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HomeMy WebLinkAboutC15-309 State of Colorado Department of Human Services MOUMEMORANDUM OF UNDERSTANDING The State of Colorado Department of Human Services And The Board of County Commissioners or other elected governing body of Eagle County(ies), Colorado This Memorandum of Understanding (or "MOU") is made thisday of between the State of Colorado Department of Human Services (the "CDHS") and the Board of County Commissioners or other elected governing body of Eagle County(ies), Colorado (the "County") CDHS is the sole state agency with the responsibility to administer or supervise the administration of the human services programs listed in CRS 26-1-201. The Colorado General Assembly enacted SB 13-231 in response to the CDHS being granted waiver authority by the United States Department of Health and Human Services, Administration for Children and Families, under Section 1130 of the Social Security Act, which authorizes states to conduct demonstration projects which are determined to promote the objectives of parts B or E of Title IV of the Social Security Act. A copy of the waiver terms and conditions are attached to this MOU as Exhibit A. CRS 26-5-105.4 requires CDHS and the County to enter into a Memorandum of Understanding that explains the County's duties and responsibilities in implementing the Title IV -E Waiver Demonstration Projects. CDHS and the County understand and agree that the services outlined in this MOU are subject to available appropriations by the General Assembly, and neither party will be obligated to provide services or assistance if adequate appropriations have not been made. 1 t 1 The following terms are agreed to by CDHS and the County: 1. MOU MEETS PERFORMANCE AGREEMENT REQUIREMENT The parties agree that the provisions of this MOU constitute compliance with CRS 26-5-105.4. 2. TERM The term of this MOU will be from July 1, 2015 to and including June 30, 2016. 3. DEFINITIONS The parties agree to provide the following minimum services to the identified populations as denoted below (check all that apply): ® Family Engagement — Meetings will be provided to families with a newly opened child welfare case during the demonstration period: • Within 7 business days of case opening; o (in FAR cases, within 7 business days after the 60th day (69 days by including weekends); • Within 7 business days of initial placement; • Every 90 days when in out -of -home care (DHS/DSS custody); • Every 6 months in in-home (case open). X❑ Permanency Roundtables — Meeting will be held quarterly for: X] All open cases involving a child/youth with a goal of Other Planned Permanent Living Arrangement; and/or ® All open cases involving a child/youth who has been in out of home care for 12+ months; and/or ❑ Other: ❑ Kinship Supports — Support services and goods will be provided to kinship families who are: ❑ Licensed kinship foster caregivers; ❑ Non -licensed kinship foster caregivers. 2 ® Trauma Informed Screening, Assessment, and Treatment to the following target population: ® All open clients listed as PAC (participating as child) 4. REQUIRED DUTIES OF THE COUNTY a) During the term of the agreement, the County agrees to implement the intervention(s) in accordance with the rules adopted by the State Board of Human Services, and as described in Exhibit B, "County IV -E Waiver Demonstration Application," modified as necessary in accordance with Section 6 of this Memorandum of Understanding. b) The County will maintain sufficient records, will submit reports, and will accurately record Colorado Trails (Trails) and CFMS actions as may be required to document all cost and case activities supporting the implementation of the Waiver, and will permit CDHS, its evaluators, duly designated agents and/or representatives of the federal government, to inspect the records and will make such records available to CDHS as specified in CRS 26-1-122. If the County complies with current record keeping requirements as outlined by current rules, such shall be considered to be "sufficient records." c) Counties shall report costs to provide an intervention service to an individual, as authorized through this MOU. The cost shall include the type of intervention service provided, the volume of such services provided, and costs of the intervention service, where applicable. The costs include intervention funds, staff and vendor costs as identified in Trails, County Financial Management System (CFMS) and/or 100% time reporting by individuals performing a waiver activity. There is a presumption that a cost is not a waiver cost unless affirmatively documented in CFMS, Trails, and/or a vendor's time detail report for 100% time reporting. d) The County agrees to participate in the evaluation of the Title IV -E Waiver Demonstration Project, as described under Section 3 of Exhibit A, and as established under CRS 26-5-105.4. e) In accordance with CRS 26-5-105.4, the County agrees to the State retaining 50% of the Child Welfare savings resulting from the IV -E Waiver activities. The remaining 50% 3 b the County for additional Child Welfare services, as defined savings will be retained y in CRS 26-5-101.3. Cost savings are determined as follows funds that were claimed for 1) The difference between i) the amount of Title IV-E ministration and eligibility foster care maintenance, case planning and in State Fiscal Year ("SFY") 2012-13, and ii) the amount of Title IV- determinationriance, case planning and funds that would have been claimed for foster care inFY 15 16, had the State of administration and eligibility determination m She United States Department of Colorado not been granted waiver authority by t Health and Human Services under Section l 130 of the Social Security for distributing the methodology 2) For the ten counties with the largest caseload entered into a Title IV -E Waiver s that have cost savings between countie all be based on the reduction in the number of foster Demonstration Project MOU sh care bed days between SFY 2012-13 and SFY 2015IV E Waiver Demonstration MOU 3) For all other counties that have entered into a Title savings between counties that have with CDHS, the methodology for distributmg c tration Project MOU shall be based on the entered into a Title IV -E Waiver Demonsn either SFY 2011-12 or S reduction in the number of foster care bed days betwee 2012-13, and SFY 2015-16, as selected by the County. Waiver Demonstration Project Tit4) "Cost savings" shall not include unspent purposes of implementing Waiver funds provided to counties through the MOU Interventions. Any such unspent funds remaining at the end of SFY 2015-16 shall I for revert to the CDHS and shall be included in the total amount of available funds counties' SFY 2016-17 IV -E Waiver Demonstration interventionsWaiver Intervention 5) The County insures any county employee funded with Title employees with 100% of time funds participates in 100% time reporting County utilize the 6 Month Certification devoted to Title IV -E Waiver intervention(s) y form in lieu of 100% time reporting. fl No later than June 30, 2017, the County agrees to use 50% of the underspent county Title IV -E Waiver funds for child welfare services that can include. 1) IV -E Waiver intervention services to eligible and non -eligible Title IV -E children 11 2) Conventional title IV -E program services that are maintained for those Title IV -E eligible children in out of home placement 3) Other child welfare services to eligible and non -eligible Title IV -E children and their families 4) The County plan to expend either allocated Title IV -E Waiver funds, or underspent county Title IV -E Waiver funds as outlined in Exhibit B. 5. DUTIES OF CDHS a) CDHS will oversee the implementation of the Title IV -E Waiver Demonstration Project, and will develop standardized forms and reporting processes for the tracking of participants, in consultation with the Counties. b) CDHS will monitor the County's provision of Title IV -E Waiver intervention services as outlined in the Exhibit B and Exhibit C. CDHS will pull any necessary records or data for monitoring purposes from existing TRAILS and other current recording/data keeping systems. CDHS will not request the County to compile records/data that CDHS may compile or access through the use of TRAILS or other record/data keeping systems. c) CDHS will exercise oversight of and responsibility for the development, implementation, maintenance, and enhancement of Trails and its application relative to Child Welfare Services. d) For SFY 15/16 and subsequent years, CDHS agrees to allocate to counties any Title IV - E funds transmitted to the Title IV -E Waiver cash fund and appropriated by the general assembly to either implement the Title IV -E Waiver Demonstration Project, or to fund out of home placement and case planning for Title IV -E eligible children, in accordance with CRS 26-5-105.4. 6. BUDGET In the preparing of Exhibit B, "County IV -E Waiver Demonstration Application," the County shall develop a detailed budget that identifies all direct costs associated with the implementation of the Waiver interventions, as defined in Section 3 of this Memorandum, for which the County has applied for IV -E Waiver Demonstration funds, G7 a) Based on the results of negotiations with CDHS, should the level of funding awarded through the MOU differ from the funding requested through the Application, the County shall prepare and submit a revised Budget and any other changes to service delivery that will differ from the County's original Application submission. The revisions to the Application, once accepted by CDHS, shall constitute the Exhibit B, and shall become part of this MOU. b) With the written approval of CDHS, the County may request a revision to its accepted budget during the term of the agreement: 1) The County may apply for additional IV -E Waiver funds for Waiver interventions already in practice, provided they evidence that the anticipated goals identified in a county's original approved application have or will be met by the close of SFY 2015-16. Additional funding may only be used to serve children and families beyond the number identified in the county's original application for each existing initiative. 2) The County may transfer budgeted funds between expenditure line items within a specific intervention, provided that the transferred amounts do not constitute a significant modification to the services as described within the Application. 3) A written statement of impact to the services as described in the Application shall be prepared by the County and accompany any requested budget revisions that exceed the thresholds as identified in Sections 6.B.1 and 6.B.2 above, and may be required by CDHS for any requested budget revision falling within the thresholds identified in Sections 6.B.1 and 6.13.2 above. 7. SEVERABILITY To the extent that this MOU is executed, and performance of the obligations of the parties may be accomplished, the terms of the MOU are severable. Should any singular term in this MOU be declared invalid or become inoperative for any reason, it will not invalidate the MOU itself, or any of the terms included therein. 8 INTEGRATION OF UNDERSTANDING 0 The parties recognize the nature of the relationship between the County and the State. This relationship is governed more broadly by pertinent provisions of the Colorado Constitution and of state statutes and rules, including lawful rules promulgated by the State Board of Human Services. The parties further recognize that this MOU is not intended to supersede or change the relationship between the County and the State as established by any legal authority. 9. NO THIRD PARTY BENEFICIARY This MOU is binding to CDHS and the County, as well as their respective successors and assigns. It is agreed that the enforcement of the terms and conditions of this MOU are reserved for CDHS and the County, to the extent permitted by law. Nothing contained in this MOU allows a claim or right of action by a third party. Any third party receiving services or benefits under the provisions of this MOU is deemed an incidental beneficiary. 10. DISPUTE RESOLUTION Prior to the execution of this document, if the parties are unable to reach agreement concerning the inclusion of, or wording of, provisions of the MOU, either party may refer the dispute to the Title N -E Waiver Demonstration Project Oversight Committee. The Committee's decision will be made by a majority vote of its members, and is non-binding. If dissatisfied with the decision of the oversight committee, either party may seek review by the Office Director of Children Youth and Families or designee. Nothing in these provisions limits a party's ability to pursue other remedies available under the law. 11. TERMINATION The parties acknowledge that withdrawal from this MOU will result in the termination of this Agreement and termination of funding and services associated with this Agreement. The County shall assure as little disruption as possible in the delivery of services provided to Recipients. a) Withdrawal/Termination. Any party may withdraw from this Agreement at any time by providing 30 days written notice to all other Parties. 