The Commonwealth of Massachusetts Executive Of?ce of Health and Human Services Department of Children and Families 600 Washington Street, 6th Floor Boston, MA 021 1 1 DEVAL L. PATRICK I Tel.: 617?748?2000 Governor I Fax: 6112617435 gov JOHN W. POLANOWICZ Secretary ERIN C. DEVENEY Interim Commissioner BY AND FIRST CLASS October 27, 2014 Mr. Pan Cataldo, Executive Director THE: MentoriiNetWO'rk, - 270' Bridge Street, Suite 201 Dedham, MA 02026 Re: Comprehensive Foster Care "Request for Response (RF Dear Mr. Cataldo: The Department of Children and Families recently completed the review of the responses received on or before October 1, 2014 under the above referenced While not all of your Service Model responses were recommended for approval, we are pleased to inform you that the following Service Models were approved: 'Ofnei Piease note that in reviewing the Model Response Packages, we identified the need for certain clarification of the approved response(s). The clarifications will be incorporated into your agency?s Master Agreement contract with DCF. Within the'next few weeks, you~ should receive an email from DCF identifying the needed clarifications. The email will also contain contact information for the purpose of arranging a meeting to discuss the clarifications. a . it is anticipated that services under the CFC RFR will The following Service not recommended for approval: . 0 Emergency Shelter 0 Transition to Adulthood As a bidder not selected for one or more Service Models, you may request a debrie?ng for any Service Model for which your agency was not recommended to discuss the basis for the decision. The debriefing process is outlined in Section 6.1 of the RFR. A request for a debriefing must be made in writing within 14 calendar days of the date of this letter. A request for a debriefing must clearly state the Service Model(s) for which the debriefing is being requested and be sent by certified mail and addressed to: Jeanne Campbell Director of Procurement Department of Children and Families 600 Washington Street, st? Floor Boston, MA 02111 A bidder aggrieved by a recommendation decisionmust participate in a debriefing as a prerequisite to a request for an administrative appeal. of such rec0mmendation. The appeal process is set forth in Section 6.2 of the RFR. If a debriefing is properly requested, one will be scheduled within 14 calendar days of thedate the request is received. if necessary, a brief extension shall be allowed by mutual agreement of the Bidder and DCF. As part of the debriefing, you will be allowed to review all documents related to the decision. Please be advised that your agency has been approved only to provide the Service Model(s) identified above for the population set forth in your Response Package(s). Your agency may submit a new Service Modei Response Package for the Service Models it did not qualify for, as well as any other additional Service Model(s) that-your agency may want to pursue. You may submit a new Service Model Response Package at any time after the RFR has been re-opened. New responses will need to be submitted and approved in accordance with Section 5 of the RFR. Check COMMBUYS for the notice of the RFR re?opening. . a . We congratulate you and your agency on the above noted approval(s). We appreciate the time, energy and resources your agency invested in this procurement and appreciate your interest in the Comprehensive Foster Care Services. Sincerely, -, Mary N.Gambon, Assistant Commissioner Foster, Adoption and Adolescent Support Services Department of Children and Families cc: Jeanne Campbeil, Procurement Director 1. if COMMONWEALTH OF MASSACHUSETTS STANDARD CONTRACT FORM This form is jointiy issued and published by the Executive Of?ce for Administration and Finance (ANF), the Office of the Comptroller (CTR) and the erational Services Division OSD as the defauit contract for all Commonwealth Departments when another form is not prescribed by regulation or policy. Any changes to the of?cial printed language of this form shall be void. Additional non-conflicting terms may be added by Attachment. Contractors may not require any additional agreements, engagement letters, contract forms or other additional terms as part of this Contract without prior Department approval, Click on hyperlinks for de?nitions, instructions and legal requirements that are incorporated by reference into this Contract. An electronic copy of this form is available under Guidance For Vendors Forms under OSD Forms. CONTRACTOR LEGAL NAME: The Mentor Network, LLC COMMONWEALTH DEPARTMENT NAME: Department'of Children and Families (and dlbla): MMARS Department Code: 033 Legal Address: (W-Q, 270 Bridge St, Suite 201, Dedham, MA, 02026 Business Mailing Address: 600 Washington St., Boston, MA 02111 Contract Manager: Paul Cataldo Billing Address (ifdifferent): E-Mail: - Contract Manager: Joy Cochran Phone: 781.320.7606 IFax: 781.326.4654 E-Mail: Joy.Cochran@state.ma.us Contractor Vendor Code: VC6000169060 Phone:617.748.2167 I Fax: 617.261.7437 Vendor Code Address ID MMARS Doc IDjs): REF: 09921520626 (Note? The Address Id Must be 591 UP for E3 Paymems-) or Other ID Number: DCF CFC15 - NEW CONTRACT CONTRACT AMENDMENT PROCUREMENT 0R EXCEPTEON TYPE: (Check one option only) Enter Current Contract End Date Amendment: Statewide Contract (OSD or an OSD-designated Department) Etitei AmENdment Amour?: - (or "no Change?) Collective Purchase (Attach OSD approval, scope, budget) I AMENDMENT TYPE: (Check one option only. Attach details of Amendment changes.) De artment Procurement (includes State or Federal grants W) Amendment to Scope or Budget (Attach updated scope and budget) (Attach RFR and Response or. other Plocummem suppomng documentatm) interim Contract (Attach justification for interim Contract and updated scope/budget) Emergency Contract (Attach justi?cation for emergency, scope, budget) Contract Employee (Attach Employment Status Form, scope, budget) Em '0 ee (A?aCh any Updates to scope or budget) Legislative/Legal or Other: (Attach authorizing language/justi?cation, scope and Le isiativeiLe ai or Other: (Attach authorizing language/insti?caiion and updated budget) scope and budget) The following COMMONWEALTH TERMS AND CONDITIONS (T has been executed, filed with CTR and is incorporated by reference into this Contract. Commonwealth Terms and Conditionsz Commonwealth Terms and Conditions For Human and Social Services COMPENSATION: (Check ONE option): The Department certi?es that payments for authorized performance accepted In accordance with the terms of this Contract will be supported in the state accounting system by sufficient appropriations or other non-appropriated funds, subject to intercept for Commonwealth owed debts under 815 CMR 9.00. i Rate Contract (No Maximum Obiigation. Attach details of all rates, units, calculations, conditions or terms and any changes if rates or terms are being amended.) Maximum Obligation Contract Enter Total Maximum Obligation fortotal duration of this Contract (or new Total if Contract is being amended). DISCOUNTS (PPD): Commonwealth payments are issued through 45 days from invoice receipt. Contractors requesting accelerated payments must identify a PPD as follows: Payment issued within 10 days m% Payment issued within 15 days Payment issued within 20 days Payment issued within 30 days PPD. If PPD percentages are left blank, identity reason: _agree to standard 45 day cycle statutory/iegat or Ready Payments (CL C. 29l only initiai payment (subsequent payments scheduled to support standard EFT 45 day payment cycle. See Prompt Pay Discounts Policy.) BRIEF OF CONTRACT PERFORMANCE or REASON FOR AMENDMENT: (Enter the Contract title, purpose, fiscal year(s) and a detailed description of the scope of performance or what is being amended fora ContractlAmendment. Attach ail supporting documentation and justitiCationS.) This contract is to purchase a variety of Comprehensive Foster Care Services as described in detail in the attachments through rates as defined by Regulation 101 CMR 414.00 Family Stabilization Services. START DATE: (Complete ONE option only) The Department and Contractor certify for this Contract, or Contract Amendment, that Contract obligations: 1. may be incurred as of the Effective Date (latest signature date beiow) and obligations have been incurred prior to the Effective Date. 2. may be incurred as of January 1 ,20 15 a date LATER than the Effective Date below and g9 obligations have been incurred prior to the Effective Date. were incurred as of 20_ a date PRIOR to the Effective Date below, and the parties agree that payments for any obligations incurred prior to the Effective Data are authorized to be made either as settlement payments or as authorized reimbursement payments, and thatthe details and circumstances of all obligations under this Contract are attached and incorporated into this Contract. Acceptance of payments forever releases the Commonweatth from further claims related to these obligations; CONTRACT END DATE: Contract performance shall terminate as of June 30 20 20 with no new obligations being incurred after this date unless the Contract is properly amended, provided that the terms of this Contract and performance expectations and obligations shall survive its termination for the purpose of resolving any claim or dispute, for completing any negotiated terms and warranties, to allow any close out or transition performance, reporting, invoicing or final payments, or during any iapse between amendments. Notwithstanding verbal or other representations by the parties, the "Effective Date? of this Contract or Amendment shall be the latest date that this Contract or Amendment has been executed by an authorized signatory of the Contractor, the Department, or a later Contract or Amendment Start Date specified above. subject to any required approvals. The Contractor makes ali certifications required under the attached Contractor Certifications (incorporated by reference if not attached hereto) under the pains and penaities of perjury, agrees to provide any required documentation upon request to support compliance, and agrees that all terms governing performance of this Contract and doing business in Massachusetts are attached or incorporated by reference herein according to the following hierarchy of document precedence, the applicable Commonwealth Terms and Conditions, this Standard Contract Form including the Instructions and Contractor Certifications, the Request for Response (RFR) or other solicitation, the Contractor?s Response, and additional negotiated terms, provided that additional negotiated terms will take precedence over the relevant terms in the RFR and the Contractor?s Response only if made using the process outlined in 80i CMR 21.07, Incorporated herein, provided that any amended RF or Response terms result in best value, lower costs, or a more cost effective Contract. AUTHORIZING SIGNATURE FOR THE CONTRACTOR: AUTHORIZING SIGNATURE FOR THE COMMONWEALTH: X: ?6 7 - . Date: 5.71/5? X: \O?b?cjxm??gw . Date: 1 . (Signature and Date Must Be Handwrittgn At Time of Signature) (Signature and Date MustiBe Handwritten At Time of Signature) r? i r3 1 i Print Name: F??f?i?j 7C ?1 Print Na e: LCiv?meQLb PrintTitIe: r? it? r?r'et Tic/r" Attire/??: Print T\Itl T.) Wetter it? Erumiretinarntr . (Updated 3l21/2014) Page 1 of5 2020 DEPARTMENT OF CHILDREN AND FAMILIES I ATTACHMENT: PROGRAMMODEL SUMMARY 09921520626 DATES FROM: 01/01/2015 T0: 6/30/2020 NAME: Massachusetts Mentor. LLC PROGRAM NAME: One DCF MODEL NAME Comprehensive Foster Care. Intensive Foster Care, IFC One PROGRAM CODE AND NAME: CIFC - Compreh_ea_1sive Intensive Foster Care One - IFC One . intensive Foster Care programs that provide therapeutic services and supports in a family-based placement setting to children and youth for whom a traditional foster care environment will not be sufficiently supportive. One related services include Sibling, Teen-Parent-and Purchase of a Home. FY: 2015-2020 7 Arnendrnent if Applicable: If Federal Funds, CFDA PURCHASE OF SERVICE - ATTACHMENT 1: PROGRAM COVER PAGE PROGRAM INFORMATION - Contractor Name: The Mentor Network, LLC Department Name: Department of Children. and Families Program Type: Comprehensive Foster Care I Document ID Program Name: IFC One a UFR Program Program Address: 270 Bridge St. Suite 201 MMARS Activity Code: CFCO City/State/Zip: Dedham, MA, 02026 - Other Reference Information (Information Purposes Only): See Attached Rate Documentation Chart Contact Person: Paul Cataldo Contact Person: Mischelle Messenger Telephone: 781.320.7606 Teiephone: 617.748.2055 RFR INFORMATION: Attached RFR Reference CFCIS legislative exemption emergency collective purchase interim amendment SCOPE OF SERVICES: Bidder's Response Attached Description of Services Attached TOTAL ANTICIPATED CONTRACT DURATION: _01/01/2015 to __06/3 0/2024 INITIAL DURATION: _01/01/2015 to 06/3 0/2020 OPTIONS TO RENEW: options to renew for _4 years each option A 1? FISCAL TERMS FUNDING SUMMARY Prior Years Current Year Future Years FY Amount FY Arnount FY Amount PRICE IS ESTABLISHED THROUGH: (CHECK I, 2, CR 3) OPTION 1: PRICE AGREEMENT (list price) See Attached Rate Documentation Chart rate regulation (if any)__101 CMR 411.00 El OPTION 2: SUMMARY BUDGET lines only) Dunit rate Dcost reimbursement [:Iother OPTION 3: COMPLETE BUDGET Boost reimbursemenI Dunit rate Total: Total: Total: Bother I Multi?Year Total: CURRENT MAX OBLIGATION: 33' UNIT RATES per: _day BILLABLE UNITS: ADDITIONAL PAYMENT OR PRICE SPECIFICATIONS: Updated [1/1/05 7 Department of Children and Families Certain Placement and Support Services RATE CHART for and Services Effective 1/1/2015 9ch one" Sibling . - 7522-99 . .. $30-44 . . Teenr'Pafrenit . Child Home?Based 77.51 7 68.01 $145.52 Emergency Shelter - $75.42., . 67123;} . Multiple Acute LevelA $104.59 $109.81 $214.40 . Multiple Acute Level $104.59? $189.20 [$293.79 Transitions to 64.96 73.28 $138.24 Adulthood - I Un?bundi'ed Respite 56.59 56.59 . Family/Residential: . . Complex Foster Care . . $284.64 Medical 7 i I - Purchase of Home $4,529.24 Servicequel Source of Rates is 101 CMR 411200 Rates for Certain Placement and Support Services and 101 CMR 414:00 Rates for Family Stabilization Services The Mentor Network, LLC Provider Name One - I November 19, 2014 Program/Service Model Name I Negotiated Adjustments/Modifications Date COMPREHENSIVE FOSTER CARE APPROVED CONTRACTOR DCF NEGOTIATED FORM Ali adjustments, modifications, or clarifications made to the Service Model Response Package as submitted by the Provider cited above in response to the Comprehensive Foster Care RFR are deacribed below and are incorporated by this referenCe into the CFC Contract that the Provider holds with the Department of Children and Families (DCF). To the extent there is any 7 inconsistency or ambiguity between the RFR and this Comprehensive Foster Care Approved Contractor Negotiated Adjustment/Modification Form, it shall be resolved in favor of the RFR terms and provisions. 1. Program Specifications The following is added to the RFR Service Specifications in: Section EMA (3a) identify the location of child workers? documentation that is not entered on child welfare information system but is generaliy recorded on paper notes and make sure the files are in a secure location. Section 8.1.A (Sc) FamilyNet lT Requirements Current active Family Resources assigned to current contract #09921420139 with active service line for Skill Level 1 and Sibling Rate will be updated to include the new CFC services of One and Sibling effective January 1, 2015. ProVider assumes responsibility to review these updated Family Resource records. . All active Family Resources assigned to current contract #09921420139 with active services of Teen Parent or Other (if applicable) must be manually updated with the new CFC services, following the usual i-FamilyNet protocol. The addition of the new service models to each specific Family Resource must reflect the appropriate skills and expertise required by that model. These activities must be completed no later than January 26, 2.015. A - The contractor shall provide to all staff working under the CFC contract, copies of the RFR, Agency response, and corresponding DCF Policies within one week of the staff person?s assignment to the contract. Primary responsibility for transportation of a child placed in Foster Home resides with the CFC Foster Parent. Back up responsibility to be provided by the provider agency staff. - 7 CFC Foster Homes must be identified specifically and approved for provision of only one service type (eg. CFC One services or CFC Other services) and for only one agency. (NOTE: Add ?No Change? if there are no changes) 2. Response Package The following adjustments, modifications and clarifications are made to the Provider?s Service Model Response Package for the above referenced Program/Service Model: One (NOTE: Add ?No Change? if there are no changes) 1. Massachusetts RFR Clari?cations OIG Screening. The Of?ce of The Inspector General informs us of any Medicaid fraud occurrences with our staff or foster parents. This is an annual check. Our Program Service Coordinators carry a caseload of 8 children, visit them weekly and are responsible for the coordination of all case management and treatment services for the 7 children. Our Family Resource Workers carry a?case load of 25 foster parents, they visit them provide support and training and are responsible for maintaining all of the regulatory and quality documentation required to re license the home and meet all of DCF standards. will not be assigned to cover children. I Client transportation. We have a Transportation Availability Statement we complete on all perspective Mentors and re do annually which assess their ability to meet transportation requirements. In ?extreme situations?, our staff will always be responsible. For Mentors without cars, we have only 3 in the Boston area. One has access to a car and the other 2 take publiciransportation and we cover if needed. Regarding placements out of area or region. At the time of the match, we discuss and come to agreement with the DCF staff regarding the client transportation needs. We have always been able to work it out to ensure the children do not miss any appointments or visits. Work Approval sign offs. All prospective Mentors work situation is screened and approved by the MA State Leadership staff at time of initial approval and then annually or whenever changes occur. New Mentor Approval is only completed once the entire prospective Mentor?s completed ?le is reviewed for 100% compliance of all quality and regulatory requirements by the 7 State Leadership Team." 4 MENTOR has a Virtual Gateway Administrator on staff who works closely with the Family Resource staff to ensure compliance. The VG Administrator meets bi?weekly with the FRW and PD to review the status of each home and any pending or upcoming events. The VG Administrator hosts a quarterly meeting with all FRW staff to update any policies and procedures, review any changes to policy from DCF IFC unit and share best practices. The VG Administrator provides ongoing training to staff on all aspects of the approval 1 process and relicensing of foster homes. Cultural Diversity. This year we are adding 2 new additional trainings. A Self Study ?Diversity Awareness Training? will be given to all staff to help them examine cultural assumptions, values and behaviors, through readings, activities and a knowledge check. At the time of the training, staff will have additional diversity resources based upon the training needs of the staff, Also, the Human Resources and Training Department will provide ?Cultural Diversity? training to all management staff in order to support and guide I them in their work with culturally diverse staff, Mentor and consumers. Page 2 of 4 9. FIG. 11. Training. Training will be conducted training to all staff on the RFR by 3/31/15. We" are in the process of creating a hand out document that has all the highlights and changes. Our RELATE training will be complete for all staff and Mentors by 2/2 8/ 5. Shared Parenting training will be complete for all staff and Mentors by 3/31/15. Family VISTAS, a treatment foster care" clinical model, will be rolled out over a 2 year process. RELATE, CANS and Shared Parenting are components of the Family Vistas model. We will pilot Family VISTAS in our Hyannis program in 2015. Staff will be required to obtain the following: a. All clinical staff (FRW, PSC, Intake worker, Recruiter, Supervisor, Program Director) are required to have a Bachelor?s degree ?(preferred in a Human services ?eld) Any current staff who does not meet this requirement will be required to obtain a BA within 4 years .of the start of this contract (by December 31, 2018) All Clinical staff (FRW, PSC, Intake worker, Recruiter, Supervisor, Program Director) must have a required license within one of the below: i. Licensed Social Work Associate Licensed Social Worker Licensed Certi?ed Social Worker Licensed Independent Clinical Social Worker Licensed Mental Health Counselor Licensed Marriage and Family Therapist ii. iv. v. vi. As of Janiiary 1, 2015 ALL Clinical Staff are required to obtain licensure by December 31?2015. MENTOR will assist and guide staff in the licensing process over the course of 2015. MENTOR will work with each staff member in obtaining their license inclusive of ?nancial assistance. . Massachusetts MENTOR is committed to providing Unbundled Services as outlined. This includes ongoing support and stabilization for placements who have moved on to a new placement setting, clients who are transitioning into a MENTOR placement to ensure a positive and smooth transition and support services to a client in a DCF home in order to prevent disruption. MENTOR will ensure that treatment plans and progress reviews are completed for all unbundled cases. MENTOR will be available for consultation and on call support and will provide weekly visits to the placement setting of unbundled cases. All unbundled cases will be assigned to a child worker who will provide a weekly visit and ongoing support and case management. MENTOR will remain ?exible in its service I delivery for this model in order to address the varied needs of the children and families. served. . - Massachusetts MENTOR provides and average of ten hours of support per home per week. These ten hours can include the following: a. Weekly or support groups are provided in each of?ce with child care available. b. Ongoing skill deVelopment opportunities are available in of?ce as well as during support groups and during weekly home visits with child worker. 0. Weekly phone support by child worker in addition to required weekly home visit. .i Phone contact or home visit by supervisor or Program Director as needed as well as required by Supervisor Checklist. home visits and weekly phone contact by the assigned FRW. Preventive disruption meetings with the treatment team as needed to support placement. . 24/7 on?call availability as needed as well as proactive support and calls from on call. staff to check in. . Referrals to MENTOR Behavioral Health programs including In?Home Therapy and Therapeutic Mentoring. I Referrals made on behalf of the child by the child worker to address any therapeutic, medical and recreational needs. A FOR THE PROVIDER: Authorized Signature . m/ an Crag/A4 Print Name - Ef??f?k Av? ?r Vic/r? Title Date FOR THE DEPARTMENT: DCF Negotiator Signature 3 Q4 (5w? (?fw?aeva Print Name 7 . Peers/am 12? Title ?25? 2.0 ,4 Date I Page 4' of 4i- - 2020 DEPARTMENT OF CHILDREN AND FAMILIES ATTACHMENT: PROGRAMMODEL SUMMARY 09921320526 . DATES FROM: 01/01/2015 TO: 6/30/2020 NAME: Massachusetts Mentor, LLC PROGRAM NAME: DCF MODEL NAME Comprehensive Foster Care, Intensive Foster Care, Sibling PROGRAM CODE AND NAME: CIFC Comprehensive Intensive Foster Care IFC One Sibling . An Intensive Foster Care program for any sibling who does not need the IFC One service but is placed in an IFC One home specifically to stay with'a brother/sister who does require that level of service. The rate associated with the IFC One Sibling includes both a payment of a regular Departmental rate to the foster home and a payment to the contractor in recognition that these placements do require a level of support consistent with aNDe?partmental Foster Care home. FY: 2015-2020 Amendment if Applicable: If Federal Funds, CFDA PURCHASE OF SERVICE - ATTACHMENT 1: PROGRAM COVER PAGE PROGRAM INFORMATION Contractor Name: The Mentor-Network, LLC Department Name: Department of Childrenand Families Program Type: Comprehensive Foster Care Document ID Program Name: Sibling UF Program Program Address: 270 Bridge St. Suite 201 MMARS Activity Code: CFCO City/State/Zip: Dedham, MA, 02026 Other Reference Information (Information Purposes Only): See Attached Rate Documentation Chart Contact Person: Paul Cataido Contact Person: Mischelle Messenger Telephone: 781.320.7606 Telephone: 617.748.2055 RFR NFORMATION: Attached RFR Reference CFCIS collective purchase El interim legislative exemption emergency amendment Bidder's Response Attached SCOPE OF SERVICES: Description of Services Attached TOTAL ANTICIPATED CONTRACT DURATION: _01/01/2015 to 0/2024 INITIAL DURATION: _01/01/201 5 to 06/30/2020 OPTIONS TO RENEW: _1 options to renew for 4 years each option a FISCAL TERMS . FUNDING SUMMARY Prior Years Current Year A Future Years FY Amount FY Amount FY Amount PRICE IS ESTABLISHED THROUGH: (CHECK 1, 2, OR 3) OPTION 1: PRICE AGREEMENT (list price) See Attached Rate Documentation Chart rate regulation (if any)__101 CMR 411.00 OPTION 2: SUMMARY BUDGET lines only) Dunit rate a Boost reimbursement Bother [j OPTION 3: COMPLETE BUDGET Dcost reimbursement [Innit rate Total: Total: Total: Multi-Year Total: A Bother CURRENT MAX OBLIGATION: UNIT RATE: :3 per: _day BILLABLE UNITS: ADDITIONAL PAYMENT OR PRICE SPECIFICATIONS: Updated 11/1/05 Department of Children and Families Certain Piacement and Support Services RATE CHART for and Services Effective 1/1/2015 - ,1 . 