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Home My WebLink AboutOut of State Travel Request - Renew2-3 GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12-.00pm on Thursday) REQUESTING DEPARTMENT: Renew . Anna Serrano REQUEST SUBMITTED BY. Dell CONTACT PERSON ATTENDING ROUNDTABLE: Anderson CONFIDENTIAL INFORMATION: 10YES RNO DATE: 4/10/2 5 PHONE: (509) 765-9239 ext: 5353 TYPE(PYOF � DOCUMENTS UBMMED: I N Now] OAgreement I Contract E, CIAP Vouchers ElAppointment ReappointmentDARPA Related 17 Bids / RFPs / Quotes Award []Bid Opening Scheduled 17 Boards / Committees 11--i B u d g e t I .7 Computer Related 01County Code ClEmergency Purchase [--]Employee Rel. 0 Facilities Related El Financial OFunds 01-learing 01 Invoices / Purchase Orders ElGrants — Fed/State/County n Leases 110 1`40A / MOU 11 Minutes 010rdinances Va Out of State Travel Petty[]Cash 0 Policies 01 Proclamations 0IRequest for Purchase 0 Resolution 0 Recommendation ElProfessional Serv/Consultant []Support Letter :]Surplus Req. 0- Tax Levies F—Thank You's I_jTax Title Property WS L C B IM, 11''Im Out-of-state travel request for Velma De La Rosa, Angela Clay & Conna Camacho-Jimenez EMDR - 5 Day Intensive Training - Albuquerque, NM- June 22-28, 2025 Estimated cost $3,366.00 / each Funding 108.150.00.0000.564.44.xxxx (MH for Corina) / 108.150.00.8059,564.44.xxxx (WISe for Velma & Angela) If necessary, was this document reviewed by accounting.? 0 YES 0 NO W NIA If necessary, was this document reviewed by legal? 0 YES 171 NN/A DATE OF ACTI ON APPROVE: DENIED ABSTAIN D1 D2, D3- DEFERRED OR CONTINUED TO: RECEIVED 4/23/24 APR 10 2025 GRANT COUNTY COMMISSIONERS Out of State Travel Request Application DEADLIN.E: Due by Thursday at 12:00 P,M. to'the,C s'sione"sbffi&e. With.qnsent' BOCC C fen aR 1pq It, Form,be o " � �tr the followingweekC''s ht'Menda 8 on,s Traveler's Name(s): I Velma De La Rosa I Department/Office:l WISe Purpose of Travel: EM DR - 5 Day Intensive Training Destination: Albuquerque, NM -------- --------- Dates of Travel: June 22-28, 2025 I'total Trip Cost Estimate: $ 3,366.00 (This line will auto -sum the costs listed below) ITravel Twe (Select One): Q Out of State Travel Q Out GNUS Travel (AK, HI or US Territory) 0 Foreign Travel Q Extradition Fund Number/Department: 108-150-00.8059-564.44.XXXX Grant Funded? If Yes, List Grant Amount: Cost Application (Select One): 0 Yes Government Rate 0 No 0 Conference Rate 0 Regular Rate Hotet - GSA Rate: Hotel - Nightly Rate: Hotel Total: $144.00 $144.00 $864.00 Explanation for Rate: Required if hotet cost is greater than ;pert em orgovernment ra N/A I Rental Car Required? If Yes, Rental Car Cost: 0 Yes M No Air Carrier: Cost of Flight: Southwest I Preparer's Name/Title.* Anna Serrano Conference Fee: 1 $1,445.00 Total Estimate of MI&E During Travel: $520.00 Preapproved by EO/DH? Q Yes 0 No Additional Expenses: $0 (Addt7 costs for extended stays, flight upgrades, etc. at the expense of the traveler) If Yes, EO/DH Name: Dell Anderson RECEIVED ret itvw Griant, Behavlorol Heolth 8, Wellness MAR 1 i 2o2s RENEW Must attach training information including agenda, start and end times and meat information. Forms missing any of the required information wilt be returned for completion. ALL fields must be fitted in compLetety. El in -State Tra 1 n ing A Out -of -State Training Cl Webinar (Must be received 30-days in advance) (Must be received 90-days in advance) Employee Name: Velma De La Rosa Training Name: ✓EMDR Dates of training: June 23-27, 2025 Departing Date: June 22,2025 DepartingTime: auY-1ime Registration Cost: $1445 Today's Date: 3/10/2025 Location: Alburquerque, NM Returning