7 b) For Loss of Funds. Any party may withdraw from this Agreement, in the event of loss or reduction of resources from its funding sources and shall provide notice of withdrawal, in writing within 30 days. c) Lack of Compliance. CDHS may terminate the agreement if it is found the County is not complying with the terms of this memorandum. In the event the memorandum is terminated for failure to perform, interventions funds may be reduced at the discretion of CDHS. IN WITNESS WHEREOF, the Parties hereto, through their authorized representatives have executed this Memorandum of Understanding effective for the dates written above. Ann Rosales, Director, Division of Child Welfare Date County Commissioners COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its BOARD OF COUNTY COMMISSIONERS By: Kath handler -Henry Chairman "y}�c ,,Kanne McQueen ,9omm * one J ian H. Ryan K Commissioner DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES CHILDREN'S BUREAU DEMONSTRATION PROJECT AUTHORITY STATE: COLORADO Waivers of the following provisions of the Social Security Act and Program Regulations are provided to the State to operate a demonstration project: Section 471(a)(10): Licensing Standards: To allow the State to waive categorically specific non -safety standards (as determined by the State) in relative foster family homes for specific children in care. Section 472 (a): Expanded Eli ibg ility: To allow the State to expend title IV -E funds for children and families who are not normally eligible under Part E of title IV of the Act as described in the Terms and Conditions. Section 474(a)(1): Expanded Claiming: To allow the State to claim at the Federal medical assistance percentage any allowable expenditures of foster care maintenance payment cost savings. Section 474(a)(3)(E) and 45 CFR 1356.60(c)(3): Expanded Services: To allow the State to make payments for services that will be provided that are not normally covered under Part E of title IV of the Act; and to allow the State to use title IV -E funds for these costs and services as described in the Terms and Conditions, Section 2.0. All waivers are granted only to the extent necessary to accomplish the project as described in these Terms and Conditions. Colorado Terms and Conditions - FINAL DEMONSTRATION PROJECT TERMS AND CONDITIONS COLORADO SECTION 1: GENERAL 1.0 The Department of Health and Human Services (hereinafter referred to as "the Department") will grant waivers to the State of Colorado (hereinafter referred to as "the State") under Section 1130 of the Social Security Act (hereinafter referred to as "the Act") to operate a demonstration project (hereinafter referred to as "the demonstration") as set forth in these Demonstration Project Terms and Conditions. The Department reserves the right, in its sole discretion, to withdraw approval of this demonstration project, including withdrawal of any and all waivers granted by the Department at such time(s) that the Department determines that the State has materially failed to meet the requirements as set forth in these Demonstration Project Terms and Conditions. The State also retains the right to terminate the demonstration. 1.1 Failure to operate the demonstration as approved and according to Federal and State statutes and regulations will result in withdrawal of approval of this demonstration project. The Federal statutes and regulations with which the State must comply in the operation of the demonstration include civil rights statutes and regulations that prohibit discrimination on the basis of race, color, national origin, disability, sex, age, and religion, including title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, title II of the Americans with Disabilities Act, the nondiscrimination provisions of the Omnibus Budget Reconciliation Act of 1981, and the Multiethnic Placement Act as amended. After the demonstration is approved, the Department reserves the right to withdraw approval if agreement cannot be reached on any item(s) cited in this document as needing approval by the Department. The State also has the same right. 1.2 The Department may terminate the State's authority to conduct a demonstration project if, after the three-year period following approval of these Terms and Conditions, the State has not made significant progress in implementing the child welfare program improvement policies proposed by the State in its application to conduct a demonstration, and as described in section 1130(a)(3)(C) of the Act (see also Section 2.3). 1.3 If Federal or State statutes or regulations that would have a major effect on the design and impacts of this demonstration are enacted, or if any deficiencies or serious problems in implementation of these Terms and Conditions are noted by the Department, the Department and the State will reassess the overall demonstration and develop a mutually agreed-upon strategy for dealing with the demonstration in the context of such changes. If such a mutually agreed-upon strategy cannot be developed, the Department reserves the right, in its sole discretion, to withdraw approval at such time(s) as the Department determines. Colorado Terms and Conditions - FINAL 2 1.4 All provisions of the Act not waived remain in effect. 1.5 The demonstration provisions will be implemented no earlier than April 1, 2013, and no later than October 1, 2013. The implementation date of the demonstration shall be the first day on which the State offers services, subsidies, or other supports under the provisions of these Demonstration Project Terms and Conditions to participating children, caregivers, or other targeted individuals. For cost -neutrality purposes, the demonstration shall be deemed to begin on the first day of the calendar quarter (hereinafter "quarter"), which includes the implementation date, but for the purpose of calculating costs for the initial quarter of the demonstration, only costs incurred beginning with the month that includes the implementation date will be counted. The demonstration shall end no later than the last day of the 201h quarter ending after the deemed beginning date. The demonstration provisions shall be as specified in Sections 2 and 3. Waivers necessary for the demonstration are approved upon acceptance by the Department and the State of these Demonstration Project Terms and Conditions. They will become effective as of the implementation date and will remain in effect until the last day of the 201h quarter ending after the deemed beginning date, unless the demonstration is terminated earlier. The State's project demonstration period may not exceed a maximum of five total years under the provisions of the Act, unless in the judgment of the Secretary, the demonstration project shall be allowed to continue. 1.6 Federal approval of these Demonstration Project Terms and Conditions shall not be construed to establish any precedent that the Department will follow in the approval of any subsequent request for Terms and Conditions. 1.7 Nothing in these Terms and Conditions shall create eligibility for any child or family for any Federal program or entitlement for which that child or family would not otherwise be entitled, except that title IV -E funds may be expended, according to the provisions of these Terms and Conditions, for persons who would not be eligible for title IV -E funds in the absence of the demonstration. Receipt of services reimbursable under title XIX but provided under these Terns and Conditions for children and families who are not eligible under title IV -E does not constitute eligibility for Medicaid. Children under this demonstration who are determined to be eligible under title IV -E will retain that eligibility through the duration of the demonstration project, so that such children will remain eligible for Medicaid, title IV -E Adoption Assistance, title IV -E Foster Care, and title IV -E Guardianship Assistance Program, if applicable. Colorado Terms and Conditions — FINAL 3 SECTION 2: IMPLEMENTATION 2.0 Under these Demonstration Project Terms and Conditions, the State is authorized to implement a demonstration project that seeks to integrate current systemic child welfare reforms and innovative practices through the use of strategies to increase family engagement and address the assessment and treatment of childhood trauma. The State's demonstration will focus on accomplishing the following goal(s): • Increase permanency for all infants, children, and youth by reducing the time in foster placements when possible and promoting a successful transition to adulthood for older youth. • Increase positive outcomes for infants, children, youth, and families in their homes and communities, including tribal communities, and improve the safety and well- being of infants, children, and youth. Prevent child abuse and neglect and the re-entry of infants, children, and youth into foster care. The demonstration will be implemented in up to 64 counties in the State; however, each county will implement some or all service interventions in varying stages during the demonstration time period. The demonstration's target population will include all title IV -E eligible and non -IV -E eligible children with screened -in reports of abuse or neglect and those already receiving services through an open child welfare case during the demonstration period regardless of custody status. Once the demonstration is fully implemented, the State estimates that it may serve up to 101,100 cases (duplicated count) through the six service interventions described in Section 2.1 below. The state may choose to implement the demonstration project either by individual county performance agreements or by a change in State regulation. . 2.1 The State's demonstration will include the following three primary service interventions to be implemented statewide: • Family Engagement: The State will introduce family engagement precepts and processes through a combination of training, coaching, and peer mentoring. Additionally, the State will modify non -safety certification regulations of relative foster family homes to facilitate the placement of children with relatives when out -of -home placement is necessary. • Trauma -Informed Child Assessment: The State will supplement existing assessment processes and instruments with standardized tools that are geared specifically toward children who have experienced trauma. The following assessment tools will be evaluated to determine the best tool for use by Colorado's county departments and behavioral health organizations and may Colorado Terms and Conditions - FINAL 4 include but are not limited to: ■ Child Observation Record ■ Battelle Development Inventory ■ Ages and Stages Questionnaire ■ Child Development Inventory ■ Behavioral and Emotional Rating Scale ■ Clinical Assessment Package for Assessing Clients' Risk and Strengths ■ Social Skills Rating System ■ Child and Adolescent Adaptive Functioning Scale ■ 4-D Strengths -Based Assessment Tools for Youth in Care ■ Family, Friends, and Self Form Colorado Behavioral Health Organizations (BHOs) and/or local child welfare service agencies may be engaged to conduct the trauma -informed assessments. The final selection of trauma -informed assessment tools, and the timeline for implementing them, will be specified in the State's Final Design and Implementation Report (Section 2.4). Trauma -Focused Behavioral Health Treatments: Counties and behavioral health organizations will increase the use of behavioral health treatments that have been shown to be effective with children who have experienced trauma through contracts with local human service providers and/or through their expanded utilization by BHOs. The treatment interventions (organized by category below) will be evaluated to determine the best tool to meet local need and may include, but are not limited, to: ■ General Case Management: Family Connections and Solution -Based Casework ■ Trauma and Anxiety: Eye Movement Desensitization & Reprocessing, Trauma -Focused Cognitive Behavioral Therapy, and Coping Cat ■ Therapeutic Interventions: Multidimensional Family Therapy, Multi- systemic Therapy, and Multidimensional Treatment Foster Care ■ Substance Abuse (adults): Motivational Interviewing ■ Depression (adults): Cognitive Therapy and Interpersonal Psychotherapy ■ Parent Training: The Incredible Years, Parent Management Training, Parent -Child Interaction Therapy, and Positive Parent Program (Triple P) The final selection of trauma -focused behavioral health treatments, and the timeline for implementing them, will be specified in the State's Final Design and Implementation Report (Section 2.4). In addition to the three primary service interventions noted above, the State will assist individual counties in identifying additional interventions to be implemented Colorado Terms and Conditions — FINAL based on the specific needs and circumstances of the county. Additional service interventions that may be implemented by counties include: • Permanency Roundtables: Expansion of Casey Family Program's existing Permanency Roundtable initiative to counties that do not directly participate in the initiative, and that make substantial use of congregate care and other planned permanent living arrangements for children in out -of -home placement. • Kinship Supports: Establishment of support groups and referral networks, combined with the provision of discretionary funds for time-limited supports and services, to assist non -licensed kin foster caregivers. • Market Seementation: Development of a tool to assist in the identification and recruitment of foster and adoptive parents. The specific counties that will implement each of these supplemental service interventions, and the timeline for implementing them, will be based upon counties' readiness to implement, driven by local need, and specified in the State's Final Design and Implementation Report (Section 2.4). 2.2 The State shall comply with the following general provisions over the full term of the demonstration project. The State will, or where appropriate, will ensure that caseworkers, supervisors, and contracted service providers: a. Work closely with the evaluator to maintain the integrity of the evaluation. b. Develop and deliver services to meet the individual needs of each child and family. C. Ensure that any services being provided to a child or family member at the time the demonstration ends will be completed. d. Ensure the confidentiality of the information collected on the children and families under the demonstration. Ensure that the rights of children and their families are protected, and that the safety of the children is a paramount concern of the demonstration project. f. Ensure that title IV -E eligibility determinations are made for all children who are involved in the demonstration project, throughout the life of the demonstration project, to ensure that eligible children retain their eligibility after the demonstration ends. g. A Bear any costs that exceed the amount of Federal funds provided for the demonstration. Colorado Terms and Conditions — FINAL 6 h. Ensure that the State is organizationally and legally prepared for all aspects of demonstration project implementation. i. Ensure that a conventional title IV -E program is maintained for those children and families that are not designated to receive demonstration services, and that these children and families continue to receive services that are consistent with the "traditional services" available to such children and families in the State at the time the demonstration begins. j. Ensure that all applicable provisions of the Act apply to all demonstration components except for those provisions that are explicitly waived above. k. Ensure that children who are eligible for the Medicaid program will retain their eligibility for a full range of Medicaid services under the demonstration. 