Loading...
HomeMy WebLinkAbout20083346.tiff RESOLUTION RE: APPROVE COLORADO PREVENTION PARTNERS PURCHASE OF SERVICES AGREEMENT AND AUTHORIZE CHAIR TO SIGN - NORTH RANGE BEHAVIORAL HEALTH 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 Colorado Prevention Partners Purchase of Services Agreement between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and North Range Behavioral Health, commencing September 30, 2008, and ending September 29, 2009, with further terms and conditions being as stated in said agreement, and WHEREAS,after review, the Board deems it advisable to approve said agreement, 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 Colorado Prevention Partners Purchase of Services Agreement between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,on behalf of the Department of Human Services,and North Range Behavioral Health, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded,adopted by the following vote on the 22nd day of December, A.D., 2008, nunc pro tunc September 30, 2008. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO 41 ATTEST: tf p %� 'p`' �` 't- 1861 • '_ illiam H. Jerke, Chair Weld County Clerk to the oa . ►�` • 4, 'EXCUSED , � '` '1 ,a Robed D. Masden, Pro-Tem BY: Dep Clerkte the Board EXCUSED Will' F. Garcia �. APPR* AS T • David E. Long Count Attorney Dougl Rademac r Date of signature: /a/ ,/es 2008-3346 SIC HS ( i Gt c HR0079 MEMORANDUM I&t DATE: December 18, 2008 TO: William H. Jerke, Chair, Board of County Commissioneisj 119Cin.C`artte1 (��.J�;l,h"WFROM: Judy A. Griego, Director, Human Servicesepaztent COLORADO RE: Colorado Prevention Partners Purchase of Services Agreement between the Weld County Department of Human Services and North Range Behavioral Health Enclosed for Board approval is a Colorado Prevention Partners Purchase of Services Agreement between the Weld County Department of Human Services and North Range Behavioral Health. This Agreement was reviewed at the Board's November 5, 2008, Work Session. Previously,the Board entered into a FY 2007 Colorado Prevention Partners Contract with the Colorado Department of Human Services. Funding was awarded under a non-competitive "Colorado Prevention Partners"application,which was submitted on behalf of Weld County's Interagency Oversight Group (HB04-1451, "Collaborative Management of Multi-agency Services Provided to Children and Families),and at the request of the Governor's Office. The Department will act as the Fiscal Agent,North Range will act as the Program Administrator. The IOG provides oversight for the Project. 1. The purpose of the project is to reduce substance abuse in Weld County following evidence-based strategies using a multi-tiered approach. 2. The Contract provides for continued funding at an amount not to exceed $183,877.00 as outlined in a budget incorporated as part of the Agreement. Funding will pay for a Project Coordinator employed by North Range Behavioral Health, survey expenses, and related operating expenses. 3. The source of funding is through the Colorado Department of Human Services' Alcohol and Drug Abuse Division. 4. The period of the Agreement is September 30, 2008 through September 29, 2009. If you have questions, please give me a call at extension 6510. 2008-3346 Contract No: SFY08-09-CPP COLORADO PREVENTION PARTNERS PURCHASE OF SERVICES AGREEMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND NORTH RANGE BEHAVIORAL HEALTH This Agreement, made and entered into the i day of September 2008, by and between the Board of Weld County Commissioners, sitting as the Board of Human Services, on behalf of the Weld County Department of Human Services,hereinafter referred to as"Human Services,"and North Range Behavioral Health, hereinafter referred to as"North Range Behavioral Health." WITNESSETH WHEREAS, required approval, clearance,and coordination have been accomplished from and with appropriate agencies; and WHEREAS,by and through Resolution#2008-1533, dated May 28, 2008, effective June I, 2008, the Board of County Commissioners of Weld County combined into one department the functions of the Weld County Department of Social Services and the Weld County Department of Human Services, thereby authorizing the Weld County Department of Human Services as the department of Weld County government to receive funding for and to perform the duties of a county department of social services according to Colorado statutes and administrative regulations; and WHEREAS, the Weld County LOG, formed under HB04-145 I, provides a focus for a collaborative planning approach to the delivery of services to children and families that may lead to the provision of more appropriate and effective delivery of services in Weld County; and WHEREAS, Human Services, on behalf of the Weld County lOG and at the request of the State of Colorado Governor's Office, submitted in July 2006 a non-completive application under"Colorado Prevention Partners"grant, which had as its goal to increase community capacity to initiate implementation of a Strategic Prevention Framework project; and WHEREAS, the Colorado Department of Human Services, Alcohol and Drug Abuse Division has contracted with and provided funding to Human Services in September 2006 to develop a community planning project entitled the"Colorado Prevention Program", designed to reduce substance abuse related problems; prevent onset and reduce progression of substance abuse, including childhood and underage drinking of alcohol; build prevention capacity and infrastructure at state and community levels; and develop a Strategic Prevention Framework model; and WHEREAS, the Weld County IOG has accepted the planning and guidance of the Colorado Prevention Program and has agreed to meet the guidelines and requirements set forth for the project by the Colorado Department of Human Services; and WHEREAS, Human Services, as the fiscal agent of the project, seeks services to develop the Colorado Prevention Program; and WHEREAS, the Weld County IOG, with the concurrence of Human Services, has selected North Range Behavioral Health to provide services to develop the Colorado Prevention Program; and WHEREAS, North Range Behavioral Health, a Colorado non-profit corporation organized for the purpose of managing and coordinating high quality, cost efficient, integrated chemical dependency and related behavioral health care services, is willing to provide services to develop the Colorado Prevention Program and wishes to enter into an Agreement with Services to receive financial support for the project. Page 1 of 3 Contract No: SFY08-09-CPP NOW THEREFORE, in consideration of the premises,the parties hereto covenant and agree as follows: L TERM: The term of the MOU and Agreement is September 30,2008,and shall expire September 29, 2009, unless sooner terminated as provided herein. 2. SERVICES PROVIDED BY NORTH RANGE BEHAVIORAL HEALTH: North Range Behavioral Health shall be in compliance with Exhibit B,"Contract Between Colorado Department of Human Services and Weld County Department of Human Services, Routing No. 08-IHM-00161",which outlines the direct services to be provided by North Range Behavioral Health and the planning oversight requirements of the Weld County 1OG, and which is attached hereto and incorporated herein by reference. 3. COMPENSATION TO NORTH RANGE BEHAVIORAL HEALTH: Human Services agrees to pay North Range Behavioral Health for services pursuant to this Agreement a sum of$183,877, according to the budget as follows: Personnel Project Director $43,677 Fringe Benefits(28%) $ 12,230 Eval Coordinator $ 12,000 Total Personnel $67,907 Travel Local $ 1,908 Out of Area $ 2,225 Total Travel $ 4,133 Operating PPB Stipends/Incentives $ 1,944 CPP Office/Phone $ 7,800 Copying/Printing $ 600 Office Supplies $ 300 Meeting Room Rental $ 300 Food/Meetings $ 2,400 Implementation $72,903 Indirect(20%) $ 12,000 Data Collection/HKCS $ 13,590 Total Operating $111,837 Grand Total $183,877 A. North Range Behavioral Health shall submit an itemized monthly bill according to proper invoices to Human Services for all costs incurred and services provided pursuant to Exhibit B of this Agreement in accordance with criteria established by Human Services. North Range Behavioral Health shall submit all itemized monthly billings to Human Services no later than the twenty-fifth (25)day of the month following the month the cost was incurred. B. Payments of costs incurred pursuant to this Agreement are expressly contingent upon the availability of the Alcohol and Drug Abuse Division -Colorado Prevention Partners Grant to Human Services. C. Human Services shall not be billed for, and reimbursement shall not be made for time involved in activities outside of those defined in Exhibit B. Work performed prior to the execution of this Contract shall not be reimbursed or considered part of this Agreement. Page 2 of 3 Contract No: SFY08-09-CPP D. Human Services may withhold any payment if North Range Behavioral Health has failed to comply with the Financial Management Requirements,program objectives, contractual terms,or reporting requirements. In the event of a forfeiture of reimbursements,North Range Behavioral Health may appeal such circumstance to the Director of Human Services. The decision of the Director of Human Services shall be final. 4. ASSURANCES: North Range Behavioral Health shall abide by all assurances as set forth in the Exhibit A,"Assurances,"which is attached hereto and incorporated herein by reference. 5. CERTIFICATION: North Range Behavioral Health certifies that, at the time of entering into this Contract, it has currently in effect all necessary licenses,approvals, insurance,etc. required to properly provide the services and/or supplies covered by this contract. 6 TERMINATION: Either party may terminate this MOU or Agreement at any time by providing the other party with a 30-day written notice thereof. Furthermore,this MOU or Agreement may be terminated at any time without notice upon a material breach of the terms of the MOU or Agreement. 7. TIME OF THE ESSENCE: Time is the essence in each and all of the provisions of this MOU and Agreement. 8. ENTIRE MOU AND AGREEMENT/MODIFICATIONS: This MOU including Exhibit B and this Agreement including Exhibit A and B constitutes the entire understanding between the parties with the respect to the promises and covenants made therein. No modification of the terms of this MOU or Agreement shall be valid unless made in writing and agreed to by all parties of the MOU and both parties of the Agreement. 9. NON-APPROPRIATION: No portion of this Agreement shall be deemed to create an obligation on the part of Human Services to expend funds not otherwise appropriated in each succeeding year. 10. WAIVER OF IMMUNITIES/THIRD PARTY LIABILITY: No portion of this Agreement shall be deemed to constitute a waiver of any immunities of Human Services or its officers or employees may possess, nor shall any portion of this Agreement be deemed to have created a duty of care with respect to any persons other than Human Services and not a party of this Agreement. IN WITNESS WHEREOF,the partieess,� to have duly executed the Agreement as of the day,month,and year first above written. ATTEST: WELD COUNTY Y OARD OF COUNTY COMMISSIONERS CLERK TO THE BOARD " J ELD COUNTY,COLORADO By: By: '11 Deputy Clerk ! William H.Jerke,Chair DEC 2 2 2008 ST ORM: NORTH RANGE BEHAVIORAL HEALTH BY County Attorney Wayne Maxwell,Executive Director WELD COUNTY DEPARTMENT OF HUMAN SER ICES By: Judy A. iego, Di ctor Page 3 of 3 09 HIM 00171 OPTION LETTER Exhibit_F_ Date: August 22, 2008 State Fiscal Year: 2009 Option Letter No. _2_ SUBJECT: (Please indicate purpose by choosing one of the following) 5- Level of service change in conjunction with renewal for additional term In accordance with Paragraph(s) _1_ of contract routing number 07 IHM 00161, between the State of Colorado, Department of Human Services, Alcohol and Drug Abuse Division, and Weld County Department of Social Services, the state hereby exercises the option for an additional term of (September 30, 2008 through September 29, 2009) at an increase in the amount of services that are specified in Paragraph 13 of Exhibit A. The amount of the current Fiscal Year contract value Is increased/decreased by $183,877.00 to a new contract value of $625,999.00 ($193,695.00 for FY 07, $248,427.00 for FY 08, and 183,877.00) to satisfy services/goods ordered under the contract for the current fiscal year 2008. The first sentence in Paragraph 13 of Exhibit A is hereby modified accordingly. The total contract value to include all previous amendments, option letters, etc. is $625,999.00. APPROVALS: State of Colorado: Bill Ritter Jr r By: Date: For the Executiv Dir tor Colorado Department of Human Services ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State Controller, or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance until the contract is signed and dated below. If performance begins prior to the date below, the State of Colorado may not be obligated to pay for goods and/or services provided. tate Controller D i J. mott, CPA By: Dat : Date Issued: February 10, 2003 Colorado Alcohol&Drug Abuse Division(ADAD) CPP BUDGET PAGE CONTRACTOR: Weld County Department of Human Services PROJECT TITLE: Weld County CPP Project Time Period: 09/30/2008-9/29/2009 Other Other Source il Annual Full # Hrs/ Total CPP Source Non-Cash/ Category&Line Item Time Salary Mos Wk Budget Funds Cash In-Kind A.Personnel % I.CPP Coordinator 1 43,677,00 12 40 43677.00 43677.00 0.00 0.00 Fringe Benefits 28% 12230.00 12230.00 2.Eval Liaison 12,000.00 12 10 12000.00 12000.00 0.00 0.00 Fringe Benefits 0% 0.00 0,00 3.Administrative Assistant 0.00 0.00 0.00 0.00 0.00 Fringe Benefits 0% 0.00 0.00 Total Personnel I 67907.00 67907.001 0.001 0.00 Consultants I,Youth Coordinator 0.00 0,00 0.00 0.00 2.Subcontractor 0.00 0.00 0.00 0.00 3.OMNI RPC 720.00 0.00 0.00 720.00 Total Consultants 720.00 0.00 0,00 720.00 C.Travel I.Local 1908.00 1908.00 0.00 0.00 2.Out of Area 2225.00 2225.00 0.00 0.00 Total Travel 4133.00 4133.00 0.00 0.00 D.Operating I.Training/Conference 0.00 0.00 0.00 0.00 2.Copying/Printing 600.00 600.00 0.00 0.00 3.Meeting Room Rental 300.00 300.00 0.00 0.00 4.Food/Meetings 2,400.00 2,400.00 0.00 0.00 5.Indirect 12,000.00 12,000.00 0.00 0.00 6.Data Collection/HKCS 13,590.00 13,590.00 0.00 0.00 7.Incentives/stipends 1,944.00 1,944.00 0.00 0.00 8.Rent/phone 7,800.00 7,800.00 0.00 0.00 9.Office supplies 300.00 300.00 0.00 0.00 Total Operating 38,934.00 38,934.00 0.00 0.00 E.Implementation 1.Goal I 68,243.00 68,243.00 0.00 0.00 2.Goal 2 4,700.00 3,700.00 0.00 1,000.00 3.Goal 3 960.00 960.00 0.00 0.00 Total Implementation 73,903.00 72,903.00 0.00 1,000.00 Grand Total I $185,597.001 $183,877.001 $0.001 $1,720.00 Contract No: SFY08-09-CPP EXHIBIT A ASSURANCES 1. North Range Behavioral Health agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees, as the result of the execution of this Agreement. 2. Weld County,the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of North Range Behavioral Health-contracted providers or its employees, volunteers, or agents while performing duties as described in this Agreement. North Range Behavioral Health shall indemnify, defend, and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers, and agents. North Range Behavioral Health shall provide adequate liability and worker's compensation insurance for all its employees, volunteers, and agents engaged in the performance of the Agreement upon request, North Range Behavioral Health shall provide Human Services with the acceptable evidence that such coverage is in effect. 3. No portion of this Contract shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, nor shall any portion of this Agreement be deemed to have treated a duty of care with respect to any persons not a party of this Agreement. 4. No portion of this Contract shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year. 5. If any section, subsections, paragraph, sentence, clause, or phrase of this Contract is for any reason held or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Contract and each and every section, subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional or invalid. 6. No officer, member or employee of Weld County and no member of their governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. 7. North Range Behavioral Health assures that they will comply with the Title VI of the Civil Rights Act of 1986 and that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under this approved Contract. 8. North Range Behavioral Health assures that sufficient, auditable, and otherwise adequate records that will provide accurate, current, separate, and complete disclosure of the status of the funds received under the Contract are maintained for three(3)years or the completion and resolution of an audit. Such records shall be sufficient to allow authorized local, Federal, and State auditors, and representatives to audit and monitor North Range Behavioral Health. Page 1 of 4 Contract No: SFY08-09-CPP 9. All such records,documents, communications, and other materials shall be the property of Human Services and shall be maintained by North Range Behavioral Health, in a central location and custodian, in behalf of Human Services, for a period of four(4)years from the date of final payment under this Contract, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the four(4)year period, or if audit findings have not been resolved after a four(4)year period,the materials shall be retained until the resolution of the audit finding. 