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HomeMy WebLinkAbout20110320.tiff RESOLUTION RE: APPROVE STATEMENT OF GRANT AWARD FOR JUVENILE ACCOUNTABILITY BLOCK GRANT AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS,the Board has been presented with a Statement of Grant Award for the Juvenile Accountability Block Grant between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Sheriff's Office,and the Colorado Division of Criminal Justice, commencing January 1, 2011, and ending December 31, 2011, with further terms and conditions being as stated in said award, and WHEREAS, after review, the Board deems it advisable to approve said award, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Statement of Grant Award for the Juvenile Accountability Block Grant between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Sheriff's Office, and the Colorado Division of Criminal Justice be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said award. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 31st day of January, A.D., 2011, nunc pro tunc January 1, 2011. BOARD OF COUNTY COMMISSIONERS WE • COUNTY, COL RADO ATTEST: • " � ' . k arbara Kirkmeyer Chair Weld County Clerk to the(a (..,) (v`� 4, , Seam Cor�w , Pro-Tem BY: Deputy Clerk to the B it . Garcia AP ED ORM: Cc>4 David . Long ounty Attorney EXCUSED Douglas Rademacher Date of signature: `);i7 uvtic S k to KGA Q , SJ a _ _ 2011-0320 I i l SO0032 C d s Division of Criminal Justice Jeanne Smith,Director 7 700 Criminal Kipling St. Suite 1000 Denver,CO 80215-5865 COLORADO (303)239-4442 DEPARTMENT FAX(303)239-4491 OF PUBLIC SAFETY December 31, 2010 Commander Ken Poncelow Weld County Sheriffs Office 1950 O Street Greeley, CO 80631 Re: "Weld County Juvenile Accountability" Grant #29-JB-L-19-13 Dear Commander Poncelow: Congratulations on the approval of this grant. Enclosed are two copies of the Statement of Grant Award (SOGA) for$28,281.00, which includes $25,453.00 in federal funds and $2,828.00 in cash match. Award Paperwork Enclosed are two sets of the Statement of Grant Award (SOGA) for the above-named project. Please do not unstaple them. Be sure to read all Special Conditions, Instructions, and Standard Conditions listed in your Statement of Grant Award. Compare the Approved Budget as shown on the Statement of Grant Award with the budget pages of the application, and review the grant duration dates. Please ensure that your financial officer or accounting office has only final, approved budget amounts. Bill Ritter,Jr. Both sets of the Statement of Grant Award must be signed by your Authorized Official and GOVERNOR returned as soon as possible. After the signatures of the Director of the Division of P A.Weir EXECUTIVE DIRECTOR Criminal Justice and the Controller of the Department of Public Safety are obtained, the Colorado State white copy of the SOGA will be returned to you with the attached application. This Patrol complete document is the official grant contract. Colorado Bureau of Investigation Division of The following bulleted issues must be resolved prior to the disbursement of funds. Criminal Justice Office of Preparedness, 0 Included in this packet is the DCJ Form 30, Certification of Compliance with Regulations, Security,and Fire Safety concerning Civil Rights Requirements and Equal Employment Opportunity Plans. This form must be completed and returned with your signed SOGA. ®By January 31, 2011, submit the following documents: a. Organizational chart for the Sheriffs Office b. Copy of the most recent financial audit for Weld County I. c. Completed Financial Management page from the application d. A copy of your CCR Registration e. A DCJ Form 16 - Professional Services/Consultant Certification, with a copy of the DC contract or statement of work. Home Page: wwa.state.co.uslgov_dirlcdpsldcj.htm E-Mail: Jeannesmith@cdpsstaleco.us 2011-0320 Commander Poncelow December 31, 2010 Page 2 Grant Reporting and Management The DCJ reporting forms that you are required to use for this project are enclosed. Please destroy any outdated forms. Submission of any outdated forms will delay any requests made to DCJ. To obtain additional forms please make copies of these or you can obtain them from our website at "http://dcj.state.co.us/oajja" and by clicking on "Grant Reporting Forms" and then by clicking "Juvenile Accountability Block Grant (JABG)." Quarterly financial and narrative reports are due fifteen (15) days after the end of each calendar quarter- April 15, July 15, October 15, and January 15. Final financial and narrative reports are due 45 days after the grant end date. In addition to narrative reports, data forms specific to the purpose area in which services are being provided are to be submitted quarterly. Blank forms have been included within the forms packet. Electronic versions of the forms can be obtain from the website address listed above as well. Cash requests (draw downs of awarded funds) can be submitted monthly or quarter for reimbursement of expenses. Please reference grant#29-JB-L-19-13 on all forms and correspondence. If you have any questions, please contact me at Michele.Lovejoy@cdps.state.co.us or (303)239-5712. Si c< Michele Lovejoy Office of Adult and Juv le Justice Assistance Enclosures COL(' -"ADO DIVISION OF CR1' 'NAL JUSTICE • • STATEMENT OF GRANT AWARD (SOGA) • FEDERAL PROGRAM INFORMATION CFDA Title& Number: #16.523 ` Federal Agency: Office of Juvenile Justice and Delinquency Prevention, OJP, DOJ ; ,, Federal Award Name&Number: #2009-JB-FX-0033 Juvenile Accountability Incentive Block Grant Program Aware '„ ! Subgrantee Name: Weld County Sheriffs Office Project Director: Commander Kenneth Poncelow Project Director Address: Weld County Sheriffs Office 1950 O Street Greeley,CO 80631 Grant Number: 29-JB-L-19-13 Project Title: Weld County Juvenile Accountability Grant Period: January 1, 2011 To December 31, 2011 Date Issued: January 7, 2011 In accordance with provisions of the Colorado Revised Statutes §24-33.5-502, the Division of Criminal Justice hereby awards a grant to the above-named subgrantee. The attached grant application(Exhibit A), including Special Provisions and Certified Assurances, is incorporated herein as a part of this document. APPROVED BUDGBY PURPOSE AREA Purpose Area ft/Project Federal Award Cash Match Total Administration 1.273.00 0.00 1,273.00 '12a-Establishing & Maintaining Programs to 24,180.00 2,828.00 27,008.00 Conduct Risk Assessments TOTAL AWARD AMOUNT 25,453.00 2,828.00 28,281.00) ' The detailed budget(s)found in the attached, approved plan provide budget category amounts for each purpose area. Use these approved detailed budget(s)for reporting expenditures by Purpose Area. ' Purchase of equipment requires prior completion and approval of DCJ Form 13. ' Professional services require prior completion and approval of DCJ Form 16. Special Condition(s): 1 This project was supported by Grant No. 2006-JB-FX-0012 awarded by the Office of Juvenile Justice and Delinquency Prevention through the Division of Criminal Justice,Colorado Department of Public Safety. The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics,the National Institute of Justice, the Bureau of Justice Assistance,and the Office of Victims of Crime. Points of view or opinions in this document are those of the author and do not represent the official position or policies of the United States Department of Justice or the Division of Criminal Justice, Colorado Department of Public Safety. Version 4-4-05 Page 1 of 3 P:IOAJJAUAEGiJ6 5OGAS12010129 16- Soga. rpd Statement of Grant Award (S A) INSTRUCTIONS 1. Grant activities must be based on the approved budget shown on page one of this Statement of Grant Award, and the approved detailed budget(s)within the attached application,which supersedes any earlier budget request submitted,and which may be different from the budget originally submitted in your application. The subgrantee must secure poor written approval from DCJ if there is to be a change in any budget category(see DCJ Form 4-A). 2. The Financial Officer of the project must be provided a copy of this document in order to adequately prepare the necessary financial reports. 3. The Subgrantee Agency affirms that the parties'agreement consists of a two-part document,the Statement of Grant Award (SOGA), and Exhibit A, attached to the SOGA, which contains the Grant Application (including Project Summary, Budget and other Documents), the Certifications,the State Special Provisions, the Grant Requirements, the Federal Certified Assurances, and signatures of persons authorized to sign on behalf of the Subgrantee Agency on each part of the two-part document. 4. Review carefully the "Administrative Guide for Federal Justice Grant Programs Administered by the Colorado Division of Criminal Justice,"which includes procedures regarding this document,draw-down of grant funds, reporting requirements and requesting grant modifications. 5. This grant award shall be effective upon the final approval by the State Controller or designee. No payment shall be made pursuant to the grant prior to State Controller approval. 6. This grant award may be voided in whole without further cause if it is not signed by the subgrantee's Authorized Official and returned to the Division of Criminal Justice within 45 days of the date of issuance. 7. The signature of the Authorized Official below should be the same as the one on the grant application.The subgrantee must promptly notify the Division of Criminal Justice of any changes in the Authorized Official, Project Director, or Financial Officer,by completing and submitting DCJ Form 4-B. (If changes have already occurred,submit completed DCJ Form 4-B with this document). ADDITIONAL DCJ REQUIREMENTS (1) Commencement within 60 Days. If the Division concludes that the project has not commenced within 60 days of the start date of the grant period, the subgrantee must report the following by letter to the Division of Criminal Justice: a. the steps taken to initiate the project; b. the reasons for delay; and, c. the expected starting date. (2) Operational Within 80 Days. If the Division concludes that the project is not operational within 80 days of the original start date of the grant period, the Division of Criminal Justice may begin termination or reduction in grant award proceedings as described in"Special Provisions& Certified Assurances", Section entitled "Termination or Reduction in Grant Award." (3) All subgrants are conditioned on the ability to report to the Division of Criminal Justice all the information contained on the DCJ quarterly narrative and financial reporting forms, which are provided with this SOGA. Technical assistance is available upon request. (4) These funds cannot be guaranteed beyond the end date of the grant period on page 1 of this SOGA. Unexpended funds remaining at the end of the grant period must be returned to the Division of Criminal Justice. RETURN: ALL SETS of the Statement of Grant Award with ORIGINAL SIGNATURES to: Division of Criminal Justice, Office of Juvenile Justice, 700 Kipling Street, Suite 1000, Denver, CO 80215. After other required signatures are obtained, the white SOGA copy with approved application will be returned to your Project Director. Statement of Grant Award (SOGA) Version Page 2 of 3 P.OAJJA'UABGB SOGASIJAIBG SOGA pages2-3 august 2008.wpd Statement of Grant Award(SOGA) Grant Routing Number THE PARTIES HERETO HAVE EXECUTED THIS BINDING SUBGRANT AWARD Persons signing for Subgrantee hereby swear and affirm that they are authorized to act on Subgrantee's behalf and acknowledge that the State is relying on their representations to that effect. SUBGRANTEE: STATE OF COLORADO: Weld County, Colorado BILL RITTER. JR.GOVERNOR Legal Name of Subgrantee Agency *SIGNATURE°, Authorize( Official IF"ECTOP Colo ado Division of Criminal Justice JEANNE M. SMITH Barbara Kirkmeyer, Chair, Board of Weld County t Punt Name& Title of Authorized Officia/Commissioner Date Signed: Date Signed: 1/31/2011 STATE OF COLORADO LEGAL REVIEW: See Contract Routing Waiver# 127 (or,if not waivod) John W. Suthers, Attorney General By: Signature -Assistant Attorney General Date Signed: ALL CONTRACTS & SUBGRANT AWARDS MUST BE APPROVED BY THE STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This subgrant award is not valid until signed and dated below by the State Controller or delegate. If performance begins prior to the date below, the State of Colorado may not be obligated to pay for the goods and/or services provided, STATE CONTROLLER: David J. McDermott, CPA By: --� -'�! Date Signed: F2,-1 ( I j Version Page 3 of 3 P:,,OAJJA\JABG1JB SOGASIJAIBG SOGA.pages2-3 august 2008.wpd .:-??0/1• DCJ FORM 30 CERTIFICATION OF COMPLIANCE WITH REGULATIONS OFFICE FOR CIVIL RIGHTS, OFFICE OF JUSTICE PROGRAMS FOR SUBGRANTS ISSUED BY THE COLORADO DIVISION OF CRIMINAL JUSTICE INSTRUCTIONS: Complete the identifying information, which is found on the Statement of Grant Award(SOGA), in the table below. Read the form completely, identifying the person responsible for reporting civil rights findings; and checking only the one certification under "II"that applies to your agency. Have your Authorized Official sign at the bottom of page 2,forward a copy to the person you identified as being responsible for reporting civil rights findings and return the original to the Colorado Division of Criminal Justice, 700 Kipling, Ste. 1000, Denver, CO 80215, within 45 days of the grant award beginning date. Grant# ,Z -se-z -/� -/3 Grant Project Title: /J1 'L& (1O!/,t) i L'7 Subgrantee Name (Funded Entity): 4,._/ p 6,-,:y62,-0 Address: /9 SieA F' 1 Co >,--)c.