S-10000-00011070 - Attachment C.pdf

Bid Solicitation S-10000-00011070 (ODHS Child Welfare) ATTACHMENT C Alternate ILP Provider List

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Contract Number 000000

STATE OF OREGON

PERSONAL/PROFESSIONAL SERVICES CONTRACT

You can get this document in other languages, large print, braille, or a format you prefer free of charge. Contact the Contract Administrator at the contact information found below. We accept all relay calls.

This Contract is between the State of Oregon, acting by and through its Oregon Department of Human Services, hereinafter referred to as “ODHS,” and

Contractor d.b.a. Facility or Assumed Name

Address Address

Attention: Name Telephone: Phone

E-mail address: Email hereinafter referred to as “Contractor.”

Work to be performed under this Contract relates principally to ODHS’

Office of Child Welfare Services Youth Transitions Programs

500 Summer Street NE Salem Oregon 97301

Contract Administrator: Name or delegate Telephone: Phone

E-mail address: Email

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1. Effective Date and Duration. This Contract shall become effective on the later of: (I) the last date all required signatures in Section 6., below have been obtained, or (II) Begin Date provided it is (i) signed by all parties on or before such date, and (ii) when required, approved in writing by the Oregon Department of Justice on or before such date, and (iii) when required, approved in writing by the Oregon Department of Administrative Services. Unless extended or terminated earlier in accordance with its terms, this Contract shall expire on End Date. Contract termination shall not extinguish or prejudice ODHS’ right to enforce this Contract with respect to any default by Contractor that has not been cured.

2. Contract Documents.

a. This Contract consists of this document and includes the following listed exhibits which are incorporated into this Contract:

(1) Exhibit A, Part 1: Statement of Work

(2) Exhibit A, Part 2: Payment and Financial Reporting

(3) Exhibit A, Part 3: Special Provisions

(4) Exhibit B: Standard Terms and Conditions

(5) Exhibit C: Insurance Requirements

(6) Exhibit D: Federal Terms and Conditions

(7) Attachment 1: Annual Report

(8) Attachment 2: Budget Form

(9) Attachment 3: Monthly Invoice

(10) Attachment 4: Transition Readiness Discussion Guide (Step 1)

(11) Attachment 5: Youth Assessment Summary (Step 2)

(12) Attachment 6: Transition Plan (Step 3)

(13) Attachment 7: ILP Service Planning Checklist (Step 4)

(14) Attachment 8: Monthly Services and Progress Report (Step 5)

(15) Attachment 9: Travel Reimbursement Form There are no other contract documents unless specifically referenced and incorporated into this Contract.

b. This Contract and the documents listed in Section 2., “Contract Documents”, Subsection a. above, shall be in the following descending order of precedence:

this Contract less all exhibits, Exhibits D, B, A, and C.

3. Consideration.

a. The maximum, not-to-exceed compensation payable to Contractor under this

Contract, which includes any allowable expenses, is $ NTE Amount. ODHS will not pay Contractor any amount in excess of the not-to-exceed compensation of this Contract for completing the Work, and will not pay for Work performed before the date this Contract becomes effective or after the termination or expiration of this Contract. If the maximum compensation is increased by amendment of this Contract, the amendment must be fully effective before Contractor performs Work subject to the amendment.

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b. Payments to Contractor shall be subject to ORS 293.462, and shall be made in accordance with the payment schedule and requirements in Exhibit A, Part 2., “Payment and Financial Reporting.”

c. ODHS will only pay for completed Work under this Contract. For purposes of this Contract, “Work” means the tasks or services and deliverables accepted by ODHS as described in Exhibit A, Part 1, “Statement of Work.”

4. Contractor or Subrecipient Determination. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.104, ODHS’ determination is that:

Contractor is a subrecipient Contractor is a contractor Not applicable Catalog of Federal Domestic Assistance (CFDA) #(s) of federal funds to be paid through this Contract: 93.674

(Remainder of page intentionally left blank)

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5. Contractor Information and Certification.

a. Contractor Information. This information is requested pursuant to ORS

305.385 and OAR 125-246-0330(1).

PLEASE PRINT OR TYPE THE FOLLOWING INFORMATION

Contractor Name (exactly as filed with the IRS): DO NOT COMPLETE THIS FORM

Street address:

City, state, zip code:

Email address:

Telephone: ( ) Fax: ( )

Is Contractor a nonresident alien, as defined in 26 U.S.C. § 7701(b)(1), a foreign person, or a foreign entity? (Check one box): YES NO Business Designation. (Check one box):

Professional Corporation Nonprofit Corporation Limited Partnership Limited Liability Company Limited Liability Partnership Sole Proprietorship Corporation Partnership Other

Contractor Proof of Insurance. Contractor shall provide the following information upon submission of the signed Contract. All insurance listed herein and required by Exhibit C must be in effect prior to Contract execution.

