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Home My WebLink About20091281RESOLUTION RE: APPROVE TASK ORDER CONTRACT FOR STATE TOBACCO EDUCATION AND PREVENTION PARTNERSHIP 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 Task Order Contract for the State Tobacco Education and Prevention Partnership Grant between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment, commencing July 1, 2009, and ending June 30, 2010, with further terms and conditions being as stated in said contract, and WHEREAS, after review, the Board deems it advisable to approve said contract, 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 Task Order Contract for the State Tobacco Education and Prevention Partnership Grant between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said contract. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 3rd day of June, A.D., 2009. ATTEST: Weld County Clerk to the Bo BY: Deputy Jerk to the Board APPROVED AS TO FORM: ty Attdvhey Date of signature. EXCUSED BOARD OF COUNTY COMMISSIONERS WELD CQTY�O ham F. Garcia, Chair L.41(v C9d2litri O- Ias demacher, P o-Tem can P. Conway Bprara Kirkmeyer A QVDavid E. Long 2009-1281 , HL0036 1 06.. ,c/e, COLORADO Memorandum TO: FROM: DATE: SUBJECT: William F. Garcia, Chair Board of County Commissioners Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment ,keltee0-4, June 1, 2009 y, State Tobacco Education & Prevention Partnership (STEPP) Contract Enclosed for Board review and approval is the contract between the Colorado Department of Public Health and Environment's State Tobacco Education and Prevention Program (STEPP) and Weld County Board of Commissioners for the benefit of the Department of Public Health and Environment (WCDPHE). The contract is for continuation funding in the amount of $226,985 for a one year period, July 1, 2009 through June 30, 2010. This budget reflects a 3.5% reduction per the request by the State Tobacco Education and Prevention Partnership (STEPP). This reduction does not impact our staffing level or our previous work plan. A large portion of the reduction can be found in staff travel, staff development, and advertising, and to a lesser degree, support for local coalitions. The funding will allow for the continuation of tobacco education and prevention activities through the Weld County Tobacco Education Program. The goal of the grant is to provide a comprehensive, evidence -based tobacco program for all Weld County citizens that encourages tobacco -free lifestyles, provides tobacco cessation resources and reaches special tobacco use populations. The objectives of this grant are to increase the number of cessation attempts, reduce exposure to second-hand smoke, and decrease youth and young adult initiation of tobacco use. Two full-time and one half-time staff members currently work in the Weld County Tobacco Education Program and no additional staff positions are being requested. I recommend your approval of this contract. Enclosure 2009-1281 Wilk COLORADO DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 WEBSITE: www.co.weld.co.us ADMINISTRATION: (970) 304-6410 FAX: (970) 304-6412 PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420 FAX: (970) 304-6416 ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 FAX: (970) 304-6411 Granting Agency: Colorado Department of Public Health and Environment Applicant's Name: Weld County Department of Public Health and Environment Applicant's Address: 1555 N. 17th Avenue Greeley, CO 80631 Applicant's Phone: (970) 304-6420, ext. 2385 Applicant's Fax: (970) 304-6452 Project Title: Weld County Tobacco Education Program Contact Person: Bryce Kyburz, Tobacco Education Program Coordinator Date: July 1, 2009 —June 30, 2010 Amount: $226,985.00 Weld County Department of Public Health and Environment Mark E. Wallace, MD, MPH,ctor Weld County Board Commissioners William F. Garcia, Chair JUN - 3 2009 Weld County Clerk to dGy e`illt- STATE OF COLORADO Bill Ritter, Jr., Governor James B. Martin, Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado 4300 Cherry Creek Dr. S. Denver, Colorado 80246-1530 Phone (303) 692-2000 TDD Line (303) 691-7700 Located in Glendale, Colorado http://www.cdphe.state.co.us Laboratory Services Division 8100 Lowry Blvd. Denver, Colorado 80230-6928 (303) 692-3090 WORK STATUS CONFIRMATION LETTER Colorado Department of Public Health and Environment Vendor Name: Contract Routing Number: CRS §24-30-202 requires the State Controller to approve all State Contracts. The above referenced Contract is not valid until it is signed and dated below by the State Controller or delegate. Therefore, your agency is not authorized to begin performance until you are notified that it's signed. If your agency begins performing Contract tasks prior to that date, the State of Colorado is not obligated to pay your agency for such performance or for any goods and/or services provided prior to the date signed. By signing below, your confirm that (Signature MUST be that of the person signing the Contract) a) b) No work has been performed under this contract No work will begin under this contract until the contract is signed by the State Controller or on the effective date, whichever is later. Signature of Authorized Officer William F. Garcia Print Name of Authorized Officer Chair, Board of Weld County Commissioners Print Title of Authorized Officer JUN -3 2009 Date Signed RETURN THIS FORM WITH YOUR CONTRACT Page 3 of 3 &CL29-/Ar/ APPLICATION BUDGET FORM State Tobacco Education & Prevention Grants Program 2009-2010 APPLICANT: PROJECT TITLE: Check only one: — Year 1 (July 1, 2009 - June 30. 2010) 2010 - June 30. 2011) 2011 June 30. 2012) Weld County Department of Public Health and Environment ❑ Year 2 (July 1, ■ Year 3 (July 1, Weld County Tobacco Education Program SOURCE OF FUNDS Requested Other Source* Other Source* CDPHE Source 1 Source 2 PERSONAL SERVICES FTE %Effort Monthly Salary Monthly Benefits # of Months If applicable, funding source name If applicable, funding source name Name Position Bryce Kyburz 1.00 $4,654.24 $1,654.12 5.5 $34,695.98 $0.00 $0.00 Bryce Kyburz 1.00 $4,817.14 $1,712.01 6.5 $42,439.48 $0.00 $0.00 Cassie Kauffman 1.00 $4,322.21 $1,536.11 5.5 $32,220.76 $0.00 $0.00 Cassie Kauffman 1.00 $4,473.49 $1,589.88 6.5 $39,411.91 $0.00 $0.00 Kathy Schlepp 0.50 $4,073.78 $1,447.82 5.5 $15,184.40 $0.00 $0.00 Kathy Schlepp 0.50 $4,343.73 $1,543.76 6.5 $19,134.34 $0.00 $0.00 Subtotal Personal Services 2.50 $183,086.86 $0.00 $0.00 DIRECT OPERATING COSTS Unit Quantity Rate Printing/Copying Month 1000.00 $ 0.10 $100.00 $0.00 $0.00 Postage/Shipping per 400.00 $ 0.43 $172.00 $0.00 $0.00 Telephone, Fax, Internet Access $0.00 $0.00 $0.00 Supplies 10.00 $ 50.00 $500.00 $0.00 $0.00 Computer Equipment $0.00 $0.00 $0.00 Staff Development 2.00 $ 250.00 $500.00 $0.00 $0.00 Meeting Expenses Month 12.00 $ 375.00 $4,500.00 $0.00 $0.00 Other Program Cost 1.00 $ 10,655.00 $10,655.00 $0.00 $0.00 Subtotal Operating Costs $16,427.00 $0.00 $0.00 TRAVEL Unit Quantity Rate Mileage Mile 10440.00 $ 0.53 $ 5,533.20 $0.00 $0.00 Lodging day 3.00 $ 200.00 $ 600.00 $0.00 $0.00 Meals day 1.00 $ 300.00 $ 300.00 $0.00 $0.00 Other Travel airline 1.00 $ 400.00 $ 400.00 $0.00 $0.00 Subtotal Travel Costs $6,833.20 $0.00 $0.00 CONTRACTUAL Unit Quantity Rate Consultant Hour $ $ - $0.00 $0.00 Contract Trainer/Speaker/Honorarium Day $ - $0.00 $0.00 Subcontract Hour $ - $0.00 $0.00 Subtotal Contractual Costs $0.00 $o.00 $o.00 OTHER COSTS Unit Quantity Rate Outreach/Educational Materials $ - $ - $0.00 $0.00 Screening $ $0.00 $0.00 Treatment _ $ $0.00 $0.00 Subtotal Other Costs $0.00 $0.00 $0.00 r TOTAL DIRECT COST: $206,347.06 $0.00 $0.00 INDIRECT COSTS: 2% Of Contractual $0.00 $0.00 INDIRECT COSTS: 10% Of All Other $206,347.06 $20,634.71 INDIRECT COSTS: 0% Other $0.00 Total Indirect Cost (Calculated on Amount Requested from CDPHE Only) $20,634.71 TOTAL AMOUNT REQUESTED FROM CDPHE i$ 226,982 'Othe Please indicate addi nayl�fun�dinQg source applicable. lAi at <, ma1a),aoG1 Rev. 10.22.08 Signature of Authorized Representative Date DI iP.ARTiMNNI OF PURI.IC I IF. AI:U I AND V.NV ❑2ON MFN'1 ROUTING NO. 10 FLA 00164 APPROVED TASK ORDER CONTRACT — WAIVER #154 This Task Order Contract is issued pursuant to Master Contract made on 01/23/2007, with routing number 08 FAA 00052 Sl:\ II'.: State of Colorado for the use & benefit of the Department of Public Health and Environment PSD-STEPP 4300 Cherry Creek Drive South Denver, Colorado 80127 I ASK 012D1.2 MADE: DAP I :: 05/20/2009 PO/SC IINCUMBRANCL Nt MItIX PO Ff.A PPG1000164 IIIR11: This Task Order shall be effective upon approval by the State Controller, or designee, or on 07/01/2009, whichever is later. The 'Task Order shall end on 06/30/2010. I'ItI(I 51IiUC IL RI' Cost Reimbursement PROCURF.NIFN I NIClMOD- Exempt IAD I21I', IS1 PISKIC AGIRI :1:Nu N1 NCNIRI:R. Not Applicable I..AAA3PGC11 11'.I) NI)O12 S I VII II. Not Applicable SI AII: I2IIPRI:SI N I All VIE Chandra Hardwick Department of Public Health and Environment PSD-STEPP 4300 Cherry Creek Drive South Denver, CO 80246 s( OPI'. ( II' AA (Ills: CONIiiACl O1P. Board of County Commissioners of Weld County (a political subdivision of the State of Colorado) for the use and benefit of Weld County Department of Public Health and Environment 1555 North 17R' Avenue Greeley, CO 80631 CON] IN] RAC I OR I NIlI1''I Vrl: Colorado 4II_I.ING SI)A I I:MI N I S ItPCFI VI S) \lonthly SI)Al l7OI0' A1111111OIV. Not Applicable Political Subdivision CONII2AGI PRIG[ NO1 IoI ?CC NFD: $226,985.00 I'I DO AI.I t NDING DOIJ.ARS: S'1)YII FUNDING DOIJdARS. $0 $226,985.00 MAXIMUM AMOUNT AVAILABLE PER NSCALVI/AR: FY 10: $226,985.00 FY NN: $ FY NX: $ FY XX: $ FYXX: $ CON I li ACIOR RI:PRI SI.NI A 1I VN: Mark E. Wallace 1555 North 1711) Avenue Greeley, CO 80631 The Contractor will conduct activities under the project Weld County Tobacco Education Program to prevent youth from using tobacco, reduce tobacco use, help people who use tobacco to quit, assist in the reduction of exposure to secondhand smoke and reduce tobacco use among groups that are disproportionately affected and/or at high risk for disease. Page I Q14 Rev 4/3/09 L0d60-60-90 tYCc ?-/J,1:11 r:xrnnns. The following exhibits are hereby incorporated: Exhibit A - Additional Provisions (and its attachments if any — e.g., A-1, A-2, etc.) Exhibit B - Statement of Work and Budget (and its attachments if any — e.g., B-1, B-2, etc.) Exhibit C - Limited Amendment Template for Task Orders Exhibit D- Budget GENERAL PROVISIONS The following clauses apple to this Task Order Contract. These general clauses may have been expanded upon or made more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task Order Contract provide more specificity than these general clauses, the more specific provision shall control. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall be performed according to the standards, terms and conditions set forth in the Master Contract. 2. In accordance with section 24-30-202(1), C.R.S., as amended, this Task Order Contract is not valid until it has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not authorized to, and shall not; commence performance under this Task Order Contract until this Task Order Contract has been approved by the State Controller or delegee. The State shall have no financial obligation to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order Contract on or before its proposed effective date, then the Contractor shall commence performance under this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order Contract after its proposed effective date, then the Contractor shall only commence performance under this Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through and including the date specified on page one of this Task Order Contract, unless sooner terminated by the parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract. Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of the terms and conditions of this Task Order Contract. 3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated, the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event of conflicts or inconsistencies between the Master Contract and this Task Order Contract (including its exhibits and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 4) the Additional Provisions -Exhibit A, and its attachments if included, to this Task Order Contract; 5) the Scope/Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other exhibits/attachments to this Task Order Contract in their order of appearance. Page 2 of 4 Rev 4/3/09 4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and attached hereto as "Exhibit B". 5. The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this Task Order Contract's Statement of Work through a "Limited Amendment for Task Orders" that is substantially similar to the sample form Limited Amendment that is incorporated herein by this reference and identified as Exhibit C. To be effective, this Limited Amendment must be signed by the State and the Contractor, and be approved by the State Controller or an authorized delegate thereof. Upon proper execution and approval, this Limited Amendment shall become a formal amendment to this Task Order Contract. This contract is subject to such modifications as may be required by changes in Federal or State law, or their implementing regulations. Any such required modification shall automatically be incorporated into and be part of this Task Order Contract on the effective date of such change as if fully set forth herein. 6. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work - Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the Contractor shall also meet those standards of performance under this Task Order Contract. 7. 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 Contractor hereunder is $100,000 or higher] By entering into this Contract, Contractor 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. Contractor's performance shall be evaluated in accordance with the terms and conditions of this Contract, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation of Contractor's performance shall be part of the normal contract administration process and Contractor'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 Contractor's obligations under this Contract shall be determined by the specific requirements of such obligations and shall include factors tailored to match the requirements of the Statement of Project of this Contract. Such performance information shall be entered into the statewide Contract Management System at intervals established in the Statement of Project and a final review and rating shall be rendered within 30 days of the end of the Contract term. Contractor 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 Contractor demonstrated a gross failure to meet the performance measures established under the Statement of Project, the Executive Director of the Colorado Department of Personnel and Administration (Executive Director), upon request by the Colorado Department of Public Health and Environment and showing of good cause, may debar Contractor and prohibit Contractor from bidding on future contracts. Contractor 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 Contractor, by the Executive Director, upon showing of good cause. Page 3 of 4 Rev 4/3/09 THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT * Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf and acknowledge that the State is relying on their representations to that effect. CONTRACTOR: STATE OF COLORADO: Board of County Commissioners of Weld County (a political subdivision of the State of Colorado) for the use and benefit of Weld County Department of Public Health and Environment Legal Name of Contracting Entity Yed Signature of Authorized Officer William F. Garcia JUN -3 1009 Print Name of Authorized Officer Chair Print Title of Authorized Officer BILL RITTER, JR. GOVERNOR For Executive Director Department of Public Health and Environment Signatory avers to the State Controller or delegate that Contractor has not begun performance or that a Statutory Violation waiver has been requested under Fiscal Rules Department Program Approval: By /( ( /,u,(✓i, .i t , I. ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. By Date STATE CONTROLLER: avid J. McDermott, CPA Page 4 of 4 WELD COUNTY DEPARTMENT OF PU LIC HEALTH AND ENVIRONMEN BY:: 4 Pao Mark E. Wallace, MD, MPH • Director 4/3/09 a9CL%%-/ask/ EXHIBIT A ADDITIONAL PROVISIONS To Task Order Contract Dated 05/20/2009 - Contract Routing Number 10 FLA 00164 These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. 1. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this contract does not constitute a Business Associate relationship under HIPAA. 2. To receive compensation under this Contract, the Contractor shall submit a signed monthly Invoice/Cost Reimbursement Statement. An Invoice/Cost Reimbursement Statement must be submitted within sixty (60) calendar days of the end of the billing period for which services were rendered. Expenditures shall be in accordance with the Statement of Work attached hereto as Exhibit B, and with the work requirements outlined in Attachment B -I, and the Approved Budget attached hereto as Exhibit D and incorporated herein. These items may include, but are not limited to, the Contractor's actual time spent on the project based on the applicable hourly rate, fringe benefits, supplies, travel, operating, indirect costs which are allowable, and other allocable expenses related to its performance under this Contract. All expenditures must be reasonable and necessary for the performance of the grant, and must comply with The State of Colorado, specifically the Colorado Department of Public Health and Environment, fiscal guidelines and rules. Invoice/Cost Reimbursement Statements shall: 1) reference this Contract by its contract routing number, which number is located on page one of this Task Order Contract; 2) state the applicable performance dates; 3) include allowable costs incurred by line item as approved in the budget; 4) include a brief description of the work performed during this performance period; and, 5) show the total requested payment in a format either provided or approved by the State. Payment during the initial, and any renewal or extension, term of this Task Order Contract shall be conditioned upon affirmation by the State that all services were rendered by the Contractor in accordance with the terms of this Task Order Contract. Invoice/Cost Reimbursement Statements shall be sent to: Colorado Department of Public Health and Environment PSD-STEPP-A5 4300 Cherry Creek Drive South Denver, CO 80246 To be considered for payment, billings for payments pursuant to this Task Order Contract must be received within a reasonable time after the period for which payment is requested; but in no event no later than sixty (60) calendar days after the relevant performance period has passed. Final billings under this Task Order Contract must be received by the State within a reasonable time after the expiration or termination of this Contract; but in no event no later than sixty (60) calendar days from the effective expiration or termination date of this Contract. The Budget, which is attached hereto as Exhibit D, shall govern the expenditure of funds by the Contractor under this Task Order Contract as well as subsequent reimbursement by the State. Failure to submit contract reimbursement statements in accordance with budget and the above time frames may result in a delay or denial of the reimbursement request. 3. Time Limit For Acceptance Of Deliverables. To be attached to CDPHE Task Order vl.0 (11/05) contract template Page 1 of 7 Revised: 12/19/06 EXHIBIT A a. Evaluation Period. The State shall have fifteen (15) calendar days from the date a deliverable is delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables that have a different time negotiated by the State and the Contractor. b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design specifications for that particular deliverable, or is otherwise deficient, then the State shall notify the Contractor of the failure or deficiencies, in writing, within twenty (20) calendar days of: 1) the date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or deficiency. The above time frame shall apply to all deliverables except for those deliverables that have a different time negotiated by the State and the Contractor in writing pursuant to the State's fiscal rules. c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed deliverable, the Contractor shall have a reasonable period of time, not to exceed ten (10) calendar days, to correct the noted deficiencies. If the Contractor fails to correct such deficiencies within ten (10) calendar days, the Contractor shall be in default of its obligations under this Task Order Contract and the State, at its option, may elect to terminate this Task Order Contract or the Master Contract and all Task Order Contracts entered into pursuant to the Master Contract. 4. The Contractor shall not use funds provided under this Contract for the purpose of lobbying as defined in C.R. S. 24-6-301(3.5)(a). 5. The Contractor shall support, cooperate and partner with other Tobacco Prevention, Education and Cessation Grantees. 6. The State of Colorado, specifically the Department of Public Health and Environment, shall be the owner of all equipment with a value of greater than $5,000 or a useful life of more than one year. Disposal or transfer of equipment procured under this contract may not occur without prior, express, written consent of the State. If requested by the State, the equipment shall be returned to the State upon completion of the contract term. 7. If the Contractor intends to subcontract any or all of its performance under this Contract, then the Contractor shall provide to the State, a copy of any proposed subcontract between the Contractor and a subcontractor. All subcontractors are subject to all the terms and conditions of this Contract. The Contractor remains ultimately responsible for any work performed by a subcontractor. 8. The contractor must notify STEPP within 30 days of a staff change of those employees performing work under this contract. 9. STEPP requires a disclosure of affiliation or contractual relationships, direct and indirect, with tobacco companies, owners, affiliate, subsidiaries, holding companies or companies involved in any way in the production, processing, distribution, promotion, sales, or use of tobacco. Companies or individuals affiliated with or receiving funds from any tobacco company or subsidiary are not eligible for funding under this proposal. Any and all subcontractors must also adhere to this policy. 