and/or placement changes,to support families to a successful case closure,and to prevent case recidivism. County Designed Direct Service-Family Group Decision Making,PA 5 cases Eagle County Children and Family Services is requesting to allocate $8,906 of 100%CORE funds to provide family group decision making services for 35 families and their children who are at-risk of needing out of home placement in the 2012-2013 fiscal year.The goal of the family group decision making program is to engage family supports and community partners in the following:preventing out of home placement in foster care or a residential treatment facility,returning children to a stable family home,preventing placement in a higher level of care and/or placement changes,supporting families to a successful case closure,and decreasing case recidivism. 4 County Designed Purchased Service-Mediation Eagle County Children and Family Services is requesting to allocate $4,320 of Eagle County’s 80/20 CORE funds to provide mediation services.Mediation serves children who are placed out of the home due to child abuse and neglect and their biological families,extended families and/or their foster/adoptive families at significant decision- making times during a case.The Mediation Service includes professional facilitation and family group decision making to resolve disagreements and offer the involved parties opportunities to find solutions in a positive, inclusive environment.The goal of the mediation services program is to prevent children from entering out of home placement,return children to a stable family home,prevent placement in a higher level of care or placement changes and/or secure a permanent family home for children in placement. Additional Funding for Evidenced Based Services to Adolescents If the county received additional funding from the additional $4,028,299 million dollars appropriated to fund evidenced based services to adolescents,and would like to continue to receive the same funding for the same expansion or created of the evidenced based county designed program to adolescents,please indicate that above,as well as on the Core Plan under County Designed. The County Designed Program may be renewed/re-approved at the sole discretion of the State Department,contingent upon funds being appropriated,budgeted and otherwise made available and other contract requirements,if applicable, being satisfied. If the county did not receive an award or did not apply,the county is welcome to apply by following the requirement set forth in Agency Letter CW-03-21 -A.Please submit the Request For Proposal with the Core Services Plan,due August XX,2012. 5 FAMILY STABILITY SERVICES TO BE PROVIDED/PURCHASED Due to budget reallocations for state fiscal year 2012-2013,funding is not available for the Family Stability Services tESS) 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 less 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. 6 CORE SERVICES COUNTY DESIGNED SERVICE Service Name:County Designed Direct Service-Family Group Decision Making-Evidenced Based Services to Adolescents 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. In the last fiscal year,Eagle County Children and Family Services served 52 families with family group decision making services including 25 adolescents.Eighty-four percent of these families avoided placement in foster care and court involvement. The purpose of family group decision making is to support collaborative partnerships with community members to best serve the individuals that we work with.By providing family centered and strength- based practices,Eagle County can develop positive relationships with clients and community partners. Families,community agencies,and others have an opportunity to participate in case decision making and to provide resources that decrease risk factors and increase the safety of children in the community. Family group decision-making services involve coordinating a meeting for parents,staff members, extended family and community partners at significant decision-making times during a case and assessment,including prior to placement,immediately after placement and during case planning.The meetings are two hours long and focus in on family strengths and areas of work and developing a plan to prevent placement out of the home,to