7. . ., .,:Costigg leC One "3856.59 ~I'fjj$ 57.7013321? Sibling I. 3 22.99 $57.45 7$ 37077.44 '7 lif$ . Child Home-Based 77.51 6801 $145.52 Emergency Shelter - 75.42, 67.23 'ii't.l Multiple Acute Level A $104.59 $109.81 $214.40 Multiple Acute Level. $104.59 $189.20 - "$293.79 Transitions to 64.96 I 73.28 $138.24 Adulthood 7 Unb?undled' -. .. . ?j 42.82 Respite 56.59 56.59 Fjamiltl'Residential I . Complex Foster Care $284.64 MediCal Purchase of Home $4,529.24 sem?ee Model - Source of Rates is 101 CMR 411:00 Rates for Certain Placement and Support Services and 101 CMR 414:00 Rates for Family Stabilization Services .- 2020 DEPARTMENT OF CHILDREN AND FAMILIES ATTACHMENT: SUMNIARY 09921520626 DATES FROM: 01/01/2015 TO: 6/30/2020 NAME: Massachusetts Mentor. LLC PROGRAM NAME: DCF MODEL NAME Comprehensive Foster Care, Intensive Foster Care, Teen Parent PROGRAM CODE AND NAME: CIFC Comprehensive Intensive Foster Care IFC One Teen Parent An Intensive Foster Care program for a teen parent when only the teen parent and not the baby is in the custody of DCF and the teen parent requires the IFC One level of care and does no have any other source of income. . I FY: 2015m2020 Amendment if Applicable: If Federal Funds, CFDA OF SERVICE - ATTACHMENT 1: PROGRAM COVER PAGE PROGRAM INFORMATION Contractor Name: The Mentor Network, LLC Department Name: Department of Children. and Families Program Typei Comprehensive Foster Care Document ID Program Name: Teen Parent UFR Program Program Address: 270 Bridge St. Suite 201 MMARS Activity Code: CFCO Other Reference Information (Information Purposes Only): See Attached Rate Documentation Chart City/State/Zip: Dedham, MA, 02026 Contact Person: Paui Cataldo Contact Person: Mischelle Messenger Telephone: 781.320.7606 Telephone: 617.748.2055 RFR INFORMATION: [1 Attached RFR Reference legislative exemption emergency collective purchase interim amendment SCOPE OF SERVICES: Bidder's Response Attached Description of Services Attached TOTAL ANTICIPATED CONTRACT DURATION: _01/01/2015 to m06/3 0/2024 INITIAL DURATION: _01/01/2015 to 06/3 0/2020 OPTIONS TO RENEW: options to renew for years each option -1 a? FISCAL TERMS FUNDING SUMMARY .r Prior Years Current Year Future Years FY Amount FY Amount FY Amount PRICE IS ESTABLISHED THROUGH: (CHECK I, 2, OR 3) OPTION 1: PRICE AGREEMENT (list price) See Attached Rate Documentation Chart rate regulation (if any)_101 CMR 411.00 OPTION 2: SUMMARY BUDGET lines only) Dunit rate [Icost reimbursement Bother El OPTION 3: COMPLETE BUDGET Dcost reimbursement Dunit rate Total: Total: Total: Dother Multi-Year Total: CURRENT MAX OBLIGATION: UNIT RATE: 7 BILLABLE UNITS: per: _day ADDITIONAL PAYMENT OR PRICE SPECIFICATIONS: Updated 11/1/05 Department of Children and Families Certain Placement and Support Services RATE CHART for and Services 1 Effective 1/1/2015 t. i .- - IFC one 56.59 1' v- Sibling I 7 $22.99 17.45? 30.44 Teen Parent '7 '5 79.58 Child Home-Based 77.51 68.01 $145.52 Rehab .. Emergency Shelter $75.42 67.23 $142.65 .1 Home 5? . Multiple Acute Level A $104.59 $109.81 $214.40 Multiple Acute LevelB $104.59 8189.20 ?8293.79 Transitions to 64.96 73.28 $138.24 Adulthood, Unbundled . . {$42.82 1 Respite . 8 56.59 56.59 Family Residential]: . Complex Foster Care 1 $284.64 Medical Purchase of Home $4,529.24 Servi?e_Mbd?I?_ 7' - $159905? ?dii?r?ftionfs- gTotal Rate it] . Source of Rates is 101 CMR 411:00 Rates for Certain Placement and Support Services and 101 CMR 414:00 Rates for Family Stabilization Services 2020 DEPARTMENT OF CHILDREN AND FAMILIES ATTACHMENT: SUMMARY 09921520626 DATES FROM: 01/01/2015 TO: 6/30/2020 Massachusetts Mentor. LLC PROGRAM NAME: 7" DCF MODEL NAME Comprehensive Foster Care. Intensive Foster Care. Purchase of Home PROGRAM CODE AND NAME: CIFC Comprehensive Intensive Foster Care IFC Purchase ofa Home A one-time product payment to CFC providers when (1) a provider?s One home becomes an approved adoptive home or guardian or (2) when a provider?sreoruitment efforts identify a potential foster home that wilt not or does not want to meet the standards to provide One but would be able to serve as a Departmental home. 7 FY: 2015-2020 1 Amendment if Applicable: If Federal Funds, CFDA .1 PURCHASE OF SERVICE ATTACHMENT 1: PROGRAM COVER PAGE PROGRAM INFORMATION Contractor Name: The Mentor Network, LLC Department Name: Department of Children and Families Program Type: Comprehensive Foster Care Document ID Program Name: Purchase of Home UFR Program #2 Program Address: 270 Bridge St. Suite 201 MMARS Activity Code: CFCO City/State/Zip: Dedham, MA, 02026 Other Reference Information (Information PurpOSes Only): See Attached Rate Documentation Chart Contact Person: Paul Cataldo Contact Person: Mischelle Messenger Telephone: 781.320.7606 Telephone: 617.748.2055 RFR INFORMATION: Attached RF Reference CFC 15_ legislative exemption . emergency collective purchase interim amendment SCOPE OF SERVICES: Eidder's Response Attached Description of Services Attached TOTAL ANTICIPATED CONTRACT DURATION: _01/01/2015 to 0/2024 INITIAL DURATION: __01/01/2015 to 06/3 0/2020 2 OPTIONS TO RENEW: options to renew for _4 years each option -- a FISCAL TERMS FUNDING SUMMARY Prior Years Current Year Future Years FY Amount FY Amount FY Amount PRICE IS ESTABLISHED THROUGH: (CHECK 1, 2, OR 3) OPTION 1: PRICE AGREEMENT (list price) See Attached Rate Documentation Chart rate regulation (if any)_101 OPTION 2: SUMMARY BUDGET lines only) Dunit rate Dcost reimbursement Bother OPTION 3: COMPLETE BUDGET Boost reimbursement Dunit rate Total: Total: Total: Bother Multi?Year Total: CURRENT MAX OBLIGATION: UNIT RATE: per: BILLABLE UNITS: ADDITIONAL PAYMENT OR PRICE SPECIFICATIONS: Updated 11/1/05 Department of Children and Families Certain Placement and Support Services RATE CHART for and SerVices Effective 1/1/2015 IFC One . I s$ 1.429 Sibling . 7 . - $22-99 7-45.. . $30-44? r_ T630 Parent 771? 1791-58 97$, 6591915 7 Child Home-Based 77.51 68.01 $145.52 EmergenCy Shelter 75.42 67.23 $142.65 A Multiple Acute LevelA $104.59 $109.81 5214.510 . Multiple AcutemLeyelB. $104.59 $189.20 5- Transitions to 64.95 73.28 $138.24 Adulthood I UnBundled- . - 7 . Respite 56.59 56.59 FamilyResifdential - 5 i $147.57" Complex Foster Care $284.64 Medical Purchase of Home $4,529.24 3601399. ?We! 5.. 71f" iF'? Stipend O'P'elratiens Source of Rates is 101 CMR 411200 Rates for Certain Placement and Support Services and 101 CMR 414:00 Rates for Family Stabilization Services - 2020 DEPARTMENT OF CHILDREN AND FAMILIES ATTACHMENT: SUMMARY 09921g20626 DATES FROM: 01/01/2015 TO: 6/30/2020 NAME: Massachusetts Mentor. LLC PROGRAM NAME: DCF MODEL NAME Comprehensive Foster Care, Support Services. Unbundled Special Support Services PROGRAM CODE AND NAME: CFSS Comprehensive Family Support Services Unbundled Special Support Services . The/purchase of the IFC One support package separately on behalf of the Department's own foster homes when necessary to reduce disruptions and unnecessary moves. It can also be bundled with?CFC placement services when necessary and recommended by the Family Team to (1) support transitions (2) prevent transitions and support placement stability or (3) maintain placement stability. FY 2015?2020 Amendment if Applicable: If Federal Funds, CFDA PURCHASE OF SERVICE - ATTACHMENT 1: PROGRAM COVER PAGE . PROGRAM INFORMATION Contractor Name: The Mentor Network, LLC Department Name: Department of Children and Families Program Type: Comprehensive Foster Care Document ID Program Name: Unbundled IFC Special Support UFR Program Program Address: 270 Bridge St. Suite 1201 MMARS Activity Code: CFCO City/State/Zip: Dedham, MA, 02026 Other Reference Information (Information Purposes Only): See Attached Rate Documentation Chart Contact Person: Paul Cataldo Contact Person: Mischelle Messenger Telephone: 781.320.7606 Telephone: 617.743.2055 RFR INFORMATION: Attached RFR Reference legislative exemption emergency collective purchase interim amendment SCOPE OF SERVICES: Bidder's Response Attached [1 Description of Services Attached ANTICIPATED CONTRACT DURATION: _01/01/2015__ to _06/3 0/2024? INITIAL DURATION: __Ol/01/2015 to _06/30/2020? OPTIONS TO RENEW: to renew for years each option 7' 91-2 FISCAL TERMS FUNDING SUMMARY Prior Years Current Year Future Years FY Amount FY Amount FY Amount PRICE IS ESTABLISHED THROUGH: (CHECK 1, 2, OR 3) OPTION 1: PRICE AGREEMENT (list price) See Attached Rate Doeumentation Chart rate regulation (if any)m101 CMR 414.00 OPTION 2: SUMMARY BUDGET lines only) Dunit rate Dcost reimbursement Bother DAOPTION 3: COMPLETE BUDGET Dcost reimbursement Dunit rate Total: Total: Total: Bother Multi-Year Total: 33 CURRENT MAX OBLIGATION: UNIT RATE: per: Mday BILLABLE UNITS: ADDITIONAL PAYMENT OR PRICE SPECIFICATIONS: Updated 11/1/05 Department of Children and Families Certain Placement and Support Services 0 RATE CHART for and RFC Services Effective 1/1/2015 Service Model. Stipend Operations".TotalRate' . IFC One i 58.59 $577.70 Sibling . . $22-99. . 7.45 .. $30-44 Teen Parent Child HemeeBased 77.51 68.01 $145.52 Rahal? .. 1. Emergency Shelter $775.42. a - 6723 ?$142.65 - Home I MuitipleAcute LevelA $104.59 $109.81 Multi?le Acute Level $104.59 Transitions to 64.96 73.28 $138.24 Aduithood . . - Unliu?ndled Respite I I - I 56.58 7 . a 5659' Family Residential) Complex Foster Care $284.64, Medical 7 Purchase of 'Home $4,529.24 0 Source of Rates is 101 CMR 41 1 :00 Rates for Certain Placement and Support Services and 101 CMR 414:00 Rates for Family Stabilization Services - 2020 DEPARTMENT OF CHILDREN AND FAMILIES ATTACHMENT: PROGRAMMODEL SUMMARY 09921520626 DATES FROM: 01/01/2015 TO: 6/30/2020 4? NAME: Massachusetts Mentor, LLC PROGRAM NAME: DCF MODEL NAME Comprehensive Foster Care, Support Services. Respite PROGRAM CODE AND NAME: Comprehensive Familv Support Services Respite A short?term, temporary placement of a child/youth in order to provide a break to the CFC foster family with whom the child normally resides. FY: 2015-2020 Amendment if Applicable: If Federal Funds, CFDA OF SERVICE - ATTACHMENT 1: PROGRAM COVER PAGE PROGRAM INFORMATION Contractor Name: The Mentor Network, LLC Department Name: Department of Children and Families Program Type: Comprehensive Foster Care Document ID Program Name: Respite UFR Program Program Address: 270 Bridge St. Suite 201 MMARS Activity Code: CFCO City/State/Zip: Dedham, MA, 02026 Other Reference Information (Information Purposes Only): See Attached Rate Documentation Chart Contact Person: Paul Cataldo Contact Person: Mischelle Messenger Telephone: 781.320.7606 Telephone: 617.748.2055 RFR INFORMATION: Attached RFR Reference MDCF CFCIS collective purchase El interim legislative exemption emergency amendment SCOPE OF SERVICES: Bidder's Response Attached [1 Description of Services Attached TOTAL ANTICIPATED CONTRACT DURATION: _01/01/2015 to _06/30/2024 INITIAL DURATION: ?__01/01/2015. to 06/3 0/2020 OPTIONS TO RENEW: options to renew for _4 years each option 9' FISCAL TERMS FUNDING SUMMARY Prior Years Current Year Future Years FY Amount FY Amount FY Amount PRICE IS ESTABLISHED THROUGH: (CHECK I, 2,011 3) OPTION 1: PRICE AGREEMENT (list price) See Attached Rate Documentation Chart rate regulation (if any):101 CMR 411.00 OPTION 2: SUMMARY BUDGET Dunit rate [:lcost reimbursement Bother lines only) I OPTION 3: COMPLETE BUDGET Ecost reimbursement [:lunit rate ., Total: Total: Total: Bother Multi-Year Total: CURRENT MAX OBLIGATION: UNIT RATE: per: _day BILLABLE UNITS: ADDITIONAL PAYMENT OR PRICE SPECIFICATIONS: Updated 11/1/05 Department of Children and Families Certain Placement and Support Services RATE CHART for and Services Effective 1/1/2015 1 A Service Model . Rate 1.42329 II I $22.99 30.44 If 1 Teen Parent; 33 7945.3$775311 11335515: '1Cf}13144173 Child Home?Based $377.51 68.01 - $145.52 Rehab Em?er?g'e'ncy?Sh?elter 1.671123 Multiple Acute LevelA $104.59 I 6109.81 I $214.40 I Multiple Acute Level $104.59 1 $189.20 5 182533.793 I .x Transitions to $64.96 - 7328 $138.24 Aduithood I I I IUn?bundIled I - .1 I .1 I 42.82 Respite 56.59 56.59 Family?Resi?esntial . Complex Foster Care $284.64 Medica! Purchase of Home I $4,529.24 Source of Rates is 101 CMR 41 1 :00 Rates for Certain Placement and Support Services and 101 CMR 414:00 Rates for Family Stabilization Services settlement agreement or judgment. The State shall not be liable for any costs incurred by the Contractor arising under this paragraph. Any indemni?cation of the Contractor shall be subject to appropriation and applicable law. 12, Waivers. Forbearance or indulgence'in any form or manner by a party shall not be construed as a waiver, nor in any way limit the legal or equitable remedies available to that party. No waiver by either party of any default or breach shail constitute a waiver of any subsequent default or breach. 13. Risk 0: Loss. The Contractor shall bear the risk of loss for any Contractor materials used for a Contract and for all deliverables, Department personal or other data which is in the possession of the Contractor or used by the Contractor in the performanceof a Contract until possession, ownership and full legal title to the deliverables are transferred to and accepted by the Department. 14. Forum, Choice of Law And Mediation. Any actions arising out of a Contract shall be governed by the iaws of Massachusetts, and shall be brought and maintained in 'a State or federal court in Massachusetts which shall have exclusive jurisdiction thereof. The Department, with the approval of, the Attorney General?s Of?ce, and the Contractor may agree to voluntary. mediation through the Massachusetts Of?ce of Dispute Resolution (MODR) of any Contract dispute and will share the costs of such mediation. No legal or equitable rights of the parties shall be limited by this Section. 15. Contract Boilerplate Interpretation. Severabilitv, Con?icts With Lawr Integration. Any amendment or attachment to any Contract which contains con?icting language or has the affect of a deleting, repiacing or modifying any printed language of these Commonwealth Terms and Conditions, as 0th? CONTRACTOR AUTHORIZED SIGNATORY: Print Name: ?Crul lk Title: E??Cutg VC Di reem? Data \?3L\Lir\ v+ (CheckiOne): t/Crganization Individual COMMONWEALTH TERMS AND CONDITIONS published by ANF, CTR and OSD, shall be interpreted as superseded'by the of?cial printed language. If any provision of a Contract is found to be superseded by state or federal iaw or regulation, in whole Or in part, then both parties shall be relieved of all obligations under that provision only to the extent necessary to comply with the supersedin'g law, provided however, that the remaining provisions of the Contract, or portions thereof, shall be enforced to the fullest extent permitted by law. All amendments must be executed by the parties in accordance with Section 1. of these Commonwealth Terms and Conditions and ?led with the original record copy of a Contract as prescribed by CTR, The printed language of the Standard Contract Form, as of?cially published by ANF, CTR and 089, which incorporates by reference these Commonwealth Terms and Conditions, shall supersede any con?ictingverbal or written agreements relating to the performance of a Contract, or attached thereto, including contract forms, purchase orders or invoices of the Contractor. The order of priority of documents to interpret a Contract shall be as follows: the printed language of the Commonwealth Terms and Conditions, the Standard Contract Form, the Department?s Request for Response (RFR) solicitation document and the Contractor?s Response to the RFR solicitation, excluding any language stricken by a Department as unacceptable and including any negotiated terms and conditions allowable pursuant to law or regulation. IN WITNESS WHEREOF, The Contractor certify under the pains and penalties of perjury that it shall comply with these Commonwealth Terms and Conditions for any applicable Contract executed with the Commonwealth as certi?ed by their authorized signatory below: (signature) Full Legal Organization or Individual Name: Mmescm?nu?beH ?5 6 i - Doing Business As: Name (If Different): Tax Identification Number: Address: 55055? $43 -9?1jw=? Telephone: BQOIHDOZFAX: INSTRUCTIONS FOR FILING THE COMMONWEALTH TERMS AND CONDITIONS A ?Request for Verification of Taxation Reporting Information? form (Massachusetts Substitute Format), that contains the Contractor's correct TIN, name and legal address information, must be on file with the Of?ce of?the comptroller. If the Contractor has not previousiy ?led this form with the Comptroiler, or if the information contained on a previously ?led form has changed, please fill out a W-9 form and. return it attached to the executed COMMONWEALTH TERMS AND CONDITIONS. If the Contractor is responding to a Request for Response (RFR), the COMMONWEALTH TERMS AND CONDITIONS must be submitted with the Response to RFR or as speci?ed in the RFR. Otherwise, Departments or Contractors must timely submit the completed and properly executed COMMONWEALTH TERMS AND CONDITIONS (and the form if applicable) to the: Payee and Payments Unit, Of?ce of the Comptroller, 9th Floor, One Ashburton Place, Boston, MA 02108 in order to record the ?ling of this form on the MMARS Vendor File. Contractors are required to execute and ?le this form only once. Page 2. of2. Issued May 2004 COMMONWEALTH OF MASSACHUSETTS CONTRACTOR AUTHORIZED SIGNATORY LISTING CONTRACTOR LEGAL NAME CONTRACTOR CODE: INSTRUCTION S: Any Contractor (other than a sole-proprietor or an individual contractor) must provide a listing of individuals who are authorized as legal representatives of the Contractor who can Sign contracts and other legally binding documents related to the contract on the Contractor?s behalf. In addition to this listing, any state department may require additional proof of authority to sign contracts on behalf of the Contractor, or proof of authenticity of signature (a notarized signature that the Department can use to verify that the signature and date that appear on the Contract or other legal document was actually made by the Contractor?s authorized signatory, and not by a representative, designee or other individual.) NOTICE: Acceptance of any payment under a Contract or Grant shall operate as a waiver of any defense'by the Contractor challenging the existence of a valid Contract due to an alleged lack of actual authority to execute the document by the signatory. For privacy purposes DO NOT ATTACH any documentation containing personal information, such as bank account numbers, social security numbers, driver?s licenses, home addresses, social security cards or any other personally identi?able information that you do not want released as part of a public record. The Commonwealth reserves the right to publish the names and titles of authorized signatories of contractors. AUTHORIZED SIGNATORY NAME TITLE c5 I certify that I am the President, Chief Executive Officer, Chief Fiscal Of?cer, Corporate Clerk or Legal Counsel for the Contractor and as an authorized officer of the Contractor I certify that the names of the individuals identi?ed on this listing are current as of the date of execution below and that these individuals are authorized to sign contracts and other legally binding documents related to contracts with the Commonwealth of Massachusetts on behalf of the Contractor. I understand and agree that the Contractor has a duty to ensure that this listing is immediately updated and communicated to any state department with which the Contractor does business whenever the authorized signatories above retire, are otherwise terminated from the Contractor?s employ, have their responsibilities changed resulting in their no longer being authorized to sign contracts with the Commonwealth or whenever new signatories are designated. Date: lQ-ll'l'lil-l- Signature Title: Egecuxw? b1r??*0{ Telephone: WapgiO? 469099 Fax: Email: [Listing can not be accepted without all of this information completed] A copy of this listing must be attached to the ?record copy? of a contract ?led with the department. Issued May - 2004 COMMONWEALTH OF MASSACHUSETTS CONTRACTOR AUTHORIZED SIGNATORY LISTING CONTRACTOR LEGAL NAME CONTRACTOR CODE: PROOF OF AUTHENTICATION OF SIGNATURE This page is optional and is available for a department to authenticate contract signatures. It is recommended that Departments obtain authentication of signature for the signatory Who submits the Contractor Authorized Listing. This Section MUST be completed by the Contractor Authorized Signatory in presence of notary. Signatory's full legal name (print or type): Title: Signature as it will appear on contract or other document (Complete only in presence of notary): AUTHENTICATED BY NOTARY OR CORPORATE CLERK (PICK ONLY ONE) AS FOLLOWS: I, 9% (NOTARY) as a notary public certify that I witnessed the signaTure of the af?omn?ntioned signatory aboxfe and I veri?ed the individual's identity on this date: see. A ,20 . My commission expires onAFFIXNOTARY 1, (CORPORATE CLERK) misty tie signature of the aforementioned signatory above, that I veri?ed the individual?s identity and con?rm the inditiiduai?s authority as an authorized Signatory for the Contractor on this date: ,20 AFFIX CORPORATE SEAL (Rev. August 2013) Department of the Treasury Internal Revenue Service Name (as shown on your Income tax return) Massachusetts MENTOR, LLC Business name/disregarded entity name, if different from above Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Check appropriate box for federal tax classification: individual/sole proprietor Corporation Print or type Other (see instructions) Corporation Limited company, Enter the tax classification (02C corporation, corporation, Papartnership) Exemptions (see instructions): Partnership Trust/estate Exempt payee code (if any) Exemption from FATCA reporting code (if any) Address (number, street, and apt. or suite no.) 1600 Osgood Street, Suite 2013-114 Requester?s name and address (optional) City, state, and ZIP code North Andover, MA 01845 See Specific Instructions on page 2. List account number(s) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the ?Name? line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a numberpage 3. Note. If the account is in more thanpne name, see the chart on page 4 for guidelines on whose number to enter. Social security number Employer identification number Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. i am not subject to backup withholding because: I am exempt from backup withholding, or I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below), and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have faiied to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. 8'9? Signature of A I I U.S. person Here General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. The has created a page on iRS.gov for information about Form W-9, at Information about any future developments affecting Form (such as legislation enacted after we release it) will be posted on that page. Purpose of Form A person .who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, payments made to you in settiement of payment card and third party network transactions, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 oniy if you are a US. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicabie, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number -to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are aiso certifying that as a U.S. person, your allocabie share of any partnership income from a US. trade or business is not subject to the Cat. No. IOZSIX (725?6er 6am - Bernese Na K. Date :3 "i withholding tax on foreign partners? share of effectively connected income, and 4. Certify that FATCA code(5) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. Note. if you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester?s form if it is substantially similar to this Form . Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: 5 - An Individual who is a U.S. citizen or U.S. resident alien, - A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, - An estate (other than a foreign estate), or A domestic trust (as defined in Regulations section 30i .7701w7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withhoiding tax under section 1446 on any foreign partners? share of effectively connected taxable income from 'such business. Further, in certain cases where a Form has not been received, the ruies under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withhoiding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income, Form (Rev. 8?2013) COMMONWEALTH OF MASSACHUSETTS OFFICE OF THE COMPTROLLER Electronic Funds Transfer Sign Up Form an Request type must be checked: I Initial Request Changing Existing Account If Closing Account I hereby certify that the account/s indicated on this form is under my direct control and access; therefore, I authorize the State Treasurer as ?scal agent for the State of Massachusetts to initiate, change or cancel credit entries to that account/s as indicated on this form. - For ACH debits consistent With the International ACH Transaction (TAT) rules check one: C11 affmn that payments authorized hereunder are not to an account that is subject to being transferred to a foreign bank account. i I affirm that payments authorized hereunder Lem an account that is subject to being transferred to a foreign bank aCcount. - This authority is to remain in full force and effect until the Of?ce of Comptroller has received written noti?cation, from ether me or an authorized of?cer of organization of the account?s termination in such time and in such a manner as to afford CTR a reasonable opportunity to act upon it. VENDOR BANK INFORMATION Vendor Bank Name: Vendor Bank Transit Numb er (ABA): Vendor Bank Account Number: Filling out this ?eld is a requirement for changing account number Vendor-Bank Old Account Number: Account Type: VENDOR INFORMATION Vendor Tax Identi?cation Number (TIN): Vendor/Business Name: Vendor Contact Name: E-mail: Telephone: Address: City: State: Zip: This authorization will remain in effect until either canceled in writing or an updated form changing information is sent to the Department you currently do business with. AUTHORIZED SIGNATURE: Print Name: Title: Date: Form forwarded to Commonwealth Department: Attached voided check herett DEPARTMENT OF CHILDREN AND FAMILIES RFR Title: COMPREHENSIVE FOSTER CARE RFR Number: DCF CF015 RFR COVER SHEET and CHECKLIST Please use this cover sheet as the first page of your response materials Agency Name: The Mentor Network, LLC. Vendor Code Massachusetts Mentor, LLC. is an existing provider for the CommonWealth of Massachusetts and currently has documents on ?le with the Comptrollers Of?ce. . - . . Agency Address: 270 Bridge Street. Suite 201; Dedham, MA 02026 nu?: . Agency Main Phone Number: (781) 320-7600 Contact Person Name and Title: Paul Cataldo, Executive Director Phone Number: (781) 3?0-7606 Fax Number: (781) 326?4654 Email Address: . Submission Package must include the following documents: Bidder Check off - a DCF Check off i RFR Cover Sheet and Checklist (one per package) I El 53 - Title Page (oneper model) Response Requirements (one per model) 7 I Re?lfi?red Attachmentsaicense and organization charts) Supplier Diversity Program for Purchase 'of Service (POS) El El Quali?cation Package (if not currently quali?ed): Currently Quali?ed I SOMBWA Certificate (if applicable): Not Applicable El 1 .. . Thefollowing documents are required upon contract award: I DCF Use Oniy Commonwealth Standard Contract Form Cl Commonwealth Terms and Conditions fer Human and Sociai Service Contractor Authorized Signature Veri?cation Form Request for Taxpayer identi?cation Number Certi?cation Form (if not already on ?le) 7 Authorization for Electronic Funds Payment Form (mandatory, if not already on EFT) POS Attachment 1 Program Cover Page (one per program) El DCF Negotiated Adjustmenthodi?cation Form El I Executive Director September 29. 2014 Signature of Authorized Representative Title - Date DEPARTMENT OF CHILDREN AND FAMILIES RFR Title: COMPREHENSIVE FOSTER CARE RFR Number: DCF CFC15 TITLE PAGE Please use this title page for each program service 'model - all Agency Name: Massachusetts Mentor, LLC. Program Contact: Paul Cataldo Program Telephone Number: (781) 320?7600 Program Email Address: Comprehensive Foster Care Check One (complete a separate form for each program) One and Related Services El Child Home?Based Rehabilitation El EmergenCy Shelter Multiple Acute Level A El -vvr . it . ch Transitions to Adulthood FRFC Family Residential FRFC Complex Foster Care Medical Check Statewide, Regions andlor Areas that the proposed program is able to serve: netateWide Region-wide Region?w: El Region-Wide El Region-Wide Pitts?eld . {1 Lowell El?Arlington El Hyde Park 'El Green?eld El El Coastal El Dimock Street El Holyoke El Haverhill El Cape islands Park Street r, El Spring?eld El Cape Ann . El Plymouth El Harbor El Robert Van Walt Center El Lawrence El Fall River a El North Central El Malden New Bedford El 8. Central/Blackstone . . . - Valley El Cambridge El Brockton :r Worcester East . El Framingham TauntonlAttleboro El Worcester West Current State Purchasers . is this program currently beingpurchased by Egg Is this program currently being purchased by other state entities? List entities ?v ?5 it?, .h .tl 7? Paul Ca?taldo 2014 Signature of AuthorizedRepresentative I Name (printed) Date me an: err-?1 Comprehensive Foster Care, 5 9.1.143. 1th See and Related Services 9.1.A. IFC ONE AND RELATED SERVICES Backgroend A. Describe how the organization ?3 philosophy and array ofsewices promote: .1. child/youth guided and?im?y centered care; thefts/nil}; ?5 voice: - eachfimziiy ?5 unique needs; - strengthening the?fizmiiy ?s ability to live successfiilly in their fecal commimz?ties; evidence informed practices; trauma informed care and employs positive behavioral supports and intervem'ions; a commitment to diversity and cultural competence. Massachusetts MENTOR, LLC, is fully committed to helping children and Within the communities Where they live. We offer innovative, quality services and supports that lead to growth and independence, regardless of the?physical, intellectual, or behavioral challenges they face. Our philosophy emphasizes partnerships?awith those we serve, families of origin, foster families (Mentors), our staff, DCF, and the communities in which we work?to help- the children and youth we serve shape the direction of theirlown lives in community-based settings. We actively collaborate with referring and collateral agencies to ensure that children and youth are part of a comprehensive continuum of care. We provide children individualized care that values the role of families and communities in the treatment process. Newaww Safe and timely permanency drive Massachusetts delivery of programs. Community integration and homelike environments are hallmarks of our programs. Our priority is to provide services to children, youth, and families that promote the establishment of permanency and lifelong connections for all children. We ?rmly believe that the best services for echildren and families incorporate the values of Family-Centered Practices. Our services are child/youth?driven, family-centered, community?focused, evidence-informed, trauma-based, and culturally competent. All Massachusetts MENTOR services are: 0' Individualizedi Providing successful, child/youth-guided and family-centered services begins With engaging children and families as key decisionwmakers in the process. Our services include a profound belief that children and families can?and do?recover from emotional and behavioral challenges. We believe strongly in the resiliency of the youth and families we serve. Resilience theory instructs us that children and families have the capacity to overcome adversity when they have access to others Who support and believe in them and provide the necessary resources to succeed and thrive. .- Family Focusedi Today?s families face complex issues. We meet their needs in practical ways that are meaningful to them. We engage families and other people and relationships 7 Page i Offii) Comprehensive Foster Care, CFCIS 9.113. IFC {Dine? and Related Services signi?cant in the child/youth?s life as part of the therapeutic process to re?ect the family?s voice, beliefs, and culture. We successfully engage the most Challenging families in an effort to empower "their voice. We provide skill development and behavioral and community support services, including respite care, to families and program participants. No two families are alike?we address each family?s unique needs to ensure that foster and families of origin are involved during all stages of the decision-making process. 0 Our services center around the child?s abilities, and skills. Our program is rooted in the use of positive, strength?based approaches that promote hope, a rather than a focus on de?cits, challenges, and barriers towards reaching goals. Our initial assessment process begins with the child/youth?s . 0 Collaborative and Integrated: We provide community-based care in collaboration with other providers and community resources. Our philosophy of integrating a variety of services to strengthen the lives of children and their families is infused into everything we do and represents how important we think it is. Examples of our community partnerships include school systems, mental health service providers, recreational and sports activities, and social groups Within the region. . 0 Evidence?Based and Trauma informed: Massachusetts MENTOR has been providing treatment foster care in the state of Massachusetts for more than three decades and is in the process of implementing our evidence?informed Family VistasSM service model, which we developed as part of our ongoing, innovative commitment to continuous quality improvement. Family VistasSM is grounded in Trauma Focused Cognitive Behavioral Therapy?s evidence-informed treatment. It also includes other evidence based interventions including Motivational Interviewing and Shared Parenting. 0 Culturally Responsive: Massachusetts MENTOR staff and Mentors re?ect the cultural backgrounds of the children and families we serve. We recruit within the areas we serve and employ a culturally diverse Workforce. All staff are trained to deliver culturally competent services. Children for whom English is not their primary language are matched with bilingual staff and Mentors who speak their native language. Focused on Continuous improvement: Quality assurance activities evaluate the services we provide through weekly, and quarterly mechanisms, documentation, and surveys, including Utilization Reviews, Satisfaction Surveys, Program Audits, and Program Outcomes. We use individual and programmatic data to drive improvement of our services to be more responsive to the needs of the youth and families we serve. Beekgroand .3. Describe the organization ?5 history and work experience injoster care including: - . years ofexperienee; 2. description ofpopularions served, specialties, geographicjeans. 3. description ofrelan?onslegos will: other providers, law enforcement, courts, and local community programs including schools, social service agencies, mental health agencies and other relevant resources Founded in 1980 and named for our innovative model,? which designs individualized treatment as needed, Massachusetts MENTOR was one of the ?rst Therapeutic Foster Care providers in the country and is- a founding member of the National Foster Family- Based Treatment Association (F FTA). We established a reputation as a pioneer in providing community-based services for children and youth who would otherwise be served in institutional M0350 clrusetl?s Page 2 of 3G Comprehensive Foster Care, DCF IFC One? and Related Services settings. By the late 19805 we were serving unique populations, such as children with chronic medical needs and trauma histories, and we have continued to grow and diversify since then. For 34 years across 15 states, The MENTOR Network?s individualized, community-based TFC model has effectively served at risk children and youth and/or court?involved youth originating from a number of different venues, including, but not limited to: de-stabilized family home situations, residential treatment programs, detention centers, and/or facilities. In 2012, The MENTOR Network introduced Family VistasSM, a trauma-focused, evidence-informed model for Therapeutic Foster Care develOped by our clinicians, which incorporates innovative clinical practices, including Trauma Focused Cognitive Behavioral Therapy, Motivational Interviewing, Skill Building, and Intensive Case Management to help children map a positive direction for their lives. We are in the process of implementing Family VistasSM throughout our program, and we intend to complete the process in consultation with DCF. Statewide, Massachusetts MENTOR provides home and community-based services to children with emotional and behavioral challenges as well as adults and children with intellectual and developmental disabilities, medically complex conditions,'and brain and spinal cord injuries-The people we serve come from a range of ethnic and cultural backgrounds and face outnof-home placements and/or reunification. They experience an array of challenges, including complex behavioral challenges, sexual offender and reactive behavior, substance abuse,'domestic violence, mental health challenges, and involvement with the juvenile justice system. We serve children and families across the state in urban, suburban, and rural communities. We emphasize building relationships with community partners to help support the people we serve. We partner with local food banks, shelters, community health centers; specialized treatment and support resources; police departments and court systems; schools; and social services, mental health, and transportation agencies. For social and vocational activities, we refer youth and parents to YMCAs, Boys and Girls Clubs and to appropriate summer, after-school, sports, and employment programs. We also link families facing substance abuse challenges with recovery groups/agencies including Alateen, Al-Anon, and Narcotics Anonymous. Background C. How will the organization ensure compliance with (112 [icemrireg/oppziovof standards for its homes rmdfoster parents? Describe the business process and the management oversight. systemic reviews and monitoring tools that will] be employed in maintaining compliance. Massachusetts MENTOR adheres to the following standards to ensure compliance with all licensing/approval standards for Mentors (foster parents) and their homes: 0 Potential Mentors? applications are reviewed by a member of the state leadership team prior to final approval and becoming licensed. All prospective Mentor records are reviewed by a member of our state leadership team for approval and to ensure 100% compliance with all quality standards and regulations. 0 Mentors receive at least two phone calls and one home visit per month from the Family Resource Worker. During home visits, the Family Resource Worker monitors changes to the household and frequent visitor status and offers additional support to the Mentor. Page 3 0f30 simmer: Comprehensive Foster Care, CPCES 9.1.A. One and Reinted Services - Massachusetts MENTOR developed a weekly Home Visit Tracking protocol to ensure every child in our program is seen every week. We maintain an average compliance rate of approximately 95%. When a child is not seen due to circumstances often beyond our control, we implement a Missed Visit Protocol which requires contact with the DCF worker to explain why a visit did not occur that week. 0 On a quarterly basis, the Child Worker conducts a formal Health and Safety Assessment of the physical environment. 0 Unannounced visits to the home are conducted annually and more frequently if needed. 0 Relicensing is conducted annually, including an evaluation of the physical home, household member changes, frequent visitor checks, required references, updated medical and CPR and First Aid reviews, and skill development hours. 0 100% reviews of all Mentor homes are performed annually and include a review of- the physical ?le, compliance on Virtual Gateway, and relevant clinical considerations. 0 Staff receive ongoing trainings regarding the Virtual Gateway System to ensure compliance with licensing standards and changes set forth by DOE and DEEC. Program Directors and Regional Directors oversee compliance with all licensing agency regulations; ensure that required safe practice, safety rules and emergency procedures are followed and carried out by all staff and caregivers; conduct safety inspections, environmental surveys, and audits; and immediately report medical emergencies to the Regional Director. Program Directors provide new staff and Mentor (foster parent) orientation and training per regulatory requirements; oversee program transition guidelines so youth have a smooth transition to a discharge environment; and facilitate weekly staff meetings with interdisciplinary team and weekly management meetings to track status of placements. Each member of the Mentor foster family must pass a criminal record background check; an approved BRO, CORI, SORI, and DOE history check; a DEEC daycare check to ensure the provider does not run a daycare within the home; and an OIG clearance. All individuals Over 15 years of age must provide ?ngerprints. The prospective Mentor?s physician must give medical authorization to proceed further with the application process, and the potential Mentor must provide three references. Frequent visitors to the home also require BRC clearance. Permanenny A. Describe the recruitment strategies the organization will use to ensure a diverse pool offoster homes and?isrerparents that will support a .S'zrccess?rl mare/t process. Mentors (foster parents) provide more than a home to a child?mthey help children grow and learn, forever changing their lives. Massachusetts MENTOR recruits for the niche populations and demographics of the children and youth we serve through a variety of strategies, including word of mouth, newspaper ads, online postings, and provider fairs. Screening includes a formal application; reference checks; health and safety inspections of the physical environmentgra complete intensive, rigorous, assessment; and medical and background checks on all household members. More detailed recruitment information can be found on page 24. Massachusetts MENTOR recruits and selects staff and Mentors who reflect the ethnic, racial, religious, and linguistic diversity of the children and youth being served. Mentors enter the program with diverse social and ethnic backgrounds, levels of education, interests, and communities of origin. They originate from urban, suburban, and rural neighborhoods, and come litiessochusetts I Page til 0103i} Comprehensive Foster Care, CFCES 9.i.A. One- and Related Services . to the program for consideration through a variety of recruitment mechanisms. Children/youth are matched with Mentors who speak their native language whenever possible. We strive to maintain family relationships by placing siblings together and parenting teens with their infants, when appropriate. Our data supports evidence that successful matching decreases the disruption to the child by decreasing. the number of moves a child experiences, 89% of children/youth placed with us for the last two years remained in placement in only one or two homes. The Family/Treatment Team, including the Program Director, Program Supervisor, Program Recruiter, Family Resource Worker, Child Worker, and DCF, partners to a provide appropriate Mentor and child/youth matches. Family Resource Workers monitor Mentor homes, provide services consistent with the ISP (Individual Service Plan), and coordinate with families and DCF staff to ensure youth and family satisfaction and stability of the Mentor home. If the Mentor is approved for more than one youth, assessments are done prior to placement to ensure the child/youth is compatible with the Mentor and other children/youth placed in the home. We focus on providing strong stable placements by considering the following points when making a match. - - - Location, proximity to community and family of origin, and continuity of care 0 Mentor family constellation 0 Mentor family skills, abilities, and areas of expertise - Ethnicity, race, culture, religion, and language 0 Shared special interests Appropriate matching is critical when serving children with extraordinary challenges. Special a _-consideration and assessments are given to the composition of the Mentor family and the identi?ed risk issues presented by these youth. The number of children in the home, their ages, gender, stage of development, and vulnerability are evaluated in light of the child?s level of functioning and ability to relate to other persons. 8. Explain the I process foster parents anal/hr program ailevz?az?e challenges and tensions in the home and request additional supports. Massachusetts MENTOR collaborates with the Family/Treatment Team and medical, and therapeutic services to make sure all aspects of the child?s needs are being considered. Staff and Mentors strongly believe that placement disruption results in a signi?cant set?back for a child trying to achieve his or her permanency goals. Mentors and staff are prepared to work through challenging behaviors that could lead to instability within the home. Mentors are also - provided thorough skill development, including RELATE training (see the box page 6). We identify early indicators of placement instability by closely monitoring the child?s behaviors. When new placement needs are identified, the Mentor, child/youth, and Treatment Team discuss services and supports needed to stabilize the home and placement. Mentors and staff participate in clinical meetings weekly to discuss dif?cult cases and work together to resolve issues causing disruptions in the home. We provide Mentor Coaches, seasoned foster parents, who work with new Mentors to answer questions and provide guidance and support as needed and during regular check-ins. Mentors Page 5 01830 EWENTU, Comprehensive Foster Care, CFC 5 9.1.A. One and Related Services attend groups and receive guidance from their peers in addition to sharing best practices. if a Mentor contacts us needing help, we increase the number of visits staff make to the home and the Mentor Coach provides additional support. We maintain a 24/7 on?call phone number that Mentors may use at any time to discuss questiOns and concerns. We also provide respite to Mentors to given much needed break during pivotal times of placement. C. Describe your organizations policies and practices that address placement stability. Stabie placement is a necessary step towards permanency. Massachusetts MENTOR believes children achieve permanency goals more readily while living in stable and nurturing family environments that fully support implementation of the ISP. We believe that any change of living environment can have a traumatic impact on a Child, and we are committed to reducing the number of homes children live in while in our care. Massachusetts MENTOR monitors the average number of placements on a basis. I The majority of our youth are placed in only one home?the average number of placements experienced by youth placed between July 2013 and June 2014 is 1.3. We use weekly home visit compliance tracking, missed visit protocols, disruption meetings, clinical reviews, skill development, and ongoing Mentor supports including our 24/7 phone availability to decrease changes in placement even further. We follow Permanency Planning Policy, which includes phone contact with the family of origin within 24 to 48 hours, face?to-faCe Visits conducted within five days of placement, and ongoing contact between the child and family of origin, including parents and siblings when indicated. Maintaining contact with the family of origin allows the child to remain connected while adjusting to a new living environment and increases the chances of successful reuni?cation. Massachusetts MENTOR is in the process of implementing Family VistasSM, a therapeutic foster care model developed by Network clinicians and designed to assist children who have suffered trauma and loss to move forward on their path of healing and independence. Family VistasSM promotes the philosophy of Shared Parenting. Our Mentors learn to promote engagement, mutual respect and cooperation with the child?s parents to help prevent or minimize loyalty binds for the child. It helps families of origin feel valued and not feel as though they are a ?bad family.? The family feels involved, appreciated, and respected, and nOt as though they need to be Children love their parents and often act out in foster care to send the message that they love their family of origin more than the foster family. When families of origin and Mentor families 5 of 30 Comprehensive Foster Care, DCF 5 9.1.A. One and Related Services connect, respect each other, and inVolve each other in parenting decisions it Sends a powerful message to the child that it is ok with their parents, and they can stop feeling disloyal by developing a good relationship with the Mentor. Shared Parenting creates harmony, respect, and ultimately bene?ts the childuit is about respect and inclusion and partnership for the bene?t of the child/youth. Shared Parenting promotes more stable placements and smoother reunificatio with all of the adults working cooperatively for the bene?t of the child. Family VistasSM also focuses on working towards permanency goals by providing Skills Building training for staff and Mentors. This refers to building social skills for children and youth who have suffered from trauma and loss. We focus on appropriate ?social behaviors and reactions to group settings, positive interactions with peers and adults (teachers, social worker, case coordinator, clinicians, etc), learning more about which social skills to emulate, and negotiating compromises with peers in new group settings. It also focuses on the different ways children/youth learn and what activities are helpful depending on their learning style. Placement stability is enhanced through better communication between the Mentor and the hchild/youth. An integral element of Family VistasSM is the RELATE curricula (Relationships and Therapeutic Engagement). See page 6'for details on RELATE and page 19 details on Family Vistas M. Massachusetts MENTOR Operating Practices and Home Visit Protocols require the Child Worker to visit the Mentor home weekly and monitor the child/youth?s progress, observe interactions between the Mentor household members and the child, monitor the physical environment, and provide support and guidance to household members. The Child Worker maintains a log of contact with the Mentor and summarizes the Mentor contractual compliance The Child Worker conducts a confidential interview with the child/youth on a quarterly basis. Key areas addressed include safety, family interactions, and community integration. Family Resource Workers speak with the Mentor at least twice a month and visit the home on a basis. The Child Worker and Family Resource Worker receive weekly supervision and guidance from the Program Supervisor and Program Director respectively, and Massachusetts MENTOR also offers ongoing, consistent clinical review opportunities to assist staff in identifying additional supports needed for the child and/or the Mentor home. ?We gather detailed information about each potential Mentor?s skills, and growth opportunities and provide program staff with the type of behaviors and permanency goals each Mentor is most capable of supportng when identifying potential matches. The child/youth and Mentor have the opportunity to meet prior to placement to ensure a successful transition into the home. The Child Worker conducts a home Visit within the ?rst 48 hours of placement. Once a placement is made, Massachusetts MENTOR is fully dedicated to providing the Mentor with the assistance, education, and skill development he or she needs to make the placement successful. We fully support Mentors so they are comfortable taking on challenging placements and are less likely to request that a child be removed from their heme during dif?cult times.