10. The Contractor is required to meet all training requirements as outlined in the STEPP Capacity Building Requirements. Newly hired staff of the Contractor may begin performing work under this Contract; however, participation in orientation training conducted by the State and completion of the STEPP learning modules within six (6) months of the commencement date of employment must be accomplished. 12. Work Plan specifications, attached to this Contract, may be modified by way of a contract amendment as outlined and described within paragraph 5, page 3, of the Contract. Contractor shall submit all requested changes to its approved Work Plan in writing to the State as needed during the contract term. The State To be attached to CDPHE Task Order v1.0 (11/05) contract template Page 2 of 7 Revised: 12/19/06 EXHIBIT A will then develop the necessary contract amendment. Contractor must submit revisions at least thirty (30) calendar days prior to the proposed work plan modification date. However, regardless of the date submitted Contractor understands that the revised Work Plan will not become effective until the associated contract amendment has been fully approved in accordance with the State's Fiscal Rules. 13. The Contractor shall participate in state -level evaluation efforts as requested by the State to include but not be limited to quarterly reports on the implementation and accomplishments of its approved Work Plan, to be due 15 days after the each calendar quarter. Calendar quarters shall be July -September, October - December, January -March, April -June, as applicable. Failure to submit quarterly reports in accordance with the above time frames may result in a delay or denial of the reimbursement request for those periods. 14. Within thirty (30) calendar days after the expiration of the term of this Contract, the Contractor shall submit a written report to the State that describes its key accomplishments in implementing its approved Work Plan, including qualitative and quantitative data collected about smoking prevalence and tobacco control in their communities. The report shall also describe the Contractor's achievements during the contract term.. 15. Unless otherwise provided for, all data collected or produced or derived exclusively from the Contractor's or subcontractor's work under this Contract shall remain the sole property of STEPP, whether in individual, aggregate, identified or de -identified form or any other form required by STEPP. To facilitate follow-up, research, surveillance and evaluation, any such data collected, used or acquired shall be made available in any form required by STEPP, to STEPP and any other contractor designated by STEPP. Any such data collected, used or acquired shall be used solely for the purposes of this Contract. The Contractor and its subcontractors agree not to release, divulge, publish, transfer, sell, or otherwise make known any such data to unauthorized persons without the express prior written consent of STEPP or as otherwise required by law. This includes a prior written request by the Contractor to STEPP for submission of abstracts or reports to conferences, which utilize data collected under this Contract. Notwithstanding the foregoing, the Contractor shall be entitled to retain a set of any such data collected or work papers necessary to perform its duties under the Contract and in accordance with professional standards. 16. The State of Colorado, specifically the Department of Public Health and Environment, shall be the owner of all printed materials, graphic representations, educational materials, audio-visual products, or any other media, in whatever form, created under this Contract. All such materials created under this Contract must be pre -approved by the STEPP Marketing Director and Contract Manager in the development phase. A minimum of ten (10) business days is required for the review and approval process. The State reserves the right to require the CDPHE logo, the STEPP logo, or other wording on any material, representation, product or other media form created under this contract. Any material, representation, product or other media form that will use the Colorado QuitLine, Colorado QuitNet or STEPP logo or information must be pre -approved by the STEPP Media Specialist. A minimum of ten (10) business days is required for the review and approval process. This requirement applies, but is not limited to, any brochure, flyer, presentation, billboard, radio spot, website, banner advertisement, etc. 17. Funds provided under this Contract may not be used to: supplant funding for any existing programs/models; develop new cessation programs/models; develop curricula for youth or adults not reviewed and approved by STEPP; pay for individual cessation aids or nicotine replacement therapy; fund capital improvements; or fund costs of enforcement of state or local laws and ordinances. 18. Funding levels within the Budget, attached to this Contract, may be modified as follows: To be attached to CDPHE Task Order v1.0 (11/05) contract template Page 3 of 7 Revised: 12/19/06 EXHIBIT A a. Up to ten percent (10%) of the total funds originally set forth in each major budget category (e.g., Personal Services, Operating, Travel, Contractual and Indirect) may be transferred to other major budget categories without prior approval by the State; b. Greater than ten percent (10%) of the total funds originally set forth in each major budget category can be transferred to other major budget categories only after written notice has been given to the State and the State has approved such transfer; c. Where the contract not -to -exceed amount is increased or decreased, the parties shall execute a contract amendment in accordance with paragraph 5, page 3 of this Contract prior to any such budget modification; and d. In all instances described in 18a and 18b above, the Contractor shall submit a revised budget to the State that shows: the original amount(s), the modification(s) made, and the new amount(s) within thirty (30) calendar days of the date the modification(s) is being requested. However, with regard to paragraph 19c above, in no case shall the transfers become effective until the associated contract amendment has been fully approved in accordance with the State's Fiscal Rules. e. Any changes in excess of 10% as outlined above requiring an amendment to this agreement, shall be submitted to the state by February 28, 2010. 19. The list of acronyms below could be referred to throughout the contract, work plan and budget. ACS -American Cancer Society ACNS-Alamosa County Nursing Service ADA-Americans with Disabilities Act ADAD-Alcohol and Drug Abuse Division AHA-American Heart Association AIDS -Acquired Immune Deficiency Syndrome ALA(C)-American Lung Association (of Colorado) AMCHP-Association of Maternal Child Health Programs ANA -Americans for Non -Smokers' Rights ARC -Addiction Recovery Centers ASC-Adams State College ASSIST — American Stop Smoking Intervention Study ASTHO-Association of State and Territorial Health Office B&G-Boys & Girls BACCHUS-BACCIIUS Peer Education Network BAG -Build a Generation BBLHC-Boulder Broomfield Latino Health Coalition BC -Boulder County BCPH-Boulder County Public Ilealth BGC-Boys & Girls Club BGCMD-Boys & Girls of Metro Denver BMTF-Baby & Me Tobacco Free BOH-Board of Health BRFSS-Behavioral Risk Factor Surveillance System BVBAG-Buena Vista Build a Generation BVSD-Boulder Valley School District CASB-Colorado Association of School Board CB — Community -based System CBO-Community-based Organization CCAP-Larimer County Child Care Assistance Program CCGC-Colorado Clinical Guidelines Collaborative CCMC-Colorado Clinical Managed Care Network CCPD — Cancer, Cardiovascular, and Pulmonary Disease CCIAA — Colorado Clean Indoor Air Act CCTCI-Colorado Chew Tobacco Collaborative Initiative CDC -Centers for Disease Control CDE-Colorado Department of Education CDPHE-Colorado Department of Public Health and Environment CEC-Career Education Center CEO -Chief Executive Officer CFFC-Colorado Foundation for Families and Children CMC-Colorado Mountain College To be attached to CDPHE Task Order v1.0 (11/05) contract template Page 4 of 7 Revised: 12/19/06 EXHIBIT A CNS-County Nursing Service COPAN-Colorado Physical Activity and Nutrition Program CPHA-Colorado Public Health Association CRUE-Culturally Responsive Urban Education CSAP-Colorado Student Assessment Program CSH-Coordinated School Health CSO-Colorado State University CSU-P-Colorado State University -Pueblo's CTEPA-Colorado Tobacco Education and Prevention Alliance CTFK-Campaign for Tobacco -Free Kids CTRP-Colorado Tobacco Research Program CTP-Crossroads Turning Point CU -University of Colorado, Boulder CWCCI — Colorado Women's Cancer Control Initiative CY-Contract Year DASH -Division of Adolescent & School Health (CDC) DHS — Department of Human Services DHHS-Unites States Department of Health and Human Services DOR-Department of Revenue DSS-Department of Social Services EAP-Employee Assistance Program ECCLC-Early Childhood Council of Larimer County E.D.-Executive Director EMT -Emergency Medical Technicians EPA -Environmental Protection Agency ETS-Environmental Tobacco Smoke (a.k.a. secondhand smoke) FIRC-Family and Intercultural Resource Center FICA -The Federal Insurance Contribution Act FDA — Food and Drug Administration FPP-Family Planning Program FRCC-Front Range Community College FTE-Full Time Employee FY -Fiscal Year FYI -Family Youth Initiatives GASO-Great American Smokeout GASP CO -Group to Alleviate Smoking Pollution of Colorado Get R!EAL (GR)-Resist! Expose Advertising Lies (Youth Empowerment Program) GLBT — Gay, Lesbian, Bisexual, and Transgender HCP-Health Care Program For Children with Special Needs HCYS-Huerfano County Youth Services HIV -Human Immunodeficiency Virus HSL-High School Leadership JAC-Juvenile Assessment Center KPC-Kevin Patrick Caleum LAHCDHD-Las Animas Huerfano Counties District Health Department LBW — Low Birth Weight LC -Learning Community LGBT-Lesbian, Gay, Bisexual, Transgender LEM-Latinas en Movimiento LHA-Local Health Agency LHD-Local Health Department LLC-Limited Liability Company LRCC-Latino Regional Community Coalition LRPC-Latino/a Research and Policy Center LSTPEN — Latino Statewide Tobacco Prevention and Education Netw MCHA-Montezuma Housing Authority MCHD-Montezuma County Health Department MCHS-Montezuma-Cortez High School MCRC-Media Campaign Resource Center — CDC MD -Medical Doctor MHCBBC-Mental Health Center Serving Boulder and Broomfield Counties MO -Month MOB -Medical Office Building To be attached to CDPHE Task Order v1.0 (11/05) contract template Page 5 of 7 Revised: 12/19/06 EXHIBIT A MOU — Memorandum of Understanding MPH -Master of Public Health MSA — Master Settlement Agreement MUH-Multi-user Housing MYAT-Multi-Disciplinary Youth Assessment Team N/A -Not Applicable NACCHO-National Association of County and City Health Officials NACR — Native American Cancer Research NAQC-North American Quitline Consortium NASBE-National Association of State Board of Education NCHD-Northeast Colorado Health Department NCI -National Cancer Institute NE -North East NFP-Nurse-Family Partnership NIDA-National Institute on Drug Abuse NIH-National Institute of Health NJH-National Jewish Medical and Research Center N -O -T -Not -on -Tobacco, (ALA's Youth Smoking Cessation Program) NPP-Nurturing Parenting Program NRf-Nicotine Replacement Therapy NSBA-National School Boards Association OSH-Office on Smoking or Health (CDC) PAC -Prevention Awareness Crew PACT -Partners Assessing Chew Tobacco PCCHD-Pueblo City -County Health Department PHN-Public Health Nurse PIO-Public Information