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HomeMy WebLinkAbout20040063.tiff RESOLUTION RE: APPROVE TASK ORDER FOR ABSTINENCE EDUCATION PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Task Order for Abstinence Education Program 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 26,2004,and ending December 31,2004,with further terms and conditions being as stated in said task order, and WHEREAS,after review,the Board deems it advisable to approve said task order, a copy of which is attached hereto and incorporated herein by reference. NOW,THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado,that the Task Order for Abstinence Education Program 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 task order. The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 7th day of January, A.D., 2004. BOARD OF COUNTY COMMISSIONERS �..` W D COU TY, CO RADO ATTEST: Weld County Clerk tot : B. pnt . ,; Robert D. Masden, Chair / A . William Jerke, Pro-Tem BY: c ,. 'A!. , _ . Deputy Clerk to the Boa M. . eile AP AS S• • David . Long ids ounty Attorney Glenn Vaad Date of signature: X3 2004-0063 H L0031 DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT DEPARTMENT OR AGENCY NUMBER FAA CONTRACT ROUTING NUMBER 04-00391 TASK ORDER Abstinence Education Proeram This Task Order is made this 29TH day of DECEMBER,2003,by and between:the state of Colorado,acting by and through the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,whose address or principal place of business is 4300 CHERRY CREEK DRIVE SOUTH,DENVER,COLORADO 80246 hereinafter referred to as`the State";and,the BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY (a political subdivision of the state of Colorado),whose address or principal place of business is 915 10th Street, 3rd Floor,Greeley,Colorado 80631,for the use and benefit of the Weld County Department of Public Health and Environment,whose address or principal place of business is 1555 North 17th Avenue, Greeley,Colorado 80631,hereinafter referred to as"the Contractor".. FACTUAL RECITALS • The United State Department of Health and Human Services("USDHHS"),through the Maternal and Child Health Bureau("MCHB")has awarded the State federal funds under Notice of Grant Award("NGA")number 6 X01 MC 00053-05 O4(see, Catalog of Federal Domestic Assistance("CFDA")number 93.235)to perform abstinence education services through local abstinence education programs, and where appropriate,mentoring,counseling, and adult supervision services. Because of prevalent sexual messages in society and peer pressure to become sexually involved at younger ages, little consistent support exists for teens to remain abstinent until marriage. A 2001 Colorado Youth Risk Behavior Survey disclosed that forty-two percent(42%)of surveyed students in grades 9 through 12 reported that they had engaged in sexual intercourse, sexual intercourse can result in an unplanned pregnancy and sexually transmitted diseases, and sexual abstinence is a healthier choice for teens. Because a need exists,and interest has been expressed by school districts,local health agencies, and community based organizations,for comprehensive abstinence education programs for youth to be implemented through local programs the State has formulated a comprehensive State plan,with associated budgets,to disburse these funds throughout the state of Colorado. Under this comprehensive State plan,the State shall allocate these funds to qualified entities to provide comprehensive abstinence education programs to the citizens of the state of Colorado on behalf of the State. This Contractor was selected by the State to provide abstinence education services as herein set forth in accordance with the terms and conditions of a grant application,in response to a Request for Grant Applications (RFA), issued by the State on 9-05-2003,to conduct local abstinence education programs in Colorado. Section 29-1-201,C.R.S. as amended, encourages governments to make the most efficient and effective use of their powers and responsibilities by cooperating and contracting with each other to the fullest extent possible to provide any function,service, or facility lawfully authorized to each of the cooperating or contracting entities. Section 29-1- 201,C.RS., as amended, further states that all state of Colorado contracts with its political subdivisions are exempt from the state of Colorado's personnel rules and procurement code. Page 1 of 11 The Contractor is a political subdivision of the state of Colorado. The State and the Contractor mutually agree that the most efficient and effective way to provide the above-described services is at the local level. The State and the Contractor previously entered into a Master Contract with contract routing number 00 FAA 00008. This Task Order is issued pursuant to the terms and conditions of that Master Contract. As to the State,authority exists in the Law and Funds have been budgeted, appropriated, and otherwise made available, and a sufficient uncommitted balance thereof remains available for subsequent encumbering and payment in Fund Code(s) 100, Organizational Unit Code(s)6035 Appropriation Code(s)591,Program Code(s)9017, Function Code(s)FLWT,Object Code(s)5420, and Grant Budget Line Code(s)NS3C under Contract encumbrance number PO FAA PSD0400391. All required approvals,clearances, and coordination have been accomplished from and with all appropriate agencies. NOW,THEREFORE,in consideration of their mutual promises to each other,stated below,the parties hereto agree as follows: A. PERIOD OF PERFORMANCE AND TERMINATION. The proposed effective date of this Contract is January 26,2004. However,in accordance with section 24-30-202(1),C.RS., as amended,this Contract is not valid until it has been approved by the State Controller,or an authorized designee thereof. If the underlying NGA authorizes the State to pay all allowable and allocable expenses of a contractor as of the effective date of that NGA,then the State shall reimburse the Contractor for any allowable and allocable expenses of the Contractor that have been incurred since the proposed effective date of this Contract. If the underlying NGA does not authorize the State to pay all allowable and allocable expenses of a contractor as of the effective date of that NGA,then the State shall only reimburse the Contractor for those allowable and allocable expenses of the Contractor that were incurred on or after the effective date of this Contract. The initial term of this Contract shall commence on its effective date and continue through and including December 31,2004. This Contract is funded entirely with federal funds. Therefore,the State's liability for payment for all services rendered,or goods supplied,under this Contract is contingent upon the State's receipt of those federal funds. If the State does not receive all,or any part,of the federal funds necessary to pay its obligations under this Contract,then the State may immediately amend or terminate this Contract without further liability to the State. The total term of this Contract,including all renewals,bilateral options to renew, and extensions,may not exceed five(5)years. B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR 1. All funding for this Contract is provided by the MCHB. This Contract is governed by those relevant administrative standards contained in Title 45 of the Code of Federal Regulations(CFR). The regulations that apply to all work performed under this Contract, and the associated reporting requirements under the RFA, are found at 45 CFR, Part 74 and 92. The Contractor shall comply with these requirements for all activities it performs under this Contract. 2. The Contractor shall implement the Comprehensive Model Abstinence Education Grant services, in accordance with the tams and conditions of the RFA,which is incorporated herein by reference,made a part hereof, and attached hereto as"Attachment A". The Contractor shall implement abstinence education services for youth between the ages of 12 and 18. The Contractor shall perform its duties and obligations hereunder in accordance with the work plan,goals, and objectives of the Contractor's abstinence education proposal, and accompanying grant conditions, which is incorporated herein by reference,made a part hereof, and attached hereto as "Attachment B". Page 2 of 11 3. The Contractor shall cooperate with the Colorado Abstinence Education Program(CAEP)to insure that program planning, evaluation,and monitoring requirements are met. Such shall include,but is not limited to,participation in mutually agreed upon site visits and meetings with the Contractor. Site visits may include program observation,materials'review, and interviews with clients,staff, and the Contractor's board of directors. 4. The Contractor shall provide the State with three(3)copies of all media or other materials it develops under this Contract. If any copyrightable material(e.g.,audiovisuals, software, publication,curricula and training materials, etc.)is developed under this grant,the State,and the Department of Health and Human Services(HHS)shall have a royalty-free,nonexclusive and irrevocable right to reproduce,publish or otherwise use, and authorize others to use the work,for purposes which further the objective of the Maternal and Child Health Bureau(MCHB). The following wording shall appear on all printed materials developed under this Contract: "Supported in part by the Abstinence Education Grant Program from the United States Department of Health and Human Services, Maternal and Child Health Bureau,as made available through the Colorado Department of Public Health and Environment" For broadcast material,the following wording must appear in audio or visual presentation: "...supported in part by the Abstinence Education Grant through the U.S. Department of Health and Human Services Administration,Maternal and Child Health Bureau." 5. The Contractor shall obtain the prior written approval of the State for all budgetary changes that adjust any line item by either ten percent(10%)or Five Hundred Dollars($500.00),whichever is less. 6. The Contractor shall obtain the prior written approval of the State for all expenditures for the purchase of equipment and furniture. The Contractor shall provide the State with appropriate supporting documentation for any request to purchase equipment or furniture. Invoices for equipment and furniture must contain sufficient data for inventory control. If the Contractor makes any equipment or furniture purchase without the prior written approval of the State,then the State may deny payment for the unauthorized purchase of equipment or furniture. 7. The Contractor shall obtain the prior written approval of the State for all anticipated or actual out- of-town air travel and lodging expenses. The Contractor shall provide the State with appropriate supporting documentation for any request for out-of-town air travel or lodging. If the Contractor makes any out-of-town air travel or lodging purchase without the prior written approval of the State,then the State may deny payment for the unauthorized purchase of out-of-town air travel or lodging. 8. If the Contractor requests reimbursement of its indirect costs in excess of ten percent(10%)of its salary costs, exclusive of fringe benefit costs,then the Contractor shall submit an indirect cost proposal to the State for review and approval. Reimbursement for indirect costs is subject to the current indirect rate reimbursement cap limits established by the State's Division of Prevention and Intervention Services for Children and Youth. The Contractor may use any indirect costs not reimbursed by the State as matching funds from the Contractor. Page 3 of 11 9. The Contractor is advised that section 18-8-307,C.R.S.,as amended,prohibits the State from requiring or directing the Contractor to deal with a particular person in procuring any goods or services under this Contract. This statutory section notwithstanding,the Contractor shall obtain the prior written approval of the State before executing a subcontract with any individual or entity for the performance of any work under this Contract, except for those subcontracts identified in the Contractor's proposal. The Contractor shall submit any proposed subcontract to the State for review and approval. While the State may authorize the Contractor to subcontract some, or all,of the services,which are to be performed under this Contract,the Contractor expressly acknowledges that a subcontractor is subject to all of the terms and conditions of this Contract. Additionally,the Contractor expressly acknowledges that it remains ultimately responsible for the timely and satisfactory completion of all work performed by a subcontractor under this Contract. 10. If the Contractor submits an invoice which requests reimbursement for its payroll expenses,then that invoice shall be supported by time and effort certifications for each employee for whom the Contractor requests reimbursement. Salaries and wages of employees chargeable to more than one grant program or other cost objective shall be supported by appropriate time distribution records. 11. Funds reported as"match"under this Contract may not also be reported as match for any other contract funded by the State or from any other Federal funds. 12. The State's federal grant from the MCI-IB requires contractors to provide and document, matching funds of at least 75 percent or$3.00 to every$4.00 federal dollars received from the state. The match may include local dollars,private or foundation dollars,or in-kind support (in-kind match may include such items as indirect costs,office/classroom space, supervisory time, etc.,in proportion to cost of the project). Federal dollars from any source may not be used as a match. Matching dollars must be used solely for the activities enumerated under the abstinence education contract. Match must be documented on all budgets and invoices. Supportive match documentation(including rationale for valuing in-kind match)must be kept and maintained by all contractors and be able to withstand an audit by using a system that follows generally accepted accounting principles. Should a program not provide sufficient year-to-date match at 75%of the invoiced amount,payment may be withheld until the match requirement is achieved. 13. On or before September 1,2004,and September l'of any subsequent contract renewal year,the Contractor shall submit a new grant application for the contract renewal year term. The Contractor shall use and submit all of the same forms or similar format required in the original grant application used in response to the RFA, as referenced in Attachment A. Within thirty(30)calendar days after the due date of submission,the CAEP shall complete review of the Contractor's grant application. Any recommendations or requirements for changes or additions to that annual scope of work,budget,or budget justification shall be provided to the Contractor by the State on or before October 1 of that year. The Contractor and State program staff shall negotiate an agreement,if necessary,regarding any State proposed recommendation(s)or requirement(s)by October 15 of that year. An approved new annual scope of work,budget, and budget justification shall be incorporated into the Limited Amendment contract renewal for the following contract year. Page 4 of 11 14. The Contractor shall submit a final accounting of actual program expenditures report to the State for the initial term-January 26,2004,through and including December 31,2004-and for each renewal or extension term of this Contract no later than two(2)months after the end of the initial, renewal, or extension term of this Contract. A final accounting of actual program expenditures report shall contain an accounting of all of the Contractor's actual expenditures under this Contract on standardized forms provided by the State. Sample forms are incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment C". The information contained in the final accounting of actual expenditures report may be used in part to match Federal funds. Therefore,the Contractor shall identify the source of all"Applicant and Other" funding in the space provided on the sample form. The Contractor shall also note whether these funds may be used to match the State's federal grant. An authorized representative of the Contractor shall certify to,the final accounting of actual program expenditures report. 