1. Ensure that any "savings" resulting from the demonstration, whether they are savings to the Federal government, to the State, or to a county or to another jurisdiction within the State, will be used for the further provision of child welfare services. For the purposes of this provision, "savings" means any amount that would have been expended for conventional title IV -E purposes in the absence of this demonstration, or that could have been expended under title IV -B of the Act. In. Ensure that the State annually will provide an accounting of any additional Federal, State, tribal, and local investments made, as well, as any private investments made in coordination with the State, to provide the service intervention(s) that the applicant intends to undertake through the demonstration (see Section 5.6). n. Ensure that in each year throughout the duration of this demonstration the appropriate State official(s) and evaluators will attend and participate in an annual meeting of the Child Welfare Demonstration States in the Washington, D.C. area. o. For the duration of the demonstration project, assure that the State shall provide health insurance coverage to any child with special needs (as determined under Sec. 473(C) of the Act) for whom there is in effect an adoption assistance agreement between the State and an adoptive parent or parents. 2.3 The State shall provide assurance of how the State has implemented, or plans to implement within three years of the date on which it submits its application the following child welfare program improvement policies: • Address Health and Mental Health Needs of Children in Foster Care: The development and implementation of a plan for meeting the physical and mental health needs of infants, children, and youth in foster care that ensures that the provision of such care is child -specific, comprehensive, appropriate, and consistent (through such means as ensuring that the child has a medical home, Colorado Terms and Conditions — FINAL 7 regular wellness medical visits, and addressing the issue of trauma, when appropriate). • Limitina the Use of Congregate Care: The development and implementation of a plan that ensures congregate care is used appropriately and reduces the placement of children and youth in such care. 2.4 Within 90 days following acceptance of these Terms and Conditions, the State will Submit a Preliminary Design and Implementation Report to the Department for approval; and a Final Design and Implementation Report will be submitted to the Department for approval within 180 days following acceptance of these Terms and Conditions (see Section 5.2). These reports will include information about program design and implementation. Report sections regarding implementation will include: • A Final Work Plan, outlining the key tasks, reporting requirements, and timelines throughout the course of the demonstration; • A phase -down plan for the demonstration so that case plans for children and their families can be adjusted, if necessary, for the post -demonstration portion of their placement (See Section 6.1); • The detailed protocol or set of policies,that will guide decisions about which families or children are to be selected to participate in the demonstration, how the selection will be made, and how the suitability of services will be determined; • Standards of quality and safety and practice requirements identified by the State to be incorporated into any agreements with public and private providers that are expected to provide support and services; and • The status of evaluation activities, including efforts to engage a third -party evaluator. The demonstration project will be reviewed periodically by the Department to ensure that the demonstration activities are consistent with the purposes of titles IV -B and IV -E of the Act and these Terms and Conditions in providing child welfare services, including an assurance of the safety of the children and families involved. The review is intended to ensure that benefit eligibility will not be impaired and that improved outcomes for the children and families will result. Any proposed amendment to these Terms and Conditions is subject to prior approval by the Department. Colorado Terms and Conditions - FINAL 8 SECTION 3: EVALUATION 3.0 The State will conduct an evaluation of the use of title IV -E funds to test the hypothesis that the flexible use of title IV -E funds to provide family engagement services, trauma -informed child assessments, and trauma -focused behavioral health treatments, as appropriate, will result in improved safety, permanency, and well- being for children. The evaluation will consist of three components: A process evaluation, an outcome evaluation, and a cost analysis. The State is required to engage a third party to conduct an evaluation of the demonstration program. The evaluator shall be an independent organization that is not affiliated with state or local government, except that state universities may be engaged to conduct the evaluation. The evaluator shall be responsible for the development of the final evaluation design within the basic evaluation parameters outlined below. The evaluator shall develop a research design and sampling plan; develop and execute the data collection and analysis plans; and prepare interim and final reports. 3.1 Evaluation Design: The State's evaluation will involve a matched case comparison design and a time -series analysis. The matched case comparison design will examine changes in outcomes for children receiving one or more interventions implemented at the beginning of or early in the demonstration period compared to similar children in counties that implemented these interventions later in the demonstration period. The time series analysis will examine changes over time in key measures of child safety and permanency. To the extent possible, the State's analysis of process and outcome findings will be based on case -level data from the State's child welfare information systems, case records, and other data sources as appropriate. Additionally, the State's process and outcome evaluation will include an analysis of the modification of State non -safety certification regulations for relative foster family homes on child safety outcomes which will include, but are not limited to, allegations of abuse in relative foster family homes. The State will also examine the differences in outcomes for children placed in relative foster family homes as they compare to those in traditional foster family homes. These outcomes will be regularly monitored by the State's Administrative Review Division and reported in the State's progress reports (Section 5.3) and interim and final evaluation reports (Sections 5.7 and 5.8). Additional details of the final evaluation design will be determined in consultation with the Department and the State's third -party evaluation contractor and described in the State's evaluation plan (Section 3.5). Throughout the evaluation, the State will apprise the Department of any difficulties encountered in achieving the estimated sample sizes for the project, and in consultation with the outside evaluator will determine if such difficulties will affect the State's ability to identify statistically significant differences in key demonstration outcomes. The State Colorado Terms and Conditions — FINAL 9 will notify the Department as soon as any serious problems are noted. Semi-annual progress reports (see Section 5.4) will include an update on the sample sizes and progress toward meeting the targeted sizes. Cases will maintain their assigned status for the full period of the demonstration. Modifications to the sampling plan may be proposed to the Department for approval if the sample sizes for the experimental and control groups are such that the number of clients in each group will provide adequate statistical power to detect differences in outcomes of interest between the two groups. 3.2 Process Evaluation: The evaluation will include interim and final process analyses that describe how the demonstration was implemented and that identify how demonstration services differ from services available prior to implementation of the demonstration, or from services available to children and families that are not designated to receive demonstration services. The analysis will include a logic model that describes the demonstration's objectives, the services or other interventions provided, and the way the intervention is linked to measurable outcomes. In addition, the process analysis will examine, at a minimum, the following: • The planning process for the demonstration including whether any formal needs assessment, asset mapping, or assessment of community readiness was conducted; • The organizational aspects of the demonstration, such as staff structure, funding committed, administrative structures, and project implementation, including ongoing monitoring, oversight, and problem resolution at various organization levels; • The number and type of staff involved in implementation, including the training they received, as well as their experience, education and characteristics; • The service delivery system, including procedures for determining eligibility, referring subjects for services, the array of services available, the number of children/families served and the type and duration of services provided; • The role of the courts in the demonstration and the relationship between the child welfare agency and court system, including any efforts to jointly plan and implement the demonstration; • Contextual factors, such as the social, economic and political forces that may have a bearing on the replicability of the intervention or influence the implementation or effectiveness of the demonstration. This discussion will note any possible confounding effects of changes in these systems, or changes resulting from other demonstrations or reforms that were implemented during the title IV -E demonstration; Colorado Terms and Conditions - FINAL 10 • The degree to which demonstration programs and services are implemented with fidelity to their intended service models; and • The barriers encountered during implementation, the steps taken to address these barriers, and any lessons learned during implementation. For each of the factors described above, the process analysis will note any differences, as appropriate for the State's evaluation design, in implementation before and after the start of the demonstration, among participating counties or other administrative units, or between the experimental and control/comparison groups. 3.3 Outcome Evaluation: The State's outcome evaluation will address, at a minimum, changes in the following outcomes: • Caregiver knowledge and capacity. • Child emotional/behavioral and social functioning. • Out -of -home placement and re-entry rates (placement avoidance). • Placement with kin caregivers (both licensed and unlicensed). • New and repeat allegations of abuse (in relative and non -relative foster family homes). • Length of stay in out -of -home care. • Frequency of changes in placement setting (placement stability). • Exits to permanency through reunification, guardianship, and adoption. • Foster care re-entry rates. • Use of congregate care. The State is free to propose additional research questions and outcome measures for inclusion in the evaluation. The State will collect data to address these questions from the State's automated child welfare information systems, child welfare agency case records, and additional information sources as appropriate. The State will work with its evaluation contractor to identify other appropriate data sources to address the process and outcome measures described above. 3.4 Cost Study: The cost analysis will examine, at a minimum, the costs of the key elements of services received by children and families designated to receive demonstration services and will compare these costs with those of services available prior to the start of the demonstration, or that were received by the children and families that were not designated to receive demonstration services. The cost analysis will also include an examination of the use of key funding sources, including all relevant Federal sources such as titles IV -A, IV -B, IV -E and XIX of the Act, as well as State and local funds. The purpose of the analysis will be to compare the costs of services available through the demonstration with those of services traditionally provided to children and their families. Where feasible, a cost-effectiveness analysis will be conducted to estimate the costs of Colorado Terms and Conditions — FINAL 11 each successful outcome achieved through the demonstration. This analysis will be conducted using one or more of the key outcome measures for which a statistically significant difference is identified. 