Officer PM -Peer Mentor PMC-Parkview Medical Center PPFC-Pikes Peak Family Connections PPN-Prevention Policy Network PRAMS -Pregnancy Risk Assessment and Monitoring Survey PRIDE -Pure Respect Initiative Direct Education PSD-Prevention Service Division PTEPP-Pueblo Tobacco Education and Prevention Partnership PVC -Prairie View Clinic Q I -Quarter One Q2 -Quarter Two Q3 -Quarter Three Q4 -Quarter Four RDAC-Regional Disparities Advisory Council RFA-Request for Applications REP -Request For Proposals RIHEL-Regional Institute for Health and Environment RMC-Rocky Mountain Center for Health Promotion & Education RMRH-Rocky Mountain Rural Health RY-Reconnecting Youth SAMHSA-Substance Abuse Mental Health Services Administration SB — School -based System SBAG-Salida Build A Generation SBHC-School-Based Health Centers SCYC-School Community Youth Coalition SCRHC-Southern Colorado Regional Health Collaborative SECI-I-Southeast Colorado Hospital SEMHS-Southeast Mental Health Services SES — Socio-Economic Status SEW -School Employee Wellness SGR — Surgeon General's Report SHAC-Smoke-free Housing Action Committee SHI-School Health Index SHS-Secondhand Smoke SIDS -Sudden Infant Death Syndrome SLV-San Luis Valley To be attached to CDPHE Task Order v1.0 (11/05) contract template Page 6 of 7 Revised: 12/19/06 EXHIBIT A SMART -Staying Motivated at Reducing Temptations SMART OUTCOME OBJECTIVE -Specific, Measurable, Achievable, Realistic, Time -Bound STD -Sexually Transmitted Disease STEPP-State Tobacco Education and Prevention Partnership STW-Straight-to-Work SVVSD-St. Vrain Valley School District SWOT -Strengths, Weaknesses, Opportunities, Threats TA -Technical Assistance TABS -Tobacco Attitudes and Behavior Survey TAG -Technical Advisory Group (for evaluation & TPEG) TANF-Temporary Aid to Needy Families TARP -Tobacco Advocacy and Resource Partnership TBD-To Be Determine TCP-Tobacco Control Partners TDG-Tobacco Disparities Grant TDS-Tobacco Disparities Subcommittee TEACH -Teaching Equity to Advance Community Health TEPP-Tobacco Education Prevention Partnership TFLC-Tobacco Free Larimer County TFS-Tobacco-Free Schools TFS Law -Tobacco -Free Schools Law TGYS-Tony Grampsas Youth Services TND-Project Toward No Drug Abuse TPEG-Tobacco Program Evaluation Group TPI-Tobacco Prevention Initiative TRC-Tobacco Education and Prevention and Cessation Program Review Committee TRI-Tobacco Rapid Improvement Activity TRIA-Tobacco Rapid Improvement Assessment TTI-Tony Grampsas Tobacco Initiative UCD-University of Colorado — Denver UCDIISC-Heath Sciences Center at UCD (sometimes abr. UCHSC) UCDIISC-University of Colorado at Denver and Health Sciences Center USSTC-US Smokeless Tobacco Company Well COA — Wellness Councils of America WIC — Women, Infants, Children Y(u�C-Youth at Crossroads YE -Youth Empowerment YPH-Youth Partnership for Health YT -Year YRBS-Youth Risk Behavior Survey YTS -Youth Tobacco Survey 5 A's — Ask, Advise, Assess, Assist, Arrange To be attached to CDPHE Task Order v1.0 (11/05) contract template Page 7 of 7 Revised: 12/19/06 EXHIBIT B STATEMENT OF WORK To Task Order Contract Dated 05/20/2009 - Contract Routing Number 10 FLA 00164 These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. 1. The Contractor, in accordance with the terms and conditions of this Contract, shall perform and complete, in a timely and satisfactory manner, all items contained in its approved Work Plan that is attached hereto as Attachment B-1 and incorporated herein, and in accordance with the associated Budget which is attached hereto as Exhibit D and incorporated herein. To be attached to CDPHE Task Order v1.0 (11/05) contract template Page 1 of 1 Revised: 12/19/06 Attachment B-1 Year One Work Plan 2009-2010 Preventing initiation among youth and young adults Promote quitting among adults and youth Eliminating exposure to secondhand smoke Identifying and eliminating tobacco -related disparities among population groups Strategy I — Community Coalition & Local Policy (Required) By June 30, 2010, Tobacco -free Weld County coalition will actively recruit youth and involve them in conducting a needs assessment to determine which aspect of youth access policy to focus on. Lead Person and Agency Responsible y 613 O 1.gG�IU Measures or data that will show Reach -and/or Implementation. Reach: 0 Implementation: Attendance at kickoff event Reach: 0 Implementation: Attendance at kickoff event Anticipated Outcomes 8 " tg c O ,.. liw >>,0 8 c I ° o 2 E .. •U aG° Imp lnentation Timeframe,,K, „ f 'r Youth Ql Target ,.5;: Population o Activity Details' What: Identifying youth organizations to recruit youth Where: Greeley youth organizations How Often: 1 How Many: 4 youth organizations What: Attend meetings/events to recruit youth Where: Greeley youth organizations How Often: Once a month How Many: 6 times a d 0 STEPP Strategy: S.M.A.R.T. Outcome Objective #1: 1;Implementation ah Carry' �I U� Policy - Organizing Policy - Organizing Attachment B-1 Health Dept. staff Boys & Girls Club staff "V ay 4 = TAMOLDx A d �mv� M 45 6 C.1 0 4 s aaUH3 v Reach: N/A Implementation: N/A Reach: 0 Implementation: Attendance at kickoff event Reach: 0 Implementation: Attendance at monthly meetings Reach: Nil l Implementation: Decision on strategy Have consistent meeting location for youth coalition meetings Bring youth together to discuss youth coalition and gain commitment Youth will meet to become educated on tobacco issues, especially on youth access 6 _8 d d QI, Q2, Q3, Q4 in O' Youth O Youth a O What: Find location for youth coalition meetings Where: Greeley youth serving organization How Often: 1 How Many: 1 What: Provide kickoff event for youth coalition _ Where: Greeley youth serving organization How Often: 1 How Many: 1 What: Education of youth coalition members Where: Greeley & SW Weld youth serving organization How Often: monthly How Many: 11 What: Determine direction of action in conjunction with Tobacco -free Weld County coalition Where: Greeley youth serving organization How Often: monthly How Many: 3 by • Policy - Organizing u .N oA a° O OM I N 04)a aO. O Page 2 of 40 Attachment B -I _ 0 A- V r�� rryy gj W a) o A 0) x aavv a � ice, 'O O a) a) C E=V Tobacco -free Weld County coalition Youth coalition z u u u) v to a) a w o So,o la o 6 E 2 a a? fa. g a, 4 a .0 Reach: 0 Implementation: Holding 12 coalition meetin s Reach: 0 Implementation: Recruitment of new members Reach: 0 O c v 3 ' y c).e.o tg) O o E O E E o- ?+b... cn.C n. Coalition members will meet to discuss and plan future activities = = s 3 ° o" = c°) ao E E i O O 9 O a) U E P. E 174 E Community members will attend an event to learn about youth access Q I, Q2, Q3, Q4 Weld County Ql, Q2, Q3, Q4 residents a O Weld County residents Weld County residents Health professionals Child care What: Recruit parents and caregivers into coalition to work on youth access policy while promoting voluntary smoke free home and car pled es. Where: Greeley youth serving organization How Often: monthly How Many: 3 What: Tobacco -free Weld County coalition will meet Where: Cache Bank & Trust How Often: monthly How Many: 12 What: Tobacco -free Weld County coalition will recruit new members, especially from disparately affected populations Where: Throughout Weld County and organizations serving disparities How Often: continuous How Many: 12 What: Tobacco -free Weld County coalition will sponsor a community event focused on youth access I Where: Weld County venue to .E 0) = p. Q ra4 Policy - Organizing N u as t1) .75. a0 Policy — Building and Educating Attachment B -I P. 5 I; B» )L/_} `~-—- /))}) Implementation: Holding the event Reach: N/A Implementation: Providing technical assistance Reach: N/A Implementation: Research collected, people interviewed, data analyzed issues and what can be done in their community and to encourage participation in coalition §\�\8\� i°e«®®° §)ao]4] J!u U P. The coalitions will begin to gauge interest and awareness of youth tobacco access issues & 3 providers City and county officials Youth coalition members k{r/7) \?\ /\E §?.\j 0-0 How Often: 1 How Many: I What: Provide technical assistance and education on youth access models and research Where: Coalition meetings How Often: As requested by coalition leadership How Many: 1 What: Research and assess community on youth access issue Where: Weld County How Often: ongoing How Many: N/A WO ) Policy- Organizing tu es O. Attachment B-1 4) a. Tzi W N Reach: Majority of Weld County residents (apprx. 200,000 people) Implementation: Placement of advertisements -d K.r"O� +r-. y 41 co .0 ca., ca.,yin" L) ++ t N 3 N O N �, = 'CItu ,:u G ct el o > Q 3 .9. C o cd U E U o d a M a N a a 4' O F, 3` What: Media for community coalition event Where: Weld County media outlets How Often: Monthly How Many: Various ads will be placed each month N 0) N C 2 .I. CO 4) Q Attachment B- l Eliminating exposure to secondhand smoke Community Coalition & Local Policy (Required) C a a 4) 7,4 o O o E: a) c es. In O 15,.• bw Ei.cucu E�2V i °. C c v wc V° 3 — C U ._8 w= �v a C c U -C Education/training enforcement Where: Luncheon site O c)1)8 o .E o Q of Uy7 �V4- > O C .5 r 5 E § Cl4U 3 n �a) Collaboration/ N a Attachment B-1 a. a x 11, , c V o x �°3 o. ��,, U • 4- cts U o flU 8 z u i Implementation: Meet with owners of businesses and provide information Reach: N/A Implementation: Presentation held Reach: N/A Implementation: Held presentations Reach: N/A Implementation: Meetings held .may a� Q po o G CC y ��+ Z�� V U Presentation and discussion with fire department personnel from Weld County o ' �'' (,o� O _O 4r O• ; C. k a ai a in ° ° o O ee O C s bp ycri U• 3 4.) o R. a N a O' r, a C N a . _4.-. 0 0 U ZO ..03 4. U v 3 e; L' O a' L> ^� c What: Provide extra assistance in communities in which non-compliance of CCIAA has been/is an issue Where: Non -complying communities How Often: periodic How Many: 5 What: Provide education on CCIAA compliance at fire chief meeting Where: Meeting location TBD How Often: I How Many: 1 What: Provide education to recreation center staff on existing smoke -free public places laws, including presentation at all team mans er's meetin Where: Meeting location TBD How Often: 1 times per city How Many: 3 What: Provide continued support of signage placement at public places Where: Community ball parks and athletic facilities How Often: Continuous How Many: 6 0 . Education/training al z .� 8 Policy — Implementing and Enforcing Attachment B-1 4. 8a) j 5 -5 oU o 0 ed =E-3° Reach: 15,000 Implementation: Notifications are included in all mailings and announcements c o �,•- cdb c o2 .9.E`vE N 2 ci bA s.. C u .b • C C 4.1 I- U 3 U E C .0 C C C C co d en" d N a a t ts c o w 0 > C .C C c.w3o ) What: Outreach through notifications and mailings to sports team managers, registration announcements, league mailings, and periodic mailin s on class schedules Where: Communities with smoke -free public places laws How Often: At least 3 times per quarter How Many: At least 12 per year. a, g 3 Attachment B-1 Year One Work Plan Strategy II — Health Disparities (Required) y 3 2 y j a Z 0 Hy 23 Q Cdo 0.) z1.4 o o 0 o o o -0 air, O o a� Fd oU a(24 a, o a) U '° • 0 Tai 5 • ▪ iC • ( a� o O n• • o • 03 • � ▪ C U C• g o ...e• 44-d a O cri0 ••0y • H • O • as U o� E Ea, P. E a 0' 0 E E c U bn o 4 E V o 4: 7 O a+ a g o x x O O O O aa A � E VfE II Attachment B -I IQ. a) a) z a. xc'1)' a. a) V =cA Reach: 0 Implementation: Participation in meetings and conference calls Reach: 0 Implementation: Meetings held Reach: 0 Implementation: Information provided = O i. U.bA U v o O O C CO y A N cn �' CL ' O = v6,.. - g Q OO �v O M C)i O 0 .' •C •E O a) Ch c.) y 0 -' == ,...,goo c.o.