>3 / Duration: Beginning date: y.4) ) a, i End date: OE-" 2,P3/t ae'Award: $ 2 / 284 o Project Director's Name & Phone#: /lz'n /7oWci'' c °a/ ( 70 ) 4/2- /S ,Y ;26'0.2 Person responsible for reporting civil rights findings of discrimination: (Name, address & phone) AUTHORIZED OFFICIAL'S CERTIFICATION: As the Authorized Official for the above Subgrantee, I certify, by my signature below, that I have read and am fully cognizant of our duties and responsibilities under this Certification. I. REQUIREMENTS OF SUBGRANT RECIPIENTS: All subgrant recipients (regardless of the type of entity or the amount awarded) are subject to prohibitions against discrimination in any program or activity, and must take reasonable steps to provide meaningful access for persons with limited English proficiency. ♦I certify that this agency will maintain data(and submit when required) to ensure that: our services are delivered in an equitable manner to all segments of the service population; our employment practices comply with Equal Opportunity Requirements, 28 CFR 42.207 and 42.301 et seq.; our projects and activities provide meaningful access for people with limited English proficiency as required by Title VI of the Civil Rights Act, (See also, 2000 Executive Order#13166). ♦I also certify that the person in this agency or unit of government who is responsible for reporting civil rights findings of discrimination will submit these findings, if any, to the Division of Criminal Justice within 45 days of the finding, and/or if the finding occurred prior to the grant award beginning date,within 45 days of the grant award beginning date. if EQUAL EMPLOYMENT OPPORTUNITY PLAN(EEOP) CERTIFICATIONS: Check the box before ONLY THE ONE APPROPRIATE CERTIFICATION(A, B, or C below)that applies to this subgrantee agency during the period of the grant duration noted above. O CERTIFICATION "A" [NO EEOP IS REQUIRED if(1), (2) or(3), below, apply.] This is the Certification that most non-profits and small agencies will use. Check all that apply to your entity. This funded entity: (1) is an educational, medical or non-profit organization or an Indian Tribe; (2) has less than 50 employees; (3) was awarded through this grant from the Colorado Division of Criminal Justice less than $25,000 in federal U.S. Department of Justice funds. Therefore, I hereby certify that this funded entity is not required to maintain an EEOP, pursuant to 28 CFR 42.301, et seq. (CONTINUED ON REVERSE SIDE) 420//—D. D Colorado Division of Criminal Justice Page 1 of 2 Rev.9/2010 DCJ FORM 30: CERTIFICATION OF COMPLIANCE WITH REGULATIONS, OFFICE FOR CIVIL RIGHTS, OFFICE OF JUSTICE PROGRAMS (Continued) II. EQUAL EMPLOYMENT OPPORTUNITY PLAN (EEOP) CERTIFICATIONS: (Continued) O CERTIFICATION "B" (EEOP MUST BE ON FILE) This funded entity, as a for-profit entity or a state or local government having 50 or more employees, is receiving, through this grant from the Colorado Division of Criminal Justice, more than $25,000,but less than $500,000 in federal U.S. Department of Justice funds. Therefore, I hereby certify that the funded entity has formulated an Equal Employment Opportunity Plan in accordance with 28 CFR 42.301, et seq., subpart E, that it has been signed into effect within the last two years by the proper authority and disseminated to all employees, and that it is on file for review or audit by officials of the Division of Criminal Justice or the Office for Civil Rights, Office of Justice Programs as required by relevant laws and regulations. O CERTIFICATION "C" (EEOP MUST BE SUBMITTED)This funded entity, as a for-profit entity or a state or loca government having 50 or more employees, is receiving, through this grant from the Colorado Division of Criminal Justice,more than $500,000 in federal U.S. Department of Justice funds. Therefore,I hereby certify that the funded entity will submit, within 60 days of the award, an EEOP or an EEOP Short Form to the U.S. Department of Justice, Office for Justice Programs, Office for Civil Rights that will include a section specifically analyzing the subgrantee (implementing) agency. (If you have already submitted an EEOP applicable to thi time period, send a copy of the letter received from the Office for Civil Rights showing that your EEOP is acceptable.) As the Authorized Official for the above Subgrantee, I certify, by my signature below, that I have read and am fully cognizant o: our duties and responsibilities under this Certification. I, hereby, also certify that the content of this form, other than the data entry required, has not been altered. 6 QA_, 1/31/2011 [Au t zed Official's signa ure] [Date Barbara Kirkmeyer Chair. Board of Weld County Commisstonei [Typed Name] [Title] * * * * * * * * * * This original signed form must be returned to the Colorado Division of Criminal Justice, 700 Kipling, Ste. 1000, Denver, CO 80215, within 45 days of the grant award beginning date. You must also forward a signed copy to the person identified in the box above. DCJ will forward a copy to the Office for Civil Rights, Office of Justice Programs, U.S. Department ofJustice. Colorado Division of Criminal Justice Page 2 of 2 Rev.9/2010 dr°mow�; COLORADO DIVISION OF CRIMINAL JUSTICE JABG- D JUVENILE ACCOUNTABILITY BLOCK GRANT �{;y. APPLICATION pY FOR �PROGRAM �pFUNDS yg,, p) {�9((� G-4N �{'+' b"U, F"rn m 0,1:P-11 k` �y �#J'P ��[ � Rtt .....I S. 1-1 STATE USE ONLY App#: I Grant#: I Award: 0211--J(4-1_- fq— f. APPLICANT AGENCY: Weld County Address 1950 O Street City,ZIP Greeley,80631 Project Director Ken Poncelow E-mail kuoncelowco.weld.co.us Telephone (970)356-4015 x 2802 FAX (970)304-6467 Federal Employer ID Number 8 4 6 0 0 0 8 1 3 Has applicant agency registered with the CENTRAL CONTRACTOR REGISTRATION(CCR) DUNS NUMBER 8 2 5 3 3 7 6 8 1 database? ❑Yes(CCR attached) ❑No IMPLEMENTING AGENCY: NORTH RANGE BEHAVIORAL HEALTH Contact KRISTEN JERNIGAN K Email RISTEN.JERNIGAN&1 NORTHRA NGE.ORG Address 1260 H STREET City,ZIP GREELEY,80631 Telephone (970)313-1151 FAX (970)352-7457 FEDERAL FUNDS REQUESTED: $25,453.00 CASH MATCH: $2,828.00 TOTAL: $28,281.00 OF AGENCY: (check one) ['State ❑City/Town ZCounty ❑Indian Tribe ❑ Other FUNCTION OF ❑ Law Enforcement ❑ Probation 0 Prosecution AGENCY: ❑ Courts ❑ Social Services 0 Youth Services ❑ Public Defense ❑ Education Z Treatment/Mental Health 0 Treatment/Substance Abuse ❑ Other Describe: TYPE OF APPLICATION:X JABG Local Allocation 9 State Program Funds ❑Other New: Continuation: 9 Start a new project ® Continue a project currently receiving JABG funds ❑ Expand or enhance an existing project not previously ❑ Expand/enhance an existing project receiving JABG funds JABG-funded For continuation applications,list up to three years of prior JABG funding in the table below. GRANT NUMBER FEDERAL FUNDS DURATION 27-JB-L-19-13 $15,248 12/01/08-9/30/09 26-JB-L-19-13 $15,327 10/01/07-9/30/08 r}r/air /4314,24 PROJECT TITLE: Weld County Juvenile Accountability PROJECT DURATION: From IAUI/201 I To 0/341/7011 , PROJECT DESCRIPTION(Limit to space provided): These funds support behavioral health services,which will be provided to juveniles in Weld County through multiple agencies: North Range Behavioral Health will deliver a continuum of mental health and substance use disorder services to both detained youth from Weld County at Platte Valley Youth Services Center and non-detained youth involved in the juvenile justice system. Services to be provided will include risk and needs assessments of juvenile offenders, crisis intervention,mental health and substance use disorder treatment, and referrals to ongoing behavioral health care services as needed,Partners in this collaboration include North Range Behavioral Health(including partners formally identified as Island Grove Regional Treatment Center), Senate Bill 94 of the 19th Judicial District,and Youth and Family Connections(formerly known as the Juvenile Assessment Center). PURPOSE AREA#1:Establishing and maintainingprograms to conduct risk and needs assessments I -_ PURPOSE AREA#2(if applicable): Accountability Based Program -2- FY2009 JABG Application Direct Awards PURPOSE AREA#3(if applicable): SERVICE AREA: U. S. Congressional District(s): 01 02 03 ®4 05 06 07 ❑Statewide Judicial District(s) (Identify by District Number): l9`h Judicial District Cities an'd Counties to be served: All cities within Weld County IS THE JURISDICTION(S)TO BE SERVED IN COMPLIANCE WITH THE =ID' t :` fir rn JJDP ACT?Oyes O No O No,but working with DCJ Compliance Monitor. = , 13gy'° ' PROJECT WILL BE USING RESEARCH OR EVIDENCE-BASED PROGRAMS OR ACTIVITIES: ❑Yes ❑No Provide the name of the Research or Evidence-based program. SEC :Y�..s+�'3. a .•• .• ,aY>d'..:: .€ 0AR TO k�✓_S,l tF'.. .,. Minimum required representation includes categories A-G: (If any category was impracticable, explain on an attached page.) A. Police F. Schools: School district and/or local middle B. Sheriffs and/or C. Prosecutors: District, County and/or City High schools (Please include students.) D. Probation Services G. Business E. Juvenile Court: District and/or H. Prevention organizations municipal jurisdiction I. Religious-affiliated, fraternal, nonprofit, and/or social services NAME AGENCY/ORG & ADDRESS CATEGORY JCEC MEMBERSHIP AND INVOLVEMENT IN YOUR LOCAL JBAG PLAN (Limit ''A page) -3 - FY2009 JABG Application Direct Awards r r # It `(, S' Fair f =1.4j''f�d 1. PROBLEM IDENTIFICATION (Limit 1 page) Identify the problem or issue to be addressed with relevant existing data. Clearly describe the nature and extent of the problem among the target population. Weld County, extending from Denver to the south to Nebraska to the east and to Wyoming in the north, covers an area of nearly 4,000 square miles.It contains 31 incorporated towns and 12 school districts. Greeley is the only area within the county that is classified as "urban," and serves as the county seat. The trends that have led the County to implement treatment courts argue for the establishment of the continuation of this grant funded service line. These trends,including sharp increases in population for this rural and frontier county, coupled with its geographic configuration and cultural diversity,have made it one of the fastest growing counties in the U. S. Local justice and mental health/substance use disorder agencies are adversely impacted by this growth, leading to unacceptable results, such as regularly exceeding the capacity of the 26-bed regional youth detention center; an increase in emergency releases; and the consideration of additional jail facilities to accommodate juvenile offender growth. The estimated population of Weld County was approximately 148,000 in 1995, and has grown to an estimated 236,857 in 2006,according to the U.S. Census Bureau. Moreover,the County's Hispanic (Latino) population is growing faster than other populations with 84.01% growth from 1990 to 2000, as compared to 59.58% for all non-Hispanic citizens. Hispanics now make up 28%of Weld County's population. The juvenile population between the ages of 10-18 is now 29, 859. Further, according to the 2005 American Community Survey, 12%of people living in Weld County were in poverty, and 12% of related children under 18 years of age were below the poverty level. According to U.S. Census figures,in 1999, 80% of Weld County households earned less than$75,000 per year. The use of the County's approved juvenile detention center bed capacity has also continued to increase. Based on Average Daily Population(ADP) figures provided through the SB 94 program(another state- local collaborative program that serves youth on pretrial through diversion and other programs), the County exceeded its bed capacity in 4 of the last 12 months 5 of the last 12 months(April 2009 to April 2010). This information is exciting because it is a decrease in bed use from previous years(historically FY 2007-2008 exceeded capacity 11 of 12 months; FY 2008-2009 exceeded capacity 8 of 12 months).To accommodate the excessive capacity, there have been approximately 39 emergency releases so far this fiscal year. Again, this statistic represents a decrease in the need for emergency releases and the pace for the current fiscal year is 47 emergency releases. Because of the public safety and health issues raised by these emergency releases,the Board of County Commissioners has had ongoing discussions about the possibility of building additional beds to house juvenile offenders, as well as implementing more evidence based programs designed to treat at risk youth within the community(i.e.,Multisystemic Therapy(MST). We have identified youth struggling with symptoms of oppositional defiant and conduct disorder as potential recipients of the grant funded services. These youth have been identified as target population because of their struggle, and their sibling's struggles,to maintain behaviors that are not in conflict with our criminal justice system. It is the intention of North Range Behavioral Health(NRBH)to utilize grant dollars to provide a continuum of behavioral health(both mental health and substance use disorder)treatment in order to intervene effectively with youth who are either at risk for criminal behavior(i.e.,prevention services provided at the Juvenile Assessment Center)and/or intervention services (i.e., services provided at the detention center,Platte Valley Youth Services Center). -4- FY2009 IABG Application Direct Awards 2. CONTRIBUTING FACTORS (Limit '''A page) Provide an analysis of contributing factors, such as risk and protective factors, identify which contributing factors this project will address and indicate the desired change for each of those factors. Contributing Protective Factors Project Intervention Type Desired Change Parental involvement Assessment of parent involvement, Increase involvement to include assessment of ecological resources supervision to help with supervision,education, role play,and prosocial activities Symmetrical parent-child relationship Educate parent on parenting types Balance between warmth and structure dynamics and pros and cons of each,and develop a plan to implement pros of each strategy with family Ability to follow rules and structure when Work with family and youth to Implement structure/rewards in home detained identify rewards for compliance post release/treatment with rules at home Contributing Risk Factors Project Intervention Type Desired Change Biological Influences