- Embracing and implementing service planning goals are necessary steps towards helping each child achieve permanency in a timely manner. Community integration and homelike environments are hallmarks of our program. Children in our program are supported with individualized care that values the role of families and communities in the treatment process and Page 7 01?30 Comprehensive Foster Care, DCF CECE 5 9.1.A. One and Related Services actively collaborates with referring and collateral agencies to ensure that children and youth are part of a comprehensive continuum of care. Each child placed with us has had a permanency goal assigned by DCF, which is discussed at - admission and immediately incorporated into treatment. The implementation of permanency goals is individualized for each child. Their Comprehensive Treatment Plan is formulated and modi?ed over time by Massachusetts MENTOR. As a child prepares to transition to his or her permanency outcome, we direct considerable effort toward ensuring a smooth transition. In most instances, a child transitions gradually to their permanent home, with a number of planned transitional visits. that increase in frequency and duration as the discharge date approaches. Faster Parents A. Describe the care and support that the foster parent wit] provide to the children. youth adults placed with them as waif as the child resource. Response slam.de address the foster parent "3 caregiver role as we]! as his/her treatment role as an active agent quZam/Ied change, as speci?ed in each bullet listed in section Massachusetts main concern is the safety and wellbeing of the children/youth in our program. We help children/youth at risk attain individual growth and development and reach their permanency goals in the most natural settings possible. Permanency and case planning fully incorporate the Mentor (foster parent), the child/youth?s family of origin, and other members of their informal support system, unless such participation is deemed clinically or legally inappropriate. We work to place children/youth with Mentors who match their cultural identity. Mentors respect the child/youth?s religious beliefs and practices and assist them. in practicing their beliefs. They provide transportation to events and services, celebrate religious holidays, and facilitate ethnic and cultural activities within the home to help the child/youth maintain a connection with his or her ethnic, racial, cultural, and religiousbackground. Mentors are an integral part of the Family/Treatment Team and partner with Massachusetts MENTOR staff to develop and implement the primary treatment plan. Mentors implement the in-home treatment strategies specified in the child/youth?s treatment plan in the home and work with the Child Worker and Family Resource Worker to ensure the child/youth?s goals are met. Mentors work cooperatively with all Family/Treatment Team members. They attend team meetings, training sessions, quarterly reviews, and other activities required by the program and the child/youth?s treatment plan, including transporting the child to therapy sessions and, when appropriate, participating in the child?s therapy; preventative, routine, and emergency medical and dental appointments; specialized medical appointments; and providing academic supports. Structured and appropriately supervised recreational and community activities are incorpOrated into the children/youths? treatment program. Mentors are actively involved in the activities the team and child/youth choose for exploration of new interests and enhancement of existing Staff work with Mentors to identify developmentally appropriate activities designed to engage and encourage the child/youth. Mentors provide activities within the home and encourage the child/youth to continue participation. They provide transportation to events and activities outside the home, including, YMCAS, Boys and Girls Clubs, sports, arts, and musical activities. T) 2 0?5: (D (I) 5?4? JJ Comprehensive Foster Care, 5 9.111%. 1le One and Related Services Mentors are committed to ensuring that the needs for each child/youth placed in their home are met. They arrange for medical and dental treatment within seven days of the placement and - schedule a comprehensive exam within 30 calendar days after placement, consistent with DCF policy. Mentors ensure that the child/youth has appointments for routine medical care and sick child visits, receives preventative and dental care, and receives specialized medical appointments and individual therapy as well as other appointments related to the safety and wellbeing of the child/youth. When applicable, the Mentor or Massachusetts MENTOR staff stay with the child/youth during the medical and dental appointments. Mentors provide for each child?s appropriate nutritional programs and needs; ensure that pre-natal and post-natal maternal care is provided to pregnant and parenting youth and young adults; and they support activities that promote physical health and wellbeing, including school and community recreational activities. Massachusetts MENTOR understands that there may he extraordinary transportation demands that involve long distances or drives. In those instances, we work with DCF staff to develop speci?c plans to address each extraordinary trip. Mentors are required to have. access to transportation but are not required to own a vehicle as long as they have other methods to transport the child/youth to needed services and activities, including transportation to medical and other appointments, school and educational events, recreational and community activities, and other needed locations. They bring the child/youth to visits with the family of origin/primary caregiver, including siblings, weekly or at the frequency speci?ed in the treatment plan. If a Mentor cannot meet a transportation need, we assist with necessary transportation. :Mentors complete a weekly observation log during the child/youth?s ?rst six weeks of placement. As a member of the 6 Week Placement Review Team, the Mentor makes the log avaiiable to help support the child?s placement and to address his or her safety, well-being, and permanency needs. Mentors attend team meetings, educational sessions, and case reviews. On'an ongoing basis, the Child Worker and Mentor together complete detailed records for the child/youth on a weekly or daily basis per the Family/Treatment Team decisions. These records include, but are not limited to, targeted areas, activities, and medication administration. They document activities as required by the program and the standards under which it operates. Mentors participate in pre?placement visits and the initial placement visit, which includes the family of origin or other family members. They participate in the discharge meeting prior to placement and attend any specialized training needed to best support the child/youth. Mentors are trained in medication management and the speci?c needs of the child. Participation in Shared Parenting and Family Interactions help the child/youth?s sense of safety and trust and maintain a connection with their family of origin. When appropriate, Mentors and staff work with the family oforigin and remain part of the child/youth?s life after discharge. When children leave the Mentor?s home, the Mentor participates in pre-placement visits to the new location and the discharge meeting and assists in providing specialized training to the new caregiver. Mentors understand that they can play a permanent and supportive role in the child/youth?s life and can help the child/youth maintain stability in their adult life. Mentors often provide life?long emotional support and family membership. iliassarhusu! is Page 9 Of 3, . Comprehensive Foster Care, DCF CECIS 9.l.A. Hit: One and Related Services The Youth Readiness Assessment Tool is used when working with youth 14 years and older so they can learn to live independently in adulthood. The tool is initiated within 20 working days of placement, and the Mentor participates in the 6 Week Placement Review, the scheduled six month review, and at discharge. As part of youth?s training to live independently in adulthood, Mentors are trained in and use the PAYA (Preparing Adolescents for Young Adulthood) program Curriculum along with the Youth Readiness Assessment Tool. Mentors promote opportunities for youth age 14 and over to develop pre-vocational and vocational skills per the treatment plan and maximize educational and vocational opportunities. They support opportunities for achieving educational success and assist the youth in achieving post-secondary educational placement, gainful employment, and skills to prepare for adulthood. Mentors assist the youth in accessing ?nancial aid for vocational and higher education. Mentors work in conjunction with youth achieving adulthood, Massachusetts MENTOR staff, and the DCF social worker to assist in planning a sustainable transition out of care and, at the youth?s request, continued involvement and support from DCF. Mentors participate in transition plan development, which includes educational options, employment or work skills development, housing, health insurance, local opportunities for mentoring, and other activities and supports for the youth in completing these activities and achieving success within the community. Mentors promote?continuity to the children/ youth in their care as they transition out of the home. They assist with information and referral coordination; participate in bridging between new services, schools, and programs; and work with the family of origin (when applicable). Mentors are active participants in the child/youth?s discharge plan from the beginning and are prepared to offer support and assistance throughout the process. They have a clear understanding of Treatment, strategies, and interventions needed to meet goals in a timely manner, and they maintain community supports and treatment services; educational and/or vocational planning; and, when applicable, an aftercare plan, crisis prevention, and intervention plan. 7 Once it has been decided that a child is ready for a planned discharge, Massachusetts MENTOR arranges for a Family/Treatment Team meeting that includes the Mentor to discuss, identify, and outline the discharge, transition, and aftercare process for the child and family. Discharge planning includes, but is not limited to, identifying goals and service responsibilities'related to education, job development, utilization of community resources, and housing. Massachusetts MENTOR works with the child and family when reuni?cation and kinship care are viable long- term options for participating youth. 7 When possible, Massachusetts MENTOR staff and Mentors visit the discharged youth to encourage a successful transition. Faster Parent?s B. Indicate whether the organization requires theirfoster parents to own a vehicle. Explain how lirefbster parent and the organization will timely meet the transportation needs referral; child. Massachusetts MENTOR requires that all Mentors (foster parents) have access to transportation. 7 They are not required to own a vehicle if they have access to public transportation, taxi cabs, and other methods to ensure the children in their care can be transported to the services they need. In 7 il?fusmehusetts Dirge i C?oi?nprehensive Foster Care, DCF CEC 5 One and Related Services extreme situations when Mentors cannot meet the transportation need, Massachusetts MENTOR staff work with them to find a transportation solution. Foster Parents C. Describe how thefoster parent will work 'irvith thefomzlies {yorigz?n and/or permanent resource of'tlze children, youth onclyonng adults placed with them. Response slronld address the bullets listed 2'77 section Massachusetts MENTOR uses Shared Parenting to promote relationships between the child and family of origin, including sibling relationships. The Mentor assists the child in maintaining contact with the family and, when safe to do so, the Mentor arranges phone contact the night of placement or within 24 to 48 hours and a family visit as soon as possible, no later than ?ve working days after the placement. Mentors foster ongoing contact through a variety of methods, including facilitating visits and communication between the child and family members within and outside the Mentor home as per the treatment plan. The Mentor supports the child?s active relationship within their home and with the family of origin unless contra-indicated by the treatment plan or deemed inappropriate by DCF. The Mentor schedules meetings and activities that involve the family of origin at times and places that maximize the child?s engagement with the family of origin. When DCF provides concurrent planning for the child, our staff work with the Mentor and family of origin to avoid conflict of interest and/or confusion for the child and family. The treatment plan, correspondence between Mentors, the family of origin, and Massachusetts MENTOR staff are written in ?everyday language? in both English and the family?s primary language to ensure that everybody is comfortable with and understands the treatment plan and interactions. :Mentors assist the child/youth in attaining their permanency plan goals, provide emotional support and information towards supporting their goals, and maintain the relationship with the youth/child and their family of origin after the child/youth has left their care, when applicable per the treatment plan. When the child/youth leaves their care, Mentors share their knowledge about effectively managing the child?s behavior and other therapeutic interventions with the permanent family. When appropriate, Mentors remain involved with the child and parent as a resource and support. Foster Parents D. Describe how the/osterporent will work with the comnumiU? and other agency partners who ore involved in the core of children placed with them. Response should address the bullets listed in section 8.1.11 (20). Mentors are advocates for the children in their homes. They maintain positive relationships within the community so the children in their care receive necessary assistance from social services agencies, mental health programs, medical professionals, recrea?tional'programs, and other community supports. Mentors assist the youth in their care become involved or stay involved in recreational activities including sports, music, and other areas of interest to the child. They facilitate youth joining activities and provide transportation to nourish their interest. MentOrs involve the children in family activities, including family BBQs and outings such as trips to museums, local parks, and - sporting events so children become a part of the community and bond within the Mentor family. Massachusetts pagg 0130 fith Comprehensive Foster Care, DCF CFC 5 91A. 1173C One and Related Services Mentors are trained to interact with the child and identify his or her needs. If they identify a need for evaluation, they work with Massachusetts MENTOR staff, DCF staff, and families of origin (when appropriate) to plan and participate in child assessments and goals. They request a special 7 education evaluation when a disability is suspected and assist the child/youth in setting and achieving their educational and vocational goals. Mentors work with teachers to assist in the educational needs of the child and maintain relationships with the child?s school by ensuring the child attends school or other daytime programs. Mentors monitor homework and help the children in their care with homework when possible and arrange tutors when necessary. They work with school behavioral or academic problems that may arise. They assist and monitor academic achievement and participate in educational and special education planning when applicable. They ensure that youth in their care attend school, tutoring, and community activities by arranging transportation. They work with supports in a positive manner. Mentors take on the role of special educational surrogate parent Unless DCF instructs them not to. They are available to the school if behavioral or academic issues occur. They collaborate with the family of origin to promote and support the child/youth?s educational success. They create and maintain a healthy routine in the home that promotes healthy study and work habits. Mentors work with the child to develop and maintain age appropriate interests and activities within the school and the community. They work with Massachusetts MENTOR and the family of origin, when applicable, to assist in the child?s permanency plans. Mentors advocate with DCF and the family of origin, when possible, on behalf of the child/youth to ensure they obtain educational, vocational, medical, and other services needed to implement the treatment plan and to ensure full access and provision of the public services the child/youth is legally entitled to. Foster Parents E. Describe iron/31201! wilt ensure and mom'torfosfer parent ctvailabi/itvfor the Child and explain supports that wiiZ be available lofbsrer pnrenrsfor emergency situations. During the initial recruitment and approval process, Massachusetts MENTOR assesses the Mentor?s lifestyle and work schedule to assure they can provide adequate time to meet the needs of our foster children. Mentors who work outside the home have approved work plans that ensure they are available to the child. Mentors are required to handle all routine and emergency situations. If they are unable to do so, we step in and provide emergency assistance. In addition, Massachusetts a 24/7 on-call support system. If Mentors have emergencies of their own, Massachusetts MENTOR provides transportation, other supports, and assistance needs. Foster Parents F. How will the organization (rejassess the appropriate number chhildren that should be placed in each home? . . All new Mentors are approved for one placement. After six months, Massachusetts MENTOR conducts a Double Placement Assessment to determine the appropriateness or a second placement. The assessment determines if the Mentor family can provide an appropriate environment for two placements, what supports will need to be in place, and in what areas they will need support. The Double Placement Assessment also determines whether the clients are appropriate matches for the same household. Double Placement Assessments are conducted fitlassaclmseits - 7- 7 Page l3 ofnli Comprehensive Foster Care, DCF 9.1.21. One and Related Services yearly as. part of our Mentor annual review and updated any time there is a change in the placements in the home. Massachusetts MENTOR provides DCF with Over Capacity requests on a case-by-case basis if a situation occurs where an exception might need to be made on the pre-approved number of children in a home, e. g. sibling placements, keeping an infant with her or his teenage mother, and situations where a child/youth returns to care and has a previous relationship with a Mentor whose home is currently full. Foster Parents G. Wat is the organization ?5 practicejor allowing foster parents to work outside the home? . During the initial recruitment and approval precess, Massachusetts MENTOR assesses the Mentor?s lifestyle and work schedule to assure they can provide adequate time to meet the needs of our foster children. Mentors who work outside the home must have approved work plans that ensure they are available to the child. Massachusetts MENTOR conducts a thorough assessment of a Mentor?s employment schedule, including wbrking hours, travel time and distance to work, and job ?exibility then evaluates these variables with respect to the child?s needs. Program staff discuss the Mentor?s work schedule with hisor her supervisor to con?rm that the Mentor has the ?exibility to leave the job at a moment?s notice should a child?s needs require such action. We use a Work Plan Approval Policy based on best practices and reevaluate it whenever the Mentor has a change of job or work schedule. A completed copy of the work plan is provided to the team when considering making a placement in the home of a Mentor who is employed. 7 TL Massachusetts MENTOR assesses the Mentor?s availability during times of the year that children are not attending school, particularly summer and school vacations. Many children need and benefit from age-appropriate, therapeutic, and recreational activities during the summer. 