Commercial General Liability Insurance Company: ____________________________________ Policy #: ______________________________________ Expiration Date: ________________ Automobile Liability Insurance Company: ___________________________________________ Policy #: ______________________________________ Expiration Date: ________________ Workers’ Compensation: Does Contractor have any subject workers, as defined in ORS 656.027? (Check one box): YES NO If YES, provide the following information:

Workers’ Compensation Insurance Company: ________________________________________ Policy #: ______________________________________ Expiration Date: ________________

b. Certification. Without limiting the generality of the foregoing, by signature on this Contract, the undersigned hereby certifies under penalty of perjury that:

(1) Contractor is in compliance with all insurance requirements in Exhibit C of this Contract, and notwithstanding any provision to the contrary, Contractor shall deliver to the ODHS Contract Administrator (see page 1 of this Contract) the required Certificate(s) of Insurance within 30 days of execution of this Contract. By certifying compliance with all insurance as required by this Contract, Contractor acknowledges it may be found in breach of the Contract for failure to obtain required insurance. Contractor may also be in breach of the Contract for failure to provide Certificate(s)

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(2) Contractor acknowledges that the Oregon False Claims Act, ORS 180.750 to 180.785, applies to any “claim” (as defined by ORS 180.750) that is made by (or caused by) the Contractor and that pertains to this Contract or to the project for which the Contract work is being performed. Contractor certifies that no claim described in the previous sentence is or will be a “false claim” (as defined by ORS 180.750) or an act prohibited by ORS

180.755. Contractor further acknowledges that in addition to the remedies under this Contract, if it makes (or causes to be made) a false claim or performs (or causes to be performed) an act prohibited under the Oregon False Claims Act, the Oregon Attorney General may enforce the liabilities and penalties provided by the Oregon False Claims Act against the Contractor;

(3) The undersigned is authorized to act on behalf of Contractor and represents and warrants that Contractor has complied with the tax laws of the State of Oregon and the applicable tax laws of any political subdivision of Oregon. Contractor shall, throughout the duration of this Contract and any extensions, comply with all tax laws of this state and all applicable tax laws of any political subdivision of Oregon. For the purposes of this Section, “tax laws” includes: (i) All tax laws of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of Oregon that applied to Contractor, to Contractor’s property, operations, receipts, or income, or to Contractor’s performance of or compensation for any work performed by Contractor; (iii) Any tax provisions imposed by a political subdivision of Oregon that applied to Contractor, or to goods, services, or property, whether tangible or intangible, provided by Contractor; and (iv) Any rules, regulations, charter provisions, or ordinances that implemented or enforced any of the foregoing tax laws or provisions.

Contractor acknowledges that the Oregon Department of Administrative Services will report this Contract to the Oregon Department of Revenue (DOR). The DOR may take any and all actions permitted by law relative to the collection of taxes due to the State of Oregon or a political subdivision, including: (i) garnishing the Contractor’s compensation under this Contract; or (ii) exercising a right of setoff against Contractor’s compensation under this Contract for any amounts that may be due and unpaid to the State of Oregon or its political subdivisions for which the DOR collects debts;

(4) The information shown in Section 5.a., “Contractor Information” above is Contractor’s true, accurate and correct information;

(5) To the best of the undersigned’s knowledge, Contractor has not discriminated against and will not discriminate against minority, women

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(6) Contractor and Contractor’s employees and agents are not included on the list titled “Specially Designated Nationals” maintained by the Office of Foreign Assets Control of the United States Department of the Treasury and currently found at: https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx;

(7) Contractor is not listed on the non-procurement portion of the General Service Administration’s “List of Parties Excluded from Federal procurement or Non-procurement Programs” currently found at:

https://www.sam.gov/SAM;

(8) Contractor is not subject to backup withholding because:

(a) Contractor is exempt from backup withholding;

(b) Contractor has not been notified by the IRS that Contractor is subject to backup withholding as a result of a failure to report all interest or dividends; or

(c) The IRS has notified Contractor that Contractor is no longer subject to backup withholding; and

(9) Contractor’s Federal Employer Identification Number (FEIN) or Social Security Number (SSN) provided to ODHS is true and accurate. If this information changes, Contractor shall provide ODHS with the new FEIN or SSN within 10 days.

https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx https://www.sam.gov/SAM

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CONTRACTOR, BY EXECUTION OF THIS CONTRACT, HEREBY

ACKNOWLEDGES THAT CONTRACTOR HAS READ THIS CONTRACT,

UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND

CONDITIONS.

CONTRACTOR: YOU WILL NOT BE PAID FOR SERVICES RENDERED BEFORE

THE EFFECTIVE DATE OF THIS CONTRACT.

6. Signatures. This Contract and any subsequent amendments may be executed in several counterparts, all of which when taken together shall constitute one agreement binding on all parties, notwithstanding that all parties are not signatories to the same counterpart.

Each copy of the Contract and any amendments so executed shall constitute an original.