Complete a medication evaluation Actively taking any medication if indicated recommended by prescribing doctor Negative Peer Associations Identify negative peers,encourage Develop new rules regarding contact parent to contact peers and express with negative peers concern for their child and their wishes for contact to stop Truancy Case management interventions Increased home-school link and a plan designed to link parents with to monitor attendance and school school behavior Substance Abuse Substance use/abuse/dependence Increased awareness of the impact of will be screened for upon first substance abuse on the body and on contact. Referrals will be made for behavior. Increased motivation to substance abuse education and continue with substance abuse treatment as needed. Substance treatment once released from abuse education groups will be detention. Increase in appropriate provided while the youth is in referrals upon release. detention. -5 - FY2009 JABG Application Direct Awards 3. INTENDED LONG-TERM OUTCOMES/CHANGES (Limit ''/3 page) Describe the intended long-term change/outcome desired. Indicate their relation to the proposed project's goals, objectives and contributing factors. Identify risk and protective Provide initial risk and needs assessment Design interventions that will decrease criminal factors and utilize each to within 48 hours of initial meeting. Utilize offending and/or criminal recidivism. develop interventions that assessment to develop interventions will support youth prior to designed to prevent criminal behavior and post-detention and/or criminal recidivism. Provide crisis intervention to youth and families engaged in JABG supported service/treatment. Guardians will increase supervision of the Increased accountability among identified youth Increase accountability youth in their care,increase structure in the and their caregivers/guardians will lead to among identified youth and home,increase home-school link and sustainable change and a decrease in new their caregivers/guardians support youth in prosocial behavior. criminal charges as well as in criminal Increase sobriety upon discharge as recidivism. evidenced by negative screens. Follow Decrease substance abuse among youth. through on referrals made for behavioral Increase school attendance. health services. Link underserved youth to Identify youth who have a need for Increase number of youth served. behavioral health services in behavioral health services but who have Increase community collaboration. their community not had access to services. Provide youth with resources and referrals to community agencies/services in order to sustain changes made during treatment. -6- FY2009 JABG Application Direct Awards 4. PROJECT DESCRIPTION (Limit 1 %2 pages) Describe in detail the project that will be supported with these funds including the services and activities to be provided and how they will not duplicate others offered in the community. If this request is for part of a larger program, the project (and associated costs) must be clearly defined. These funds support behavioral health services, which will be provided to juveniles in Weld County through multiple agencies: North Range Behavioral Health will deliver a continuum of mental health and substance use disorder services to both detained youth from Weld County at Platte Valley Youth Services Center and non-detained youth involved in the juvenile justice system. Services to be provided will include risk and needs assessments of juvenile offenders, crisis intervention, mental health and substance use disorder treatment (Behavioral Health Treatment) provided in both individual and group formats, and referrals to ongoing behavioral health care services as needed. Partners in this collaboration include North Range Behavioral Health, Senate Bill 94 of the 19'h Judicial District, Juvenile, and Youth and Family Connections (formerly the Juvenile Assessment Center). Through this proposal NRBH seeks to be able to continue to quickly and appropriately identify, assess, evaluate, and treat detained youth who are in need of Behavioral Health services; to communicate effectively with the juvenile court, probation officers, human service workers, detention facility staff, mental health and substance abuse therapists, school personnel, caregivers/guardians, and pertinent others about each referred youth; and to provide timely behavioral health services to those identified as needing such services. JABG funds have helped accomplish many of these tasks in past years. Because of restrictions on staff time and clearance requirements, youth served by grant funds would have no other assessment and treatment options while being detained at PVYSC. -7- FY2009 JABG Application Direct Awards 5. POPULATION TO BE SERVED (Limit 'A page) Complete the Table provided to define the proposed target population. Number of Juveniles Targeted to be Served White Black Hispanic Asian/Pacific Native Other/ Total Islander American Unknown Males 100 14 220 13 14 14 375 Females 25 5 80 5 5 5 125 Total 125 19 300 18 19 59,0 Percent of Total to be Served with Limited English Proficiency: <10 % Provide a description of the target population including age, gender, ethnicity and other characteristics of those the project is intending to serve. Describe how the proposed services are culturally, gender and age appropriate to the proposed target population. Monies awarded as a result of this proposal will be applied to NRBH services at Platte Valley Youth Services Center. Youth served are juvenile offenders who have been detained as a result of criminal activity or inability to maintain in the community solely with the support of probation services. NRBH is committed to providing culturally competent services to all consumers. In achieve this goal all clinicians are required to participate in a minimum of three cultural competency trainings each evaluation year. In addition,NRBH has committed to providing a bi-cultural bi-lingual counselor at PVYSC and ensures that consumer preferences are met in any intervention provided. Gender sensitivity is achieved by providing both a male and female counselor at PVYSC and offering youth the choice of whom they prefer to work with. Services provided to youth who are emergency released are provided in-home so that family culture may be adequately addressed. -8- FY2009 JABG Application Direct Awards b o r o d p ht F w t .a p .5 ° tu a o .5 ° ° ° O td • >•b 74 0ti5 a al CiD M Q tat a o v o a 0 0 o 0 p p a > 0 ,p v ,5 V a « a y0. ,^ a y °�to a o [�< El]I [z] '°to-a .r[��' o .ov0 2 la 01 0 • 'men .5 '� o 44 .5 o o C7 ..>. y ° /. !•1 0 T-O .F ° O is 'O co dal o�A QJ to a 0 b of c �p y .0 8, h C 0 5� 0' a) 0R0 '° �. b ° , Op 0 0 a ,5y �. rri O V °a O p 0 C m o V o C ' U O >"CS ° pp F 8 ;: N ti a 'd 'y a'7 a�o ~ '.� O -t,' g T Q., 2 b [r] V A O >y T .co an b Uco un j,0 � T OA al �y O I'eGl E, Q 1. C 5 Q 0 at .°. .'5 U 3 .5 U .5 'a Z 0 I Z. co >>' - o c, 5 a ° w C 5 o ° I. 3 y y e w a) al b > '2 � ^�� .-. t —0 C r5 o O g a c a ° v d, or ° a' 0 w >°. as 0 d .5 v vii Ls. .o �y -° 0 0 0 v F T v ' 0 C pp w ° h o ' V a " ° `� v ° 04 Le 05 0 A 110400 AA A > '� C C o o col I Q o o 0 w 0 w pap,;; 0 t .0 '' Q, = to W N C...) 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'J o N 0 O F 0 - y W U a3D o E u y A O N ty O A O N A O 0 .C 0 a) obO N ❑ G g go .G on b i 0 0 O ti > 0 to .4 pp 0 [ H N ti 0 0 6 U N Q d ctl U t° W O aAOw 0 q a) to d 0 Ct O 0 N >. 0 >" a. 0 0 4: W .b O O W co b O .F. 1 F W .0 0 0 i • F m N 0 i fx 0 A F 0 0 H p{ o o F. �d b CCI• W "P. E .0 '� 0 `N° q boo a '0 '.0 aL.) G ic-i R• O N 7 v O 0 W y to ' a � SEw � S V7 m b y 0 W 1a) F 0 ac '0 .0 U C 'd U U U ''4 U p n 0 T .N. c" ¢ .� 0 « pop T 0 y .N ,g61 > N O 0 N w 0 U 8 W O 0 a >" t v O • 0 U .S 0 up is m al o. C, o ❑❑ a U U A b = O '- > « G U CC0 ro .0 ro 'O N U 0 0 m .-d ry PO... A .. N F b 24 6i 'C N 0N. CJ H W •N 0 N .4 1. a 0 0 O .O. [�] q Q� O .0 >, > 0 O N P" GI U wy b.0 .0 F Gy i0, F Ili is) N E" m0 O H a .0 Q a o c u .to 00 o U .� o f W Pr O a? as OD.. Cp m as o p v C7 o Ow o o b O > W 0 7. PROJECT/PROGRAM IMPLEMENTATION OR ENHANCEMENT (Limit 1 page) 'Provide evidence that the proposed program or program enhancement will result in the intended outcomes including delinquency prevention and maximizing community safety. Cite the evidence or research utilized. In July 2008,North Range Behavioral Health(NRBH)merged service lines with Island Grove Regional Treatment Center(IGRTC). This service integration continues to enhance services supported by JABG grant funds to include substance use disorder treatment and increased family involvement in all interventions provided. Research indicates that rates of comorbid mental health and substance use disorders are as high as 65%. It was this knowledge that informed our decision to combine service lines so that all youth served via JABG grants will be assessed for both mental health and substance abuse risks and needs and will be matched to the most appropriate service (i.e., education, support,intervention services; individual or group modalities)in the spirit of providing comprehensive behavioral health services. Finally, all services will be enhanced to include a family component. This change is supported by Scott Henggeler's (Multisystemic Therapy (MST) Model Developer) research on correlates and causes of youth behavior problems. Family involvement in case management, education, and treatment enhance youth and family accountability and have proven to increase sustainable changes in behavior, which ultimately decrease risk factors and increase community safety. - 11 - FY2008 JABG Application Direct Awards 8. APPLICANT AGENCY CAPACITY, COMMUNITY COLLABORATION AND SUPPORT. (Limit Y2 page) Show that the applicant agency has the resources and necessary skill set to adequately manage the project. Describe collaboration with other agencies and groups in the community. As its mission, "North Range Behavioral Health provides professional,culturally competent behavioral healthservices for Weld County." Known previously as the Weld Mental Health Center,Inc.,NRBH has served the mental health needs of the people in this area for more than four decades. From 1995 to 1997,it functioned as the Mental Health Assessment Service Agency(MHASA)for Weld County. In 1998,NRBH joined with the Larimer Center for Mental Health and Centennial Mental Health Center to form Northeast Behavioral Health Partnership,which is now the Behavioral Health Organization(BHO)for Weld County, Larimer County, and the 12 counties comprising the northeastern corner of Colorado. NRBH has developed numerous collaborative efforts over the years. Most notably, it currently works with Weld County School District Six(District Six)to provide day treatment and education services through the Kathleen P. Littler Center in Greeley to children 12 years of age and under facing serious mental health problems. NRBH has also worked with staff from District Six and other Weld County school districts to provide mental health services to students attending alternative educational programming at Weld Opportunity School, Trademark, and Colorado High. Staff members of NRBH also provide on-site services to the students of Centennial,Dos Rios, and Cameron Elementary Schools and Northridge, Greeley Central, and Greeley West High Schools. A positive working relationship between the Family Education Network of Weld County and NRBH enables selected Head Start students to receive mental health care in their schools. Staff of NRBH also worked collaboratively with staff of the Platte Valley Youth Services Center(PVYSC)and with the Juvenile Services Planning Committee (Senate Bill 94 or SB 94) to provide basic mental health services to detained youth. In addition,NRBH was again awarded a JABG grant for the current fiscal year that helped provide services to juveniles while they are detained. NRBH is a regular participant in meetings of the local Juvenile Services (SB94)Planning Committee, local JABG,the Greeley-Evans Prevention Council,the Weld County Community Juvenile Review Board, and the Weld County Child Abuse Team. NRBH is a member of the Weld County Interagency Oversight Group and works with A Kid's Place in the reviewing and updating of the Weld County Child Abuse Protocol. An NRBH administrator is a member of the Board of Directors of A Kid's Place,which operates the local children's advocacy center and the Court Appointed Special Advocate(CASA)program. A related collaborative effort,Promises for Children, is now in place as well,necessitated by continuing needs in the community. An ongoing collaborative effort called the Multidisciplinary Youth Assessment Team(MYAT)is now in its seventh year. Comprised of the Weld County Department of Human Services(WCDHS),Weld County Probation, St. Vrain School District,Life Bridge Church and NRBH, this team has planned for and developed a community-wide system to meet various needs of youth and families in conflict or in need of positive youth development. NRBH has also joined in a community collaborative resulting in the formation of Youth and Family Connections(formerly the Juvenile Assessment Center(JAC))an agency designed to assess,provide crisis intervention and triage services to appropriate services for juveniles in the community. - 12- FY2008 JABG Application Direct Awards ' 4 . ., h :.. 4, as 1 {" L .. =o-.. .a .u. ....... r n.✓nxn.rw. a. ,,.. ... . . T..a3 .M a'. 