3.5 Evaluation Reporting Requirements: The following reports and documents shall be provided to the Department for review and approval (also noted in Section 5): The State will submit to the Department for review a draft of the specifications or Request for Proposals (RFP) for the agreement to conduct an evaluation of the demonstration within 60 days after acceptance of these Terms and Conditions. The draft specifications must detail the objectives of the project, the evaluation design, the specific tasks to be conducted, the time frames for conducting those tasks, and a schedule and list of deliverables. The research questions, key variables, data collection methods, sample sizes and other aspects of the evaluation noted in these Terms and Conditions will be clearly described. The State will submit an evaluation plan to the Department for approval within 120 days after the evaluation contract is awarded. The evaluation plan must present the underlying logic linking interventions to expected outcomes, the research questions to be studied, the major variables to be measured, the final sampling plan, the data sources (including an assessment of the reliability and validity of each source), data collection procedures, and the major data analyses to be performed. The plan will describe the comparability of selected time periods and groups on key variables. Not later than 60 days after the conclusion of the 10`x' quarter following the demonstration's implementation date, the State will submit an interim evaluation report (see Section 5). The report will include a process analysis of the evaluation to date and any outcome data available at that time. The report will also include a brief description of the outcome and cost components of the evaluation planned and note any issues or problems anticipated in completion of these components. If the findings are unclear or incomplete, the Department may request revisions and resubmission of the report. • Not later than six months after the conclusion of the demonstration (201' quarter), a final report integrating the process, outcome and cost components of the evaluation will be submitted. If the findings are unclear or incomplete, the Department may request revisions and resubmission of the report. • The State will post copies of the interim and final evaluation reports on the State's child welfare agency Website (see Section 5.10). • Not later than six months after the conclusion of the demonstration (2& quarter), the State will have the evaluation contractor produce and make available public -use data tapes, including documentation necessary to permit re -analysis of the data gathered during the course of the evaluation. Colorado Terms and Conditions — FINAL 12 Public release of any evaluation or monitoring reports required under this agreement will be made only by the Department or the State. Prior to public release of such reports, the Department and the State will have at least a 30 -day period for review and approval. 3.6 Program Changes: Additional program changes that are not applied equally to experimental and control/comparison groups, or that would substantially affect the evaluation of the demonstration, must be approved by the Department as an amendment to these Demonstration Project Terms and Conditions. Colorado Terms and Conditions - FINAL 13 SECTION 4: COST NEUTRALITY 4.0 As required by section 1130(h) of the Act, the amount of Federal funds expended for this project may not exceed the amount of such funds that would be expended by the State under the State plans approved under parts B and E of title IV if the demonstration project were not conducted. Therefore, except for costs of evaluating and developing this project (as specified in Sections 4.4 and 4.5 below), starting with the deemed beginning date (see Section 1.5) the operation of this demonstration is to be cost -neutral to the Federal government with respect to maintenance and administrative costs for titles IV -B and IV -E of the Act. 4.1 Section 4 Terms: Costs. All references made to costs (unless otherwise specifically noted) consist of total computable (gross) costs. The Federal share of demonstration project costs will be computed using the matching rate applicable to the funding category. Maintenance Costs. All references made to maintenance costs include title IV -E allowable foster care maintenance assistance payments (per Section 475(4)(A) of the Act), and such other costs for cases deemed as title IV -E allowable through a waiver granted for this demonstration project. Administrative Costs. All references made to administrative costs include title IV -E allowable administrative costs (per Federal regulations at 45 CFR 1356.60(c)) and other costs deemed as title IV -E allowable through a waiver granted for this demonstration project. Cumulative. All references made to cumulative in the context of costs will indicate that costs are to be summed for all quarters from the deemed beginning date through the quarter in question. 4.2 The total costs of foster care payments, including maintenance and administrative costs, shall be an amount determined by a base allocation as determined in Section 4.2.1 below plus any annual change factor or exclusions as specified in Section 4.2.2. The results of this calculation are shown in Section 4.3, Table 1. The aggregate five- year sum of Federal share payments shall be the cumulative fixed payment that shall be made to the State. Receipt by the State of payments not greater that the cumulative fixed payment shall be considered cost neutral to the Federal government. At least 90 days prior to implementation, the State shall provide the Department with a document showing a fixed schedule of payments for the five-year demonstration period. The State may receive quarterly payments in accordance with a schedule of quarterly payments the sum of which do not exceed the total cumulative payments under the demonstration. Colorado Terms and Conditions — FINAL 14 4.2.1 The foster care base allocation amount to be used for purposes of establishing a cap to reflect cost neutrality to the Federal government for demonstration project operations has been determined for each of the funding categories impacted by the demonstration project through the following processes: Source of claims: The base amount is the calculated State Fiscal Year (SFY) total computable (gross) title IV -E Foster Care claims (including current and prior quarter adjustments) submitted by Colorado on quarterly reports of expenditures and estimates (i.e. form ACF -IV -E-1 or CB -496, as applicable) during the specified time periods for the following cost categories and adjusted for baseline increases as specified below: • Foster care maintenance costs: Total computable costs of $35,943,219. This total is calculated from the average of maintenance payments claims for SFY 2008-2010. Foster care administrative costs (excluding SACWIS, non-SACWIS child welfare information systems, and training): Total computable costs of $54,251,490. This total is calculated from the average of administration claims for SFY 2008-2010 in the following specific categories of administration: eligibility determinations and case management. Application of base allocation: The base amount will be applied separately in determining annual allocations for maintenance assistance payments and administration. 4.2.2 The payments for each full FFY during the 5 -year operational period of the demonstration project shall consist of the base amount adjusted each FFY by the change factor(s) and the exclusions described in the subsections below. Thus, payments in the second and subsequent full FFYs of demonstration operations will equal the amount calculated for the prior FFY plus any further applicable changes. Payments for demonstration operations during any partial FFY will be pro -rated proportionally by quarter to reflect the portion of the FFY when the demonstration project is operational. 4.2.2.1 The annual allocation change factors applied have been determined by the following process: a. Maintenance assistance payments: Three year average annual rate of change in the ratio of total computable maintenance payment claims to average monthly number of children. b. Administration: Three year average annual rate of change in total computable administration claims for the specified categories. Colorado Terms and Conditions — FINAL 15 4.2.2.2 The foster care costs excluded from the cost neutrality calculation and thus subject to payment outside of the capped allocation are as follows: a. Any allowable foster care administrative costs not previously identified in Section 4.2.1 will be excluded from the calculation of the demonstration's capped allocation (see Section 4.3), and will be reimbursable separately in addition to the amount of the capped allocation. b. Any allowable SACWIS or non-SACWIS child welfare information system development or operational costs will be excluded from the calculation of the demonstration's capped allocation (see Section 4.3), and will be reimbursable separately in addition to the amount of the capped allocation. Costs associated with the development, maintenance and operation of the State's SACWIS project will be subject to applicable advance planning document and approval processes. c. Any allowable staff/provider or professional partner training costs will be excluded from -the calculation of the demonstration's capped allocation (see Section 4.3), and will be reimbursable separately in addition to the amount of the capped allocation. 4.3 Federal title IV -E payments to the State for this demonstration, including expenditures of any realized savings, will be made for, amounts in accordance with Table 1 (shown below) quarterly based on State estimates of demonstration .expenditures for the next quarter in accordance with the payment schedule (as determined in Section 4.2 above). Table 1- Colorado Title ME Foster Care Total Computable Demonstration Project Capped Allocation Payments Demonstration Base SFY SFY 2013 SFY 2014 SFY 2015 SFY 2016 SFY 2017 SFY 2018 Project Funding Amount Allocation Allocation Allocation Allocation Allocation Allocation Category Cap Cap Cap Cap Cap Cap Maintenance Payments 35,943,219 36,593,888 37,212,120 38,486,500 39,353,687 40,323,825 41,414,040 Administration 54,251,490 55,651,178 56,669,595 57,383,632 58,468,183 59,438,754 60,389,774 All Capped Categories 90,194,709 92,245,066 93,881,715 95,870,132 97,821,870 99,762,579 101,803,814 Federal title IV -E payments for demonstration operational expenditures will be made for any quarter beginning in accordance with the dates specified in section 1.5 of these terms and conditions when the demonstration is in operation and for a total period of no longer than five years (20 quarters) thereafter. Colorado Terms and Conditions — FINAL 16 Actual expenditures claimed for the demonstration project, including expenditures of any realized savings, along with estimates in advance of each quarter, will be identified separately on the ACF quarterly claim form, CB -496. Summary fiscal information on the results of the project must be reported in Part 3 as well as other applicable parts of form CB -496. These estimates and claims relating to the demonstration will be subject to review and deferral or adjustment according to the normal procedures for reviewing title IV -E estimates and paying title IV -E claims. All other title IV -E claims that are not related to this demonstration will continue to be filed in accordance with current quarterly claiming requirements for payments for allowable cost. The State must examine its cost allocation plan to determine whether any of the components will affect the calculation of or claiming for any administrative costs under title IV -E, and if so the State must submit an amendment to the cost allocation plan prior to the implementation date to address any such effects appropriately. 4.4 Developmental Costs. Developmental costs are the expenses the State incurs to establish the demonstration prior to the project's implementation. These costs are excluded from the cost -neutrality calculation. For activities undertaken prior to the implementation date specified in Section 1.5 above, the Federal government will match the approved administrative costs related to development of the demonstration project (otherwise called developmental costs) at the applicable matching rate without application of cost allocation. Such costs can begin with the preparation of the State's proposal and may also include automated systems development and changes, policy or procedures development, and staff training. Developmental costs do not include costs for activities performed on or after the deemed start date of project operations. No later than 30 days after the State formally accepts these Terms and Conditions, the State will submit a plan, for approval by the Department, designating which administrative costs will be treated as developmental costs for purposes of this section (see Section 5.0). This section is not intended to supersede other requirements for Federal approval for administrative costs of the programs involved in the demonstration. 4.5 Evaluation Costs. Evaluation costs are expenses incurred by the external evaluator as well as those incurred by the State that are directly related to the evaluation effort. These costs are excluded from cost -neutrality calculation. Evaluation costs begin with the first evaluation planning activities and continue until the final evaluation report is submitted. Such costs will encompass all costs necessary to carry out the approved evaluation plan, including costs for evaluation activities carried out by State and local agencies as well as those carried out by the evaluation contractor. The costs of approved evaluation activities may be charged to title IV -E administrative costs without cost allocation so that the State may claim a full 50 percent of these costs as title IV -E administrative costs. The State shall address any changes needed to implement this provision through submission of appropriate amendments to its approved State cost allocation plans. Costs of evaluation that arise from the demonstration project(s) approved under these Terms and Conditions may be claimed for a reasonable period of time after the expiration of the period of this demonstration (Section 1.5) so long as the costs are for activities required by the evaluation plan(s) approved by the Department and are otherwise allowable and Colorado Terms and Conditions - FINAL 17 reasonable. Evaluation components not approved by the Department will not qualify for Federal matching funds. Colorado Terms and Conditions - FINAL 18 SECTION 5: MONITORING The State will send all reports required in this section to the Children's Bureau, the Regional ACF Office, and the evaluation technical assistance contractor for this initiative. 