15. Administrative and Reporting Requirements Site Visits: The contractor shall coordinate and participate in site visits with Colorado Abstinence Education Program(CAEP)staff. Each site will be visited at least once during the contract. Additional site visits may occur on an as-needed basis.Projects are responsible for the following components of the visit: Working with State staff to set a date and agenda;coordinating parents, youth and project staff for interviews; organizing services for site visitors to observe;participating in the actual visit;and implementing resulting recommendations from the State. State Meetings: The CAEP shall conduct a one-or two-day workshop for all contractors,up to twice a year. Workshops are usually held in the spring and fall. Most workshops will occur in Denver,but some will occur in other regions of the state,so applicants should budget for travel accordingly. Workshops will provide guidance on data usage, abstinence education programming, grant requirements,technical assistance,resources, educational opportunities, and networking opportunities. The Contractor is required to send at least one representative to the above meetings. Legislation Compliance: Programs shall comply with all current,applicable federal legislation (Abstinence Education,Americans with Disabilities Act,Civil Rights Act, etc.). Evaluation: Contractor must submit a plan for monitoring and evaluating process objectives, client satisfaction and shifts in knowledge level. Informal evaluation tools such as pre-and post- program surveys are acceptable evaluation strategies. However, if the CAEP secures funding for a formal evaluation,all Comprehensive Model Abstinence Education Program Grant recipients shall be required to participate in the state-funded evaluation. During the initial term of the Contract,and any renewal or extension,the Contractor shall submit to the State, a six-month progress report detailing the achievements of the first six months of the program by July 30'"of each contract year,and a twelve-month report by February 28th following each contract year thereafter. The State shall provide the Contractor with the required reporting guidelines for the six-month and twelve-month progress reports,a minimum of thirty(30)days prior to the report due date. Page 5 of 11 The minimum reporting requirements for the six(6)month and twelve(12)month progress reports shall include federally required data of at least the following: a. An unduplicated count of all males and females served by the Contractor within the following age groups: less than ten(10)years of age,ten(10)to fourteen(14)years of age, and fifteen(15)to seventeen(17)years of age, eighteen(18)to nineteen(19)years of age,twenty(20)to twenty-four(24)years of age,youth greater than twenty-four(24) years of age, and parents,by race and ethnicity. The Contractor shall use the sample reporting forms provided by the State. These sample reporting forms are incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment D". b. The total number of encounters by the above age groups,by race and ethnicity; c. A statement of the progress,which has been made toward meeting the Contractor's goals and objectives; d. The total number of clients who have either completed the program or dropped out,by age group,race, and ethnicity; and, e. An update on any independent evaluation,including all relevant data C. DUTIES AND OBLIGATIONS OF THE STATE. 1. The Contractor shall be compensated in accordance with the rates set forth in Attachment A hereto. In consideration of those services satisfactorily and timely performed by the Contractor under this Task Order the State shall cause to be paid to the Contractor a sum not to exceed SIXTY-FIVE THOUSAND DOLLARS,($65,000.001 for the initial term of this Task Order. Of the total financial obligation of the State referenced above, Sixty-Five Thousand Dollars, ($65,000.00)are identified as attributable to a funding source of the United States government and,Zero Dollars,($0.00)are identified as attributable to a funding source of the state of Colorado. 2. Payments under this Task Order shall be made either through the State's Electronic Fund Transfer system or,upon the Contractor's periodic submission of a duplicate"Task Order Reimbursement Statement". 3. If this Task Order requires the Contractor submit a"Task Order Reimbursement Statement",then the Contractor shall submit a signed, monthly or quarterly Task Order Reimbursement Statement within sixty(60)calendar days of the end of the billing period for which services were rendered. A sample Task Order Reimbursement Statement is incorporated herein by reference,made a part hereof, and attached hereto as"Attachment E". Expenditures shall be in accordance with those items identified in"Attachment F'incorporated herein by this reference,made a part hereof, and attached hereto. These items may include,but are not limited to:the Contractor's salaries,fringe benefits, supplies,travel, operating,and indirect costs which are allowable and allocable expenses related to its performance under this Task Order. Each Task Order Reimbursement Statement shall reference the related Matter Contract by its contract routing number and this Task Order by their respective contract routing numbers. The contract routing numbers are located on page one of these documents. Each Task Order Page 6 of 11 Reimbursement Statement shall also indicate the applicable performance dates,the names of payees; a brief description of the services performed during the relevant performance dates;all expenditures incurred;and,the total reimbursement requested. Reimbursement during the initial, or any renewal,term of this Task Order shall be conditioned upon affirmation by the State that all services were rendered by the Contractor in accordance with the terms of this Task Order. Each Task Order Reimbursement Statement shall be sent to: Lee Joseph Prevention Services Division Colorado Department of Public Health and Environment PSD-MCH-A4 4300 Cherry Creek Drive South Denver,CO 80246-1530 4. The State may prospectively increase or decrease the amount payable under this Task Order through a"Task Order Change Order Letter"that is substantially similar to the sample Task Order Change Order Letter that is incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment G". To be effective, a Task Order Change Order Letter must be: signed by the State and the Contractor; and, approved by the State Controller or an authorized designee thereof. Additionally, a Task Order Change Order Letter shall include the following information: A. Identification of the related Master Contract and this Task Order by their respective contract routing numbers and affected paragraph number(s); B. The type(s)of service(s) or program(s)increased or decreased and the new level of each service or program; C. The amount of the increase or decrease in the level of funding for each service or program and the new total financial obligation; D. A provision stating that the Task Order Change Order Letter is effective upon approval by the State Controller,or designee, or its proposed effective date,whichever is later. Upon proper execution and approval, a Task Order Change Order Letter shall become an amendment to this Task Order. Except for the General and Special Provisions of the Master Contract,and the Additional Provisions of the Task Order,if any,the Task Order Change Order Letter shall supersede this Task Order in the event of a conflict between the two. It is expressly understood and agreed to by the parties that the task order change order letter process may be used only for increased or decreased levels of funding,corresponding adjustments to service or program levels, and any related budget line items. Any other changes to this Task Order,other than those authorized by the task order option to renew letter process described below, shall be made by a formal amendment to this Task Order executed in accordance with the Fiscal Rules of the state of Colorado. Page 7 of 11 If the Contractor agrees to and accepts a proposed Task Order Change Order Letter,then the Contractor shall execute and return that Task Order Change Order Letter to the State by the date indicated in that Task Order Change Order Letter. If the Contractor does not agree to and accept a proposed Task Order Change Order Letter, or fails to timely return a partially executed Task Order Change Order Letter by the date indicated in that Task Order Change Order Letter,then the State may,upon written notice to the Contractor,terminate this Task Order no sooner than thirty(30) calendar days after the return date indicated in the Task Order Change Order Letter has passed. This written notice shall specify the effective date of termination of that Task Order. If a Task Order is terminated under this clause,then the parties shall not be relieved of their respective duties and obligations under that Task Order until the effective date of termination has passed. Increases or decreases in the level of contractual funding made through the task order change order letter process during the initial,or renewal, term of a Task Order may only be made under the following circumstances: E. If necessary to fully utilize appropriations of the state of Colorado and/or non- appropriated federal grant awards; F. Adjustments to reflect current year expenditures; G. Supplemental appropriations,or non-appropriated federal funding changes resulting in an increase or decrease in the amounts originally budgeted and available for the purposes of a Task Order; H. Closure of programs and/or termination of related contracts or task orders; I. Delay or difficulty in implementing new programs or services; and, J. Other special circumstances as deemed appropriate by the State. 5. The State may renew a Task Order through a"Task Order Option to Renew Letter"substantially similar to the sample Task Order Option to Renew Letter that is incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment H". To be effective, a Task Order Option to Renew Letter must be: signed by the State and the Contractor; and, approved by the State Controller or an authorized designee thereof. Additionally, a Task Order Option to Renew Letter shall include the following information: A. Identification of the related Master Contract and that Task Order by their respective contract routing numbers and affected paragraph number(s); B. The type(s)of service(s) or program(s),if any,increased or decreased and the new level of each service or program for the renewal term; C. The amount of the increase or decrease,if any,in the level of funding for each service or program and the new total financial obligation; D. A provision stating that the Task Order Option to Renew Letter is effective upon approval by the State Controller,or designee, or its proposed effective date,whichever is later. Page 8 of 11 Upon proper execution and approval, a Task Order Option to Renew Letter shall become an amendment to this Task Order. Except for the General and Special Provisions of the Master Contract, and the Additional Provisions,if any of that Task Order,a Task Order Option to Renew Letter shall supersede that Task Order in the event of a conflict between the two. It is expressly understood and agreed to by the parties that the task order option to renew letter process may be used only to:renew a Task Order;increase or decrease levels of funding related to that renewal; make corresponding adjustments to service or program levels, and,adjust any related budget line items. Any other changes to a Task Order,other than those authorized by the task order change order letter process described above, shall be made by a formal amendment to a Task Order executed in accordance with the Fiscal Rules of the state of Colorado. If the Contractor agrees to and accepts a proposed Task Order Option to Renew Letter,then the Contractor shall execute and return that Task Order Option to Renew Letter to the State by the date indicated in that Task Order Option to Renew Letter. If the Contractor does not agree to and accept the proposed renewal term, or fails to timely return a partially executed Task Order Option to Renew Letter by the date indicated in that Task Order Option to Renew Letter,then the State may,upon written notice to the Contractor,terminate this Task Order no sooner than thirty(30) calendar days after the return date indicated in the Task Order Option to Renew Letter has passed. This written notice shall specify the effective date of termination of that Task Order. If a Task Order is terminated under this clause,then the parties shall not be relieved of their respective duties and obligations under that Task Order until the effective date of termination has passed. 6. All attachments or exhibits to this Task Order are incorporated herein by this reference and made a part hereof as if fully set forth herein. If a conflict or inconsistency is found to exist between the terms and conditions of this Task Order and those of any attachment or exhibit hereto,then the terms and conditions of this Task Order shall control. D. ADDITIONAL PROVISIONS. 1. Title V, Section 504(b) (6). Title V funds may not be used to pay for any item or service(other than an emergency item or service)furnished by an individual or entity convicted of a criminal offense under the Medicare or any State health care program(i.e., Medicaid, Maternal and Child Health, Colorado Child Health Plan Plus(CHP+), or Social Services Block Grant programs). 2. Contractor shall ensure that the provisions of Section 601 of Title VI of the Civil Rights Act of 1964 are carried out. That Act states that"no person in the United States shall on the ground of race, color,or national origin,be excluded from participation in,be denied the benefits of,or be subjected to discrimination under any program or actively receiving Federal financial assistance." The Office of Civil Rights has concluded that it is the responsibility of any program which is a recipient of funds from the Department of Health and Human Services to ensure that clients who do not speak or understand English well,be provided interpretation services to ensure that the service provider and the client can communicate effectively. The Contractor shall have policies and procedures to ensure that interpretation services are available for clients with Limited English Proficiency and will advise such clients that an interpreter will be provided for them. If a client has their own interpreter,they shall be advised that the Contractor will provide an interpreter if the client so chooses Page 9 of 11 3. The Contractor agrees to provide services to all Program participants and employees in a smoke-free environment in accordance with Public Law 103-227,also known as"the Pro-Children Act of 1994", (Act). Public Law 103-227 requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18,if the services are funded by Federal programs either directly or through State or local governments,by Federal grant,contract,loan,or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed,operated,or maintained with such Federal funds. The law does not apply to children's services provided in private residences;portions of facilities used for inpatient drug or alcohol treatment;service providers whose sole source of applicable Federal funds is Medicare or Medicaid;or facilities where WIC coupons are redeemed. Failure to comply with the provision of Public Law 103-227 may result in the imposition of a civil monetary penalty of up to$1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing this Contract,the Contractor certifies that the Contractor will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The Contractor agrees that it will require that the language of the Act be included in any subcontracts which contain provisions for children's services and that all contractors shall sign and agree accordingly. 4. The Contractor certifies,to the best of its knowledge and belief, that no federally appropriated funds have been paid or will be paid by or on behalf of the Contractor,to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of this Contract,and the extension,continuation,renewal, amendment,or modification of this Contract,or any grant,loan,or other cooperative agreement that utilizes Federal funds. If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, Member of Congress,an officer or employee of Congress in connection with this Contract,or any other grant,loan,or other cooperative agreement,then the Contractor shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying"in accordance with its instructions. The Contractor shall require that the language of this certification be included in the award documents for subawards at all tiers(including subcontracts,subgrants, and contracts under grants,loans,and cooperative agreements)and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. This certification is a prerequisite for making or entering into this transaction imposed by section 1352,title 31,U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. 