1. Summarize the progress made in meeting your previous or current grant goals and objectives and the specific services that have been provided. Describe any changes or improvements made and/or problems encountered in implementing the project. (Limit '/2 page) All goals and objectives for the current fiscal year will be met or exceeded, based on data gathered through 5/1/2010.Timely evaluation, case management, and treatment services have been delivered to all youth referred. Specifically, 24-hour responses were provided to youth referred as well as to relevant stakeholders and referral sources occurred more than 90% of the time. Fortunately we have seen a decrease in the number of emergency releases,however the current rate of emergency releases at —4 per month continues to make the number of new referrals relatively high and makes continuity of care a challenge for those being unexpectedly released into the community. To impact this dynamic we have maintained the changes in staffing patterns to include the use of an intern and increased hours at the beginning and end of the week and have increased staff in our Community Based Child and Family Team. Again this year we were saddened to find that Hispanic youth were disproportionately represented among youth in detention at PVYSC. Of the 664 (up from 580 youth served in Fiscal Year 2008-2009) youth served so far this Fiscal Year, 68%were Hispanic, 30% were Caucasian, 1%were African American, and 1% were Native American. In addition, males made up 78% of the total number of youth served and females accounted for the remaining 22%. - 13 - FY2008 JABG Application Direct Awards 2. Explain the project's effectiveness and impact on the intended outcomes to date. Include specific data related to changes in contributing factors. (Limit V2 page) Intended outcomes for JABG supported services included reducing overall recidivism rates of youth enteringthe juvenile justice system and the negative impact of their behaviors on their families and the community. Unfortunately we have seen a 22% (148 total youth)return rate for youth we have served out at Platte Valley Youth Services Center. We believe our success in reaching this outcome has been limited for various reasons including low family engagement, low follow-through with services post-detention, and untreated substance abuse problems. In the coming year we intend to address these barriers in order make a greater impact on the contributing factors identified throughout this proposal. The current proposal includes a plan for increasing caregiver/guardian engagement by providing them with more contact and resources while their child is in detention so that chances of developing sustainable engagement in services are increased. In addition, NRBH will be receiving 100% of treatment dollars awarded by this grant which will enable us to re-direct money from other sources which have historically funded our PVYSC positions. Program enhancements include the provision of integrated behavioral health treatment so that youth services are no longer limited to mental health treatment. NRBH has provided a significant amount of Certified Addiction Counselor (CAC) training to staff working at PVYSC so that this outcome may be reached effectively. Finally,NRBH has continued to expand home and community based services so that barriers related to lack of resources can be addressed and overcome. Specifically we will be requesting that excess Senate Bill 94 dollars be redirected to Multisystemic and Functional Family therapy modalities so that youth who are emergency released will be more able to access in home family therapy and monitoring services. - 14- FY2008 JABG Application Direct Awards 3. LESSONS LEARNED (Limit'/Z page) Share any information learned that is not/was not part of the original evaluation design. For instance, unintended results, lessons learned, and challenges overcome. This information is not often part of the formal reporting process, but is very valuable in designing and evaluating future projects. It is also beneficial to share this information with other agencies. Because of the continued increase in emergency releases NRBH has had to refine the screening tool used upon first contact so that time spent with clients has become more efficient. In addition, we have increased our collaboration with the court and other community partners and begun staffing cases more frequently so that we can provide the most appropriate services to youth more quickly. In order to address the needs of youth who are emergency released from PVYSC NRBH has developed a proposal to submit to Senate Bill 94 requesting that funds historically used to supplement JABG awards be re-directed to support evidenced based community based services such as Functional Family Therapy(FFT)and Multisystemic Therapy(MST). - 15 - FY2008 JABG Application Direct Awards 4. PROJECT CHANGES (Limit %2 page) Describe any significant project changes (programmatic or budgetary) in this proposal from previously funded projects. This year the 19th Judicial Probation Department has decided to discontinue services associated with the JABG monies previously awarded. Because the Probation Office will no longer be a partner in this grant more money will be available to fund Behavioral Health Services. This increase in money will allow NRBH to re-direct Senate Bill 94 dollars that have been historically used to subsidize the services associate with the JABG Grant. In the 2010-2011 Grant Year NRBH will use excess Senate Bill 94 money to provide Multisystemic Therapy and Functional Family Therapy services to youth currently on probation with the 19"' Judicial Probation department. - 16- FY2008 JABG Application Direct Awards • Ni ..t dy}}.. t *%7 r.. ' �!F' •,{ ..4„ 4, r.. r... r r � .. r� !x#&414.j'E rc �Ie�1 a r }3t E�i.g`e: sr t.4 P 1. Specifically define the outcomes, impacts, or products you intend to achieve (within the proposed grant period) and how you will measure the degree to which your grant-funded activities are achieving them. Explain how you will document progress toward your objectives. (Limit ''A pages) NRBH seeks to continue its capacity to provide services to youth detained at the PVYSC. This project has served, and will continue to serve, as a model for how initial triage and evaluation,treatment, and case management services can be provided to this target population in a manner best suited to reducing recidivism and the severity of repeat offenses for those who do re-offend. Ideally, a full array of mental health and substance use disorder treatment services should be available to detained juveniles and their families. This project, as proposed, when linked with the other services to youth provided by the NRBH Community Based Child and Family program,will serve as a larger step toward achieving that ideal. The treatment and case management services to be delivered are part of a service plan developed with and for each youth admitted to NRBH services. Some of the youth served by this project will not complete their behavioral health services during the fiscal year, even some of those who are referred early on in the year. NRBH will continue to track them once they do finish and add their data to that of the others. Those who do finish will immediately help prove the value of services such as these and demonstrate the need for continuing this work. Over the time this project has been funded,the benefit of such services to the children and their families has been clearly shown,demonstrating that NRBH does provide cost savings to the community and the State as the mental health treatment costs are much less than those involved in detaining them and immensely less than serving them as committed youth. This project will continue to allow NRBH access to juveniles who otherwise would not have accessed behavioral health care either because they would have refused it or never would have been referred to it. Access is also gained to their siblings and other family members of the referred youth, again expanding NRBH's ability to help others make positive changes in their lives. Measurement of the achievement of the goals set forth herein will be ongoing with reports made at required or requested intervals. Both positive and negative results will be used to modify plans as the year progresses to realize maximum goal attainment and to ensure attainment of the desired impact on the needs the therapists are striving to meet. NRBH will continue to regularly evaluate how best to serve the target population over the course of the new grant period. The efficacy of various evaluation and treatment approaches will be studied to show what, if any,revamping of services is indicated. Strong efforts will be made to improve communications with all others involved in this project and the overall grant. - 17_ FY2008 JABG Application Direct Awards 2. Will research be conducted as part of this project? (Limit %2 page) NO ❑YES If yes, check the type of research proposed: Z The planned research/evaluation activities do not involve the collection of information identifiable to private persons. O The planned research/evaluation activities involve the collection of information identifiable to private persons. If the second box is checked, describe the procedures that will be put in place to ensure administrative and physical security of identifiable data and to preserve anonymity of private persons to whom information relates. �...#J..� Vilib : is a, 'M, . �'•l`"� } �r�. .. r:��� ,. i y ry��,� rOridtt i 3� �` 1. Describe the plan for reducing reliance on federal funding in the future. Describe the steps you have taken to diversify your funding sources, and/or incorporate this project into local funding sources, e.g. state or local government funding, and/or broad-based community support. ( Limit %2 page) NRBH has made a commitment to work as a collaborative partner in the Weld County Juvenile Treatment Court,to begin operating in July 2010. In addition,the Division of Youth Corrections has partnered with NRBH through a contract to provide services to youth and families post-commitment,to ensure successful reintegration into the community. NBRH has also begun implementing the Transitions for Independence program which provides case management services designed to support youth who are on track to emancipate or live independently without the support of a family. These services will include case management to qualifying youth and families as well as services designed to link youth and families to community supports designed to increase accountability. Finally,prevention services have been developed,i.e.,The Day Reporting Center,in the spirit of decreasing the need for detention center services. Unfortunately, funding sources are limited for many of the youth whose services are provided by JABG funds so NRBH continues to rely on the grant to fund services otherwise unfunded. - 18 - FY2008 JABG Application Direct Awards SECTION VII-BUDGET Copy this Budget Table and complete the Table and Narrative for each purpose area as well as the applicant agency's administrative portion of the funds. For continuation applicants: Identify and justify all new budget items and increases in each budget category from previous year funding. ROUND ALL AMOUNTS TO THE NEAREST WHOLE DOLLAR. Project Title: Weld County Juvenile Accountability Purpose Area: Administrative (1) (2) (3) (4) Source Annual Full- Annual Sub-Total % of time TOTAL Fed$ Cash Mate time Salary Fringe for This 1. PERSONNEL Benefit Cost Project + = X % $ = X % $ + = X % $ TOTAL PERSONNEL COST $ TOTAL Source 2. SUPPLIES AND OPERATING Fed$ Cash Matcl Administrative $ 1,273 1,273 TOTAL SUPPLIES AND OPERATING COSTS $ 1,273 1,273 TOTAL Source 3.TRAVEL(Designate specifically in-state and out-of-state travel.) Fed$ Cash Matc TOTAL TRAVEL COST $ TOTAL Source 4. EQUIPMENT Fed$ Cash Matc TOTAL EQUIPMENT COST $ 5. CONTRACTED CONSULTANT AND PROFESSIONAL SERVICES TOTAL Source Attach a copy of each contract with a detailed budget. Fed$ Cash Mat4 TOTAL CONTRACTED COST $ 6. TOTAL OF ALL PROJECT Source COSTS TOTAL Fed$ % of Total Cash Match$ % of Tota (1 through 5) TOTAL COST $ 1,273 $1,273 5% -19- FV7009 TARC; Annliratinn Tlirect Awarric 2. BUDGET NARRATIVE: (Limit 3 pages) Refer to instructions. Follow the same categories and line items as in the Budget Table. Complete a Budget Narrative for each purpose area/project as well as the applicant agency's administrative portion of the funds. For continuation applicants: Identify and justify all new budget items and increases in each budget category from previous year funding. Project Title: Weld County Juvenile Accountability Purpose Area: Administrative Funds to be utilized by Weld County Sheriff's office to assist in the administrative functions of this grant. -20- FV9009 IARG Annliratinn firers Awarris SECTION VII BUDGET Copy this Budget Table and complete the Table and Narrative for each purpose area as well as the applicant agency's administrative portion of the finds. For continuation applicants: Identify and justify all new budget items and increases in each budget category from previous year funding. ROUND ALL AMOUNTS TO THE NEAREST WHOLE DOLLAR. Project Title: Weld County Juvenile Accountability Purpose Area: #12—Establishing and maintaining programs to conduct risk assessments (1) (2) (3) (4) Source Annual Full- Annual Sub-Total % of time TOTAL Fed$ Cash Matc time Salary Fringe for This 1. PERSONNEL Benefit Cost Project + = X % $ + = X % $ TOTAL PERSONNEL COST $ TOTAL Source 2. SUPPLIES AND OPERATING Fed $ Cash Matcl TOTAL SUPPLIES AND OPERATING COSTS $ TOTAL Source 3.TRAVEL(Designate specifically in-state and out-of-state travel.) Fed$ Cash Matcl TOTAL TRAVEL COST $ TOTAL Source 4. EQUIPMENT Fed$ Cash Matcl TOTAL EQUIPMENT COST $ 5. CONTRACTED CONSULTANT AND PROFESSIONAL SERVICES TOTAL Source Attach a copy of each contract with a detailed budget. Fed$ Cash Matcl NRBH PVYSC Services(Assessment,Case Management,Crisis Intervention $ 27,008 $24,180 $2,828 TOTAL CONTRACTED COST $ 27,008 $24,180 $2,828 6. TOTAL OF ALL PROJECT Source COSTS TOTAL Fed$ %of Total Cash Match$ % of Total (1 through 5) TOTAL COST $ 27,008 $24,180 95% $2,828 10% -21- FV7009 1ARC; Annliratinn Ilirert Awarric 2. BUDGET NARRATIVE: (Limit 3 pages) Refer to instructions. Follow the same categories and line items as in the Budget Table. Complete a Budget Narrative for each purpose area/project as well as the applicant agency's administrative portion of the funds. For continuation applicants: Identify and justify all new budget items and increases in each budget category from previous year funding. Project Title: Weld County Juvenile Accountability Purpose Area: #12—Establishing and maintaining programs to conduct risk assessments -22- FVM009 TART Annliratinn Direct Award 3. TOTAL PROJECT FUNDING: A. In the box below, provide ALL sources of funding you are CURRENTLY RECEIVING for this project. List the other sources of funding for this project by the type of funds and amount. List the type and amount of other funding that will be provided to this project. Fund Type/Describe Amount Federal: State: County Government: Municipal Government: Private: Other—specify: TOTAL PROJECT COSTS B. What percentage of the total project costs will be supported by the federal funds you are requesting in this proposal? 