Attachment_2-B_Experience_and_Capacity.pdf

Request for Proposal State of Arizona

Solicitation No. Department of Child Safety

BPM003714 Office of Procurement & Contracts 3003 N. Central Ave., 20th Fl.

Description:

Process Improvement Psychological Consultant

Phoenix, AZ 85012

Attachment 2-B

Offeror’s Experience and Capacity

The Offeror is cautioned that it is the Offeror's sole responsibility to submit information related to the evaluation categories and that the State of Arizona is under no obligation to solicit such information if it is not included with the

Offeror's proposal. Failure of the Offeror to submit such information may cause an adverse impact on the evaluation of the Offeror's proposal. It is strongly discouraged for you to copy the Scope of Work in lieu of providing unique responses below.

OFFER MAY BE DETERMINED AS NON-RESPONSIVE IF ALL QUESTIONS ARE NOT ANSWERED FULLY.

Question 1: Describe your experience, including the number of years of experience, history and capability, in providing the Service offered in response to this RFP.

Offeror Response:

I chose a career in psychology after being trained as an intelligence analyst with a specialty in psychological operations in the U.S. Army. I subsequently earned a Bachelor’s degree with a major in psychology in 1986, a Master’s degree with a major in general psychology in 1988, and a PhD with a major in clinical psychology in 1991. I completed an APA-accredited program through the University of North Dakota, as well as an APA-accredited internship through the VA Medical Center in Tucson, Arizona.

I subsequently completed a postdoctoral fellowship in short-term therapy through Biodyne, Inc.

I have been licensed in the State of Arizona since 1991. My license currently is and always has been in good standing. I have been in practice for 30 years. I formed a private practice in 1993, which became an S Corporation in 1997. I have been contracted with CPS/DCS, during which I have been a unit consultant since 1994. I specialize in psychological assessment, which includes intellectual, cognitive, and objective and projective personality assessment. I have extensive experience with child abuse and neglect;

domestic violence; substance abuse; and general mental health, which includes dual-diagnoses and severe mental health conditions. As a Social Security contractor, I also have extensive experience with developmental disabilities, learning, memory, attention/concentration, and organic brain conditions. In addition, I have considerable familiarity with the legal considerations in DCS cases, as well as experience in courtroom testimony.

With 27 years of experience as a CPS/DCS unit psychologist, I have demonstrated history of effective work with cross-functional teams, the ability to develop and maintain professional relationships, and a working knowledge of available services. As a military-trained intelligence analyst, I have excellent analytic skills. My standards reflect precision. It also is notable that I was employed as a teaching assistant for two years, a Master’s level instructor for two years, and trained predoctoral interns and postdoctoral residents for about 15 years.

Question 2: Describe in detail, how you will comply with the General Requirements, as listed in the Scope of Work, both in person and through electronic methods.

Offeror Response:

I will accept all referrals for service upon receipt of a service request from the assigned ADCS contact and provide all services indicated on the service request. I will be responsible for providing the service within the agreed-upon time frame. I will ensure that services, procedures and forms provided are culturally relevant and linguistically appropriate. I will comply with all applicable federal, state, and local statutes, regulations, and policies as may be amended, stipulated herein. I will provide the required service through electronic methods (virtual service), or in person, if essential to the specific service provided, as determined at the discretion of the ADCS.

Question 3: Describe your experience with each of the following:

a. Provision of Unit Psychological Services within a State Child Protection Agency

b. Children and parents in the Child Welfare System

c. Clients with Domestic Violence history

d. Clients with Substance Abuse issues

e. Clients with severe mental illness or cognitive delays

Offeror Response:

A. I believe my primary role is to provide psychological support to the DCS system in general and my assigned units, in particular. My strength is in analysis. My orientation is eclectic. I conceptualize individual dynamics to be the result of biological, temperamental, developmental, personality, cultural, societal, and historical influences. Identification of the primary factors contributing to an individual’s circumstances allows for multi-faceted approaches to resolve issues and diminish risk factors.