Date: June 28,2025 Returning Time: Early morning Motet: 9 Yes El No Are there any room blocks for this training at a specific hotel.? Hilton Garden Inn Albuquerque Air -port Transportation-, 0 Personal Car PY Company Car (if requesting to take personat car, direct supervisor signature is required below) Airfare: A Yes El No Flight/ airport preferences? .dune 22(eariy moming); .dune 28th--(early moming) How witt this training add value to the organization? This is a transfer training, originally was scheduled for April 2-6th; there will not be another training in Washington State. We are able to transfer to training as it has been paid for. This training will help me better support my staff who are trained in EMDR. This is an evidence base practice to help children, youth and adults process their Trauma events. TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY Estimated Cost: -V Funding Source: vV!sf.r* Training Approved: es ONo Direct Supervisor Signature: / T------" &d Date:,- --u U Personal Car Approval: Direct Supervisor Signature: El Yes .-.+40 Executive Staff ApprovaL-, es No Executive Staff Signature - Date: Date: o renew Gront Behavioral Hoolth 6 Wellness Must attach training information including agenda, start and end times and meat information. Forms missing any of the required information will be returned for completion. All fields must be filled in completely. 4 In -State Training El Out -of -State Training (Must be received 30-days in advance) (Must be received 90-days in advance) elma De La Rosa Employee Name: v 11 Training Name: EMDR El Webinar Today's Date: 1/22/2025 Location: Everett, WA Dates of training: 4/2/25-4/6/25 Departing Date: 411/25 Returning Date: 4/6/25 Departing Tirane: 1:OOP Returning Time: 9:00P Registration Cost: 1,445.00 Hotel: 9 Yes 0 No Are there any room blocks for this training at a specific hotel? Hotel Indigo Seattle Everett Waterfront 1028 13th Transportation: 0 Personal Car X Company Car if requesting to take personal car,, direct supervisor signature is required below) Airfare: 0 Yes 9 No Flight / airport preferences? How will this training add value to the organization? EMDR is the most common requested practice from clients to be able to process trauma. When working with younger children and teenager talk therapy will not out it, being certified in EMDR will help me support my staff be able to process trauma without the traditional talk therapy. TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY A -,-,---,-- OC Estimated Cost.Fund�nMig20A J-f Training Approved: Yes1 No� I V, "J/ Direct Supervisor Signature: Personal Car Approval: 0 Yes .Ovo Direct Supervisor Signature: Executive Staff Approval: Executive Staff Signature: es El No Date: Date:- Out of State Travel Request Application DEADLINE: Due by Thursday at 12:00 p.m. to the Commissioner's Office with BOCC Consent Agenda Request Form, to be on the following week's Consent Agenda. ITraveler's Name(s): I Angela Clay I Department/office: WISe Purpose of Travel: EMDR - 5 Day Intensive Training Destination: Albuquerque, NM Dates of Travel: June 22-28,2025 iTotal Trip Cost Estimate: $ 3,366.00 (This line will auto -sum the costs listed below) I Travel Twe (Select One) : o Out of State Travel Q Out CONUS Travel (AK, HI or US Territory) E0 Travel 0 -Foreign Extradition Fund Number/Department: 108.150.00.8059.564.44.xxxx --Grant Funded? If Yes, List Grant Amount: Cost Application (Select Or -- --------- - ----------- - -0 Yes a Government Rate No 0 Conference Rate 0 Regular Rate Hotel - GSA Rate: Hotel - Nightly Rate.