100 % -23- FV,M19 !ARC; Annliratinn Direct Awardc 4. FINANCIAL MANAGEMENT: Please complete the items below. „A. •Has a copy of your last independent audit or financial review been previously submitted to DCJ? YES/ NO. If YES,to which program? If audit last provided to DCJ is older than one year, include one copy of the most recent audit or financial review, including any management report or other auditor comments in the appendix. Also, if there were findings, please attach the audit resolutions and/or corrective action plan. B. Does your agency expend over $500,000 from combined federal sources in a year? YES / NO If YES, attach a copy of the A-133 audit, including audit resolutions and/or corrective action plan. C. Please respond to the following questions about whether your accounting system meets the criteria for managing federal grant funds. (These questions cover areas that will be monitored by DCJ staff during site visits or through other reporting mechanisms. They are not intended to be all inclusive and do not substitute for the agency's responsibility to meet all federal and state requirements for these grant funds.) OYES ONO Does your accounting system separate ALL revenues and expenditures by funding source? OYES ONO Does your system track revenues and expenditures for each grant award separately through a sub-ledger system? OYES ONO Does your system allow expenditures to be classified by the broad budget categories listed in the approved budget in your grant, i.e. Personnel, Supplies and Operating, Travel, Equipment and Professional Services? OYES ONO Do you reconcile sub-ledgers to your general ledger at least monthly? EYES ONO Do you mark your invoices with the grant number? OYES ONO Do you maintain time sheets, signed by the employee and supervisor for each employee paid by DCJ grant funds? OYES ONO Do you have written financial policies and procedures in place? OYES ONO Do you have accounting internal controls in place, such as separation of duties, two signatures on certain checks, reconciliations or other reviews? For Continuation Applicants only OYES ONO Do you use your accounting system data to prepare your quarterly financial reports for DCJ? OYES ONO Do you reconcile your accounting system data with your quarterly financial reports for DCJ? If you answered "No" to any of the questions above, please provide an explanation on an inserted page referencing Section V Item#4. -24- cv70f19 TARn Annliratinn T)irrrt Awardc '` q�7 �l[�R , f �.�,.{�(�t 4���0r il'IK` 04 skip , This Certification of Appropriation of Match form should be completed by all agencies providing match. Certification of Appropriation of Match Date: June 30,2010 Colorado Division of Criminal Justice Office of Adult and Juvenile Justice Assistance 700 Kipling Street Denver, Colorado 80215 To Whom It May Concern: Please be advised that North Range Behavioral Health has committed support in the form of form of cash match in the amount of$2.828.00 to match the State of Colorado funds for the Juvenile Accountability Block Grant for the Weld County Juvenile Accountability program Execution of this document represents a certification that said funds have been earmarked within the appropriation of budget process for use as matching funds for this grant application. Sincerely, ��f < y47/22,47( tce,/I G 3O -0)-o(0 Signature/Date Wayne A. Maxwell,Ph.D. Executive Director 5 FY2008 JABG Application Direct Awards SECTION IX - CERTIFICATIONS/SIGNATURES`' These pages contain the required federal and state certified assurances and certifications (updated) necessary for the applicant to qualify for federal funding. Read these carefully. If you have any questions regarding these assurances, call OAJJA. These pages must accompany the completed application. X- ATTACHMENTS Attach the following applicable items behind the Signature page (Page 11 of the Special Provision and Certified Assurances pages) and label with the appropriate title: A. Organizational Chart—Highlight any positions included in the budget personnel category. B. Job Descriptions for the positions included in the budget personnel category. C. Memoranda of Understanding/Agreement or Letters of Commitment—Refer to the Application Instructions and the specific program area to which this application is responding to determine if these are required. If so, attach and label. D. Copy of CCR Registration. E. Copy of last audit or formal financial review—Supply only one copy of the last audit or formal financial review. However, if there were any management reports or other auditor comments, attach them to each copy of the application. It is not necessary to provide copies with each copy of the application. NOTE: Applicants for federal funding are required to undergo an annual A-133 audit if$500,000 or more is spent annually from any federal source. Applicants that spend less than $500,000 in federal assistance must maintain records and internal controls sufficient for audit. DCJ requires all subgrantees, regardless of amount received, to submit a current formal financial review or audit report every year. -26- FV2009 TAR(; Annliratinn Direct Awardc COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES Special Provisions&Certified Assurances must remain attached to the application August 20W SPCA t�- Page 1 of 11 RFC t CHECK BELOW TO INDICATE WHICH CATEGORY BEST DESCRIBES YOUR AGENCY:'VC� oY Dcj Inter-Governmental Grant JAN 05 2011 Grant to a Colorado State Agency(Section A does not apply) 1/ Grant to a Unit of Local Government, Tribal Government, or Special District. Grant to a Non-Profit, Private Organization(Non-Governmental) The applicant certifies by signing that the project described in this application meets all the requirements of the applicable governing legislation as indicated below; that all information contained in the application is correct; that there has been appropriate coordination with affected agencies;and,that the applicant will read, understand and comply with all provisions of the governing legislation and all other applicable federal and state laws, rules and regulations that have been or may hereafter be established. The applicant further understands and agrees that any subgrant award received as a result of this application shall be subject additionally to the grant conditions set forth in the Statement of Grant Award, and in the current applicable Administrative Guide of the Division of Criminal Justice. GOVERNING LEGISLATION FOR THIS GRANT PROGRAM• Juvenile Accountability Block Grant Program. From the United States Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, under federal statutory authority, PL107-273, November 2002, Making Appropriations for the Departments of Commerce, Justice and State, the Judiciary, and related Agencies and for other Purposes (Appropriations Act) and under applicable program guidelines established by said federal program office. • A. STANDARD STATE SPECIAL PROVISIONS Revised 1-1-09 1. CONTROLLER'S APPROVAL. CRS 24-30-202(1) This subgrant award shall not be valid until it has been approved by the Colorado State Controller or designee. 2. FUND AVAILABILITY. CRS 24-30-202(5.5) Financial obligations of the State payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted, and otherwise made available. 3. GOVERNMENTAL IMMUNITY. No term or condition of this subgrant shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions, of the Colorado Governmental Immunity Act, CRS §24-10-101, et seq., or the Federal Tort Claims Act,28 U.S.C. §§1346(b)and 2671 , et seq. as applicable now or hereafter amended. 4. INDEPENDENT CONTRACTOR. (THIS PROVISION IS NOT APPLICABLE TO GRANTS TO COLORADO STATE AGENCIES): THE SUBGRANTEE AGENCY SHALL PERFORM THE DUTIES FUNDED UNDER THIS GRANT AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE OF THE STATE. NEITHER THE SUBGRANTEE AGENCY NOR ANY AGENT, SUB-CONTRACTOR, OR EMPLOYEE OF THE SUBGRANTEE AGENCY SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE BY VIRTUE OF THIS SUBGRANT. SUBGRANTEE AGENCY SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID PURSUANT TO THIS GRANT. SUBGRANTEE AGENCY ACKNOWLEDGES THAT THE SUBGRANTEE AGENCY AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE SUBGRANTEE AGENCY OR THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. SUBGRANTEE AGENCY SHALL NOT HAVE AUTHORIZATION, EXPRESS OR IMPLIED, TO BIND THE STATE TO ANY AGREEMENTS, LIABILITY, OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. IF COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 2 of 11 THIS GRANT PROVIDES FUNDS FOR ANY PERSONAL SERVICES, SUBGRANTEE AGENCY SHALL PROVIDE AND KEEP IN FORCE WORKERS COMPENSATION (AND SHOW PROOF OF SUCH INSURANCE) AND UNEMPLOYMENT COMPENSATION INSURANCE IN THE AMOUNTS REQUIRED BY LAW AND SHALL BE SOLELY RESPONSIBLE FOR ITS ACTS OF ITS EMPLOYEES, INDEPENDENT SUB-CONTRACTORS AND AGENTS. 5. COMPLIANCE WITH LAW. The Subgrantee Agency shall strictly comply with all applicable federal and State laws,rules, and regulations in effect or hereafter established, including,without limitation, laws applicable to discrimination and unfair employment practices. 6. CHOICE OF LAW. Colorado law, and rules and regulations issued pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this subgrant. Any provision included or incorporated herein by reference, which conflicts with said laws, rules, and regulations shall be null and void. Any provision incorporated herein by reference which purports to negate this or any other Special Provision in whole or in part shall not be valid or enforceable or available in any action at law, whether by way of complaint, defense, or otherwise. Any provision rendered null and void by the operation of this provision shall not invalidate the remainder of this subgrant,to the extent capable of execution. 7. BINDING ARBITRATION PROHIBITED. The State of Colorado does not agree to binding arbitration by any extra judicial body or person. Any provision to the contrary in this subgrant award or incorporated herein by reference shall be null and void. 8. SOFTWARE PIRACY PROHIBITION.(Governor's Executive Order D 002 00) State or other public funds payable under this subgrant shall not be used for the acquisition, operation, or maintenance of computer software in violation of federal copyright laws or applicable licensing restrictions. The Subgrantee Agency hereby certifies and warrants that,during the term of this subgrant and any extensions,the Subgrantee Agency has and shall maintain in place appropriate systems and controls to prevent such improper use of public funds. If the State determines that the Subgrantee Agency is in violation of this provision, the State may exercise any remedy available at law or equity or under this Subgrant, including, without limitation, immediate termination of the Subgrant and any remedy consistent with federal copyright laws or applicable licensing restrictions. 9. EMPLOYEE FINANCIAL INTEREST/CONFLICT OF INTEREST CRS §§24-18-201 &CRS 24-50-507. The signatories aver that to their knowledge, no employee of the State has any personal or beneficial interest whatsoever in the service or property described in this subgrant award. The Subgrantee Agency has no interest and shall not acquire any interest, direct or indirect,that would conflict in any manner or degree with the performance of Subgrantee Agency's services and Subgrantee Agency shall not employ any person having such known interests. 10. VENDOR OFFSET. CRS§§24-30-202(1)& CRS 24-30-202.4 [Not applicable to intergovernmental grants[ Subject to CRS §24-30-202.4 (3.5), the State Controller may withhold payment under the State's vendor offset intercept system for debts owed to State agencies for: (a)unpaid child support debts or child support arrearages; (b) unpaid balance of tax, accrued interest, or other charges specified in CRS §39-21-101, et seq.; (c) unpaid loans due to the Student Loan Division of the Department of Higher Education; (d) amounts required to be paid to the Unemployment Compensation Fund; and(e)other unpaid debts owing to the State as a result of final agency determination or judicial action. 11. FEDERAL FUNDING. This subgrant is subject to and contingent upon the continuing availability of federal funds for the purposes hereof. 