10. North Range Behavioral Health assures that authorized local, federal, and state auditors and representatives shall, during business hours, have access to inspect any copy records, and shall be allowed to monitor and review through on-site visits, all contract activities, supported with funds under this Contract to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. 11. This Contract shall be binding upon the parties hereto, their successors, heirs, legal representatives, and assigns. North Range Behavioral Health or Human Services may not assign any of its rights or obligations hereunder without the prior written consent of both parties. 12. North Range Behavioral Health certifies that federal appropriated funds have not been paid or will be paid, by or on behalf of North Range Behavioral Health,to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, loan, grant, or cooperative agreement. 13. North Range Behavioral Health assures that it will fully comply with all other applicable federal and state laws. North Range Behavioral Health understands that the source of funds to be used under this Contract is Colorado Works or Temporary Assistance for Needy Families funds. 14. North Range Behavioral Health assures and certifies that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by a federal department of agency. b. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public Page 2 of 4 Contract No: SFY08-09-CPP transaction; violation of federal or state antitrust statutes or commission of embezzlement,theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state, or local) with commission of any of the offenses enumerated in paragraph 11(b) of this certification; and d. Have not within a three-year period preceding this Contract, had one or more public transactions(federal, state, and local)terminated for cause or default. 15. The Appearance of Conflict of Interest applies to the relationship of a contractor with Human Services when the contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the contractor to gain from knowledge of these opposing interests. It is only necessary that the contractor know that the two relationships are in opposition. During the term of the Contract, North Range Behavioral Health shall not enter any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,North Range Behavioral Health shall submit to Human Services, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for Human Services' termination, for cause, of its contract with North Range Behavioral Health. 16. North Range Behavioral Health shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of Child Protection, no information about or obtained from any applicant/recipient in possession of North Range Behavioral Health shall be disclosed,in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with North Range Behavioral Health written policies governing access to, duplication and dissemination of, all such information. North Range Behavioral Health shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality requirements. North Range Behavioral Health shall provide its employees, agents, and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. 17. Proprietary information for the purposes of this Contract is information relating to a party's research, development,trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2)that which is in the public domain, or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Contract. Any proprietary information removed from the State's site by North Range Behavioral Health in the course of providing services under this Contract will be accorded at least the same precautions as are employed by North Range Behavioral Health for similar information in the course of its own business. Page 3 of 4 Contract No: SFY08-09-CPP 18. North Range Behavioral Health certifies it will abide by Colorado Revised Statue (C.R.S.)26-6-104, requiring criminal background record checks for all employees, contractors, and sub-contractors. 19. North Range Behavioral Health certifies that it shall comply with the provisions of Colorado Revised Statutes (C.R.S.) 8-17.5-101, et seq. North Range Behavioral Health shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to North Range Behavioral Health that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. North Range Behavioral Health represents, warrants, and agrees that it(a) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and(b) otherwise will comply with the requirements of C.R.S. 8-17.5- 102(2)(b). North Range Behavioral Health shall comply with all reasonable requests made in the course of an investigation under C.R.S. 8-17.5-102 by the Colorado Department of Labor and Employment. If North Range Behavioral Health fails to comply with any requirement of this provision or C.R.S. 8-17.5-101, et seq., Human Services may terminate this Contract for breach and North Range Behavioral Health shall be liable for actual and consequential damages to Human Services. Except where exempted by federal law and except as provided in C.R.S. 24-76.5-103(3), if North Range Behavioral Health receives federal or state funds under this Contract, North Range Behavioral Health must confirm that any individual natural person eighteen (18)years of age or older is lawfully present in the United States pursuant to C.R.S. 24- 76.5-103(4) if such individual applies for public benefits provided under this Contract. If North Range Behavioral Health operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it(a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. 24-76.5-103 prior to the effective date of this Contract. Page 4 of 4 Contract No: SFY08-09-CPP EXHIBIT B CONTRACT BETWEEN COLORADO DEPARTMENT OF HUMAN SERVICES AND WELD COUNTY DEPARTMENT OF HUMAN SERVICES ROUTING NO. 08-IHM-00161 Table of Contents Section Description Page Nos. 1. Contract Page 1 of 11 Pages 2. Exhibit A—Additional Provisions Page 1 of 7 Pages 3. Exhibit B — Phase 2 Strategic Plan and Budget Page i through 41 Pages 4. Exhibit C—Contractor Response Page i through 14 Pages 5. Exhibit D—CPP General Guidelines Page i through 19 Pages 6. Exhibit E—CPP Budget Page Page lof l 7. Exhibit F—Option Letter Page lof 1 8. Exhibit G— Sample Bilateral Change Order Letter Page 1 of 1 9. Exhibit H— Sample Funding Letter Page 1 of 1 Page 1 of 1 Attachments - Colorado Prevention Partners Continuation Application for Funds (AFF) 2008-2009 Attachment Section Colorado Prevention Partners Continuation Application for Funds (AFF) 2008-2009 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment I ASSURANCES (For Reference Only—Do Not Sign) This itemization of Assurances is to be read, each assurance initialed, and the document signed by the autographic signature of the Applicant or an officer of the Applicant legally authorized to execute contractual obligations to indicate that the Applicant agrees to comply with the Assurances through the end of the grant period. An original of these pages must be included with your original hardcopy Response to this Continuation Application for Funding ACCEPTANCE OF CPP APPLICATION TERMS AND CONDITIONS: An application submitted in response to this application is a binding offer. ADAD assumes that by submitting an application the Applicant acknowledges all Terms and Conditions of the Application. APPLICATION CONTENT ACCEPTANCE: The contents of the response (including persons specified to implement the project) of the successful Applicant will become contractual obligations if acquisition action ensues. Failure of the successful Applicant to accept these obligations in a contract, purchase document, delivery order or similar acquisition instrument may result in cancellation of the award and such Applicant may be removed from future solicitations. INCURRING COSTS: The State of Colorado is not liable for any cost incurred by Applicants prior to issuance of a legally executed contract. No property interest of any nature must occur until a contract is awarded and signed by all concerned parties. PRIVACY, CONFIDENTIALITY: The Applicant will comply with all federal and state laws, regulations and rules related to the privacy and confidentiality of client information, records, etc., including compliance with both 42 CFR Part 2 and HIPAA, where applicable, throughout the duration of any resulting contract. (http://www.hiPaa.samhsa.gov/Priyacvmle.htm) CHARITABLE CHOICE: Faith-based recipients have read, understand and will comply with Charitable Choice Provisions and Regulations found in 42 CFR Parts 54 and 54a. (http://www.access.epo.Rov/nara/cfr/waisidx 03/426.54 03.html) Handwritten Signature by Authorized Date Officer of Fiscal Agency or Agent of Applicant 2 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment II TERMS AND CONDITIONS (For Reference Only—Do Not Sign) Colorado Prevention Partners and The Alcohol and Drug Abuse Division, Prevention Services Section, require the following Terms and Conditions for any County or Tribal Community funded by this contract. The applicant's signature at the end of this section, returned with the Continuation Application, signifies that the applicant understands and agrees to the terms and conditions as well as agreements for participation. A. Terms and Conditions • All activities supported by ADAD/CPP funding including printed materials, notice of these materials or trainings on websites, etc., must acknowledge ADAD, COLORADO DEPARTMENT OF HUMAN SERVICES, COLORADO PREVENTION PARTNERS and CSAP/SAMHSA as the funding sources, using the ADAD, CDHS, CPP and SAMHSA logos when appropriate. • All collections—data requirements, training materials, videos, books, files such as evaluation instrument files, and other library collections—purchased under a contract resulting from this application may be requested to be returned or given to another recipient at ADAD's option, when the contract ends. • Any equipment purchase over $1,000 must first be approved by ADAD as part of the ongoing Continuation Application review. All equipment valued at $2,500 or over which is purchased under a contract resulting from this Continuation Application may be requested to be returned or given to another recipient at ADAD's option, when the contract ends. • All computer equipment and software used to implement any contract resulting from this Continuation Application must be compatible with ADAD's requirements and must meet evaluation requirements. Funds can be budgeted for that purpose. (Only one computer purchase is allowed per contract per grant.) • Communities are also strongly encouraged to use CPP dollars to support an upgrade of internet service (e.g. high speed line, DSL etc.). Dial-up internet access will cause increased delays in data entry. Current minimum requirements: IBM PC or compatible, Pentium class (II or III) CPU, VGA 800x600, 16mb Ram, tomb free hard drive space, 56.6k modem, Windows 95 and up or NT 4.0 and up, Internet connection (regular phone line) with Microsoft Internet Explorer browser 5 and up. 3 Colorado Prevention Partners AFF Continuation Application 2008-2009- Attachments If you are purchasing new equipment,the following set ups are recommended: If stand-alone workstation: Pentium III 450+ CPU, SVGA 8mb video card, 64mb+ SDRAM, 6GB hard drive, CD-ROM, sound card and speaker, 56k modem or high speed connection through DSL or cable, Windows 98 or 2000, Microsoft Explorer browser 5 and up. If on a network: Pentium III 450+ CPU; SVGA 8mb video card; 128mb+ SDRAM; 6GB hard drive, CD-ROM; sound card and speaker; Ethernet network card; high speed connection through DSL, Frame Relay, or TI line; Windows 98 or 2000; Microsoft Explorer browser 5 and up Web Browser: The web browser supported by the CO Prevention System is Microsoft Internet Explorer (IE). Currently Mozilla Firefox, Netscape, AOL, MSN and other browsers are not supported. They may function, but not to design specifications. We recommend users have the latest version of IE installed on their computer along with the updates provided by Microsoft(which are released periodically). • Any agency receiving a contract resulting from this Continuation Application must have an e-mail address. • No Federal appropriated funds will be used for any activity that would he deemed as lobbying. • Any agency receiving a contract resulting from this Continuation Application for Funding whose staff, subcontractors and volunteers have direct contact with children/youth or other vulnerable populations must have a background screening policy in keeping with CRS 27-1-110 that requires fingerprinting and a nationwide criminal check (including Colorado) for felonies, misdemeanors and outstanding warrants. This screening is permitted under CRS 24-72-305.3 (Part II,Overview). • No vehicles will be leased or purchased under any contracts funded by this Continuation Application for Funding. • Indirect rates are not to exceed 20%. The applicant must justify in the "budget narrative" section all costs that have been placed in both the "direct" and "indirect"categories. The process for arriving at the costs listed must be clearly described. 4 o/ \oq cdhsO �*` )l+ Colorado Department of Heinen Services people who help people A !8 76 Instructions for Colorado Prevention Partners Continuation Application September 30,2008-September 29,2009 Use this page as a checklist to ensure inclusion of all required pages. ❑ Review 08-09 CPP Continuation Application: ❑ Instructions and timeline ❑ Attachments ❑ Modify forms as needed(including HKCS Reporting Request Form) ❑ Sign and submit 2008-2009 Work Agreement ❑ Complete Cover Page(Part I) ❑ Complete ADAD Prevention Program Directory Summary(Part 2) ❑ Describe any changes from your 2007-2008 AFF response and the rationale for those changes(Part 3) ❑ Complete CPP Program Outcomes Narrative Summary(Part 4) ❑ Submit a revised Strategic Prevention Plan(see Part 5 for directions)using the original format ❑ Complete the Line Item Budget and Budget Narrative for year 2008-2009(Part 6) ❑ Send one electronic copy of the application to Melody.Dursostate.co.us no later than close of business Tuesday,July 15,2008 ❑ If you have electronic signature technology,send the signed cover page(Part 1) with your electronic copy ❑ If you do not have electronic signature technology, mail the signed cover page (Part 1)to the address below no later than close of business Tuesday, July 15, 2008. By mail or hand delivered: Alcohol and Drug Abuse Division 4055 South Lowell Blvd Denver,CO 80236 Attention: Melody Durso adad Alcohol and Drug Abuse Division Colorado Prevention Partners 2008-1009 Continuation Application '.__- f Formatted:Bottom: 0.13' . CPP Application for Continuation Funding Cover Page 2008-2009 Fiscal Agent Weld County Department of Human Services Address 315 North I I'a Avenue,Greeley,Co.80631 Central Telephone 970 352-1551 Fax 970 353-5215 Fiscal Contact Person Lennie Bottorff Email Phone Number 970352-1551 x6530 Address bettorll@co.weld.co.us Total Amount Requested(Must agree with budget forms) $ 183,876.56 2. Project Director/Coordinator Maria"Nomie"Ketterling Agency Employed By North Range Behavioral Health/Island Grove Treatment Center Address 1260 H Street Greeley,CO 80631 Phone 970 313-1159 Email Address maria.ketterling@northrange.org Name of CPP Project Weld County Colorado Prevention Partners(CPP) 3. APPROVALS: a.Officials Authorized to Sign Contract "1--1LG>. JUL 1 6 2008 William 11.lathe,Weld Cou Commissioner Date Phone 7 ( 110(c a 70. 352 - 1551 Judy go,Dire for Dat Phone Billing Address P.O.Box A,Greeley,Co 80632 Federal Tax ID Number #84-6000813 b F' ancial) leer r e Contractor 7hylox T7o-IC2.-isS- 1-eii--( CCg7 Lennie B..