'In such cases, MENTOR staff work to locate camps, programs, and other activities for children during summer vacation. For youth who are of age to work, program staff assist them in ?nding part 1 time or summer job opportunities. - Whenever possible, MENTOR recruits and licenses two parent households. In two parent households, both individuals are credentialed and trained as IFC providers. This often allows for greater ?exibility with work schedules. In such cases, Recruiters and program staff evaluate the schedules of both co?Mentors to ensure that at least one is available to the child/youth at all times. . Program StaffYSapport Sari-ices A. the strategies that the organization will employ to ensure compliance with the educational and licensing standards. What type ofszamorl will the organization make available to staff to achieve these requirements? Massachusetts MENTOR provides pre-service orientation and in?service training to all direct care, clinical, and administrative staff, and we provide opportunities for staff to attend relevant outside training and professional CEU training at no cost to the employee. Such training ensures that staff members understand their responsibilities to the program and its participants. It also results in both personal and professional development of the staff, which correlates with individual job satisfaction and the retention of motivated, quali?ed employees. In addition Atlantic/1 melts 1 lit/innit?an Comprehensive Foster Care, CiiC 5 9.1..A. One and Related Services standard pro-service orientation and in-service training program, we deliver trainings speci?c to our Family VistasSM model which are further detailed in the section on page 23. Massachusetts MENTOR recruits new staff who have the licensure required by DEEC, including a current and valid license as a Licensed Social Work Associate, Licensed Social Worker, Licensed Certi?ed Social Worker, and/or a Licensed Independent Clinical Social Worker by the Massachusetts Board of Registration in Social Work or a Licensed Mental Health Counselor or Licensed Marriage and Family Therapist by the Massachusetts Board of Registration of Allied Mental Health and Human Services. New staff members who are not licensed are offered assistance in completing the licensing requirements within six months of being hired. Current staff who do not meet the licensure requirements will be licensed as appropriate within one year of the start of work date for this contract. Any exceptions to the requirements will be submitted to the Department for review on a case-by-case basis. Current staff who do not currently meet the educational requirement of course completion at an accredited educational college or university will meet the requirement within four years of the contract start of work date. The Massachusetts MENTOR Training rManager monitors licensing and educational requirements, and the Regional and Executive Directors ensure that the requirements are met. Program Services .8. Indicate the organization ?3 eon-zmz?tn-zent to a dedicated child worker and a dedicatedjemily resource worker within one home. Massachusetts MENTOR is committed providing each child with a dedicated Child Worker and each Mentor with a dedicated Family Resource Worker. Program Services C. Wirhfumimg to support one (1) child workerfor each eight (8) placed children/youth, describe the strategies that will be tailspin/red to ensure program all activities included in the text 1A Indicate the organization is commitment to meeting all activity requirements: 4 Each Child Worker has a maximum case load of eight children/youth. At a minimum, the Child Worker visits each child/youth in the home weekly, with the ?rst visit occurring within 48 hours of placement. If placement occurs on Friday, the child/youth is seen at intake or over the weekend to ensure that they are seen within the ?rst'48 hours of placement. If the child/youth is seen in the community, then a visit to the Mentor (foster) home is also completed that week. The Child Worker provides ongoing child-specific skills, training, and problem?solving during the weekly visit and documents the in-home treatment strategies on the Virtual Gateway, including proactive goal-setting and planning as required. Weekly progress reports (contact notes) are completed at each home visit with the Mentor and signed off by the Mentor, Child Worker, and youth if she or he is over 14 years old. Program Supervisors verify the weekly contact notes. Child Workers maintain a 10 of contact with the Mentor (foster parent) and summarize the Mentor contractual compliance each month. The Child Worker completes i?FamilyNet of all documentation related to work with the IFC One family, including safety plans and behavioral charts when indicated. . Rage 1 of El} Comprehensive Foster Care, DCF 5 9. LA. One and Related Services Child Workers support, consuit, and assist the families of the children/youth under their care. They arrange for and encourage regular contact between child and their family of origin, as speci?ed by the treatment plan. They actively work with the family of origin to keep them involved throughout the placement process. Families of origin are involved in treatment meetings, plans, and decisions throughout the child/youth?s placement. Massachusetts MENTOR keeps families of origin involved in every aspect of placement planning, when appropriate. Child Workers are trained to respond to, intervene in, and provide de-escalation techniques in crisis situations. Massachusetts MENTOR maintains 24/7 on-cali support that Mentors and children/youth can call if a crisis arrives. Child Workers use the CANS Clinical Assessment Process to assess the child?s progress; they make observations/ assessments of family interactions; and they assess and respond to safety issues. They participate in Family/Treatment Team Meetings, 6 Week Placement Reviews, and other case conferences as needed. The Child Worker monitors the child/youth?s progress and services received. She or he also observes interactions between the Mentor household members and the child/youth, monitors the physical environment, and provides support and guidance to househOld members. The Child" Worker sees the Mentor during each weekly meeting and meets with each member of the household at least once a month. Child Workers and Mentors use the Youth Readiness Assessment with youth 14 years and older until discharge. It is completed in multiple meetings over time to target areas youth need assistance in. They also use the PAYA (Preparing Adolescents for Young Adulthood) curriculum to address ongoing skills development with the youth. :Child Workers ensure the child/youth?s transition plans are implemented as planned and in accordance with DCF policy. DCF provides a transition plan 90 calendar days before discharge based on the assessment of the youth?s readiness for living independently. The plan includes discussions around education, employment or work skills, housing, health insurance, other medical care, and support services (if needed). - Massachusetts MENTOR is committed to successfully meeting all activity requirements. Program Staff/Support Services D. With?mdz?ng to one (Dfamih? resource workerjbr A each n-remyjive homes, describe the strategies that will be employed to ensure program staff'eomplez?e all activities included in the text Indicate the organization ?5 contentment to successfully meeting all activity requirements. Each Family Resource Worker supports a maximum of 25 Mentor (foster) homes. They receive technical support and participate in regularly scheduled calls with the Virtual Gateway Administrator that also include the Program Director. Family Resource Workers monitor Mentor homes and coordinate with families to ensure compliance and stability of the home. Screening includes child speci?c and kinship resources. Throughout the recruitment process, staff continually assesses applicants to determine if they are appropriate for providing IFC One level of care or are more appropriate?as a Departmental home. usmrh usetts i323 genres . ?5 Comprehensive Foster Care, {3613- 5 9.1.A. lli?C One and Related Services Family Resource Workers meet with the Mentors at least once a month and engage them in phone conversations every two weeks to ensure quality, compliance, safety, and completion of activities; share best practices; and review requirements. During contact, they provide consultation to the Mentors and work with them on a. professional development plan to address the needs of the child/youth, and arrange for further Mentor skill development when necessary. We recruit and retain Mentors capable of connecting with children/youth and their families as a result of shared past experiences including language, culture, religion, ethnic, racial, sexual orientation, and/or gender orientation backgrounds. We provide strong stable placements by considering location, proximity to community and family of origin, and continuity of care; composition of the Mentor family; skills, abilities, and areas of expertise of the Mentor family; ethnicity, race, culture, religion, and language in the Mentor home; and shared interests. Massachusetts MENTOR staff use the strength-based CANS Clinical Assessment Process and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). We are implementing our proven, evidence?informed Family VistasSM model within the state and we intend to bring this to Massachusetts in consultation with DCF. As part of the amil?y VistasSM program, all staff and Mentors are trained in RELATE, Relationships and Therapeutic Engagement, Training (detailed on page 6), an active approach to working with children who have suffered from trauma. Massachusetts MENTOR does not use physical restraints. All staff and Mentors receive ongoing skill development education in verbal de-escalation and crisis intervention. All recruitment, matching, and other activities are performed in a manner consistent with MEPA (Multi Ethnic Placement Act). - ?Massachusetts MENTOR staff and Mentors maintain positive relationships in the community so the children/youth receive the proper assistance from social services agencies, mental health programs, medical professionals, and other community supports. We promote the full engagement of children/youth, Mentors, and families of origin in community activities including education, extracurricular activities, and spiritual growth of the child/youth and family?s choice. Family Resource Workers visit each foster home at least once a month and speak with the Mentor on the phone at least every two weeks throughout placement. Prospective Mentors and their family must pass a criminal record background check; an approved BRC and SORI and DOE history check; a DEEC daycare check to ensure the provider does not run a daycare Within the home; and an OIG clearance before placement. All individuals over 15 years of age must provide ?ngerprints. The prospective Mentor?s physician must also give medical authorization to proceed further with the application process, and the potential Mentor must provide three references. Frequent visitors to the home also require BRC clearance. Family Resource Workers provide Mentors with support and feedback during phone calls and visits. They provide oversight of the home and consider all the children in the home. They document Mentor home reviews and give them to Supervisors for review. Yearly reviews are performed to ensure Mentor compliance with standards and that-their files are up-to-date. All Mentors participate in 40 hours of MAPP training prior to children/youth being admitted into their home. They receive at least 20 hours of ongoing, additional skills development and training Page it? 01930 Comprehensive Foster Care, CFC 5. .A. 1F One and Related Services yearly, which can include Shared Parenting and Life Book. Mentors receive training in working with trauma, grief, and transitions issues as well as emergency first aid. Regular reviews are conducted to ensure Mentor training meets DCF and Massachusetts MENTOR standards and that training remains relevant to Mentors and their needs. Detailed training information can be found on page 26. The Family Resource Worker ensures Mentors receive any special training required for a speci?c placement. All Mentors providing services to youth over 14 years of age are trained in Preparing Adolescents for Young Adulthood (PAYA) curriculum. Training ensures that Mentors understand their responsibilities to the program and its participants and that they are fully prepared to respond to the challenges presented by caring for youth in placement. Massachusetts MENTOR is committed to successfully meeting all activity requirements. Fragrant Steffi/Sammie Services E. Describe the process available in jbsrer parents and program sfcg?'to access seaport services. Include in the response the organization "5 approach to maintaining consistency personnel staf?irovidersfor each home. When Mentors are recruited, the Recruiter goes into detail about the joys fostering can provide and the challenges they may face. To ensure successful transition, Mentors participate in a careful matching process and pre-piacement visits before a child/youth is placed in their home. Massachusetts MENTOR provides Mentor Coaches, experienced Mentors who have been successfully fostering for a long time who make themselves available to new Mentors for questions and support. Mentors also attend Mentor Support Groups for support. Child Workers visit the Mentor home weekly, and Family Resource Workers are in contact with the Mentor at least every two weeks as well as visiting them in their home at least once a month. Mentors contact them at other times when they need support and assistance. They may also contact our 24/7 on?call staff if needed. Massachusetts MENTOR provides an average of ten hours of support per home per week and an average of five respite days per year to our Mentors. Additional respite days can be provided to Mentors as needed. Our Pediatric Medical Director and Medical Director are available for consultation as needed. We also utilize outside consultants, including nursing consultants and licensed social workers, to encourage positive outcomes and minimize disruptions. Many children/youth in our care also have access to our behavioral health services, which include In-Home Therapy, therapeutic mentoring, and other support services outside of the IFC One services. We focus on staff retention throughout the employment cycle to provide continuity between staff and children/youth. During recruitment and selection, applicants are vetted to ensure they meet job quali?cations and are an appropriate ?t for our mission and culture. Staff receive yearly evaluations to measure current performance and set future goals. They participate in weekly peer meetings to discuss case loads and ongoing training to further develop and enhance performance, . therapeutic, and clinical skills. Staff supervisors are available for assistance and consultation, and staff have access to the resources of our parent organization. We strive to build an employee base of creative thinkers with varying perspectives whose common trait is the commitment to the children and youth we serve. We provide a variety of incentives to retain staff, including rewards and recognition for employees who achieve significant contributions through efforts or above-and-beyond situations. '7 17 0mg . genre; Comprehensive Foster Care, CFC i 5 9,11%, ill-"C One and Related Services Program Stef?/Support Services F. Describe the tragic: 7 My, organizations approach to assessmg and addressmg ??exible service needs re?t each child unique situation. :?ruqmiufm?m mama?! he response should address the strategy to maintain an adequate level of'skilled, licensed and?or credentialed personnel consistent with placement population service needs. Mentors and staff encourage and promote positive relationships with peers through extracurricular activities, youth activities, YMCA and Scout activities, and other activities that involve peer relationships. The of the child drive all activities from the time of referral, including placement, intake assessment, initial treatment plans, weekly contact notes, quarterly ongoing treatment plans, and progress reviews. Con?dence and competence are built through the enrollment in extracurricular activities that also allow the youth to develop peer groups and empower them to assume leadership roles. Massachusetts MENTOR provides opportunities for the youth in our care to learn healthy behaviors. We identify vocational supports and assist the youth in pursuing their goals. Staff and Mentors promote skills that support their physical and environmental safety. Developing relationships with adults they can trust, including Mentors, staff, teachers, church leaders, activity organizers, and coaches, promotes strong role models and trust in adults around them helps the child/youth feel safe because they know there are adults they can go to if they need assistance or reassurance. We are in the process of implementing our Family VistasSM clinical practice model, a ?exible program that incorporates an array of clinical modalities and therapeutic interventions initiated during the assessment and treatment planning phase of service. Family VistasSM will continue being implemented in consultation with DCF. Family VistasSM tools are used to address the unique needs of the child and create an Individual Treatment Plan which best serves the specific needs of each child. The Family VistasSM model provides ?exible methods and tools used during each phase of treatment to help meet the child?s goals. We use four phases of treatment (on the left), as well as a pre-service phase. The phases include: Pre?Service: Assessment 0 Stabilization Pa tie in 01930 Comprehensive Foster Care, CECE 9. .A. One and Related Services 0 Capacity Building 0 Mastery 0 Transition All staff are RELATE trained, and we are in process of educating our Mentors with the RELATE curricula (described on page 6). The Child and Adolescent Needs and Assessment, CANS trauma?version assessments, Shared Parenting, Skills Building, Separation, Loss and Grief, Motivational Interviewing, and Trauma Focused Cognitive Behavioral Therapy make up the other formal trainings included in the Family VistasSM Model. Family VistasSM has been implemented in eight other states within The MENTOR Network and is in process of being implemented. in another four states, including Massachusetts. The ?exible structure provided by the Phases of Treatment allows children to move in and out of the different phases in accordance with their healing journey. The stages serve as a guide to the process and help keep the entire treatment team focused on the goals determined during the course of treatment. The ultimate length'of stay in a foster home per child varies according to the trauma history of the child. Child Workers meet with the child weekly and work with the child and Mentor to evaluate and update the child?s treatment plan. Massachusetts MENTOR Works with the child throughout each phase, challenging them in ways that build their competence and con?dence. Goals and methods for each Phase are based on the model?s treatment foci, Trauma-Informed and Relationship?Focused Care, While the tools used are determined by the intervention systems that appear. on the Clinical Compass and represented in the Clinical Path. - Skills ?ame The Clinical Compass (on the left) comprises the i i set of clinical tools used in our Family VistasSM model and is intended to guide clinical practice, dictating a direction for a flexible course of treatment and laying the foundation for an individualized Clinical Path (an individualized combination of the clinical tools), as indicated by the needs of the child and family. The various . . points of the Compass are represented as Trauma? Si??ifjjf? I Focused Cognitive Behavioral Therapy, Skill Building, Motivational Interviewing, Intensive Case Management, and Family Systems Work. These are the tools that are used by the clinical team in designing the individualized Clinical Path for?children and families. Depending on the assessment ?ndings, these elements represent the various tools Which may be clinically indicated for a particular consumer/family, as well as appropriate to the phase of treatment. Traimia~Fueusml cur Mattress-net minister-ring rift-ea Fiat; h?ienitoring. anti Safety .To ensure a continual focus on safety in all aspects of service delivery, Massachusetts MENTOR constantly and pro-actively manages risk. The Family Resource Worker and Child Worker provide ongoing monitoring of the Mentor, and supervisors monitor the Family Resource Worker and Child Worker. Monitoring provides frequent opportunities to pro-actively manage issues related to environmental safety, health, medical and behavioral needs and other risk areas. I I Page ii? Olly} BNTO Comprehensive Foster Care, CFC i 5 9.1.A. if One and Related Services Prevention of harm or danger is our highest priority. A safety plan is incorporated into the treatment plan, which identi?es interventions for recognized high-risk behaviors as Well as the level of supervision that the child requires. We use a systematic, pro?active approach to creating safe environments for children, the families that care for them, and the community. We conduct quarterly health and safety checks and meet with the child apart from their foster parents at least to assess safety and encourage them to communicate their feelings about their emotional and physical safety. We provide trauma-informed care so children and their families acquire new skills to process past trauma, manage and resolve behaviors resulting from past trauma, and improve on their family?s safety, parenting skills, and communication. We only place children in homes that are in full compliance with state safety requirements. Safety measures are ?exible and vary based on the child/youth?s needs and behaviors. Some of the individualized measures we have taken to promote safety of the child/youth, the Mentor family, the family of origin, and the community in the past include, but are not limited to, the following: - Specialized safety evaluations conducted by a credentialed expert for children presenting with dangerous behaviors, including fire-setting behavior, sexual perpetrators, and children with assaultive and/ or self-injurious behaviors. Environmental Assessments to evaluate the safety of the home and local neighborhood. Specialized Behavior Plans and development of self?monitoring skills. Line-of-sight, Constant, Close, or Intermittent supervision. Motion detectors, door alarms, or auditory monitoring devices, when indicated. Smoke and carbon monoxide detectors and ?re extinguishers. Restricted access to potentially harmful articles and substances (matches, alcohol, etc). Regular inspections for contraband. I Additionally, Massachusetts MENTOR conducts unannounced visits to Mentor homes, implements a thorough screening and selection process for all prospective Mentors, and conducts quarterly Health and Safety Assessments (HSAs) for all children. HSAs evaluate the living environment in the Mentor home and require a private interview with the child out of the presence of the Mentor to assess physical and emotional safety. IFC One Related Services Incidents! Purchases A. Describe the unique characteristics and naming needs to appropriately care?ir sibling groups and teen parents, as well as the unique szmport service needs Qf?fhese Whenever possible, sibling groups are placed together in one house. When siblings are in placement, we evaluate each child independently in addition to evaluating the family unit including the hierarchy, and boundaries in the family of origin. Family dynamics can have a profound impact on subsequent placements. Mentors (foster parents) provide a nurturing and loving environment and treat the siblings like part of the family and encourage them to rely on their bond with each other. Shared Parenting, an integral component of the Family VistasSM Model, based on the concept of expanded family, is central to maintaining family relationships. It emphasizes connectivity and preservation of family?of~origin through Shared Parenting activities and Family Interactions, when allowed by law or the legal guardian. Sibling relationships are examined and assessed as a easements Page 20 of '30 Comprehensive Foster Care, DCF CFC 5 9.1.A. IFC One and Related Services dynamic in minimizing trauma and contributing to the well-being of the children in care. We train staff and Mentors in the Family VistasSM model, including Mentor family strengthening and non-therapeutic resource siblings? needs and services. Shared Parenting allows children to expand their family instead of leaving one behind for another. Their family of origin and their Mentor family become pieces of the family system. Keeping siblings together in a foster home increases the connectivity the children feel and minimizes the negative impact and trauma of placement for both the children and the family of origin While helping children prepare for their permanency goals. Massachusetts MENTOR believes that a child?s relationship with family is critical, and When possible, it is best for children to be raised by his or her birth parents. We believe that even young, inexperienced parents, if properly assisted, can care for their own children. The primary focus when working with teen parents is to empower the participating youth by providing them with the skills and resources they need to effectively and independently care for their babies. This also provides children the opportunity to be raised and cared for their biological mother, regardless of her age or lack of experience. Mentors are recruited to work with teen parents partly based on their ability to serve as good - parenting role models for the young mothers in the program. They receive education regarding a range of parentingissues; ways of teaching young mothers?through modeling and coaching?how to care for their children in a normalized, home-like setting; and various methods of providing Support for the youth in their home. Mentors are taught to encourage