From a practical perspective, when I arrive at the building, I walk through my units and greet the workers and supervisors, which gives them the opportunity to direct me to issues that need my attention. I obtain communications present in my mailbox from workers who are not available on-site to meet with me during my allotted hours. I make sure I meet with the workers who have texted, emailed, or otherwise contacted me, in order to address their needs. I am present at scheduled meetings whether in person on-site or by telephone from more remote offices. I do a mid-afternoon walk through to be sure I reach as many people as possible. I make sure all of the work is completed before I leave the site.

When I complete a referral, I read the file, read the referral information prepared by the worker, talk to the worker about the main issues, write questions, and sign the referral. I review psychological evaluations that arrive back to the units when the workers have questions or concerns. If necessary, I send out a request for clarification to the evaluator. I listen to issues and make suggestions for how to resolve issues between the evaluator and the treatment team. For example, the treatment team may decline the evaluator’s recommendation(s) or the they cannot be implemented in the context of the available services.

In these cases, the evaluator can be contacted for comment about the treatment team’s concerns or the worker may arrange a staffing. In cases where the evaluator cannot be reached or does not respond, I have been asked to directly address the issue.

I often have requests for review of the appropriateness of visitation, particularly in cases of severe trauma.

The neuropsychological effects of trauma on the developing brain have indicated emotional reactivity in children exposed to repeated and/or severe trauma. I have provided expert testimony in court a number of times this year on this issue, due to concern about visitation with a severely traumatized child or children.

I also observe visits and in order to assess the child to determine whether visits result in further trauma.

In addition, I attend meetings with the supervisor and case worker in order to provide psychological support. Workers meet with me to analyze cases that are not progressing and children who are not succeeding in order to generate alternatives. I also educate the staff on mental illnesses, treatment alternatives, and organic conditions. Some areas the staff have recently encountered are Factitious disorder, Imposed upon another, Dissociative identity disorder, and frontotemporal dementia. In these cases, the workers needed information about significant issues typical in managing and treating these conditions, as well as the course and prognosis. In addition, I screen for potential neuropsychological contributors, such a past history of injury or a condition that affects the frontal lobe in the context of an anger management issue.

B. My observation of children and families in the DCS system is a sense of disintegration in the family unit.

Parents often initially feel a sense of helplessness and trauma after the removal of their children. Parents react to this issue in different ways. Some react with proactive cooperation and engaged participation, while others demonstrate projected anger and fortified defensiveness. Sometimes, it is difficult to understand why engaged clients return to the system, but often identification and treatment of contributory factors is the solution to a successful resolution. The clients who project anger and defensiveness are challenging, but often a respectful approach can facilitate rapport and effective engagement. It also is notable that successful clients often report satisfaction with services, as well as improved confidence with parenting.

Children often are traumatized by the separation from their parents. Even in the context of maltreatment, their bond is disrupted. Placement with relatives and/or other familiar supportive individuals often offers comfort and results in a more adaptive response. Children with or without a history of mental health issues who react in a maladaptive manner often benefit from the provision of supports and therapy services. Children who are in long-term care without a family often benefit from encouragement and caring external interpersonal supports.

C. I have extensive experience with domestic violence. I trained in anger management in the VA Medical Center. In addition, I spent my fourth year as a clinical psychology graduate student in a forensic psychology track with domestic violence cases. My training began with the Duluth Model and the work of Lenore Walker. The elements of power and control, which include using children; economic abuse;

isolation; intimidation; coercion and threats; male privilege; minimizing, denying, blaming; and emotional and physical abuse are often present. However, with societal changes, such as the escalation of methamphetamine use in the 1990’s, this issue has evolved as well and often now involves chronic drug use and mutual violence. As a DCS psychologist, I have worked daily with these cases for the past 25 years both as a consultant and with assessment. It is important to determine the specific dynamics underlying each individual case in order to appropriately intervene.

Families which present with domestic violence often have a history of multigenerational violence and parental modeling. The modeling for domestic violence dynamics has been hypothesized to occur while children are forming their perceptions of adult roles, so it is quite early. In addition, research has indicated in 40-70% of domestic violence cases, the perpetrator also is abusive toward the children. Children who are physically abused have a substantial risk of becoming physically violent as adults. Thus, without effective intervention, the pattern has a high risk of continuing into subsequent generations.