• `, .scal and Budget Manager Date Phone Colorado Prevention Partners 2008-1009 Continuation Application 2. ADAD Prevention Contract Directory Summary Please complete the following items. Your responses will be used in the ADAD Prevention Directory and ADAD's website so, please be clear and concise. Fiscal Agency Name Weld County Department of Human Services Fiscal Agency Director Judy Griego Telephone 970 353-1551 800 Number Fax 970 353-5215 Fiscal Agency Director's Email Address greigoja@co.weld.co.us Website Address www.weldhumanservices.org Program Title: Colorado Prevention Partners Weld County Colorado Prevention Partners Formatted:Right: 0.48",Tabs: Program(CPP)Coordinator Maria"Nomie"Ketterling 1.34",Right+ 2",Left Program Mailing Address 1260 H Street,Greeley,Co. 80631 Coordinator Email Address maria.ketterling@northrange.org Telephone 970 313-1159 •-------{Formatted Table Prevention Strategies XX Information Dissemination Alternative Drug-Free Activities Problem ID and Referral XX Prevention Education XX Environmental Strategies Community-Based Process(list training and technical assistance) Other activities or services delivered to individuals Other activities or serviced not delivered to individuals Geographical region(s)served by this program Target Populations(check all that apply) African American Pregnant women _ Asian/Pacific Islander White Hispanic Elementary school students Middle school XX students XX High school students College students Under 18 Under 21 Young adults(18-25) Construction American Indian/ Gay/lesbian/bisexual/transgender/ workers Alaska Native men who have sex with men Other target population (describe) XX Parents/community 2 Colorado Prevention Partners 2008-1009 Continuation Application Project Description The WC CPP is a Colorado Prevention Partners(CPP)project funded by the Substance Abuse and Mental Health Services Administration's(SAMHSA)Center for Substance Abuse Prevention's Strategic Prevention Framework State Incentive Grant. WC CPP Mission Statement:To promote a safer, healthier Weld County through strategies that prevent and reduce substance abuse. The WC Colorado frevention Partner's strategic prevention plan includes the following evidence-based Deleted:PP's strategies using a multi-tiered approach. I. Community Environmental Strategies: • Community Trials-Responsible Alcohol Retailer Group forming and to begin implementation summer'08. • Keep Events Festive and Safe- Supporting law enforcement at the Greeley Stampede to provide police officers at the event. • Social marketing-Windsor and Greeley to begin the process this summer with the likely focus on parents. • Social Norms-Team Fort Collins ACTUALITY campaign to be implemented in Windsor High School fall '08. H. Family/Parents and Youth: • Substance Abuse Prevention Handbook-Dissemination/Education in Windsor High School complemented with facilitated sessions for faculty/staff and parent/community held at the Windsor Recreation Center. • Family Classes for parents and MS youth-to be implemented in Greeley School District 6 through the school-based health centers.The model currently being researched is the Strengthening Families which includes both parents and youth. • Life Skills curriculum to supplement health sessions of ninth graders in Greeley School District 6. • Functional Family Therapy model to fill the need of addressing youth who selected and indicated in Greeley School District 6 provided by North Range Behavioral Health. Information dissemination/Education - Supporting community wide prevention events/activities in the area-Tailgate the Safety Way, Substance Abuse Summit with IOG/JAC,the 9 Health Fair and Journey- a young women's conference and paid advertising in the Windsor Beacon-Prevention TIP of the Month which is geared towards parents. 3 Colorado Prevention Partners 2008-1009 Continuation Application 3. Changes for FY 2008-2009 from Original RFP Response In Parts A and B,please describe any changes from your 2007-2008 AFF response and the rationale for those changes. If there are no changes from last year's application,please continue with Part 4 of the application. A. Community Wide Collaboration/Planning • Target Community • K-12 • Higher Education Aims Community College located in Greeley,Colorado has made a recent commitment to engage with WC CPP for their students. Aims is a community college with recent expansion to their student numbers(with more younger aged students) and programming. Along with six other Team Greeley members,an Aims representative attended social norms training with ACTUALITY Summer Camp. • Youth Engagement • Cross-Discipline/Cross-Agency Collaboration B. Prevention Infrastructure Development • Prevention Policy Board • Community/Coalition Infrastructure Development • Cultural Responsiveness • Sustainability 4 Colorado Prevention Partners 2008-1009 Continuation Application 4. Program Outcomes Narrative Summary For each of the following questions,please answer in 2-3 paragraphs or less. The purpose is to be brief Feel free to add additional information. A. Please describe how the Strategic Prevention Framework process has contributed to your efforts to prevent or reduce underage drinking.Please refer to your local data in your discussion. Issue Statements/Supporting Data: From the needs assessment conducted in 2007 and an updated look at the Healthy Kids Colorado Survey data in 2008,there are high rates of reported alcohol use by students in Weld County. As compared to the state and other urban counties(Denver,Mesa,and Pueblo),Weld is either higher or comparable in 30-day alcohol use and 30-day binge drinking among juveniles and young adults. In addition, in 2002 and 2003 Weld County had higher rates of Alcohol Related Fatal Accidents among 15-20 year olds than state and these urban counties.These numbers speak to a need to have strategies in place for the more indicated and selected populations. There is a rise in 30 day use from grades 7th tol2th,coupled with reports of favorable attitudes to drug use(by youth and parents),low perceived risk,and easy access to alcohol in middle and high school aged youth were reported through surveys and focus groups. Weld County's Health Status Report 2006,as well as the standard indictors from ASPIRE,provide a picture of some of the consequences of underage drinking such as the high rates of alcohol-related car crashes, underage alcohol treatment admission rates,teen pregnancy and attempted suicides. These are of great concern to the Coalition.Also troubling are high rates of youth antisocial behaviors, favorable attitudes of parents toward antisocial behaviors, and a steady decline of parental involvement from middle school through high school.Misdemeanor alcohol filing rate was also higher than the state average for Weld County. In examining the consumption,consequence,and causal data in conjunction with the resource assessment,there is a need for dissemination of information and broad-based environmental strategies to address the prevention of underage drinking in Weld County. Also, as it regards the data on 30 day binge drinking and alcohol-related car fatalities,there is a need to address the indicated and selected population in addition to the universal strategies.There are also a variety of programs/practices/policies that have been identified and have been integrated into the implementation of the plan. One of the identified communities- Windsor has demonstrated in numerous ways their readiness for the CPP project. Windsor schools and parents have cooperated since the beginning of 2007, asking for assistance with the concerns the community was having for substance use at the high school level. The community group morphed into the CPP community coalition in Windsor called WC CPP TEAM WINDSOR and began meeting regularly May 2007. TEAM WINDSOR membership includes representatives from all levels in the Windsor school district,parents and grandparents,police,treatment professionals, health professionals,journalist,local media,and other interested citizens. The group actively identified and acquired parent information in the 5 Colorado Prevention Partners 2008-1009 Continuation Application purchase of the"Parent Guidebook to Substance Abuse Prevention"though the Circle of Concern Consortium and than developed a local resource list as an attachment. The guidebooks were systematically placed in the hands of every high school and middle school family by February 2008. Elementary school is also included in the distribution. Parents who have been involved in the smaller forums have identified the need to have more community-wide messaging,hence TEAM WINDSOR will be developing a social marketing campaign for parents and have been doing information dissemination in the newspaper. The other identified community is Greeley/UNC/AIMS. Greeley schools have been on academic watch from the State of Colorado until recently. The focus has been on improvement in all academic areas at all levels. The school District has been cooperative in the administration of the HKCS and participated in the CDE school engagement activities as a part of the WC CPP efforts. A pilot pro bono project in the schools,Functional Family Therapy(FFT)for selected and indicated populations,was implemented by North Range Behavioral Health(NRBH)and WC CPP in the Spring of'08. FFT has proven successful and will be offered in the next school year. Other seeds have been sowed with regard to more prevention strategies in the schools,for example, Strengthening Families,social norms and supplementing the health curriculum with decision making/life skills tools.TEAM GREELEY has also identified the need to do a social marketing campaign in the community and might be coordinated with Windsor depending on the selected behavior/outcomes and target audience. A social marketing campaign might also involve the Responsible Alcohol Retailers Group/Community Trials. B. Please describe your 2007-2008 project successes and challenges/lessons learned. CHALLENGES: 1.Turnover and attrition is a CHALLENGE: Since beginning this work in Weld County, members have joined and left,(including two OMNI RPC's). Community coalition membership and agency representation on the community coalition changes. The CHALLENGE of new members is to orient and ground each new member in the SPF SIG framework and the history and goals of WC CPP. Also Island Grove Treatment Center is merging with North Range Behavioral Health (NRBH). WC CPP staff will be a part of the NRBII Youth and Family team. Weld County Social Services is merging with Weld County Human Services but will continue to be the WC CPP fiscal agent. 42. Also a CHALLENG is that the"process"of coalition work takes time,and lots of it! -- (I Deleted:Others Since decisions and discussions happen with many voices,at meetings and trainings the work is slow. It is important to provide a forum for networking and discussions,as well as decision-making/visioning for the group. Consequently,the work of coalition building and introduction to the framework and the science of prevention has to happen to identify prevention strategies that may be implemented SUCCESSES: The SUCCESS of the community coalition comes from commitment and hard work from (I Deleted:has been exceptional all the members. The WC CPP community coalition structure has provided effective . I Deleted:since It I) Ieadership_From Jhe two CO-CHAIRS whom were selected from each identified - I Deleted:fonned as the community and team: TEAM GREELEY and TEAM WINDSOR. This executive board Deleted: consisting of the four CO CHAIRS have worked together;o solve problems,find - Deleted:ha resources and guide the WC CPP work.Group decisions are meaningful and accepted. I Deleted:communicat 6 Colorado Prevention Partners 2008-1009 Continuation Application Kacy Murray a TEAM WINDSOR CO CHAIR has become the WC CPP Evaluation Liaison. C. Besides what you are currently doing as part of the statewide evaluation of CPP,please describe any current or planned local evaluation efforts for your CPP project.That is, what are you measuring;how are your using your data?For example,are you conducting a community survey?How often?How does it inform your local evaluation efforts?(If you include the CLI,please describe how you are using that information to inform your local evaluation efforts.) 1. Locally,the results of the HKCS has been shared in a number of planning venues. - -. Formatted:Indent:left: 0.5 First line: 0^ The data is being used for grant writing in Fort Lupton Schools,for prevention planning ` in Greeley Schools,and shared with the Windsor School Board for information and planning as they implement a social norm campaign this fall '08. In addition,working with the WC Department of Health and Environment,WC CPP has had discussions regarding the results of the YRBS and how best to administer the fall '08 surveys and to benefit from the data in our organizations and community. 2. A pro bono pilot FFT project was made available to School District 6 youth by North Range Behavioral Health with the intention that WC CPP would support the project if positive outcomes/feedback were received. The project is deemed"successful"by the District 6 Administration and Weld County Probation both reporting that youths/families involved are in school and making healthy progress, D. Describe collaborations related to your CPP work and how such collaborations have impacted your efforts. If you have identified areas where increased collaboration between organizations or sectors would lead to increased positive outcomes,please briefly describe your ideas. WC CPP collaborates with many organizations and agencies in the two targeted communities,as well as working with eight school districts to administer the HKCS in the fall. The membership list of WC CPP community coalition members includes a number of schools,Probation,Social Services,State Liquor Enforcement,the Windsor and Greeley Police Departments,private treatment providers and health professionals, local recreation center,the lOG executive director, Aims Community College,the University of Northern Colorado.the Health Department.concerned citizens,business owners,parents and grandparents and retired professionals. Youth have been involved as an"advisory group"to WC CPP through Windsor High School. WC CPP is hopeful to expand this"advisory group"and the contribution it can make to the WC CPP project. Here are some specific examples of collaboration and impact: -WC CPP has been asked for letters of support from the WC Tobacco Coalition,the Weld---- • Formatted:Indent:Left: 0.5",First County Health Department and School District 6. line: 0",Border:Right:(Single solid P line,Auto, 0.5 pt Line width) -WC CPP is collaborating with the IOG/PPB to assist with the October 2008 Substance Abuse Summit in Greeley. The WC CPP Coordinator participates with the planning committee. 7 Colorado Prevention Partners 2008-1009 Continuation Application -WC CPP has contracted with Team Fort Collins for assistance with their social norm project called"ACTUALITY"and their Responsible Alcohol Retailers group- RAR. -WC CPP partnered with the Greeley Police Department to provide law enforcement/officer for the Greeley Stampede event. -WC CPP has coordinated with North Range Behavioral Health(NRBH)to support the Functional Family Therapy project at School District 6. -WC CPP coordinated with School District 6 and the CDE school engagement application to provide the Prevention Institute and focus groups for WC school staff. -WC CPP are sponsors with many agencies for community events, including the Weld Formatted:Indent:Left: 0.5•,First County Department of Health and Environment on the"Tailgate the Safety Way"event. line: 0 Border:Right:(Single solid line,Auto, 0.5 pt Line width) -WC CPP has coordinated with Weld County Department of Health and Environment on planning the administration of HKCS in School District 6. -WC CPP provided through Island Grove Treatment Center trained facilitators to provide 4- Formatted:Indent:Left: 0.5",First education/information and planning for the Windsor School District faculty/staff and line: Q°,Border:Right:(Single solid line,Auto, 0.5 pt Line width) parents/community around the Guide for Substance Abuse Prevention. Those guidebooks were purchased with WC CPP dollars in addition to monies from the Town of Windsor, the Windsor Chamber of Commerce and local service club contributions_ -WC CPP has purchased paid advertising with the local newspaper the Windsor Beacon _..--f Formatted:Font:Italic } for a monthly Prevention TIP. This non-profit arrangement comes after months of free coverage of the WC CPP Team Windsor activities. -It is anticipated that implementation of prevention strategies will occur in Greeley School District 6 and possibly,at Aims Community College-both entities are interested in social norming. -Additionally,as WC CPP Team Greeley continues to work on the goal of reduction of retail access in Weld County. We anticipate working closely with business owners and operators to develop a Responsible Alcohol Retailers group that will meet regularly, create RAR by-laws,a code of ethics,advertising standards,and enforcement considerations,and continue to make available beverage server trainings for new employees and establishments in Weld County_ This will also include a close working relationship with law enforcement. E.Please share any ideas for further support of technical assistance needed to carry out your work. Support for the writing of subcontracts,training of trainers in identified strategies, assistance with budget revision when necessary,facilitator for the Substance Abuse Summit to be held October 2008,searching for appropriate strategies to implement/curriculum and supplemental materials for in school projects,application writing,budgeting and evaluation of implemented strategies. F. Please share with us any recommendations;you have for the CPP grant making or reporting process. 