= o vv,. , A u° 0"D b w cO) c a M a N a a a M a N a a a r a N a a 'flp O D U C N .O U•= 4cRi a) •2 Ems.g a� co) 01:,O.r3 'O O o a p. O vi g, -N E 42 E�.E o 0 o t,,0.0 E U ° .Z2 p• r-' . g U .N E ,� 5_•E o v O 4 b E U o Cl What: Attendance and participation at LSTPEN meetings and conference calls Where: Denver/regional locations and by phone How Often: At least monthly How Many: 10 -12 What: Host Regional Community Coalition meetings and develop agenda and action items Where: Loveland 1 How Often: Every other month How Many: 6 What: Provide technical assistance and education on disparate populations tobacco control best practices Where: Loveland How Often: Every other month How Many: 6 Collaboration/ partnerships o v. C U a. o ch cad a' U a. Attachment B- l E.' Q s z a Ca x.g Reach: 0 Implementation: Participation in meetings and conference calls Reach: 10,000 people Implementation: PhotoVoice results displayed at various locations C y0 0U cad V N to o.-°roa. U c3 co Q 41 8 0 u e� zz h C .o � p rn .E —Vs. o" 4- c4 Q1, Q2, Q3, Q4 M O' N d a "CC' CO " UO cd C 'C + CC L 0 0E rod= p bf1 p, "0 0 V U Cd a„ • C & 5..a ca y What: Attendance and participation at PACT meetings and conference calls Where: Denver and by phone How Often: Monthly and quarterly How Many: 8 - 12 What: Publicity of PhotoVoice results Where: Weld County How Often: 1 per quarter How Many: 4 Collaboration/ partnerships Awareness 1 Attachment B -I Year One Work Plan 2009-2010 GOAL: Identifying and eliminating tobacco -related disparities among population groups. Strategy II — Health Disparities (Required) By June 30, 2010, establish and maintain relationships with all disparate populations by bringing about awareness and strategies to reduce tobacco use. Lead Person and Agency Responsible \ k - co / is I ] Measures or data that will show Reach and/or Implementation Reach: 0 Implementation: Relationships developed and maintained through meetin Reach: 0 Implementation: Written formal policy 2 6 rt : § k o ^ .... coo00 . 4- J • k 2 @ 2 0 k _ 2 8 2 § \ - § . = § 8 disparate organizations Implementation Timeframe 3 a a a— �. Target Population -0 I'O § § c O toJ '8 4 0.�a§k § 0 Activity Detai s L IL What: Attending local organization meetings of disparately affected ulations Where: Various locations How Often: Monthly How Many: 10 What: Assisting organizations serving disparate populations in developin written licies Where: Weld County community based organizations How Often: As needed How Many: N/A STEPP Strategy: , S.M.A.R.T. Outcome Objective #2: ■ O to r /a d 11 �44 J 76/ I ,_ » .) 3 k to a 9 2 9 S 2 d E Attachment B -I • a o. a. Health Dept. staff Reach: 0 Implementation: Relationships developed and maintained through meetin s Reach: 0 Implementation: Relationships developed and maintained through meetin s Reach: 0 Implementation: Relationships developed and maintained through meetin s Reach: 1,000 people who attend the rodeo and read the program Implementation: Advertisements placed Cvi 0.n bq C O ro OU C C C O U C z 'ro .o 8 Q. y E w -zv -6i -ti o g o C� ,. o N bQ .Ey bq O y RIy U C ,� .� C C C G G U 'a .o c8i n., i gii E. b ^O 0 o w L O dA C to O -- N .� OU C -- • C C C tom. o .O U •Fi o o A.2 R 0 E -Eo v -v o w cd sr o V U Increased calls to the QuitLine O a d a $ a a O' a a a a .-, 0' bC _ d cd i-UI 0 O v '0 O 8;3 n,U - on - a�i 5 °) y ice. O = En U a0i _ -o 0 3 Rural residents attending rodeo What: Attending local substance abuse meetings (Colorado Prevention Partners, Substance Abuse Summit, etc.) Where: Various locations How Often: Various How Many: 6 What: Partnering with organizations serving disparate populations to provide tobacco education Where: Various locations How Often: Various How Many: 6 What: Partnering with organizations serving rural residents to provide tobacco education (CSU Extension Office, etc.) Where: Various locations How Often: Various How Many: 6 What: Purchase spit tobacco cessation advertisement for South County Rodeo program Where: Keenesburg How Often: 1 How Many: 1-2 •o Y _Q. U C. f'• 0. • M. U c.(-) 0 cn •-' c° a. Awareness Attachment B-1 Health Dept. staff Health Dept. staff Health Dept. staff a Ca s c a a) CZ s N O xTM Reach: 500 people who attend the rodeo and read the program Implementation: Advertisements placed Reach: 250,000 people who attend the rodeo and read the program Implementation: Advertisements placed Reach: 20,000 people who attend the rodeo and read the program Implementation: Advertisements placed Reach: 10,000 — 15,000 Spanish-speaking Latino Implementation: Advertisements placed Reach: Dependent on number of articles published and the media venue which publishes articles or messages Implementation: Earned media published Increased calls to the QuitLine Increased calls to the QuitLine Increased calls to the QuitLine Increased calls to the QuitLine and decreased smoking in homes and cars y cn ca c -o .E u '13 ❑ 1.1. Q 0 ° w y'D E -G ° `t ° o s ca a a a QI,Q2,Q3,Q4 v d r, a nj O1 a Rural residents attending rodeo Attendees of the Stampede Attendees of the County Fair Spanish- speaking Latino community TM �o ctt og En 'D O Q. What: Purchase spit tobacco cessation advertisement for Grover Rodeo program Where: Grover How Often: 1 How Many: I What: Purchase spit tobacco cessation advertisement for Greeley Stampede program Where: Greeley How Often: 1 How Many: 2 What: Purchase spit tobacco cessation advertisement for Weld County Fair program Where: Greeley How Often: 1 How Many: 1 What: Purchase secondhand smoke and cessation advertisements in various Spanish media outlets Where: Various locations How Often: 1 per quarter How Many: 4 What: Earned media promoting tobacco education in various media venues that served above disparate populations Where: Various media outlets (newspapers, publications, etc.) How Often: 1 per quarter How Many: 4 TM TM a) C) Awareness Awareness Awareness N N v C 0) O 0 O 0.0 Attachment B-1 / 0 2 n 0 X 2 Reach: 800 people Implementation: Activities implemented and material received Reach: N/A Implementation: Training held 2 0 -`§ i k . �.§ ©§'�%§\ § © ■ m a 0 O '� O \ o. 0 0' Coalition Q4 members Community partners Community members Where: Greeley/Weld County How Often: 1 week How Many: 3 locations What: Provide cultural proficiency training for coalition members and communi at lar e Where: Greeley How Often: 1 How Many: 1 Awareness Education/training Attachment B-1 Year One Work Plan Promote quitting among adults and youth Eliminating exposure to secondhand smoke Identifying and eliminating tobacco -related disparities among population groups Strategy IIIa — Systems Integration, Internal Providers 0.6 a o 4) Ce 5 et 0 I- 0 G U C. V) C- a)) os al N N ags :\n chment B-1 75 1.0 A s ac)i cla Implementation: Ordering of materials and distributing the materials Reach: 0 Implementation: Staff will attend the One Step training and provide information to families 6 11 04��.• 'b== E 83•;°,2. 3m y o: 00., 1 O-0 3 a� i g g °jz-8 � o r e,. '>sE o ED'$ �'' •3 :5 V2g 'er w c30 a0i 2 O.P 3 g :2:� 0'E £.2 a a a a d a w v) 3 a v) :-. What: Work with Women, Infant and Children (WIC) program and the Weld County Food Bank to provide tobacco cessation and secondhand smoke messages by ordering materials from steppitems.com and provide information to consumers. Where: Monfort Family Clinic & Weld County Food Bank How Often: Quarterly How Many: 4 What: Work with Family Education Network of Weld County (Head Start) to provide information on secondhand smoke exposure and work with ALA to provide ONE, STEP training. lWhere: Weld County How Often: 2 times a year How Many: 2 o cn V o H U Attachment B-1 0 )a ±) 0 \t ±; • )a ±) Reach: 0 Implementation: Messages will be sent ca azi Implementation: Articles written Reach: 0 Implementation: Information is collected )§/a2; a) •— En ��\ 0' Weld County employees will learn about tobacco cessation resources ) ='a `: ^`;« �t0)cd C \./ a U \ / \ ± / _ e »s; V a) Weld County employees &s \\\ &; What: Make available information regarding tobacco cessation, secondhand smoke and prevention resources to all county em to ees. Where: Weld County How Often: Every other month How Many: 6 What: Write an article for the Weld County newsletter talking about the tobacco ro am Where: Weld Coui How Often: Two times a year How Many: 2 What: Work with Weld County Safety and Wellness Committee to research information regarding insurance costs associated with smokin activity Where: Committee meetings How Often: monthly How Many: 12 } & az \\ Collaboration/ partnerships to t \ \ 0 00 O. Attachment 13-1 ai a o CI IS xy ti n. 4) O x Reach: 0 Implementation: Assistance provided to other grant administrators Reach: 0 Implementation: Messages will be incorporated into classes and curriculums s- -ate oo�a, oog•°6 t3 � •gib fg O O= O coca.0 C = oV L V O aj .� a O o x C�, 8 - a�°g •�o6 Oin gHI 2. �.g -CUa. O, O O •.J 8 N ' a) G •5 co A E -- N cd O ls a M a N a a mot• a M a N a a- 4' =� C� a E4 341 8 c O O 3 a2 13 ._ t:11.) a. What: Collaborate with Livewell and Heart of Weld grant programs to assist in the implementation of tobacco initiatives for the nts Where: Health Department How Often: monthly How Many: 12 What: Work with Healthy Marriages to provide tobacco cessation and secondhand smoke messages by ordering materials from steppitems.com and provide information to consumers. Where: Weld County How Often: Quarterly How Many: 4 OIn Cl. jg cu U 1. Q CA.471 w a as I U Attachment B -I Year One Work Plan 2009-2010 Preventing initiation among youth and young adults Promote quitting among adults and youth Eliminating exposure to secondhand smoke Identifying and eliminating tobacco -related disparities among population groups Strategy IIIb — Systems Integration, External Systems By June 30, 2010, provide outreach information and assistance to 20 external service providers to integrate 2A's and an R model, One Step messaging, and prevention messages into their daily practice, especially those providers serving disparate populations. Lead Person and, Agency Responsible a. co Ci 73 Y 7 Measiu 's or' data that . t y � ,• willL$ iz t d'Reach; .mod/or . O t u et ai a Anticipated Outcomes O F..cs oa-a w3 I aa)aQ) v) .0. o =see .a Implementation Timeframe a en" a N a a ACd a ^..>c. 0 cC 0 .O y •C U G. Activity Details r` What: Provide information to fire departments to include secondhand smoke information to families while installing and/or inspecting child car seats and while distributing home smoke alarms Where: Weld County fire departments a STEPP Strategy: S.M.A.R.T. Outcome Objective #1: Implementation Ca ory O ) cd O Q. Attachment B -t / - )\ S. ) ±) / e \) Implementation: Information on secondhand smoke will be rovided to families Reach: 0 Implementation: Information on secondhand smoke will be rovided to families Reach: 0 Implementation: Certificates delivered to businesses Reach: 0 Implementation: Letters sent and visits to non- complying vendors O. } o °�}\ \ §)}2; to \o§\a{5\ ��} \\}® \}\ k�/\/) < a)O CL \�\\)/�\S /goo )a) 3 5 5 }))g ��9)a ��2kse B\7 § , 'to 6®;�© /E\s \\ »`_^$ 2.