Contractor Name By:

Do Not Sign. Not Executable. Do Not Complete Authorized Signature Printed Name

Title Date

State of Oregon, acting by and through its Oregon Department of Human Services By:

Will not be signed or executed Do Not Complete Authorized Signature Printed Name

Title Date

Approved by the Oregon Department of Administrative Services:

Will not be submitted for approval – Non-executable

Authorized Signature Title Date

Approved for Legal Sufficiency:

Will not be submitted for approval – Non-executable Oregon Department of Justice Date

Reviewed by Office of Contracts and Procurement:

Will not be submitted for approval – Non-executable Contract Specialist Date

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EXHIBIT A

Part 1

Statement of Work

1. Purpose. The purpose of this Contract is to provide Independent Living Program (ILP) model of services to be performed in the following Service Area: Service Area/District.

ILP services assist Young People with their educational and employment skills, health education and access, Life Skills, healthy and supportive relationships, transportation, and housing needs.

2. Definitions. For the purposes of this Contract, capitalized words are defined in OAR 125-246-0110 or as defined below.

a. “Aftercare Client” means a Young Adult who has submitted a self-referral and has been accepted and enrolled in an ILP.

b. “Community Mentors” means a member of the community who volunteers to participate in group sessions with participants or whom the Contractor has screened and trained to serve as a Mentor to children and Young Adults outside of group sessions.

c. “Completion of Services” means A Young Person’s ILP services will be considered completed when a Young Person has:

i. Achieved self-sufficiency to the extent that there is no longer a need for services; or

ii. Made the voluntary and informed decision to no longer participate in services; or

iii. Reached age 24.

d. “Experiential Learning Activities” means the process where knowledge is created through the transformation of peer experience (i.e., Kolb’s Experiential Learning Cycle).

e. “Federally Recognized Tribes of Oregon” or “Tribe” means Burns Paiute Tribe; Confederated Tribes of Coos, Lower Umpqua, and Siuslaw Indians;

Confederated Tribes of Grand Ronde Community of Oregon; Confederated Tribes of Siletz Indians; Coquille Indian Tribe; Confederated Tribes of the Umatilla Indian Reservation; Confederated Tribes of Warm Springs; Cow Creek Band of Upper Umpqua Tribe of Indians; and Klamath Tribe.

f. “Flex Funds” means Funding to motivate or encourage youth engagement, or to stimulate a Young Person’s investment in services. Allowable use of Flex Funds is outlined in Section 8. “Additional Resources”.

g. “Foster Care” means 24-hour substitute care for children and Young Adults placed away from their parents or guardians for whom the state agency or Tribe has placement and care responsibility, which may include custody.

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This includes but is not limited to placements in resource family homes, relative care, group homes, emergency shelters, residential facilities, childcare institutions, supervised independent living, self-selected placements, and pre-adoptive homes. It further covers ILP enrolled Young People placed in the State’s Independent Living Subsidy Program. A Young Person is in Foster Care in accordance with this definition regardless of whether the Foster Care setting is receiving payment from ODHS or Tribe.

h. “Group(s)” means skill building activities or classes for three or more Young People.

i. “ILP Services” means Services include, but are not limited to, skill building classes, group workshops, conferences, Experiential Learning outings/field trips, leadership opportunities/support and one-on-one meetings that are geared toward assisting a Young Person to gain the knowledge, skills, and ability to make a successful transition to self-sufficiency and adulthood. Services may be provided directly by the Contractor, or the Contractor may facilitate the Young Person’s services from another entity. Facilitated services may include, but are not limited to, educational supports, vocational training, job placement, health education, supportive relationships (Community Mentor) and community connections.

j. “Independent Living Program or ILP” means Program to assist ODHS and Federally Recognized Tribes of Oregon, by providing Young People that experienced the Foster Care system or are expected to age out of the Foster Care system, with the knowledge, skills, and ability to make a successful transition to self-sufficiency and adulthood.

k. “Intangible skills” means Skills needed for building interpersonal relationships, self-determination, and maintaining employment, e.g., decision-making, problem solving, planning, communication, and social skills.

l. “Leadership Opportunity” means Activities which allow a Young Person to develop their skills, work closely with others, share ideas and influence change.

Requires Contractor to assist Young Person to prepare for the activity, ensure Young Person is supported during the activity, and debriefing the experience with the Young Person to determine whether support efforts were adequate, identify opportunities for growth and provide mutual feedback.

m. “Life Skills” means Skills a Young Person needs to function and succeed in everyday life including, but not limited to cooking, comparison shopping, money management, education, employment, housing options & maintenance, transportation, decision making, legal issues, personal hygiene, community resources, interpersonal skills, pregnancy prevention/parenting awareness, substance abuse prevention, emergency, and safety skills.

n. “ODHS Sponsored Teen Events” means ODHS sponsored events intend to bring children and Young Adults that are in or have experienced Foster Care together from across the state to provide a unique learning experience and fun activities they would otherwise not get to experience. Conference locations may vary each year. The events vary between 1 to 4 days, including overnight stays.