1 appreciate the text boxes that make it easier to submit the request electronically. The technical assistance and support from OMNI staff is priceless. The availability of funds from CDE as well as ADAD(carry over dollars)do not coincide with the planning process and are difficult to budget and spend out in the federal fiscal year. Colorado Prevention Partners 2008-1009 Continuation Application 5. Strategic Prevention Plan . Please submit an updated copy of your Strategic Prevention Plan as an attachment. Please work with your Regional Prevention Consultant regarding the format for presenting updates. Implementation Planning Template Format Narrative story: In Weld County, our readiness assessments told us that some sectors of the county were unaware of the problems with underage drinking and/or not ready to work on solutions. In some cases, there may have been more pressing issues such as in Greeley School District 6-the need for academic recovery-making it difficult to make inroads into the District 6 schools. hi Windsor, the schools were the driving force for change. The underage drinking concerns for Windsor schools,parents and community have spurred the efforts to raise awareness,educate and effect the misunderstood perceptions. Parents were clamoring for information about how to talk to their kids and school personnel wanted tools to identify and address substance use violators. Through a number of approaches, WC CPP has made inroads into raising awareness and providing guidance and resources to the communities to implement strategies into the two- targeted communities of Greeley and Windsor. Goals/Objectives: Overall goals and objectives were a result of three strategic planning sessions held in March 2007 and strategies were selected based on a set of criteria,which includes having broad-based applicability to Weld County as a whole.Draft versions of the goals/strategies* were then presented to key Coalition members for discussion and feedback;final versions are shown below and have evolved since the first version of the plan. * In May 2008 the WC CPP invited community and coalition members to revisit the original plan at a Spring Retreat facilitated by OMNI staff,resulting in approaches reflected in the work plan provided. The WC CPP Prevention plan document has been a useful tool that has guided the WC CPP work in our county. 1.To modify social norms accepting/encouraging youth drinking and reduce social access to alcohol by middle and high school aged population using a multilevel parent, school, and communitywide program designed to be alcohol specific. 2.To reduce access and availability of alcohol to Middle School and High School youth by reducing retail and social access through increased enforcement of underage drinking laws/penalties. 3.To modify the social norms accepting/encouraging youth drinking alcohol and reduce social access of alcohol to youth through the strategy of keeping special events festive and safe in Windsor and Greeley(to be addressed in year two of implementation). 9 • Colorado Prevention Partners 2008-1009 Continuation Application GOAL 1 -Team Greeley To modify social norms accepting/encouraging youth drinking and reduce social access to alcohol by middle and high school aged population using a multilevel parent,school, and communitywide program designed to be alcohol specific. OBJECTIVE 1.1 - Explore strategies/resources that provide in school or community prevention education and support to parents/families and youth. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES 1. In school: introduce Introduce August 2008- -CPP Coordinator and and/or shore up ongoing Evaluation Liaison parent/family support -School Administration and opportunities through allies at District 6 existing programs at -Comprehensive Health District 6 such as,PBS staff at District 6 parent training at the middle school level and implement new models through school based health centers i.e. Strengthening Families for parent and MS youth. 2. In community: support Introduced in District 6 -CPP Coordinator Functional Family Therapy spring 2008-ongoing 2008 -NRBH FFT Team Leader being provided by NRBH. -District 6 Administration The schools will be providing referrals. Fall 2008-ongoing -CPP Coordinator -District 6 staff 3. In school: provide supplemental materials for the adopted Health curriculum-the Glencoe model that will focus on decision-making and life skills for ninth graders. OBJECTIVE 1.2 - Explore media campaign at middle school or high school level. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES Introduce school August-December 2008 -CPP Coordinator administration to social -Social norm project staff norm theory and model and -OMNI staff social marketing at the Prevention and Health Institute-to be held August 6 and 7,2008. 10 • Colorado Prevention Partners 2008-1009 Continuation Application OBJECTIVE 1.3-To conduct a social marketing/media campaign in the community to focus on family/parenting. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES I. 1. Introduce concept and Beginning summer 2008- -CPP Coordinator model;begin selection of ongoing -Team Greeley members behavior/outcome based on -OMNI Staff data and community information.Answer the six essential questions through a facilitated process and research, including:targeted behaviors and audience, benefits to promote,costs to address,products to support change,and _promotion/places. 2. Test messaging and Fall 2008 -CPP Coordinator work with designer and -Team Greeley members anticipate promotion in the -OMNI Staff community via newspaper, TV,radio,table tents, posters,door hangers, billboard,etc... 3. Launch of ongoing January 2009 -CPP Staff campaign. -Team Greeley members -OMNI Staff 4. Continue monitoring and January-September 2009 -CPP Staff revision as necessary of the -Team Greeley member campaign. -OMNI Staff GOAL 2-Team Greeley To reduce access and availability of alcohol to Middle School and High School youth by reducing retail and social access through increased enforcement of underage drinking laws/penalties. OBJECTIVE 2.1 -Implement"Community Trials"interventions in our community-Community Mobilization. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES WC CPP brought Dr. February 2008 -Co Chair Team Greeley Treno, CA of"Community -CPP Coordinator Trials"to Greeley to -Team Greeley members introduce and train including City of Greeley community coalition Clerk to the Liquor Board members. and Greeley Police (.Community mobilization: Summer 2008-ongoing Department n Colorado Prevention Partners 2008-1009 Continuation Application Contact and organize a Responsible Alcohol Retailers groups to meet regularly and create by- laws, code of ethics and standards around the service and access of alcohol to minors. OBJECTIVE 2.2-Implement"Community Trials" interventions in our community- Responsible Beverage Server training. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES Training alcohol retailers Fall 2008 -ongoing -Trainers provided by CPP and servers to avoid selling -Consultants from Greeley to minors and those who Police Department provide alcohol to minors. OBJECTIVE 2.3 Implement"Community Trials"interventions in our community- Community member recognition. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES Recognition of those Summer 2008-ongoing -Co Chair Team Greeley retailers who are in -CPP Staff compliance with state and -Consultants from State local compliance checks Liquor Enforcement through media articles and certificates/plaques. GOAL 3-Team Greeley To modify the social norms accepting/encouraging youth drinking alcohol and reduce social access of alcohol to youth through the strategy of keeping special events festive and safe in Windsor and Greeley(to be addressed in year two of implementation). OBJECTIVE 3.1 -Implement"Community Trials"interventions in our community-law enforcement and compliance. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES Support the Greeley Police Summer 2008 -CPP Coordinator Department and the -Team Greeley members Colorado State Liquor from law enforcement-the enforcement to shore up Greeley Police Department, existing compliance UNC Police Department operations and enforcement of state and local liquor laws at the Greeley 12 Colorado Prevention Partners 2008-1009 Continuation Application Stampede and other community events. GOAL 1 -Team Windsor To modify social norms accepting/encouraging youth drinking and reduce social access to alcohol by middle and high school aged population using a multilevel parent,school,and communitywide program designed to be alcohol specific. OBJECTIVE 1.1- Provide education and information dissemination to parents and families. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES I.Distribution of Began in July 2007- -CPP Coordinator educational, parenting and ongoing -Team Windsor members prevention materials to -Windsor School Staff parents and families at all school levels. Free- "Substance Abuse Prevention Guidebook to Parents"and other materials. OBJECTIVE 1.2- Implement a social norms campaign called-ACTUALITY in Windsor High School-to reduce underage drinking and related risky behaviors in and around the community of Windsor. Note: ACTUALITY will provide training,implementation and evaluation of this social norm campaign in the Windsor High School. Seven WC CPP coalition members attended a two and one half day social norm training provided by ACTUALITY,June 2008. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES I. Initial two day training September 2008-June 2009 -Team Fort Collins- and site visit ACTUALITY staff 2. Data/survey coordination -CPP Coordinator and consultation -Team Windsor members 3.Technical assistance and -Windsor School staff trouble shooting 4. Youth marketing strategic development and research/creative development and ongoing youth marketing consultation. 5 Follow-up site visits, consultation and management 13 Colorado Prevention Partners 2008-1009 Continuation Application OBJECTIVE 1.3-Implement a community based social marketing focused on parents. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES I. Introduce concept and Beginning summer 2008- -CPP Staff model;begin selection of ongoing -Team Windsor members behavior/outcome based on -OMNI Staff data and community information. Answer the six essential questions through a facilitated process and research, including: targeted behaviors and audience, benefits to promote,costs to address,products to support change,and promotion/places. 2. Test messaging and Fall 2008 -CPP Staff work with designer and -Team Windsor members anticipate promotion in the -OMNI Staff community via newspaper, TV,radio,table tents, posters,door hangers, billboard,etc... 3.Launch of ongoing January 2009 -CPP Coordinator campaign. -Team Windsor members -OMNI Staff 4. Continue monitoring and January-September 2009 -CPP Staff revision as necessary of the -Team Windsor members campaign. -OMNI Staff OBJECTIVE 1.4-To effect school policy for substance use violations. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES 1. Establishing a Fall 2008 -Windsor School staff philosophy of concern -Team Windsor members instead of punishment for -Juvenile Assessment those students who have Center staff substance use violations. Recommendations from Team Windsor are currently being presented to the Windsor school board. Students will have an option for assessment/evaluations and 14 • Colorado Prevention Partners 2008-1009 Continuation Application referrals for classes/treatment that will defer expulsion/suspension time by the school. GOAL 2-Team Windsor To reduce access and availability of alcohol to Middle School and High School youth by reducing retail and social access through increased enforcement of underage drinking laws/penalties. OBJECTIVE 2.1 -Implement"Community Trials"interventions in our community-Community member recognition. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES Recognition of those Spring 2008-ongoing -Co Chair Team Greeley retailers who are in -CPP Staff compliance with state and -Consultants from State local compliance checks Liquor Enforcement through media articles and certificates/plaques. GOAL 3-Team Windsor To modify the social norms accepting/encouraging youth drinking alcohol and reduce social access of alcohol to youth through the strategy of keeping special events festive and safe in Windsor and Greeley(to be addressed in year two of implementation). OBJECTIVE 3.1-To educate/inform/disseminate prevention information to the community. ACTION STEPS TIMEFRAME RESPONSIBLE PARTIES I,Participate in Fall 2008-ongoing -WC CPP Coordinator school/community -Team Windsor members health/activity booths and -Windsor school personnel venues to distribute prevention information. i.e. Spirit Night at the Windsor school 2.Create and publish a April 2008-ongoing -WC CPP Coordinator PREVENTION TIP of the -WC CPP Evaluator month in the local -Team Windsor members newspaper,the Windsor Beacon 15 Colorado Prevention Partners 2008-1009 Continuation Application Participation of school district representatives in the community planning process is essential. Be sure to list in your plan any school engagement activities that will be included in your CDE school engagement application later this year. As a reminder,school engagement funds cover: • School personnel time compensation(out-of-contract work for classroom teachers, and if applicable,time compensation for other district/school personnel,i.e., administrators, finance office,data assembly,etc.) l The CDE-School engagement application made it possible to hold a community focus group/Spring Retreat on May 21,2008. Those participants received stipends as well as lunch. The groups revisited the WC CPP Prevention Plan goals and new strategies to implement. High on the list for Team Greeley in the Strengthening Families project and for Team Windsor ACTUALITY the social norm project. The Health and Prevention Institute will be a two-day in-service training held August 6 and 7, 2008 at school District 6 Administration Building,Greeley. The Institute is the cooperative work of District 6 Comprehensive school grant/personnel and WC CPP grant/personnel. Being offered to school faculty(for a stipend and one CEU credit)across the county,especially in those districts that have participated in the I-IKCS processes,the Institute will offer an introduction to prevention science,a review of the current HKCS Weld Community Report, presentations on prevention strategies such as social marketing,social norming, Strengthening Families,Functional Family Therapy and supplemental curriculum to the Glencoe health curriculum. It is anticipated that additional funding would continue the work of this Institute in providing prevention education/information and strategies for schools. A Substance Abuse Summit is planned for October 2008 with the IOG members with CPP supporting those efforts with incentives and conference costs. Budget Narrative Personnel: $67,906.56 Project director salary=$43,677.00 annually full time,which includes a 3.5%cost of living increase from the previous year. Finge benefits are calculated at an additional 28% annually. FTE$43,677.00= 12 months x$3639.75 28%fringe benefits x $3639.75/month=$1019.00/month x 12=$12,299.56 Evaluation Liaison salary=$12,000.00.25 FTE,no benefits. Hourly rate of$25.00/hour for 10 hours/week=$250.00 x 4=$1000.00/month for one year= 12 x$1000.00= $12,000.00 16 • Colorado Prevention Partners 2008-1009 Continuation Application Consultant: $720.00 Services you receive from consultants: • RPC facilitator from OMNI for community meeting: $50/hour x 15 hours = $750 in-kind • RAR(Responsible Alcohol Retailers)facilitator/consultant from Team Fort Collins$40.00/hour x 3 hours x 6(once a month meeting for six month)_ $720.00. Travel: $4133.00 Out-of-area expenses: Conference-$1210.00 • Denver Trips: Mileage for two trips to Denver @ 130 miles round trip x 2 trips=260 miles @.53 per mile=$138; lodging for two rooms @$120 per room=$240 per night x 1 night=$240 x 2 meetings=$680; meals per diem($49 per day Denver)x 2 people=$98 x 2 days=$196 x 2 meetings=$392. • Regional Prevention Summit Meeting: $1015.00 One trip to Colorado Springs for 3 people @ 200 miles round trip @ .53 per mile= $106; lodging for 3 rooms @$65 per room=$195 per night x 3 nights=$585;meals per diem($49 per day less$13 lunch=$36)x 3 people=$108 x 3 days=$324. In-area Local mileage:300 miles per month x 12 months @.53 cents=$1908. Out of county: included above Operating Expenses: $38,934.00 Training and conferences: Social norm training for team of four i.e.