12. PUBLIC CONTRACTS FOR SERVICES. CRS §8-17.5-101. [Not Applicable to agreements relating to the offer, issuance, or sale of securities, investment advisory services or fund management services, sponsored projects, intergovernmental agreements, or information technology services or products and services] The Subgrantee Agency certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this subgrant and will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this subgrant,through participation in the E-Verify Program or the Department program established pursuant to CRS §8-17.5-102(5)(c), the Subgrantee Agency shall not knowingly employ or contract with an illegal alien to perform work under this subgrant or enter into a contract with a subcontractor that fails to certify to the COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES `' Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 3 of 11 Subgrantee Agency that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this subgrant. The Subgrantee Agency (a) shall not use E-Verify Program or Department program procedures to undertake pre-employment screening of job applicants while this subgrant is being performed, (b) shall notify the subcontractor and the contracting State agency within three days if the Subgrantee Agency has actual knowledge that a subcontractor is employing or contracting with an illegal alien for work under this subgrant, (c) shall terminate the subgrant if a subcontractor does not stop employing or contracting with the illegal alien within three days of receiving the notice, and (d) shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to CRS §8-17.5-102(5), by the Colorado Department of Labor and Employment. If the Subgrantee Agency participates in the Department program, the Subgrantee Agency shall deliver to the contracting State agency, Institution of Higher Education or political subdivision a written, notarized affirmation, affirming that the Subgrantee Agency has examined the legal work status of such employee, and comply with all of the other requirements of the Department program. If the Subgrantee Agency fails to comply with any requirement of this provision or CRS §8-17.5-101 et seq., the contracting State agency, Institution of Higher Education or political subdivision may terminate this subgrant for breach and, if so terminated, the Subgrantee Agency shall be liable for damages. 13. PUBLIC CONTRACTS WITH NATURAL PERSONS. CRS §24-76.5-101. Subgrantee Agency, if a natural person eighteen (18) years of age or older, hereby swears and affirms under penalty of perjury that he or she (a) is a citizen or otherwise lawfully present in the United States pursuant to federal law, (b) shall comply with the provisions of CRS §24- 76.5-101 et seq., and (c) has produced one form of identification required by CRS §24-76.5-103 prior to the effective date of this subgrant. B. GRANT REQUIREMENTS 1. FINANCIAL&ADMINISTRATIVE MANAGEMENT a. The Subgrantee Agency assures that fund accounting, auditing, monitoring, evaluation procedures and such records as necessary will be maintained to assure adequate internal fiscal controls, proper financial management, efficient disbursement of funds received, and maintenance of required source documentation for all costs incurred. These principles must be applied for all costs incurred whether charged on a direct or indirect basis. b. All expenditures must be supported by appropriate source documentation. Only actual, approved, allowable expenditures will be permitted. c. The Subgrantee Agency assures that it will comply with the provisions of the current applicable Administrative Guide of the Division of Criminal Justice which is hereby incorporated by reference. However, such a guide cannot cover every foreseeable contingency, and the Subgrantee Agency is ultimately responsible for compliance with applicable state and federal laws,rules and regulations. 2. PAYMENT& REPORTING a. The Division of Criminal Justice will pay the Subgrantee Agency the reasonable and allowable costs of performance, in accordance with current Colorado State Fiscal Rules, not to exceed the amount specified herein as the Total Award Amount,as identified in the Statement of Grant Award. b. The Division's requirements for invoice and cost reporting submissions are contained in the DCJ Form 3 - Cash Request Procedures,and DCJ Form 1-A-Subgrant Financial Report,which are hereby incorporated by reference. c. The Subgrantee Agency assures that it shall maintain data and information to provide accurate quarterly program narrative and financial reports to the Division. Said reports shall be provided in such form and contain such data and information as the Division of Criminal Justice reasonably requires to administer the program. d. The Subgrantee Agency assures that quarterly financial and narrative reports shall be submitted within 15 days of the end of each calendar quarter and shall be current and actual. e. The Subgrantee Agency further assures that final financial and narrative reports shall be submitted on the forms provided by the Division of Criminal Justice within 45 days of the end date of the subgrant. I The Division reserves the right to make and authorize modifications, adjustments, and/or revisions to the Grant Award for the purpose of making changes in budget categories, extensions of grant award dates, changes in goals and objectives, and other modifications which do not change the total amount of the Grant Award. The Division's requirements for such grant adjustments are contained in the procedures for DCJ Forms 4A, 4B, 4C, and 4D,which are hereby incorporated by reference. g. The Division may withhold payment in the event the Subgrantee Agency fails to comply with conditions, including COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES ' - 4 Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 4 of 11 all financial reporting requirements and certifications contained in this grant award. 3. PROCUREMENT AND CONTRACTS a. The Subgrantee Agency assures that open, competitive procurement procedures will be followed for all purchases under the grant. All contracts for professional services, of any amount, and equipment purchases over five thousand dollars (per item, with a useful life of at least one year) must receive prior approval by the Division of Criminal Justice. b. The Subgrantee Agency assures that no contract or agreement will be made for execution of project activities or provisions of services (other than purchase of supplies or standard commercial or maintenance services)that is not incorporated in the approved application or approved in advance by the Division of Criminal Justice. c. The Subgrantee Agency assures that contractors/vendors who assist the Subgrantee Agency to develop specifications, requirements, statements of work and/or Request For Proposal for a proposed procurement shall be excluded from bidding or submitting a proposal to compete for the award of such procurement. d. The Subgrantee Agency assures that where activities supported by this subgrant produce any discovery or invention, original computer programs, writing, sound recordings, pictorial reproductions, drawing or other graphical representation and works of any similar nature,the following requirements apply: i. The Division of Criminal Justice reserves a royalty-free, non-exclusive, and irrevocable license to reproduce, publish, or otherwise use, and authorize others to use, for Federal government purposes: The copyright in any work developed under an award or subaward; and 2) Any rights of copyright to which a recipient or subrecipient purchases ownership with support. ii. If any program produces patentable items, patent rights, processes or inventions, in the course of work sponsored by the Federal award or subaward funds, such facts must be promptly and fully reported to the awarding agency, Division of Criminal Justice. The awarding agency shall determine whether protection on the invention or discovery shall be sought. The awarding agency will also determine how rights in the invention or discovery (including rights under any patents issued thereon) shall be allocated and administered in order to protect the public interest pursuant to published Presidential and government memorandums and guidelines, and the regulations promulgated by the Department of Commerce in 37 CFR Part 401. When issuing statements, press releases, requests for proposals, bid solicitations, and other published documents describing projects or programs funded in whole or in part with these grant funds, all Subgrantee Agencies must clearly: a) State the percentage of the total cost of the program or project, which will be financed with this grant money; b) State the dollar amount of state or federal funds for the project or program; c) Use the phrase-"This project was supported by federal grant # , issued by the Colorado Division of Criminal Justice." e. The Subgrantee Agency may not assign its rights or duties under this grant without the prior written consent of the Division of Criminal Justice. 4. AUDIT,RECORD-KEEPING,AND MONITORING/INSPECTION a. The Subgrantee Agency assures that it will procure an audit or financial review, incorporating this subgrant, by an independent Certified Public Accountant(CPA), licensed to practice in Colorado. If the agency expends more than $500,000 per year in combined federal funds, a Single Audit must be conducted in accordance with OMB Circular A-133 (Audits of States, Local Governments, and non-profit organizations). If the agency expends less than $500,000 per year in combined federal funds,the following policy applies: Agencies with total annual revenue from all sources of$200,000 or more shall procure a financial audit; a financial review shall not be sufficient to meet this requirement. Agencies with total annual revenue of less than $200,000 shall procure either a financial review or financial audit. i. At such time as the audit or financial review is completed, ONE COPY OF THE REPORT, INCLUDING THE CORRESPONDING MANAGEMENT LETTER, MUST BE FORWARDED TO THE DIVISION OF CRIMINAL JUSTICE for clearance. The audit or financial review incorporating this subgrant must be completed and received within 12 months of the end of the fiscal years that includes the end date of the grant. H. The Subgrantee Agency accepts responsibility for the costs of a financial program audit to be performed by COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES .1 Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 5 of 11 the Department of Public Safety in the event that the audit report or financial review: a) does not meet the applicable A-133 or DCJ standards; b) is not submitted in a timely manner;or, c) does not provide an audit response plan with corresponding corrections made sufficient to satisfy any audit findings. b. The Subgrantee Agency assures that: i. It will retain all project records, as will facilitate an effective audit, for seven years after the end of the state fiscal year that includes the end date of the grant. (For example if the grant ended 9/30/2001, the state FY would be July I, 2001-June 30,2002. The files could be destroyed after 6/30/2009);except, ii. If an audit is in progress and/or the findings of a completed audit have not been resolved satisfactorily,then records must be retained beyond the seven-year period until such issues are resolved. c. The Subgrantee Agency assures that it will keep copies of all documents, correspondence, and required receipts related to this subgrant in a separate file bearing the project title and grant number. d. The Division may periodically request submission of supporting financial and programmatic documentation, subcontracts, general and sub-ledgers for the purpose of monitoring compliance with the grant award via desk review, or in preparation for an on-site monitoring visit. Routine or special on-site visits may be conducted at the subgrant agency, and at the location of any collaborating entities, for the same purpose. Subgrantee Agencies will be notified in advance of any on-site monitoring visit. e. The Subgrantee Agency assures that the Division of Criminal Justice, Colorado Department of Public Safety, shall have access for purposes of monitoring, audit and examinations to any bonds, documents, papers and records of the Subgrantee Agency and to relevant books and records of subcontractors of the Subgrantee Agency. It is the responsibility of the Subgrantee Agency to notify any of its project collaborators and subcontractors of these provisions. f The Subgrantee Agency assures that signatories of the application and subgrant award and personnel employed through this subgrant will appear when requested at any administrative hearing, monitoring site visit, conference or meeting conducted by the Division of Criminal Justice. 5. TERMINATION or REDUCTION IN GRANT AWARD The Division will monitor the performance of the Subgrantee Agency against goals and performance standards as found in the application, Section VI required herein. The Division will provide reasonable assistance to the Subgrantee Agency concerning project goals, performance standards and subgrant requirements. Any determination of substandard performance on the part of the Subgrantee Agency shall be within the discretion of the Division, based upon the Division's review of the terms and conditions of the Grant Award, the application and project summary, the grant terms and assurances, and the requirements of applicable law. Substandard performance, as determined by the Division, shall constitute non-compliance, which may result in termination for cause, or reduction of the Grant Award for cause, as follows: a. Reduction In Grant Award Amount for Cause i. The Division may reduce the total Statement of Grant Award amount for cause, without compensation for reduction costs. ii. If the state reduces the grant amount for cause, it will first give ten (10) days written notice to the Subgrantee Agency, stating the reasons for reduction, steps taken to correct the problems, and the date the subgrant award amount will be reduced in the event problems have not been corrected to the satisfaction of the Division. iii. In the event this grant is reduced for cause, the Division will only reimburse the Subgrantee Agency for acceptable work or deliverables received up to the date of reduction. iv. In the event this grant is reduced for cause, final payment to the Subgrantee Agency may be withheld at the discretion of the Division until completion of final Division review. b. Termination for Convenience: i. Either party may terminate the grant with thirty days written notice of intent to cancel or terminate. ii. If the grant is terminated for convenience by either the Subgrantee Agency or the state, the Subgrantee Agency shall be paid the necessary and allowable costs incurred through the date of termination, but not exceeding a prorated amount based on the number of days of project operation prior to the date of termination. c. Termination for Cause: i. The Division may terminate the grant for cause without compensation for termination costs. ii. If the state terminates the grant for cause, it will first give ten (10) days written notice to the Subgrantee COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES • Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 6 of 11 Agency, stating the reasons for termination, steps taken to correct the problems, and the date the subgrant will be terminated in the event problems have not been corrected to the satisfaction of the Division. iii. In the event this grant is terminated for cause, the Division will only reimburse the Subgrantee Agency for acceptable work or deliverables received up to the date of termination. iv. In the event this grant is terminated for cause, final payment to the Subgrantee Agency may be withheld at the discretion of the Division until completion of final Division review. d. Any equipment purchased under this grant would revert, at the option of the Division, to the Division of Criminal Justice upon termination of the grant for any of the above reasons. 