5.0 The State must submit a plan, for approval by the Department, designating which administrative costs will be treated as developmental costs (see Section 4.4) no later than 30 days after accepting these Terms and Conditions. 5.1 Within 60 days of acceptance of these Terms and Conditions, the State will submit to the Department a draft of the specifications or Request for Proposal (RFP) and evaluation specifications for review. 5.2 Within 90 days following acceptance of these Terms and Conditions, the State will submit a Preliminary Design and Implementation Report to the Department for approval; and a Final Design and Implementation Report will be submitted to the Department for approval within 180 days following acceptance of these Terms and Conditions (see Section 2.4 for detailed elements of the reports). 5.3 The State shall submit quarterly progress reports beginning 90 days after the acceptance of these Terms and Conditions and continuing until implementation. The Preliminary Design and Implementation Report will serve as the first quarterly report. All subsequent reports are due no later than 30 days after the conclusion of each quarterly period and will include a basic update on the status of each activity or task identified in the Implementation Report. The report will also identify any problems encountered that may have an impact on the design or anticipated implementation schedule. Suggestions for resolving these problems will be provided for the Department's review and approval. 5.4 Once implementation has begun, semi-annual progress reports will be required throughout the project period summarizing project and evaluation activities and accomplishments during the reporting period as well as interim findings from the evaluation, if available. The semi-annual monitoring reports shall indicate issues or problems and resolutions regarding the implementation of the demonstration or evaluation as approved, including updates on the resolution of any significant problems identified in the implementation report. The State will address its progress toward implementing the Child Welfare Program Improvement Policies as described in Section 2.3. These reports are due no later than 30 days after the conclusion of each reporting period. 5.5 The State will submit an evaluation plan to the Department for approval within 90 days after the evaluation contract is awarded (Section 3.5). The evaluation plan must be approved by the Department prior to implementation. 5.6 The State will submit an annual accounting during the demonstration project period of all investments, public or private, made in coordination with the State to provide services under the proposed demonstration project. Colorado Terms and Conditions - FINAL 19 5.7 The State will submit an Interim Evaluation Report 60 days after the conclusion of the 10th quarter following the demonstration's implementation date (Section 3.5). Additional reports may be proposed by the State and, subject to approval by the Department, may be considered allowable components of the evaluation of the demonstration. 5.8 The State will submit a Final Evaluation Report six months after the project ends, integrating the process study, the outcomes study, and the cost analysis (Section 3.5). 5.9 The State will post copies of the interim and final evaluation reports on the State's child welfare agency Website (see Section 3.5). 5.10 The State will submit, or have the evaluation contractor produce and make available, public -use data tapes, including documentation necessary to permit re -analysis of the data gathered during the course of the evaluation, six months after the project ends (Section 3.5). Colorado Terms and Conditions — FINAL 20 SECTION 6: TERMINATION PROCEDURES 6.0 Federal financial participation in demonstration activities requiring waivers will not be provided beyond the period approved by the Department. 6.1 As part of the Preliminary Design and Implementation Report and the Final Design and Implementation Report (Section 2.4), the State will submit for the Department's approval a plan to phase down and end the demonstration to ensure that there are no demonstration -related Federal costs incurred beyond the period approved by the Department. All activities requiring Department approval must cease on the date decided by the Department if the project is terminated prior to the end of the 20th quarter after the deemed beginning date of the demonstration. Approval: and Families Acceptance: Reggie Bicha Executive Director Colorado Department of Human Services Date Date Colorado Terms and Conditions — FINAL 21 COLORADO DEPARTMENT OF HUMAN SERVICES Title IV -E Waiver Demonstration Project Individual County Year 3 (SFY 2015/2016) Application Colorado Department of Human Services encourages you to apply to participate in the third year of the Title IV -E Waiver Demonstration Project. It is not mandatory for you to participate in all 5 interventions. Research your county's child welfare needs and gaps in service delivery and utilize this funding to improve services to children, youth and families in need. Use data to support needed FTE's and funding for hard goods. Structure and positions must be in place for implementation on 7/1/15. Please visit www.cdhs.state.co.us to review the "Frequently Asked Questions" section or contact Tyler Allen, Administrator of the Title IV -E Waiver Demonstration Project at tyler.allen .state.co.us, 303.866.2154, with questions related to this application. Name of County/Region: Eagle County Department of Human Services Primary Contact: Kendra Schleff, LCSW Date: 4/6/15 County: Eagle County Agency: Department of Human Services Address: 551 Broadway Street City, State Zip Eagle, CO 81631 Phone: 970-328-8827 Waiver Interventions Email: Kendra.Schleff@eaglecounty.us What Title IV -E Waiver Interventions are you applying for funding? ❑ Family Engagement Total Funding Amount Requested: ❑ Permanency Roundtables Total Funding Amount Requested: ❑ Kinship Supports ® Trauma -Informed Screening, Assessment, and Treatment Total Funding Amount Requested: Total Funding Amount Requested: TOTAL: $7,500 $7,500 Are there Title IV -E Waiver Interventions you are implementing with fidelity, to be included in the evaluation, but are not requesting funding? Please fill out the corresponding area of this application. ® Family Engagement ❑ Kinship Supports ® Permanency Roundtables ❑ Trauma -Informed Screening and Referral Management Plan for Waiver Intervention(s) Implementation, Who will provide oversight, coaching, and supervision of the interventions? Will your management team include the data analyst, financial manager, staff members throughout the hierarchy? If a Region, include representation from each county. Name: Toni Rozanski Title: Director, Children, Family & Adult Services Agency: Eagle County DHS Phone: 970-328-8852 Email: Toni.Rozanski@eaglecounty.us Specific Intervention: Family Engagement, PRTs and Trauma -Informed Screening, Assessment, and Treatment Name: Agency: Kendra Schleff, LCSW Eagle County DHS Title: Child & Adult Protection Manager Phone: Specific 970-328-8827 Email: Kendra. Schleffea lecoun .us Intervention: Family Engagement, PRTs and Trauma -Informed Screening, Assessment, and Treatment Name: Agency: Heather Lawdermilk, LCSW Eagle County DHS Title: Child & Adult Protection Supervisor Phone: Specific 970-328-8854 Intervention: Family Engagement, Email: Heather. Lawdermilkea lecoun .us PRTs and Trauma -Informed Screening, Assessment, and Treatment Draft 3.7.14 1 1 P a g e Name: Melinda Dow Agency: Eagle DHS Phone: 970-328-8823 Specific Intervention: Fam ement Family Engagement Specialist; Child & Adult Protection Title: Caseworker Email: Melinda.Dow@eaglecountv.us Describe the structure of the oversight, coaching, and supervision. If you are a region, which county will be the fiscal agent? (Frequency of meeting as a group, individual supervision, consultation, peer coaching, intra -county support, etc. If implementing multiple interventions please provide separate plans as necessary.) Eagle County Child & Adult Protection Team's vision statement: Customers, partners and stakeholders of Eagle County Child and Adult Protective Services trust they will be helped and respected as we work to keep people safe and families together. We deliver high-quality services that ensure appropriate resources and betterment for families. We educate and collaborate with partners and stakeholders in the region to ensure continued leadership and accountability. Our competent and responsive team demonstrates we understand individual familial needs and follow through to meet their best interests. Family Engagement: The family engagement intervention will be managed by Kendra Schleff, LCSW, Child & Adult Protection Manager and Heather Lawdermilk, LCSW Child & Adult Protection Supervisor in Eagle County. Supervision will occur weekly. Training and coaching occur formally and informally as needed. Melinda Dow is the family engagement specialist. The family engagement intervention in the western portion of the county is managed by Kim Dubois, Manager, Pitkin County Family and Adult Services. Pitkin County provides family engagement services to Pitkin County and Western Eagle County clients. These services will be provided by staff and contractors. Permanency Roundtables (PRTs): Eagle County was previously the fiscal agent representing a seven county partnership for the PRT intervention. In the third year, this partnership will not continue as each county has decided to pursue individual implementation plans. In the coming year, the Eagle County PRT intervention will be implemented through our family engagement continuum. This will be managed by Kendra Schleff, Heather Lawdermilk and Melinda Dow. Training and coaching with occur formally and informally as needed. These services will be provided by staff and contractors. Trauma Informed Screening, Assessment and Treatment: Kendra Schleff, LCSW will provide oversight for the trauma screening, assessment and treatment in Eagle County. In 2013, Kendra Schleff completed requirements of the National Child Traumatic Stress Network to be a trainer in the Child Welfare Trauma Training Toolkit (CWTTT). This knowledge will be the base for trauma informed practice coaching on the child welfare team in Eagle County. Coaching related to trauma screening and referrals will take place during individual and group supervision. Mind Springs Health will partner with Eagle County DHS to provide the trauma focused assessments and mental health services. Have you identified any barriers or potential barriers in providing the monitoring, oversight, coaching and supervision of the intervention(s)? If you are a region, which county(les) will provide monitoring, oversight, coaching and supervision? Family Engagement: qualify, timely and accessible A potential barrier for the oversight of the family engagement program is having a pool of qualified and accessible facilitators to ensure the meetings take place in a timely manner. This barrier can become a great issue due to staff burnout and turnover. As a medium sized county, our team members, contractors and partners have numerous duties and Draft 3.7.14 2 1 P a g e are pulled in many different directions. This creates a potential barrier for the oversight of fidelity of the program. Permanency Roundtables (PRTs): Eagle County previously had a staff member solely responsible for implementing PRTs to fidelity of the model. We are no longer able to dedicate a full FTE for this position which creates a barrier for the oversight of this program. In addition, scheduling and travel has been a barrier to the successful implementation of PRTs. It has been a challenge to build the PRT teams for each youth with fidelity and find locations for meetings that are agreeable for all team members. Eagle County does not have placements located within the county. As a result, youth in care are often placed in more urban areas (i.e. Denver and Grand Junction). This means when the youth voice meeting takes place, the PRT team is required to take an entire day out of the office for the meeting. For smaller counties having multiple professionals out for a day can make it difficult to maintain other responsibilities. Trauma Informed Screening, Assessment and Treatment: A potential barrier continues to be the lack of availability of evidence -based trauma focused mental health services within Eagle County. There are a small number of mental health clinicians in the community who utilize these specific modalities. How can CDHS support you in meeting your technical assistance, coaching, and/or training needs? CDHS can support Eagle County by providing ongoing training on the family engagement techniques that are effective and maintain fidelity to the IV -E Waiver requirements, including PRTs, for both staff and community members who provide facilitation. There is a need for further exploration at the system level between HCPF and CDHS. In addition, CDHS can support Eagle County by providing funding for training the local mental health clinicians in trauma focused evidence based practices. We would specifically love to see a training offered for Child Parent Psychotherapy (CPP) or Eye Movement Desensitization and Reprocessing (EMDR). Draft 3.7.14 3 1 P a g e If you are part of a region, which counties will participate in this intervention? Eagle County provides the family engagement