(Spring Camp- Actuality)x$400.00 each=$1600.00(if available in spring '09) Copying/printing: copy paper, ink,toner,$50.00/month x 12=$600.00 Meeting Room Rental: $100/2 hour meeting x 3=$300.00 Food for meetings: $100/meeting x 2 per month x 12=$2400.00 Indirect-(utilities,bookkeeping staff, IT support, insurance)—$1000/month—$12,000.00 Data Collection costs: $13,590.00 HKCS -survey materials-5,000 students x$2.15=$10,750.00 • Administration costs may include substitute teacher @ $55.00/hr x 4 hours x 2= $440.00 • Mailing supplies, copies and postage-$1,500.00 • Incentives for classrooms- $ 900.00(Weld County Health Department will support District 6 survey process) Incentives/stipends: $18/hour for attending meetings(3 hours each),or in equivalent gift card; trainings and assisting the project x 3 volunteers x 12 month=$1944.00 Office rent/phone: $650/month x 12=$7800.00 Office supplies: $25/month x 12= $300.00 Implementation Expenses: Please break down your implementation expenses in detail, listing each approach in your implementation plan. n • Colorado Prevention Partners 2008-1009 Continuation Application Greeley Goal 1: I.Team Greeley- Strengthening Families-$25,443.00 (if available spring '09) • Trainer's fee for a three day training for up to 30 people-$3000.00 • Travel, food and lodging for two trainers-$1500.00 • Training manuals-$525.00 per 3 -$1575.00 • Nine DVD/videos-$298.00 • Implementation : Family incentives-$100.00 per 15 families x 3 sessions =$4500.00 • Teaching staff-$110.00/session for 4 staff for 3 program series/7 sessions- 15 families/group-$12,320.00 • Food-$500.00,transportation and childcare costs$250.00 x 3 series of 15 families each-$2250.00. Goal 1: 2.Team Greeley-Functional Family Therapy- 8 cases=$20,800.00 Fifteen cases for year optimally. ($39,000.00 if available spring '09) Services(trained FFT therapist,transportation,materials)provided to families can range from 2-7 months(average 4 months)at a monthly rate of$650.00 Goal 1: 3.Team Greeley- Life Skills trainers-$200.00/person x 10 staff=$2,000.00 Supplemental materials to complement the Glencoe Health Curriculum- (iffunds are available) Goal 1: 4.Team Greeley/Windsor- Social marketing/media campaign in two communities -$20,000.00 Print materials,advertising,bill boards, radio, and website Trainers provided by OMNI- in kind- 10 hours/$50.00/hr x 2=$1000.00 Goal 2: 1.Team Greeley-Retail Access-Community Mobilization-$2000.00 Meeting expenses-refreshment, invitations,postage-brochures Goal 2: 2.Team Greeley-Retail Access- Beverage Server training=$1200.00- 4/available spring '09) $200.00 x 6 sessions with trainer instructor Goal 2: 3.Team Greeley-Retail Access- Incentives/recognition-$500.00 Windsor Goal 1.Team Windsor-ACTUALITY-social norm campaign-$13,925.00(-) (paid in July 2008 for fall '08 school year) Project design and management:Total $9,300.00 • Initial 2 day training and site visit-$4,000.00 • Follow-up site visit,consultation and management-$2,500.00 • One year technical assistance,trouble shooting(50 hours @$40.00/hour)- $2,000.00 • Communication,reporting,documents for community,under- $800.00 Message Development and Marketing: Total $4,000.00 18 • Colorado Prevention Partners 2008-1009 Continuation Application • Youth Marketing Strategic Development and Research-$1,000.00 • Creative Development-$2,500.00 • On-going Youth Marketing Consultation-$500.00 Research and Evaluation:Total $625.00 • Data/Survey Coordination and Consultation(includes coordination with on-site Evaluator,question development,coordination with CSU R&D Center) Goal 3.Team Windsor-Paid advertising-$80.00/month x 12=$960.00 19 Colorado Prevention Partners 2008-1009 Continuation Application 20 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment I ASSURANCES (For Reference Only —Do Not Sign) This itemization of Assurances is to be read, each assurance initialed, and the document signed by the autographic signature of the Applicant or an officer of the Applicant legally authorized to execute contractual obligations to indicate that the Applicant agrees to comply with the Assurances through the end of the grant period. An original of these pages must be included with your original hardcopy Response to this Continuation Application for Funding. ACCEPTANCE OF CPP APPLICATION TERMS AND CONDITIONS: An application submitted in response to this application is a binding offer. ADAD assumes that by submitting an application the Applicant acknowledges all Terms and Conditions of the Application. APPLICATION CONTENT ACCEPTANCE: The contents of the response (including persons specified to implement the project) of the successful Applicant will become contractual obligations if acquisition action ensues. Failure of the successful Applicant to accept these obligations in a contract, purchase document, delivery order or similar acquisition instrument may result in cancellation of the award and such Applicant may be removed from future solicitations. INCURRING COSTS: The State of Colorado is not liable for any cost incurred by Applicants prior to issuance of a legally executed contract. No property interest of any nature must occur until a contract is awarded and signed by all concerned parties. PRIVACY, CONFIDENTIALITY: The Applicant will comply with all federal and state laws, regulations and rules related to the privacy and confidentiality of client information, records, etc., including compliance with both 42 CFR Part 2 and I-IIPAA, where applicable, throughout the duration of any resulting contract. (http://www.hipaa.samhsa.gov/privacyrule.htm) CHARITABLE CHOICE: Faith-based recipients have read, understand and will comply with Charitable Choice Provisions and Regulations found in 42 CFR Parts 54 and 54a. (http://www.access.gpo.gov/nara/cfr/waisidx 03/42cfr54 03.html) Handwritten Signature by Authorized Date Officer of Fiscal Agency or Agent of Applicant 2 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment II TERMS AND CONDITIONS (For Reference Only—Do Not Sign) Colorado Prevention Partners and The Alcohol and Drug Abuse Division, Prevention Services Section, require the following Terms and Conditions for any County or Tribal Community funded by this contract. The applicant's signature at the end of this section, returned with the Continuation Application, signifies that the applicant understands and agrees to the terms and conditions as well as agreements for participation. A. Terms and Conditions • All activities supported by ADAD/CPP funding including printed materials, notice of these materials or trainings on websites, etc., must acknowledge ADAD, COLORADO DEPARTMENT OF HUMAN SERVICES, COLORADO PREVENTION PARTNERS and CSAP/SAMHSA as the funding sources, using the ADAD, CDHS, CPP and SAMHSA logos when appropriate. • All collections—data requirements, training materials, videos, books, files such as evaluation instrument files, and other library collections purchased under a contract resulting from this application may be requested to be returned or given to another recipient at ADAD's option, when the contract ends. • Any equipment purchase over $1,000 must first be approved by ADAD as part of the ongoing Continuation Application review. All equipment valued at $2,500 or over which is purchased under a contract resulting from this Continuation Application may be requested to be returned or given to another recipient at ADAD's option, when the contract ends. • All computer equipment and software used to implement any contract resulting from this Continuation Application must be compatible with ADAD's requirements and must meet evaluation requirements. Funds can be budgeted for that purpose. (Only one computer purchase is allowed per contract per grant.) • Communities are also strongly encouraged to use CPP dollars to support an upgrade of internet service (e.g. high speed line, DSL etc.). Dial-up internet access will cause increased delays in data entry. Current minimum requirements: IBM PC or compatible, Pentium class (II or III) CPU, VGA 800x600, 16mb Ram, 10mb free hard drive space, 56.6k modem, Windows 95 and up or NT 4.0 and up, Internet connection (regular phone line) with Microsoft Internet Explorer browser 5 and up. 3 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments If you are purchasing new equipment, the following set ups are recommended: If stand-alone workstation: Pentium III 450+ CPU, SVGA 8mb video card, 64mb+ SDRAM, 6GB hard drive, CD-ROM, sound card and speaker, 56k modem or high speed connection through DSL or cable, Windows 98 or 2000, Microsoft Explorer browser 5 and up. If on a network: Pentium III 450+ CPU; SVGA 8mb video card; 128mb+ SDRAM; 6GB hard drive, CD-ROM; sound card and speaker; Ethernet network card; high speed connection through DSL, Frame Relay, or T1 line; Windows 98 or 2000; Microsoft Explorer browser 5 and up Web Browser: The web browser supported by the CO Prevention System is Microsoft Internet Explorer (IE). Currently Mozilla Firefox, Netscape, AOL, MSN and other browsers are not supported. They may function, but not to design specifications. We recommend users have the latest version of IE installed on their computer along with the updates provided by Microsoft (which are released periodically). • Any agency receiving a contract resulting from this Continuation Application must have an e-mail address. • No Federal appropriated funds will be used for any activity that would be deemed as lobbying. • Any agency receiving a contract resulting from this Continuation Application for Funding whose staff subcontractors and volunteers have direct contact with children/youth or other vulnerable populations must have a background screening policy in keeping with CRS 27-1-110 that requires fingerprinting and a nationwide criminal check (including Colorado) for felonies, misdemeanors and outstanding warrants. This screening is permitted under CRS 24-72-305.3 (Part II, Overview). • No vehicles will be leased or purchased under any contracts funded by this Continuation Application for Funding. • Indirect rates are not to exceed 20%. The applicant must justify in the "budget narrative" section all costs that have been placed in both the "direct" and "indirect" categories. The process for arriving at the costs listed must be clearly described. 4 • Colorado Alcohol&Drug Abuse Division(ADAD) CPP BUDGET PAGE CONTRACTOR: ! Weld County.Department of Humati:ServicO,7 ., ._ EIROJECx`( T)TCE-- Weld Counts/CPP.. ' . TIME PERIOD: 9/30/2008 -9/29/2009 Other Source Hrs/ TOTAL Other Source -Non-Cash I Category & Line Annual Time #Mos Week BUDGET CPP FUND -Cash In-Kind Personnel 1. CPP Coordinator 43,677.00 12 : : 40 43,67 ,30 0.00 0.00 0.00 Fringe Benefits 28% 12,229.56 0.00 0.00 0.00 2. oval Liaison 12,000:00 12 r , 10 : 12,000;0.0, 0.00 0.00 0.00 Fringe Benefits 0"10 0.00 0.00 0.00 0.00 3. Admin Assistant 0.00 0.00 0.00 0.00 Fringe Benefits 0%Lo; 0.00 0.00 0.00 0.00 i otal Personnel I I I 1 1 67,906.561 0.001 0.001 0.00 Consultants 1. Youth Consultants 0.00 0.00 0.00 0.00 2. Subcontractor 0.00 0.00 0.00 0.00 3. Consultants/OMNI 0.00 0.00 0.00 720.00 total Consultant I I 1 1 I 0.001 0.001 0.001 /20.00 I ravel 1. Local 1,908.00 0.00 0.00 0.00 2. Out of Area 2,225.00 0.00 0.00 0.00 I otat i ravel I 1 1 1 1 4,133.001 0.001 0.001 0.00 Operating 1. Training/Conference 0.00 0.00 0.00 0.00 2. Copying/Printing 600.00 0.00 0.00 0.00 3. Meeting Room 300.00 0.00 0.00 0.00 4. Food 2,400.00 0.00 0.00 0.00 5. Indirect 12,000.00 0.00 0.00 0.00 6.Data Colllection/HKCS 13,590.06 7.1 ncentives/stipends 1,944.00 8.Rent/phone 7,800.00 9.Office supplies 300.00 I otal Operating I I I I 138,934.001 0.001 0.001 0.00 Implementation 1. Goal 1 68,243.00 0.00 0.00 0.00 2. Goal 2 3,/00.00 0.00 0.00 1,000.00 3. Goal 3 960.00 0.00 0.00 0.00 l otal Implementation I I I 1 1 /2,903.001 0.001 0.001 1,000.00 Granci Iota! I I 1 I 11ss,61b.bbl 0.001 U.UUI 1,/ZU.UU Instructions: This is the budget format required for the next fiscal year. The budget should reflect and individually identify costs for both the fiscal agent and any subconstractors. Billings to ADAD should be prepared referencing the line items in the budget. Your budget narrative must match the budget. Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment III WORK AGREEMENT CPP Strategic Prevention Framework Funds 2008.2009 PLEASE RETURN A SIGNED COPY OF THIS WORK AGREEMENT WITH THE 2008-2009 CONTINUATION APPLICATION. Timeline: September 30, 2008 to September 29,2009 Goals and Objectives: Goal#1: Continue with SPF Steps 1-3 of Needs Assessment, Readiness Assessment, Capacity Development and Planning to Enhance and Improve the Strategic Prevention Framework (SPF)Plan Objective 1.1: Between September 30, 2008 and September 29, 2009, continue SPF-SIG work on Steps One —Three (].Conduct needs assessments; 2. Build state and local capacity; 3. Develop a comprehensive strategic plan) and as needed, submit any revisions to the Comprehensive Strategic Plan&budget to the CPP Management Team for approval. Activities: Revisit Needs Assessment • Revise or update as needed the indicators that are part of the Needs Assessment section in ASPIRE. • Revisit your data with subcommittee on the cause-consumption pattern-consequence model as needed to see what more can be learned about underage drinking and related issues in the community. • As needed, subcommittee identifies additional steps for the collection of local data and entry into ASPIRE. • Revise or update the resource assessment in ASPIRE. • As needed, subcommittee reports additional findings from Step I activities to PPB/Coalition. • Continue to refine a plan of action for working with school officials to administer the Healthy Kids Colorado Survey in targeted schools. • Review results of the Healthy Kids Colorado Survey and share highlights with the PPB/Coalition. • Conduct higher education CORE surveys in any higher education institutions that are included in the community strategic plan. Only communities that have identified using the CORE survey in their strategic plan need to administer this survey. Data collected through the CORE survey should be used for needs assessment purposes. Continue to Enhance Local Capacity • Hold Coalition/PPB meetings to review any updated assessment findings and to refine capacity building goals and action steps. 7 • Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments • Continue to build relationships with potential partners in sectors of the community that do not participate actively in prevention. • Continue to address sustainability, including preparation of a local sustainability plan. • Continue to address cultural responsiveness in all aspects of strategic plan implementation. • For those communities that include higher education in their strategic plan, work with technical assistance provider, BACCHUS Network, to enhance community prevention efforts related to prevention in higher education. Comprehensive SPF Plan for Prevention • PPB/Coalition revisits or updates identified goals and action steps based on readiness and available community resources for addressing underage drinking. • PPB/Coalition revisits or updates identified goals and action steps based on underage drinking data and the gaps in prevention services. • Hold meetings with key stakeholders, other coalitions or community groups, and service providers to gather any additional feedback on findings, goals and action steps. • Evidence-based prevention programs, policies and practices are identified with the technical support of OMNI RPCs, based on the assessment of needs and existing resources. • Identified set of evidence-based prevention programs, policies and practices are examined for complementary and comprehensive design with fidelity and adaptation considerations to make strategies responsive to local culture, populations and assessment findings. • Strategic plan is updated or refined as needed, at a minimum annually with the Continuation Application, and submitted to ADAD with a revised budget that details the use of implementation funds for specific strategic plan approaches. Goal#2: Continue with SPF-SIG Step 4 and Implement Programs, Policies, and Practices Objective 2.1: Between September 30, 2008 and September 29, 2009, Coalition and/or PPB will continue to implement evidence-based prevention programs,policies and practices based on the approved Strategic Plan developed during SPF Steps One-Three. Activities: • Staff are trained and appropriate protocol are developed to implement selected evidenced-based prevention programs,policies, and practices. • The CPP project continues to implement selected evidenced-based prevention program, policy and practice approaches as reflected in Strategic Prevention Plan and Template with guidance from Community Coalition/Prevention Policy Board, Project Director/Coordinator, Local Evaluation Liaison and OMNI RPCs. Goal #3: Continue with SPF-SIG Step 5 Evaluation of the Strategic Prevention Framework project 8 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Objective 3.1: Implementation of the Strategic Prevention Framework will be evaluated within identified community. Activities: • PPB/Coalition notes are submitted to OMNI on a monthly basis. • Local Evaluation Liaison and Project Coordinator work with OMNI evaluation Liaison to coordinate completion of the CLI every 6 months. • Local Evaluation Liaison works with the OMNI Evaluation Liaison to coordinate - evaluation activities such as site visits, stakeholder interviews and technical assistance when needed. • Continue using process/fidelity instruments and the Environmental Output Instrument on a monthly basis or as otherwise stated. Communities implementing programs such as Project Alert should continue administering the YPLAN instrument. These communities should contact their OMNI Evaluation Liaison for administration assistance. • Submit NOM Implementation Spending Form to OMNI Evaluation Liaisons on a monthly basis. Communities will be trained by.their OMNI Evaluation Liaisons on how to complete these forms. Goal #4: Prepare for FY09-10 CPP Strategic Prevention Framework No-Cost Extension Funding Year Objective 4.1: By July 2009,an application is submitted for No-Cost Extension Year 09-10 of the CPP Strategic Prevention Framework project,which includes a sustainability plan. Activities: • No-cost Extension Application is completed and approved. • Planning for transition of activities into final fiscal year is carried out. • Sustainability plans are finalized. • Project close out activities are forecast. Hand • :'g• •lure by Authorized Date Officer of Fiscal Agency or Agent of Applicant Weta C...,.41 Ott.Li flvnow .S[rv.?-G .'