* Hotel Total*. $144.00 $144.00 $864.00 Explanation for Rate: Required if hotel cost is greater than per them orgovernment ra NIA I Rental Car Required? If Yes, Rental Car Cost: 0 Yes No Air Carrier: Cost of Flight: Southwest 1- $537.00 I Preparer's Name/Title: Anna Serrano Conference Fee: 1 $1,445.00 Total Estimate of MI During Travel: $520.00 Preapproved by EOIDH? Q Yes 0 No Additional Expenses: $0 (Addt'l costs for extended stays, flight upgrades, etc. at the expense of the traveler) If Yes, EO/DH Name: Dell Anderson RECEIVED " 71"N L!-- �\,•, 9 renew Gront Behavioral Health 6 Wellness ❖ Must attach training information including agenda, start and end times and meat information. Forms missing any of the required information will be returned for completion. All fields must be filled in completely. El In -State Training A Out -of -State Training (Must be received 30-days in advance) (Must be received 90-days in advance) Employee Name: Angela Clay Training Name: EMDR Training: Intergratnig EMDR In Your Practice Dates of training: ,June 23rd-June 27th, 2025 Departing Date: June 22nd, 2025 Departing Time: Early Morning Registration Cost: 1445.00 Hotel: 110 Yes nNo Are there any room blocks for this training at a specific hotel? RENEW F Webinar Today's Date: 3/10/2025 Location: Albuquerque, New Mexico Returning Date: June ' 28th, 2025 Returning Time: Early Morning_ Transportation: El Personal Car X Company Car if requesting to take personal car, direct supervisor signature is required below) Airfare: X Yes 0 No Flight / airport preferences? Spa Howwill this training add value to the organization? EMDR training will equip me with evidence based approach to help children to process and heal from trauma more effectively. This modality is particularly beneficial in reducing distress associated with traumatic memories, imporoving, emotional regulation, and enhancing resilience in young clients. By intergrafing EMDR into clinical practice, I can offer a structured and efficient intervention that complements traditional talk therapy. This training will strengthen our agency's capacity to provide high -quality, trauma informed care improving client outcomes. TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY Estimated Cost: U Funding Source:,- T 1% �ZZ Training Approved: 'kO Yes 0 No Direct Supervisor Signature: Date: . . ...... . .. Personal Car Approval: 0 Yes ISN 0 Direct Supervisor Signature: Date: Executive Staff Approval: es 7No Executive Staff Signature: I Date: Grant Grant Behavioral Health 6 Wellness Must attach training information including agenda, start and end times and meat information. Forms missing any of the required information wilt be returned for completion. Alt fields must be fitted in completely. A In -State Training El Out -of -State Training (Must be received 30-days in advance) (Must be received 90-days in advance) Employee Name: Angela�Clay Training Name.- EMDR El Webinar Today's Date: 01/2112025 Location: Everett, WA Dates of training: 4/2/25-4/6/25 --- ---- ---------- Departing Date: 4/1/25 - ----- - Returning Date: 416/25 Departing Time: I .0opm returning Tune: 9,00prn Registration Cost: -1 445.00 Hotel: A Yes 11 No Are there any room blocks for this training at a specific hotel? Transportatiom 0 Personal Car A Company Car if requesting to take personal car, direct supervisor signature is required be ow Airfare: 0 Yes 9 No Flight/ airport preferences?._____ How will this training add value to the organization? EMDR is the most common requested practice from clients to be able to process trauma. When working with younger children and teenager talk therapy is not effective, being certified in EMDR will help me support my clients who come to me for help. TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY IT Estimated Cost: MI Training Approved: A -Yes 0 No Direct Supervisor Signature. I Date:. r W-�P? ...... Personal Car Approval: 0 Yes o Direct Supervisor Signature.