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HomeMy WebLinkAbout20042634 RESOLUTION RE: APPROVE APPLICATION FOR RENEWAL FOR THE COLORADO ABSTINENCE EDUCATION PROGRAM COMMUNITY IMPLEMENTATION GRANT AND AUTHORIZE CHAIR TO SIGN WHEREAS,the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS,the Board has been presented with an Application for Renewal for the Colorado Abstinence Education Program Community Implementation Grant between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment,commencing January 1,2005,and ending December 31,2005, with further terms and conditions being as stated in said application, and WHEREAS,after review,the Board deems it advisable to approve said application, 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 Application for Renewal for the Colorado Abstinence Education Program Community Implementation Grant between the County of Weld,State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment,and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was,on motion duly made and seconded, adopted by t owing vote on the 1st day of September, A.D., 2004. IS . 6% BOARD OF COUNTY COMMISSIONERS ' atf '�.�� 4 , / W�l D COUNTY, C ORADO ' 1861 .�� �+* `r Robert D. Masden, Chair ne lerk to the Board 'rr William H. rke, Pro-Tem BY: ♦ .�_._�._ . Deputy Clerk to the Board -C-44- M. J. eile APP D AS TO . EXCUSED David E. Long ounty Attorn€y EXCUSED �,� � Glenn Vaad Date of signature: ��`.`'` �Zi 2004-2634 H L0031 ('( I / ItX - „) O9-77-&c% 6 resDEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 17TH AVE GREELEY, CO 80631631 WEBSITE: www.co.weld.co.us ADMINISTRATION (970) 304-6410 FAX (970) 304-6412 VI O PUBLIC HEALTH EDUCATION AND NURSING (970) 304-6420 FAX (970) 304-6416 ENVIRONMENTAL HEALTH SERVICES (970) 304-6415 COLORADO FAX (970) 304-6411 Memorandum TO: Robert D. Masden, Chairman, Board of County Commissioners From: Mark E. Wallace, MD, MPH, Executive Director S /t�''` w,- Date: August 30, 2004 / Subject: Colorado Abstinence Education Program Community Implementation Grant Enclosed for Board review and approval is the application for renewal for the Colorado Abstinence Education Program Community Implementation Grant. If funded, the time period for this renewal between the Weld County Department of Public Health and Environment and the Colorado Department of Public Health and Environment will be January 1, 2005 through December 31, 2005. The total amount of this request for federal Title V funding is $65,000. The Weld County Department of Public Health and Environment will use this funding to reduce teen sexual activity and the subsequent consequences of premarital sex in Weld County; to increase parental involvement and communication between parents and their children about the benefits of delaying sexual activity until marriage and to increase the prevalence of community based, medically accurate, age appropriate sexual abstinence messages in Weld County. I recommend your approval. Enclosure 2004-2634 6 DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 WEBSITE: www.co.weld.co.us l(it iD ADMINISTRATION: (970) 304-6410 FAX: (970) 304-6412 C PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420 O FAX: (970) 304-6416 ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 COLORADO FAX: (970) 304-6411 Granting Agency: Colorado Department of Public Health and Environment Applicant's Name: Weld County Department of Public Health and Environment Applicant's Address: 1555 N. 17th Avenue Greeley, CO 80631 Applicant's Phone: (970) 304-6420, ext. 2388 Applicant's Fax: (970) 304-6416 Project Title: Colorado Abstinence Education Program Community Implementation Grant Contact Person: Griselda Still, Abstinence Education Coordinator Amount Requested: $65,000 for one year Time Period of Request: January 1, 2005 —December 31, 2005 Weld County Department of Public Weld County Board of Commissioners Health and�jEnvv roonnmmeennt % ‘, IMark E. Wallace, MD, MP , ••,,i• '- 4 Q obert D. Masden', Ch [r U 1 2004 01 fr t 1 i ee. al /� /��!/t/ � � ietch r. t�eld County Clerk to the Board BY e uty Cle to the Board 9C a —OH COLORADO ABSTINENCE EDUCATION PROGRAM COMMUNITY IMPLEMENTATION GRANTS CONTRACT RENEWAL January 1 —December 31,2005 DEADLINE: September 10, 2004 Please submit one signed original and two copies of your renewal application to: Carla Beeson,A4 Colorado Department of Public Health and Environment 4300 Cherry Creek Drive Denver, CO 80014 Applications CANNOT be submitted via e-mail or fax. Organization Name: Weld County Department of Public Health and Environment Tax ID#: 84 6000 813 Website: www.co.weld.co.us Mailing Address: 1555 North 171°Avenue City: Greeley State: Colorado Zip: 80631 Legal Address: (if different from above) City: State: Zip: Program Contact Name: Griselda Archuletta-Still,Abstinence Education Coordinator Telephone#: (970)304-6420 ext.2388 Fax#: (970)304-6416 e-mail address: gstill@co.weld.co.us Fiscal Contact Name(if different from above): Judy Nero Telephone#: (970)304-6410 ext.2122 Fax#: (970)304-6412 e-mail address: inero@co.weld.co.us Please provide the name and title of the individual(s)with contractual signing authority for the organization. Name: Mark E. Wallace,MD,MPH Title: Executive Director Name: Robert D. Masden, Chair Title: Board of County Commissioners I. Budget overview: Programs may request an amount equal to or less than the amount awarded in 2004. Please complete the following budget table: A. Amount Requested from CDPHE $65,000.00 B. Matching Funds(must be at least 75%of requested $97,520.41 funds above) C. Total Project Budget(A+B) $162,520.41 Colorado Abstinence Education Program Grant Renewal Applications Page 2 of 20 2. Please complete the following table: Number of paid staff dedicated to project(in FTE ... count part-time as .5 FTE) 1.75 FTE Number of clients to be served by project. 