the young mother to bond with her child, spend time with her child, and care for her child as much as possible. It is the gxpectation that the young parent handles the bulk of the parenting duties, with supportive assistance and coaching from the Mentor. Mentors receive, training on using the PAYA (Preparing Adolescents for Young Adulthood) curriculum, and those working with teen parents receive a special emphasis on teaching the tools addressed in Module V, Parts A and B: Young Parents? Guide. This module targets topics such as relationships, sexually transmitted diseases, and pregnancy prevention and sexuality. The material also treats issues related to unplanned pregnancy, the challenges involved in being a teen and single parent, and other information and skills which are related to pregnancy and parenting, namely prenatal care and child development. In addition to the program?speci?c training described above, Massachusetts MENTOR provides pre-service and in-service education to all Mentors and encourages them to participate in outside educational opportunities Whenever possible. Such education ensures that Mentors understand their responsibilities to the program and its participants and that they are fully prepared to respond to the challenges presented by caring for youth with special needs. All activities in Appendix of the RFR, Teen Parent Foster Care Placement with the Baby for DCF Placements, are implemented as part Massachusetts teen parent placement services. Page 2 of 3 i} Comprehensive Foster Care, CFC i 5 liliC One and Related Services One Related Services Incidental Purchases .8. Describe the strategies the organization will use to informfosrcr parents and children/youth of'tlie availability ofl'lrc Incidental Purchase Sel~Asidcfanrls and communicate the organization "s policies and practices to access flzc?mrls. I Incidental Purchase funds are explained to Mentors (foster parents) during the recruitment process and on an ongoing basis at relicensing, during oUr annual Re?Service skill development sessions, and during weekly visits from the Child Worker. Mentors and staff are aware of this funding resource, can request these funds for clientneeds, and can identify these funds to meet client needs. If a Child Worker or Family Resource Worker identi?es a possible need for Incidental Purchases funds, they will discuss it with the Mentor and child/youth (if age appropriate). Massachusetts MENTOR spends the funds allotted by DCF for each child on that child. A child who is placed with us has access to incidental funds for a variety of uses, including music and recreational lessons, camps, and interests and activities that child may have. We monitor and account for expenditure of these dollars to ensure the children have full access to these funds. IF One Related Services Incidental Purchases C. prroposz?ng Unbundled IFC Special Services, explain the internal systems that will be employed to ensure basic stripper: services awfully utilized to bezorc accessing additional Unbundled Special Stanton. Massachusetts MENTOR Program Directors and Supervisors work with staff to ensure all support services are in place and utilized before requesting additional support through Enbundled services. This will be reviewed during weekly supervision as well as during quarterly case review meetings with the treatment team. We provide support groups and ongoing staff consultations as well as a 24/7 on-call contact phone number. - We evaluate all the eligible services a child and family may qualify for such as CBHT services, which includes In-Home Therapy, an evidence~based practice called Family Centered Treatment?, and Therapeutic Mentoring. Other services include family/individual therapy, community resources, and natural supports that are available through community health centers, churches, or other social service organizations. Only when all alternative supports have been exhausted, or when there are special circumstances that make Unbundled IFC the support option of choice, will we initiate a request to provide Unbundled IFC Special Support Services. Program Standards .52 Operations A. Provide an organization chart showing the CFC program within the organization and a detailed organization chart CFC program itself Organization charts are included in the forms folder, per Amendment 1 of the Program Standards ?it Operations B. Describe the recruitment, hiring and training activities used in strafing both program parents. Massachusetts staff and Mentors (foster parents) have diverse social and ethnic backgrounds, levels of education, interests, and communities of origin. They originate from urban, suburban, and rural neighborhoods and come to the program through a variety of recruitment mechanisms, including newspaper ads and recommendations from other Mentors or Page 22 of 3 ll Comprehensive Foster Care, DCF 9.1..A. One and Related Services staff members. We place an emphasis on recruiting and retaining caregivers and direct care staff capable of connecting with children/youth and their families as a result of their shared life experiences, language, culture, religion, and/or sexual orientation. Massachusetts MENTOR is an Equal Opportunity Employer who seeks to hire quali?ed staff with knowledge of child welfare who understand the needs of the children and families we serve and the experience needed to deliver these critically important services. Program administrators seek people who are assertive, possess good communication and listening skills, enthusiasm, a cooperative team-oriented spirit, and good integrity and workhabits. Employees are hired on the basis of their quali?cations, educational and experiential requirements, their personal characteristics, and their commitment to our mission. Massachusetts staff recruitment includes newspaper ads, online job postings, social media notices, provider fairs, and local university job fairs. Massachusetts MENTOR provides pie-service and ongoing in?service training to our entire direct care, clinical, and administrative staff and encourages staff to avail themSelves of outside training opportunities Whenever possible. Such training ensures that staff understand their responsibilities to the program, the youth and families we serve, and DCF and results in personal and professional skill development. This correlates with individual job satisfaction and retention of motivated, quali?ed employees. We maintain a record of training which includes the person trained, the date 6f training, source of training, instructor(s), topic(s), and training hours, as well as copies of any certi?cates received. This applies to both pre-service and in?service training. Orientation training includes, but is not limited to, Reducing the Risk of SIDS, HIPPA, Cultural Mandated Reporting, Family Resource Policy Regulations, Educational Advocacy,- Cand Working with Biological Families. In addition to our standard training, we deliver trainings speci?c to our Family VistasSM model: Cognitive Behavioral Therapy (CBT) Overview an introduction to CBT Child and Adolescent Needs and Assessment (CANS-Trauma Version) CBT Self-Study based on Paul Stallard?s books/preparation for Core Model Days 1 2 Motivational Interviewing Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) provided by a certi?ed TF-CBT Trainer . The MENTOR Network?s Family VistasSM Core Model Training Relationships and Therapeutic Engagement (RELATE) Curricula - Separation, Loss, and Grief Shared Parenting, Life Books and IMAPP (lndividualize Mentor Assessment Planning Process) 10. Skills Building Training 11. Rules of the Road Training (Intensive Case Management) pm?n Staff duties and performance are reviewed yearly. Training sessions are available on an ongoing basis and are supplemented by staff attendance at professional workshops, conferences, and seminars, as well as required state trainings. The MENTOR Network University (TMNU) provides information about training and professional development opportunities from within The MENTOR Network, including classroom, telephone and web-based modules. We periodically - Page 23 Ol" earn Con'iprehensive Foster Care, CF 5 9.l.A. 11in One and Related Services survey staff to ensure in?service topics maintain relevance to their positions within th organization and their professional growth interests and requirements. All staff members participate in an ?Understanding Diversity? exercise as part of their orientation training. The exercise is taken directly from the Massachusetts Approach to Partnerships in Parenting (MAPP) curriculum. As a group, staff dissect the difference in - de?nitions of Culture, Race, Ethnicity, and Nationality and discuss how those differences play a part in our work with our Mentors, the children/youth in our care, and their families. Staff also discuss how to be culturally sensitive in our work and in our approaches with the families we serve. All staff are properly trained in medication management and are properly licensed as needed. Detailed descriptions of each updated staf?ng positions will be provided to DCF upon request. Staff and Mentors receive training related to crisis intervention and de-escalation techniques. Massachusetts MENTOR does not employ the use of time-outs, restraints, search and seizure, intrusive aversive therapy, or seclusion. Massachusetts MENTOR has a clear, frequently communicated Zero Tolerance policy regarding abuse and neglect. The policy is provided to all Mentors and staff during the application process; is in the Employee Code of Conduct and the Independent Contractor Code of Conduct; is in documentation pr?ovided to Mentors on the prohibition of corporal punishment; during pre- service, orientation, and ongoing training presentations; and during Mentor Re-licensure. Each method of communication requires sign-off from Staff and Mentors to demonstrate their understanding of the material and their agreement to abide by the expectations. ?A?ll incidents or allegations of abuse are immediately reported in accordance with Massachusetts mandated reporter statutes to DCF and the Clinical Supervisor. They are also reported to Program Directors and the Quality Assurance Department, pursuant to our Operating. Practices. The substantiation of any allegation may result in immediate termination of the employee or independent contractor. Our well-established incident management. and investigation system dictates that staff, incollaboration with Risk Management, immediately report any incident that compromises the safety of a consumer, employee, or any individual who comes in contact with consumers. Massachusetts MENTOR completes, transmits, and logs Incident Reports as follows: A. Include a factual recording of events that preceded the incident and constituted the incident as well as the intervention to the incident. Suppositions, opinions, or evaluations about the events and/or individuals involved are not included. Completed Incident Reports are reviewed by the supervisor or operations manager within the timeframes specified for their level of incident or as required by local regulations. A copy of each incident is maintained in a central ?le. Incident Reports are ?led in the individual?s service record as required by DEEC. Copies of reports are forwarded to The MENTOR Network Risk and Litigation Counsel as soon as the report has been reviewed and signed by the appropriate supervisory staff. Incident Reports do not replace Department mandated reports. The Program Director ensures reports are made and staff is familiar with state and local reporting requirements. F. Analyze incident data and implement changes based on ?ndings. F11 il-flassnrii asserts Page 243%? {if 3 i} Comprehensive Foster Care, 5 9.l.A. 1F One and Related Services Our Mentors come to the program for consideration through a variety of recruitment mechanisms, which include, but are not limited to: Newspaper and online/ social media advertisements Customer Relationship Management System (lead generation tool) Radio spots Cable television advertisements Flyers and bulletins Presentations to community groups I Regularly scheduled recruitment events Presentations to houses of worship Mentor or staff referrals Word of mouth Interested candidates attend an orientation session and participate in an extensive screening process that examines the family constellation and type of residence, as well as their motivation for becoming a foster parent. Candidates may be eliminated for a variety of reasons, including: Inadequate housing arrangements Lack of availability to transportation sources Improper family constellation too many children) The revelation of a criminal history or DCF history Scheduling or work commitments that are too rigid or demanding ., Parenting style or practices that are not a good ?t for the children we serve 0 Other personal factors that are inconsistent with Foster Parenting Applicants may also decide they are not interested in pursuing the application process further. Candidates who pass the preliminarily screening complete an Application Packet designed to explore the prospective Mentor?s attitudes about children, understand a typical household day, and provide us with a detailed account of the history of the family. If the completed packet reveals a history consistent with candidacy, a formal home visit and Home Inspection/Health and Safety reviews are undertaken. - The Recruiter conducts a formal home study and makes a rigorous and comprehensive assessment of all adult family members living in the home. This process includes interviewing, evaluating, and assessing the Mentors, their families, and their homes before approving them and ?ling for certi?cation. Family members are questioned regarding their own childhood, their parents, their important relationships, and their satisfaction with life in general. The Recruiter explores family members? feelings regarding children who have been abused and neglected, beliefs about disciplining children, and thoughts about cultural sensitivity. All children living in and outside of the home are extensively interviewed. This comprehensive assessment, done over the course of several visits, culminates in a ?nal report, which recommends the family for a placement or disquali?es them from further consideration. Once a Mentor is certi?ed, we use this information when matching children with Mentors. Page 35 Of 30 rarure_ Comprehensive Foster Care, 5 9.1.A. ,liiC One and Related Services Each member of the Mentor foster family must pass a criminal record background check; an approved BRC, CORI, SORI, and DCF history check; a DEEC daycare check to ensUre the provider does not runa daycare within the home; and an OIG clearance. All individuals over 15 years of age must provide ?ngerprints. The prospective Mentor?s physician must give medical authorization to proceed further with the application process, and the potential Mentor must provide three references. The Program Director and state leadership team do a ?nal review before Mentors are approved. Frequent visitors to the home also require BRC clearance. We provide pre?service and in?service education to all independently contracted Mentors and encourage them to participate in outside educational opportunities whenever possible. Such education ensures thatMentors understand their responsibilities to the program and its participants and that they are fully prepared to respond to the challenges presented by caring children/yOuth in their homes. I Mentors receive 40 hours of pro-service education using MAPP Curriculum, plus ?rst aid and CPR. The pre-service process is designed to familiarize Mentors with our model, policies, and procedures and educate them about the different types of youth involved in the program. The following courses are included in Mentor Training: Introduction to The MENTOR Network - Philosophy and Mission Introductio?n to population served - Expectations and Realities Role of the Mentor Program Policies and Procedures/ Operating Practices Minimum Standards for Foster Family Homes Emergency Procedures Record Keeping and Reporting Requirements Mandated Reporting - Identifying and Preventing Child Abuse/ Sexual Abuse Professional Documentation Universal Precautions and Infection Control Cardiopulmonary Resuscitation and First Aid Child/Youth Supervision Community Resources Pharmacology Behavior Management/Positive Approaches Crisis De-escalation, Prevention, Intervention Tutoring the Special Needs Child Understanding Mental Health Issues and its Impact on Families Clients' Rights Fire Safety Grief and Loss for Children in Care The Child in Care's Point of View Family Integration Working with Bio/Extended Families of Children in Care Cultural Competency Needs, and Service Assessment amily Strengthening and Visitation I I .Iiciiassochuseits . Page 26 i1 39 - Comprehensive Foster Care, DCP 5 9i. .A. One and Related Services 0 Special Needs of the TFC Child/Youth (Sexual Abuse Issues, Understanding Emotional Disturbance, Medication Management, Educational Vocational needs, EffeCts of Emotional Deprivation of Children) Team and Group Approach Partnership Principles Parenting Techniques I Foster Family Strengthening Understanding Allegations of Abuse/Neglect and the Reporting Process Building Positive Relationships and Interpersonal Helping Skills Stress Management A Categories of-Foster Care and Process/Policies of Changing Categories HIPPA Mentors also receive RELATEeRelationships and Therapeutic Engagementw?training, a relationship-based, trauma informed, active approach to working with children who have experienced separation, loss, and trauma. They receive education in non-violent crisis intervention because Massachusetts MENTOR does not use physical restraints. They receive individualized, one?on?one sessions provided by our staff regarding each placement that is made in their home, including additional education on diagnosis, intervention techniques, crisis prevention, and crisis response strategies. Additional Family VistasSM training includes Family VistasSM Core Model; Skills Building; Shared Parenting; and Separation, Loss, and Grief. Mentors attend a Support Group Meeting where they also receive additional skill development sessions related to Behavioral Interventions, Natural Supports, and Skill?Building Techniques. The Massachusetts MENTOR team makes frequent training needs assessments and curricula accordingly to ensure topics have relevance for Mentors. Reassessments ensure that we disseminate the most current thinking for all topical areas. Program Standards Operations C. Describe the current quality review processes of programs and Operations, including the evaluation coniponent and any related improvement activities. .[f'rhe organization does not yet have a review process in place, describe the Strategies and chl?ivz'fz'es you will use to institute the practice throughout the organization. Massachusetts MENTOR monitors quality of care througha comprehensive system that focuses on continuous quality improvement. Program data is retrieved at least and is evaluated by the Program Director, Quality Assurance Director, Executive Director, and the leadership team according to'our "Continuous Quality Improvement Plan.? The following focus areas receive the Manager?s constant attention: Careful monitoring 'of planned versus unplanned discharges. Weekly monitoring of service pians, including the degree of the youth?s goal attainment. ?Weeklv monitoring and tracking of home visits to ensure the safety of the children. Assessment of child/youth and families and purchaser satisfaction, as indicated by analysis of responses from children, youth, and their families and referral sources through the use of satisfaction surveys. Weeklv Peer Reviews assessing the appropriateness of the youth?s diagnoses, completeness of client records, and implementation of the support plan. 0 I 1H arse eh use its Page '27 of C?on'iprehensive Foster Care, CFC 5 IFC {inc and Related Services 0 Monthiv "Utilization Reviews assessing the allocation of program reSources in relation-to the youth?s needs, with the goal of moving each participant to the least intensive level of care appropriate to his or her clinical status. 0 Safetv issues and infection Control Reviews monitoring status of homes and program of?ces to ensure safety. 0 Program Evaluation and Outcome Analyses assessing the quality of program services and measureing outcomes from services. This ongoing activity is regularly undertaken with assistance from the corporate of?ce. Training/Risk Managements assessing incidents and providing related training'resources to direct service and administrative staff. 0 Core Quality Assurance Processes: 0 Internal Audits monitoring program compliance with both internal operating practices and standards and with external requirements and contract obligations. 0 Quality of Care Reviews utilizing the framework of our Quality of Care Standards, Protocols and Guidelines, Health and Safety Assessments, Best Practices, and Preferred ProCedures. 0 Risk Management and Incident Reporting Procedures identifying, evaluating, and reducing the risks childrenjyouth in care are exposed to. 0 Network Performance Audits reviewing key performance indicators to monitor compliance with internal and external requirements and contractual obligations for billing, quality and Mentor (foster parent) credentialing, and testing that billing is properly supported by authorizations and documentation. 0 Orientation and Training resources provided through our Training Resource Library, intranet materials, and technical assistance and consultation of our expertise. 0 Systems Analysis, Design, and Improvement assessing need and effectiveness of systems, identifying areas for improvement, providing technical assistance and support, and assessing effectiveness of interventions. - investigations conducting internal investigations of critical incidents, reports of non- compliance with internal or external standards, and other activities related to client safety and identifying technical assistance and quality improvement strategies related to ?ndings of investigations. i 0 Survevs facilitating children/youth and family satisfaction on a regular basis. 0 Comnliance: Massachusetts MENTOR operates in compliance with our high internal operating standards in addition to the applicable federal, state and local regulations that govern business practices and the provision of high quality Services. The program evaluation plan is available to the Department at their request. We cooperate with DCF contract reviews and compliance and will provide access to documentation and a suitable temporary work space as needed. We have developed a comprehensive Compliance Program that serves to prevent unwanted events from happening and conveys expectations and education to all employees and independent contractors so they can comply with organizational standards and our expectations for ethical practices. The Compliance Program is made up of the following components: A-fasmciiusetts Page 28 of 30 Comprehensive Foster Care, DCF CFCIS 9.1. .A. IFC One and Related Services 1. Code of Conduct consisting of a statement of values and'ethics and a guide to day-to-day business practices. 1 2. Compliance Plan Handbook with an outline of the Compliance Program. Compiiance Hotline toll?free, anonymous number operating 24/7 365 days a year. 4. Home Visit Compliance Protocols to ensure all home visits are performed and documented. 4 U.) Performance and quality improvement activities are everybOdy?s responsibility and are integrated in all tasks. Benchmarks and standards are de?ned as part of the training process, supervision, or subsequent memorandum from leadership. Quantitative and qualitative information and data is measured against previously defined expectations or benchmarks. Family Resource Workers take notes on the Mentor and the Mentor?s home during their visit, and provide yearly re-licensing activities for the Mentors. Mentors go througha recerti?cation process every year. In conjunction with our leadership and quality assurance teams, the Family Resource Worker provides 100% Mentor reviews of all Mentor homes annually, which includes a review of the physical ?le, compliance on Virtual Gateway, and relevant clinical considerations. Massachusetts currently provides very good placement stability?the average number of placements experienced by youth placed by Massachusetts MENTOR between July 2013 and June 2014 is 1.3. We constantly strive to improve our services and are in the process of implementing Family VistasSM in the state and will be completely implementing in communication with DCF. Mentors receive more intensive training and signi?cant increases in - petite support they receive from the staff and their peers with Family VistasSM. The following outcomes from Massachusetts sister agency, MENTOR, demonstrate that children receiving Family VistasSM during 2013 and 2014 showed significant improvements. 