5. The Contractor shall protect the confidentiality of all applicant or recipient records and other materials that are maintained in accordance with this Contract. Except for purposes directly connected with the administration of this Program,no information about or obtained from any applicant or recipient shall be disclosed in a form identifiable with the applicant or recipient without the prior written consent of the applicant or recipient or a minor's parent or guardian or as otherwise properly ordered by a court of competent jurisdiction. The Contractor shall have written policies governing access to,duplication and dissemination of, all such information.The Contractor shall advise its employees, agents, servants, and subcontractors,if any,that they are subject to these confidentialities. Page 10 of 11 IN WITNESS WHEREOF,the parties hereto have executed this Task Order as of the day first above written. d CONTRACTOR: STATE: BOARD OF COUNTY COMMISSIONERS STATE OF COLORADO OF WELD COUNTY Bill Owens.Governor (a political subdivision of the state of Colorado) for the use and benefit of the Weld County Department of Public Health and Environment _ By: By: Name: - Robert 1 Masden or he xecntive ector Title: Chair DEPARTMENT UBLIC HEALTH FEIN: 84-6000813 AND ENVIRO Date: 1 /7/7004 Date: (Seal) TE T -��� PROGRAM APPROVAL: lq 7/ By: (�wLt G1 r a 1 y Deputy Clerk to t d 1 APPROVALS: 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 the goods and/or services provided. STATE CONTROLLER: Arthur L.Barnhart � WELD COUNTY DEPARTMENT OF By: �E! PUBLIC HEALTH ANDD�E_N�VIRRONNMEN Date: /— I�o —e�Y BY: w�r_�� /(AXI•-e aA. Ma k E. Wallace, MD, MPH-Director Revised:12/31/02 O1-C.:3'- Page 11of11 Title V Abstinence Education Program —Program RFA 1 ATTACHMENT A ,. OF •co, tEDUCATION-.COLORADO ABSTINENCE EDUCATION PROGRAM PROGRAM NCOLORADO ABSTINENCE 0 * * A collaborative effort between: * * Colorado Department of Public Health and Environment (CDPHE) and the Office of the Governor * 1876 Community-based Abstinence Education Program Grant REQUEST FOR GRANT APPLICATIONS APPLICATIONS MUST BE DELIVERED BY 4:00 P.M. ON OCTOBER 10, 2003 SUBMIT ONE (1) SIGNED ORIGINAL PROPOSAL AND THREE (3) COPIES. Applications may be delivered or mailed to(no faxes): Carla Beeson,Director Abstinence Education Program Prevention Services for Children and Youth(PSD-A4) Colorado Department of Public Health&Environment 4300 Cherry Creek Drive South Denver, CO 80246-1530 Upon review and verification, any application that is found to be incomplete or not in compliance with the requirements specified in the application will be disqualified from funding consideration, and the applicant will be notified by mail. Title V Abstinence Education Program —Program RFA 2 Table of Contents I. Introduction ,3 A. Colorado Abstinence Education Program Purpose B. Program Background C. Federal Abstinence Education Definition D. Colorado Abstinence Education Goals E. Priority Needs in the State for Abstinence Education Programs II. Statement of Work _5 A. Eligibility B. Contractor Requirements III. Offeror Response 10 A. Proposal Format B. Evaluation Criteria C. Proposal Outline IV. Administrative Information 13 V. Contract General Provisions 17 VI. Special Provisions 23 VII.Appendices 25 A. State Performance Measures B. Client Tracking Forms C. Indirect Costs D. Standards for Working with People with Disabilities&Standards of Cultural Competency and Proficiency E. Assurances Page F. Program Abstract G. Sample Work Plan H. Line Item Budget Form I. A-H Compliant Curricula Title V Abstinence Education Program --Program RFA 3 I. INTRODUCTION A. COLORADO ABSTINENCE EDUCATION PROGRAM PURPOSE The Colorado Abstinence Education Program(CAEP)was established to help reduce out-of-wedlock births,teen fertility rates and sexually transmitted diseases among teens by encouraging sexual abstinence until marriage.CAEP does this by: I. Supporting abstinence-only education programs for school-aged children,males and females,grades 6 through 12. 2. Developing and implementing strategic,statewide communication efforts designed to increase awareness and acceptance of abstinence as a healthy choice and a positive lifestyle. 3. Involving parents and the community in the development and implementation of programs and activities that are accessible and promote abstinence decisions. B. PROGRAM BACKGROUND U.S.Public Law 104-193,signed into law on August 22, 1996, added a new formula grant program(Sec. 510)to Title V of the Social Security Act. Its purpose was to"enable the State to provide abstinence education, and at the option of the State,where appropriate mentoring,counseling,and adult supervision to promote abstinence from sexual activity,with a focus on those groups which are most likely to bear children out of wedlock." In 1996,the Office of the Governor and the Colorado Department of Public Health and Education established the CAEP,which$498,756 receives annually as its proportionate allocation of the$50 million annual allocation for abstinence-until-marriage education.These funds have been used to fund local abstinence education programs throughout the state, a statewide social marketing campaign and community and family education strategies throughout the state. C. FEDERAL ABSTINENCE EDUCATION DEFINITION According to the law,the purpose of the Abstinence Education Program is to"enable the state to provide abstinence education,and at the option of the state,where appropriate,mentoring,counseling,and adult supervision to promote abstinence from sexual activity,with a focus on those groups that are most likely to bear children out of wedlock." The law further defines abstinence education as: "An educational or a motivational program which- (A) has as its exclusive purpose,teaching the social,psychological,and health gains to be realized by abstaining from sexual activity; (B) teaches abstinence from sexual activity outside marriage as the expected standard for all school age children; (C)teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy,sexually transmitted diseases,and other associated health problems; (D) teaches'that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity; (E) teaches that sexual activity outside of the context of marriage is lately to have harmful psychological and physical effects; (F) teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child,the child's parents,and society; (G) teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances;and (H) teaches the importance of attaining self-sufficiency before engaging in sexual activity." According to federal guidelines,abstinence education may not teach anything inconsistent with the abstinence education definition. Title V Abstinence Education Program —Program RFA 4 D. COLORADO ABSTINENCE EDUCATION GOALS For Federal Fiscal Year 2004,the CAEP has established the following goals: 1. Improve the health and well-being of Colorado youth ages 12—18 by increasing their awareness of abstinence as the healthiest choice and by providing them with opportunities to increase their knowledge and skill level to improve their potential to choose and sustain an abstinent lifestyle. 2. Reduce the health disparity among youth of color--particularly Hispanic youth—by ensuring that they and their families have access to culturally-specific and relevant prevention strategies to improve awareness of and increase acceptance of abstinence until marriage as the healthiest choice. 3. Provide parents and other adult gatekeepers with information and resources to help them reinforces the abstinence message at home,at school,and in the community. 4. Provide local abstinence education programs with technical assistance to develop administratively,fiscally and programmatically sound programs;and assistance in evaluating their programs to ensure they are effectively implementing programs that impact youth behaviors in a positive manner. E. PRIORrry NEEDS IN THE STATE FOR ABSTINENCE EDUCATION PROGRAMS Colorado has been seeing promising trends in teen fertility rates and sexually transmitted diseases among teens since 1991.Colorado celebrated a complete reduction in syphilis cases among youth aged 15-19 from a rate of 1.8 per 100,000 in 1996 to 0.0/100,000 in 20002. In addition,fertility rates for all Colorado girls 15-17 dropped 15%from 34.6/1000 in 1991 to 29.4/1000 in 2000.Fertility rates to black girls 15-17 declined most significantly from 86.2/1000 in 1991 to 46.6/1000 in 2000,a 46%drop in one decade. Hispanic teen fertility,however,has not dropped as quickly and its high level is cause for concern.The rate in 1991 was 84.4/1000,declining to 77.8/1000 in 2000,a drop of 8%,but a level five times the rate for white non-Hispanic girls and almost double the rate for black teens.The number of Hispanic teen births was 1,380 in 2000,comprising more than half of the total number of births to girls 15-17(2,612).3 According to the National Campaign to Prevent Teen Pregnancy, "Between 1991-1999,the U.S.birth rate for teens aged 15-19 declined 20.1 percent to 49.6 births per 1000 teen girls in 1999, after reaching its highest point in two decades(62 births per 1000 teen girls aged 15-19 in 1991).While this trend is encouraging,the U.S. teen birth rate remains notably higher than the rates in other industrialized democracies."4 Recent reductions in teen birth rates have been attributed by several sources as the result of less sexual activity and better contraceptive use.There is evidence to suggest that one of the reasons behind these trends is that more teens are taking a more cautious attitude toward casual sex.5 According to a survey of teens in school,the percentage of high school males who had ever had sex,steadily declined from 61 percent in 1990 to 49 percent in 2001.For high school females,48 percent reported that they were sexually experienced in 1990.This number climbed to 52 percent in 1995 before declining to 43 percent in 2001.6 Teens themselves appear to support abstinence education. A recent survey by the National Campaign to Prevent Teen Pregnancy revealed that 85%of teenagers in the United States think it is important that school-aged children and teenagers receive a strong abstinence message.' The CAEP priority needs reflect efforts to increase statewide awareness about the benefits of an abstinent lifestyle for youth and to encourage a social environment that supports abstinent behavior.These priority needs reflect efforts by the Office of the Governor,Colorado Department of Public Health and Environment and the Colorado Abstinence Education Steering Committee to tailor its program to reflect Title V Abstinence Education Program —Program RFA 5 the emerging needs of youth,their families and the local organizations that serve them. I. Youth ages 12-18 need positive,multi-media messages that establish abstinence from sex as the healthiest choice for youth, educational opportunities to develop the skills necessary to abstain from sexual activity,and support networks to help them maintain their positive choices. 2. Youth of color--particularly Hispanic youth--and their families need culturally-specific and relevant prevention strategies to improve awareness of and increase acceptance of abstinence until marriage as the healthiest life choice. 3. Parents and other adult gatekeepers need education and assistance in reinforcing the abstinence message at home,at school,and throughout the community. 4. Local abstinence education programs need assistance developing community support for their efforts; technical assistance to develop administratively, fiscally and programmatically sound programs;and assistance in evaluating their programs to ensure they are effectively implementing programs that impact youth behaviors in a positive manner. II. STATEMENT OF WORK The purpose of the CAEP Program Grants is to provide support to public and private nonprofit entities for the development and implementation of abstinence education programs for adolescents,in grades 6— 12,in communities across the state of Colorado. Two types of grants will be awarded under this RFA.Entities may apply for three-year Community-based Abstinence Education Program Grants,ranging from$20,000-$45,000 per year,or three-year Comprehensive Model Abstinence Education Program Grants,ranging from$50,000-$65,000 per year. Funding for subsequent years for either grant program is contingent on the availability of funding. Applicants are advised to apply for the grant for which their program is most compliant: However,the CAEP Application Review Team,has at its sole discretion the opportunity to recommend modified grant categories and budgets based on review of the individual applications. A. ELIGIBILITY Private,non-profit(classified as 50I(c)3 by the Internal Revenue Service),faith-based and public agencies are eligible to apply.Projects must clearly and consistently focus on the designated definition of"abstinence education"and applicants must agree not to provide a participating adolescent any other education regarding sexual conduct in the same setting.Applicants proposing to provide abstinence-until-marriage education and who have a public health mandate,such as State or local health departments,community health centers or other community-based clinics,must provide assurance that any discussion of other forms of sexual conduct or provision of services is conducted in a setting different from where and when the abstinence-until-marriage course is being conducted. B. CONTRACTOR REQUIREMENTS All contractors must comply with the requirements listed below and applicants must sign and submit the "Assurances"page(Appendix E)stating they agree to these requirements. Failure to conform to these requirements may result in contract termination through written notification. 1. Target Population(s): CAEP will provide program support for organizations that provide direct services to youth in 6th to 12'"grade,or ages 12 to 18.CAEP has identified target populations who may require heavier focus during the program year.In evaluating programs for grant funds,the CAEP prefers projects that: • Provide services to youth at greater risk for participating in pre-marital sexual activity.Based on state and national studies these groups would be: Title V Abstinence Education Program --Program RFA 6 • Youth of color • Low-Some youth • Incorporate into their program prevention strategies targeting youth during the transitional period between ages 12 to 15. • Include parent education and communication strategies within the program design and implementation. 2. Program Elements:Programs must follow sound,health-education principles,including the need to be multi- faceted and comprehensive.They should offer multiple levels of intervention and ongoing support. a. Educational Component: Programs will deliver abstinence-only education that: • is scientifically based and medically sound; • follows a model that builds on the strengths and assets of youth; • does not teach or promote anything inconsistent with the eight criteria of the Federal Abstinence Education Definition. (While a separate abstinence education project may operate inside an organization providing services other than those consistent with the abstinence education definition, the project funded by these dollars must be separate with staff participants, and funding specific to this program.); • does not provide any type of contraceptive instruction;and • delivers the abstinence education project separate and apart from any religious education or emphasis.(Religious organizations may apply for an abstinence education grant. However, its abstinence education programs must be delivered separate and apart from any religious education or activities.) b. Intensity:CAEP seeks to fund programs that are multi-faceted and have medium to high levels of intensity for the average participant.For the purposes of this RFA,program intensity requirements vary depending on the type of grant. • Community-based Abstinence Education Program Grants:($25,000-$45,000) This grant category requires a medium level of intensity. Organizations must provide a minimum of five 50-minute sessions of curricula-based abstinence education classes with a student/adult ratio no greater than 20 youth/1 adult.Contact with youth must span a period of at least one week.Programs must document a minimum of 10 encounters per youth,inclusive of the five curricula-based abstinence education classes. Additional contacts include,but are not limited to: additional abstinence education classes,after-school activities,community activities,mentoring,support groups,interactive web-based communication or special events with a focus on abstinence. • Comprehensive Model Abstinence Education Program Grants:($50,000-$65,000) This grant category requires a high level of intensity. Organizations must provide a minimum of ten 50-minute curricula-based abstinence education sessions with a student/adult ratio no greater than 20 youth/1 adult. Contacts with youth must span a period of no less than three months.Programs must document a minimum of 15 encounters per youth,inclusive of the ten curricula-based abstinence education classes. Additional contacts include,but are not limited to:additional abstinence education classes,after-school activities,community activities,mentoring,support groups,interactive web-based communication or special events with a focus on abstinence. To qualify for the maximum$65,000 grant award, applicants must also include a parent/guardian component with a minimum offive contacts per parent/guardian. c. Multi-faceted Approaches:The CAEP will also score programs based on the inclusion of multi-faceted approaches, including: • Educational components that promote character education and include strategies to address youth protective and resiliency factors(see web site:http://aspe.hhs.gov/hsp/PositiveYouthDev99/); Title V Abstinence Education Program —Program RFA 7 • Practical skill building activities to improve youths' efficacy in such areas as conflict resolution, anger management,communication,and refusal skills; • Leadership and service opportunities through which youth may give input into program development,serve within the community and have the opportunity to work as advocates for abstinence(i.e.,serve on an advisory committee,provide community presentations on the program, conduct volunteer work in the community,meet with program stakeholders,etc.); • Positive life choice modeling through strong adult supervision and mentoring programs; • Family component that creates an avenue for parent/guardian communication and participation to increase the potential of an environment in which abstinence is supported within the home;and • Community collaboration with parents,parent groups,community leaders,educators,healthcare providers,faith-based organizations,other youth-serving organizations,abstinence education programs statewide, and other stakeholders with the potential to increase awareness and support of abstinence education within the community. • Referral System:To ensure youth participants have access to the greatest variety of resources to improve their success levels,programs must develop a referral system through which participants can be referred to services that are outside the scope of the program. 