3,500 Anticipated hours of contact per client 13 3. Program Goal(s)and Objective(s): Please provide the goals and objectives for the year two implementation of your Title V Abstinence Education Grant. These may be revised from year one,or new goals and/or objectives. Additional pages may be attached, if necessary. a. Program Goals i. To reduce teenage sexual activity and the subsequent consequences of premarital sex in Weld County. ii. To increase parental involvement and communication between parents and their children in regards to the benefits of waiting until marriage to engage in sexual activity. iii. To increase the prevalence of community-based,medically accurate, age-appropriate sexual abstinence messages in Weld County communities. b. Process Objectives i. By December 31,2005,provide at least 100 presentations to teenagers, in Weld County,to promote abstinence until marriage as a healthy,realistic goal. ii. By December 31,2005,host at least six(6)activities for teenagers during Weld County's Abstinence Awareness Week and promote participation in the state-wide Abstinence Awareness Campaign. iii. By December 31,2005,facilitate sexual cessation counseling to teenagers who participate in the STD and/or Family Planning Clinics at the WCDPHE. iv. By December 31,2005,provide at least five(5)abstinence education workshops for parents in Weld County. v. By December 31,2005, implement at least one(1)boundary building workshop for parents during Weld County's Abstinence Awareness Week. vi. By December 31,2005,host at least four(4)parent presentations during Talk to Your Kids about Sex Month in Weld County. vii. By December 31,2005,assist at least three(3)community organizations in implementing a Quincefiera Rite of Passage Mentoring Program. viii. By December 31,2005,at least ten(10)youth serving organizations will promote the abstinence message in Weld County. ix. By December 31,2005,provide a social norming media campaign to educate Weld County residents about the abstinence message. c. Impact Objectives i. By December 31,2005,at least 75%of Weld County school districts will be exposing their students to the A-H compliant curriculum,WAIT Training and/or The Art of Loving Well. ii. By December 31,2005,at least 50%of adolescents,who attend at least three(3)consecutive sexual cessation support group sessions,will commit to maintain their virginity or will commit to renewed abstinence. Hi. By December 31,2005,increase the understanding of abstinence from risky sexual behaviors as the only 100%effective method for preventing STDs. 4. Briefly describe the target population(s). Weld County,the third largest county in Colorado, is located in the Northeastern part of the state. It covers 3,999 square- miles and in the year 2003 inhabited an estimated population of 207,120. a. Our primary target population is the teenagers in the 12-18 year old age group in Weld County. The population projection for this age group,for 2005, is 23,492. There are 12 school districts with 14 high schools and 16 middle schools,hosting 70.5%white and 27%Hispanic youth, of which many are high risk. b. Our secondary target population groups would be the following: parents,teachers,youth pastors,healthcare professionals and other community youth program leaders. Although these are secondary target groups,the main intention for making them aware of the problem of teenage sexual involvement and the importance of abstinence and relationship education is for the benefit of our primary target population. Colorado Abstinence Education Program Grant Renewal Applications Page 3 of 20 5. Briefly describe the program's services. IF the program has changed curricula,format or major elements for implementation in Year Two, please provide details.(Additional pages may be used to provide supplemental information) a. For implementation in year two,our program curricula,format and major elements will remain basically the same. i. We will continue our outreach to the schools throughout Weld County with the WAIT Training and The Art of Loving Well A-H compliant curricula. ii. We will continue implementing the Quinceafiera community based educational program to promote abstinence to Hispanic adolescent females and their families. iii. We will continue with the parent education presentations and workshops to provide parents with skills to communicate to their children and receive up-to-date sexuality information. iv. We will continue to host events for teenagers and parents during Abstinence Awareness Week and Talk to Your Kid about Sex Month. v. We will continue to host trainings for teachers,youth pastors,healthcare professionals and other Weld County community members who interact with the teenagers of Weld County. b. For implementation in year two,our program will expand in the following areas. i. The program plans to hire a.25 FTE sexual cessation nurse to ensure counseling services to teenagers in Weld County. ii. The sexual cessation nurse will form and facilitate sexual cessation support groups at WCDPHE. iii. The program will concentrate on presenting more STD education for teenagers and parents in Weld County. iv. The program staff will focus on expanding the abstinence message to other youth serving organizations within the community(i.e.: City of Greeley and/or City of Evans youth programs, Boys and Girls Clubs, After-School Programs,Girl Scouts, Boy Scouts, Churches). v. The program staff will develop a positive media campaign to saturate Weld County. 