secure a permanent placement and/or to reunify as quickly as possible.The team meets again if necessary or when there are changes in placement or the treatment plan. Eagle County aims to engage all clients involved in Youth In Conflict cases,both voluntary or court ordered,in family group decision making services to develop case plans,visitation plans,or permanency plans.Youth in Conflict/Adolescent cases represent twenty percent of open cases at Eagle County.Currently,the agency provides all eligible families with an open PA 4 and PA 5 case with purchased and/or direct CORE Services including sexual abuse treatment,intensive family therapy,home 7 based intervention,mental health and substance abuse treatment,and special economic assistance.Very few of the CORE Services available in Eagle County specialize in work with adolescents. Annual surveys show that youth in Eagle County are struggling and there is a need for community collaboration to address issues facing adolescents and their families.Youth in Eagle County have high levels of suicide ideation rates,high levels of school drop-out rates,and high levels of substance abuse.There are limited resources for adolescent services and no day treatment facility in Eagle County,as well as limited specialized mental health/substance abuse services for local adolescents. Many adolescents involved in youth in conflict/child welfare cases in Eagle County are also involved in other systems including juvenile justice,mental health and special services within the school district. Adolescents are often placed in treatment facilities outside of the county.In response to this need, Eagle County launched a Family Group Decision Making program for families with an open child welfare! youth in conflict case.It is the goal of the Family Group Decision Making program to involve community partners and family members to seek solutions and effective services before placement becomes imminent. Eagle County is requesting to continue utilizing $10,860 in Evidenced Based Services for Adolescents funds to provide family group decision making services for 25 youth and their families during the 2012- 2013 state fiscal year. 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 Trails. No new Trails Service detail required 3.Define the eligible population to be served. Families and or/youth aged 10-18 years involved in the child welfare system for the following reasons: -Youth in Conflict -Assessments or Cases where there is an imminent risk of removal -Assessments that deem consideration of case DnN or voluntary -Voluntary cases where a case plan needs to be developed -Ongoing cases where there is an imminent risk of removal -Ongoing cases where there is a need to develop case plans -Ongoing cases that need to develop or change visitation plans -Ongoing cases that need permanency!concurrent plans. -Placement changes -Closing cases 8 4.Define the time frame of the service. Assessment/Opening of Case Youth in Conflict Within 5 days of receiving referral Imminent risk of removal and/or removal Within 48 hours of opening case Voluntary Cases and/or D&N Within 72 hours of imminent risk Voluntary Cases Each month to the .Case Plan development (NCFAS)maximum of 90 days .Assess imminent risk of removal On Going Cases/Permanency Cases Imminent Risk of Removal Within 48 hrs.of removal Case Plan development (NCFAS)/visitation Within 30 days of open schedules case Concurrent Planning/Permanency Goals:Within 30 days of open Adoption,APRs,etc case Placement Changes including returning 3 weeks prior to hearing children home date Closing Case 3 weeks prior to hearing date 5.Define the workload standard for the program: The family group decision making meeting coordinator will serve no more than 10 families each month. Currently,there is one coordinator and one supervisor managing the family group decision making program. 6.Define the staff qualifications for the service,e.g.,minimum caseworker Ill or equivalent,see 7.303.17 for guidelines. Staff will have at a minimum a Master’s degree in social work,counseling or related degree and/or at least 3 year’s experience working with child welfare,youth,and/or families. 7.Define the performance indicators that will be achieved by the service,see 7.303.18. Prevent out of home placement,secure permanency. 