Individuals who present with domestic violence often have different underlying dynamics. There are classic presentations of one partner with a domestic violence pattern and a dependent partner. There are cases in which latent issues with violence are precipitated in the context of chronic substance use issues due to the associated biochemical imbalance, personality deterioration, increased stress, and poor coping skills. There are cases in which the violence is mutual. Sometimes the perpetrator demonstrates violence only within the family and sometimes it is pervasive across settings.

D. I have extensive training in substance abuse, which includes facilitating substance abuse treatment groups at four training placements; working within an alcohol and drug treatment program for an entire rotation of my internship; and leading groups, as well as performing assessment for detoxification placement during my postdoctoral fellowship. Indeed, one of my placements even required I spend time as a “patient” in an inpatient treatment facility. During my training, I was required to attend AA and other support groups outside of normal business hours. I was required to read the Big Book, as well as texts by Claudia Black and other authors about the effects of substance use on the family system. I have provided analysis and assessment in these cases every day for the past 25 years as a DCS evaluator and consultant. In every adolescent and adult psychological evaluation, I perform an alcohol and drug assessment. In addition, I assess substance-related cognitive decline for Social Security, such as visuospatial dysfunction, memory impairment present in Korsakoff’s, and cerebrovascular accidents due to and/or precipitated by substance use issues. In addition, I have trained numerous predoctoral and postdoctoral students in community psychology, which includes issues related to substance use and domestic violence.

80% of the DCS cases in Southern Arizona are substance-related cases. Substance abuse cases often present with substance-exposed newborns, domestic violence incidents precipitated by use, parents who leave their children with other caregivers while they use for long periods, children who reside around drug activity and sometimes are involved in drug busts, and motor vehicle accidents in which the children traveled in vehicles with intoxicated parents. These individuals need referrals to evaluate their substance use, insight, and the underlying contributory historic, psychosocial, personality, and circumstantial issues.

It is also helpful to determine any barriers to treatment, such as denial, minimization, and externalization of blame. Once these are identified, referrals are made to address any identified dynamics and barriers to treatment.

E. Clients with severe mental illness, which include individuals who have complex combinations of substance abuse, severe mental illness, and/or organic contributors to their condition often come into the system due to destabilization. They typically require a multi-faceted, multi-disciplinary approach to treatment. Organic contributors need to be addressed by medical professionals, such as psychiatrists in the case of severe mental illness and medical doctors in primarily physical cases, such as those that involved neurological conditions. If substance abuse is a contributing factor, it must also be controlled or it will preclude stabilization. If the client continues to struggle after integrated treatment, then a psychological and/or neuropsychological assessment may be helpful to identify and obtain treatment recommendations for residual issues.

Cognitive delays are static conditions, so they need to be accommodated by service providers and within interventions. Such individuals often struggle to adequately parent. Often, they have difficulty with protection and basic care. Parenting services may be helpful. If they continue to have difficulty, the family often is a source of support and may assist them sufficiently to reunify.

Question 4: What is the role of a Process Improvement Psychological Consultant, and how would you make an impact in this role?

Offeror Response:

I believe the role of a Process Improvement Consultant is to provide service through timely psychological support to the State of Arizona staff working to review the efficacy of the current system; improve communication and training; design and implement an efficient system; and develop guidelines within the context of the DCS structure. I would make an impact in this role by gathering information about relevant issues from the current unit consultants; providing requested information, review, analysis, and reports;

performing case reviews and making suggestions for resolution; facilitating seamless and coordinated communication between the DCS infrastructure, direct services staff, and unit consultants; providing support for development, coaching, and training; participating in meetings and recording minutes; and consolidating and maintaining continuity of records via the development and application of appropriate measures.

End of Attachment 2-B

PART 2 of the Solicitation Documents SECTION 2-D: Offer Forms, Attachment 2-B

A v a i l a b l e o n l i n e a t : A P P . A Z . g o v https://procure.az.gov/bso/