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o. “Peer Specialist” means a near-peer mentor usually aged 18-23 with experience living in Foster Care. This individual or individuals will facilitate the curriculum, serve as inspirational role models to participants, and provide technical assistance to Community Mentor(s).

p. “Self-Determination means the ability to set personal goals; take action;

advocate for self; and believe in one’s own capacity to succeed.

q. “Service Area” means the ODHS District named in Section 1. “Purpose” of this Contract, in which the Contractor is permitted to provide ILP services.

r. “Social Capital” means the social relationships and networks that support healthy development.

s. “Staff” means the individual(s) employed by the Contractor, paid or non-paid, and assigned the task of managing recruitment, training, support, retention and all other work for children and Young Adults, Peer Specialist(s) and Community Mentor(s) under this Contract.

t. “State Meeting” means an activity the Contractor shall participate in or a training the Contractor has obtained permission from the ODHS Contract Administrator to attend. State Meeting activities and trainings aid the Agency in carrying out the purpose of the Independent Living Program. Allowable costs are outlined in Section 8. “Additional Resources.”

u. “Transition Plan” means the plan that is to be crafted, with a Young Person’s involvement, that outlines a Young Person’s seven areas (Personal Growth & Social Development, Family Support & Healthy Relationships, Health Education & Risk Prevention, Education, Employment/Career Preparation, Housing & Home Management. Money Management, Transportation, and Other Life Skills), and the steps and services necessary to help a Young Person achieve their goals.

v. “Transition Readiness Discussion Guide” means a worksheet to guide initial discussion with the Young Person to aid in assessing skills and developing the Transition Plan. The purpose is to prompt discussion to assess the Young Person and prioritize skill-building activities.

w. “Young Adult” means a person who is between the ages of 18 through 23 (ending on 24th birthday), who exited Foster Care on or after their 14th birthday and had at least 180 days of, State or Tribal child welfare substitute care services after the age of 13.

x. “Young Person” or “Young People” means a person who is between the ages of 14 through 23 (ending on 24th birthday), who is in foster care or exited Foster Care on or after their 14th birthday and had at least 180 days of State or Tribal child welfare substitute care services after the age of 13.

y. “Youth Served per Month (YSM) means the number of Young People served by Contractor during a calendar month.

z. “Youth Transitions” means the central and administrative center, housed at Central Office, for administering the Youth Transitions Programs which include Independent Living Skill Building, Discretionary Funds, the Independent Living

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Subsidy Program (ILSP), the Chafee Housing Program (ILP-CH), Driver’s Education, Credit Reports, the Education and Training Voucher Program (ETV), and the Oregon Tuition and Fee Waiver.

3. ILP Group Based Skills Services (Young People Ages 14 – 23). Work to be performed.

a. Contractor shall provide ILP services for an average of [00] Young People per month, not to exceed [00] Young People per quarter, residing in the Service Area.

b. Groups are available for all ILP Eligible Young People. Contractor shall confirm eligibility with Youth Transitions staff by emailing ILP.Central@odhsoha.Oregon.gov prior to providing services.

c. Group-based skills workshops and Experiential Learning events (at least 90 minutes in duration) shall be provided monthly to allow for skill building, peer exposure and community building. Group events shall rotate target populations throughout the year as follows:

(1) Four (4) months of curriculum devoted to the younger population (based on chronological age or developmental stage);

(2) Four (4) months of curriculum devoted to the older population (based on chronological age or developmental stage); and

(3) Four (4) months devoted to group outings and Experiential Learning in the community (volunteering, holiday activities, excursions, field trips, etc.).

d. Group events do not replace one-on-one, face-to-face skill building meetings with an assigned ILP provider.

e. A Young Person may attend one (1) monthly group for reimbursement.

f. Contractor may bill for ILP group meetings, regardless of whether the young person participates in any other ILP activities.

g. Contractor shall complete the following within 30 days of the effective date of this Contract:

(1) Make all arrangements for appropriate meeting space including being compliant with the American Disabilities Act.

(2) Determine precise dates and times for group meetings in collaboration with Young People.

(a) Provide a group schedule no less than three (3) months in advance for planning and engagement purposes.

(b) Distribute the group schedule to Young People, ODHS and the

Tribes’ child welfare staff, and Youth Transitions ILP.Central@odhsoha.Oregon.gov

(c) Coordinate with other ILP contractors for regional group events, when possible.

mailto:ILP.Central@odhsoha.Oregon.gov

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(d) For Group Experiential Learning excursions, Contractor shall submit an email application to the ODHS Contract Administrator requesting pre-approval for expenditures.

i. Provide date, time, location, and duration of the proposed event, including the plan for legal guardian consent, transportation, supervision, emergency plan, food, activity costs, equipment costs, etc.

ii. Provide supportive narrative about how the event will meet the definition of an Experiential Learning activity.

iii. Once written approval is provided by the ODHS Contract Administrator, Contractor shall execute plan.