-2(0 §/ 0 How Often: Quarterly How Many: 32 municipalities What: Provide secondhand smoke information to be distributed to families having car seats inspect/installed at the Tailgate the Safety Way event Where: Greeley West High School How Often: 1 How Many: 1 What: Work with the Department of Revenue Tobacco Enforcement division to provide certificates to vendors who passed com liance check Where: Weld County How Often: 1 How Many: 80 What: Write letters and visit vendors who failed the compliance checks and provide information on current laws Where: Weld County How Often: 1 How Many: apprx. 15 businesses Cu,c, \- CA \a) /\ j{ \} Attachment B- I E -ci-o ky $ § V k 2 6 k 2 Reach: 0 Implementation: Trainings provided to health roviders Reach: 0 Implementation: Training provided Reach: 0 Implementation: Information will be provided to attendees Reach: N/A Implementation: Training completed, N -O -T projrams started k 2 2§ 2 �' �' ,g §§ ihU 1 u/ 2 ,,,2 '3 Z 2 �� 2 §...2..e; 2 2 e 7 2,d% c- u§ -§.§ q .3 o a o g %\ • E# . - k / E k .- 31 a d O 0' a CY & & C Ci CY _ d t, , §'J o/ 2 / § § �27 /'u k = •§ ' .§ = k —�U 0 o What: Work with Colorado Clinical Guidelines Collaborative (CCGC) to deliver 5 A's and secondhand smoke training to medical roviders Where: Weld County How Often: Quarterly How Many: 4 What: Work with childcare providers to provide information on secondhand smoke exposure and work with ALA to provide ONE STEP trainin . Where: various locations How Often: quarterly How Many: 4 trainings What: Participate in monthly YouthNet meetings and provide tobacco -related u tes to attendees Where: Rodarte Center How Often: Monthly How Many: 12 What: Link schools with ALA's Not On Tobacco (NOT) program and help host the training Where: Weld County schools How Often: 1 How Many: 1 • .9 ii 7 • a. �3 2 u ± d . Collaboration/ partnerships Education/training Attachment B-1 a b X a ° 0 z a. I) CS CD T x, Reach: 0 Implementation: Own Your C events will be held Reach: 11,000 middle and high school students Implementation: Meetings will be held, signs will be posted and law will be enforced Reach: 0 Implementation: Fonun held and videos made - o8 >>°, o .'o g t o Q. } a o = ,,, �o-0o0 u 82 o 8 3 ) a aa) o ct 3 48 -O, . o o 5 ° +° c� 61 A r.it.s 8 2 ki E o --t M a N d M a U u'' U . � '° 6=O 8'0 0 3-�wy U `� .� 7.3 .O,, 3 What: Promote Own Your C events at middle and high schools, youth organizations and other venues and events across Weld County Where: Weld County J How Often: twice a year How Many: 2 What: Work with Weld County middle and high schools to enforce Tobacco - free Schools Law and offer to com lete the TFSL checklist Where: Weld County How Often: 3 schools per quarter How Many: 12 What: Collaborate with District 6 schools to host 4th annual Health Media Literacy Forum Where: UNC How Often: l How Many: 1 O V1 R Uto g a v - U° a° aO F 2 e O U c. Attachment B-1 a - o c row CU ctl x • CU O s ro 0 Col x 17) Reach: 0 Implementation: Counter -marketing messages will be aired Reach: 0 Implementation: Participation in meetings, policy implemented, and campaign promoted T O b0 ' O y aNi a�i c Y bO cal O Li t H Oi E N> '00 E D 3 a� cU L aCi :9 7 'O' VI N O b n...J �. C C cn ''3 W ' .4.-; r u c❑ g 7 U o ..C O N a 3 L 4O in = O ' N O 04" N• O t v, • iC N C 0 CUci G..v ° y O O. °�° O ° o t °a: o °' o u° o I) a v E c C a C) Q (Q - O O N T O ❑ E o • 6 0.F o a a M a v a a N a a >, " <tl y y 7 C.) 'O O O Vcy CL. U ., Q av, 7 'e v; o tC C W yyU G 3 cis What: Health Media Literacy Forum videos will be aired on Greeley TV Where: Greeley How Often: Continuous loop on tv channel How Many: Tobacco commercial will be aired What: Participate on tobacco task force meetings at the University of Northern Colorado (UNC) and Aims Community College (ACC) to assist with policy development and implementation and promote The Cigarette Is Dead campaign when possible Where: UNC & ACC How Often: quarterly How Many: 8 Collaboration/ partnerships t O N N C L N et t Y O U d a 0 N u m m Attachment B -I a a) Q i a) xN • a> CZ raw d A x1, Reach: 0 Implementation: Announcement for cessation services sent to UNC & ACC Human Resources Reach: 70 multi -unit housing managers and owners Implementation: Information will be provided ur N t 0a.5 v y. CW G', v, U ¢ N g iiI! C w a 4+ c C. N N O cd N oz cb0 VI 3 v > E Q O N V a M a N a a 7 a ri a N d O' U 4 U a U o w 1:1 U+ 6 'v a w .. N o .- N cd O •C toy N 'C op N E vl 7 .5 ai c a .E a) W C ,- a C .a '_ a t1. 03 0 E '� U N E S O What: Promote tobacco cessation support group and You Can Quit class to UNC and ACC staff and faculty by sending information to Human Resources Where: UNC & ACC How Often: Monthly How Many: 24 What: Provide outreach to multi -unit housing managers and owners regarding smoke- !, free housing options by providing available information and possible services Where: Weld County How Often: Quarterly How Many: 4 O N -• S 's U n. W a E C114. o 0 7 w O w O Cal ro a Attachment B -I a a. Reach: 70 multi -unit housing managers and owners Implementation: Newsletters will be sent and emailed Reach: 0 Implementation: Participation in meetings and conference calls r.. y w o iiL_a �, c c..x a� Q S o•� y E E' > E a� o ' o :0 I. pq . 4 3 'n,°= v > 3x04, .5�o i C a 3 E o a N a a a N a a c 4-, c t, c a) go E= O U Q ≥ a) U -c E.� .� co C o U cO Lo tlj a. L. What: Mail and email smoke - free housing newsletter to managers and owners of multi -unit housin Where: Weld County How Often: two times a year How Many: 2 What: Participate on Smoke - free Housing Steering Committee Where: Phone and Denver area How Often: every two months How Many: 6 U, cv Q y Y a. I 5 o cj c.) a. Attachment B -1 Implementation: Training will be provided by Get Real Implementation: Resources will be distributed to target populations a) ° O .9 Q "g :72 : =3°°q to 3� o- o 0 Iv ° . Eyou-d2 E L ° c F°-' ° 0$ 'O = >, c°i3"$ m �fl- I-� O .o E .5. o >, O' a o, a a a a 41 0 V 8 b= 3 , What: Work with Get Real to provide education, training and guidance to the newly formed youth coalition Where: Greeley How Often: one time per month How Many: 12 r icmu, ruvviiiic rtaacaauicui Center (JAC), Probation, etc.) to provide tobacco resources Where: Weld County How Often: Once per quarter How Many: 4 1 U a Attachment B-1 ti, 0 a4) cu. O c. 0 R Reach: 0 Implementation: Participation in committee and attend meetings P V 61 a Implementation: Articles placed in newsletters Reach: 0 Implementation: Membership in Chamber of Commerce and attend meetin s `n n y; C 0 C OA C. 7 '� <.)c ` U C _ O 4. N 'O (A Oc. 0 a) V N OU 'U O p C •- C> rn p - .,- O 49, O � "Ti O v).L .SG p V > .p 3' E H L— O'cYn a r N 0 a o0 z C 4'2 C��3 rL • c� U 0 0� a 3 b cn = 'a t a'� y 5 � V o V What: Work with worksite wellness committee and WELCOA to provide tobacco information and resources to participating worksites Where: Weld County How Often: Every other month How Many: 6 What: Place articles on benefits of tobacco -free workplace in Chamber of Commerce newsletters Where: Weld County How Often: Once per Chamber How Many: 3 What: Continue membership and attend meetings with Greeley, Carbon Valley and Windsor Chamber of Commerce `Where: Greeley, Carbon Valley and Windsor How Often: yearly membership How Many: 1 U o y E — V1 U a. N CO U Q. Attachment B-1 \ /) / �]\§)§ 2 W mn )k)/ )0CC) 1 /\� Cr, 3 \ \ 0 cc O \\ } o .19 r2 \c / 0 \ / \ ( OD c ctl )){• ca O Ct O. 0- vo \}\\ 3 0 ct 2cn R. \a Policy - organizing Attachment B-1 a. a.) b a. a) Tts Reach: 0 Implementation: Meet with organization and brainstorm collaborative efforts Reach: 0 Implementation: Resources provided to EMT personnel c c.6`n v �, Q 0 .9. C " 'e • • c �3..cd .- c O O .I^ ice. Q CQ 6, E '71 >1:c- O O O O 0° v b . aq C O O O C '- vii E L y a1a fd as 6) b a. L y o 0'= M a N CY -o c- al v i ," co 0 Tu o a. w What: Collaborate with Boy and Girl Scout's to brainstorm on methods how their organization can bring about awareness of tobacco issues in our community Where: Greeley How Often: 4 How Many: 4 meetings What: Establish relationship with Emergency Medical Technicians (EMT) personnel and provide tobacco cessation resources to staff Where: Greeley How Often: 1 How Many: 1 o O M. cn a o U a+ Attachment B-1 15 Q• o c o g ris c8Cj .2 E ld R. tO4.i . E ld.E E E a 0 0 0 0 O e▪ s a Q61' TJ CD 0 E CV Oa 'C E b I U y• En a) . s N M8- t )4 v U Ca M O' d a Q1 , Q2, Q3, Q4 • .s z -o w RI U -0 0 E 0 0 O inz E g D W W U y Q U ▪ 4 Ub U 0 ' b E Attachment B-1 a a) -b a a) -a x Reach: 200,000 people Implementation: Web ad placed and articles posted Reach: 200,000 people Implementation: Radio spots aired and interview given lo g - ~moo w i O' is A 0 a M a o a a a M a a a o= U -o 32 o= U4 • 3 3` What: Promote STEPP media campaigns (QuitLine, The Cigarette is Dead, One Step myths, Own Your C, etc.) through website banner ads and articles posted to their websites Where: Weld County websites How Often: Monthly How Many: 12 What: Promote STEPP media campaigns (QuitLine, The Cigarette Is Dead, One Step myths, Own Your C, etc.) through radio spots and on -air interviews Where: Weld County radio stations How Often: 4 months out of year How Many: 12 spots per month for a total of 48 spots Cl) Cl) a? C Q Cl) Cl) a) = 2 Q Attachment B -1 a. V -v x Reach: 200.000 people Health dept. staff Reach: 200,000 people Implementation: 1'V spots aired and interviews given o -8b �i�W)8 4 1 U S 3� 0 O c, �_ . 0-o N 8.5 &. 4 P4 oa L o r 'O o -�° as `ro cn0 U O '� 3� ad O *� - V .g 'p v., -vim CL) S n� O, N a a a a a a a a V :o 'Q N 3� U o 'C N 3� What: Promote STEPP media campaigns (QuitLine, The Cigarette Is Dead, One Step myths, Own Your C, etc.) through television commercials (Telemundo, North Colorado TV — 5, GTV8, District 6 TV, etc.) Where: Weld County television stations How Often: monthly How Many: 12 What: Promote STEPP media campaigns (QuitLine, The Cigarette Is Dead, One Step myths, Own Your C, etc.) through static advertisements (billboards, bus benches, bus signs, bathroom stall ads, movie theatre screens, etc.) Where: Weld County media venues How Often: monthly How Many: 12 N N 61 - 4 N N N 2 Attachment B-1 Preventing initiation among youth and young adults Promote quitting among adults and youth Eliminating exposure to secondhand smoke Identifying and eliminating tobacco -related disparities among population groups Strategy IVa — Infrastructure (Reporting Activities) O =7 CIS 0 e d p a C • G. "• e CioZ a88 a E o C � O 4. •o Q ua E>, a T -a Ch 00 W as • 6 Ig a ae o Ei O cr or) O 'C U O ;1_4; "5." t E ac Attachment B-1 a v 7,6 cu cl a a> 74 Reach: N/A Implementation: Annual report submitted to STEPP prior to due date Reach: N/A et C- 1 v � 0 c cn pn N a 3� a S • Z to cc� = >, 3 �� b E 3 ¢ c— m -a °cL� 4, �+ a a M a N a a a z z What: Complete annual report highlighting activities accomplished in the work plan and provide copy to Board of County Commissioners Where: Weld County Health Department How Often: Annually How Many: 1 report What: Data will be collected regarding meetings held, policies implemented, people reached, QuitLine calls, and media messages produced. Where: Weld County Health Department How Often: Monthly How Many: 12 a 2 N co W 2 N co f.. 5 Attachment B- I v Reach: N/A Reach: N/A V c IL. 0 L U � 3 V e Q1, Q2, Q3, Q4 Ql,Q2,Q3,Q4 L O O - Ea. c 3 v En CA CA ats�:= o O.c 0 30 V �a >, O N 031 vs 0g o o v OA 2 49 3 V 1.0c.) 0§- v) p. 0 °ogao 3 - ' 0 oo N og � x Infrastructure Infrastructure Attachment B-1 Year One Work Plan Preventing initiation among youth and young adults Promote quitting among adults and youth Eliminating exposure to secondhand smoke Identifying and eliminating tobacco -related disparities among population groups Strategy 1Vb — Infrastructure (Capacity Building Activities) aa) cas ti b h a E. .5o E 4) w by y a"b a � 0 uc � U b a) W a O v z o o� r o o M 5 a) 4 .) al 3 e 9 a) x g Q z 0 O O 0.C U ae II Activity Details Where: Denver Cl (71 vS a, v Objective #1: Infrastructure Attachment B -1 a O a.) ta x� «; a CS 8 xV, a es xy Reach: N/A Implementation: Completing the online module and gaining new knowledge on tobacco control Reach: N/A Implementation: Staff will attend the professional development training Reach: N/A Implementation: Staff will attend the Tobacco Control Institute i . -o to U O bin � � o Vi r-•1' 'p a a� a N a N a z x z What: New staff member will complete the Online Training modules Where: Denver Metro area How Often: Two per year How Many: Two What: Staff will attend required STEPP trainings and meetings Where: Denver Metro area Mow Often: 1 How Many: 1 What: Staff will attend the Tobacco Control Institute training Where: Denver Metro area How Often: 1 How Many: 1 2 Bo 2 U y L Attachment B -1 a a. Reach: N/A Implementation: Participation on conference calls and gaining of new knowledge Reach: N/A Implementation: Participation on conference calls 1 ..5 112, QyQ o o:�'�g 3 ,... 