.t C,t.dj. j Mn.,,,sr- 9 , e Attachments - Colorado Prevention Partners Continuation Application for Funds (AFF) 2008-2009 Attachment Section Colorado Prevention Partners Continuation Application for Funds (AFF) 2008-2009 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments • Attachment I ASSURANCES (For Reference Only—Do Not Sign) This itemization of Assurances is to be read, each assurance initialed, and the document signed by the autographic signature of the Applicant or an officer of the Applicant legally authorized to execute contractual obligations to indicate that the Applicant agrees to comply with the Assurances through the end of the grant period. An original of these pages must be included with your original hardcopy Response to this Continuation Application for Funding. ACCEPTANCE OF CPP APPLICATION TERMS AND CONDITIONS: An application submitted in response to this application is a binding offer. ADAD assumes that by submitting an application the Applicant acknowledges all Terms and Conditions of the Application. APPLICATION CONTENT ACCEPTANCE: The contents of the response (including persons specified to implement the project) of the successful Applicant will become contractual obligations if acquisition action ensues. Failure of the successful Applicant to accept these obligations in a contract, purchase document, delivery order or similar acquisition instrument may result in cancellation of the award and such Applicant may be removed from future solicitations. INCURRING COSTS: The State of Colorado is not liable for any cost incurred by Applicants prior to issuance of a legally executed contract. No property interest of any nature must occur until a contract is awarded and signed by all concerned parties. PRIVACY, CONFIDENTIALITY: The Applicant will comply with all federal and state laws, regulations and rules related to the privacy and confidentiality of client information, records, etc., including compliance with both 42 CFR Part 2 and HIPAA, where applicable, throughout the duration of any resulting contract. (http://www.hipaa.samhsa.gov/privacvrule.htm) CHARITABLE CHOICE: Faith-based recipients have read, understand and will comply with Charitable Choice Provisions and Regulations found in 42 CFR Parts 54 and 54a. (http://www.access.gpo.cov/nara/cfr/waisidx 03/42cfr54 03.html) Handwritten Signature by Authorized Date Officer of Fiscal Agency or Agent of Applicant 2 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment II TERMS AND CONDITIONS (For Reference Only —Do Not Sign) Colorado Prevention Partners and The Alcohol and Drug Abuse Division, Prevention Services Section, require the following Terms and Conditions for any County or Tribal Community funded by this contract. The applicant's signature at the end of this section, returned with the Continuation Application, signifies that the applicant understands and agrees to the terms and conditions as well as agreements for participation. A. Terms and Conditions • All activities supported by ADAD/CPP funding including printed materials, notice of these materials or trainings on websites, etc., must acknowledge ADAD, COLORADO DEPARTMENT OF HUMAN SERVICES, COLORADO PREVENTION PARTNERS and CSAP/SAMHSA as the funding sources, using the ADAD, CDHS, CPP and SAMHSA logos when appropriate. • All collections—data requirements, training materials, videos, books, files such as evaluation instrument files, and other library collections—purchased under a contract resulting from this application may be requested to be returned or given to another recipient at ADAD's option, when the contract ends. • Any equipment purchase over $1,000 must first be approved by ADAD as part of the ongoing Continuation Application review. All equipment valued at $2,500 or over which is purchased under a contract resulting from this Continuation Application may be requested to be returned or given to another recipient at ADAD's option, when the contract ends. • All computer equipment and software used to implement any contract resulting from this Continuation Application must be compatible with ADAD's requirements and must meet evaluation requirements. Funds can be budgeted for that purpose. (Only one computer purchase is allowed per contract per grant.) • Communities are also strongly encouraged to use CPP dollars to support an upgrade of internet service (e.g. high speed line, DSL etc.). Dial-up internet access will cause increased delays in data entry. Current minimum requirements: IBM PC or compatible, Pentium class (II or III) CPU, VGA 800x600, 16mb Ram, 10mb free hard drive space, 56.6k modem, Windows 95 and up or NT 4.0 and up, Internet connection (regular phone line) with Microsoft Internet Explorer browser 5 and up. 3 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments If you are purchasing new equipment, the following set ups are recommended: If stand-alone workstation: Pentium III 450+ CPU, SVGA 8mb video card, 64mb+ SDRAM, 6GB hard drive, CD-ROM, sound card and speaker, 56k modem or high speed connection through DSL or cable, Windows 98 or 2000, Microsoft Explorer browser 5 and up. If on a network: Pentium III 450+ CPU; SVGA 8mb video card; 128mb+ SDRAM; 6GB hard drive, CD-ROM; sound card and speaker; Ethernet network card; high speed connection through DSL, Frame Relay, or T1 line; Windows 98 or 2000; Microsoft Explorer browser 5 and up Web Browser: The web browser supported by the CO Prevention System is Microsoft Internet Explorer (IE). Currently Mozilla Firefox, Netscape, AOL, MSN and other browsers are not supported. They may function, but not to design specifications. We recommend users have the latest version of IE installed on their computer along with the updates provided by Microsoft (which are released periodically). • Any agency receiving a contract resulting from this Continuation Application must have an e-mail address. • No Federal appropriated funds will be used for any activity that would be deemed as lobbying. • Any agency receiving a contract resulting from this Continuation Application for Funding whose staff, subcontractors and volunteers have direct contact with children/youth or other vulnerable populations must have a background screening policy in keeping with CRS 27-1-110 that requires fingerprinting and a nationwide criminal check (including Colorado) for felonies, misdemeanors and outstanding warrants. This screening is permitted under CRS 24-72-305.3 (Part II, Overview). • No vehicles will be leased or purchased under any contracts funded by this Continuation Application for Funding. • Indirect rates are not to exceed 20%. The applicant must justify in the "budget narrative" section all costs that have been placed in both the "direct" and "indirect" categories. The process for arriving at the costs listed must be clearly described. 4 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Agreements for Participation By submitting this Continuation Application you are agreeing to: • Maintain staffing requirements, including at a minimum a .5 FTE Project Director/Coordinator and a .25 FTE Local Evaluation Liaison to work with ADAD, OMNI, and CPP. • Maintain and enhance a Community Coalition and/or Prevention Policy Board and describe the roles and responsibilities of those groups. • Maintain the involvement of a Fiscal Agent (Unit of Local Government) to a) receive the funds from ADAD and b) complete and submit monthly billings for reimbursement to ADAD. • If not yet submitted, provide a statement or statements of participation (MOU) that identify the key stakeholders who have agreed to participate in the CPP Project as of July 13, 2007 and identify their roles and participation commitments. • Continue to implement a youth involvement strategy for SPF Steps 1-5 of the CPP process. • Continue to collaborate across funding streams, disciplines, age and cultural groups. • Obtain a written Memoranda of Agreement (MOA) with required signatures from participating school districts. • Obtain required consent forms, preferably passive, from all students that will participate in the next administration of the Healthy Kids Colorado Survey. • Administer the Healthy Kids Colorado Survey in the fall of every grant year among all high schools and feeder middle schools in the target area, using either a census or sampling model based on population, for all 6th— 11th graders. • If desired, apply through one designated school district for SPF-SIG funds through the Colorado Department of Education for out-of-contract stipends and related costs to involve all K-12 representatives in the target area to help ensure school participation on the Coalition and/or PPB. • Involve representatives from Higher Education institutions in planning, and build funds into the budget to support higher education involvement. • Conduct higher education CORE surveys in any higher education institutions that are included in the community strategic plan. 5 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments • Send CPP-funded staff to required meetings and trainings, including the following: o CPP Community Infrastructure Workgroup and Colorado Prevention Partners Advisory Council (CPPAC): The CPP Community Project Director/Coordinator and Local Evaluation Liaison must attend a minimum of three annual 2-day Denver-based meetings. o State Workgroups: The Project Director is encouraged to participate in, or assign other staff, to other possible workgroups that advance the work of the statewide project (e.g., Underage Drinking Prevention & Reduction Workgroup, Evaluation Workgroup, etc.). o Substance Abuse Prevention Specialist Training (SAPST): All CPP staff must complete the SAPST within 6 months of contract start or hiring, whichever date comes first, unless the training was completed in the last 3-5 years; o Prevention Summit: CPP Coordinator and Local Evaluation Liaison must attend a two-day Prevention Summit; o Other Strategic Prevention Framework or Evaluation Trainings: CPP staff as designated must attend any other required trainings or meetings announced by Colorado Prevention Partners. • Build funds from this contract into the budget for required trainings and professional development. For example, $75 per registrant (and an optional $90 for continuation education credits) for the four-day Substance Abuse Prevention Specialist Training (SAPST) plus lodging and per diem at the state rate (if applicable), and lodging and per diem costs at the state rate for two people to attend a two-day local or regional orientation and evaluation training. • Fiscal agency tracks time and effort of project staff and tracks costs by programs and/or funding source. Handwritten Signature by Authorized Date Officer of Fiscal Agency or Agent of Applicant 6 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment III WORK AGREEMENT CPP Strategic Prevention Framework Funds 2008-2009 PLEASE RETURN A SIGNED COPY OF THIS WORK AGREEMENT WITH THE 2008-2009 CONTINUATION APPLICATION. Timeline: September 30, 2008 to September 29, 2009 Goals and Objectives: Goal #1: Continue with SPF Steps 1-3 of Needs Assessment, Readiness Assessment, Capacity Development and Planning to Enhance and Improve the Strategic Prevention Framework (SPF) Plan Objective 1.1: Between September 30, 2008 and September 29, 2009, continue SPF-SIG work on Steps One — Three (1.Conduct needs assessments; 2. Build state and local capacity; 3. Develop a comprehensive strategic plan) and as needed, submit any revisions to the Comprehensive Strategic Plan& budget to the CPP Management Team for approval. Activities: Revisit Needs Assessment • Revise or update as needed the indicators that are part of the Needs Assessment section in ASPIRE. • Revisit your data with subcommittee on the cause-consumption pattern-consequence model as needed to see what more can be learned about underage drinking and related issues in the community. • As needed, subcommittee identifies additional steps for the collection of local data and entry into ASPIRE. • Revise or update the resource assessment in ASPIRE. • As needed, subcommittee reports additional findings from Step 1 activities to PPB/Coalition. • Continue to refine a plan of action for working with school officials to administer the Healthy Kids Colorado Survey in targeted schools. • Review results of the Healthy Kids Colorado Survey and share highlights with the PPB/Coalition. • Conduct higher education CORE surveys in any higher education institutions that are included in the community strategic plan. Only communities that have identified using the CORE survey in their strategic plan need to administer this survey. Data collected through the CORE survey should be used for needs assessment purposes. Continue to Enhance Local Capacity • Hold Coalition/PPB meetings to review any updated assessment findings and to refine capacity building goals and action steps. 7 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments • Continue to build relationships with potential partners in sectors of the community that do not participate actively in prevention. • Continue to address sustainability, including preparation of a local sustainability plan. • Continue to address cultural responsiveness in all aspects of strategic plan implementation. • For those communities that include higher education in their strategic plan, work with technical assistance provider, BACCHUS Network, to enhance community prevention efforts related to prevention in higher education. Comprehensive SPF Plan for Prevention • PPB/Coalition revisits or updates identified goals and action steps based on readiness and available community resources for addressing underage drinking. • PPB/Coalition revisits or updates identified goals and action steps based on underage drinking data and the gaps in prevention services. • Hold meetings with key stakeholders, other coalitions or community groups, and service providers to gather any additional feedback on findings, goals and action steps. • Evidence-based prevention programs, policies and practices are identified with the technical support of OMNI RPCs, based on the assessment of needs and existing resources. • Identified set of evidence-based prevention programs, policies and practices are examined for complementary and comprehensive design with fidelity and adaptation considerations to make strategies responsive to local culture, populations and assessment findings. • Strategic plan is updated or refined as needed, at a minimum annually with the Continuation Application, and submitted to ADAD with a revised budget that details the use of implementation funds for specific strategic plan approaches. Goal #2: Continue with SPF-SIG Step 4 and Implement Programs, Policies, and Practices Objective 2.1: Between September 30, 2008 and September 29, 2009, Coalition and/or PPB will continue to implement evidence-based prevention programs, policies and practices based on the approved Strategic Plan developed during SPF Steps One-Three. Activities: • Staff are trained and appropriate protocol are developed to implement selected evidenced-based prevention programs, policies, and practices. • The CPP project continues to implement selected evidenced-based prevention program, policy and practice approaches as reflected in Strategic Prevention Plan and Template with guidance from Community Coalition/Prevention Policy Board, Project Director/Coordinator, Local Evaluation Liaison and OMNI RPCs. Goal #3: Continue with SPF-SIG Step 5 Evaluation of the Strategic Prevention Framework project 8 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Objective 3.1: Implementation of the Strategic Prevention Framework will be evaluated within identified community. Activities: • PPB/Coalition notes are submitted to OMNI on a monthly basis. • Local Evaluation Liaison and Project Coordinator work with OMNI evaluation Liaison to coordinate completion of the CLI every 6 months. • Local Evaluation Liaison works with the OMNI Evaluation Liaison to coordinate evaluation activities such as site visits, stakeholder interviews and technical assistance when needed. • Continue using process/fidelity instruments and the Environmental Output Instrument on a monthly basis or as otherwise stated. Communities implementing programs such as Project Alert should continue administering the YPLAN instrument. These communities should contact their OMNI Evaluation Liaison for administration assistance. • Submit NOM Implementation Spending Form to OMNI Evaluation Liaisons on a monthly basis. Communities will be trained by their OMNI Evaluation Liaisons on how to complete these forms. Goal #4: Prepare for FY09-10 CPP Strategic Prevention Framework No-Cost Extension Funding Year Objective 4.1: By July 2009, an application is submitted for No-Cost Extension Year 09-10 of the CPP Strategic Prevention Framework project, which includes a sustainability plan. Activities: • No-cost Extension Application is completed and approved. • Planning for transition of activities into final fiscal year is carried out. • Sustainability plans are finalized. • Project close out activities are forecast. Handwritten Signature by Authorized Date Officer of Fiscal Agency or Agent of Applicant 9 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment IV EVALUATION REQUIREMENTS Overview Evaluation and monitoring is one of the five steps of the Strategic Prevention Framework. Colorado is utilizing CPP funding to develop and implement evaluation systems that can be used statewide. OMNI Institute will