8.Identify the service provider. This will be a direct service. 9.Define the rate of payment (e.g.,$250.00 per month). $905/month 9 CORE SERVICES COUNTY DESIGNED SERVICE Service Name:County Designed Direct Service-Family Group Decision Making,PA 5 cases 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 Countyes)’Core Services Program Plan. 1.Describe the service and components of the service;define the goals of the program. In the last fiscal year,Eagle County Children and Family Services served 52 families with family group decision making services.Eighty-four percent of these families avoided placement in foster care and court involvement and less than 5%were involved in a child welfare referral during the six months after closing the case.In addition, 85 Community Partners participated in family group decision making meetings including mental health professionals,substance abuse professionals,school staff,Early Head Start,Economic Services,Law Enforcement,Probation Officers,At Risk Resources,Community Paramedic Program. The purpose of the Family Group Decision Making service is to support collaborative partnerships with families and community members to best serve the individuals that we work with.By providing family centered and strength-based practices,Eagle County can develop positive relationships with clients and community partners. Families,community agencies,and others have an opportunity to participate in case decision making and to provide resources that decrease risk factors and increase the safety of children in the community. Family group decision-making services involve coordinating a meeting for parents,staff members,extended family and community partners at significant decision-making times during a case and assessment,including prior to placement,immediately after placement and during case planning.The meetings are two hours long and focus in on family strengths and areas of work and developing a plan to prevent placement out of the home,to secure a permanent placement and/or to reunify as quickly as possible.The team meets again if necessary or when there are changes in placement or the treatment plan. Eagle County aims to provide family group decision making for all families involved in a child welfare assessment with children who are at imminent risk of removal,assessments that deem consideration of a case either voluntary or D &N or in voluntary cases to develop a case plan to assess imminent risk of removal. Eagle County will also coordinate family group decision making meetings for ongoing cases where there is an 10 imminent risk of removal,to develop case plans,visitation plans,or permanency plans.The meetings will occur quickly and regularly throughout the case. Eagle County requests to allocate $8,906 in 80/20 CORE funds to coordinate family group decision making meetings for 35 families during the 2012-2013 fiscal year.The continued goals of this program are to prevent out of home placement in foster care or a residential treatment facility,return children to a safe family home, prevent placement in a higher level of care and/or placement changes,support families to a successful assessment/case closure,and prevent case recidivism. 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. No new Trails Service detail required 3.Define the eligible population to be served. Families and or/youth aged 0-18 years involved in the child welfare system for the following reasons: -Assessments or Cases where there is an imminent risk of removal -Assessments that deem consideration of case D&N or voluntary -Voluntary cases where a case plan needs to be developed -Ongoing cases where there is an imminent risk of removal -Ongoing cases where there is a need to develop case plans -Ongoing cases that need to develop or change visitation plans -Ongoing cases that need permanency/concurrent plans. -Placement changes -Closing cases 4.Define the time frame of the service. Assessment/Opening of Case Imminent risk of removal and/or removal Within 48 hours of opening case Voluntary Cases and/or D&N Within 72 hours of imminent risk Voluntary Cases Each month to the maximum .Case Plan development (NCFAS)of 90 days .Assess imminent risk of removal n Going Cases/Permanency Cases Imminent Risk of Removal A Within 48 hrs.of removal Case Plan development (NCFAS)/visitation Within 30 days of open case schedules C 11 Concurrent Planning/Permanency Goals:Within 30 days of open case Adoption,APRs,etc. Placement Changes including returning 3 weeks prior to hearing date children home Closing Case 3 weeks prior to hearing date 5.Define the workload standard for the program: The family group decision making meeting coordinator will serve no more than 10 families each month. Currently,there is one coordinator and one supervisor managing the family centered meeting program. 