intervention as a sole entity; however, Eagle County contracts with Pitkin County to administer child welfare services in the Roaring Fork Valley (the western area of Eagle County). Pitkin County provides family engagement facilitation services for both Pitkin and Western Eagle County families, located in the Roaring Fork Region. Are you building on existing ®Yes ❑No practice? If yes, describe current model, including target population, and efforts to ensure fidelity. Is there anything unique to your efforts to implement Family Engagement? Eagle County recognizes the importance of involving family, their identified supports, and community partners in decision making about their own family. The Family Engagement program actively seeks the collaboration and leadership of family groups in crafting and implementing plans that support the safety, permanency and well- being of their children. Eagle County has three meeting formats within the Family Engagement program: Team Decision Making Meetings (TDM'sj will be utilized for decisions pertaining only to placement decisions. These criteria include: o Emergency Removal o Considered Removal o Placement Change o Permanency Planning o Reunification Team Decision making meetings will use the Annie E. Casey model. These meetings will focus on the strengths of the family, concerns and a plan to address the concerns. Eagle Connection Meetinds (ECM's) will be utilized for: o Case opening —within 7 business days after the 60th day (69 days including weekends); o Every 90 days when a child/youth is in out -of -home care (DHS custody); o Every 6 months when a family remains intact (case open). o Case Closure Eagle Connection Meetings utilize the consultation and information sharing framework. We utilize risk and goal statements and scaling for safety with the family and plan around issues that are identified during the meeting. An action, plan will be created from the next steps category. Follow up meetings will begin with reviewing the previous action plan and scaling for progress towards case closure, The most recent addition to our family engagement meeting program includes: Permanency Round Table Meetings (PRT's) will be utilized for children and youth placed in out of home care. The criteria for PRT's include: o Youth over the age of 16 with a permanency goal of OPPLA (other planned permanent living arrangement) o Youth will a permanency goal of OPPLA who have been in care for twelve months or longer, regardless of age o Children and youth in care for over twelve months, regardless of permanency goal The Casey Family Services model will be used for PRTs. There are two different types of PRT meetings: initial and youth voice. Meetings will occur every 90 days for PRT eligible children and youth. During our engagement with families if a family engagement meeting is required and a PRT is also required, Eagle County will complete one family meeting that will capture permanency planning (PRTs) as well as family engagement by including both requirements. This will increase efficiency and ensure all participants feel like their time is valued. Family Engagement Referral Process: Planning for family engagement meetings will be managed by the caseworker, manager and family engagement worker. If the caseworker and manager decide a meeting is needed, they will work with family engagement worker to schedule a meeting time, prepare the family for the meeting, decide which type of meeting will be appropriate, discuss safety concerns and goals for the meeting. 1. Caseworker shall talk with family using the framework to create familiarity with the process and the language used during the meeting; discuss risk and goal statements with the family, advise family that FE Coordinator will be following up with all invitees about the meeting 2. Select two to three times with the family that will work for their schedules 3. Confirm meeting times and availability with FE Coordinator and your manager 4. Fill out referral form and send to FE Coordinator no later than 4 days before the scheduled meeting, unless it is an Draft 3.7.14 4 1 P a g e emergency meeting 5. Book time and room on Google calendar, schedule for two hours to allow enough time, include all invitees. (please book room for an extra 15 minutes before meeting starts to allow for set-up) 6. FE Coordinator will follow up with the family 3 days prior to the meeting 7. FE Coordinator will conduct survey's with families for feedback and suggestions Tips for caseworkers: o Encourage parents/family to bring their support system to the meetings o Explain the purpose of the meeting in advance o Invite the right people. Give as much notice as possible o Be on time. Talk to family about being on time or meeting may be rescheduled if necessary o Be open and honest. Discussions should be strength based and straight forward o Be clear about agency position o Come prepared. Be prepared to discuss the risk statement with the family Role of facilitator at meeting: o Provide a structured, facilitated, safe environment o Assures use of family friendly language (no acronyms) o Defines issues, goals and options to address concerns o Leads a strength -based, solution focused process o Remains impartial throughout the meeting o Assures everyone has a voice, all voices are heard and everyone is engaged o Supports participants in problem solving o Moves the group towards consensus, assisting participants through the process o Provides summary report Role of Caseworker at meetinq: o Provides facilitator with specific concerns to include: circumstances, safety, cultural, and/or adaptive (no -contact orders, large group attendance, interpreter, child care needs) o Actively participates o Provides honest and open dialogue o Articulates safety, risk, needs for all concerned, shares the risk and goal statements o Articulates a clear understanding of the Department involvement o Shares strengths of the family o Remains open-minded to the family's input o Prepared to assist in plan development with knowledge of community resources o Moves the group towards consensus, assisting participants through the process Role of Supervisor: o Supervisor present to authorize services within the same day of the meeting o Available for support and consultation o Voice and representative of the Department's perspective o Supervisor presence at the meeting is not required for status updates or closures If you have, prior to your involvement to the IV -E Waiver, practiced Family Engagement with fidelity to the model as defined by volume 7, you are ineligible for title IV -E funding due to supplanting rules, unless you are demonstrating an enhancement or modification (or maintaining enhanced performance from prior waiver applications of the IV -E Waiver) of practice. How will you ensure you are enhancing or modifying current practice to eliminate the concern of supplanting? At the onset of the IV -E Waiver, Eagle County significantly changed the family engagement work. The family engagement position is primarily funded by CORE services. Eagle County will not be using IV -E Waiver funds to support the family engagement program and this will negate the concern of supplanting. Are you prepared for intervention service delivery by 7/1/15? If not, what is your intervention start date? Yes, Eagle County has a family engagement specialist and a contract with a community member to facilitate family engagement meetings. They are both ready to begin service delivery by 7/1/15. We continue to explore additional contractual relationships to support our facilitation needs. Draft 3.7.14 5 1 P a g e Is your staff currently trained in a model, consisting of the core components? If not, what are your plans to train staff in preparation for implementation by 7/1/15? Yes, Eagle County has a lead family engagement specialist and a contract with a community member to facilitate family engagement meetings. They are both trained in the model and are ready for service delivery by 7/1/15. Based on your county/region's Trails data, what is the number of families currently being served through Family Engagement? (Regions — specify data for each county) Eagle County served 40 families with the family engagement program through the 2014-2015 year of the waiver. There was a total of 60 family engagement meetings that took place (44 in Eagle and 16 in Western Eagle). Currently, 19 families continue to receive family engagement services (14 in Eagle and 5 in Western Eagle). This number is inclusive of all of the families in Eagle County, including the Western Eagle areas of EI Jebel & Basalt. Based on our MOU, the number of families served in Western Eagle will be included in Pitkin County's IV -E Waiver application as well. Based on your county/region's Trails data, what is the anticipated number of families to be served through Family Engagement with the additional IV -E Waiver funds? (Regions - specify data for each county) Based on the Trails data for Eagle County, it is anticipated that we will provide family engagement services to 45 families in the third year of the waiver. This anticipated number also includes families in Western Eagle and Pitkin County will implement these services. If you implemented the Family Engagement intervention as part of Title IV -E Waiver Demonstration Project Year 2, what was your progress towards meeting your goals? (such as: did you meet your desired outcomes? What challenges did you experience? How will you practice change and/or improve in Year 3?) In the last year, one of the main goals of our family engagement program was to expand our family meetings to include more than Team Decision Making meetings (TDMs) and this was successfully accomplished. Our family engagement specialist travelled to different counties to observe the family engagement programming. As a result, Eagle County implemented the Eagle Connections Meetings (ECM). ECMs utilize the consultation and information sharing framework, risk and goal statements and scaling for safety with the family. These meetings are an especially good fit for the families we serve through FAR. We will continue to expand the family engagement program through the Permanency Roundtables (PRTs) in the coming year. The challenges experienced by Eagle County are similar in nature to other small and medium sized counties. Our team members have numerous responsibilities and are often pulled in different directions in order to resolve crises. An area for improvement will be to continue to track the timeliness of family engagement meetings in order to ensure meetings take place as best practice recommends. We continuously recruit contractors to fulfill this need for Eagle County. What are your specific goals and desired outcomes for this upcoming year in implementing Family Engagement in your county/region? Family Engagement encourages "no decision about us without us." Eagle County has strived to engage families to come to the table and make decisions as to what is best for their families along with child welfare staff to ensure safety for children. Additional goals included maintaining children safely in their homes, supporting least restrictive placements, closing cases earlier, and decreasing the reoccurrence of abuse and neglect. Through our family engagement meetings we have been able to create plans with families that allow their children to remain in the homes and utilize the family's natural supports to ensure safety in the home, thus preventing out of home placement. Engaging families in this process has also created fewer placements in congregate care and assisted in more kinship support and placements. In the third year of the waiver, we plan to continue this important work with similar outcomes and to increase our community capacity and participation in order to better support families. We will expand our family engagement services to include PRTs as this seems the logical place to provide PRT services since our family engagement facilitators are also master practitioners for PRTs. Furthermore, Eagle County is actively working on a LEAN project that will reduce turnover and burnout within child welfare team members thus resulting in more positive outcomes for our clients. We hope to maintain full staff in order to allow our family engagement specialist to dedicate all of her time to family engagement facilitation, tracking and planning. Draft 3.7.14 6 1 P a g e FAMILY ENGAGEMENT BUDGET Complete the table below to justify FTE funding: (Cost of FTE to include salary, benefits, mileage, and cellphone.) (Examples are FLe en in ra and italicized Positionvel Function Workload Status Cost n1a 0.00 E" TOTAL $0.00 the table below to justify OTHER fundis : (E.g., hard goods, services, travel for families) Goods/Service Families Served Cost/Unit Cost n/a 0. "OTHER" TOTAL $0.00 Do you have specific infrastructure and/or start up needs that would be a one-time request? $0.00 (Reflected on page 1) "FTE/OTHER/INFRASTRUCTURE" TOTAL $0.00 If you are a regional model describe how staff/goods/services will be shared: N/A Additional Comments, Concerns, Justifications: None Draft 3.7.14 7 1 P a g e If you are part of a region, which counties will participate in this intervention? Eagle County Are you building on existing ®Yes ❑No practice? If yes, describe current model, including target population, and efforts to ensure fidelity. Is there anything unique to your efforts to implement Permanency Roundtables? Eagle County was previously the fiscal agent representing a seven county partnership for the PRT intervention. In the third year, this partnership will not continue as each county has decided to pursue individual implementation plans. In the coming year, the Eagle County PRT intervention will be implemented through our family engagement continuum. Eagle County currently uses the Casey Family Services model for PRT. There are two types of PRT meetings. The first meeting is labeled the initial PRT which is facilitated by the master practitioner and is attended by the professional team working with the youth as well as an