6. Briefly describe how the program will monitor and evaluate its impact and process objectives. The Weld County Department of Public Health and Environment will consult with Cindy Kronauge of Prime Solutions, Ft. Collins,CO, as the Abstinence Education Program's evaluator. Abstinence staff will assist the program evaluator in data collection and management activities. All evaluation information collected will be anonymous. There is currently a pre/post questionnaire used in Weld County to assess the success of the curriculum in schools. Additionally,there will be a scanable form in both English and Spanish to evaluate the Quinceafiera program. A post-training survey is used in WAIT Training teacher trainings. Students are also asked to fill out a survey after the presentations that we present in the classroom or other youth organizations. We will create and distribute a survey to the support group members in order to determine the success of this new piece that we will be implementing. Parents will also fill out a questionnaire after presentations. All of the monitoring and evaluation documents will be kept in a binder at WCDPHE. Anonymous client data will be tabulated and stored electronically by the abstinence staff and evaluator. The evaluator will prepare a year- end summary report of all the evaluation information. 7. Will there be any changes in program staffing? If so,please provide details. 0 Yes ❑ No We plan on hiring a sexual cessation counselor who can work with the nurses at WCDPHE and counsel sexually active teenagers toward renewed virginity. It is our intention to hire a registered nurse who can counsel and work with the Weld County Abstinence Program for 10 hours per week. The .25 FTE position will include, but not be limited to, the following: counseling teens,encouraging the increase of the use of sexual cessation counseling among nurses at the WCDPHE,promoting the use of sexual cessation counseling in other medical practices in Weld County,and providing STD presentations to youth programs throughout Weld County. Colorado Abstinence Education Program Grant Renewal Applications Page 4 of 20 8. Provide a one or two-page budget narrative explaining the attached budget. Provide details regarding how costs were calculated and justification for any personnel identified within the budget. a. Line item budget: Please see Appendix A b. Budget justification: TOTAL Project Cost=$162,520.41 Direct Costs=$154,343.41 i. Personal Services and Fringe Benefits—$99530.79 Currently,there are three positions,a.75 FTE,a.50 FTE and a.25 FTE employed with the Abstinence Education Program. There is an additional .05 supervisor and .05 administrative assistant that spend time on abstinence education projects. The funding for personnel including fringe benefits and$2,500 for contractual services for the evaluator is provided as matching from the WCDPHE. Our projected goal for 2005 is to hire a .25 FTE nurse who will work in the clinical area of the WCDPHE and use the medical model of sexual cessation to counsel sexually active clients. $85820.41 provided by Weld County Board of County Commissioners(matching). $13710.38 requested from CDPHE for.25 FTE sexual cessation nurse. ii. Quinceafiera Rite of Passage Mentoring Program—$8855 Assisting at least three community partners in implementing a Quinceflera program targeted to 60 Hispanic females ages 11-15 and their families. Three new and revised leader's guides @$185 X 3. 60 Quinceafflera handbooks and 60 parent handbooks that provide abstinence education and relationship building information that are targeted to the Quinceafleras and their parents @$20 X 120. Meeting expenses($1,000)will help assist community organizations with the cost of the logistical expenses that are involved with implementation of meetings. Class materials and incentives will help provide handouts and other abstinence items that the girls can take home as a remembrance of the education that was received($1,000). The tiaras($15 X 60=$900),the DJ/sound($700),and the decorations($300)will be used for the graduation ceremonies that will be held at the completion of each Quinceflera program. Promotional materials/recruitment materials($1000)will be used to collaborate with Friends First in implementing a special Quinceflera event. Funds requested from CDPHE. iii. WAIT Training—$11550 Host one-2-day WAIT Training teacher training for at least 30 participants. Trainer fee/expenses for the two day training costs$2500. Curricula for 30 Weld County middle/high school teachers, counselors and nurses @$295 each costs$8850. Conference continental breakfast and snacks for two days for the 30 participants costs$200. Funds requested from CDPHE. iv. WAIT Training Technical Support—$4000 Provide 10 Weld County middle/high school teachers,counselors,nurses and other community youth leaders a scholarship to attend a WAIT Training teacher training that is being hosted by another organization costs$295 each @ 10 is$2950. To supply 10 Weld County teachers who have been trained in WAIT Training,but do not have the upgraded,revised,user-friendly curricula costs$75 per curricula X 10 is$750. To host 3 teacher in-service luncheons with 10 participants at each luncheon would be a total of 30 teachers @$10 per teacher for lunch costs$300. Funds provided by WCDPHE (matching). v. Art of Loving Well Teacher Training Scholarships—$2500 To supply 20 Weld County middle/high school teachers,counselors,nurses and other community youth leaders a scholarship to attend an Art of Loving Well teacher training that is being hosted by another organization costs$125 each @ 20 is$2500. Funds provided by WCDPHE(matching). vi. Sexual Cessation Support Groups—$1000 Promotion and incentives($500)for the support groups include the cost to create reminder cards and provide some transportation vouchers for those who may have conflicts with transportation. To host an average of bi-monthly meetings,25 meetings @$20 per meeting,for snacks,cost$500. Funds requested from CDPHE. vii. Abstinence