(3) Obtain background checks on any adult Community Mentor(s) and on Contractor’s Staff that do not have a current background check on file.

This requirement includes any Peer Specialists who are no longer in the care or custody of a state or Tribal child welfare agency.

(a) To request a Background Check the Subject Individual (SI) submits an email which includes the Contract number and Contractor’s email address to:

childwelfare.contractbackgroundchecks@odhsoha.oregon.gov

(b) The SI receives a secure email to collect the necessary information which is then entered into ORCHARDS to initiate the background check.

(c) SI receives an email from bcu.orchards@dhsoha.oregon.gov with instructions and a link to complete the Authorization and Disclosure in ORCHARDS. Note: The background check is closed if the Contractor does not complete within 21 days.

(d) The final determination is emailed to the SI, contractor, and the ODHS Contract Administrator. Contractor and ODHS Contract Administrator should keep in file.

h. Contractor shall provide services that:

(1) Build intangible skills needed for building interpersonal relationships, Self-Determination, and maintaining employment, e.g., decision-making, problem solving, planning, communication, and social skills.

(2) Build tangible skills needed for daily living, self-maintenance, maintaining healthy relationships and obtaining employment (e.g., money management, household management, and vocational aptitudes).

(3) Provide experiences which assist the young person in making connections to their local community (people, services, businesses, and recreational outlets).

(4) Provide instruction and assistance to Young People about personal growth, social development, and Self-Determination, including serving others, mailto:childwelfare.contractbackgroundchecks@odhsoha.oregon.gov mailto:bcu.orchards@dhsoha.oregon.gov

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(5) Assist Young Person in identifying how past trauma influences current behavior and responses to situations. Build skills to help Young Person self-regulate and learn how to maintain relationships after a conflict or stressful situation has occurred.

(6) Assist Young Person to build skills to establish healthy relationships and build Social Capital that helps the Young Person to achieve their life goals. Assist Young Person to understand and gain skills for internal motivation, goal setting, planning and problem-solving.

(7) Provide activities which follow Kolb’s Experiential Learning Cycle.

Provide a process where knowledge is created through the transformation of experience. Contractor may access the Experiential Learning Activities Funds to support the Experiential Learning activities executed each quarter.

i. Monthly Reports. The Contractor shall communicate with Youth Transitions staff monthly to provide a list of services delivered and engagement level achieved by the Young Person, using the Monthly Services & Progress Report (MSPR). The MSRP form is provided by the ODHS Contract Administrator. The MSPR shall be completed and submitted by the 15th calendar day of the month following the month in which services were provided. MSPRs will be used to validate invoices. Contractor shall include the following information on the MSPR that includes:

(1) The date of group session;

(2) The duration of the group session;

(3) The appropriate federal categories and subcategories for the group activities;

(4) A description of the skill building delivered by the provider;

(5) A summary of the group discussion and activity; and

(6) When applicable, a description of how the Peer Specialist(s), Community

Mentor(s), and Young Person are interacting and whether the group is building connections and Young People are expanding their Social Capital.

4. ILP Skill Building Services (Young People Ages 14 - 23)

a. Work to be performed. Contractor shall:

(1) Provide ILP services for a maximum of [00] Young People per month, residing in the Service Area. Young People will be referred by:

(a) ODHS staff; or

(b) A Federally Recognized Tribe of Oregon (referring agent); or

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(c) Young Adult (if a self-referral) based on the Young Adult’s needs and interests. Young Adults who no longer have an open ODHS Child Welfare case may refer themselves to their local ILP Contractor directly.

(2) Provide services to each Young Person in accordance with developmental readiness and stages of independence (not chronological age). Services shall be individualized, trauma informed and culturally appropriate.

(3) Accept all referrals made by eligible Young Adults, ODHS staff or a staff member of a Federally Recognized Tribe of Oregon, unless:

(a) Young person poses a danger to self or others;

(b) Young Person poses as a health risk;

(c) Young Person declines to participate in program services; or

(d) Based on YSM maximum limits established for the Service Area.

(4) When deemed appropriate, ODHS shall authorize Contractor’s Exception to Policy request to serve Young People who reside outside of the Contractor’s Service Area. This will be approved by the Youth Transitions Program Manager (or designee) on a case-by-case basis. The Young Person must be able to attend or get to regularly scheduled Contractor groups and skill building activities. The ODHS or Oregon Tribal Child Welfare caseworker is responsible for submitting the Exception to Policy (form CF88) for approval unless the Exception is to support an Aftercare client. The Exception to Policy form is provided by the ODHS Contract Administrator.

b. Contractor shall provide the following services within the timelines listed:

(1) Response to Referral.