continue to work closely with CPP-funded communities to implement these evaluation systems so that information is available at the federal, state and local levels to monitor and refine Strategic Prevention Framework implementation and outcomes. Evaluation Expectations for 2008-2009 Counties receiving CPP continuation funds remain committed to the following requirements: Local Evaluation Liaison • Identify a minimum .25 FTE Local Evaluation Liaison to coordinate with the OMNI evaluation team and to notify the OMNI evaluation team contact of any project changes. Training and Technical Assistance • Participate in CPP evaluation trainings and technical assistance forums (e.g., webinars, conference calls, etc.). Please see the CPP Training and TA Calendar for more information. • Utilize the assigned OMNI evaluation team contact to address evaluation questions such as submission of the semiannual cross-site Community Level Instrument (CLI) and monthly data collection forms. • Utilize the assigned OMNI evaluation team contact to address technical needs assessment questions, such as use of ASPIRE or Healthy Kids Colorado Survey data to update needs assessments annually. CPP Formative Evaluation • Participate in formative evaluation activities such as coalition and PPB note taking, (submitted to OMNI evaluation contact on a monthly or bimonthly basis), OMNI stakeholder interviews, and OMNI evaluation site visits. • Assist with coordination of at least one annual OMNI evaluation site visit (primarily observational to learn from your process) and supplemental stakeholder interviews. Healthy Kids Colorado Survey (HKCS) • The Local Evaluation Liaison will oversee the administration of the school survey with OMNI evaluation TA and coordinate the ordering of needed survey supplies (including answer sheets forms) through online registration (http://omnisurvev.omni.orq/ssc/survey/hkcsregistration.htm) and phone confirmation with OMNI. Online registration for survey administration is due a minimum of two weeks prior to the planned administration dates, in order to ensure adequate time for ordering and delivery of survey materials. • Costs: $2.15 per person/survey l0 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments • Survey administration: Administer the Healthy Kids Colorado Survey in the fall of every year among all high schools and feeder middle schools in the target area, using either a census or sampling model based on population, for all 6th— 11`h graders. (Communities are welcome to include 12`h graders, but this is not required as a part of the state evaluation.) Survey administration must be completed no later than December 15, 2008. • OMNI Institute must be consulted on the development and implementation of any student level or school level sampling procedures. Sampling strategies that do not meet OMNI's guidelines will make HKCS participation null and void for the school entities where the non-scientific sampling strategies were employed. • MOA: In 2007-2008 the contractual period for the MOA was modified to reflect the remainder of the SPF-SIG project, 2007 through 2009. If the Superintendent has changed since that time, work with target schools to develop a new MOA. A sample MOA document and instructions are located in section IV of the Attachments. Submit completed MOAs, including all necessary signatures from participating school districts 2 weeks prior to survey administration. Be mindful of confidentiality protections and sensitive to potential concerns of school regarding public release of information. • MOA Reporting Request Form: Please review your FY07-08 Reporting Request Form for any necessary changes (e.g. different individuals should be receiving reports or additional school-level reports are needed this year). If changes are required,please update the form and send it with your continuation application. If no changes are needed OMNI will use the FY07-08 form for report dissemination in FY08-09. ASPIRE • Continue the use of ASPIRE to review updated data indicators and enter custom-level indicators. This information will be used to update the strategic plan as needed for next year's continuation application. CPP Data Collection Forms • Submit monthly process data collection forms. • Submit outcome data collection forms on a semiannual basis. • Utilize OMNI evaluation contact to ensure data quality. CLI (Community Level Instrument) • Coordinate with the Project Coordinator, Local Evaluation Liaison and OMNI to complete the web-based Community Level Instrument for the national cross-site evaluation every 6 months, and any other supplemental evaluation instruments required. Higher Education CORE Surveys: • Conduct higher education CORE surveys in any higher education institutions that are included in the community strategic plan. Only communities that have identified using the CORE survey in their strategic plan need to administer this survey. Data collected through the CORE survey should be used for needs assessment purposes. 11 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment V PARTICIPATION AGREEMENTS/MOA Non-school Agency or Entity If you did not submit a participation document or documents (e.g., Memorandum of Understanding, letter of support or other) with your 2006-2007 or 2007-2008 application that details the commitment of all participating non-school agencies or entities, including PPB representatives, submit that document or documents with this Continuation Application, or provide an updated document or documents to reflect new agency or entity representatives. School Participation Each participating school district must sign a Memorandum of Agreement. In 2007, the contractual period for the MOA was modified to reflect the remainder of the SPF-SIG project, 2007 through 2009, unless there was a change in the superintendent. If a change has occurred, a new MOA must be agreed upon. A sample MOA document and instructions are located in Part IV of the Attachments below. If required, submit completed MOAs, including all necessary signatures, no later than 2 weeks prior to survey administration. Be mindful of confidentiality protections and sensitive to potential concerns of school regarding public release of information. 12 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments MOA Attachment A: Memorandum of Agreement (MOA) Template for Schools CPP Strategic Prevention Framework Funds 2008-2009 Memorandum of Agreement Between Community Coalition/PPB And School District Name School District Name (Use additional blank if appropriate) School District Name (Use and add additional school district and potentially individual school name lines as appropriate) I. Background In fiscal year 2004-05, the Colorado Prevention Partners (CPP) received funding from a State Incentive Grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), awarded to the Governor's Office to implement the Strategic Prevention Framework. The state underwent a preliminary needs assessment process to identify areas in Colorado that have elevated rates of underage drinking, substance abuse and related problems and that have proportionately fewer public resources allocated to address these issues. The Colorado Prevention Partnership Advisory Council (CPPAC) selected [County] and 13 other areas in Colorado to receive funding in fiscal year 2005-06. One purpose of these funds is to support collaboration between school systems and other organizations in the community to promote the prevention of underage drinking and other problems by supporting communities in building and enhancing local prevention infrastructure. Infrastructure includes prevention-focused coalitions, organizations and networks, professional workforce, and policy decision-making bodies. Purpose of the Agreement The CPP awarded funding to [County] to enhance school-community collaboration and the coordination of substance abuse-related prevention efforts for children, youth and adults. This MOA represents an agreement between the [Community Coalition/PPB] and the [School District(s)] to collaborate on the implementation of the Strategic Prevention Framework in [Community]. Through this collaboration, [School District(s)] and [Coalition/PPB] will collaborate on their efforts to reduce substance 13 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments abuse within [Community] and to build, enhance and sustain effective prevention strategies, policies, programs and practices, particularly as these relate to underage drinking. II. Shared Concerns Both the [Community Coalition/PPB] and [School District(s)] recognize that enhancing the collaboration between [Community Coalition/PPB] and [School District(s)] represents an essential step in strengthening local prevention and reducing substance abuse, particularly underage drinking, in [Community]. We recognize that children and youth spend a significant amount of time working with school personnel on a daily basis, making school personnel and school systems a key part of prevention efforts. We also recognize that underage drinking and substance abuse impact school attendance, academic performance and other areas of students' lives that are important predictors of current and future health and well-being. Collectively, our work will strengthen schools and the broader community. III. Substance of Agreement The [Coalition/PPB] will advise community needs assessment, mobilization, planning, implementation and evaluation activities funded through the CPP. School representatives have agreed to serve on the [Coalition]. A district official or designated representative also has agreed to serve on the [PPB or policy-making subcommittee of the Coalition]. Refer to Attachment 2 for details about coalition and school plans to work together. In their roles on the [Coalition/PPB], school representatives will help support and guide the CPP Project Coordinator, Local Evaluation Liaison, and state evaluator (OMNI) in administering the Healthy Kids Colorado Survey (HKCS) as part of the local needs assessment and state evaluation. HKCS is supported by the Colorado Department of Education and Colorado's interagency Prevention Leadership Council. Refer to Attachment 3 for survey administration and data sharing protocol. IV. Confidentiality Protection The local PPB and participating schools must be in agreement that HKCS data can be used in the planning process. To protect the identity of individual respondents, a number of safeguards are put in place. These are as follows: a. PPBs/Coalitions and schools will not have access to raw data. b. Data will be presented in the aggregate with summaries of items and scales. c. Data will be disaggregated by gender and grade (giving the presence of certain conditions (see d.). No other sub-groups will be provided (i.e., by ethnic group). d. No data for gender or grade will be provided for any sub-group smaller than 30 students. e. Either participating schools or the Coalition/PPB can specifically ask that no sub- group comparisons are provided in the report. 14 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments f. Schools with fewer than 30 students will not be presented singly (i.e., schools will be aggregated with other schools in the district, and no individual school data will be available for these schools). g. OMNI will not release school or community-identified data to the general public for any purposes. There must be written agreement between the school(s) and Coalition/PPB in order for data to be used for any other than the purposes detailed in this document. (See Attachment 4, Data Release Form for Other Community Needs, on page 29.) V. CPP Project Staff and Participating School District Representatives Contact Information [Project Coordinator name and contact information] [Local Evaluation Liaison name and contact information] [School representative names and contact information] VI. Period of Agreement September 30, 2008 —September 29, 2009, to be renewed annually if a change in superintendent occurs. VII. Acceptance and approval of authorizing officials The following signatures verify that the schools and community groups have discussed data dissemination, agreed to the above-mentioned administration procedures and confidentiality protections, and clarified at what level data release permissions have been granted. All Community Level Reports will be sent to the CPP Coordinator to be shared with the Coalition. School and District Level Reports will be sent to individuals identified on the Reporting Request Form (Attachment 1). [If superintendents and/or principals are releasing the district and/or individual school level reports to the CPP Coalition for planning purposes (with the same confidentiality agreements, as specified in Attachment 3), this should be indicated here. In addition, they will be asked to sign the Reporting Request Form (Attachment B)]. School Superintendent Date [Name,Position of School District Official] Date [Name, Position of School District Official] Date [Name, Position of School Official(if applicable)] Date CPP Project Coordinator Date 15 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments MOA Attachment B: Reporting Request Form 2008-2009 CPP HKCS Survey Year In addition to the CPP Community Healthy Kids Colorado Reports, OMNI also will create district and school level reports upon request. District Level Reports A district level report will provide survey results for all of the high schools and middle schools that participated in the Healthy Kids Colorado Survey for a given district. This report will be submitted to the superintendent of the district. If signatures are provided and it is specified in the MOA, a copy of this report also can be provided to the CPP Project Coordinator. School Level Reports A school level report will present the data for an individual middle or high school that participated in the survey. The final school report will be submitted to the school principal. If signatures are provided and it is specified in the MOA, a copy of this report also can be provided to the CPP Project Coordinator. In both cases, district level and school level data cannot be released to the public without a written release from school partners. Please complete the information below and return to your OMNI evaluation contact. Thank you! County Name: CPP Coordinator: Date Submitted: The following district level HKCS Reports are requested: School District Name Superintendent Phone Email Signature Name Number Address (indicates agreement to release a copy to the CPP Project Coordinator)' Note: A signature of the superintendent named must be provided in the signature section of the MOA. 16 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments The following school level HKCS Reports are requested: School Name Principal Name Phone Email Signature Number Address (indicates agreement to release a copy to the CPP Project Coordinator)* Note: A signature of the school principal named must be provided in the signature section of the MOA. 17 Attachments - Colorado Prevention Partners Continuation Application for Funds (AFF) 2008-2009 MOA Attachment C: Agreement and Work Plan Details Example CPP Project will: • Notify school officials of Coalition/PPB meeting times, locations and related information on a regular basis. • CPP Project Coordinator will serve as a liaison between community and school stakeholders. • CPP Local Evaluation Liaison will work with OMNI to obtain survey supplies and to provide information about the school sample and survey administration timeline. • Work with appointed school officials to coordinate the HKCS administration including mailing out passive/active consents to families, meeting with school personnel to review administration procedures, and ensuring that completed surveys are boxed, inventoried and returned to OMNI in a timely manner. • Pay for costs associated with the administration of HKCS. • The Coalition/PPB review school/school district data for needs assessment, planning and evaluation purposes. • Obtain technical support on interpreting school data from OMNI evaluation team contact. • Obtain technical support on using school data for planning purposes from OMNI Regional Prevention Consultant (RPC). Appointed School District Officials will: • Appoint school official(s) to participate in Coalition/PPB meetings, strategic planning activities and project advisory/oversight responsibilities. • School officials represent school perspective, serve as a resource on school issues and serve as a liaison between the CPP project and others involved in the school system. • Work with the CPP Local Evaluation Liaison to provide needed information. • Work with CPP Project Coordinator and Local Evaluation Liaison to provide information and support needed to coordinate the HKCS administration each fall in grades 6-11 of participating schools. Help prepare teachers for survey administration. • Dedicate approximately 1-hour classroom period to administer the HKCS. • As members of the Coalition/PPB, participate in reviewing school/school district data for needs assessment, planning and evaluation purposes. • Participate in Coalition/PPB meetings to discuss school survey results. • Participate in Coalition/PPB meetings that use school and other sources of data to develop Community Strategic Prevention Plan. 18 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments MOA Attachment D: Healthy Kids Colorado Survey (HKCS) Administration and Data Sharing Protocol I. Administration Protocol and Agreements 1. Surveys will be administered to participating high schools and feeder middle schools in the fall semester of each year, beginning fall 2007. 