Awareness Week Events—$3300 Motivational, out-of-state speaker for Latina/Latino Youth Leadership Conference @$1800 for speaker fee/expenses plus$500 for incentives(100 CDs @$5 each)for the participants. In-state speaker fee/expenses for middle and/or high school assemblies for the five days of Abstinence Awareness Week @$200 X 5 costs$1000. Funds requested from CDPHE. Colorado Abstinence Education Program Grant Renewal Applications Page 5 of 20 viii. Parent Education Workshops—$1500 Ten trainer fees @$100/workshop costs$1000. Food per workshop costs$50 X 10 workshops is $500. Four(4)of the ten(10)parent workshops will be implemented during Talk to Your Kid about Sex Month. One(1)of the parent workshops will be implemented during Abstinence Awareness Week. The last five(5)parent workshops will be strategically implemented throughout the year. Funds requested from CDPHE. ix. Community Empowerment—$3500 To create a variety of different community wide abstinence activities,we plan to collaborate with different community groups and provide at least two(2)community events that focus around the abstinence message(i.e. Mother-Daughter Modesty Day, Purity Ball). We will contribute to the events the following amount of money: 2 community events of$1000 each is a total of$2000. To supply 50 youth from 5 different organizations(10 per organization)scholarships to the Pure by Choice Rally is 10 X 5 =50 X$10 for a cost of$500. In order to promote what is taking place in Weld County on a state-level and provide resources to teenagers who attend the Pure by Choice Conference,$500 is for a booth rental. To provide at least 20 volunteers that donate their time and energy to help spread the abstinence message through Weld County a$25 gift certificate of appreciation would be a total of$500 (20 X$25). Funds requested from CDPHE. x. Weld County Media Campaign—$8780.62 $9000 will supply us with the power to implement a vast media campaign throughout Weld County for the entire year. We will develop an updated website(estimated$1200)and a quarterly newsletter that will be useful for our program partners and other community members. We plan to display the abstinence message through a variety of different sources such as billboards(estimated$3000),theatre slides(estimated$3000),newspapers(estimated$400),posters in several different youth organizations ($180.62), and possibly the local radio/T.V. stations($1000). Funds requested from CDPHE. xi. Abstinence Education Incentives/Promotional Items—$1925 To supply the teenagers of Weld County with educational incentives and promotional items that will have the abstinence message engraved on the item in order to keep the abstinence message engraved in their minds and hearts! We plan to have items to leave with the students after our presentations and also give teachers incentives to give out to the students during their WAIT Training and Art of Loving Well lessons. Examples: brochures, stickers,temporary tattoos,water bottles,pens/pencils, highlighters,mints, suckers and bookmarks. Funds requested from CDPHE. xii. Miscellaneous—$4200 Office supplies$500, operating supplies$500,postage$500,copying/printing$500,subscriptions(i.e. Journal of Adolescent Health, Seventeen,Cosmo Teen)$300,phones$400 and meeting expenses $1500. Funds provided by WCDPHE(matching). xiii. Travel—$3702 1. Medical Institute for Sexual Health Conference—$2000 Registration fee,airfare,hotel&food for.25 FTE nurse to attend the conference costs$2000. Funds requested from CDPHE. 2. Colorado State Abstinence Education Bi-Annual Meetings—$213 Mileage and per diem for WCDPHE staff to attend 2 meetings in Denver area costs$213. Funds requested from CDPHE. 3. Colorado Coalition of Abstinence&Relationship Educators Meetings—$489 Mileage for WCDPHE staff to attend 9 meetings in Denver area costs$489. Funds requested form CDPHE 4. Local Travel—$1000 Funds provided by WCDPHE(matching). xiv. Administrative/Indirect Cost—$8177 I. Indirect Approved County Rate @ 14.39%costs$8,177.00 TOTAL FUNDS REQUESTED FROM CDPHE=$65,000.00 6 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To reduce teenage sexual activity and the subsequent consequences of premarital sex in Weld County. Objective(s): By December 31, 2005, provide at least 100 presentations to teenagers, in Weld County, to promote abstinence until marriage as a healthy, realistic goal. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Contact and distribute information December 31, Abstinence Staff # of flyers, advertisements Complete distribution of services about the services we provide 2005 and contacts available through the abstinence through the Weld County program Abstinence Education Program to youth serving organizations in Weld County, especially schools in the county. Implement 100 presentations. December 31, Abstinence Staff Unduplicated client counts Post evaluations of the 2005 presentations 7 NOTE: PLEASE COPY THIS FORM (OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To reduce teenage sexual activity and the subsequent consequences of premarital sex in Weld County. Objective(s): By December 31, 2005, host at least six (6) activities for teenagers during Weld County's Abstinence Awareness Week and promote participation in the state-wide Abstinence Awareness Campaign. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Plan and advertise at least six (6) April 30, 2005 Abstinence Staff # of flyers, advertisements, Planning meeting minutes and activities for youth during contacts and planning completion of organization and Abstinence Awareness Week in meeting agendas advertisement of events Weld County. Host on empowering Latino April 30, 2005 Abstinence Staff Speaker contract, Post survey of youth attending abstinence speaker for the Latino unduplicated client count the event Youth Conference that is held in and conference attendance Greeley, Colorado. sheet Host five (5) abstinence April 30, 2005 Abstinence Staff Speaker contract, Post survey of youth attending presentations within schools,youth unduplicated client counts the presentations groups, and/or other youth serving and conference attendance community organizations sheets throughout Weld County during Abstinence Awareness Week. 8 NOTE: PLEASE COPY THIS FORM (OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To reduce teenage sexual activity and the subsequent consequences of premarital sex in Weld County. Objective(s): By December 31, 2005, facilitate sexual cessation counseling to teenagers who participate in the STD and/or Family Planning Clinics at the WCDPHE. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Hire a .25 FTE nurse to implement January 31, Abstinence Posted employment ad and Completion of hire sexual cessation counseling. 2005 Supervisor and interviews Staff Develop a centralized location for January 31, Abstinence Discussion and planning Completion of the workstation the nurse to work from that is easily 2005 Supervisor and with the department head accessible to the clinic area. Staff Develop and disseminate February 28, Abstinence Staff Copies of brochures and Tracking sheets of individuals informational brochures to the 2005 and Sexual distribution list receiving counseling nurses of WCDPHE that includes Cessation Nurse information about sexual cessation counseling and the new services that will be provided through the Abstinence Program and the sexual cessation counseling nurse. Encourage nurses at WCDPHE to December 31, Sexual Cessation # of contacts Tracking sheets of individuals refer their clients to the sexual 2005 Nurse receiving counseling and who cessation nurse for individual referred them counseling. 9 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To reduce teenage sexual activity and the subsequent consequences of premarital sex in Weld County. Objective(s): By December 31, 2005, at least 75% of Weld County school districts will be exposing their students to the A-H compliant curriculum, WAIT Training and/or The Art of Loving Well. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Organize and advertise one (1) November 30, Abstinence Staff # of flyers, advertisements, Complete organization and WAIT Training teacher training 2005 and contacts implementation of one WAIT within Weld County. Training teacher training Host one (1) WAIT Training November 30, Abstinence Staff Evaluation of WAIT Post training survey completed teacher training for at least 30 2005 Training, sign-in sheets, by trained teachers interested classroom teachers, unduplicated client counts counselors, school nurses, youth pastors and healthcare professionals in Weld County. Organize and facilitate the December 31, Abstinence Staff Registration forms Complete of organization and attendance of ten(10) middle/high 2005 registration of the teachers school teachers, counselors, nurses, and other community youth leaders to attend a WAIT Training teacher training being hosted by another local organization. 10 Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Organize and facilitate the December 31, Abstinence Staff Registration forms Complete of organization and attendance of twenty(20) 2005 registration of the teachers middle/high school teachers, counselors, nurses, and other community youth leaders to attend an Art of Loving Well teacher training being hosted by another local organization. Organize and facilitate a variety of December 31, Abstinence Staff Number of technical Complete pre/post observation technical assistant discussions that 2005 assistance visits and and conference with trained will be attended by a grand total of unduplicated client counts teachers 50 teachers who are trained in WAIT Training and/or The Art of Loving Well. Encourage previously trained December 31, Abstinence Staff Contacts with the teachers, Results from teacher meetings teachers (Program Partners)to 2005 and Program unduplicated client counts and Pre/post Classroom surveys provide a minimum of 10 hours of Partners and student attendance curricula based abstinence records education sessions to the same set of participants. 11 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To reduce teenage sexual activity and the subsequent consequences of premarital sex in Weld County. Objective(s): By December 31, 2005, at least 50% of adolescents, who attend at least three (3) consecutive sexual cessation support group sessions, will commit to maintain their virginity or will commit to renewed abstinence. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Plan and organize support group February 28, Sexual Cessation # of contacts, logistical Completion of organization of meetings for sexually active youth 2005 Nurse and details of location and sexual cessation support groups to be held at WCDPHE. Abstinence Staff schedule of meetings Develop and disseminate reminder February 28, Sexual Cessation Copies of cards and Attendance sheets from support cards for health care providers to 2005 Nurse and distribution list group meetings distribute to teens who are receiving Abstinence Staff sexual cessation counseling to attend the support group. Host support group sessions at the December 31, Sexual Cessation Unduplicated client counts, Post survey of support group WCDPHE. 2005 Nurse and sign-in sheets and meeting Abstinence Staff agendas 12 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To reduce teenage sexual activity and the subsequent consequences of premarital sex in Weld County. Objective(s): By December 31, 2005, increase the understanding of abstinence from risky sexual behaviors as the only 100% effective method for preventing STDs. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Provide STD presentations for December 31, Sexual Cessation Unduplicated client counts Post evaluations of the schools and other youth serving 2005 Nurse and presentations organizations in Weld County. Abstinence Staff Plan and advertise quarterly (at least December 31, Sexual Cessation # of flyers, advertisements Complete organization and 3) STD trainings for school staff 2005 Nurse and and contacts advertising of the trainings and other interested organizations. Abstinence Staff Host quarterly(at least 3) STD December 31, Sexual Cessation Unduplicated client counts Post evaluations of the trainings trainings for school staff and other 2005 Nurse and and registration forms organizations that are interested in Abstinence Staff the basics of STDs for educational purposes. Encourage STD testing to those December 31, Sexual Cessation Post evaluation after # of teenagers in Weld County who are, or have been, sexually 2005 Nurse and presentations (intend to getting tested active. Abstinence Staff receive an STD test) Promote and distribute educational December 31, Sexual Cessation Distribution list # of educational resources resources during presentations and 2005 Nurse and distributed upon request. Abstinence Staff 13 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To increase parental involvement and communication between parents and their children in regards to the benefits of waiting until marriage to engage in sexual activity. Objective(s): By December 31, 2005, provide at least five (5) abstinence education workshops for parents in Weld County. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Plan and advertise at least five (5) December 31, Abstinence Staff # of flyers, advertisements Completion of organization and abstinence education workshops for 2005 and contacts advertisement of event parents. Host at least five (5) abstinence December 31, Abstinence Staff Unduplicated client counts Post workshop surveys education workshops for parents. 2005 and sign-in sheets 14 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31.2005 GOAL: To increase parental involvement and communication between parents and their children in regards to the benefits of waiting until marriage to engage in sexual activity. Objective(s): By December 31, 2005, host at least one (1)boundary building workshop for parents during Weld County's Abstinence Awareness Week. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Plan and advertise at least one (1) April 30, 2005 Abstinence Staff # of flyers, advertisements Completion of organization and boundary building workshop for and contacts advertisement of event parents during Abstinence Awareness Week in Weld County. Implement at least one (1)boundary April 30, 2005 Abstinence Staff Unduplicated client counts Post survey of parents attending building workshop for parents and sign-in sheets event during Abstinence Awareness Week in Weld County. 15 NOTE: PLEASE COPY THIS FORM (OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To increase parental involvement and communication between parents and their children in regards to the benefits of waiting until marriage to engage in sexual activity. Objective(s): By December 31, 2005, host at least four(4)parent presentations during Talk to Your Kids about Sex Month in Weld County. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Plan and advertise at least four(4) November 30, Abstinence Staff # of flyers, advertisements Completion of organization and presentations for parents and their 2005 and contacts, speaker advertising of events children during Talk to Your Kids contract about Sex Month in Weld County. Implement at least four(4) November 30, Abstinence Staff Unduplicated client counts Post surveys after the events presentations for parents and their 2005 children during Talk to Your Kids about Sex Month in Weld County. Encourage parents to host an November 30, Abstinence Staff Sign-up sheets Event and/or support completion Abstinence Awareness Event and/or 2005 support an Abstinence Awareness Event in their community. 16 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To increase the prevalence of community-based, medically accurate, age-appropriate sexual abstinence messages in Weld County communities. Objective(s): By December 31, 2005, assist at least three (3) community organizations in implementing a Quinceanera Rite of Passage Mentoring Program. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Train at least three (3) interested December 31, Bi-lingual Unduplicated client counts Complete organization and Weld County youth sewing 2004 Abstinence Program and sign-in sheets implementation of training and organizations, including faith-based Coordinator and training evaluations professionals, in the Quinceanera Abstinence Staff program who will collaborate with WCDPHE. Plan and organize three (3)parent December 31, Bi-lingual # of flyers, advertisements Completion of organization and recruitment/education sessions for 2005 Abstinence Program and contacts advertisement of sessions the Quinceanera Program to Coordinator and Hispanic parents of teens in Abstinence Staff Spanish. Implement three (3)parent December 31, Bi-lingual Unduplicated client counts # of Hispanic girls and families recruitment/education sessions for 2005 Abstinence Program and sign-in sheets enrolled in Quinceauera program the Quinceafiera Program to Coordinator and and post evaluations of parents Hispanic parents of teens in Abstinence Staff sessions Spanish. 