7.Define the staff qualifications for the service,e.g.,minimum caseworker Ill or equivalent,see 7303.17 for guidelines. Staff will have at a minimum a Master’s degree in social work,counseling or related degree and/or at least 3 years’experience working with child welfare,youth,and/or families. 8.Define the performance indicators that will be achieved by the service,see 7.303.18. Prevent out of home placement,secure permanency. 9.Identify the service provider. This will be a direct service. 10.Define the rate of payment (e.g.,$250.00 per month). $742/month 12 CORE SERVICES COUNTY DESIGNED SERVICE Service Name:County Designed Purchased Service-Mediation 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. Eagle County Mediation serves children who are placed out of the home due to child abuse and neglect and their biological families,extended families and/or their foster/adoptive families at significant decision- making times during a case.The Mediation Service includes professional facilitation and family group decision making to resolve disagreements and offer the involved parties opportunities to find solutions in a positive,inclusive environment.The goal of the mediation services program is to prevent children from entering out of home placement,return children to a stable family home,prevent placement in a higher level of care or placement changes and/or secure a permanent family home for children in placement. Additionally,the mediation program aims to support alignment of parties involved in the case. 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 Trails. Trails detail for Mediation Services will display the following: -Treatment Package 3.Define the eligible population to be served. Families and or/youth aged 0-18 years who meet the CORE Services Eligibility Criteria and are involved in the child welfare system for the following reasons: -Youth in Conflict -Assessments or Cases where there is an imminent risk of removal -Assessments that deem consideration of case D&N or voluntary -Voluntary cases where a case plan needs to be developed -Ongoing cases where there is an imminent risk of removal -Ongoing cases where there is a need to develop case plans -Ongoing cases that need to develop or change visitation plans -Ongoing cases that need permanency and working towards finalizing adoption. -Placement changes -Closing cases 13 4.Define the time frame of the service. Time frames for this program will be up to one month per family. 5.Define the workload standard for the program: Mediator will serve no more than two families at a time. 6.Define the staff qualifications for the service,e.g.,minimum caseworker Ill or equivalent,see 7.30317 for guidelines. Mediators will have a graduate degree or higher in a human services field such as counseling or social work or a law degree and have completed training in mediation techniques. 7.Define the pertormance indicators that will be achieved by the service,see 7.303.18. Family Conflict Management’:The family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment,running away,status offenses and delinquent behavior. “Parental Competency”:Parents will show ability to maintain sound relationships with their children and provide care,nutrition,hygiene,discipline,protection,instructions,and supervision. -80%of children discharged from this program will not be involved with Child &Family Services after 1 yr. -95%of children in this program will have a permanent home or finalized adoption by the end of the service. 8 Identify the service provider. Various Providers 9.Define the rate of payment (e.g.,$250.00 per month). $60/hour 14 IN FORMATION 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). 