- Date; Executive Staff Approval: OYes [IN o Executive Staff Signature: Date: �- #ut of State Travel Request Application- DEADLINED pe by Thursd6Y' :it 12,00 PM. to the Commiss*0ner.s Office with,80CCCo nsent kenda' Re west 1=orrn b h; f Ws�C ri; a ,the oLtowinaw e Cans t Age d' Traveler's Name(s): I Corona Camacho-Jimenez I Department/Office: MH Purpose of Travel: EMDR - 5 Day Intensive Training Destination: Albuquerque, NM Dates of Travel: June 22-28, 2025 Total Trip Cost Estimate: $ 3,366.00 (This line will auto -sum the costs listed below) ITravel Toe (Select One): Out of State Travel, --------------------- 0 Out CONUS Travel (AK, HI or US Territory) 0 Foreign Travel Q Extradition Fund Number/Department: 108.150.00.0000.564.44.xxxx Grant Funded.? If Yes, List Grant Amount: Cost Application (Select One),- 0 Yes 0 Government Rate No 0 Conference Rate ERegular Rate Hotel - GSA Rate: Hotel - Nightly Rate: Hotel Total-. $144.00 $144.00 $864.00 I Explanation for Rate: Required if hotel cost is greater than per them or govemment ra I N/A Rental Car Required? If Yes, Rental Car Cost: 0 Yes 5 No Air Carrier: Cost of Flight, Southwest 1 1 $537.00 I Prepa re r's Name/Title: Anna Serrano Conference Fee: $1)445.00 Total Estimate of MI&E During Travel: $520.00 Preapproved by EO/DH? Yes o No Additional Expenses.- $0 (Addt't costs for extended stays, flight upgrades, etc. at the expense of the traveler) If Yes, EO/DH Name: Dell Anderson RECEIVED F&I renew Grant Hethavioral Heolth -Y W Must attach training information including agenda, start and end times and meal. information, Forms missing any of the required information will be returned for completion. ALL fields must be filled in completely. 1:1 In -State Training A Out -of -State Training (Must be received 30-days in advance) (Must be received 90-days in advance) RENEW 0 Webinar G Corona amacho-Jimenez Employee Name: Today's Date. 03/11/2025 EMDR Training, Integrating EMDR into your Clinical Practice Training Name: Dates of training: 06/23/2025-06/27/2025 Departing Date: ' 06/22/2025 DepartingTime: Registration Cost: already paid Location: Albuquerque New Mexico Returning Date: 06128/2025 Returning Time: Hotel: 9 Yes El No Are there any room blocks for this training at a specific hotel? Hilton Garden Inn Albuquerque Airport Transportation: 0 Personal Car A Company Car (if requesting to take personal car, direct supervisor signature is required below) Ai rfa re: A Yes 0 No Flight / airport preferences? How will this training add value to the organization? provide therapeutic technques and processing to better assit clients in therapy TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY 1k t Estimated Cost: )1000 Funding Source: YM Training Approved: `�1Yes 0 No &r 0"" _ft4_ Direct Supervisor Signature: f-A Date: ZZ ----- - - V1 or Personal. Car Approval: Direct Supervisor Signature: Executive Staff Approval: Executive Staff Signature: 0 Yes �No es— 11 No Date: Date: --)I / 2- —Y renewGvanb Sehovloral Health 0 Wellness + Must attach training information including agenda, start and end times and meal. information, Y+ Forms missing any of the required information will be returned for completion. 