external consultant. The external consultant provides an objective presence and is meant to increase "out of the box" thinking within the team. There can be follow up meetings as needed. The second type of meeting is labeled the Youth Voice. This meeting is facilitated by the master practitioner and attended by the professional team from the initial meeting as well as the youth and youth chosen support person. Once the professionals on a youth's PRT team are established it is a goal for them to consistently attend each meeting pertaining to that youth. Eagle County will implement the PRT intervention for the following youth: • Youth who have been in care for longer than one year and have aermanenc Lp y goal of Other Planned Permanent Living Arrangement (OPPLA) • Youth over the age of 16 with a permanency goal of OPPLA • Children/youth in care over 12 months, no matter what the permanency goal (dependent on PRT resources) Meetings will occur at least every 90 days for PRT eligible youth. If you have, prior to your involvement to the IV -E Waiver, practiced Permanency Roundtables with fidelity to the model, you are ineligible for title IV -E funding due to supplanting rules, unless you are demonstrating an enhancement or modification (or maintaining enhanced performance from prior waiver applications of the IV -E Waiver) of practice. How will you ensure you are enhancing or modifying current practice to eliminate the concern of supplanting? Eagle County did not provide PRTs prior to involvement with the IV -E Waiver. Are you prepared for intervention service delivery by 7/1/15? If not, what is your intervention start date? Yes, we are prepared for service delivery to begin by 7/1/15. We continue to explore additional contractual relationships to support our facilitation needs. As a part of the implementation of the Permanency Roundtable practice, the following training schedule is required: Achieving Permanency through Roundtables, Permanency Roundtables Skills and Youth Centered Permanency Roundtables. IV -E waiver funding cannot be utilized for training expenses (though the state offers alternative provisions for PRT trainings). is your staff currently trained in the PRT model? If not, what are your plans to train staff in preparation for implementation by 7/1/15? Between July and October 2013, Melinda Dow successfully completed the training to become a Master Practitioner to facilitate PRTs. Our current and future contractor(s) will need to complete the Master Practitioner training and our current contractor will attend at the next available offering. Based on your county/region's Trails data, what is the number of youth currently being served through Permanency Roundtables? (Regions - specify data for each county) Based on Eagle County's Trails data, we currently serve two youth through PRTs. One youth who receives PRT services is from Western Eagle and therefore Pitkin County oversees this case. Based on your county/region's Trails data, what is the anticipated number of youth to be served through Permanency Roundtables with the additional IV -E Waiver funds? (Regions - specify data for each county) Based on Eagle County's Trails data, we anticipate serving two to three children/youth through PRTs. Draft 3.7.14 8 1 P a g e If you implemented the Permanency Roundtables intervention as part of Title IV -E Waiver Demonstration Project Year 2, what was your progress towards meeting your goals? (such as: did you meet your desired outcomes? What challenges did you experience? How will you practice change and/or improve in Year V) Outcomes: It is a goal of the Permanency Roundtable intervention to increase placement with kin for children needing placement, decrease the number of children placed in congregate care, decrease length of stay and increase exit to permanency. In Eagle County in 2014-2015, seven children/youth were eligible and received PRT services. Of the seven children who received PRT services, five were adopted and legal permanence was established. Two youth continue to receive PRT services. Challenges: In 2014-2015, Eagle County lead the regional implementation of PRTs and the following challenges were identified: • As a rural region the distance between where youth are placed and the location of the county office is often a substantial distance. This distance makes it costly and timely for teams of professionals to travel and take a day out of the office to attend a PRT every 90 days for each youth. • The number of staff required to fill PRT roles often requires most of the staff in a smaller county to be present for the PRT. This can be problematic because it leaves county departments short staffed. • Scheduling has been challenging. It is difficult to find a time when seven professionals and the youth can meet together for two hours. • Finding trained external consultants who are willing and able to travel to participate in the meetings continues to be an area needing improvement. These issues have made it challenging to maintain fidelity and cooperation for the region. Finally, the PRT Coordinator, Annie Larkin, resigned from this role in early January 2015. Due to the nature of the grant funding for this position it has not been refilled. A meeting took place for all of the regional partners to discuss their hopes and plans for this coming year. All of the partners agreed to continue implementing the PRT work on an individual basis. Practice changes and improvements: Eagle County will continue to provide PRT services for our target population. The PRT facilitator will be our family engagement specialist, Melinda Dow and contractors. Achieving greater fidelity to the PRT model will yield more positive outcomes. PRTs are one piece of the family engagement continuum in Eagle County. What are your specific goals and desired outcomes for this upcoming year in implementing Permanency Roundtables in your county/region? Goals for Eagle County: • Decrease the number of youth in care • Decrease the number of days youth spend in care • Find, foster and maintain permanent connections for youth PERMANENCEY ROUNDTABLES BUDGET Complete the table below to justify FTE funding: (cost of FTE to include salary, benefits, mileage, and cellphone.) (Exam les are written in ray and italicized Position L.....l /a FunWorkload Status Cost Complete the table below to justify OTHER Goods/Service i1/a "FTE" TOTAL hard goods, services, travel for families) Youth Served Cost/Unit Draft 3.7.14 9 1 P a g e "OTHER" TOTAL $0.00 $0.00 Do you have specific infrastructure and/or start up needs that would be a one-time request? N/A $0.00 (Reflected on page 1) "FTE/OTHER/INFRASTRUCTURE" TOTAL If you are a regional model describe how staff/goods/services will be shared: N/A Additional Comments, Concerns, Justifications: None Draft 3.7.14 101Pa9e If you are part of a region, which counties will-participate in this intervention? Eagle County Are you a current SOC community of excellence? If no, please identify your collaborating local mental health provider(s) and describe what efforts you are making to ensure ongoing collaboration with them? Is your local mental health provider(s) willing to participate in the evaluation processes of the IV -E Waiver? Yes, Eagle County is currently a SOC Community of Excellence. We have an ongoing collaborative partnership with the local mental health provider, Mind Springs Health. Trauma informed screening, assessment and treatment is an area of focus in the collaborative partnership between Eagle County and Mind Springs Health. Describe the prioritization of your target population with consideration of your local mental health provider's capacity to assess and treat. The target population for trauma informed screening, assessment and treatment will include all open clients listed as PAC (participating as child). This population will first receive a trauma screen completed by a Child Welfare Caseworker, the client (if old enough to participate) and the client's current caregiver. The Caseworker will add the trauma screen to Trails. The trauma screening will be completed within 60 days of case opening. If the screen identifies a need for a trauma assessment then a referral to Mind Springs Health will be completed. Note: We our expanding our population to include all PAC in out of home placements. If the child/youth is currently receiving therapeutic services, an additional assessment will not be completed in order to avoid assessing one child multiple times. The Caseworker will inform the current therapist of the outcome of the trauma screen and engage in discussions about the ways to meet all of the child's mental health needs. Are you building on existing ®Yes ❑No practice? If yes, describe current model, including target population, and efforts to ensure fidelity. Is there anything unique to your efforts to implement Trauma -Informed Screening, Assessment and Treatment? In year two of the IV -E Waiver, Eagle County prioritized the population of children with open, voluntary child welfare cases to receive trauma screening, assessment and treatment. We plan to expand the target population to all PAC in out of home placements. In addition, in year two the following activities took place to enhance our practice of trauma screening, assessment and treatment: • Community outreach: Encourage local clinicians to attend TF -CBT training — June 2014 • Internal training: Trauma 101 for child & adult protection team members — July 2014 • Internal training: Trauma screening for child & adult protection team members — July 2014 • Community training: Parenting children who have experienced trauma — October 2014 • Community outreach: share information about trauma informed practice work with Prevention Action Team — March 2015 • Trauma informed partnerships: meetings with Mind Springs Health - ongoing Furthermore, in year three Eagle County will partner with six other counties, Larimer, Denver, Douglas, Boulder, Arapahoe and Jefferson, to enhance the trauma informed practice. Through this partnership, Eagle County will utilize the TOP assessment tool in addition to the trauma screen by Dr. Henry. The TOP tool provides a more complete view of the child • Gain up to date information about well-being with minimal paperwork and training • Identify concerns in clear behavior categories, with scientific comparisons to average, healthy children • Easily collect the perspectives of multiple adults to build a more complete and accurate understanding of each child's needs and strengths • Provides the team with factual data that informs safety and placement decisions Improve case management • Use TOP results to get children the services they need, when they are needed Draft 3.7.14 11 1 P a 9 e • Use TOP analyses to understand how the child's well-being changes while in care and the effectiveness of the services delivered • Quantify each child's unique strengths and build on them Promote better decision making • Provide an easy and safe forum for stakeholders and children to share their perspectives • Focus brainstorming on the ways to help the child in the areas of greatest need • Enable the team to view the child with fresh eyes, moving beyond original impressions from the past If you have, prior to your involvement to the IV -E Waiver, practiced Trauma -Informed Screening, Assessment, and Treatment, you are ineligible for title IV -E funding due to supplanting rules, unless you are demonstrating an enhancement or modification (or maintaining enhanced performance from prior waiver applications of the IV -E Waiver) of practice. How will you ensure you are enhancing or modifying current practice to eliminate the concern of supplanting? Eagle County has not provided trauma informed screening, assessment and treatment prior to our involvement with the IV -E Waiver. Are you prepared for intervention service delivery by 7/1/15? If not, what is your intervention start date? Yes, our team is trained and prepared for this intervention service delivery by 7/1/15. Is your staff currently trained in using the screening tool? If not, what are your plans to train staff in preparation for implementation by 7/1/15? Yes, the majority of our team is trained in using the screening tool. However, due to staff turnover we will need to train the newest members to our team (two Caseworkers). Kendra Schleff will train these Caseworkers in preparation for implementation. Kendra is a Train the Trainer for the National Child Traumatic Stress Network (NCTSN), specifically for the Child Welfare Trauma Training Toolkit (CWTTT) and Kendra will use this background and knowledge while training the new team members on the principles of trauma informed practice and using the screen. Implementation and evaluation of the IV -E Waiver requires that participating mental health providers include in their client assessment: • The Trauma History section of the Mental Health Referral Tool in the NCTSN/CTISP Child Welfare Trauma Training Toolkit, and • one of the following three (age dependant) tools: o Trauma Symptom Checklist for Young Children, o The Child Post Traumatic Stress Checklist, or o PTSD Checklist. Is your local mental health provider prepared to administer these assessments? What additional assessment tool(s) will be utilized? Yes, Mind Springs Health is prepared to administer these assessments during trauma assessments. In addition, in our supplemental IV -E waiver request with the seven county collaboration we are hoping to utilize Dr. Jim Henry and his team to complete a small number of trauma assessments with the intent to grow our capacity in Eagle County to become a trauma center. Implementation and evaluation of the IV -E Waiver requires that participating mental health providers include at least one of the following treatment modalities: • Child Parent Psychotherapy (0-5) • Trauma Focused Parent Child Interaction Therapy (2-7) • Trauma Focused Cognitive Behavioral Therapy (3-18) • Alternatives for Families Cognitive Behavioral Therapy • Adolescent Dialectical Behavioral Therapy • Skilled therapist trained in sensory