A.     Service:

Intensive Home-based Services

B.   Organization Providing Service(s): 

Midland/Gladwin Community Mental Health

C.   CP/CP Funds Allocated   $  44,781.00

Home-based services provided by a local contractor utilizing a strength-based approach to

target services specifically to the needs of the family.  These services are typically provided in

the home but are too flexible to respond to individual needs.  The services are intended to

impact the chronic neglect families, families with unique circumstances, school issues and

improve self-image/self-esteem.

A .    Eligibility Requirements  (Other than CP/CP and TANF requirements):

N/A

B.      Target Population (s):

Families with issues surrounding chronic neglect, transportation issues, low

self-esteem, isolated, single parents, parents with special need children.

C.

Service Components & Participants

A. Service Component

B. Participants

Defined As

C. Estimated # 

Participating

D. Actual #

Participating *

1.Home-based service

One family

45

47

2. Provider

3.

4.

5.

6.

* Column “D” for “Actual # Participating” will only be filled out at the end of each fiscal year.

24.

SERVICES CONTRACTOR SHALL DELIVER

Service #

1

of

1

:

Intensive Home Based Services

(Name of Service)

1.

Activities Contractor shall perform:  (Use reverse, if necessary)

The Contractor shall:  (begin each activity with an action word)

a.               Within 5 working days of referral from the Gladwin County Family Court, the Gladwin/Beaverton school district or FIA, excepting vacation and sick leave  of the facilitator, the facilitator will make contact with the youth and family to conduct a child and family strength and needs assessment.  Family members and significant others will be identified or invited to the initial meeting at the request of the family. These individuals are identified by the family as individuals who could make specific contributions.  All relevant life domain areas will be considered. Details of the relevant life domains will be recorded.  The facilitator will assure the family’s strength and natural structures for support will form the cornerstone of the plan wherever possible.

b.               During the strength assessment the facilitator will emphasize family strengths, collect the parent and youth social history, and assess medical needs and other factors relevant to treatment.  As part of intake, the contractor shall provide an orientation to the youth and family to: give specific information regarding the program, provide an opportunity for parents and youth to meet staff, and conduct a tour of the facility.

c.               Initial treatment plans will be developed for each family and will contain at minimum; the specific treatment goals for the youth and family; the activities that shall be performed to meet treatment goals and objectives and the time frames within which the objectives shall be achieved.  Ongoing case notes will be maintained and changes to the plan documented. Facilitator will draft a written case plan and prepare copies and make available to all parties.

d.               Contractor shall provide mentoring for the youth and family 24 hours per day 7 days per week upon availability of staff. A job description for the mentors shall be developed and a copy given to FIA. Mentoring shall include, but not be limited to the following:

1.    To work as part of a team to help a young person make the changes necessary to do well in the community.

2.    To be willing to be part of the plan of service to participate with the youth in school, home, social and recreational experience.

3.    To listen and be willing to share experiences.

4.    To assist in problem solving assertiveness and help with the development of self-confidence and self-esteem.

5.    To encourage the youth to make appropriate decisions and explain possible consequences

6.    To act as a positive role model

7.    Transport youth/family members.

8.    Supervise youth in holdover site.The holdover site is located in the Gladwin County courthouse basement and youth shall be court ordered to the holdover site.

9.    Attend to required paperwork timely.

e.   Assure all mentors receive appropriate training.  Included but not limited to CPR/First aid, safety, Agency orientation, crisis management and other training  as appropriate.

f.   Utilize the flexible funds provided in the budget attached to provide needed items and services to maintain youth’s placement in their home including, but not limited to: transportation, recreation, food, shelter, clothing, parental skill building groups appliances, etc.  Any planned expenditure in excess of $300.00 per client will be pre approved by FIA.

g.              Contractor will assure youth/family have access to individual, peer or group therapies as needed.  Referrals will be made to community providers to address specific therapeutic needs of the family or individual. Cost of community providers will not exceed FIA fair market rate established for the service and will have local FIA office approval for the service.

h.              Assure that a Drop In center availability for youth and families. Center to be located at contractor facility and should have a meeting area, kitchen facility, shower, toilet and washer/dryer. Facility to be handicap accessible.

i.              The current status of a child shall be reviewed and recorded in the case record in conjunction with court reviews/hearing. A summary of the client progress will be provided to the family court and FIA.

j.              Preparation of transition plans and long term follow-up will be the responsibility of the facilitator and become part of treatment planning and ongoing evaluations.  Three months prior to termination from the program, there will be a lessening of services unless a court order states an immediate change in the plan.

k.              In the event of the facilitator’s absence, the Contractor will assure that necessary services will continue to be provided and emergency needs responded to by an appropriate provider.

l.              Contractor agrees not to withhold services from a child or the parents of a child and agrees to change the program as necessary rather than changing placement.  Court orders allow for exceptions.

m.              Contractor will participate in unconditional care, developing and/or accessing services as needed in order to maintain the youth in the community.

n.              Client records: For each youth served under this Agreement the Contractor shall maintain youth and family records, consisting of mentor reports, ongoing progress reports, plans transition plans, departmental forms, date of contacts, significant event notes and methods of service delivery. Releases of information, court orders and school documents shall be part of the client record.

A.  Statement of Outcome – What do you want to happen as a result of the service?

B:  Statement of Objectives – How will you know you have achieved your outcome?

C:  Indicators – What information will you use / and where will you get the information to measure your progress?

 1. Reduce re-referrals to CPS

Over the next 3 years

re-referrals to CPS will be

reduced

MIR

 2. Increase in # of days of school

   attendance

Families assisted by this

program will have increase

in school attendance

School attendance reports to show

improvement

 3. Improve self-esteem

Customers will experience

positive interactions

with agencies/schools

Customer survey

 4. Improve customers’ lives

Customers will experience

better housing, less fre-

quent shut-offs, better

budgeting