(a) Contractor shall respond in writing to the referring agent or Young Adult within five working days of referral regarding the Young Person’s acceptance or non-acceptance (i.e., Young Person declined or placed on a wait list) into the Contractor's ILP Skill Building Services. Referring agent includes ODHS and the Federally Recognized Tribes of Oregon that ODHS partners with.

(b) When the Contractor must implement a wait list, the process for removing a Young Person from the wait list and enrolling in the Contractor’s ILP services will be crafted in collaboration with the local ODHS branch staff. Waitlist management shall be communicated immediately and directly to Youth Transitions via email at: ILP.Central@odhsoha.Oregon.gov as soon the waitlist is implemented. This shall also be indicated on the submitted invoices every month to determine if a workplan needs to be implemented or the contract needs to be amended to support Youth Transitions programming (if funding is available).

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(2) Assessment, Engagement, and Skill Building.

(a) Youth Engagement and Skill Building Services. Contractor shall deliver skill building services to the Young Person for a minimum of 60 minutes, one-on-one and in-person.

i. Prior permission from the ODHS Contract Administrator is required when the Provider plans to use technology to meet or supplement the face-to-face requirement.

ii. The option to use technology to meet the face-to-face requirement is to be requested when there are significant barriers to an in-person meeting with a Young Person (e.g.:

extreme weather conditions, illness, etc.) or to supplement a previous one-on-one Meeting during the same month which was less than 60 minutes.

iii. ILP Skill Building Services are to facilitate access to individualized services and supports across all independent living domains guided by the Young Person’s Transition Plan goals or immediate needs. Contractor shall include the Young Person in determining the services to be provided.

iv. The Contractor shall engage with young people and their support team to promote the Young Person’s goal attainment and engagement in services.

v. The Contractor may access Flex Funds to provide the Young Person with an incentive or stipend to promote engagement in service provision and participation in the assessment and transition planning process.

(b) One-on-one meetings may have a dual meaning as follows:

i. Contractor is to meet with a Young Person individually, face-to-face for a minimum of 60 minutes to provide ILP Skill Building Services, or

ii. A meeting where all parties in attendance are focused solely on a specific Young Person and their needs.

(c) Transition Readiness Discussion Guide (Step 1). Contractor shall use the form provided by the ODHS Contract Administrator to build rapport and gain a global sense of the Young Person’s knowledge, skills, and abilities, as well as a sense of the Young Person’s Self-Determination, readiness, and priorities for adulthood. The Transition to Readiness Discussion Guide, also referred to as the “life skills assessment,” will inform the Contractor’s placement of which Stage the Young Person appears to be functioning.

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(d) Youth Assessment Summary (YAS) (Step 2). This summary form is provided by the ODHS Contract Administrator. The YAS identifies a Young Person’s level of awareness, knowledge, and skill on a variety of topic areas, to be completed following assessment using the Transition Readiness Discussion Guide.

Contractor shall:

i. Complete the YAS form based on information gathered from the Young Person and their support team based on conversation resulting from the Transition Readiness Discussion Guide.

ii. Identify which stage the Young Person is in using the YAS form. The assessment provides vital information about a Young Person’s functioning that is critical when planning service delivery. The YAS also determines a knowledge and skills baseline that allows a Contractor to track progress over time.

iii. Use the following scale to determine a Young Person’s stage:

Stage I, Awareness Stage II, Learning Stage III, Doing

First circle

Has minimal information about this topic area

Has started gaining knowledge and developing new skills in this area

Has started applying some skills in real-life settings or activities, with support

Second circle

Has basic information about this topic area and some understanding of why it is important

Has basic knowledge and skills in this area, needs further opportunities to practice and strengthen most skills

Is regularly applying some skills in real-life settings and or activities, with limited support

Third circle

Has solid information about this topic and understands why it is important, but has not started developing knowledge or skills

Has solid knowledge and skills in this area, but has not started applying these in real-life settings or activities

Is consistently applying many skills in real-life settings and activities, with limited support (May stay in this stage for as long as provider monitors application of skills)

(3) Reports.

(a) Transition Plan (TP). The Transition Plan is crafted with input from the Young Person and other supportive adults.

i. ILP services require collaboration with ODHS in the development of a written TP for each Young Person in the

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ii. To create the Transition Plan, an ODHS Caseworker or ILP provider must arrange for a youth decision-making meeting between the Young Person, Contractor, caseworker, resource parent, attorney, Court Appointed Special Advocate, family members, and other significant adults the Young Person has invited. The Young Person must have the opportunity to invite up to two additional participants.

I. The purpose of the decision-making meeting is to determine the Young Person’s goals and identify what steps and services are needed to assist the Young Person to achieve the identified goals and determine which ILP Skill Building Services can be provided directly, and which services are best obtained within the community by means of other resources.

II. The Transition Plan (Step 3) outlines:

A. The steps the Contractor and ODHS will take to facilitate referral for those services that are to be obtained in the community.