3. Fiscal Requirements a. Invoicing:Projects will be required to submit invoices either monthly or no less often than quarterly(at their discretion),listing the prior month's or quarter's expenditures and match,according to the categories of the approved line item budget. CDPHE will provide a standard billing form with the contract. Programs are required to keep records of back up documentation for expenditures and match, and may be required to submit these,at the request of the CDPHE,prior to payment. b. Annual Expenditure Reports:The contractor will submit a final report of actual project expenditures to the CDPHE within two months of contract year end. c. Cost-Based Reimbursement System:Programs should have sufficient financial reserve to conduct the program on a cost-based reimbursement system. This means that contractors will be reimbursed only for actual expenses,after the contractor submits an invoice to the CDPHE,and that invoice is approved for payment.My substantial changes to the approved scope of work and line-item budget must be approved by CDPHE. d. Budget Adjustments:The contractor shall obtain prior written approval from CAEP for all budgetary changes that adjust any line item by either ten percent(10%)or five hundred dollars($500.00), whichever is lesser. e. Equipment&Furniture Purchases:The contractor shall obtain prior written approval of the CAEP for all expenditures for the purchase of equipment and furniture. The contractor shall provide the State with appropriate supporting documentation for any request to purchase equipment or furniture.Invoices for equipment and furniture must contain sufficient data for inventory control. If the contractor makes equipment or furniture purchase without prior written approval of the CAEP,then the CAEP may deny payment for the unauthorized purchase of equipment or furniture. f. Out-of-town Travel:The contractor shall obtain prior written approval of the CAEP for all anticipated or actual out-of-town air travel and lodging expenses. The contractor shall provide the CAEP with appropriate supporting documentation for any request for out-of-town air travel or lodging. If the contractor makes any out-of-town air travel or lodging purchase without the prior written approval of the CAEP,then the CAEP may deny payment for the unauthorized purchase of out-of-town air travel or lodging. Title V Abstinence Education Program —Program RFA 8 g. Convicted Criminal Funding Restriction:Title V funds may not be used to pay for any item or service(other than an emergency item or service)which is furnished by an individual or entity which has been convicted of a criminal offense under the Medicare ore any state health care program(e.g.,Medicaid,Abstinence Education,Maternal and Child Helath,or Social Services Block Grant programs). h. Match Requirement:This grant requires contractors to provide and document matching funds of at least 75 percent or$3.00 to every$4.00 federal dollars received from the state.The match may include local dollars,private or foundation dollars,or in-kind support(in-kind match may include such items as indirect costs,office/classroom space,supervisory time,etc.,in proportion to cost of the project). Federal dollars from any source may not be used as a match.Matching dollars must be used solely for the activities enumerated under the abstinence education contract. Match must be documented on all budgets and invoices. Supportive match documentation(including rationale for valuing in-kind match)must be kept by all contractors and be able to withstand an audit by using a system that follows generally accepted accounting principles.Should a program not provide sufficient year-to-date match at 75%of the invoiced amount,payment may be withheld until the match requirement is achieved. i. Subcontracts:The CDPHE is prohibited by state law from requiring or directing the contractor to deal with a particular person in procuring any goods or services under any contracts resulting from this RFA.However,the contractor shall obtain the prior written approval of the CDPHE before executing a subcontract with any individual or entity for performance of work under a contract resulting from this RFA.While the CDPHE may authorize the contractor to subcontract some,or all,of the services which are to be performed,the subcontractor is subject to all of the terms and conditions of any contract resulting from this RFA.Additionally,the contractor remains ultimately responsible for the timely and satisfactory completion of all work performed by a subcontractor. 4. Media and Printed Materials:The contractor shall provide CAEP with three(3)copies of all media or other materials it develops using funds awarded through this RFA. If any copyrightable material(e.g.;audiovisuals,software,publication,curricula and training materials,etc.)is developed under this grant,the State,and the Department of Health and Human Services(MIS) shall have a royalty-free,nonexclusive and irrevocable right to reproduce,publish or otherwise use,and authorize others to use the work,for purposes which further the objective of the Maternal and Child Health(MCH)Bureau. The following wording shall appear on all printed materials developed through funding awarded through this RFA: "Supported in part by the Abstinence education Grant Program from the United States Department of Health and Human Services,Maternal and Child Health Bureau,as made available through the Colorado Department of Public Health and Environment." For broadcast material,the following wording must appear in audio or visual presentation: "...supported in part by the Abstinence Education Grant through the U.S. Department of Health and Human Services Administration,Maternal and Child Health Bureau." 5. Workplace Requirements In accordance with Public Law 103-227,also known as the Pro-Children Act of 1994, the offeror shall provide all services to all program participants and employees in a smoke-free environment. "Smoke-free"shall mean that smoking is not permitted in any portion of any indoor facility owned,leased, or otherwise contracted for by the offeror if that facility is routinely or regularly used for the provision of child care or health services to any child under the age of eighteen(18)years when those services are funded in whole or in part with federal funds. 6. Confidentiality Title V Abstinence Education Program --Program RFA 9 The offeror shall protect the confidentiality of all program participants. Except for purposes directly related to the administration of a contract resulting from this RFA,no information obtained from any participant shall be disclosed by the offeror to any third person in a form which identifies,or could identify,the participant without the prior written consent of: the participant,the parent or legal guardian of a minor participant; or, as otherwise properly ordered by a court of competent jurisdiction. The offeror shall have written policies governing the access to,and the duplication and dissemination of, all such information. The offeror shall advise its directors,officers,employees, agents, servants,and subcontractors, if any,that they are subject to these confidentiality requirements. 7. Administrative and Reporting Requirements a. Progress Reports:The contractor will submit a six-month progress report to the CDPHE by July 30, during each contract year.The contractor wilt submit an annual progress report by February 28, following each contract year. b. Site Visits:The contractor will coordinate and participate in site visits with State Abstinence Education Program staff Each site will be visited at least once during the contract.Additional site visits may occur on an as-needed basis.Projects are responsible for the following components of the visit: Working with State staff to set a date and agenda;coordinating parents,youth and project staff for interviews;organizing services for site visitors to observe;participating in the actual visit;and implementing resulting recommendations from the State. c. State Meetings:The CAEP will conduct a one-or two-day workshop for all contractors,up to twice a year. Workshops are usually held in the spring and fall. Most workshops will occur in Denver,but some will occur in other regions of the state,so applicants should budget for travel accordingly. Workshops will provide guidance on data usage,abstinence education programming,grant requirements,technical assistance,resources,educational opportunities,and networking opportunities. d. Legislation Compliance:Programs will comply with all applicable federal legislation (Abstinence Education,Americans with Disabilities Act,Civil Rights Act,etc.). e. Data Tracking:Programs will track the unduplicated count of clients and the total number of client encounters by gender,age group,race and ethnicity. Parents should be included in these numbers. (Reporting forms are provided in this RFA as Appendix B and will be attached to the contract.) f. Evaluation: • Applicants for Community-based Abstinence Education Program Grants will be required to submit a plan for monitoring their process and impact objectives. Projects may choose to subcontract the evaluation component with an evaluation expert. Program evaluation should include process and impact measures such as client satisfaction and changes in knowledge. Informal evaluation tools such as pre-and post-program surveys are an acceptable evaluation measure. • Applicants for Comprehensive Model Abstinence Education Program Grants must submit a plan for monitoring and evaluating process objectives,client satisfaction and shifts in knowledge level. Informal evaluation tools such as pre-and post- program surveys are acceptable evaluation strategies. However,if the CAEP secures funding for a formal evaluation,all Comprehensive Model Abstinence Education Program Grant recipients will be required to participate in the state-funded evaluation. Title V Abstinence Education Program —Program RFA 10 III. OFFEROR RESPONSE A. PROPOSAL FORMAT CDPHE would prefer abstinence education grant be submitted using the format below. Proposals become the property of the CDPHE. Faxed or e-mailed proposals will not be accepted. • The length of the narrative should not exceed 10 pages,excluding supporting information such as letters of support and attachments.Proposals not meeting this requirement will be judged based upon the first 10 pages plus appendices. • Use a 12-point font • Double spaced lines • One-inch margins • Number each page of the application • • Provide a table of contents • Include all relevant forms from this RFA(Appendix E-H) • Follow the proposal outline(below),using the same headings and structure • Reference and label all attachments and appendices. • Provide all required signatures in original copy.(Invitation to Bid page,Line Item Budget) • Provide four(4)copies of all materials,including the original. B. EVALUATION CRITERIA Prior to proposal evaluation,applications will be assessed for compliance with the above technical requirements.Proposals meeting the technical requirements will be scored by a proposal review committee with a possible 100 points. Evaluation values are assigned to each section of the Offeror's Response. Proposals that receive a rating of 75%or less will be disqualified. Proposals achieving greater than 75% will be prioritized for funding based on their score. C. PROPOSAL OUTLINE 1. PROJECT ABSTRACT (Total Evaluation Value: 15 points) Prepare a one-page abstract using the form provided in Appendix F,or by recreating the form within the program's word-processing system. 2. TARGET POPULATION (Total Evaluation Value: 10 points) a. Describe the target population(s),how they were selected,and how the population(s)will be recruited to participate in the project. b. Provide a brief demographic description of the project's community.Justify its need for abstinence education/promotion with qualitative and quantitative data.Appropriate data includes local sexually transmitted disease and fertility rates,the number and/or percentage of community population that axe in higher risk categories for teen pregnancy,and level of poverty(i.e.,percent of students enrolled in free or reduced lunch).If known,include community perception of need.Cite references. c. If appropriate,describe the lack of resources or gaps in service with respect to the unique characteristics of the target population. Describe how the proposed project would address these gaps. d. Describe the organization's experience directly serving the target population(s)or the plan to collaborate with organizations that have expertise in this area. e. Explain how the program addresses cultural competency and inclusion of individuals with special needs.(See Appendix D.) HELPFUL WEBSITES: • Maternal and Child Health County Datasets: http://www.cdphe.state.co.us/ps/mch/mchadmin/mchdatasets2003/data2003hom.asp ♦ Colorado Health Information Dataset:http://www.cdphe.state.co.us/cohid/ Title V Abstinence Education Program --Program RFA 11 3. PROPOSED PROJECT DETAIL(Total Evaluation Value: 20 points) a. Abstinence Education Program:Describe the abstinence education project and include the information listed below. • Identify the A-H compliant abstinence education curricula to be used and attach a copy of the curricula outline. (If the curriculum is not one of the approved curricula in Appendix I,the RFA Review Team may request a copy of the entire curricula for review.) • Provide a course outline detailing the number of curricula-based abstinence education sessions and the topics to be discussed each session. • Other than curricula-based education sessions,describe other services and programs provided. • For each program component,state the number of participants to be served per year. • What is the estimated cost per client?(total number of clients served per year, divided by the total program cost per year including match). b. Youth Participation:Describe how the project will involve youth in meaningful ways in planning as well as implementing the program.(This could include using youth as advisory board members,focus group participants,participants in key stakeholder meetings, volunteers for community service, etc.) c. Community Collaboration:Provide a plan for collaborating and/or coordinating with other abstinence education programs,local agencies,and other community entities to accomplish the statement of work. Indicate any referral processes that may be incorporated in the plan to provide services beyond the scope of the grant,and how confidentiality will be maintained. d. Project Planning and Implementation:Explain how the program will be developed and implemented. Include a description of how members of the target population(s),parents,and community members will be involved in project planning and implementation. e. Community Support:Attach letters of support and collaboration from other service providers, community organizations/businesses,and/or referral sources. f. Evaluation Plan:Describe how the program will evaluate progress toward meeting goals and objectives,assess project impact,and assess client satisfaction. g. Participant Tracking:Describe tracking mechanisms to fulfill reporting requirements. (The projects must track unduplicated count of males and females served by age group,race and ethnicity;and total encounters by age group,race and ethnicity.) 