integration and the Neurosequential Model of Therapeutics • Complementary supports addressing goals from assessment Is your local mental health provider prepared to utilize at least one of these treatment modalities? What additional treatment modalities may be utilized? Clinicians at Mind Springs Health are prepared to utilize the Trauma Focused Cognitive Behavioral Therapy (TF -CBT). In addition, two clinicians recently completed the training to become certified in Eye Movement Desensitization and Draft 3.7.14 121Page Reprocessing (EMDR). We are always working to expand the number of qualified clinicians to perform this work with fidelity in our area. Based on your county/region's Trails data, what is the anticipated number of families to be served through Trauma -Informed Screening? (Regions - specify data for each county) Based on the Eagle County Trails data, we can anticipate to serve approximately 30 families through the trauma informed screening project. In year two of the IV -E Waiver, we served approximately 20 families and 36 unique clients. Are your local mental health providers prepared to implement Trauma -Informed Assessment and Treatment? What is their capacity to assess and treat? Yes, Mind Springs Health is prepared to continue implementing trauma informed assessment and treatment. Mind Springs has the capacity to complete trauma assessments. One clinician is trained and certified as a TF -CBT provider. This TF - CBT provider is also bilingual in English and Spanish. In addition, two clinicians recently completed the training to become certified in Eye Movement Desensitization and Reprocessing (EMDR). What are your specific goals and desired outcomes in implementing Trauma -Informed Screening, Assessment and Treatment in your county/region? Do you anticipate needing any technical assistance in the implementation of this intervention? Goals: • Support and build resiliency for children, families and staff • Decrease length of stay in out of home placements for children in care • Increase the number of child who remain home • Increase access to timely trauma services and interventions • Increase the availability of trauma -focused interventions within Eagle County TRAUMA -INFORMED SCREENING, ASSESSMENT, TREATMENT BUDGET Complete the table below to justify FTE funding: (Cost of FTE to include salary, benefits, mileage, and cellphone.) Exam les are written in graX and italicized Position Level Function Workload riga Cost 181 TOTAL $0.00 IUUAL Do you have specific infrastructure and/or start up needs that would be a one-time request? $7,500 $7,500 (Reflected on page 1) "FTE/OTHER/INFRASTRUCTURE" TOTAL $7,500 If you are a regional model describe how staff/goods/services will be shared: N/A, this is not a regional model Draft 3.7.14 131Page Additional Comments, Concerns, Justifications: None Rate each of your major community partners and their knowledge and support of the county/region on a scale of 1-5 with 1 being the least knowledgeable, supportive, etc. add other major partners specific to your county/region. unaerstanding of the Title IV -E Waiver Understanding of Family Engagement Understanding of Permanency Roundtables Understanding of Understanding of Trauma -Informed vvnungness to work with county/region re: implementation Commitment of staff to intervention Court Domestic Probation Violence rile iv -r- Waiver in you Use additional columns to Substance Abuse 2 2 2 3 2 2 4 4 3 5 3 4 3 3 2 3 2 3 2 3 2 3 2 3 3 5 3 4 3 5 3 3 3 2 3 d-3 2 3 2 2 2 3 "Please note, due to the small number of children who interface between all of these systems of community partners do not have consistent exposure to the details of our child welfare system. Describe you county/region's effort to increase community understanding and engagement in Waiver interventions. Family Engagement: In Eagle County, the family engagement intervention is thread throughout every aspect of our work with families. Community partners are regularly included in the meetings and informed of their purpose and goal. We also have a goal of increasing community participation in family engagement meetings. Permanency Roundtables: Efforts have been made to train all staff and many community partners on Permanency Roundtable including court best practice groups. Regional gains have been made that allow each county to implement this intervention independently. Trauma Screening, Assessment & Treatment: Trauma Informed Screening, Assessment and Treatment is an area of focus in the collaborative partnership between Eagle County and Mind Springs Health. Mind Springs has participated in both local and State meetings on the trauma informed practices. Describe how your county/region envisions the connections between the Title IV -E Waiver and the following initiatives. Community Prevention Initiatives: • We continue to work diligently to expand the prevention and protection continuum in Eagle County. Wayfinder is a multi -agency county -wide collaborative effort governed by the Interagency Oversight Group (IOG). This county -wide multi -agency collaborative improves access to care and outcomes of treatment in adolescents with multi -systems needs including but not limited to: mental health treatment, substance abuse treatment, juvenile justice, child welfare, and education. The IOG has broad representation by key decision makers from a number of community service providers. IOG members not only assist in setting program direction, but are advocates for community resources as well. • In order to further build out the prevention and protection continuum, Eagle County successfully expanding the population that is now able to qualify for wraparound services. Through Cimplemented Colorado Community Response (CCR) program. CCR serves children 0 to 18 years case manager has been hired to support the community in carrying out Wayfinder's efforts and broadening CR, an additional the community support network in Eagle County. Draft 3.7.14 14IPage Another highlight is the creation of a community coalition to mitigate the effects of poverty on children's health and learning. The newly established community coalition has worked hard to engage a broad base of community members and service providers in sharing their thinking about the future they truly care about creating for children and families in Eagle County. The shared vision the group created is, "We are an inclusive community in which all children are loved. Our kids are safe, engaged, nourished, healthy, valued, hopeful, empowered, learning, and are successful in life." To work toward that vision, InteGreat! is organizing efforts and training opportunities that will increase the wide array of individuals who are able to identify needs and connect families with the appropriate services. Differential Response: Eagle County "went live" as a DR county in November 2014. Family engagement interventions are an essential part of the DR programming. Families on the HRA and FAR tracks will be offered the family engagement services. Permanency by Design: N/A Trauma -Informed Systems of Care: Mind Springs Health, our BHO is actively involved in planning and initiating the trauma informed screening, assessment and intervention, Community clients will benefit from the collaborative partnership with Mind Springs Health. Additional Comments: None Describe your county/region's expertise and capacity for data management. Eagle County currently has an active Quality Practice Team which evaluates areas of improvement, best practices and child welfare data on an ongoing basis. The team meets monthly and interprets new data sources as needed and makes recommendations to inform practice changes. In addition, the management team evaluates data through the scorecard, ROM, and other sources at least quarterly. Furthermore, the child and adult protection team is in the midst of a LEAN project with the goal of enhancing the quality of services for clients through creating our "well organization" and retention improvement work. Will your county/region complete evaluation activities independent of the statewide evaluation of the Title IV -E Waiver and identified interventions? Yes, both the Eagle County Quality Practice Team and the management team will complete evaluation activities related to the IV -E waiver. Currently, intervention leaders our monitoring compliance to fidelity in each area. Additional Comments, Concerns, Justifications: None Do you foresee barriers internally in implementing the Title IV -E Waiver? In engaging community partners? In participating in the statewide evaluation? In collaborating with CDHS to ensure the success of Title IV -E Waiver? Family Engagement: A potential barrier for the oversight of the family engagement program is staff burnout and turnover. As a small/medium sized county, our team members have numerous duties and are pulled in many different directions. This creates a potential barrier for the oversight of the program. We continue to seek contractors who can increase our facilitation capacity. Permanency Roundtables (PRTs): Scheduling and travel has been a barrier to the successful implementation of PRTs. It has been a challenge to build the PRT teams for each youth with fidelity and find locations for meetings that are agreeable for all team members. Eagle . County does not have placements within the county. As a result, youth in care are often placed in more urban areas (i.e. Denver and Grand Junction). This means when the youth voice meeting takes place, the PRT team is required to take an Draft 3.7.14 151Page entire day out of the office for the meeting. For smaller counties having multiple professionals out for a day can make it difficult to maintain other responsibilities. Trauma Informed Screening, Assessment and Treatment: A potential barrier continues to be the lack of availability of evidence -based trauma focused mental health services within Eagle County. There are a small number of mental health clinicians in the community who utilize these specific modalities. How may CDHS assist with addressing any of these barriers? CDHS can support Eagle County by providing training on the family engagement techniques that are effective and maintain fidelity to the IV -E Waiver requirements. In addition, CDHS can support Eagle County by providing some cost for training the local mental health clinicians in trauma focused evidence based practices. We would specifically love to see a training offered for Child Parent Psychotherapy (CPP) or Eye Movement Desensitization and Reprocessing (EMDR). Additional Comments, Concerns, Justifications: None Current Data NUMBER OF OUT OF HOME PLACEMENTS Foster Homes Certified Kinship Care iver Homes Group Homes Residential Care Facilities 1 4 In care 24-29 months 0 0 "1 youth in care for longer than 36 months; 3 youth in care for less than 6 months. AVERAGE LENGTH OF STAY Foster Homes Certified Kinship Caregiver Homes == Group Homes Residential Care Facilities Bd Reduction NUMBER OF OUT OF HOME PLACEMENTS Foster Homes CertifiedKinship Caregiver Homes Group Homes Residential Care Facilities 2 0 0 2 AVERAGE LENGTH OF STAY Foster Homes Certified Kinship Care fiver Homes Group Homes Residential Care Facilities Projected Cost Savings: Foster Homes Amount ($500/mos x12 mos x2 ADP) Certified Kinship Caregiver Homes Group Homes Residential Care Facilities ($5,000/mos x12 mos x2 ADP) TOTAL: $132,000 The IV -E Waiver funding is a time-limited resource. Describe you county/region's plan to reinvest the savings and to sustain the intervention efforts beyond the 1V -E Waiver. Draft 3.7.14 16IPage Eagle County plans to reduce total bed days by 5% and with this goal plans for a 5% decrease in out of home placement expenses. This savings will be reinvested in the family engagement, PRT and trauma informed practice programming. UWAe Please accept this signature as verification of the information in the application as correct and support of my county's participation in the Title IV -E Waiver Demonstration Project, SFY 2014/2015. Regional Models must include each county's Director's signature. Printed Nameignature Da e Draft 3.7.14 171Page * ° I o=utonOfcmmWelfare Ann M. Rosales, MSW, Director Ms. Rita Wocds Eagle County 0HHS PD Box 660, 551 Broadway Eagle, [O81631 May 15, 2015 Dear Director Woods, We are pleased to include Eagle County DHS in the Colorado Department cfHuman Sewices, Office cfChildren, Youth, and Families Title JV -E Waiver Demonstration Project, Each application was reviewed and follow-up contact made with each applicant as needed for clarification. The review process included: ° review by two separate staff toassure county plan was evaluated against criteria established by sta\e/cnunLyworkgvuup, ° removal offederally disallowed expenditures, ° removal ofcosts not directly related toservice, ° removal of optional or other components not defined as core components of the models, ° focus onfidelity, and ° focus on average cost per child. Following thorough review cfyour application, itwas determined your county will not receive Waiver funding as requested in this application. However. Eagle County is accepted to participate in the Project and its related evaluation activities. Your county iseligible 10 apply for additional funding or intervention expansion funding based on your agreement to participate without funding in the following interventions: 1575Sherman Street, 2nd Floor, Denver, 0800] p��866-5932 F��66-5563 www,mlorado.gov/cdhs The Memorandum of Understanding YAlt be sent separately for signature. Please direct any questions you have about your participation to Tyler Allen, Title (V -E Waiver Administrator, at tyler.allen@state.co.tis or at {303)-866- 2154. We are appreciative of your ongoing participation in the Project and took forward to continued collaboration. Please contact us with any questions, Sincerely, Ann Rosales Director, Division of Child Welfare 1575 Sherman Street, 2nd Floor, Denver, CO 80203 P 303-866-5932 F 303-866-5563 www.catorado.gov/cdhs John W. Hickenlooper, Governor I Reggie Bicha, Executive Director