B. The services that will be offered;

C. The needs the services intend to address;

D. The anticipated time frame for when services will begin and end; and E. What responsibility each member of the decision-making team will assume.

III. Transition Plan type:

A. Youth Transition Plan (YTP): If the Transition Plan is crafted with input from the Young Person and other supportive adults, but the ODHS or Tribal child welfare caseworker is absent, or Young Person is an Aftercare client, the Transition Plan will be considered a Youth Transition Plan.

B. Comprehensive Transition Plan (CTP): If the Transition Plan was crafted with input from the Young Person, ILP Provider, and other supportive adults, including the Young Person’s ODHS caseworker or Tribal worker (unless the young person is an Aftercare Client), the document shall be

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C. The Transition Plan form is provided by the ODHS Contract Administrator.

(b) ILP Service Planning Checklist (Step 4). The ILP Service Planning Checklist is a list of skills a Young Person should possess in order to transition to adulthood successfully. The ILP Services Planning Checklist is the framework for Oregon’s ILP and intended to be used as a tool to guide service planning and service provision.

Contractors shall employ the ILP Service Planning Checklist (provided by the ODHS Contract Administrator) as a tool during the following activities:

i. When training Staff;

ii. When assessing a Young Person’s knowledge, skills, and abilities;

iii. During supervision to ensure Staff are working within

Oregon’s ILP framework;

iv. During transition planning sessions to aid in the creation of meaningful goals and short-term steps/actions;

v. When planning group classes, workshops, or experiential activities to ensure appropriate skills are being discussed and taught; and

vi. The ILP Service Planning Checklist is provided by the ODHS Contract Administrator.

(c) Annual Update. Contractor shall update the YAS and the TP annually following the initial TP.

i . The purpose of the YAS update is to assess the Young

Person's progress in gaining knowledge, skills, and movement between stages in preparation for a successful transition to adulthood.

ii. The purpose of the TP update is to:

I. Reflect on ILP’s service delivery and on the Young

Person’s progress in achieving the goals set forth in the TP; and

II. Update transition goals as needed based on Young Person’s input to ensure appropriate services are being provided with and for the Young Person, and that the Young Person is actively engaged in the planning process and the services identified in the

TP.

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III. The TP also dictates ILP service delivery for the upcoming year.

(d) On-going Progress Monitoring & Service Report. Contractor shall:

i. Communicate with the referring agent and Youth

Transitions monthly. Use the Monthly Services and Progress Report (MSPR) to provide documentation regarding the following:

I. Date(s) of face-to-face, one-on-one skill building;

II. Location of service provision;

III. The minutes spent during face-to-face skill building;

IV. The appropriate federal categories and subcategories for the skill building activities; and V. Description of the skill building services delivered

(including Group and Experiential Learning excursions and leadership activities), or to document the three (3) engagement efforts provided.

ii. Communicate with the Young Person on a regular basis as outlined in Section 9. “Annual Report and Basic Program Expectations.”, Subsection e. “Contractor shall maintain contact with referred Young Person as follows:”

iii. Document accomplishments, needs, and progress toward goals.

iv. The MSPR is to be submitted by the 15th of the month following the month in which services were provided. Late submissions will result in a delay of payment for services provided.

(e) It is ODHS’ plan to transition all MSPR documentation to be entered by the Contractor into a provider portal. Development of the provider portal is currently underway. The Contractor shall be assigned security clearance and will receive training to utilize the provider portal once available.

(f) Final Progress & Service Report. Contractor shall:

i. Prepare the final MSPR when client is discharged from the

Contractor’s program or Completion of Services.

ii. Provide the referring agent and Youth Transitions a termination summary of each Young Person within fifteen calendar days of discharge from the program or Completion of Services. The discharge summary must

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(g) Filing of Reports. Unless defined differently, each of the above reports must be submitted to the Referring Agent and Youth Transitions ILP.Central@odhsoha.Oregon.gov within five (5) business days of completion in order to be filed in the Young Person’s case records.

5. ILP Plus “ILP+” (Young People Ages 16 - 23). Work to be performed:

a. Contractor may provide up to [00] ILP+ 30-minute service segments for Young

People (ages 16 – 23) receiving ILP Skill Building Services each month, not to exceed three 30-minute ILP+ segments per Young Person per month.

b. If ILP+ services are provided, services shall be implemented in accordance with each Young Person’s developmental readiness and stages of independence (not chronological age). Services shall be individualized, trauma informed and culturally appropriate.

c. ILP+ additional skill building activities are intended to support a Young Person (ages 16 – 23) during a time of higher need or transition (planned housing transition, housing instability, substance use issues, tragedies, transitioning to college, parenting struggles, educational challenges, employment barriers, mental/behavioral health symptoms, leadership opportunities, etc.). Appropriate ILP+ Young People are age 16+ who will benefit from more intensive skills training focused on developing internal assets and external resources (housing, treatment services, medical care, planning/modeling support, community-based resources, etc.).