6. ORDER OF PRECEDENCE Any inconsistency or conflict in this grant shall be resolved by giving precedence in the following order: (a) Special Provisions and Certified Assurances,(b) Statement of Grant Award; and, (c)the final approved Subgrant Application. 7. DISPUTE RESOLUTION(THIS PROVISION APPLIES ONLY TO INTERAGENCY AGREEMENTS): Any failure of either party to perform in accordance with the terms of this agreement shall constitute a breach of the agreement. Any dispute concerning the performance of this agreement which cannot be resolved at the divisional level shall be referred to superior departmental management staff designated by each department. Failing resolution at that level, disputes shall be presented to the executive directors of each department for resolution. Failing resolution by the executive directors,the dispute shall be submitted in writing by both parties to the State Controller, whose decision on the dispute will be final. C. FEDERAL CERTIFIED ASSURANCES 1. FEDERAL PUBLIC POLICY ASSURANCES a. The Subgrantee Agency hereby agrees that it will comply, and all of its contractors will comply with the applicable provisions of: i. Title I of the Omnibus Crime Control and Safe Streets Act of 1968,as amended; ii. The Juvenile Justice and Delinquency Prevention Act and/or the Victims of Crime Act,as appropriate; iii. All other applicable Federal laws,orders, circulars,regulations or guidelines. b. The Subgrantee Agency hereby agrees that it will comply, and all of its contractors will comply with the provisions of 28 CFR applicable to grants and cooperative agreements including: i. Part 18,Administrative Review Procedure; ii. Part 22,Confidentiality of Identifiable Research and Statistical Information; iii. Part 23, Criminal Intelligence Systems Operating Policies; iv. Part 30 Intergovernmental Review of Department of Justice Programs and Activities; v. Part 35,Nondiscrimination on the Basis of Disability in State and Local Government Services; vi. Part 38, Equal Treatment for Faith Based Organizations; vii. Part 42 Nondiscrimination/Equal Employment Opportunity Policies and Procedure; viii. Part 61 Procedures of Implementing the National Environmental Policy Act; ix. Part 63 Floodplain Management and Wetland Protection Procedures; and, x. Federal Laws or regulations applicable to Federal Assistance Programs. 2. FINANCIAL& ADMINISTRATIVE MANAGEMENT a. Subgrantee Agency assures that it will comply with appropriate federal cost principles and administrative requirements applicable to grants as follows: i. For state, local or Indian tribal government entities; a) 2 CFR Part 225, Cost Principles for State, Local & Indian Tribal Governments (codified at 28 CFR Part 66, by reference and(formerly known as OMB Circular A-87) b) OMB Circular A-102, Common Rule-Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments c) 28 CFR 66, Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments ii. For non-profit organizations; a) 2 CFR Part 230, Cost Principles for Non-Profit Organizations(formerly known as OMB Circular A-122) COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION (JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS e „ SPECIAL PROVISIONS AND CERTIFIED ASSURANCES • Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 7 of 11 b) 2 CFR Part 215, Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other Nonprofit Organizations (codified at 28 CFR Part 70 and formerly known as OMB Circular A-110) c) 28 CFR 70, Uniform Administrative Requirements for Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other Non-Profit Organizations iii. For colleges and universities; a) 2 CFR Part 220, Cost Principles for Educational Institutions (codified at 28 CFR Part 66, by reference and formerly known as OMB Circular A-21) b) 2 CFR Part 215, Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other Nonprofit Organ izations(codfed at 28 CFR Part 70 and formerly known as OMB Circular A-110) c) 28 CFR 70, Uniform Administrative Requirements for Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other Non-Profit Organizations iv. For each agency spending more than$500,000 per year in federal funds from all sources; a) OMB Circular A-133,Audits of States, Local Governments and Nonprofit Organizations b. The Subgrantee assures that it will comply with the provisions of the U.S. Department of Justice, Office of the Chief Financial Officer, Office of Justice Programs, Financial Guide for Grants, current edition. (For practical purposes, the requirements pertinent to the management of these funds have been extracted from the above documents and are contained in the current applicable Administrative Guide of the Division of Criminal Justice, which is hereby incorporated by reference. However, such a guide cannot cover every foreseeable contingency, and the Subgrantee is ultimately responsible for compliance with applicable state and federal laws,rules and regulations.) 3. NON-SUPPLANTING OF FUNDS (Governmental Agencies Only) a. The Subgrantee Agency certifies that any required matching funds used to pay the non-federal portion of the cost of this subgrant are in addition to funds that would have otherwise been made available for the purposes of this project. b. The Subgrantee Agency certifies that federal funds made available under this grant: i. Will not be used to supplant state or local funds; ii. Where there is a reduced or unchanged local investment,then the Subgrantee Agency shall give a written explanation demonstrating that the Subgrantee Agency's reduced or unchanged commitment would have been necessitated even if federal financial support under this federal grant program had not been made available. 4. PROHIBITIONS ON LOBBYING WITH FEDERAL FUNDS (Subgrantee Agencies receiving$100,000 or more in total federal funds per year. See 28 CFR Part 69.) The prospective Subgrantee Agency certifies,by submission of this proposal,that: a. No federal funds received through this subgrant will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the making of any federal grant, the entering into of any cooperative agreement, and the extension, continuation,renewal, amendment, or modification of any federal grant or cooperative agreement;and, b. If any funds other than funds through this subgrant will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this subgrant, the prospective Subgrantee Agency shall complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities." 5. CERTIFICATION REGARDING DEBARMENT,SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION (Subgrantee Agencies receiving$100,000 or more in total federal funds per year. See, 28 CFR Part 67.) The prospective Subgrantee Agency certifies,by submission of this proposal,that neither it nor its principals, subcontractors or suppliers: a. Are presently debarred,suspended,proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from participation in this transaction by any Federal department or agency; b. Have not within a three-year period preceding this application been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State, or local)transaction or contract under a public transaction;violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES SJ Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 8 of 11 c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal, State,or local)with commission of any of the offenses enumerated in paragraph(5)(b)of this certification;and d. Have not within a three-year period preceding this application had one or more public transactions(Federal, State, or local)terminated for cause or default; and e. Where the prospective Subgrantee Agency is unable to certify to any of the statements in this certification,he or she shall attach an explanation to this application. 6. CERTIFICATION REGARDING DRUG FREE WORKPLACE (See, 28 CFR Part 67, Subpart F.) The prospective Subgrantee Agency certifies, by submission of this proposal, that it will comply with the Drug Free Workplace Act of 1988, as implemented at 28 CFR Part 67, Subpart F. 7. CIVIL RIGHTS COMPLIANCE (See, 28 CFR Part 42.) a. Upon award, each Subgrantee Agency will be provided DCJ's Form 30, entitled "Certification of Compliance with Regulations Regarding Federal Civil Rights Requirements and Equal Employment Opportunity Plans (EEOP), and will be required to do the following: i. The Project Director must submit the form to the Subgrantee Agency's Authorized Official for this grant; ii. The Authorized Official must review the form in conjunction with subgrant agency personnel responsible for reporting civil rights findings of discrimination; iii. The Authorized Official must accurately complete the required information and provide all information requested; iv. The Authorized Official must provide an original signature on the form as indicated; and, v. The DCJ 30 Form with original signature must be returned to the Division with the Statement of Grant Award(SOGA). b. Any subgrant agency findings of discrimination must be reported to the Division of Criminal Justice within 45 days of receipt of this grant award, and to the Office for Civil Rights, Office of Justice Programs, U.S. Department of Justice. 8. NON-DISCRIMINATION The following federal non-discrimination cites apply in particular: the nondiscrimination requirements of the Omnibus Crime Control and Safe Streets Act of 1968, as amended; Title VI of the Civil Rights Act of 1964; Section 504 of the Rehabilitation Act of 1973, as amended; Subtitle A,Title II of the Americans with Disabilities Act of 1990,42 U.S.C. 12101, et. seq. and Department of Justice Regulations on Disability Discrimination, 28 CFR Part 35 and Part 39;Title IX of the Education Amendments of 1972; the Age Discrimination Act of 1975; the Department of Justice Nondiscrimination Regulations 28 CFR Part 42, Subparts C, D, E, and G; and Executive Order 11246, as amended by Executive Order 11375, and their implementing regulations,41 CFR Part 60.1 at seq.,as applicable to construction contracts. 9. NATIONAL ENVIRONMENTAL POLICY ACT(NEPA)AND NATIONAL HISTORIC PRESERVATION ACT (NHPA)COMPLIANCE (42 USC§§4321-4370 and 16 USC§470) a. The Subgrantee Agency agrees to assist the Division of Criminal Justice and the Office of Justice Programs, U.S. Department of Justice, in complying with the National Environmental Policy Act, the National Historic Preservation Act (NHPA) and other related federal environmental impact analyses requirements in the use of these grant funds either directly by the Subgrantee Agency or by a subcontractor. As long as the activity needs to be undertaken in order to use these grant funds,this NEPA requirement first must be met whether or not the activities listed below are being specifically funded with these grant funds. The activities covered by this special condition are: b. New construction; c. Minor renovation or remodeling of a property either listed on or eligible for listing on the National Register of Historic Places,or located within a 100-year flood plain; d. Renovation, lease or any other proposed use of a building or facility that will either result in a change in its basic prior use,or significantly change its size. e. Implementation of a new program involving the use of chemicals other than chemicals that are either purchased as an incidental component of a funded activity and traditionally used, for example, in office, household,recreational or educational environments. 10. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (This provision applies only to entities that COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES Special Provisions&Certified Assurances must remain attached to the application August 2010 SPCA Page 9 of II provide medical care and treatment) The Subgrantee Agency acknowledges that it is a covered health care provider under the Health Insurance Portability and Accountability Act,42 U.S.C. 1320d-1320d-8,and its implementing regulations and agrees to comply with the requirements of HIPAA concerning any uses and disclosures of protected health information. 11. Uniform Relocation Assistance and Real Property Acquisitions Act of 1970(Government Entities Only) The prospective Subgrantee Agency certifies, by submission of this proposal, that it will comply with the requirements of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970,which govern the treatment of persons displaced as a result of federal and federally-assisted programs. 12. Political Activity of Certain State and Local Employees (5 U.S.C. §§ 1501-08 and §§ 7324-28 — applies to Government Entities Only) The prospective Subgrantee Agency certifies, by submission of this proposal, that it will comply with requirements of 5 U.S.C. §§ 1501-08 and §§ 7324-28, which limit certain political activities of State and local government employees whose principal employment is in connection with an activity financed in whole or part by federal assistance. D. PROGRAM SPECIFIC REQUIREMENTS The following program specific requirements are imposed by the Federal or State sponsoring agency concerning special requirements of law, program requirements, and other administrative requirements which must be passed on to subgrant award recipients. 