0 21% increase in placement stability. In the year after implementing Family VistasSM, 95% of children remained in placement in one or two homes. In the year prior to implementation, 74% of children remained in placement with or 2 homes. 0 15% increase in positive discharges. In the year after implementing Family VistasSM, 72% of participating children had positive discharge. In the year prior to implementation, 57% had positive discharges?a 15% increase. A 0 54% less reportable incidents. In the year after implementing Family VistasSM, our operation had a 54% decrease in critical incidents, which is strongly A believed to be a result of the enhanced skill of our staff and Mentors in serving children and youth with histories of trauma. Program Standards Operations D. Indicate tharyonr organimlirm meets the I 7 requirements. [fit does not. describe the steps your organization will take ensure it does and the expected time rams to meet these requirements. Massachusetts MENTOR currently meets the IT requirements for this contract and is currently using the Virtual Gateway system. I Page 29 of Bi} Comprehensive Foster Care, DCF CFCI 5 One and Related Services Fragrant Standards d2 Clearances E. Describe the oversight and svsrems to be employed that will ensure approval requests are adequately and appropriately documented endure submitted timely; and that no placements will occur prior fofinal approval. Placements do not occur without ?nal approval from DCF. One of the Family Resource Worker roles is ensuring the approval process is handled for all events, including relicensing and service referrals and making sure all of our billing information is handled properly. All approval requests are discussed during clinical reviews and are reviewed and signed by the Executive Director. Fragrant Standards a {?nerzn?lens F. Describe how the organization will ensure compliance with receipt and disbursement of'otl'zer payment (was; quarterly clothing, annual holiday and birthday payments. emergencv clothing and personal needs disbursements. Funds are received from DCF both by check and by direct deposit (i?Stream). DCF does not automatically send details (by client, by type of funds) supporting the remittance with the electronic transfer. The backup sent by DCF is received through the mail and the Accounts Receivables (AR) Coordinator identi?es the funds and categories then enters the details and the remittances into our records. Examples of codings include, but are not limited to, birthday grants (received during the month of a child/youth?s birthday), quarterly clothing allowance, holiday bonus grant (issued once a year to any child that appears in a D88 placement on December 25), and other needs. The amount is then diSpersed to the Mentor (foster parent) through their paycheck. The Child Worker and Family Resource Worker verify with the child/youth and Mentor that the money has been received and was used as per the DCF requirements. use its t. Page 3i}! of3l3 DEPARTMENT OF - - RFR Title: COMPREHENSIVE FOSTER CARE RFR Number: DCF TITLE PAGE Please use this title page for each program service model ub_mis if Agency Name: Massachusetts Mentor, LLC. "Program Contact: Paul Cataldo Program Telephone Number: (781) 320-7600 Program Email Address: Comprehensive Foster Care Check One (complete a separate form for each program) One and Related Services IFC Child Home?Based Rehabilitation IFC Emergency Shelter Multiple Acute Level A 8; IFC Transitions to Adulthood FRFC Family Residential FRFC Complex Foster Care Medical Check Statewide, Regions andlor Areas that the proposed program is able to serve: E?statewwe eglon?wr . I El Region?Wide El Pitts?eld El Lowell El Arlington - [l Hyde Park El Green?eld El [3 Coastal. . El Dimock street - El Holyoke Haverhill [3 Cape Islands El Park Street El Spring?eld Cape Ann [1 Plymouth Harbor 55- l] Robert Van Wart Center [3 Lawrence. Fall River North Central Maiden New Bedford l] S. Central/Blackstone - - Valley [1 Cambridge Brockton Worcester East El F'ramingham l] Taunton/Attleboro El Worcester West Current State Purchasers Is this program currently being purchased by is this program currently being purchased by other state entities? LL 1- List entities . A ??rh?r 3515-. - 5 'PauiCataldo Segtember29,2014 Signature of Authorized Representative Name (printed) Date Comprehensive Foster Care, CFC 5 93$. Emergency Shelter Homes Service Model 9.1.C. EMERGENCY SHELTER HOMES SERVICE MODEL Emergencv Shelter Service Model A. Describe the sla?lls and trainings that the organization will require ofz'z?s program staffand?asfer parents to appropriately support this speci?c population ofplaced adults. . Massachusetts MENTOR, LLC provides pre?service orientation and opportunities for staff to attend releVant outside training and professional CEU training at no cost to the employee. This ensures that staff understand their responsibilities to program participants and results in personal and professional staff development, which correlates with retention of motivated, quali?ed employees and individual job satisfaction. Emergency Shelter staff receive all IF One training as well as training on conducting emergency intakes and placements with the limited information often available for Emergency placements. Staff are trained to be sensitive to the needs of children being placed in emergency situations and discuss how to be culturally sensitive in our work and in our approaches with the families we serve. As a group staff dissect the difference in de?nitions of Culture, Race, Ethnicity and Nationality and consider how those differences play a part in our work with our Mentors, our censumers and 1 their families. All staff and Mentors (foster parents) participate in an ?Understanding Diversity? exercise from the MAPP curriculum. Staff and Mentors receive training on verbal de-escalation techniques to useduring crisis situationsmMassachusetts MENTOR policy is to not use restraints. Emergency Shelter Mentors and staff receive'short-term speci?c training emphasizing sudden loss and trauma, working with a child on a short-term basis, and helping a child adapt to sudden life changes. They learn about grief and loss from the child in care?s point of View and =enderstanding mental health issues and its impacts on family. Education ensures that Mentors understand their responsibilities to the program and the children/youth who need emergency/same day placements. We provide pre-service education using the MAPP curriculum to familiarize them with our model, policies, and procedures and?to educate them about the?different types of youth involved in the program. Mentors receive training on trauma informed relationships. Research increasingly con?rms the effects of trauma on healthy development, so we assess and address the trauma history of children and youth in our program. Mentors learn the minimum standards for foster family homes as well as record keeping and professional documentation. They receive ?rst aid and CPR training as well as universal precautions, infection control, ?re safety, and pharmacology. They learn about 18193, reuni?cation, concurrent planning, and permanency as well as team and group approach and partnership principles. Mentors are trained on mandatory reporting laws-and identifying/preventing child and sexual abuse. They learn. the Allegations of Abuse/Neglect, Reporting Process, categories of foster care, and Process/Policies of Changing Categories. They learn behavior management and positive approaches for situations and are trained in crisis de?escalation, prevention, and intervention. Mentors learn about family strengthening, visitations, and positive parenting techniques. During crisis, children/youth need stability. Mentors are trained in family integration and working with the family of origin, family strengthening, and building positive relationships and interpersonal rlxlossoclt itsetts . Page 0i it ?sinprehensive Foster Care, CFC 9&3. Emergency Shelter Homes Service Model skills. When available, special training regarding the child/youth placed in their care is provided to Mentors, but information on Emergency Shelter placement needs are not always ayailable. Mentors are trained to work with the Child Worker to assess the child/youth?s needs. Mentors learn the child/youth?s rights and advocate for their care. They work with community resources to assist the child/youth and are trained to access a variety of resources including social services agencies, mental health programs, medical professionals, educational needs, and recreational activities. They learn to supervise children and youth and to work with special needs children sexual abuse issues, understanding emotional disturbance, medication management, educational and vocational needs, and the effects of emotional deprivation). Only experienced foster parents are trained to become Emergency Shelter Services Mentors. Emergency Shelter Mentors learn about stress management for themselves and for the child/youth in their care. They attend a Support Group Meeting where they receive additional skill development sessions related to Behavioral Interventions, Natural Supports, and Skill-Building Techniques. The Massachusetts MENTOR team makes frequent training needs assessments and revises curricula accordingly to ensure topics have relevance for Mentors. Reassessments ensure that the team disseminates the most current thinking for all topical areas. Emergency: Shaker Seneca Merle! B. Describe the treatment model that will be medic benefit this particular placed population and supports all 7 characteristics listed in the Backgn?ound within Section 8, (page 1 third paragraph ofthe program speci?cations) will; particular emphasis on theprz?mzples chl'zz'ld/jlozrrh guided andfamz?ly centered care; [lint is trauma informed employing positive behavioral supports and interwar/trims. Massachusetts MENTOR is fully committed to helping children and families within the communities they live. We offer children and their families innovative, quality services and supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. Children being placed in Emergency Shelter homes are experiencing immediate trauma. Foster parents, who we call Mentors, are trained to work with the child and to provide contact with the family of origin, as deemed appropriate by DCF. Children in the Emergency Shelter program are supported with individualized care that values the role of families and communities in the treatment process, and we actively collaborate with referring and collateral agencies to ensurelthat children and youth are part of a comprehensive continuum of safe care. Our Emergency Shelter services are: 0 Individualized: Providing successful, child/youth-guided and family-centered services begins with engaging children and families as key decision-makers in the process. Our services include a profound belief that children and families can?and do?recover from emotional and behavioral challenges. We believe strongly in the resiliency of the youth and families we serve. Resilience theory instructs us that children?and families have the capacity to overcome adversity when they have access to others who support and believe in them and provide the necessary resourCes to succeed and thrive. Children/youth often enter the Emergency Shelter program with little or no pro?les, so staff and Mentors work with DCF to provide services and assessments for each individual child/youth. 0 Family Focused: Today?s families face complex issues. We meet their needs in practical ways that are meaningful to them. We engage families and other people and relationships signi?cant in the child/youth?s life as part of the therapeutic process to reflect the family?s llflassnelmseits Page 2 Oi? 5 Comprehensive Foster Care, CFCES 9.1.0 Emergency Shelter Homes Service Model voice, beliefs, and culture. We sucCessfully engage the most challenging families in an effort to empower their voice. We provide skill development and behavioral and community support services, including respite care, to families and program participants. No two families are alike?we address each family?s unique needs to ensure that foster and families of origin are involved during all stages of the decision?making process. 0 filtrene= tins~l?ased: Our services center around the child?s abilities, and skills. Our program is rooted in the use of positive, strength-based approaches that promote hope, rather than a focus on de?cits, challenges, and barriers towards reaching goals. Our initial Emergency Shelter assessment process begins with the child/youth?s 0 Collaborative and integrated: We provide community-based care in collaboration with other providers and'community resources. Our philosophy of integrating a variety of services to strengthen the lives of the children and their families is infused into everything we do. It is even included. in training. Some of ourcommunity partnerships include school systems, mental health service providers, recreational and sports activities, and social groups within the region. We work with the child?s current school to provide some consistency and stability in their lives. 0 Evidence?Based and Trauma informed: Massachusetts MENTOR has been providing treatment foster care in the state of Massachusetts for more than three decades and is in the process of implementing our evidence?informed Family VistasSM service model, which we developed as part of our ongoing, innovative commitment to continuous quality improvement. Family VistasSM is grounded in Trauma Focused Cognitive Behavioral Therapy?s (TF-CBT) evidence-informed treatment. It also includes other evidence based interventions including Motivational Interviewing and Shared Parenting. - Culturally Responsive: Massachusetts MENTOR staff and Mentors reflect the cultural backgrounds of the children and families we serve. We recruit within the areas we serve and employ a culturally diverse workforce. All staff are trained to deliver culturally competent services. Children for whom English is not their primary language are matched with bilingual staff and Mentors who speak their native language. 0 Focus on Continuous Improvement: Quality assurance activities evaluate the services we provide through weekly, quarterly mechanisms; documentation; and surveys, including Utilization Reviews, Satisfaction Surveys, Program Audits, and Program Outcomes. We use individual and programmatic data to drive improvement of our services to be more responsive to the needs of the youth and families we serve. Emergency; Shelter Service Model C. Describe how the organization will meet all additional req?zrz?remem's of this service model. Response should address the bullets in Section Massachusetts MENTOR staff meet with Emergency Shelter Mentors (foster parents) in the home at least once a week and participate in 72 hour and 30 day meetings and 14 day placement reviews organized by the Lead Agency, which may include the child/youth?sparent/primary caregiver, our'staff, Mentors, and the child/youth and are typically held in the BOP Area Of?ce. These meetings generally focus on reviewing the placement and progress in meeting treatment plan goals and discharge planning, which is truncated due to the limited time of the placement. Our staff and Mentors ensure the child/youth receives immediate medical assistance. They ensure that children receive the proper assistance from social services agencies, mental health programs, medical professionals, and other community supports. Mentors arrange for medical usetts Page 3 Oi" f; Comprehensive Foster Care, CPU 5 9. .l .C. Emergency Shelter Homes Serviee Model and dental treatment within seven days of the child/youth being placed in their home and they schedule a comprehensive exam within 30 calendar days after placement. When applicable, the Mentor or Massachusetts MENTOR staff stay with the child/youth during the medical and dental appointments. Staff and Mentors maintain positive relationships within the community and facilitate continued placement in the school of origin. Our staff have ?exible schedules and can meet in the Mentor?s home on the weekends and/Orin the evenings as necessary to stabilize the child/youth as quickly as possible. Staff and Mentors work together to maintain and support continued community care services. Massachusetts MENTOR guarantees that we will maintain the minimum number of homes, established at contract negotiations, available to accept placements at all times. Referrals will be managed at the DCF regional of?ce and authorized/approved by DCF or Lead Agency staff. DCF staff approved to authorize this service will be identi?ed during contract negotiations. We place Emergency Shelter children and youth on the day we receive the referral. Placements in Emergency Shelter homes do not exceed 45 days, and Mentors commit to being available for the child/youth for the entire duration of their stay. Massachusetts MENTOR staff and Mentors know that the nature of Emergency Shelter Services means that most placements will occur without pre?placement visits, there may be limited background information, and pro?les may not be completed when the child/youth is placed. Mentors providing Emergency Shelter are trained on issues speci?c to short term placements (grief and loss, multiple transitions, crisis management, trauma related behaviors and interventions). They routinely address crisis conditions appropriately and react professionally to the emergency nature of the work. They are experienced foster care providers who meet the needs of the child/youth, usually with limited background information on the child/youth. Mentors are aware that children and youth need stability in their lives. They are trained and recruited speci?cally for this program and do not previde services for any other IFC models at the same time. If an Emergency Shelter placement becomes longer-term because of matching and compatibility, the home is removed from our Emergency Shelter listing and changed to the appropriate listing. If the change results in our moving below our minimum number of Emergency Shelter homes, a new Emergency Shelter home is recruited. Emergency Shelter Mentors understand that this is a short-term model and commit to being available for the child/youth for the entire duration of their stay and agree not to request a move. Emergency Shelter Mentors only work outside the home if they have a co?Mentor in the home so that at least one Mentor is available to the child/youth at all times. Mentors who work outside the home have an approved work plan on ?le at Massachusetts MENTOR. Mentors interact with the child. When they identify a need for evaluation, they work with Massachusetts MENTOR staff, DCF staff, and families of origin (when appropriate) to plan and participate in child assessments and goals. They work with teachers to assist in the educational- ij'age 4i of f5 Comprehensive Foster Care, DCF 9.1.0 Emergency Shelter Homes Service Model needs of the child and maintain relationships with the child?s school by ensuring the child attends school or other daytime programs. Mentors help the child/youth in their care with homework and are available to the school if behavioral or academic issues occur. Mentors do not provide in-home child care or other services to children or adults. A Massachusetts MENTOR ensures that the recreational/incidental needs of the children placed through Emergency Shelter are met. We will access SSI funds as needed for any special services indicated in the youth?s treatment plan. We understand that Incidental Purchase Set?Aside funds are not included in the rate for Emergency Shelter. Emergency! Shelter Serrieeliferlel How will the orgmiizetion parent support each placement so that no disruptions occur throughout the potential .45 days of placement. Mentors in the Emergency Shelter Program have access to all the services and supports available to IFC One foster parents, including Mentor Support Workers, Mentor Coaches, and 24 hour on call support; They are also offered speci?c support and trainings and support groups, which avoids disruptions in this time limited program. The Family/Treatment Team works to ensure appropriate matches are made between Mentors and youth. Family Resource Workers monitor Mentor homes and coordinate with families and DOE staff to ensure child and family satisfaction and home stability. Mentors approved to provide Emergency Shelter are experienced providers who are familiar with the short term nature of this model. Mentors who provide this service will have one stay-at-home provider to ensure that someone is available to the youth at all times. Staff working with these homes will provide :the necessary support to ensure the stability of the placement throughout the 45 days. We make every effort to recruit and select a staff and Mentors who re?ect the ethnic, racial, religious, and linguistic diversity of the children/youth being served. Mentors have diverse social and ethnic backgrounds, levels of education, interests, and communities of origin. They originate from urban, suburban, and rural neighborhoods and come to the pro gram through a variety of recruitment mechanisms, including newspaper ads and recommendations from other Mentors or staff members. Children/youth are matched with Mentors who speak their native language whenever possible, and translating/interpreting services are arranged when needed. Special consideration is given to the composition of the Mentor family. The number of children in the home, their ages, gender, stage of development and vulnerability will be evaluated in light of the child?s level of functioning and ability to relate to other people. Eiriereenev Shelter Service .Medel E. Describe the recruitment efforts and strategies that will be employed to maintain agreed upon capacity. . Massachusetts MENTOR employs a variety of Mentor (foster parent) recruitment strategies, including word of mouth,'newspaper ads, online postings, and provider fairs. Screening includes . a formal application, reference checks, multiple interviews, and home visits, and medical and background checks on all household members. Emergency Shelter Services Mentors are selected from experienced providers; if an Emergency Shelter Services Mentor transitions to a longer- term pro gram, we review our current iong term Mentor base for a Mentor who is appropriate for training and offering services in this program. it?! (Israeli usetts - DEPARTMENT OF CHILDREN AND FAMILIES, . RFR Title: COMPREHENSIVE FOSTER CARE Number: DCF. TITLE PAGE 5 . Please use this title page for each program service model Ssion Date: October 1, 2014 ?Agency Name: Massachusetts Mentor, LLC. Program Contact: Paui Cataldo- Program Telephone Number: (781) 320-7600 Program Email Address: Comprehensive Foster Care Check One (complete a separate form for each program) IFC One and Related Services IFC Child Home?Based Rehabilitation IFC Emergency Shelter . IFC Multiple Acute Level A Transitions to Adulthood FRFC Family Residential FRFC Cemplex Foster Care Medical . Check Statewide, Regions andior Areas that the proposed program is able to senile: a 7 El Reglon?WIde Reglorl-WIde El Region?wide El Regionuwide El Pitts?eld? a - El Lowell l:l Arlington . Hyde Park [3 Greenfield El Coastal l3 Dimock Street Holyoke Haverhill . . El Cape Islands El Park Street Spring?eld . D_Cape Ann El Plymouth A El Harbor fl Robert Van wart Center El Lawrence [Zl Fall River North Central :1 Maiden a New Bedford El 8. Central/Blackstone . Valley - Cambridge [1 Brockton El worcester East Framingham [l Taunton/A?leboro El Worcester West amt Current State Purchasers is this programcurrently being purchased by is this program currently being purchased by'other state entities? List entities r; . '42Paul Cataldo September 29, 2014 Signature of Authorized Representative - Name (printed) Date Comprehensive Foster Care, DCF CFC 5 9. LE. Transitions to Adulthood Service Model 9.1.E. TRANSITIONS TO ADULTHOOD SERVICE MODEL Transitions to Adulthood Service Model A. Describe the skills and nail/rings that the organization will require ofz'ts program s'ftrfi'aml?mrer parents to appropriately this specific population ofplaceclyoart?ltfi?oung adults. - Massachusetts MENTOR provides pre-service orientation to all staff, and we provide opportunities for staff to attend relevant outside training and professional CEU training at no cost to the employee. This ensures that staff understand their responsibilities to the program and participants and results in personal and professional development of the staff?all circumstances that correlate with individual job satisfaction and the retention of motivated, quali?ed employees. In addition to the training provided to all One staff, Transitions to Adulthood staff receive specialized training on coaching and modeling basic living skills for youth in daymto?day activities; setting up experiential learning situations to allow youth to develop basic living skills and try them out; developing plans with youth for how they Will handle daily tasks, such as managing their own medication, budgeting, managing a household, cooking, accessing formal and informal support systems, preparing for emergencies, ?rst aid, and any needs unique to the individual youth. They are also trained in effectively communicating information and skill- building to the. youth and young adults in the Transitional Living program. Transitions to Adulthood Mentors are recruited based on their ability to serve as good adult role models for the young adults in the program. We provide pre?service and in-service education to all Mentors and encourage them to participate in outside educational opportunities so they understand their responsibilities to the program and its participants and are fully prepared to respond to the challenges presented. Mandatory pre?service education for Transitions to "A?dulthood Mentors is a minimum of 40 hours in duration. The mandatory MAPP curriculum is usually done in a series of three-to four-hour meetings. The pre-service orientation process familiarizes the Transitions to Adulthood Mentor with our model, philosophies, policies, and procedures and educates them about the different types of yOuth' involved in the program. They learn about stress management and MAPP curriculum, are introduced to the Transitions to Adulthood service model; and learn program policies and procedures, minimum standards for foster family homes, record keeping and reporting requirements, and professional documentation. Mentors learn about Mandated Reporting Identifying and Preventing Child Abuse/ Sexual Abuse; universal precautions and infection control; CPR and first aid; pharmacology; ?re safety; and emergency procedures. They learn about grief and loss from the youth/young adults point of view and are taught to understanding allegations of abuse/neglect and the reporting process. MentOrs receive training in understanding diversity. We recruit Mentors who believe in our family-centered approach and train them to understand mental health issues and its impact on families; youth supervision; family integration?working with families of origin; the family?s role in the treatment team; family strengthening and visitation; parenting techniques; foster family strengthening (matching, non?transitions to adulthood siblings? needs and services). 