17 Advertise and promote three (3) December 31, Bi-lingual # of flyers, advertisements Completion of organization and Quinceanera(Rites of Passage) 2005 Abstinence Program and contacts advertisement of programs Mentoring Programs that will be Coordinator offered through Weld County and Community community partners. Partners Facilitate three (3) Quinceanera December 31, Bi-lingual Unduplicated client counts Pre/post evaluations (Rites of Passage)Mentoring 2005 Abstinence Program and sign-in sheets Programs, in collaboration with Coordinator and Weld County community partners, Community which will be attended by Hispanic Partners adolescent females and their parents. 18 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment,Abstinence Education Program Year Two Grant Period: January 1 —December 31,2005 GOAL: To increase the prevalence of community-based, medically accurate, age-appropriate sexual abstinence messages in Weld County communities. Objective(s): By December 31, 2005, at least ten (10) youth serving organizations will promote the abstinence message in Weld County. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Contact and distribute information December 31, Abstinence Staff # of flyers, advertisements Complete distribution of services about the services we provide 2005 and contacts provided to youth programs through the Weld County Abstinence Education Program to youth serving organizations in Weld County. Host community education and December 31, Abstinence Staff Meeting attendance sheets Meeting agendas collaboration meetings with leaders 2005 and Community and agendas to collaborate on Abstinence Organizations Events. Implement abstinence events in December 31, Abstinence Staff Unduplicated client counts Post evaluations of presentation collaboration with youth serving 2005 and/or service provided organizations in Weld County. Continue to educate staff of youth December 31, Abstinence Staff # of flyers, advertisements Registration forms of those who serving organizations in Weld 2005 and contacts decided to attend the trainings County through abstinence education and trainings. 19 NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Weld County Department of Public Health and Environment Year Two Grant Period: January 1 —December 31,2005 GOAL: To increase the prevalence of community-based, medically accurate, age-appropriate sexual abstinence messages in Weld County communities. Objective(s): By December 31, 2005, provide a social norming media campaign to educate Weld County residents about the abstinence message. Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Develop and advertise a fun, December 31, Abstinence Staff # of flyers, advertisements Completion of the website and interactive, educational website that 2005 and contacts advertising and a"hit-counter" contains a vast amount of updated on the actual website information that contains components for teenagers, parents, teachers, youth pastors, and healthcare professionals. Develop website and media December 31, Abstinence Staff Copies of promotional items Completion of distribution and campaign promotional items to 2005 and distribution list "hit-counter" on website distribute throughout Weld County. Display billboard ads in Weld December 31, Abstinence Staff # of billboard ads and Completion of the running time County. 2005 contracts with companies for the billboard ads Advertise print ads in high school December 31, Abstinence Staff # of advertisements and list Completion of the running time newspapers in Weld County 2005 of school newspapers who for the newspaper ads throughout the school year. advertised for the WCDPHE 20 Place abstinence messages on December 31, Abstinence Staff Contract with theatre Completion of the showing of theatre slides during peak times 2005 the theatre slides and evaluations throughout the year. from movie participants Distribute a quarterly updating December 31, Abstinence Staff # of quarterly newsletters End-of-the-year evaluation of the newsletter to program partners and 2005 sent and a copy of the newsletter interested Weld County residents in mailing list order to maintain the county-wide effort of abstinence promotion. Order and make available, upon December 31, Abstinence Staff Inventory list and request Inventory year-end-count and request, a variety of brochures, 2005 forms completed request forms pamphlets,posters and other printed materials to Weld County residents. Dispense brochures, pamphlets and December 31, Abstinence Staff Distribution list Complete delivery of the printed posters to schools and other youth 2005 material organizations throughout Weld County. Appendix A Colorado Abstinence Education Program BUDGET REQUEST (Page 1) APPLICANT: Weld County Department of Public Health & Environment, Abstinence Education Prose. PROJECT: Comprehensive Model Abstinence Education Program Grant Source of Funds Detailed Budget Total Applicant Requested For the Period Amount and from 01/01/05 Annual Number Required Other CDPHE to Salary Months 12/31/05 Rate Budget %Time DIRECT COST Personal Services: $ $ $ .75 FTE Health Education Specialist 31,842.34 31,842.34 0 .50 FTE Health Education Specialist 18,344.58 18,344.58 0 .25 FTE Health Education Specialist 10,614.11 10,614.11 0 .25 FTE Community Health Nurse I 10,299.45 0 10,299.45 .05 Office Tech 1,326.70 1,326.70 0 Contractual/Fee-for-service: 2,500.00 2,500.00 0 Sub-Total $74,927.18 $64,627.73 $10,299.45 Supervising Personnel: .05 FTE Health Promotion Supervisor 2,690.70 2,690.70 0 Sub-Total $2,690.70 $2,690.70 $3410.93 Fringe Benefits: 31.97% $21,912.91 $18,501.98 $3410.93 Total Personal Services $99,530.79 $85,820.41 $13,710.38 Colorado Abstinence Education Program BUDGET REQUEST (Page 2) APPLICANT: Weld County Department of Public Health & Environment, Abstinence Education Prog. PROJECT: Comprehensive Model Abstinence Education Program Grant Source of Funds Requested Total Applicant From Amount and CDPHE Required Other DIRECT COST(Continued) Operating