0 • a °� E Q 1, Q2, Q3, Q4 Staff will participate on relevant weekly conference calls (i.e. guest speakers, case study discussion, hot topic issue, updates on new campaigns or media) 6, M a N a a z z What: Staff will participate in the smoke -free housing conference call Where: Phone conference call How Often: Monthly How Many: 12 What: Participate on weekly conference calls on relevant topics or for guest speakers Where: Phone conference call How Often: Weekly How Many: approx. 20 calls Q L U cd L C v � U 2 ct W Attachment B-1 Evaluation Summary Through a systems approach, the Tobacco Education Program staff will reach our target populations through media, policy implementation, and education on tobacco cessation, prevention and harms of exposure to secondhand smoke. Information will be shared with employees through worksite wellness programs, to parents at childcare centers, to citizens receiving services through Weld County departments, and through numerous collaborations with community agencies and organizations. Utilizing media and strategies developed by STEPP, we will reach out to four disparately impacted populations: Latinos, rural spit tobacco users, people who abuse substances, and people with mental illness. We will place advertisements in rural newspapers and utilize Latino media outlets. We will distribute materials, and instruct them on how order these materials from STEPPitems.com, to agencies serving these groups. We will also utilize data provided by STEPP to determine reach. We will monitor the monthly calls to the QuitLine, analyze the quarterly QuitLine report showing who (age, ethnicity, SES, etc.) is calling, and how they heard about the Quitline. Successful implementation will be demonstrated through quarterly reports showing the completion of each activity for that quarter. Each staff member is assigned a specific area to complete and each staff member is expected to complete their required tasks for the quarter. The tobacco coordinator will supervise and oversee the work of 1.5 FTE health educators and will complete each quarterly report. Reporting and tracking for quarterly reports will include: • Progress to recruit and establish a youth coalition, attendance at meetings, number of meetings and progress toward activities by youth coalition. • Progress to recruit members for adult coalition, attendance at meetings, number of meetings and progress toward activities. Record technical assistance and training provided to coalition. • Number of presentations and distribution of CCIAA materials to law enforcement, Environmental Health, fire departments, and municipal recreation staff. Included will be number of implemented activities to educate businesses, patrons, and general public on the CCIAA. • Number of meetings with municipal recreation center about increasing signage and number of implemented activities to educate general public of smoke -free facilities • Number of meetings and conference calls with LSTPEN and contact with organization to apply for small grants. • Number of LRCC and attendance at each meeting. Number of times Technical assistance is provided to organizations serving disparate populations. • Number of meetings and conference calls with PACT. • Number of ads placed in rodeo programs and other media reaching disparate populations. • Number if internal agencies we collaborated with and activities that resulted from collaborations. • Number of external agencies we collaborated with and activities implemented from collaborations. • Number of meetings attended with external partners. • Number of contacts with multi -unit owners/managers and number of smoke -free rules adopted. • Number of media placed with external agencies • When possible or applicable, the number of people impacted or reached by each service Progress toward and completion of activities will be reported in the quarterly reports and highlighted in the annual report to STEPP. These reports will be completed by the tobacco coordinator. It is expected that throughout the 2009-2010 that various activities will take place sooner than anticipated and others may be delayed due to unexpected or unseen factors. These changes will be communicated to STEPP staff and documented in the appropriate reports. Page 40 of 40 EXHIBIT C DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ADD DIVISION -PROGRAM ACRONYMS DEPARTMENT OR AGENCY NUMBER *** CONTRACT ROUTING NUMBER ELIMINATE :Al.1. INFORMATION APPEARING IN RFD LIMITED AMENDMENT FOR TASK ORDERS #* This Limited Amendment is made this **** day of *********, 200*, by and between the State of Colorado, acting by and through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or principal place of business is 4300 Cherry Creek Drive South, Denver, Colorado 80246, hereinafter referred to as the "State"; and, LEGAL NAME OF ENTITY, (legal tune of entity), whose address or principal place of business is Street Address, City, State & Zip Code, hereinafter referred to as the "Contractor". FACTUAL RECITALS The parties entered into a Master Contract, dated ******** **, ****, with contract routing number ** *** *****. Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order Contract, dated ******** **, ****, with contract encumbrance number PO *** , and contract routing number ** *** *****, Iinsert the following if previous amendment(s), change order(s), renewal(s) hale been processed: as amended by] 'include all pros ions amendment(s), change order(s), renewal(s) and their routing numbers[, 'insert the following if prey ions amendment(s), change order(s), renewals) have been processed: collectively' referred to herein as the "Original Task Order Contract, whereby the Contractor was to provide to the State the following: 'Briefly describe whin the Contractor was to do under the Original Task Order Contract — indent this paragraph] !Please choose one of the following four options and delete the other three options not selected' The State promises to 'choose one and delete the other' increase/decrease the amount of funds to be paid to the Contractor by ********** Dollars. (S*.**) during the current term of the Original Task Order Contract in exchange for the promise of the Contractor to perform the [choose one and delete the other I increased/decreased work under the Original Task Order Contract. The State promises to pay the Contractor the sum of ********** Dollars, ($*.**) in exchange for the promise of the Contractor to continue to perform the work identified in the Original Task Order Contract for the renewal term of **** years/months, ending on ******** ** ****. The State promises to 'choose one and delete the otherl increase/decrease the amount of funds to be paid to the Contractor by ********** Dollars, ($***) for the renewal term of ****'choose one and delete the other] years/months, ending on ******** **, ****, in exchange for the promise of the Contractor to perform the [choose one and delete the other' increased/decreased work described herein. The State hereby exercises a "no cost" change to the 'choose those that apply and delete those that don't apply] budget, specifications within the Statement of Work, project management/manager identification, notice address or notification personnel , or performance period within the Ichoose one and delete the other] current term of the Original Task Order Contract or renewal term of the Original Task Order Contract. Page 1 of 4 Rev 4/3/09 EXHIBIT C NOW THEREFORE, in consideration of their mutual promises to each other, stated below, the parties hereto agree as follows: 1. Consideration for this Limited Amendment to the Original Task Order Contract consists of the payments and services that shall be made pursuant to this Limited Amendment, and promises and agreements herein set forth. 2. It is expressly agreed to by the parties that this Limited Amendment is supplemental to the Original Task Order Contract, contract routing number ** *** *****, ]insert the following language here if previous ameadruent(s), change order(s), renewalts) have been processed] as amended by ]include all precious amendrnent(s), change order(s), renewals) and their routing numbers', ]insert the following word if previous amenrinteut(s). change order(s), renewal(s) have been processed, otherwise delete "cullectivel"'collectively referred to herein as the Original Contract, which is by this reference incorporated herein. All terms, conditions, and provisions thereof, unless specifically modified herein, are to apply to this Limited Amendment as though they were expressly rewritten, incorporated, and included herein. 3. It is expressly agreed to by the parties that the Original Task Order Contract is and shall be modified, altered, and changed in the following respects only: ]Please choose one of the following three options and delete the two options not selected] A. ]l se this paragraph when changes to the tirrtding level of the Original Task Order Contract occur during the current term of the Original Task Order Contract] This Limited Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract identified by contract routing number ** *** *****. This Limited Amendment is for the current term of ********* ** ****, through and including ********* **, ****. The maximum amount payable by the State for the work to be performed by the Contractor during this current term is ]choose one and delete the otherl increased/decreased by ********** Dollars, ($* **) for an amended total financial obligation of the State of ********** DOLLARS, ($*.**). ]Delete the following sentence if not applicable in our situation] The revised Statement of Work is incorporated herein by this reference and identified as "Attachment a". 'Delete the following sentence if not applicahle in your sit ultra kill' The revised Budget is incorporated herein by this reference and identified as "Attachment *". The Original Task Order Contract is modified accordingly. All other terms and conditions of the Original Task Order Contract are reaffirmed. A. 'Use this paragraph when the Original "Task Order Contract will he renewed fin- another term' This Limited Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract identified by contract routing number ** *** *****. This Limited Amendment is for the renewal term of ********* **, ****, through and including ********* **, ****. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is ********** Dollars, ($* **Z for an amended total financial obligation of the State of ********** DOLLARS, ($***). 'Delete the following sentence if not applicable in your situation] The revised Statement of Work is incorporated herein by this reference and identified as "Attachment *". (Delete the following sentence if not applicable in your situation] The revised Budget is incorporated herein by this reference and identified as "Attachment *". The Original Task Order Contract is modified accordingly. All other terms and conditions of the Original Task Order Contract are reaffirmed. A. It :se this paragraph when there are "no cost changes" to the Budget. the specifications within the original Statement of Work, allowable contract provisions as noted, or performance period.' This Limited Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract identified by contract routing number ** *** *****. This Limited Amendment 'choose those that apply and delete those that don't' modifies the Budget in 'identify location in contract', modifies the Statement of Work in Iidentil ' location in Page 2 of 4 Rev 4/3/09 EXHIBIT C contract], modifies the project management/manager identification in ]identify location in contract!, modifies the notice address or notification personnel in 'identify location in contract], modifies the period of performance in 'identify location in contract) of the Original Task Order Contract. The revised Ichoose those that apply and delete those that don't] Budget, Statement of Work, project management/manager identification, notice address or notification personnel is incorporated by this reference and identified as Exhibit * or Attachment *-*. If you are changing, the performance period, choose the following two sentences or delete both sentencesI The period of performance of the choose one and delete the other} current/renewal term is hereby I choose one and delete the other] extended/reduced by ***** (*) months, changing the current ending date from ********* ** **** to ********* ** ****. The revised period of performance is ********* ** **** through and including ********* **, ****. The Original Task Order Contract is modified accordingly. All other terms and conditions of the Original Task Order Contract are reaffirmed. 4. The effective date of this Limited Amendment is ******** **, ****, or upon approval of the State Controller, or an authorized delegate thereof, whichever is later. 5. Except for the Special Provisions and other terms and conditions of the Master Contract and the General Provisions of the Original Task Order Contract, in the event of any conflict, inconsistency, variance, or contradiction between the terms and provisions of this Limited Amendment and any of the terms and provisions of the Original Task Order Contract, the terms and provisions of this Limited Amendment shall in all respects supersede, govern, and control. The Special Provisions and other terms and conditions of the Master Contract shall always control over other provisions of the Original Task Order Contractor any subsequent amendments thereto. The representations in the Special Provisions to the Master Contract concerning the absence of personal interest of state of Colorado employees and the certifications in the Special Provisions relating to illegal aliens are presently reaffirmed. 6. 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. Page 3 of 4 Rev 4/3/09 EXHIBIT C IN WITNESS WHEREOF, the parties hereto have executed this Limited Amendment on the day first above written. * Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf and acknowledge that the State is relying on their representations to that effect. CONTRACTOR: STATE: [LEGAL NAME OF CONTRACTOR] STATE OF COLORADO (Legal type of entity) Bill Ritter, Jr. Governor By: Signature of Authorized Officer Print Name of Authorized Officer Print Title of Authorized Officer For the Executive Director DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Signatory avers to the State Controller or that Contractor has not begun performance or that a Statutory Violation waiver has been requested under Fiscal Rules PROGRAM APPROVAL: By: ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. By: Date: STATE CONTROLLER David 3. McDermott, CPA Page 4 of 4 Rev 4/3/09 APPLICATION BUDGET FORM State Tobacco Education & Prevention Grants Program 2009-2010 APPLICANT: PROJECT TITLE: Check only one: 0 Year 1 (July 1, 2009 - June 30. 2010) 2010 - June 30. 2011) 2011 - June 30. 2012) Weld County Department of Public Health and Environment ■ Year 2 (July 1, ❑ Year 3 (July 1, Weld County Tobacco Education Program SOURCE OF FUNDS Requested Other Source' Other Source* CDPHE Source 1 Source 2 PERSONAL SERVICES FTE %Effort Monthly Salary Monthly Benefits # of Months If applicable, funding source name If applicable, funding source name Name Position Bryce Kyburz 1.00 $4,654.24 $1,654.12 5.5 $34,695.98 $0.00 $0.00 Bryce Kyburz 1.00 $4,817.14 $1,712.01 6.5 $42,439.48 $0.00 $0.00 Cassie Kauffman 1.00 $4,322.21 $1,536.11 5.5 $32,220.76 $0.00 $0.00 Cassie Kauffman 1.00 $4,473.49 $1,589.88 6.5 $39,411.91 $0.00 $0.00 Kathy Schlepp 0.50 $4,073.78 $1,447.82 5.5 $15,184.40 $0.00 $0.00 Kathy Schlepp 0.50 $4,343.73 $1,543.76 6.5 $19,134.34 $0.00 $0.00 Subtotal Personal Services 2.50 $183,086.86 $0.00 $0.00 DIRECT OPERATING COSTS Unit Quantity Rate Printing/Copying Month 1000.00 $ 0.10 $100.00 $0.00 $0.00 Postage/Shipping per 400.00 $ 0.43 $172.00 $0.00 $0.00 Telephone, Fax, Internet Access $0.00 $0.00 $0.00 Supplies 10.00 $ 50.00 $500.00 $0.00 $0.00 Computer Equipment $0.00 $0.00 $0.00 Staff Development 2.00 $ 250.00 $500.00 $0.00 $0.00 Meeting Expenses Month 12.00 $ 375.00 $4,500.00 $0.00 $0.00 Other Program Cost 1.00 $ 10,658.00 $10,658.00 $0.00 $0.00 Subtotal Operating Costs $16,430.00 $0.00 $0.00 TRAVEL Unit Quantity Rate Mileage Mile 10440.00 $ 0.53 $ 5,533.20 $0.00 $0.00 Lodging day 3.00 $ 200.00 $ 600.00 $0.00 $0.00 Meals day 1.00 $ 300.00 $ 300.00 $0.00 $0.00 Other Travel airline 1.00 $ 400.00 $ 400,00 $0.00 $0.00 Subtotal Travel Costs $6,833.20 $0.00 $0.00 CONTRACTUAL Unit Quantity Rate Consultant Hour $ - $ - $0.00 $0.00 Contract Trainer/Speaker/Honorarium Day $ - $0.00 $0.00 Subcontract Hour $ - $0.00 $0.00 Subtotal Contractual Costs $0.00 $0.00 $0.00 OTHER COSTS Unit Quantity Rate Outreach/Educational Materials $ - $ - $0.00 $0.00 Screening $ - $0.00 $0.00 Treatment $ - $0.00 $0.00 Subtotal Other Costs $0.00 $0.00 $0.00 CDPHE 1 ,.-Source 1 Source 2 . TOTAL DIRECT COST: $206,350.06 $0.00 $0.00 INDIRECT COSTS: 2% Of Contractual $0.00 $0.00 INDIRECT COSTS: 10% Of All Other $206,350.06 $20,635.01 INDIRECT COSTS: 0% Other $0.00 Total Indirect Cost (Calculated on Amount Requested from CDPHE Only) $20,635.01 TOTAL AMOUNT REQUESTED FROM CDPHE $ 226,985 *Other: Please indicate additional funding sources if applicable. Exhibit D Page 1 of 3 Exhibit D State Tobacco Education and Prevention Partnership Grants Program Weld County Tobacco Program Grant Period: July 1, 2009 through June 30, 2010 Budget Narrative PERSONAL SERVICES: Program Coordinator Health Educator Health Educator Bryce Kyburz will provide overall program administration, budget management, completion of reports and oversight of work plan activities. Supervise 1.5 FTE staff 5% of time will be dedicated toward program evaluation Resource contact for university and community college. Smoke -free housing and worksite wellness liaison. 1 FTE salary: $56,909.73 Benefits: $20,225.72 Cassie Kauffman is responsible for program activities related to working with schools, coalition recruitment, community based organizations, law enforcement and linking disparate populations to services. Coordination of special events. Resource contact for Latino community. 1 FTE salary: $52,849.85 Benefits: $18,782.82 Kathy Schlepp is responsible for program activities and outcomes within community systems including work with schools, youth organizations, daycares, healthcare providers, overall health care system, and community based organizations. Coordination of community smoking cessation classes and support group. Coalition recruitment. .5 FTE: $25,320.02 Benefits: $8,998.72 Total Salary: $135,079.60 Total Benefits: $48,007.26 (Benefits are calculated at 35.54%) Total Salary and Benefits $183,086.86 OPERATING COSTS: Printing/copying — letters, notifications, announcements Postage/Shipping - letters, compliance check notification Office Supplies - folders, awards, gift cards, display materials Staff Development - national and regional conference registrations Meeting Expenses 1000 copies @$.10 ea $100 400 mailings @ $.43 ea $172 $500 (2 @ $250) $500 $4,500 Page 2 of 3 Exhibit D - meeting expenses for youth, adult, LRCC coalitions & annual forum Other Program Costs (local media buys including radio, newspaper, internet) • Next Media (2 months @ $1500) - billboards $3,000 • See Hear Media (12 months @ $104 month) $1,250 • Greeley Tribune (Stampede ads, various ads) $2,025 • Rocky Mountain Parent Magazine (web ads) $1,200 • Leisure Connection (4 issues — secondhand smoke) $ 680 • Rural Ad Network (Through with Chew campaign) $2,503 $10,658.00 Total Operating Costs $16,430.00 TRAVEL: In -state Mileage for staff contacting and meeting with community members and system partners to effect tobacco control initiatives. Covering 4,000 square mile county and periodic trips to Denver for meetings and training 3 staff x 290 miles/month x $0.53 (Standard Weld County rate) $5,533.20 Out-of-state Travel for up to two staff at national conference • Lodging (1 person @ $200 @ 3 nights) $600 • Meals (1 person @ $100/day @ 3 days $300 • Airfare (1 person a. $400) $400 $1,300.00 Total Travel INDIRECT COSTS: 10.00% of the total direct costs Total Budget Request $6,833.20 $20,635_01 S226,985 Page 3 of 3 STATE OF COLORADO Bill Ritter, Jr., Governor James B. Martin, Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado 4300 Cherry Creek Dr. S. Denver, Colorado 80246-1530 Phone (303) 692-2000 TDD Line (303) 691-7700 Located in Glendale, Colorado http://www.cdphe.state.co.us July 1, 2009 Judy Nero 1555 North 17th Ave. Greely, CO 80631 Dear Ms. Nero: Laboratory Services Division 8100 Lowry Blvd. Denver, Colorado 80230-6928 (303) 692-3090 Colorado Department of Public Health and Environment Enclosed is a fully executed contract, Routing No. 10 FLA 00164, for the State Tobacco Education and Prevention Partnership (STEPP) Program. Work can begin under this contract. The contract was compiled using the following method: 1) The Work Plan and Evaluation, if available, were included as the Scope of Work in the contract and labeled with corresponding headers to match the references in the contract; 2) Any work objective past June 30, 2010 was removed to coincide with the time frame of the contract which is one year; 3) Acronyms from the work plan were defined and included as part of the contract; 4) The funded dollar amount on the first page of the contract or the total on the budget page may have been modified so that both dollar figures are identical. These non -substantial corrections were made as "running changes." Pages of the original contract highlighting the corrected language may be included for your reference. Please contact me at (303) 692-2505 or chandra.hardwick(alstate.co.us with any questions. Respectfully, Chandra Hardwick Colorado Department of Public Health and Environment PSD Contracts & Purchasing Fiscal Officer Enc. Hello