15 ReunificationIssuesPleaseindicatebelowhowthecountyisaddressingReunificationIssueswiththechildrenservedintheCoreServicesProgram.ReunificationIssuesStrategytoResolveDuetolimitedtrainedfosterhomes,EagleCountyplacesEagleCountyisworkingwithPitkinandGarfieldCountiestodevelopachildreninfosterhomesandtreatmentfacilitiesoutsideofRegionalFosterCareProgramwhichwillorganizeresourcestosupporttheCountysometimes2-3hoursaway.Thedistancetherecruitmentofandretentionofwelltrained,multilevelfosterhomesinpreventsregularandeffectivevisitations.EagleCountyandsurroundingareas.In2012,thispartnershipcertified3homeshowevereffortscontinuetodevelopandtrainfosterhomesthatmeettheneedsofadolescents.ItisachallengetoeffectivelyassessandmanagesafetyEagleCountyChildandFamilyServicesiscoordinatingFamilyGroupandriskfactorscausingoriginalreferral.DecisionMakingmeetingstoallowstafftopartnerwithcommunitypartnerstoaddresssafetyissuesquicklyandeffectively.Therearelimitedin-homeintensiveservicesinEagleCurrently,EagleCountyispartofaCollaborativeManagementProgramCountyincludinglifeskillsservices,inhomeparentingandisalsoamemberoftheCommunitiesofExcellence.EagleCountyisservicesandinhomeintensivetreatmentserviceslaunchingasystemofcareaimedatprovidingcasemanagementandcounselingservicesforfamilieswithchildrenaged10-18withseverebehavioral/mentalhealthdisorders.Inaddition,EagleCountyChild,FamilyandAdultServicesispreparingtouseadditionalCOREdollarstocontractwithcommunitypartnersforincreasedIntensiveFamilyTherapyServicesandlifeskillsandparentingclasses.TherearelimitedsubstanceabusetreatmentservicesthatEagleCountyismeetingmonthlywithBHOserviceproviderstodiscussofferaspectrumofservicesincludingquality,clientneeds,servicesavailableandgapsinservices.EagleCountyChildcomprehensiveoutpatientaswellasinpatientoptions.andFamilyServicesisalsousingadditionalCOREdollarstodevelopadditionalcontractswithlocalprovidersforneededsubstanceabusetreatmentservices16 HOMEBASEDINTERVENTIONSERVICESDIRECTSERVICEDELIVERY-CORESERVICESPROGRAMCFMS—FunctionCode1700,1800Definition7.303.1AHomeBasedIntervention:Servicesprovidedprimarilyinthehomeoftheclientandincludesavarietyofserviceswhichcanincludetherapeuticservices,concreteservices,collateralservicesandcrisisinterventiondirectedtomeettheneedsofthechildandfamily.Indicateinformationforeachlineserviceworkerandhis/herimmediatesupervisorforwhomCoreServicesfundingisproposedinwholeorinpart.IncludeonlyamountsthataretobechargedtoCoreServices.StaffpositionstobeincludedareCountyCoreServicesemployeepositionsandemployeecontractpositions.12345678910111213PositionJobTitleGrossMonthlyMonthlyMonthlyPercentPercentPercentofPercentTotalNumberTotalNumberMonthlyFringeTravelOperateofofSalarySalarySalaryMonthlyofDirectSalarySalaryFundedFundedbyFundedDirectMonthsServiceFundedbyTANF,FSS,byServiceofCostCostby100%Other(CircleCountyCost80/201800allthatBlock(3+4+5+6)1700apply)1HomeBased$2556$106050%$361612$43,392ServicesCaseworker2CORE$250$1305%$38012$4,560ServicesAdministrator3ChildWelfare$306$1165%$42412$5,088SupervisorTOTAL$53,040CoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).18 INTENSIVEFAMILYTHERAPYDIRECTSERVICEDELIVERY-CORESERVICESPROGRAMCFMS—FunctionCodes1710,1810Definition7.303.1BIntensiveFamilyTherapy:Therapeuticinterventiontypicallywithallfamilymemberstoimprovefamilycommunication,functioning,andrelationships.Indicateinformationforeachlineserviceworkerandhis/herimmediatesupervisorforwhomCoreServicesfundingisproposedinwholeorinpart.IncludeonlyamountsthataretobechargedtoCoreServices.StaffpositionstobeincludedareCountyCoreServicesemployeepositionsandemployeecontractpositions.12345678910111213PositionJobTitleGrossMonthlyMonthlyMonthlyPercentPercentPercentofPercentTotalNumberTotalNumberMonthlyFringeTravelOperateofofSalarySalarySalaryMonthlyofDirectSalarySalaryFundedFundedbyFundedbyDirectMonthsServiceFundedbyTANF,CountyServiceofCostCostby100%FSS,BlockCost80/201800Other(3+4+5+6)1700(Circleallthatapply)1CORE$250$1305%$38012$4,560ServicesAdministrator2ChildWelfare$308$1165%$42412$5,088SupervisorTOTAL$9,648CoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).19 