1. Right if Privacy for Recipients of Service and Sharing of information. The prospective Subgrantee Agency certifies,by submission of this proposal, that: a. Pursuant to Section 223(a)(I 8)of the Juvenile Justice and Delinquency Prevention Act,procedures have been established to ensure that this program will not disclose program records containing the identity of individual juveniles. Exceptions to this requirement are authorization by law; consent of either the juvenile or his/her legal authorized representative;or justification that otherwise the functions of this title cannot be performed. Under no circumstances may public project reports or findings contain names of actual juvenile service recipients. b. Necessary information will be shared appropriately among schools, law enforcement,courts and juvenile- serving agencies pursuant to the Family Educational Rights and Privacy Act(FERPA)(20 U.S.C. §1232g),as amended by Improving America's School Act of 1994(IASA). FERPA allows schools to play a vital role in a community's effort to identify children who are at risk of delinquency and provide services prior to a child's becoming involved in the juvenile justice system. c. Necessary information will be shared in accordance with the"Children's Code Records and Information Act," 19-1-301 et seq.,Colorado Revised Statutes,to balance the best interests of children and the privacy interests of children and their families with the need to share information among service agencies and the need to protect the public safety. 2. In addition to the"Termination for Cause" item, F.3 under Grant Requirements above,the subgrant may be suspended or terminated by the Division of Criminal Justice if the Subgrantee Agency fails to comply with the core requirements of the Juvenile Justice and Delinquency Prevention Act, 1974, as amended: Deinstitutionalization of Stats Offenders, Section 223 (a)(12)(A); Separation of Juveniles from Incarcerated Adults, Section 223(a)(13); Removal of Juveniles from Adult Jails and Lockups, Section 223 (a)(14); Disproportionate Minority Confinement, Section(a)(23). E. GENERAL PROVISIONS 1. INDEMNIFICATION. a. To the extent authorized by law, the Subgrantee Agency shall indemnify, save, and hold harmless the State, its employees and agents, against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees and related costs, incurred as a result of any act or omission by the Subgrantee Agency, or its employees, agents, subcontractors, COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP) ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES r Special Provisions& Certified Assurances must remain attached to the application August 2010 SPCA Page 10 of 11 or assignees pursuant to the terms of this subgrant award. FOR GRANTS TO STATE AGENCIES AND HIGHER EDUCATION ONLY: b. A self-insured, Subgrantee state Agency agrees that its Self-Insurance Program shall BE RESPONSIBLE FOR any and all claims, damages, liability and court awards, including costs, expenses, and attorney fees and related costs, incurred as a result of any act or omission by the Subgrantee Agency,or its employees, agents, subcontractors, or assignees pursuant to the terms of this subgrant award. 2. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective Date is on or after July 1, 2009 and the maximum amount payable to Subgrantee hereunder is$100,000 or higher] By entering into this subgrant, Subgrantee agrees to be governed, and to abide, by the provisions of CRS §24-102-205, §24- 102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. Subgrantee performance shall be evaluated in accordance with the terms and conditions of this subgrant, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation of Subgrantee's performance shall be part of the normal contract administration process and Subgrantee's performance will be systematically recorded in the statewide Contract Management System. Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the performance of Subgrantee's obligations under this subgrant shall be determined by the specific requirements of such obligations and shall include factors tailored to match the requirements of the Project Plan of this subgrant. Such performance information shall be entered into the statewide Contract Management System at intervals established in the Project Plan and a final review and rating shall be rendered within 30 days of the end of the Subgrant term. Subgrantee shall be notified following each performance and shall address or correct any identified problem in a timely manner and maintain work progress. Should the final performance evaluation determine that the Subgrantee demonstrated a gross failure to meet the performance measures established under the Project Plan, the Executive Director of the Colorado Department of Personnel and Administration(Executive Director), upon request by the Colorado Division of Criminal Justice, and showing of good cause, may debar Subgrantee and prohibit Subgrantee from bidding on future contracts. Subgrantee may contest the final evaluation and result by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation(CRS §24-105- 102(6)), or (ii) under CRS §24-105-102(6), exercising the debarment protest and appeal rights provided in CRS §§24-109- 106, 107, 201 or 202, which may result in the reversal of the debarment and reinstatement of Subgrantee, by the Executive Director, upon showing of good cause. 3. The Subgrantee Agency shall comply with all applicable revisions or additional requirements that may be imposed by law and any future state and federal guidance including clarifications of requirements. Any revisions to such provisions or regulations shall automatically become a part of these Special Provisions and Certified Assurances, without the necessity of either party executing any further instrument. The State of Colorado may provide written notification to the Subgrantee Agency of such revisions,but such notice shall not be a condition precedent to the effectiveness of such revisions. COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES Special Provisions& Certified Assurances must remain attached to the application August 2010 SPCA Page 11 of 11 SIGNATURE PAGE ->->-> TO BE COMPLETED BY ALL APPLICANTS (ORIGINAL SIGNATURES REQUIRED-Please sign in BLUE ink. See instructions for description of proper signatories.) The Subgrantee Agency and responsible signatories certify by signing that they have read the Application including the Special Provisions and Certified Assurances,and are fully cognizant of their duties and responsibilities for this project. The Subgrantee Agency understands and agrees that any subgrant award received as a result of this application shall incorporate by reference the information contained herein. Responsibility for narrative and fiscal reporting requirements are delegated to the designated Project Director, who will sign all such reports. This delegation is for purposes of reporting to the Division and for operational ease, and in no way limits the authority and responsibility of the Authorized Official. In accordance with the Colorado Revised Statutes 24-72-202.6,information supplied in this application is considered a public record. AUTHORIZED OFFICIAL Name Barbara Kirkmeyer Position Chair Pro—Tem Agency Board of Weld County Commissioners Mailing Address 915 10th Street (P.O. Box 758) City,State,Zip Greeley, Colorado 80631 Telephone# 970-356-4000 Ext 4200 Fax# 970-352-0242 E-mail Address bkirkmeyer@co.weld.co.us Signature {/ Date 12/28/2010 FINANC AL OFFICER Name Ili i Position • f � i 1� r 1llti 1AC� ' , r I II Agency O.; tJ C1 �„ r., IV') " . C`-i)i C Mailing Address i , City,State,Zip ( 1 \� ( �.-� (t t { v ti Telephone# (.'� --� _ , b r Fax# ` 1 -I D — 11'.) 9 .- & H i E-mail Address R R j f- t �"_ �-'_ C D ,t� if fr , l_ G - V- S Signature Date z,� � ��� ��' ti� -�-� __ 12/28/2010 PROJECT DIRECTOR Name /(&,/n/(5-1:-/z/ /_- , /90/LiCyCc J Position co iripi a:/c. Agency LGO Codn/7-Y ..S//e/etl'/ S d/—"ALLGt Mailing Address /2 -5—° v -5-7—A'Sr-"T City,State,Zip Cie �. �) CO gods/ Telephone# ( 9?a ) Fax# /570 ) ,30- -�≤ YC'7 E-mail Address /1C'OAc_e/° Ctj do . c.6/c/e ` ec ‘,/.J Signature r Date C �� 12/28/2010 Donna Bechler From: Barbara Kirkmeyer Sent: Tuesday, March 15, 2011 10:52 PM To: Bruce Barker; Esther Gesick; Donna Bechler Subject: Fw: Certified Assurances Attachments: image001.jpg; image002.gif; JABG revised CASP updated august 2010.doc Seen this??? Original Message From: Ken Poncelow To: Barbara Kirkmeyer Sent: Tue Mar 15 07:31:36 2011 Subject: FW: Certified Assurances Commissioner, could you please sign this and I will come and get it. It is part of the JAIBG packet that you signed on December 28, 2010. 2011-0320 If you have any questions, call me at 590-6825. Thanks 6eefiofe Snua 4 a a� b ��/� �/_D�� ) /eQ� on r Original Message Was S 4ed oil 77a�G/a&/ K20 iedd) From: Deb Ristow fmailto:Deb.Ristow0cdps.state.co.us1 skile m, /lleeu Sent: Monday, March 14, 2011 10:34 AM < To: Ken Poncelow 6:0;* IOtis (,&pied 0/1J / /ate//r, Subject: Certified Assurances v Ken, I need the attached Certified Assurances filled out and signed by Barbara Kirkmeyer. The ones we have are signed by Douglas Rademacher. Let me know if you have any questions. I need these right away. Thanks! Deb Deb Beckham-Ristow Financial Grant Officer (303) 239-4471 Office (303) 239-4491 FAX Under Colorado's Open Records Act (CORA), all e-mails sent by or to me on this state-owned e- mail account may be subject to public disclosure. 1 COLORADO DIVISION OF CRIMINAL JUSTICE JUVENILE JUSTICE AND DELINQUENCY PREVENTION(JJDP)ACT APPLICATION FOR JUVENILE ACCOUNTABILITY BLOCK GRANT PROGRAM FUNDS SPECIAL PROVISIONS AND CERTIFIED ASSURANCES • +• 4 Special Provisions& Certified Assurances must remain attached to the application August 2010 SPCA Page 11 of 11 SIGNATURE PAGE ->->-> TO BE COMPLETED BY ALL APPLICANTS (ORIGINAL SIGNATURES REQUIRED-Please sign in BLUE ink. See instructions for description of proper signatories.) The Subgrantee Agency and responsible signatories certify by signing that they have read the Application including the Special Provisions and Certified Assurances, and are fully cognizant of their duties and responsibilities for this project.The Subgrantee Agency understands and agrees that any subgrant award received as a result of this application shall incorporate by reference the information contained herein. Responsibility for narrative and fiscal reporting requirements are delegated to the designated Project Director, who will sign all such reports. This delegation is for purposes of reporting to the Division and for operational ease, and in no way limits the authority and responsibility of the Authorized Official. In accordance with the Colorado Revised Statutes 24.72-202.6, information supplied in this application is considered a public record. AUTHORIZED OFFICIAL in. rs M2 !ICES Name Douglas Rademacher Ov`�`r Position Chair l)/avep7 Agency :����7<are " g y Board of Weld County Commissioners ,. /7ECI �� ClYQNCt Mailing Address 915 10th Street (P.O. Box 758) ,rkmeyer- Per City,State,Zip Greeley, Colorado 80631 revues+ by 6fafe. Telephone# 970-356-4000 Ext 4200 Fax# 970-352-0242 E-mail Address drademacher@co.weld.co.us Date Signature •c J �r -, lI f1 Yna 12/28/10 j /FII(NAACN.CIALOFFICER Name ✓ 1 ii\ IV1jLtE✓ Position O CI:i ice C/ (�C, 11e2, n e ✓ Agency to e-Ia vcti1-.17 h S e vr.'Cr. ' ot'n (icc Mailing Address ' 9s D C Si- r a- t City,State,Zip rC3r= Ia/ (lc RO(>a / Telephone# q it: • ? Sit - Li U i-S — Fax# q -7D -- 3bLI ` (oL4 47 E-mail Address i,< }11 J we_ -4 0 c O • wC Ed - C O * Li S Signature Iii. ` Date I a I lO PROJECT DIRECTOR Name /edNadere C . /°aNC6' L6v Position C 0 e t ... p N o d de Agency UL•' LO Coutvrr flh ,l'_r.f er ,: L• Gd Mailing Address ( 5 s o 0 S T R el J City,State,Zip coGsil e L en- co to( 3 / Telephone# ( 770 ) 3 $-h - go / s- Fax ( 970 I 3o `( - Gro7 a' E-mail Address N gyaeel. 4, Co • A/C ( Cs . 0 Date Signature /�� ea Wr1A it LIL II} 4"c7 COLORADO DIVISION OF CRIMINAL JUSTICE DCJ Form 4-B: CHANGE IN SIGNING AUTHORITY SUBGRANTEE: &)C J) Liu,y £Qrk-I rt.-1O�frc=c GRANT NUMBER: 2 5 - fl-(-Jf- 1 3 PROJECT TITLE: / PROJECT DURATION (VELD Gi,..e) J4VI Vitt AL"'»Ou7FROM: / 1)120)Z- TO: Op I/20X PREPARED BY: %. crtaS6F1 PHONE: ('z)354-go/5 DATE: 07/061/1 A GRANT MODIFICATION IS NOT AUTHORIZED UNTIL IT IS APPROVED IN WRITING BY THE DIVISION OF CRIMINAL JUSTICE. For change, submit two forms with original signatures. One approved copy will be returned for your records. See reverse side for full instructions. All other terms and conditions of the original grant with any approved modifications thereto remain in full force and effect. I, hereby certify that the content of this form,other t the data entry required,has not been altered.Change requested l '1LJ /. -� —� -771112t it SUBGRANTE PROJECT DIXECTOR Signature DATE PROJECT DIRECTOR'S MAILING ADDRESS: THE PURPOSE OF THIS REQUEST IS TO: NV CHANGE THE PROJECT DIRECTOR CHANGE THE FINANCIAL OFFICER _CHANGE THE AUTHORIZED OFFICIAL Date Change Effective: 0 S I 01 I ( From: OS. Icfi t To: %bb —Ocu-('SGt-k �UYvr/)'rr.1'tU�fi� PRINT OR TYPE FULL NAME/TITLE 6-5 CU) Covool 5-ncoctiff i5FCtcc Oat) (w. r 37-elyrrS 4`l/cC Agency Name Agency Name (cl So "O" St a_61 G� 6063 14$a O" S7 Ga=E Cu Soc3 r Mailing Address 11 Mailing Address (G7(1 3S6-yo/S ( ) Telephone Fax Email Tit ctmm,N c r. we-th.Co. L. s Original Signature of new Official(required) Reason for change: ken-, fo,t) Ce{ULA.I K.En •••Division of Criminal Justice Use Only'•• THIS REQUEST IS _Approved _Denied,see attached By: PROGRAM SPECIALIST,DCJ DATE Rev.8-04 dcjf4bvl.pdf Hello