4. METHODOLOGY(Total Evaluation Value: 10 points) a. Program Rationale:Applicants must demonstrate that the proposed program is evidence-based. Provide the rationale for models of service and interventions,include peer-reviewed research or program evaluated experience to support the rationale. b. Demographic Appropriateness:Describe how interventions/strategies will respond to characteristics unique to the target population including language,culture,developmental and literacy level,and special needs. 5. GOAL(S), OBJECTIVES AND WORKPLAN(Total Evaluation Value:20 points) a. Project Goal(s): Goals are defined as the overall purpose of the program,the desired ultimate result the of program.Please list all goals pertinent to the abstinence education project. For example an appropriate goal may be: To increase youth awareness about the value of abstinence so that youth participation in sexual activity is reduced in Denver. Programs are encouraged to have no more than three primary goals. b. Process Objectives:Provide at least two process objectives per goal. Objectives should be realistic, specific,time-framed,and measurable.A process objective describes who is receiving what intervention/activity,how many times,by what date. For example: An appropriate process objective may be:By January I, 2004, Title V Abstinence Education Program --Program RFA 12 50 tenth grade students at Cedar Middle School will receive 20 hours of the Smart Kids Abstinence Education curriculum. c. Impact Objectives.Provide at least one impact objectives per goal.Describe the attitudes,norms, values,and/or behaviors the project intends to impact.Objectives should be realistic,specific,time- framed,and measurable. For example: An appropriate impact objective may be:By January 1,2001, increase by 35 percent the number of youth participants who commit to remaining sexually abstinent until marriage. d. Workplan: Attach a Year One work plan(See Appendix G)covering the period January 1,2004 to December 31,2004 that provides the following information: • Program goal(s) • Realistic,specific,measurable,and time-framed program objectives(process and impact) • Specific,major activities to meet the objectives • A description of how activities will be tracked,monitored,and evaluated • A time line for completion of each activity • The title of the person responsible for each specific activity 6. BUDGET AND JUSTIFICATION (Total Evaluation Value: 15 points) a. Line Item Budget:Attach a Year One line item budget to this section of the proposal. (A budget form has been provided under Appendix H. Applicants are encouraged to create a similar form using a spread sheet software. For applicants without this capability, make sure your budget balances so that all rows and columns add together) Break down the budget by the following categories: I. Direct Costs: personnel,fringe,travel,equipment,supplies,contractual,and operating expenses. 2. Indirect Costs(See Appendix C for explanation) b. Budget Justification:Within the 10-page narrative,describe in detail how the funds in each line item will be spent. In the budget justification,describe and justify each line item by budget category, including matching fund sources. For personnel,include the number and/or percent of full-time employees(FTE)and description of duties. Offeror shall demonstrate appropriate allocation of staff and resources to produce the results detailed in the work plan.Information about appropriate justification is provided below. Justification should describe what is beinr paid for instead of why it should be paid for. Correct: Smart Kids Abstinence Education Curriculum—$3,100 This curriculum is composed of 15 lessons that provide skill building,role playing, parent interviews and other creative activities. Each student book costs$15 and 200 youth will receive a book. Four teacher manuals will also be purchased for$25 a piece. Incorrect: Smart Kids Abstinence Education Curriculum--$3,100 Our program has reviewed several curricula and this one is most aligned with our program goals and is needed to meet our program objectives.In addition,we believe that youth react positively to this curriculum. (Descriptions such as these belong in the Proposed Project section and not the budget justification. This does not describe nor juste$3,100 in curriculum costs) Title V Abstinence Education Program --Program RFA 13 7. CAPABILITY OF THE APPLICANT (Evaluation Value: 10 points) a. How long has your organization been in business? b. Describe the organization's experience and expertise to provide the proposed program/campaign. c. Provide a detailed description that indicates that your organization possesses the necessary resources such as materials,equipment,facilities,FTE,funding,etc.,or the ability to obtain them. d. Provide a description that indicates the organization's experience,expertise and organizational structure to manage the fiscal,programmatic and administrative aspects of this grant. f. Attach an organizational chart. g. If you are applying with more than one organization in a collaborative effort,designate the fiscal agency and describe the relationship between organizations,including subcontractors.List the responsible parties in each organization. h. Provide letters of support from all collaborating agencies and organizations(schools,youth-serving agencies,parent organizations,health agencies,etc.)who are listed specifically as collaborators.Non- school applicants who plan to implement a program in a school(s)must have letters of support from the school principal(s). 8. ASSURANCES Complete and sign the Assurances Page(Appendix E)and submit it with the proposal. IV. ADMINISTRATIVE INFORMATION A. ISSUING OFFICE: This Request for Applications(RFA)is Issued for the Colorado Department of Public Health &Environment(CDPHE)for the benefit of the CDPHE Colorado Abstinence Education Program (CAEP). All communication must be done through the Director of the CAEP Program. B. PURPOSE: This RFA provides prospective offerors with sufficient information to enable them to prepare and submit proposals for consideration by the Colorado Department of Public Health & Environment to satisfy the need for expert assistance in the completion of the goals of this RFA. C. SCOPE: This RFA contains the instructions governing the proposal to be submitted and the material to be included therein; mandatory requirements which must be met to be eligible for consideration; and other requirements to be met by each proposal. D. SCHEDULE OF ACTIVITIES: TIMELINE(Local Time) . 1. RFA AVAILABLE 09-05-03 2.INQUIRY PERIOD(responses within 7 days of receipt) 09-05-03 To 09-26-03 3.PROPOSAL SUBMISSION DEADLINE 10-10-2003,4:00 p.m. SUBMIT 4 COPIES OF THE PROPOSAL(INCLUDES ORIGINAL) 4. PROPOSAL REVIEW 10-20-2003 5. INITIAL CONTRACT PERIOD 01-01-04 To 12-31-04 8. THIS RFA IS ISSUED FOR A BASE TERM OF ONE YEAR,THE RESULTING CONTRACT MAY BE RENEWED FOR ADDITIONAL YEARS(UP TO A MAXIMUM OF FOUR ADDITIONAL YEARS)AT THE SOLE DISCRETION OF THE STATE. Title V Abstinence Education Program --Program REA 14 E. INQUIRIES: Offerors may make written, e-mail or fax inquiries concerning this RFA to obtain clarification of requirements. No inquiries will be accepted after the date and time indicated in the Schedule of Activities. Send all inquiries to: Co Dept of Public Health & Environment 4300 Cherry Creek Drive So. (A-4) Denver,CO 80246-1530 FAX: (303) 691-7852 E-mail: abstinence@state.co.us Abstinence Education RFA Inquiry F. PROPOSAL SUBMISSION AND DEADLINE: Proposals must be received on or before the date and time indicated in the Schedule of Activities. LATE PROPOSALS WILL NOT BE ACCEPTED. It is the responsibility of the offeror to ensure that CAEP receives the proposal on or before the proposal opening date and time deadline. Offerors mailing their proposals shall allow sufficient mail delivery time to ensure receipt of their proposals by the time specified. The proposal package shall be delivered or sent by mail to: Cob. Dept of Public Health &Environment 4300 Cherry Creek Drive So. (A-4) Denver,CO 80246-1530 Attn:Abstinence Education RFA Submit one original signed copy of the Request For Application , and three duplicate copies. The original MUST be signed in ink by the offeror or an officer of the offeror legally authorized to bind the offeror to the proposal. Proposals,which are determined to be at a variance with this requirement,may not be accepted. Proposals must be submitted and sealed in a package.The outer envelope of the package must include the following information: OFFEROR'S NAME ABSTINENCE EDUCATION RFA PROPOSAL DUE DATE &TIME Applications that are sent by facsimile of electronic transmission will NOT BE accepted. G. ACCEPTANCE OF RFA TERMS: A proposal submitted in response to this RFA shall constitute a binding offer. The autographic signature of the offeror or an officer of the offeror legally authorized to execute contractual obligations shall indicate acknowledgment of this condition. A submission in response to this RFA acknowledges acceptance by the offeror of all terms and conditions including compensation,as set forth herein. An offeror shall identify clearly and thoroughly any variations between its proposal and the State's RFA. Failure to do so shall be deemed a waiver of any rights to subsequently modify the terms of performance,except as outlined or specified in the RFA. H. CONFIDENTIAL/PROPRIETARY INFORMATION: Any restrictions of the use or inspection of material contained within the proposal shall be clearly stated in the proposal itself. Written requests for confidentiality shall be submitted,by the offeror with the proposal. The offeror must state specifically what elements of the proposal are to be considered confidential/proprietary. Confidential/proprietary information must be readily identified, marked and separated/packaged from the rest of the proposal. Co-mingling of confidential/proprietary and other information is NOT acceptable. Neither a proposal, in its entirety, nor proposal price information will be considered confidential and proprietary. Any information that will be included in any resulting contract cannot be considered confidential. Title V Abstinence Education Program --Program RFA 15 The CDPH&E Purchasing Section shall assist the CAEP to determine the validity of any written request for confidentiality. If the parties do not agree as to the disclosure of data, the Purchasing Section shall inform the bidder in writing what portions will be disclosed. The written decision of the Purchasing Section will be sent to the offeror. Ref.Section 24- 72-201 et. seq., C.R.S., as amended, Public(open) Records. I. RFA RESPONSE MATERIAL OWNERSHIP: All material submitted regarding this RFA becomes the property of the State of Colorado. Proposals may be reviewed by any person after the"Notice of Award" letters have been issued,subject to the terms of Section 24-72- 201 et. seq.,C.R.S.,as amended, Public(open) Records. J. SELECTION OF PROPOSAL:All offerors will be notified in writing regarding the results of the RFA evaluation. Upon review and approval of the evaluation committee's recommendation for award,the CDPHE will issue a"Notice of Award" letter to the apparent successful offerors. K. ACCEPTANCE OF PROPOSAL CONTENT: The contents of the proposal (including persons specified to implement the project)of the successful offeror will become contractual obligations if acquisition action ensues. Failure of the successful offeror to accept these obligations in a contract, purchase document,delivery order or similar acquisition instrument may result in cancellation of the award and such offeror may be removed from future solicitations. L. STANDARD CONTRACT: The State of Colorado will incorporate standard State contract provisions(Special Provisions) into any contract resulting from this RFA. M. RFA CANCELLATION: The State reserves the right to cancel this Request for Application at any time,without penalty. N. STATE OWNERSHIP OF CONTRACT PRODUCTS/SERVICES: Proposals, upon established opening time, become the property of the State of Colorado. All products/services produced in response to the contract resulting from this RFA will be the sole property of the State of Colorado, unless otherwise noted in the RFA. The contents of the successful offeror's proposal will become contractual obligations. O. INCURRING COSTS: The State of Colorado is not liable for any cost incurred by offerors prior to issuance of a legally executed contract or procurement document. No property interest, of any nature shall occur until a contract is awarded and signed by all concerned parties. P. MINORITY-OWNED/WOMAN-OWNED BUSINESS ENTERPRISE PARTICIPATION: It is the State's intent to achieve the goals of the Governor's Executive Orders D005547 and D0005-94 regarding minority/woman-owned businesses. Offerors are reminded it is illegal to discriminate. Q. NON-DISCRIMINATION: The offeror shall comply with all applicable state and federal laws, rules and regulations involving non-discrimination on the basis of race,color,religion, national origin,age or sex. R. REJECTION OF PROPOSALS: The State of Colorado reserves the right to reject any or all proposals and to waive informalities and minor irregularities in proposals received and to accept any portion of a proposal or all items proposed if deemed in the best interest of the State of Colorado. S. PARENT COMPANY: If an offeror is owned or controlled by a parent company,the name, main office address&parent company's tax identification number shall be provided in the proposal.The tax identification number provided must be that of the offeror responding to the RFA. T. NEWS RELEASES: News released pertaining to this RFA shall NOT be made prior to execution of the contract without prior written approval of CDPHE. Title V Abstinence Education Program --Program RFA 16 U. CONTRACT CANCELLATION: CDPHE reserves the right to cancel,for cause, convenience or lack of fiscal funding, any contract resulting from this RFA by providing timely notice to the contractor. V. TAXES: CDPHE,as purchaser, is exempt from all federal excise taxes under Chapter 32 of the Internal Revenue Code(Registration No. 84-730123K) and from all state and local government use taxes (Ref. Colorado Revised Statutes Chapter 39-26.114(a)). Our Colorado State and Local Sales Tax Exemption Number is 98-02565. Seller is hereby notified that when materials are purchased in certain political sub-divisions(for example- City of Denver)the seller may be required to pay sales tax even though the ultimate product or service is provided to the State of Colorado. This sales tax will not be reimbursed by the State. W. ASSIGNMENT AND DELEGATION: Except for assignment of antitrust claims,neither party to any resulting contract may assign or delegate any portion of the agreement without the prior written consent of the other party. X. AVAILABILITY OF FUNDS: Financial obligations of the State payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. In the event funds are not appropriated, any resulting contract will become null and void,without penalty to the State of Colorado. Y. INDEPENDENT CONTRACTOR CLAUSE: All personal service contracts must contain the following clause: "The contractor shall perform its duties hereunder as an independent contractor and not as an employee. Neither the contractor nor any agent or employee of the contractor shall be or shall be deemed to be an agent or employee of the state. Contractor shall pay when due all required employment taxes and income tax withholding,shall provide and keep in force worker's compensation(and show proof of such insurance)and unemployment compensation insurance in the amounts required by law,and shall be solely responsible for the acts of the contractor,its employees and agents." Z. INDEMNIFICATION: To the extent authorized by law,the contractor shall indemnify,save and hold harmless the State,its employees and agents, against any and all claims, damages, liability and court awards including costs,expenses,and attorney fees incurred as a result of any act or omission by the contractor or its employees,agents,sutconbaclors, or assignees pursuant to the terms ofihe conhadresultirg from this RFA AA.VENUE: The laws of the State of Colorado, U.S.A. shall govern in connection with the formation, performance and the legal enforcement of any resulting contract. Further,Title 24, C.R.S. as amended,Article 101 through 112 and Rules adopted to implement the statutes govern this procurement. BB.INSURANCE: If the RFA so states,the contractor shall obtain,(at its own expense)and maintain at all times during the terms of this agreement, insurance in the following kinds and amounts: A Standard Workers' Compensation and Employer Liability as required by state statute, including occupational disease,covering all employees on or off the work site,acting within the course and scope of their employment. B. General and/or Personal Injury and/or Professional and/or Automobile Liability- (including bodily injury, personal injury and property damage)with the following coverage,depending on the policy format: 1. Occurrence basis policy-combined single limit of$600,000. 2. Annual Aggregate limit policy-not less than $1 million plus agreement that vendor will purchase additional Insurance to replenish the limit to$1 million if claims reduce the annual aggregate below$600,000. 