LIFESKILLSDIRECTSERVICEDELIVERY-CORESERVICESPROGRAMCFMS—FunctionCodes7720,1820Definition7.303.1CLifeSkills:Servicesprovidedprimarilyinthehomethatteachhouseholdmanagement,effectivelyaccessingcommunityresources,parentingtechniques,andfamilyconflictmanagement.Indicateinformationforeachlineserviceworkerandhis/herimmediatesupervisorforwhomCoreServicesfundingisproposedinwholeorinpart.IncludeonlyamountsthataretobechargedtoCoreServices.StaffpositionstobeincludedareCountyCoreServicesemployeepositionsandemployeecontractpositions.12345678910111213PositionJobTitleGrossMonthlyMonthlyMonthlyPercentPercentPercentofPercentTotalNumberTotalNumberMonthlyFringeTravelOperateofofSalarySalarySalaryMonthlyofDirectSalarySalaryFundedFundedbyFundedbyDirectMonthsServiceFundedbyTANF,CountyServiceofCostCostby100%FSS,BlockCost80/201800Other(3+4+5+6)1700(Circleallthatapply)1CORE$250$1305%$38012$4,560ServicesAdministrator2ChildWelfare$308$1165%$42412$5088SupervisorTOTAL$9648CoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).20 DAYTREATMENTDIRECTSERVICEDELIVERY-CORESERVICESPROGRAMCFMS—FunctionCodes1730,1830Definition7.303.1DDayTreatment:Comprehensive,highlystructuredservicesthatprovidetherapyandeducationforchildren.Indicateinformationforeachlineserviceworkerandhis/herimmediatesupervisorforwhomCoreServicesfundingisproposedinwholeorinpart.IncludeonlyamountsthataretobechargedtoCoreServices.StaffpositionstobeincludedareCountyCoreServicesemployeepositionsandemployeecontractpositions.12345678910111213PositionJobTitleGrossMonthlyMonthlyMonth[yPercentPercentPercentofPercentTotalNumberTotalNumberMonthlyFringeTravelOperateofofSalarySalarySalaryMonthlyofDirectSalarySalaryFundedFundedbyFundedbyDirectMonthsServiceFundedbyTANF,CountyServiceofCostCostby100%FSS,BlockCost80/201800Other(3+4+5+6)1700(Circleallthatapply)TOTAL_____________CoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).21 SEXUALABUSETREATMENTSERVICESDIRECTSERVICEDELIVERY—CORESERVICESPROGRAMCFMS—FunctionCodes1740,1840Definition7.303.1ESexualAbuseTreatment:Therapeuticinterventiondesignedtoaddressissuesandbehaviorsrelatedtosexualabusevictimizationsexualdysfunction,sexualabuseperpetration,andtopreventfurthersexualabuseandvictimization.Indicateinformationforeachlineserviceworkerandhis/herimmediatesupervisorforwhomCoreServicesfundingisproposedinwholeorinpart.IncludeonlyamountsthataretobechargedtoCoreServices.StaffpositionstobeincludedareCountyCoreServicesemployeeequivalentpositionsandemployeecontractpositions.12345678910111213PositionJobTitleGrossMonthlyMonthlyMonthlyPercentPercentPercentofPercentTotalNumberTotalNumberMonthlyFringeTravelOperateofofSalarySalarySalaryMonthlyofDirectSalarySalaryFundedFundedbyFundedbyDirectMonthsServiceFundedbyTANF,CountyServiceofCostCostby100%FSS,BlockCost80/201800Other(3+4+5+6)1700(Circleallthatapply)CoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B). COUNTYDESIGNEDSERVICEDIRECTSERVICEDELIVERY—CORESERVICESPROGRAMCFMS—FunctionCodes1750,1850Definition7.303.1JCountyDesignedServices:innovativeand/orotherwiseunavailableserviceproposedbyacountythatmeetsthegoalsoftheCoreServicesProgram.Indicateinformationforeachlineserviceworkerandhis/herimmediatesupervisorforwhomCoreServicesfundingisproposedinwholeorinpart.IncludeonlyamountsthataretobechargedtoCoreServices.StaffpositionstobeincludedareCountyCoreServicesemployeepositionsandemployeecontractpositions.2345678910111213PositionJobTitleGrossMonthlyMonthlyMonthlyPercentPercentPercentofPercentTotalNumberTotalNumberMonthlyFringeTravelOperateofofSalarySalarySalaryMonthlyofDirectSalarySalaryFundedFundedbyFundedbyDirectMonthsServiceFundedbyTANF,CountyServiceofCostCostby100%FSS,BlockCost80/201800Other(3+4+5+6)1700(CircleallthatapplyFamilyGroup$10,680100%$90512$10,860DecisionMakingCoordinatorPA4Adolescents.12FTE2FamilyGroup$8,906100%$742128,906DecisionMakingPA5.O9FTE3COREServices$250$130100%$38012$4,560Administrator.O5FTE4ChildWelfare$308$116100%$42412$5,088Supervisor.05FTETOTAL$29,41423 HOMEBASEDINTERVENTIONSERVICEPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsproviderfromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,Service!ServiceofFSS,OtherMonthCost(Circleallthatapply)TOTAL_______________________Identificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).24 INTENSIVEFAMILYTHERAPYPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsprovidertromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,FSS,Service!ServiceofOther(CircleMonthCostallthatapply)VariousProviders$40,28030$112$3,35612$40,280TOTAL$40,280Identificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).25 LIFESKILLSPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsproviderfromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,FSS,Service!ServiceofOther(CircleMonthCostallthatapply)VariousProviders$14,30820$60$119212$14,308TOTAL$14,308Identificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).26 DAYTREATMENTPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsproviderfromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,FSS,Service/ServiceofOther(CircleMonthCostallthatapply)TOTAL______________________Identificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).27 SEXUALABUSETREATMENTPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsproviderfromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,Service/ServiceofFSS,OtherMonthCost(Circleallthatapply)VariousProviders3,600475.00300123,600TOTAL$3,600Identificationofunitis:H=Hourly,D=Daily,W=Weekly,MMonthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).28 SPECIALECONOMICASSISTANCEPURCHASEOFSERVICECORESERVICESPROGRAMOurCountywouldliketoapplytoearmark$_____________________inSpecialEconomicAssistance,outofourcounty’s100%fundingline.Pleasenote:UnlesstheCountyhascompellingrationaletoincreasetheiroverallearmarkedSEAallocationfromSFY2OJ2(lastfiscalyear),theamountcannotbemorethanlastfiscalyear.OurCountywouldliketoapplytokeepthe$400perfamily,peryearlimit,outofourcounty’s100%funding.IndicateinformationforeachTrailsproviderfromwhomCoreservices(SEA)areproposedtobepurchased.23456789PROVIDERNAMETrailsAmountofAmountofNumberofPaymentCostPerNumberofTotalCostResource!ContractContractUnitsofRateperMonthMonthsofPerProviderProviderFundedbyFundedbyService!Unitof(5x6)Cost(7x89)Number100%TANF,MonthServiceFSS,Other(Circleallthatapply)TOTALIdentificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).29 SPECIALECONOMICASSISTANCE(SEA)PURCHASEOFSERVICEWAIVERREQUESTTOINCREASESEAOurCountywouldliketoapplytoearmark$_____________________inSpecialEconomicAssistance,outofourcounty’s100%fundingline.Pleasenote:UnlesstheCountyhascompellingrationaletoincreasetheiroverallearmarkedSEAallocationfromSFY2O12(lastfiscalyear),theamountcannotbemorethanlastfiscalyear.Wewouldliketoapplytowaivethe$400perfamily,perrollingmonthyearlimit.Wewouldliketoraisethelimitto$800.00perfamilyperyear—nottoexceed$800perfamily,perrollingmonthyear,outof100%.IndicateinformationforeachTrailsproviderfromwhomCoreServices(SEA)areproposedtobepurchased.123456789PROVIDERNAMETrailsAmountofAmountofNumberofPaymentCostPerNumberofTotalCostResource!ContractContractUnitsofRateperMonthMonthsofPerProviderProviderFundedbyFundedbyService!MUnitof(5x6)Cost(7x89)Number100%TANF,onthServiceFSS,Other(Circleallthatapply)VariousProviders1,6001600400-60031,600TOTAL$1,600Identificationofunitis:HHourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).30 MENTALHEALTHSERVICESPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsproviderfromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,Service!ServiceofFSS,OtherMonthCost(Circleallthatapply)TOTAL______________________Identificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).31 SUBSTANCEABUSETREATMENTSERVICESPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsproviderfromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,FSS,Service/ServiceofOther(CircleMonthCostallthatapply)VariousProviders17,2801880.0014401217,28017,280TOTAL$17,280Identificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B).32 COUNTYDESIGNEDSERVICESPURCHASEOFSERVICECORESERVICESPROGRAMIndicateinformationforeachTrailsproviderfromwhomCoreservicesareproposedtobepurchased.2345678910PROVIDERNAMETrailsAmountofAmountofAmountofNumberPaymentCostPerNumberTotalCostResource/ProviderContractContractContractofUnitsRateperMonthofPerProviderNumberFundedbyFundedbyFundedbyofUnitof(6x7)Months(8x9)80/20100%TANF,Service!ServiceofFSS,OtherMonthCost(Circleallthatapply)VariousProviders4,320660360124320MediationTOTAL$4,320Identificationofunitis:H=Hourly,D=Daily,W=Weekly,M=Monthly,E=EpisodeCoreServicesProgramexpenditureswillnotbereimbursedwhentheexpendituresmaybereimbursedbysomeothersource.(SetforthinRuleManualVolume7,at7.414,B). PurchaseofServices,FixedRatelGuarenteedlill2thContractsFixedRate/Guarenteed/1/l2thContracts:AllcontractsthatcountiesenterintowithaCoreServiceproviderthatisfixedrate/guaranteed/1/l2thcontractmustincludethefollowinginformation(youmaywishtocopythispageforeachfixedrate/guaranteed/i/lcontract):Costofcontractpermonth.Servicesprovided.>Costperservice.Costperchild.Howthecontractisbeingmonitoredforaccountability..