4+4 All fields must be filled in completely. X In -State Tralffling ❑ Out -of -State Train'Ing F-1 We b-1 n a r (Must be received 30-days in advance) (Must be received 90-days in advance) Employee Name: Corina Camacho-Jimenez Today's Date: 01128/2025 Training Name,* EMDR Triaining Everett Washington 0 Location-, Dates of training: April 2-6 of 2025 Departing Date: April 1st, 2025 Returning Date: April 6th, 2025 Departing Time: April fist, 2025 -1 PM Returning Time: April 6th, 2025 -9:30PM Registration Cost; $1,445 0 HoteL, 09 Yes El No Are there any room blocks forthis trainingat a specific hotel? Hotel Indigo Seattle Everett Waterfront Transportation: OPersonal Car 9 Company Car (If requestingto take personal car., direct supervisor signature is required below} Airfare: 7 Yes 0 No Flight / airport preferences? How wM this training add value to the organization? Provide additional support for, --**clients in metting and marnaging Mental health needs TO BE COMPLETED BY DIRECT SUPERVISOR AND EXECUTIVE STAFF ONLY Estimated Cost: 1006 Funding Source;..........Mut6l Training Approved,: .Yes R No Direct Supervisor Signature: Persona[ Car Approval: Ej Yes Direct Supervisor Signature: Executive Staff Approval., 0 Yes 0 No Executive Staff Signature: Zo 1!!�� Date: -4 Date: Date:, rZ I S-DAY TRAINING -.SAY 1, (7:30AM- �:30PM) Munday June 23.3 2025 , 7:3".-00 - Commu W-- Networift 8:0"*.15 - Training Oven-diew 8:15--8:343 - Background of EMIR 8:30-9:00 - Newabialogy of A] P 9:0&-10:00 -What is EMT? 10:00-10:45--- BREAK 10:1510:45- Stage 1: Case Form.ulFit[bn (Phase 1: Httory talino: iopsychosodal" 10-.45-12:00 - Stage. 1 -, Case Formulation (Phase 1: Affe cit RegulaWn) 12:010-1:00 - LUNCH 0& induded!a te). 1 -.00-1 -430- - Stage I -_ Case FormWq atton (can fflneed) 1:30-5:15 - Pradz^ce Session 1: AdFact Regullaition fincludes break) 5:15-5:30 - PracHce Session 1; Q&A; Day I Wrap-up- DALY SCH E.-DULE AND ITINLE-RARY S-DAY TRAINING - DAY 2 (7:30AM- W- 5:30PM) Tums-day June 212 3- 5-DAY TRAINING - DAY 3 (7:30AM- 5:30pm) Vlednme�day June 254 2-025 7:308: GO - CommunW NeWorWing T.3":00 - Community Networking :9: 0":F 15 - Day I Re'vievi 8,:00-4:15 - Day 2 ReView 8:1":45 -Stage 1: Case Formulaffon 8:15--9:45 - Stago 2: Processin. g Tbases Z-7) (Phase I.- -target Sequenos Plannting) 9:45-10:00 - BREAK 9:454 0:00 -BREAK 40:00-12:00- EMDR.procming (Phases 2-7 continued) 10:0012:00 -Stage 1: Case Formulation 12:00-1:00 - WNCH (not iWuded ft?. Fee) -(Tlargst Sequence Planning continued) VOG-6:15 - Practice Session I EMOR (Includes break) 12:001:00 - LUNC14 (not incladeer in fee) 5:15-5:3-0 - Praefte Sestibn 3; Q&A; Day 3 Wrap-up 1,:OM:30 -Stage 1: Case Fo nnW: ation (conf. nued) 1:30�-5:15 - Przfflce Session 2: Target Sequence Plann, ingfinforme7d Consent fincludes break) 5:15-5:M - Praalce Session 2; Q&A; Day 2 Wrap-up S-DAY TRAINING - DAY 4 (7:30AM- 5-DAY TRAINING - DAY 5 (7:30AM- r" 5:30pm)l 5:30PM) ThursdaY JUM 24, 2025 Community Met%rorking Day 3 Revileiv Stage 2: FrDeessing IhaSes 3-7) Adaptartons to procassing (containaid and, restricita-d-EMD) 9:45-10:00 - BREAK 10:00-12:00 -Stage 2: Processing i,elMical Injerventonsi'Managing EM-off-ons) 12: 00-T'(00 - LUNCH Qwt fndvd�ed in, 1:0t_j :15 - Stage 3: IntegmUon (Phase 8: Reevaluafion Overview) 1: 15-5-.15 - prac9ce Session 4: Procesdo. g (EMDR, Contained or EMD) 5:15-5: 30 - Practice Sessian,!I�. 0&,A-. Day 4 Wrap-up 'a"';1day Jug 27, 2025 7:3":00 - Commun4 Networking 8:0"1:15. - Day 4 ReVI-ew a: 158':30 - Stage 3: IntegratiOn .(Phase a: Rae -valuation) 8:30".12:00 - FT-acf1ram' SESSIOn 5: Processing, Megrab"an flincludes. break) 112:00-1:00 - LUNCH (not included hT Feet, 1 %SM--2:145 -Ad dMon- a I APON ca-h-Ons 2:45-3:00- - BREAK 3.,OM-.00- - AddMonal AppUcaffons (confinued-) 5:00-5�30- - Altaf s next: Gonsu]Mfio n.-, Leamfn 9! Managamient System (LMS), eta