3. Claims-Made policy-Combined single limit of$600,000 plus an endorsement that extends coverage 2 years beyond the policy expiration date. Title V Abstinence Education Program --Program RFA 17 C. Vendor shall provide such other insurance as may be required by law.The State of Colorado shall be named as an additional insured on all liability policies.The insurance shall include a provision preventing cancellation without 60-calendar days prior written notice to the State by certified mail.Vendor shall provide the following documentation to the State within 7 working days of a request therefore, unless otherwise provided: 1. Certificate's of adequate insurance coverage,each with a reference to the State being named as an additional insured,or 2. Certificate's of adequate insurance coverage and an endorsement/s of additional insured coverage. V. CONTRACT GENERAL PROVISIONS. 1. Because this Contract involves the expenditure of federal,state,or private funds,this Contract is subject to,and contingent upon,the continued availability of those funds for payment pursuant to the terms and conditions of this Contract. If those funds,or any part thereof,become unavailable as determined by the State,then the State may immediately terminate this Contract. 2. The parties warrant that each possesses actual,legal authority to enter into this Contract. The parties further warrant that each has taken all actions required by its applicable law,procedures, rules,or bylaw to exercise that authority,and to lawfully authorize its undersigned signatory to execute this Contract and bind that party to its terms. The person or persons signing this Contract, or any attachments or amendments hereto,also warrant(s)that such person(s)possess(es)actual, legal authority to execute this Contract,and any attachments or amendments hereto,on behalf of that party. 3. The Contractor is a"public entity"within the meaning of the Colorado Governmental Immunity Act(CGIA),section 24-10-101,er seq.,C.R.S.,as amended. Therefore,at all times during the initial term of this Contract,and any renewals or extensions hereof,the Contractor shall maintain such liability insurance,by commercial policy or self-insurance,as is necessary to meet its liabilities under the CGIA. If requested by the State,the Contractor shall provide the State with written proof of such insurance coverage. 4. The Contractor certifies that,as of the effective date of this Contract,it has currently in effect all required licenses,certifications,approvals,insurance,permits,etc.,if any,that are necessary to properly perform the services and/or deliver the products specified in this Contract. The Contractor also warrants that it shall maintain all required licenses,certifications,approvals, insurance,permits,etc.,if any,that are necessary to properly perform this Contract,without reimbursement by the State or other adjustment in the Contract price. Additionally,all employees or subcontractors of the Contractor performing services under this Contract shall hold,and maintain in effect,all required licenses,certifications,approvals,insurance,permits,etc.,if any, that are necessary to perform their duties and obligations under this Contract. Any revocation, withdrawal or nonrenewal of any required licenses,certifications,approvals,insurance,permits, etc.,if any,that are necessary for the Contractor,or its employees and subcontractors,to properly perform its duties and obligations under this Contract shall be grounds for termination of this Contract by the State for default without further liability to the State. 5. If this Contract involves federal funds,or compliance is otherwise federally mandated,then the Contractor shall comply with the requirements of the following: A. Office of Management and Budget Circulars A-2I,A-87,A-102,A-110,or A-122,as applicable; B. the"Hatch Act"(5 U.S.C. 1501-1508)and Public Law 95-454,Section 4728. These federal statutes declare that federal funds cannot be used for partisan political purposes of Title V Abstinence Education Program --Program RFA 18 any kind by any person or organization involved in the administration of federally- assisted programs; C. the"Davis-Bacon Act"(40 U.S.C.276A-276A-5). This federal Act requires that all laborers and mechanics employed by contractors or subcontractors to work on construction projects financed by federal assistance must be paid wages not less than those established for the locality of the project by the Secretary of Labor; D. 42 U.S.C.6101 et sea.,42 U.S.C.2000d,29 U.S.C.794. These federal Acts mandate that no person shall,on the grounds of race,color,national origin,age,or disability,be excluded from participation in or be subjected to discrimination in any program or activity funded,in whole or in part,by federal funds; E. the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C. 12101, 12102, 12111 - 12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213 and 47 U.S.C.225 and 47 U.S.C.611); F. if the Contractor is acquiring an interest in real property and displacing households or businesses in the performance of this Contract,then the Contractor is in compliance with the"Uniform Relocation Assistance and Real Property Acquisition Policies Act",as amended,(Public Law 91-646,as amended,and Public Law 100-17, 101 Stat.246-256); G. when applicable,the Contractor shall comply with the provisions of the"Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments"(Common Rule);and, H. Section 2101 of the Federal Acquisition Streamlining Act of 1994,Public Law 103-355, which prohibits the use of federal money to lobby the legislative body of a political subdivision of a State. 6. If this Contract involves federal funds,or compliance is otherwise federally mandated,then by signing and submitting this Contract,the Contractor affirmatively avers that: A. the Contractor is in compliance with the requirements of the"Drug-Free Workplace Act" (Public Law 100-690 Title V,Subtitle D,41 U.S.C.701 et seq.); B. the Contractor is not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from covered transactions by any federal department or agency;the Contractor shall to comply with all applicable regulations pursuant to Executive Order 12549,including,Debarment and Suspension and Participants' Responsibilities,29 C.F.R.98.510(1990);and, C. the Contractor shall comply with all applicable regulations pursuant to Section 319 of Public Law 101-121,Guidance for New Restrictions on Lobbying,including, Certification and Disclosure,29 C.F.R.93.110(1990). 7. To be considered for payment,billings for payments pursuant to this Contract must be received within a reasonable time after the period for which payment is requested;but in no event no later than sixty(60)calendar days after the relevant performance period has passed. Final billings under this Contract must be received by the State within a reasonable time after the expiration or termination of this Contract;but in no event no later than sixty(60)calendar days from the effective expiration or termination date of this Contract. 8. Unless otherwise provided for in this Contract,"Local Match"shall be included on all billing statements,in the column provided therefore,as required by the funding source. Title V Abstinence Education Program —Program RFA 19 9. The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. 10. In accordance with Office of Management and Budget(OMB)Circular A-133 (Audits of States, Local Governments,and Non-Profit Organizations),if the Contractor receives federal funds from any source,including State pass through monies,in an aggregate amount in excess of $300,000.00 (June 24, 1997),in a State fiscal year(July 1 through June 30),then the Contractor shall have an annual audit performed by an independent certified public accountant which meets the requirements of OMB Circular A-133. If the Contractor is required to submit an annual indirect cost proposal to the State for review and approval,then the Contractor's auditor shall audit the proposal in accordance with the requirements of OMB Circulars A-21 (Cost Principles for Educational Institutions),A-87(Cost Principles for State,Local and Tribal Governments),or A- 122(Cost Principles for Non-Profit Organizations),whichever is applicable. The Contractor shall furnish one(1)copy of the audit report(s)to the State=s Accounting Office within thirty(30) calendar days of issuance;but in no event later than nine(9)months after the end of the Contractor's fiscal year. If(an)instance(s)of noncompliance with federal laws and regulations occurs,then the Contractor shall take all appropriate corrective action(s)within six(6)months of the issuance of(a)report(s). 11. The Contractor shall grant to the State,or its authorized agents,access to the records and financial statements of the Contractor that directly relate to its performance under this Contract. The Contractor shall retain all such records and financial statements for a period of six(6)years after the date of issuance of a final audit report. This requirement is in addition to any other audit requirements contained in other paragraphs of this Contract. 12. Unless otherwise provided for in this Contract,for all contracts with terms longer than three(3) months,the Contractor shall submit a written progress report specifying the progress made for each activity identified in this Contract. These progress reports shall be submitted in accordance with any applicable procedures developed and prescribed by the State. The preparation of progress reports in a timely manner is the responsibility of the Contractor. If the Contractor fails to comply with this provision,then the failure:may result in a delay of payment of funds;or,termination of this Contract. 13. The Contractor shall maintain a complete file of all records,documents,communications,and other materials that directly relate to this Contract. These materials shall be sufficient to properly reflect all direct and indirect costs of labor,materials,equipment,supplies,and services,and other costs of whatever nature for which a contract payment was made. These records shall be maintained according to generally accepted accounting principles and shall be easily separable from other records of the Contractor. Copies of all such records,documents,communications,and other materials shall be the property of the State and shall be maintained by the Contractor,in a central location as custodian for the State,on behalf of the State,for a period of six(6)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any pending matters,including,but not limited to,audits performed by the federal government. 14. The Contractor authorizes the State,or its authorized agents or designees,to perform audits or make inspections of those records that directly relate to its performance under this Contract. Audits and inspections may be made at any reasonable time during the term of this Contract and for a period of three(3)after the termination or expiration date of this Contract. The Contractor shall permit the State,or any other duly authorized governmental agent or agency,to monitor all activities conducted by the Contractor pursuant to the terms of this Contract. Monitoring may include,but is not limited to:internal evaluation procedures,examination of program data,special analyses,on-site checks,formal audit examinations,or any other reasonable procedures. All monitoring shall be performed by the State in a manner that does not unduly interfere with the • work of the Contractor. 15. Subject to the Public(Open)Records Act,section 24-72-101,et seq.,C.R.S.,as amended,if the Contractor obtains access to any records,files,or other information of the State in connection with, Title V Abstinence Education Program —Program RFA 20 or during the performance of,this Contract,then the Contractor shall keep all such records,files, or other information confidential and shall comply with all laws and regulations concerning the confidentiality of all such records,files,or information to the same extent as such laws and regulations apply to the State. Any breach of confidentiality by the Contractor,or third party agents of the Contractor,shall constitute good cause for the State to cancel this Contract,without liability to the State. Any State waiver of an alleged breach of confidentiality by the Contractor,or third party agents of the Contractor,does not constitute a waiver of any subsequent breach by the Contractor,or third party agents of the Contractor. 16. Unless otherwise provided for in this Contract,or in a written amendment executed and approved pursuant to Fiscal Rules of the state of Colorado,all material,information,data,computer software,documentation,studies,and evaluations produced in the performance of this Contract for which the State has made a payment under this Contract are the sole property of the State. 17. If any copyrightable material is produced under this Contract,then the State,and any applicable federal funding entity,shall have a paid in full, irrevocable,royalty free,and non-exclusive license to reproduce,publish,or otherwise use,and authorize others to use,the copyrightable material for any purpose authorized by the Copyright Law of the United States as now or hereinafter enacted. Upon the written request of the State,the Contractor shall provide the State with three(3)copies of all such copyrightable material. 18. If required by the terms and conditions of a federal or state grant,the Contractor shall obtain the prior approval of the State and all necessary third parties prior to publishing any materials produced under this Contract. If required by the terms and conditions of a federal or state grant, the Contractor shall also credit the State and all necessary third parties with assisting in the publication of any materials produced under this Contract. 19. If this Contract is in the nature of personal/purchased services,then the State reserves the right to inspect services provided under this Contract at all reasonable times and places during the term of this Contract. "Services",as used in this clause,includes services performed or written work performed in the performance of services. If any of the services do not conform with the terms of this Contract,then the State may require the Contractor to perform the services again in conformity with the terms of this Contract,with no additional compensation to the Contractor for the reperformed services. When defects in the quality or quantity of the services cannot be corrected by reperformance,then the State may:require the Contractor to take all necessary action(s)to ensure that the future performance conforms to the teens of the Contract;and,equitably reduce the payments due to the Contractor under this Contract to reflect the reduced value of the services performed by the Contractor. These remedies in no way limit the other remedies available to the State as set forth in this Contract. 20. If,through any cause attributable to the action(s)or inaction(s)of the Contractor,the Contractor: fails to fulfill,in a timely and proper manner,its duties and obligations under this Contract;or, violates any of the agreements,covenants,provisions,stipulations,or teens of this Contract,then the State shall thereupon have the right to cancel this Contract,in whole or in part,for cause by giving written notice thereof to the Contractor. The written notice shall be given to the Contractor no less than thirty(30)calendar days before the proposed cancellation date and shall afford the Contractor the opportunity to cure the default or state why cancellation is otherwise inappropriate. If this Contract is cancelled for default,then all finished or unfmished data,documents,drawings, evaluations,hardware,maps,models,negatives,photographs,reports,software,studies,surveys, or any other material,medium or information,however constituted,which has been or is to be produced or prepared by the Contractor under this Contract shall,at the option of the State, become the property of the State. The Contractor shall be entitled to receive just and equitable compensation for any services or supplies delivered to,and accepted by,the State. If applicable, the Contractor shall return any unearned advance payment it received under this Contract to the State. Notwithstanding the above,the Contractor is not relieved of liability to the State for any damages sustained by the State because of the breach of this Contract by the Contractor. The State may withhold any payment due to the Contractor under this Contract to mitigate the damages of the State until such time as the exact amount of those damages is determined. If,after canceling Title V Abstinence Education Program --Program RFA 21 this Contract for default,it is determined for any reason that the Contractor was not in default,or that the action(s)or inaction(s)of the Contractor was excusable,then such cancellation shall be treated as a termination for convenience,and the respective rights and obligations of the parties shall be the same as if this Contract had been terminated for convenience as described below. 