-TheCounty’srationaleforenteringintoafixedrate/guaranteed/i/i2thcontractvs.afeeforservicecontract.Service(s)tobePurchaseofCostofCostPerCostPerHowtheContractisCountyRationaleforProvidedServiceProviderContractEachChildBeingMonitoredforEnteringintoContractPerMonthServiceAccountability34 PROJECTED CORE SERVICES OUTCOMES FOR PERFORMANCE INDICATORS FOR FY 201 2-2013 Service Over 85%1 85%25%2 Under 25%Total Clients Served 20 7 3 30 Home Base 20 7 3 30 Intensive Family Therapy 15 3 2 20 Life Skills Day Treatment 4 1 5 Sexual Abuse Treatment Mental Health Treatment 10 3 2 15 Substance Abuse Treatment 2 1 1 4 Special Economic Assistance 2 1 1 4 County Design (List)Mediation Evidence Based Practice for 18 4 3 25 Adolescents Family Group Decision Making 25 5 5 35 Family Group Decision Making 1Client meets 86%or more of the treatment goals 2Client meets between 85%-25%of the treatment goals 3Client meets 24%or less of the treatment goals 35 CORE SERVICES PROGRAM OVERHEAD COST DIRECTSERVICE A.Total Salary/Fringe/Travel/Operating Costs of Line Service Workers and their Immediate Supervisors B.Formula Percentage Allowed for Overhead Costs 15% C.Provided Service Overhead Costs (A X B)$15,262 2.PURCHASED SERVICE A.Purchased Service Dollar Amount _i38 B.Formula Percentage Allowed for Overhead Costs 4o $0 -50,000 =5%$50,001 -100,000 =4.9% For each $50,000 (in total expenditure)increase the overhead decreases by .1 ¾. C.Allowed Amount for Overhead Costs (A X B) D.Base Overhead Cost Allowed $500.00 E.Purchased Service Overhead Costs (C +D) 3.TOTALOVERHEAD COSTS (1C+2E) DISTRIBUTION OF OVERHEAD COSTS AMONG SERVICES* SERVICE Provided Service Purchased Total Overhead Overhead Costs Service Overhead Costs Costs 1.Home Based Intervention $3052 $898 $3950 2.Intensive Family Therapy $3052 $898 $3950 3.Sexual Abuse Treatment $3052 $898 $3950 4.Day Treatment 5.Life Skills $3053 $897 $3950 6.County Designed Service $3053 $897 $3950 COLUMN TOTALS $1 5,262 $4,488 $1 9,750 *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 ¾listed 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. 36 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 37 COUNTY(IES)EacileSTATEBOARDSUMMARYCORESERVICESPROGRAMFY2012-201380/20FUNDINGServicesResource/Provideror#ofFamilies#ChildrenCostperChildCostperYearNumberofFTEAgeofChildServedPerServedPerPerMonthMonthMonthCountyDesign.12FTE10-18years6B$113$10,860AdolescentFamilyGroupDecisionMakingServicesLifeSkillsVariousProviders0-18years47$170$14,308IntensiveFamilyVariousProviders0-1Byears510$335$40,280TherapyServicesSexualAbuseVariousProviders0-18years11$300$3,600TreatmentMediationVariousProviders0-18years11$360$4,320TOTAL80/20CORE$73,36838 COUNTY(IES)EaQie100%FUNDINGSUMMARYCORESERVICEPROGRAMFY2012-2013ServicesResource/Provideror#ofFamilies#ChildrenServedCostperChildCostperYearNumberofFTEAgeofChildServedPerPerMonthperMonthMonthHomeBased.50FTE0-18years58$552$53,040InterventionServices-Direct.5FTE.5FTEIntensiveFamily.5FTE0-18years510$80$9648Therapy-Direct.5FTELifeSkills.5FTE0-18years47$114$9648Direct.5FTEFCM.5FTE0-18years1015$53$9,648Supervision.5FTESpecialEconomicVariousProviders0-18years11$600$1,600AssistanceEagleCountyVariousProviders0-l8years35$288$17,280SubstanceAbuseServicesCountyDesign.09FTE0-12years610$62$8,906FCM0-12-DirectTOTAL700%CORE$70977040 FINALBUDGETPAGEFY2012-2013CORESERVICESPROGRAMCFMSFunctionCodes17xxdenotes80/20fundedCoreServiceCFMSFunctionCodes18xxdenotes100%fundedCoreServiceCFMSFunctionsCodesforFamilyStabilityServiceswillbedeterminedbyfundingsource:303.866.5962formoreinformation.CFMSServiceNameOtherDSSOtherTotalFundsTotalFunds100%TotalFSSTOTALFunctionFundsSource80/20(Core,SEA,FundsFUNDSCodeFundsSubstanceAbuse,(Specifyfund1700MentalHealth)source)(SpecifyFund1800source)1800HomeBasedIntervention$53,040$53,040Services-Direct1810IntensiveFamilyTherapy-Direct$9,648$9,6461710IntensiveFamilyTherapy$40,280$40,2801820LifeSkills-Direct$9,648$9,6481720LifeSkills$14,308$14,308SpecialEconomicAssistance$1,600$1,600SubstanceAbuseServices$17,280$17,2801740SexualAbuseTreatment$3,600$3,6001750CountyDesign-FamilyCentered$10,860$10,860Meetings-DirectEvidencedBasedServicesforAdolescents1850CountyDesign-FamilyCentered$18,554$18,554MeetingDirect1760CountyDesignMediation$4,320TOTALS$73,368$109,770$183,138ChildWelfareBlockorCountyFunds.PleasecontactMelindaCoxat41