(1) Contractor shall focus on stabilization, successful transition, and building

Self-Determination skills, such as youth-driven goal identification, problem-solving, and stress management.

(2) Contractor shall oversee ILP+ minutes to ensure equity in service delivery.

This will be demonstrated by the Contractor serving the ILP+ population in a way that mirrors the demographic makeup of their overall population.

(3) ILP+ Services allow the Contractor to serve Young People aged 16+ in additional increments of 30-minutes (Basic 60-minute service plus 30 minutes, 60 minutes, or 90 minutes; not to exceed a total of 150 minutes per month).

(4) The Contractor shall oversee ILP+ minutes to ensure they do not surpass the “not to exceed” number of 30-minute segments listed above and Young People served do not exceed the maximum 150 minutes.

(5) This service is not meant for compliant Young People that might appreciate more time. It is designed to support Young People (ages 16 –

23) experiencing circumstances that warrant additional skill-building activities to meet stabilization or transition goals.

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d. On-going Progress Monitoring & Service Report.

(1) Contractor shall include the following details on the MSPR when providing ILP+ services:

(a) Date(s) of face-to-face, one-on-one ILP+ skill building;

(b) Location of service provision;

(c) The additional ILP+ minutes (beyond the basic 60 minutes) spent during face-to-face and in-person skill building meeting(s);

(d) The appropriate federal categories and subcategories for the ILP+ skill building activities;

(e) Description of the ILP+ skill building services delivered; and

(f) Summary of why the additional service minutes were necessary.

(2) The MSPR is to be submitted by the 15th of the month following the month in which services were provided. Late submissions may result in a delay of payment for services provided.

6. Leadership Opportunities Ages 16 – 23. Contractor shall support young people (ages 16 – 23) to access leadership activities which allow a Young Person to develop their skills, work closely with others, share ideas and influence change.

a. Contractor shall:

(1) Assist Young Person (ages 16+) to prepare for Leadership Opportunity activities;

(2) Collaborate with ODHS staff (local office as well as Central office), and other entities who include Young People’s voice in their policies and programming.

(3) Ensure Young Person (age 16+) is supported during activities.

(4) Debriefing the experience with the Young Person (age 16+) to determine whether support efforts were adequate.

(5) Identify opportunities for growth and provide mutual feedback.

(6) Follow-up with any feedback for improvement to the entity who hosted the Leadership Opportunity.

(7) Provide a leadership stipend to the Young Person (age 16+) using the leadership stipend.

(8) Identify and recruit Peer Specialists to participate in the ILP Group meetings and be interactive with the Young People.

(9) Ensure Peer Specialist is prepared to engage as a co-creator, co-facilitator, and mentor to their peers.

(10) Peer Specialists should be supported prior to and during the ILP Group or activity.

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(11) Provide a debrief following the activity to allow the Young Person (age 16+) to reflect on their experience and provide feedback.

b. The time spent preparing, supporting and debriefing with a Young Person is skill building (organization, planning, public speaking, advocating for needed supports, and communication skills or brainstorming solutions), as such the Contractor may bill for time spent supporting a Young Person (age 16+) engaged in a Leadership Opportunity, using the ILP Skill Building Service, and if necessary, the ILP Plus service (not to exceed a total of 150 minutes of skill building per month).

7. Engagement Efforts Only (EEO) Ages 14 – 23. Engagement efforts Only is a service type to support the Contractor’s unsuccessful attempts to engage a Young Person in Group or skill building activities within a given month.

a. Contractor shall document, using the MSPR, at least three (3) attempts to contact and engage the Young Person and the various means used: phone, text, email, family, resource parent, caseworker, home visit, etc. Contractor must include the following details on the MSPR:

(1) Dates of engagement attempts,

(2) Means of engagement attempts (see above), and

(3) Description of contact efforts and results.

b. EEO may be invoiced for two (2) consecutive months. If a Young Person has not re-engaged after two months of EEO, no additional payments will be provided until the Young Person has either attended a Group Session or been provided an ILP Skill Building Service.

8. Additional Resources. Additional financial resources are being made available to the Contractor to assist with a successful implementation of service provision. Following are the various funding resources and when they are to be accessed:

a. Leadership Opportunities for 16 – 23-year-olds: The Contractor shall provide a stipend or other form of compensation to a Young Person (age 16+) when participating in a Leadership Opportunity offered by ODHS (meeting/training), by a community partner, or taking a leadership role within the Contractor’s ILP.

b. Types of Leadership Opportunities Young People (age 16+) may participate in shall include:

(1) Peer Specialist work during ILP Groups, mentoring peers during Transition

Planning activities, assisting Contractor with co-crafting curriculum, or planning ILP skill building activities;

(2) Participating in a focus group;

(3) Participating on the Contractor’s Advisory Committee or other Advisory

Committees;

(4) Participating in ODHS hiring/interview panel, workgroups, Policy Advisory

Committee,…