21. The State may,when the interests of the State so require,terminate this Contract,in whole or in part,for the convenience of the State. The State shall give written notice of termination to the Contractor. The written notice shall specify the part(s)of the Contract terminated. The written notice shall be given to the Contractor no less than thirty(30)calendar days before the effective date of termination. If this Contract is terminated for convenience,then all finished or unfinished data,documents,drawings,evaluations,hardware,maps,models,negatives,photographs,reports, software,studies,surveys,or any other material,medium or information,however constituted, which has been or is to be produced or prepared by the Contractor under this Contract shall,at the option of the State,become the property of the State. The Contractor shall be entitled to receive just and equitable compensation for any services or supplies delivered to,and accepted by,the State. If applicable,the Contractor shall return any unearned advance payment it received under this Contract to the State. This paragraph in no way implies that a party has breached this Contract by the exercise of this paragraph. If this Contract is terminated by the State as provided for herein, then the Contractor shall be paid an amount equal to the percentage of services actually performed for,or goods actually delivered to,the State,less any payments already made by the State to the Contractor for those services or goods. However,if less than sixty percent(60%)of the services or goods covered by this Contract have been performed or delivered as of the effective date of termination,then the Contractor shall also be reimbursed(in addition to the above payment)for that portion of those actual"but-of-pocket"expenses(not otherwise reimbursed under this Contract)incurred by the Contractor during the term of this Contract that are directly attributable to the uncompleted portion of the services,or the undelivered portion of the goods,covered by this Contract. hi no event shall reimbursement under this clause exceed the total financial obligation of the State to the Contractor under this Contract. If this Contract is canceled for default because of a material breach of this Contract by the Contractor,then the above provisions for cancellation for default shall apply. 22. Neither the Contractor nor the State shall be liable to the other for any delay in, or failure of performance of,any covenant or promise contained in this Contract to the extent that the delay or failure is caused by a supervening cause. As used in this Contract,"supervening cause"is defined to mean: an act of God,fire,explosion,action of the elements,strike,interruption of transportation,rationing,court action,illegality,unusually severe weather,war, or any other cause which is beyond the control of the affected party and which,by the exercise of reasonable diligence,could not have been prevented by the affected party. A delay or failure to perform that is caused by a supervening cause shall not constitute a material breach of this Contract or give rise to any liability for damages therefore under this Contract. 23. The enforcement of the terms and conditions of this Contract,and all rights of action related to that enforcement,shall be strictly reserved to the State and the Contractor. Nothing contained in this Contract shall give rise to,or allow,any claim or right of action whatsoever to or by any third person. Nothing contained in this Contract shall be construed as a waiver of any provision of the Colorado Governmental Immunity Act,section 24-10-101 et seq.,C.R.S.,as amended. Any person or entity,other than the State or the Contractor,who may receive services or benefits under this Contract shall be deemed an incidental beneficiary only. 24. To the extent that this Contract may be executed and performance of the obligations of the parties may be accomplished within the intent of this Contract,the terms of this Contract are severable. If any term or provision of this Contract is declared invalid by a court of competent jurisdiction,or becomes inoperative for any other reason,then that invalidity or failure shall not affect the validity of any other term or provision of this Contract. 25. The waiver of a breach of a term or provision of this Contract shall not be construed as a waiver of a breach of any other term or provision of this Contract or,as a waiver of a breach of the same term or provision upon subsequent breach. Title V Abstinence Education Program —Program RFA 22 26. If this Contract is in the nature of personal/purchased services,then,except for accounts receivable,the rights,duties,and obligations of the Contractor shall not be assigned,delegated,or otherwise transferred,except with the prior,express,written consent of the State. 27. Unless otherwise provided for in this Contract,this Contract shall inure to the benefit of,and be binding upon,the parties hereto and their respective successors and assigns. 28. Unless otherwise provided for in this Contract,the Contractor shall notify the State,within five(5) working days after being served with a summons,complaint,or other pleading in any case that involves any services provided under this Contract and which has been filed in any federal or state court or administrative agency.The Contractor shall deliver copies of any documents that it was served with to the State within five working(5)days of the date of service. 29. This Contract is subject to such modifications as may be required by changes in applicable federal or state law,or federal or state implementing rules,regulations,or procedures of that federal or state law. Any required modification(s)shall be automatically incorporated into,and be made a part of,this Contract as of the effective date of the change as if that change was fully set forth herein. Except as provided above,no modification of this Contract shall be effective unless that modification is agreed to in writing by both parties in the form of a written amendment to this Contract that has been previously executed and approved in accordance with the Fiscal Rules of the state of Colorado. 30. Unless otherwise provided for in this Contract,all terms and conditions of this Contract,and the attachments or exhibits hereto,that may require continued performance or compliance beyond the termination or expiration date of this Contract shall survive that termination or expiration date and shall be enforceable as provided for herein. 31. Unless otherwise provided for in this Contract,no term or condition of this Contract shall be construed or interpreted as a waiver,express or implied,of any of the immunities,rights,benefits, protections,or other provisions of the Colorado Governmental Immunity Act(CGIA),section 24- 10-101,et sea.,C.R.S.,as amended. Liability for claims for injuries to persons or property arising out of the alleged negligence of the State or the Contractor,their departments,institutions, agencies,boards,officials,and employees is controlled and limited by the provisions of section 24- 10-101 et seq.,C.R.S.,as amended. 32. The captions and headings used in this Contract are for identification only,and shall be disregarded in any construction of the terms,provisions,and conditions of this Contract. 33. The exclusive venue for any action related to this Contract shall be in the City and County of Denver,Colorado. 34. All attachments or exhibits to this Contract are incorporated herein by this reference and made a part hereof as if fully set forth herein. In the event of any conflict or inconsistency between the terms of this Contract and those of any attachment or exhibit to this Contract,the terms and conditions of this Contract shall control. 35. This Contract is the complete integration of all understandings between the parties. No prior or contemporaneous addition,deletion,or other amendment hereto shall have any force or effect whatsoever,unless embodied herein in writing. No subsequent novation,renewal,addition, deletion,or other amendment hereto shall have any force or effect unless embodied in a written amendment to this Contract executed and approved in accordance with applicable law. Title V Abstinence Education Program --Program RFA 23 VI. SPECIAL PROVISIONS. 1. CONTROLLER'S APPROVAL.CRS 24-30-202(1) This contract shall not be deemed valid until it has been approved by the Controller of the State of Colorado or such assistant as he may designate. 2. FUND AVAILABILITY.CRS 24-30-202(5.5) . Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted,and otherwise made available. 3. INDEMNIFICATION. To the extent authorized by law,the contractor shall inden reify,save,and hold harmless the State against any and all claims,damages,liability and court awards including costs,expenses,and attorney fees incurred as a result of any act or omission by the Contractor,or its employees,agents, subcontractors,or assignees pursuant to the terms of this contract. No term or condition of this contract shall be construed or interpreted as a waiver,express or implied,of any of the immunities,rights,benefits,protection,or other provisions for the parties,of the Colorado Governmental Immunity Act,CRS 24-10-101,et seq.,or the federal tort claims act, 28 U.S.C.2671 et seq.,as applicable as now or hereafter amended. 4. INDEPENDENT CONTRACTOR.4 CCR 801-2 THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. CONTRACTOR SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID BY THE STATE PURSUANT TO THIS CONTRACT. CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE.CONTRACTOR SHALL HAVE NO AUTHORIZATION, EXPRESS OR IMPLIED,TO BIND THE STATE TO ANY AGREEMENTS,LIABILITY,OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN.CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS' COMPENSATION(AND PROVIDE PROOF OF SUCH INSURANCE WHEN REQUESTED BY THE STATE)AND UNEMPLOYMENT COMPENSATION INSURANCE IN THE AMOUNTS REQUIRED BY LAW,AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR, ITS EMPLOYEES AND AGENTS. 5. NON-DISCRIMINATION. The contractor agrees to comply with the letter and the spirit of all applicable state and federal laws respecting discrimination and unfair employment practices. Title V Abstinence Education Program —Program RFA 24 6. CHOICE OF LAW. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,and enforcement of this contract.Any provision of this contract,whether or not incorporated herein by reference,which provides for arbitration by any extra judicial body or person or which is otherwise in conflict with said laws,rules,and regulations shall be considered null and void.Nothing contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint,defense,or otherwise.Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the contract is capable of execution. At all times during the performance of this contract,the Contractor shall strictly adhere to all applicable federal and State laws,rules,and regulations that have been or may hereafter be established. 7. SOFTWARE PIRACY PROHIBITION GOVERNOR'S EXECUTIVE ORDER No State or other public funds payable under this Contract shall be used for the acquisition, operation or maintenance of computer software in violation of United States copyright laws or applicable licensing restrictions.The Contractor hereby certifies that,for the term of this Contract and any extensions,the Contractor has in place appropriate systems and controls to prevent such improper use of public funds.If the State determines that the Contractor is in violation of this paragraph,the State may exercise any remedy available at law or equity or under this Contract, including,without limitation,immediate termination of the Contract and any remedy consistent with United States copyright laws or applicable licensing restrictions. 8. EMPLOYEE FINANCIAL INTEREST.CRS 24-18-201 &CRS 24-50-507 The signatories aver that to their knowledge,no employee of the State of Colorado has any personal or beneficial interest whatsoever in the service or property described herein. Title V Abstinence Education Program —Program RFA 25 IN WITNESS WHEREOF,the parties hereto have executed this Contract on the day first above written. CONTRACTOR: STATE: STATE OF COLORADO Bill Owens,Governor By: By: Title: For the Executive Director FEIN: DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT If Corporation,Town/City/County,or Equivalent: PROGRAM APPROVAL: ATTEST(Affix Seal) By: By: Corporate Secretary,or Equivalent,Town/City/County Clerk APPROVALS: COLORADO DEPARTMENT OF LAW OFFICE OF THE ATTORNEY GENERAL Ken Salazar,Attorney General By: 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 the goods and/or services provided. STATE CONTROLLER: By Date Title V Abstinence Education Program --Program RFA 26 VII. APPENDICES All appendices may be sent to Offerors upon request in Microsoft Word 97 format. A. State Performance Measures B. Client Tracking Forms C. Indirect Cost Options D. Standards for Working with People with Disabilities & E. Standards of Cultural Competency and Proficiency F. Assurances Page G. Program Abstract H. Sample Work Plan I. Line Item Budget Form Title V Abstinence Education Program —Program RFA 27 APPENDIX A STATE ABSTINENCE EDUCATION PERFORMANCE MEASURES The State of Colorado must report annually to the federal government,on the progress of meeting its abstinence education performance measures. 1. Fertility Rate:In the State of Colorado,reduce by 30%,the rate of births to female teenagers,aged 15-17,from 31.2 per 1,000 in 1996,to 21.8 per 1,000 in 2002.(Baseline source:Family and Community Health Services Division, CDPHE) 2. Sexual Activity:In the State of Colorado,reduce by 15%,the proportion of adolescents in grade nine who report having engaged in sexual intercourse,from 32.9%in 1995,to 27.96%in 2002;and reduce by 15%,the proportion of adolescents in grade twelve who report having engaged in sexual intercourse,from 62.0%in 1995, to 52.7%in 2002. (Baseline source: 1995 Colorado Youth Risk Behavior Survey) 3. Sexually Transmitted Disease Rates:In the State of Colorado,reduce by 15%the number of gonorrhea cases in youth aged 15-19,from 205.7 per 100,000 in 1996,to 174.8 per 100,000 in 2002;and reduce by 100%the number of syphilis cases,from 1.8 per 100,000 in 1996,to 0 per 100,000 in 2002.(Baseline source: Sexually Transmitted Diseases in Colorado Surveillance Report, 1996)' 4. Pregnancy Rate:In the State of Colorado,reduce by 10%,the rate of pregnancy for females aged 15-17,from 55 per 1,000 in 1995 to 50.0 per 1,000 in 2002. (Baseline source: Colorado Health Statistics and Vital Records Division, CDPHE) 5. Number of Sexual Partners:In the State of Colorado,reduce by 15%,the proportion of teens in grades 9- 12 who report having engaged in sexual intercourse with four or more people,from 16.0%in 1995,to 13.6%in 2002.(Baseline source: 1995 Colorado Youth Risk Behavior Survey) 6. Alcohol or Other Drug Use at Last Intercourse:In the State of Colorado,reduce by 15%,the proportion of adolescents in grades 9- 12 who report using alcohol or other drugs at last intercourse,from 13.0%in 1995,to 11.1%in 2002. (Baseline source: 1995 Colorado Youth Risk Behavior Survey) 'Gonorrhea and Syphilis were chosen because they are two reportable sexually transmitted diseases Title V Abstinence Education Program —Program RFA 28 APPENDIX B Program Name Director For the Time Period State of Colorado Abstinence Education Program Table I TOTAL ENCOUNTERS BY CLIENTS* <10 10-14 15-17 18-19 20-24 >24 Parents TOTAL MALES Non-Hispanic White Black Hispanic Others FEMALES Non-Hispanic White Black Hispanic Other TOTAL *Client may include program participants, as well as adult stakeholders. Title V Abstinence Education Program --Program RFA 29 Appendix B continued... Program Name Director For the Time Period State of Colorado Abstinence Education Program Table II • TOTAL UNDUPLICATED COUNT OF CLIENTS* <10 10-14 15-17 18-19 20-24 >24 Parents TOTAL MALES Non-Hispanic White Black Hispanic Other FEMALES Non-Hispanic White Black Hispanic Other TOTAL *Client may include program participants, as well as adult stakeholders. Title V Abstinence Education Program --Program RFA 30 APPENDIX C INDIRECT COSTS Proposals may include a request for reimbursement of indirect/overhead costs. This may be handled in one of the following four ways: 1. If the applicant's organization already has an indirect rate approved by the CDPHE(i.e.,local health departments),such rate will be accepted as the indirect rate. Indirect rates must be approved annually. 2. If the applicant's organization does not have an approved indirect rate,the applicant's proposed budget may include a flat indirect rate of 10%of salary costs,excluding fringe benefits,requested from the CDPHE. This rate does not need to be justified or broken down by line item category. 3. The applicant may choose not to use an indirect rate,but to instead include overhead costs under the Direct Cost category of the proposed budget. These actual costs for overhead should be broken down under the specific individual line items in the Direct Cost budget category. These costs must be substantiated in the budget justification by describing the methods of allocating these costs to the Abstinence Education Program. 