7 Mentorslearn about the special needs of the Transitions to Adulthood Youth/Young Adults, including preparing for independence, human sexuality, sexual abuse issues, safer sex, understanding emotional disturbance, self-administration of medication, medication management, ili'iassuclluseizfs Page i Oi? 5 Comprehensive Foster Care, 9.l.E. Transitions to Adulthood Service Model and educational and vocational needs. They are trained in accessing community resources and client rights as well as behavior management/positive approaches and crisis de-escalation, prevention, and intervention. They learn about needs, and service assessment. Mentors are trained in building positive relationships and interpersonal helping skills. Transitions to Adulthood Mentors receive special training in the Preparing Adolescents for Young Adulthood (PAYA) curriculum. They participate in at least 20 hours of in-service training on an annual basis. We make frequent training needs assessments and revise curricula accordingly to ensure topics remain relevant to the Transitions to Adulthood Mentors and that we disseminate'the most current thinking with respect to all topic areas. Transitions to Adulthood Service Model B. Describe the treatment model that will he used to bene?t this particular placedpopularton and supports all 7 characteristics listed in the Background within Section 8, (page third paragraph ofthe program speci?cations) with particular emphasis on. the (y?hetng child/)muth guided ondfamtly centered care; that is responsive to ?3 unique needs. Massachusetts Transitions to Adulthood program is designed to give each youth and young adult support and guidance over time so they can make a smooth transition to independence in the community and achieve independence with supervision and support thus increasing their chances of success. Program goals are to build the youth?s basic living skills in preparation for eventual independence and self-suf?ciency and to work on employment, teach the youth employment skills for both ?nding work and keeping a job, money management, banking, transportation resources, tax obligations, and other sets of knowledge, skills, and abilities they will encounteras they begin moving into independence and self-suf?ciency. Our ?program focuses on equipping youth and young adults, ages 16 to 22, with a solid skill set to . enable them to achieve successful, sustained independent living. Youth/young adults in our program are either in school, working, or participating in a day program. Our services are: 0 Individualized: Providing successful, youth-guided and family-centered services begins with engaging youth and families as key decision-makers in the process. We believe youth and families are resilient and can?and do?recover from emotional and behavioral challenges. Resilience theory instructs us that youth and families have the capacity to overcome adversity when they have access to others who support and believ in them and provide the necessary resources to succeed and thrive. 0 "Family Focused: Families face complex issues. We meet their needs in practical ways that are meaningful to them. We engage families and other people and relationships signi?cant in the youth?s life as part of the therapeutic process to re?ect the family?s voice, beliefs, and culture. We successfully engage the most challenging families in an effort to empower their voice. We provide skill development and behavioral and community support services, including respite care, to families and program participants. No two families are alike?we address each family?s unique needs to ensure that foster and families of origin are involved during all stages of the decision-making process. 0 Our services center around the youth?s abilities, and skills. Our program is rooted in the use of positive, strength-based approaches that promote hope, rather than a focus on de?cits, challenges, and barriers towards reaching goals. Our initial assessment process begins with the youth/young adult?s Page?: 2 Oil 5 Comprehensive Foster Care, DCF 9. Transitions to Adultheod Service Model 0 Collaborative and Integrated: We provide community-based care in collaboration with other providers and community resources. Our philosophy of integrating a variety of services to strengthen the lives of the youth and their families is infused into everything we do. Some of our community partnerships include school systems, mental health service providers, recreational and sports. activities, and social groups Within the region. Evidence?Based and Trauma Informed: We have been providing treatment foster care in the state for over thirty years and are implementing our evidence-informed Family VistasSM model, which we developed as part of our ongoing, innovative commitment to continuous improvement. Family VistasSM is grounded in Trauma Focused Cognitive Behavioral Therapy?s evidence-informed treatment and includes other evidence based interventions including Motivational Interviewing and Shared Parenting. . 0 Culturallv Responsive: Massachusetts MENTOR staff and Mentors re?ect the cultural backgrounds of the youth and families we serve. We recruit Within the areas we serve and employ a culturally diverse workforce. All staff are trained to deliver culturally competent services. Youths for whom English is not their primary language are matched with bilingual staff and Mentors who speak their native language. 0 Focus on Continuous Inmrevement: We evaluate our services through weekly, quarterly mechanisms, documentation, and surveys, including Utilization Reviews, Satisfaction Surveys, Program Audits, and Program Outcomes. Individual and programmatic data drive improvement of our services. Massachusetts MENTOR staff are well-versed in basic living skills acquisition, permanency planning, supports for academic success, and community?based care and services, all of which are critical components of successful Transitions to Adulthood programming. We use the PAYA teaching model and train Transitions to Adulthood Mentors in the special skills required to serve - this population and to produce the best outcomes possible. A registered nurse is available to assist with medication management. Support staff for the Transitions to Adulthood model includes the availability of a Licensed Independent Clinical Social Worker (LICSW) and a Licensed Social Worker (LSW). Youth/yOung adults in the program are Supported with these resources as they learn to access community and medical supports and as they transition to independence and handling their own medication management. Transitiuns to Adultiwrm Service Mule! C. Describe how the organization will meet all additional requirements aft/11's service model. Response should address flu-3 bullets in Section 8. .1 Massachusetts Transitions to Adulthood services provide a safe, stable, and home- like setting for youth and young adults to live in while participating in a comprehensive curriculum designed to increase their capacity to care forthemselves. only one youth .is assigned to each Mentor home with exceptions being made on a case-by-case basis. Program staff use the Youth Readiness Assessment tool and update it regularly With the youth/young adult. staff meet with the young adult at least twice a month andare trained on independent living coaching skills and how to effectively communicate information and skill-building to the young adult- They are trained in our family-centric approach and supporting relationships with both the llriasserluiselts Page 3 (if 5 MM Comprehensive Foster Care, DCF CFC 5 9.1 ?Transitions to Adulthood Service Model foster family and the family of origin and have special training on helping youth develop daily living skills, including cooking and nutritional information and working to set goals. Transitions to Adulthood Youth/Young Adult Workers spend an average of six hours per week working with the young adult in achieving permanency goals, including but not limited to job and acquisition, budgeting, preparing for college or training programs, obtaining a driver?s license, and other tasks needed for managing their future household. These activities 7 help youth/young adults to lead self-suf?cient, health, productive, and responsible adult lives. Staff and Mentors use the Youth Readiness Assessment tool and update it regularly with the youth/young adult. Massachusetts Transitions to Adulthood model focuses on empowering participating youth/young adults by providing the skills and resources needed to effectively and independently care for themselves once they are no longer in placement. Youth and young adults participate in interviews with prospective Mentors and determining the best match. We work to increase each youth?s functional living skills, employment seeking and retention skills, transitional and permanent employment experiences, and enrollment in'functional educational classes, through practice, education, and supervision. As goals are reached, Massachusetts MENTOR staff meet with the youth/young adult to reassess the level of intervention and negotiate the intensity of support with the youth/young adult and her or his Mentor (foster parent). Staff are available to support activities for a transition to adult serving agencies when needed. "Si?aff meet in the Mentor?s home weekly during the first ?ve weeks of placement and thereafter. Mentors know they can contact staff if necessary, and we have a 24/7 Crisis Intervention On-call staff who can be contacted if needed. Massachusetts MENTOR staff is well?versed in the critical components of successful Transitions to Adulthood programming. Mentors are trained in basic living skills acquisition, permanency planning, supports for academic success, and community-based care and services. Mentors are trained to use the PAYA teaching model and the special skills required to serve this population and produce the best outcomes possible. Mentors provide transportation assistance that may include assistance in learning to access public transportation. Mentors work with the yOuth/young adult in their home and support their growth towards independence. They help the youth/young adult learn to navigate the adult world by assisting them in reaching out to the community, accessing support services (including medical and ?nancial assistance), and provide a nurturing, caring environment for them to live. Youth/young adults participate in the daily activities in the Mentor?s home, including caring for the home, preparing meals, and sharing in family discussions. A Mentors are committed to the youth/young adult in their home until their transition to independence is complete. At their request, young adults discharged from the program can attend regularly scheduled meetings and trainings to support their continued success. assuehusett, Page ii {If 5 Comprehensive Foster Care, CFC 5 9.1.E. Transitions to Adulthood Service Model Mentors do not work outside the home more than 40 hours a week. They need an approved work plan to ensure evening availability and that at least one Mentor is at home during overnight hours. Mentors do not provide in?home childcare or other services to children/ adults within their home. Massachusetts MENTOR ensures that the recreational/incidental needs of the young adults placed through the Transitions to Adulthood services are met. We will access 381 funds as needed for special services indicated in the youth?s treatment plan. We understand that Incidental Purchase Set-Aside funds are not included in the rate for Transitions to Adulthood services. Transitions to Adulthood Service Mlodel D. How will the organization andfost'er parents S?Llpporf each placement so that no occur throughout the placement? Mentors in the Transitions to Adulthood Program have access to all the services and supports availableto IFC. One foster parents, including Mentor Support Workers, Mentor Coaches, and 24 hour on call support. Additionally, Transition to Adulthood Mentor-s are offered speci?c support and trainings through in-house trainings and support groups. 7 As part of the empowerment process, youth and young adults participate-in interviews with prospective Mentors and determining the best match for them. Family Resource Workers monitor Mentor homes, provide services consistent with the ISP (Individual Service Plan), and coordinate with families and staff to ensure youth and family satisfaction and stability of the Mentor home. Massachusetts MENTOR considers location, proximity to community and family of origin; Mentor family constellation, skills, abilities, and areas of expertise; proximity to and ability to access community resources, particularly schools; ethnicity, race, culture, religion, and language; and shared special interest when choosing matches for the youth/young to interview as part of the matching process. Transitions to Adulthood Service Model E. Describe the organization ?5 experience in providing services to the young adult and adultpopnlaz?ion; anchor explain any relationships the organization has with adult service providers. Massachusetts MENTOR has been serving the youth/young adult population for over 30 years. We are committed to a team approach inclusive of DCF and the identi?ed adult agency. Our programs are experienced in the process of applying for adult eligibility and securing long term, appropriate services for our transitions population. We work to identify speci?c supports and services IFC youth may be eligible for as adults, including DDS, AFC, DMH and MCB funding sources. Our agency currently services approximately 200 adult individuals from ages 16 to end of life who are af?liated with numerous adult agencies, including DDS, AFC, DMH, and MCB. We are approved providers working With these adult agencies and are currently approved to provide various services including Shared Living, Adult Supplemental Supports, Independent Living, Adultcompanion, and Adult Foster Care. We strive to provide a seamless transition from DCF to the adult service provider and our goal is to maintain the identi?ed IF youth with consistent relationships. We contract with many regions throughout the state to provide adult services to individuals and their families. headliners Page 5 of 5 it, QENTO, - THE COMMONWEALTH on: MASSACHUSETTS DEPARTMENT OF EARLY EDUCAHON AND Deva?- 9mm? - . a. 53?" . . . 2:113; r??g?mmw vi ngram Number: 4904128 License Number: 9016554 In accordance with the provisions of Chapter 150 of the Gena-a! laws; and regulations esbab?shed by the Deparhnent of Early Education and Care, a license is hereby granted to: Umbrella Organization: MaSSachuseus Menmr, Inc. Program Name: "Massachusetts Mentor-Bosgzon Ch?dren's Program Aeress: 280 BRIDGE St $115 201, MA 62025?1759 Condition: Issue date: Expiration date: 1121/ 2016 License printed on 11212014 License: 62017 I Womasz. Weber; Commissioner Please Post: Conspicuously This License is Not Transfer-awe . . 13.6130/2915? ?1 ,1 i COMMONWEALTH 4 . . ?m?L-Pam?z Wm? *1 9013413." ?53?ordaxi?e With 156 85 ?i?l?ehe'i?l?law's} By th? "Deparh?ent o?Ear'hL Education ahd Care,a' license?is hgeby'granfed to: . - I . I'"Adar?sslf' . I, J-w: 'V'Cd?dition1'171112'pi4? .1 ucen's'on'siz'?zla I I I .- mamasL-ngegpommissioner"" Pi?ase-?b?t Co??bibubu'?ly '5 This Licehseis r. . Progiam 7 THE pp. MAssAcHusE-ns DEPARTMENT OF EARLY EDUCATION CARE myL?cen?? Num?e?'sou'dzy In with the provisions ofbh?apter 15D 61" 13mg, 5115 r?gula?o?s established by thebepafhneniz of Early' Education and Care, a license is hereby wanted to: Umbrella Organization's Massachuth Meritor, Ian ProgratnN?me: . Massachu?e?'s MentowNew Bedford . . Address: Samue! Barrie?: Blvd, New Bedford, MA 1227454214 .- Iv COndition: 505' (2) Quali?ca?brf bf Social Wofker? Issue date: 2126/2014 Expiration date: 212512016 - I - License printed an 3/16/2012licensor: SR015 I Please Post Conspicqously . mamasL Weber; Commissioner is Licens?'is' Not transferable- I THE commomw?agm .oF e?aa mgw-Ewmm AND CARE Progra'm I I - License Number: 9014810 In acco'fdanoe with the provisions ofrchaptet 1536f we Genie}?! laws, and reydlatiorisestablished by the Departmenf of Early Edupatiqn and_ Cam, 3 gicenseis?hereby granteq to: . Organizatio?lg .M?ssachusetts Men-tor, the. Prd?ragn Nagging: - Mgssachusetgstentor - witnesth '.Addre$si - - . ms Gnovazsi-srg idyt-wq?c?sraa; MA 616054651 3- - -: 'Is'sqe?at?omas- Lain/ab? Away aisgfa'nver . This Liqeris??is No?t Transf?ra'ble? I 3 117155 Qbmwi?nwEAL?B-H 9? ?ght? Emm?ow mp CARE ?P'ev?n?fatfici?b'??iefn?f ~131gogram License'N?gizbera?d1szz?s?? Iri ?ra??ib?s' of C?ap?r 1.515916 Ge'n?r'aliia'wsg'and rg?ul??ibns ,egtablished?bf?-Ie . qfiEarly Eddaatiqrg'grgd" Cage? licgnseis herg?by gpahtgd to; .. . . . ?ass?c?use?si . .?ilPr?gir?m?Iftamei-f M?SSadhds?tEs . . . . . s?hlm?s??rknb?n MA 02739-233? :chditionr . 1 gig/42.014 I . i i Ex?rationd?te: 2110-315 - Licerg??r: sa?ozls ThisgLicen?e: fat-Not fianSf?fablge" . ?um xgg?t? {Ag?um .a ?ma -. Mr.) 7- 'u . nu 1 ?55 THE COMMONWEALTH or MASSACHUSETTS DEPARTMENT OF EARLY enucn'non AND CARE 09"? L- Swim? . tipengeitn, Qgera?tefester Care Piacen?ient Agency Program Number: 4?04i?5 License Number: 9014811 In acmrdance with the provisions of Chapter 151) of the General laws, and regulations established by the Department of Early Educatign and Care, a license is hereby granted to: Umbrella Organization: Massachusetts Mentor, Inc. Program Name: 'EMassach usetts Mentor - Spring?eld Address: 117 PARK AVE ST 303, SPRINGFIELD, MA 01039?3363 Condition: Issue date: 7 12/ 2013 ExPiration date: 7/ 11/2015 License printed on 8/812013 Licensor:1R001 . . . . Thomas L. Weber; Ar:ng Commissioner Please Post Conspicuously This License is Not Transferable Comprehensive Foster Care, CFCIB Organization. Charts Massachusetts MENTOR CFC Program Level Organization Chart Executive Director QA Director Recruiter ManagesManager Regmml Dirac?)! CFC Training Manager I Virtual Gateway Administyator L. ?a Fragrant Dii?ec?iors Intake Manager i Intake . Coordinator Of?ce - . Manager Program Supervisor 8.111} 1y Resource Walker Fragrant A Recruiter Child I. Worker (mach use its mm Comprehensive Foster Care, Organization Charts Massachusetts MENTOR State Level Organization Chart Executive Direc?mr QA Director Recruiter Manager QA Manager Trainiaag Manager Virtuai Gateway Administramr Regional Director 1 Regional Direct?r Regional Director CFC EDD Behavioral Hea?th Massachus?a?s Mg ENTQ E, . Instructions: (foinpletin? all barts oftnis form is required in orderfor a provider to?be qualified to contract imith Commonwealth Agencies for, seruicesi. :This fund is due annually a brovlder's Uniform Financial and a of the form is to be when . contract with an or I i I . Part I - Bidder?Contractor information BusinessName and Full Address: Massachusetts Mentor, LLC. Narne: Paul Cataldo 0 (781} 320-7606 address? ll - Contractor's SDP Partners SDP Partner?s Company Name Address. Providers that are 500 Certi?ed may not list (Fili in Applicable Lines; Attach additional pages as needed) Committed Expended Amount Check SDP Partner's Certificationis) below in in Prior Fiscal Fiscal Year Year of Business Reiationship, i.e. Explain business [3 M58 wee Ci SDVOBECI Non Pro?t MrwaelIl SDVOBEEI WW Nomi! 1,185.00 $295.00 WBE M/wglj le Non Profit 400.00 520000 MBE WEE wwssij SDVOBEEI WW NonPro?t 27,135.00 $5,000.00 MBE WBE [j M/waeEi WW Non Pro?t 2,106.00 $686.00 MBE was [1 Nonrrora 57,500.00 $18,400.00 MBE WBE . M/w 25,174.00 $0.00 MBE was [3 "Ma?a SDVOBEEI M/w Non Profit 23,205.06 $23,613.50 of P05 21% By signing and submitting this form, you certify that Certi?cation Status has been checked for the above noted SDP Partners and the information provided aboma is correct. Certi?cation Status can be checked on the Supplier Diversity Webpage Date: 3/29 2014 Name: Paul Cataldo Title: Executive Director lsignature: Overall Providers that hoid PCS contracts with Commonwaalth Agencies are required to file a "Supplier Diversity Program (SDP) Form for Purchase of Service each year and upload with their Uniform Financial Report (UFR). This requirement includes bidders who have already been certi?ed as SDO Certified Partners by OSD. Providers that are exempt from UFR ?ling requirements must submit the SDP form when they upload their exemption request. Providers responding to P05 bids posted on COMMBUYS will be directed to submit the most recent copy of their Form for Purchase of Service" with their proposals/quotes. Part I Bidder/Contractorinformation: Business name, Full address, contact name, phone number and email. Part ll - Contractor?s SDP Partners . SDP Partner(s) must be a Women Owned?lWBE), Minority Owned (MBE) or Minority and Woman Owned (MIWBE) Business Enterprise, a Service-Disabled Veteran-Owned Busmess Enterprise (SDVOBE) or Woman Nonpro?t (WNPJ or Minority Nonpro?t (MNP) certified by the Supplier Diversity Of?ce. You must include the partner?s business name and full address. Description of Business Relationship: in this section, the prime Bidder/Contractor must provide a description of the business relationship/arrangement with the $00 Certified Partner. The supplier Diversity Program offers trainings on the SDP Pian requirements. See link below for information on upcoming trainings. Check SDP Partners Certi?cation: Check the appropriate boxles) Fln'anclajjiornmitment: In fourth column, include the amount (as an exact dollar ?gure) your organization is committed to spend with identi?ed SDP partners during the current Fiscal Year. In the ?fth column, enter the amount [as an exact dollar ?gure) that your organization expended with SDP partners during the past fiscal (UFR reporting year). Total commitment is for the organization and not by contract. As an example, for the FY2014 UFR reporting year. the commitment column would include total expenditures anticipated to be made in FY2015. The expended amount would include all expenditures with SDP Certi?ed Partners in FY2014. The total SDP spend will automatically calculate. The total P05 spend amount can be found on the Federal tistingposted by OSD on the provider?s UFR eFiling site. Once this amount is. entered, the percent will automatically calculate. I Resources available to assist Prime?idders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WEE) partners can be found on the Supplier Diversity Program Webpage ov sd - For a complete list of certified vendors refer to: - Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise partners can be found on the Supplier Diversity Of?ce Webgage - The. dates of upcoming SDP trainings can be found on the OSD Training 8: Outreach Webpage. in addition, the SDP Webinar can be located on the Supplier D?versity Erogcam Webpage