2. Surveys will be administered to students in grades 6-11 in participating school district(s), during one classroom period of approximately one hour. 3. OMNI Institute must be consulted on the development and implementation of any student level or school level sampling procedures. Sampling strategies that do not meet OMNI's guidelines will make HKCS participation null and void for the school entities where the non- scientific sampling strategies were employed. (Refer to sampling procedures in CPP General Guidelines, Evaluation Requirements, Section 4 last paragraph.) 4. School personnel and CPP project staff work together to implement HKCS administration guidelines, including the use, appropriate labeling and timely return of sealable envelopes for student answer sheets. II. Individual Protections and Agreements 1. Parental Consent: If there is a district policy regarding parental consent, schools follow district policy. If there is not a district policy regarding parental consent, schools may choose to utilize either an active or passive parental consent process for students being requested to participate in the HKCS. "Active Consent" means that a parent must explicitly state on paper that his or her child may participate. If no record of this consent is obtained, a student may not participate in the survey. "Passive Consent" means that a parent must explicitly state on paper that his or her child cannot participate in the survey, otherwise it is assumed that the student can. Note that active consent procedures are more time consuming and are more difficult to manage as they require schools to track parent consent forms for all possible students. 2. Student Participation: Despite a parent's acknowledgement that his or her child may participate in the HKCS (through either passive or active consent processes), a child is always instructed before the survey administration that he or she may voluntarily choose not to participate in the entire survey or may choose not to answer any items for which he or she feels uncomfortable. 3. Survey Completion: Upon completion of a classroom survey administration, teachers are instructed to have all students insert their completed scan form (student answer sheets) into a sealable envelope. Once all the scan forms are in the envelope, it is to be sealed and assembled with other classroom envelopes. No teacher or school administrator is allowed to examine an individual student's survey responses. Students are instructed not to write their names anywhere on the answer sheet. 19 • Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments 4. Survey Reporting: Raw data will not be released to school, community or state entities. Aggregate raw data, using school and individual identifying numbers, may be provided to the federal cross-site evaluators. III. Limited Use of Survey Data Agreements and Protections of School Survey Data 1. State Evaluation. As a recipient of federal SPF-SIG dollars, Colorado is required to participate in the SPF-SIG national evaluation and to collect National Outcome Measures. The HKCS is one part of this evaluation. OMNI Institute will analyze HKCS for this purpose. Confidentiality protection: While these data will be analyzed at the school, district, and/or community level, these analyses will use confidential and unique identifying identification numbers. No data for individual schools, districts, or communities will be released to the public. A final report may be issued from ADAD for the CPP project, but no HKCS data will be presented that specifically identifies participating schools or districts by name. 2. Local Planning. HKCS data is meant to be used to support planning and decision making at the local level. To do so requires that the local Coalition/PPB have access to the data for use in planning processes. An aggregated data report will be provided to agreed upon school entities and the CPP Project Coordinator simultaneously, unless an alternative agreement has been made between the Coalition/PPB and schools. The CPP Coalition/PPB is not permitted to use, distribute or advertise these data to any party or group outside of the Coalition/PPB structure unless there is written agreement between the Coalition/PPB and appropriate school officials. 3. Local Evaluation: Annual HKCS data also will be used for the PPB local evaluation effort. The data will be used to help the PPB reflect on any changes to targeted population groups, possible emerging trends, and to support changes to the local strategic plan. Confidentiality Protection: All conditions cited in Local Planning (above) apply for the Local Evaluation use of the data. 20 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments • MOA Attachment E: HKCS Data Release Form for Other ()MN I Community Needs COLORADO . >, HEALTHY KIDS COLORADO SURVEY (HKCS) DATA REPORT RELEASE OF INFORMATION I give the OMNI INSTITUTE permission to name of authorized school/district representative provide access to name of person requesting data,organization name 2008-09 HKCS school survey report. name of school or district I understand that information contained in this report will be used only to support community planning and decision-making. The person and organization requesting the data is not allowed to use, distribute, or advertise the information contained in the report(s) to any party or group outside of those named in this release without written agreement between the authorized school/district representative and the requester of the data report. There must be written agreement between the school(s) and the requester for data to be used for any other purposes than that detailed in this document. [See attachment 5 for an example of a written agreement.] Authorized School Representative Signature Date Authorized School Representative Printed Name and Title Date Name of Requester of Data,Organization Name Date 21 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments MOA Attachment F: Example of Data Sharing Letter April 12, 2008 To: Superintendent From: CPP Coordinator Re: Healthy Kids Colorado Survey Data Dear Superintendent, This letter is to confirm yesterday's conversation and outline our agreement regarding the release and sharing of data from the Healthy Kids Colorado Survey (HKCS). We have appreciated the opportunity to partner with the School District to conduct the HKCS this past year. Because the work of the is focused on the prevention of substance abuse and our goals and strategies are data-driven, the results from the HKCS will be invaluable to us in seeking funding. The CPP and the School District agreements for releasing and sharing HKCS data with potential funders are outlined as follows: 1- Aggregate data at the district level only will be shared; 2- The content of data shared will be limited to HKCS survey results on Substance Use (Section IV.,pp. 12- 46) and Risk and Protective Factors (Section IV., pp. 132-146); and 3- School specific HKCS reports will remain on file with the CPP Coordinator and the School District for reference purposes only. No school-level specific data will be released or shared. Our signatures below indicate acceptance of this agreement. CPP Coordinator Date Superintendent Date 22 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment VI LIST OF FREQUENTLY USED ACRONYMS ATOD Alcohol, Tobacco, & Substance abuse prevention focus. Other Drugs SPF-SIG Strategic Prevention The federal name for the federal grant that Colorado received to do a Framework- State multi-county funded process and apply a specific 5 step planning Incentive Grant process that it requires. CPP Colorado Prevention What Colorado calls the multi-county funded process and the Partners specific 5 step planning process that is required. PLC Prevention Leadership The name of the group that meets with all of the leaders of Council prevention efforts in the state. ADAD Alcohol Drug Abuse The name of the state agency in Colorado which receives the federal Division block grant dollars for substance abuse prevention and treatment. CDPHE Colorado Department The state agency for addressing public health and environment for of Public Health & all of Colorado. Environment CDE Colorado Department The state agency for addressing education in the state. of Education CDOT Colorado Department The state agency for addressing transportation in the state. of Transportation RPCs Regional Prevention The name of the statewide project which provides prevention Services(project) technical assistance and training and what the regional staff calls Regional Prevention themselves. Consultants PPB Prevention Policy What the required advisory boards are called which each CPP Boards funded community must have. ASPIRE Assessment Prevention Data assessment system to manage and report indicator and resource Indicators& Resources data. (Web-based system) CO KIT Colorado Knowledge- The web-based evaluation system which each CPP funded based Information community will use. Technology HKCS Healthy Kids Colorado The integrated school youth survey which each CPP funded Survey community will have their schools use. SEOW State Epidemiological State group assembled to look at data sets. Outcomes Workgroup SWCAPT CSAP's Southwest Center for the Provides technical assistance &training to the states in their Application of prevention work. They cover multiple states in the Southwest part Prevention of the country. Technologies CSAP Center Substance National agency that leads policy on substance abuse prevention. Abuse Prevention Their website is a good resource for lots of information.: http://prevention.samhsa.gov/ SAMHSA Substance Abuse & Mental Health Services Federal agency that is the parent organization of CSAP. Administration 23 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Attachment VII GLOSSARY *(Note: Changes from previous year are noted in italics) ASPIRE: (Assessment Prevention Indicators and Resources) ASPIRE is a web- based data system designed to store and manage indicator and resource data that can be queried to meet the user's needs. ASPIRE contains indicator data within numerous domains such as demographics, early childcare and education, community and civic involvement, mental health, and substance abuse and treatment. Capacity: The process by which a community develops the ability to build an effective and sustainable infrastructure. The community will have various types and levels of resources at its disposal to meet implementation demands. Community Level Web-based community level instrument for the national cross-site Instrument (CLI): evaluation Community Coalition: CPP communities are required to have a community-based coalition that will work in conjunction with or include policy makers as members that serve as a Prevention Policy Board (PPB) to plan, manage, and implement the CPP project. Because many of Colorado's communities already have one or more functioning coalitions, CPP communities have been encouraged to build on these existing groups as considered appropriate, particularly if the community has a coalition funded by a federal Drug Free Community Grant. CPP communities are expected to have developed their coalitions and to have obtained participation agreements (e.g., Memoranda of Understanding, letters of support, declaration of support). Updates are to be submitted with the Continuation Application Packet. However, the process of building a coalition is ongoing and will continue throughout the CPP project. Coalitions are defined as organized groups with multiple partners that have in place a process that includes a needs assessment; vision, mission, and goals; an action plan; and benchmarks for specific outcomes addressing reductions in alcohol, tobacco, or other drug use or related problems. Coalitions need not be separate legal entities or have non-profit status. Community Prevention Policy Board (PPB): CPP communities are required to continue efforts to engage key decision- makers from across disciplines to comprise a Prevention Policy Board that will work in conjunction with, or be part of, a Community Coalition to plan, mobilize and implement the project. Key decision-makers are 24 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments defined as those individuals that hold policy-level positions in the county (e.g., school district superintendents, sheriffs, county commissioners, city officials and other governmental representatives, school board presidents, etc.) and that have the authority to institute changes in the local infrastructure. CPP communities are expected to have progressed considerably in the development of their PPBs and to have obtained participation agreements (e.g., Memoranda of Understanding, letters of support, declaration of support). Updates are to be submitted with the Continuation Application Packet. However, the process of building a PPB is ongoing and will continue throughout the CPP project. Contract Signer: The individual in the Fiscal Agency that is authorized to obligate the agency. Cultural Responsiveness: An inclusive approach of inquiry and action to foster effective programs, policies, and practices that is respectful of cultural conditions within communities. Evaluation: The systematic collection of information about community needs, prevention strategies and program activities, participant characteristics and outcomes. Evidence Based: To include those interventions that fall within one of the following three categories: • Included on a Federal List or Registries of evidence-based interventions; • Reported with positive effects in peer reviewed journals; or • Documented effectiveness based on guidelines for evidence: An outside evaluator has written a comprehensive evaluation report which includes: 1) A pre-post quantitative design using statistical analyses; and 2) A thorough literature review of the theoretical basis behind the approach; and 3) A comparison group (which could be comparable data such as national or state-level data); and 4) Positive findings. 25 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Fiscal Agent: Person or persons responsible for financial matters; the agent must be a representative of a Unit of Local Government. Formative Evaluative activities undertaken during the design and pretesting of Evaluation: programs to guide the design process. Goal: Clearly stated, specific, measurable outcome(s) or change that can be reasonably expected at the conclusion of a methodically selected program. Key Informant: A community representative identified to participate in an evaluation or community readiness interview. Memorandum of Official and formalized contractual agreement with schools for their Agreement (MOA): participation and administration of the FMCS. (See Appendix F). Memorandum of Understanding (MOU): Participation agreements from community members involved with coalitions and/or PPB's to formalize relationships supporting the community initiative. The MOU may be a collectively signed document or individual letters of agreement. Needs Assessment: This is a type of evaluation that involves the systematic assessment of various targeted populations and prevention resources within the community and studies of current indicators to identify unique vulnerabilities and strengths that affect substance abuse in communities. Outcomes: The extent of change in targeted attitudes, values, behaviors or conditions between baseline measurement and subsequent points of measurement. Changes may be identified as immediate, intermediate, and long term. Prevention Infrastructure: The policies, networks, coalitions, resources, professional staff and skills, programs and delivery system that serve as a foundation for prevention work within a community. Stakeholder: An individual or an organization that has a vested interest and investment in a project or program (e.g., funder, program champion, community leader, etc.). Strategic Plan: A plan developed and used to guide the successful implementation of prevention programs, practices and policies. The strategic plan defines specific objectives and actions to be taken, in order to accomplish the proposed goals. 26 Colorado Prevention Partners AFF Continuation Application 2008-2009 - Attachments Supplanting: According to OMB A-133, a compliance supplement used by auditors to determine federal grantee compliance with federal laws and regulations, federal funds should be used so as to supplement the level of Federal, State and local public funds that, in absence of such availability, would have been expended for programs and in no case to supplant such Federal, State and local public funds. The "supplement, not supplant" provision means that federal funds must be used only to provide additional services, staff, programs, or materials that could not be provided by the state of local agency in the absence of the federal funds. In other words, federal funds cannot be used to pay for things that would otherwise be paid for with state and/or local funds. 27 Hello