Expenses: $ $ $ Quinceanera Program 8855 8855 Program leader's guide @ $185 X 3 555 555 Quinceanera handbooks @ $20 X 60 1200 1200 Parent handbooks @ $20 X 60 1200 1200 Meeting expenses 1000 1000 Class materials/educational incentives 1000 1000 Tiaras 900 900 DJ &sound system 700 700 Media/advertising 1000 1000 Promotion materials/recruitment materials 1000 1000 Decorations 300 300 WAIT Training @ 30 participants 11550 11550 WAIT Training Curricula X 30 @ $295.00 8850 8850 Trainer fee X 2 days @ $1,250 2500 2500 Conference food X 2 days X 30 participants 200 200 WAIT Training Technical Support 4000 4000 10 WAIT Training scholarships @ $295 X 10 2950 2950 10 Upgraded/revised curriculum @ $75 X 10 750 750 3 Teacher in-service luncheons w/10 participants each @ $10 X 30 300 300 Art of Loving Well Teacher Training Scholarships 2500 2500 20 Scholarships @ $125 X 20 2500 2500 Sexual Cessation Support Groups 1000 1000 Promotion/incentives for Participants 500 500 Meeting Expenses & Food 500 500 2 Abstinence Awareness Week Events 3300 3300 Out-of-State speaker fee and expenses 1800 1800 Promotion/incentives for event 500 500 In-State speaker fee and expenses @ $200 X 5 1000 1000 10 Parent Education Workshops 1500 1500 Trainer fee @ $100/event X 10 1000 1000 Food @ $50/event X 10 500 500 Community Empowerment 3500 3500 Community Events 2000 2000 Pure by Choice Rally Scholarships 500 500 Pure by Choice Rally Booth 500 500 Volunteer incentives 500 500 Weld County Media Campaign 8780.62 8780.62 Abstinence Education Incentives/Promotional Items 1925 1925 Miscellaneous 4200 4200 Office Supplies 500 500 Operating Supplies 500 500 Postage 500 500 Copying/Printing 500 500 Subscriptions 300 300 Phones 400 400 Meeting Expenses 1500 1500 Sub-Total $51,330.00 $10,700.00 $40,530.00 Travel: Medical Institute for Sexual Health Conference 2000 2000 Registration Fee, Airfare, Hotel, Food X 1 2000 2000 Colorado State Abstinence Education Bi-annual Meetings 213 213 Mileage to Denver @.340/mile X 160 miles X 2 meetings ' 108 108 Per Diem for staff @ $35.00/day X 3 staff 105 105 CCARE Meetings 489 489 Mileage to Denver @ .340/mile X 160 miles X 9 meetings 489 489 Local Travel 1000 1000 Sub-Total $3702.00 $1000 $2702 Equipment: Sub-Total $0.00 $0.00 $0.00 TOTAL DIRECT COST $154,343.41 $97,520.41 $56,823.00 Colorado Abstinence Education Program BUDGET REQUEST (Page 4) APPLICANT: Weld County Department of Public Health & Environment,Abstinence Education Prop. PROJECT: Comprehensive Model Abstinence Education Program Grant Source of Funds Requested Total Applicant from Amount and CDPHE Required Other ADMINISTRATIVE/INDIRECT COST $ $ $ Indirect Approved County Rate 14.39% 8,177 8,177 Sub-Total $8,177 $ $8,177 TOTAL PROJECT COST $162,520.41 $97,520.41 $65,000.00 *Local County BOCC SOURCE OF FUNDING FOR THE MATCH, i.e. State, Local, in-kind, etc. Local: Board of County Commissioners (BOCC), County funding $ 97,520.41 In-kind: Other(Itemize): Total $97,520.41 May the non-Federal funds be used to match this grant? Yes X No Signature of Director or Authorized Representative: Dr. Mark E. Wallace,Director Weld County Department of Public Health&Environment APPLICATION BUDGET AND/OR EXPENDITURE REPORT FORM APPLICANT: Weld County Department of Public Health and Environment FOR THE PERIOD: 1/01/05 TO 12/31/05 I PROJECT:ABSTINENCE EDUCATION PROGRAM Annual No.of Total SOURCE OF FUNDS -- - - - - - - - - - Requested I Salary Months Amount Applicant&Other _ Received Rate Budget FTE Required Match from CDPHE PERSONAL SERVICES: .75 FTE Health Education Specialist $31,842.34 12 75% $31,842.34 $31,842.34 .50 FTE Health Education Specialist $18,344.58 12 50% $18,344.58 $18,344.58 _25 FTE Health Education Specialist $10,614.11 12 25% $10,614.11 $10,614.11 .25 FTE Community Health Nurse I $10,299.45 12 25% $10,299.45 $10,299.45 .05 FTE Office Tech _ - $1,326.70 12 5% $1,326.70 $1,326.70 .05 FTE Supervising Personnel _.. _ $2,690.70 12 5% $2,690.70 _ $2,690.70 ContractuaVFee for Service $2,500.00 $2,500.00 $2,500.00 Fringe Benefits: Rate=31.97% $21,912.91 $21,912.91 $18,501.98 $3,410.93 Total Personal Services $99,530.79 $85,820.41 $13,710.38 OPERATING EXPENSES(which are not part of indirect): Quinceanera Prowram $8,855.00 $0.00 $8,855.00 WAIT Training _ $11,550.00 $0.00 $11,550.00 WAIT Training Technical Support $4,000.00 $4,000.00 $0.00 Art of Loving Well Teacher Training Scholarships $2,500.00 $2,500.00 $0.00 Sexual Cessation Support Groups _ $1,000.00 $0.00 $1,000.00 Abstinence Awareness Week Events $3,300.00 $0.00 $3,300.00 Parent Education Workshops $1,500.00 $0.00 $1,500.00 Community Empowerment $3,500.00 _ $0.00 $3,500.00 Weld County Media Campaign _ $8,780.62 $0.00 $8,780.62 Abstinence Education Incentives/Promotional Items $1,925.00 $0.00 $1,925.00 Miscellaneous Operating Expenses $4,200.00 $4,200.00 $0.00 Total Operating $51,110.62 $10,700.00 $40,410.62 EQUIPMENT $0.00 $0.00 $0.00 Total Equipment $0.00 $0.00 $0.00 TRAVEL(In-state/Out-state)8.Meetings Medical Institute for Sexual Health Conference $2,000.00 $0.00 $2,000.00 Colorado State Abstinence Education Bi-Annual Meetings $213.00 $0.00 $213.00 Cola Coalition of Abstinence&Relationship Educators Meetings $489.00 $0.00 $489.00 Local Travel $1,000.00 $1,000.00 $0.00 Total Travel 3 702.00 1 000.00 2 702.00 ADMINISTRATIVE/INDIRECT COST At 14.39% i $8,177.00 $0.00 $8,177.00 Total AdmInistratIve/Indirect Costs $8 177.00 $0.00 177.00 ; r11rv'111tr' r .yvfwrq wnx>ry�s" rwrs,r�v"ra ':✓ ,..<.N p,:;d� rw».�. ." `...;; !iu.rs :. t;llu �Gr *Source of funding for"Other"(Match or In-kind) I .. Weld County Board of County Commissioners $97,520.41 , $ I $ $ TOTAL $97,520.41 May the NON FEDERAL funds be used as match? YES X NO I Signature of Authorized Representative Date Rev 8/30/2004 BUDGETAPPLFORM.XLS Hello