4. If the applicant's organization does not have an approved indirect rate but wants reimbursement for overhead(indirect)cost in excess of 10%of funds requested,they may go through the approval process with the State. Please note that this process takes several weeks and may not be the best option for agencies that do not have multiple State contracts.Once a contract is received,a contractor can submit an indirect cost proposal to the CDPHE for review and approval. Such indirect rates are valid for one year and must be approved prior to payment for indirect costs.For CAEP-funded programs there is a maximum cap for indirect rates,as follows:27%salaries only,or salaries and wages(including fringe benefits)or 25%total direct costs,whichever is used for calculating the indirect cost proposal. CDPHE will recognize as match or local cost-sharing any unreimbursed indirect costs.Such unreimbursed indirect costs should be identified as a specific item on the budget form in column "Applicant and other." Definition of Direct verses Indirect costs: Direct costs are those that can be identified with a specific program. Indirect costs are those that have been incurred for common or joint organization objectives,and are not specific to any one program or project. Example:Rent 1) If a space were rented to house only the abstinence education program,the rent could be charged as a direct cost.Or if abstinence program space were part of another organization's facilities,it could be billed as a direct expense by calculating a value based on square footage. 2) If an organization houses the abstinence education program,in addition to other programs and staff,a justifiable proportion of rent could be considered an indirect cost. Title V Abstinence Education Program —Program RFA 31 APPENDIX D STANDARDS FOR WORKING WITH PEOPLE WITH DISABILITIES The State's Abstinence Education Steering Committee has recommended that funded projects demonstrate their efforts to effectively and respectfully provide abstinence education for people with disabilities. Programs should describe how their services will be made available to these populations. For example,an organization would have a reasonable plan for accommodating people who use wheelchairs by holding a workshop in a wheelchair accessible location,or a qualified interpreter would be provided so a person with a hearing impairment could attend a training. Abstinence education service organizations that target or serve youth with disabilities should collaborate with other agencies whose primary mission is to serve people with disabilities/hearing impairments,in order to'obtain training, technical assistance and consultation on how best to serve these populations. Organizations are encouraged to recruit and hire a culturally diverse work force including people with disabilities/hearing impairment STANDARDS OF CULTURAL COMPETENCY AND PROFICIENCY The State's Abstinence Education Steering Committee has recommended that funded programs embrace a philosophy of cultural competence and strive for an organization that is culturally proficient. A culturally competent organization is characterized by the following: Acceptance of and respect for difference; Continuous expansion of cultural knowledge and resources;and Ongoing self-assessment regarding culture adaptations of service models in order to better meet the needs of communities of color. This type of organization provides support for staff to become comfortable working in cross-cultural situations. Further, culturally competent agencies understand the interplay between policy and practice, are committed to policies that enhance services to diverse clientele and are committed to moving the organization to a position of cultural proficiency. Culturally proficient organizations hold culture in high esteem and seek to add to the knowledge base of culturally competent practice through such venues as research;development of therapeutic approaches based on culture;and publishing and disseminating demonstration project results. Attitudes,policies, and practices are the three major areas wherein development can and must occur if agencies are to move toward cultural proficiency. Organizations are encouraged to recruit and hire a culturally diverse workforce including people of color. Title V Abstinence Education Program —Program RFA 32 Appendix E Assurances I hereby affirm the following regarding my organization's Title V funded abstinence education project: (please initial) Project staff/volunteers will provide education and materials that are scientifically and medically sound. The project will follow a model that builds and the strengths and assets of youth. No component of the project shall be inconsistent with the eight criteria of the Federal Abstinence Education Definition. Project staff/volunteers will not provide any education about contraceptive methods. This project shall be delivered separate and apart from any religious education or affiliation. The project will provide direct services to youth between 5t°to 12th grade,or 10 to 17 years of age. Project staff/volunteers will incorporate higher-risk youth into the programs'demographic mix. Organization staff and program volunteers will assure the confidentiality of the youth.Information will not be shared unless the youth has signed a Release of Information form. The project will pursue collaborations with parents,parent groups,community leaders,educators,healthcare professionals,other youth-serving agencies and other potential stakeholders as necessary to accomplish the scope of work. ORGANIZATION NAME: NAME OF INDIVIDUAL AUTHORIZED TO SIGN THIS FORM: Title V Abstinence Education Program —Program RFA 33 Appendix F Program Abstract Organization Name: Tax ID#: Contact Name: Address: City Zip Telephone#: Fax#: e-mail address: 1. Type of grant for which the program is applying: ❑ Community-based Abstinence Education Program Grants ❑ Comprehensive Model Abstinence Education Program Grants 2. Amount Requested from CDPHE:$ 3. Please complete the following table: Number of clients to be served by project. Anticipated hours of contact per client per year. Total program cost per year(including match and requested CDPHE funds) 4. Program Goal(s) 5. Briefly describe the target population(s). 6. Briefly describe the program's services. 7. Briefly describe how the program will monitor and evaluate its impact and process objectives. Title V Abstinence Education Program --Program RFA 34 Appendix G NOTE: PLEASE COPY THIS FORM(OR RECREATE WITHIN PROGRAM'S WORDPROCESSING SOFTWARE)AND COMPLETE ONE PAGE PER OBJECTIVE. Work Plan Name of Organization: Year One Grant Period: January 1. 2004—December 31,2004 GOAL: Objective(s): Activities to Meet the Objective By When Person Responsible Monitoring Process Evaluation Process Title V Abstinence Education Program --Program RFA 35 Appendix H Colorado Abstinence Education Program BUDGET REQUEST (Page 1) APPLICANT: PROJECT: Source of Funds Detailed Budget Total Applicant Requested For the Period Amount and from 01/01/04 Annual Number Required Other CDPHE to Salary Months 12/31/04 Rate Budget Time DIRECT COST Personal Services: $ $ $ Contractual/Fee-for-service: Sub-Total $ $ S Supervising Personnel: Sub-Total $ $ $ Fringe Benefits: $ $ $ Total Personal Services $ $ $ Title V Abstinence Education Program —Program RFA 36 Colorado Abstinence Education Program BUDGET REQUEST (Page 2) APPLICANT: PROJECT: Source of Funds Requested Total Applicant From Amount and CDPHE Required Other DIRECT COST(Continued) Operating Expenses: $ $ $ Sub-Total $ S $ Travel: Sub-Total $ $ $ Equipment: Sub-Total $ $ $ TOTAL DIRECT COST $ $ $ Title V Abstinence Education Program —Program RFA 37 Colorado Abstinence Education Program BUDGET REQUEST (Page 3) APPLICANT: PROJECT: Source of Funds Requested Total Applicant from Amount and CDPHE Required Other ADMINISTRATIVE/INDIRECT COST S $ $ Sub-Total S S S TOTAL PROJECT COST S S * S *SOURCE OF FUNDING FOR THE MATCH, i.e.State, Local, In-kind,etc. Local: S In-kind: Other(Itemize): Total �* *May the non-Federal funds be used to match this grant? Yes No Signature of Director or Authorized Representative: Title V Abstinence Education Program —Program RFA 38 Appendix I A-H Compliant Curricula The following abstinence education curricula have been identified by various national and state agency representatives to meet the minimum requirements for compliance with the Title V Section 510 definition of"abstinence-only" education curricula. This list is provided to aid in the selection process. This is not an exhaustive list,nor is it an endorsement for any of the following curricula. Programs are expected to conduct their own curricula review to determine the curricula best suited to their community's needs. A Choice in Education Choosing the Best Series 15100 General Stevens Court Choosing the Best Chantilly VA 20151 2470 Windy Hill Road, Suite 300 703-263-2799 Marietta GA 30067 mo4character@juno.com 800-773-BEST Age Level: middle school-college www.choosingthebest.org Age Level: 6th - 12th grade Abstinence&Absolutes 7090 Co.Rd. 70 Creating Positive Relationships Edison OH 43320 30 N. Rangeline Road, Suite A 419-946-9335 Cannel IN 46032 abstinence@redbird.net 317-846-0386 www.webtulsa.com/ana cpr@iquest.net Age Level: 3rd grade- college www.crpl.org Age Level: teens Art of Loving Well,The School of Education Facing Reality The Loving Well Project Project Reality Boston University P.O. Box 97 605 Commonwealth Ave. Golf IL 60029 Boston,Massachusetts 02215 847-729-3298 617-353-4088 info@projectreality.org Age Level: 8th grade—high school www.projectreality.org Age Level: 10th- 12th grade Changes-Preparing for Adolescence SAFE, Inc. FACTS Curriculum Series 1486 MONTGOMERY HIGHWAY Northwest Family Servies Birmingham AL 35216-6307 4805 NE Glisan 205-979-1703 Portland OR 97213 Age Level: 4th- 5th grade 503-215-6377 service@facts.cc www.facts.cc Age Level: 5th grade -high school Title V Abstinence Education Program —Program RFA 39 Free to Be HIV: You Can Live Without It P.O. Box 4900 Teen-Aid Santa Rosa CA 95402 723 E. Jackson 707-526-3819 Spokane WA 99207 info@free-to-be.net 509-482-2868 www.free-to-be.net teenaid@teen-aid.org Age Level: middle-high school www.teen-aid.org Age Level: 5th- 12th grades Free Teens Center for Educational Media I've Got the Power P.O. Box 97 A.C. Green Youth Foundation Westwood NJ 07675 P.O. Box 1709 201-358-1504 Phoenix AZ 85001 CenEdMedia@aol.com 800-AC.YOUTH www.freeteens.org pr@acgreen.com Age Level: 13 - 19 years old www.acgreen.com Age Level: middle-high school Friends First Mentoring Program P.O. Box 356 Let's Talk to Teens About Chastity Longmont CO 80502 The Center for Learning 303-776-0715 P.O. Box 910 info@friendsfirst.org Villa Maria PA 16155 www.friendsfirst.org 800-767-9090 Age Level: 9th - 12th grades, adults cfl@stratos.net www.centerforleaming.org/religion.htm Game Plan Age Level: 7th- 12th grades Project Reality P.O. Box 97 Managing Pressures Before Marriage Golf IL 60029 Adolescent Center for Reproductive Health 847-729-3298 Box 26158, 80 Butler Street, SE info@projectreality.org Atlanta GA 30335 www.projectreality.org 404-616-3513 Age Level: 7th- 10th grades Age Level: 6th- 8th grades GO APE Me,My World, My Future Project SOS Teen-Aid 13705 Beach Blvd 723 E. Jackson Jacksonville FL 32224 Spokane WA 99207 904-992-3999 509-482-2868 lorraine@mail.projectsos.com teenaid@teen-aid.org www.projectsos.com www.teen-aid.org Age Level: 6th - 12th grades Age Level: 12 - 19 years old Title V Abstinence Education Program —Program RFA 40 RSVP Navigator Abstinence the Better Choice Project Reality 222 Issaquah St P.O. Box 97 Cuyahoga Falls OH 44221 Golf IL 60029 330-940-4240 847-729-3298 abstaincfo@msn.com info@projectreality.org www.abstinencebetterchoice.com www.projectreality.org Age Level:k-12 Age Level: 8th- 10th grades SAFE Inc. No Apologies: The Truth About Life,Love & 1486 Montgomery Highway • Sex Birmingham AL 35216 Focus on the Family 205-979-1703 P.O.Box 15379 Age Level: 6th- 12th grades Colorado Springs CO 80935 800-932-9123 Sex and Character resourcesales@fotf.org Foundation for Thought and Ethics www.focusresources.org P.O. Box 830721 Age Level: 14+ Richardson TX 75083 972-661-1661 Peers Educating Peers About Positive Values fte-books@juno.com (PEP) Age Level: middle—high schools PO Box 1410 Indianapolis IN 46206 Sexuality and Character Education: 317-236-1478 K-12 Abstinence Edition jacksonj@iquest.net Authors: Linda Meeks,Philip Heit Age Level: middle-high school McGraw-Hill 1333 Burr Ridge Parkway Pure Talk Burr Ridge,I160521 Treasured Values (630)789-4000 P.O. Box 323 www.books.mcgraw-hill.com Sunbury OH 43074 Age Level: middle—high schools 740-965-2046 histreasure@hotmail.com Sexuality, Commitment&Family www.treasuredvalues.com Teen-Aid Age Level: 5th grade—college 723 E. Jackson Spokane WA 99207 Real Life, Real Love 509-482-2868 New Life Family Resources teenaid@teen-aid.org 1515 E. 66th St. www.teen-aid.org Richfield MN 55423 Age Level: 14—18 651-260-0231 nlfsarc@clearsail.net www.newlifefamilyservices.com Age Level: 7th- 10th grades Title V Abstinence Education Program —Program RFA 41 TASK WAIT Training Prevention Services of the Crisis Pregnancy 10427 E.Dorado Place Center Englewood CO 80111 960 University, Suite 114 720-488-8888 Tempe AZ 85281 Jkrauth@aol.com 480-829-0707 Age Level: middle-high school www.cpcphoenix.org Age Level: middle school and above Why kNOw 6125 Vance Road Teen Sexuality Today Chattanooga TN 37421 SAFE Inc. 423-899-9188 113 N.Frontage mail@whyknow.org Deer Lodge MT 59722 www.whyknow.org 406-846-2451 Age Level: middle-high school safe@imine.net www.safeinc.org Age Level: 7th- 12th Title V Abstinence Education Program --Program RFA 42 2 Disease Control and Environmental Epidemiology Division,Colorado Department of Public Health and Environment, Sexually Transmitted Diseases in Colorado Surveillance Report,2000. 'Maternal and Child Health Section,Division of Prevention and Intervention Services for Children and Youth,Colorado Department of Public Health and Environment,Sue Ricketts,Ph.D. `The National Campaign to Prevent Teen Pregnancy,Washington, D.C,April 2001, http://www.teenpregnancv.org/brates.html. 5 Terry, E., &Manlove,J. (2000).Trends in Sexual Activity and Contraceptive Use Among Teens.Washington, DC: National Campaign to Prevent Teen Pregnancy. e Centers for Disease Control and Prevention, 2001 National Youth Risk Behavior Survey, results as reported in MMWR Princeton Survey Research Associates for the Association of Reproductive Health Professionals and the National Campaign to Prevent Teen Pregnancy. (1997, May). National Omnibus Survey Questions About Teen Pregnancy. Washington, DC:Author. Attachment B 0 DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 WEBSITE: www.co.weld.co.us ' ADMINISTRATION: (970) 304-6410 FAX: (970) 304-6412 PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420 FAX: (970) 304-6416 • ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 COLORADO FAX: (970) 304-6411 November 21,2003 Carla Beeson Abstinence Education Director Colorado Department of Public Health& Environment 4300 Cherry Creek Drive South Denver, CO 80246-1530 Dear Carla, In response to the question in your letter dated November 18,2003 the following items have been addressed: • The work plan has been changed to reflect an increase of 7 (seven) in the number of individuals trained in WAIT Training at @295.00/pp. The original grant request reflected a possible price per person of$350.00 based on the revised WAIT Training curriculum, which we expected to be more costly than the original version. The cost for WAIT Training will be$13,865 for curriculum in the objective instead of 14,000. The remaining funds, $135.00 subtracted from the WAIT Training objective were added to the Quinceafiera Program media expense budget. • The scope of work has been changed to reflect the above and is attached to this letter. The narrative and budget narrative have also been changed to reflect the difference. • The letter of support from Greeley West High School will be faxed as soon as possible as a separate attachment. • I have e-mailed a copy of the revised budget, scope of work and budget narrative to Mr. Lee Joseph, CDPHE. Please let me know if there are other issues that need to be addressed. Sincerely, Griselda Still, Health Educator Weld County Department of Public Health& Environment Greeley West High School " 44,On,as gm.Ave 2401 35 Avenue • Greeley, CO 80634 • (970) 348-5400 • rex (970)348-5431 November 24,2003 • Shelly Donahue,Abstinence Education Coordinator Weld County Department of Public Health&Environment 1555 N. 176 Ave. Greeley,CO 80631 Dear Ms.Donahue, I am pleased to provide this letter of commitment for the Weld County Dept. of Public Health&Environment's application for the Colorado Abstiner.e Education Grant. Per my principal's approval I have implemented 18 weeks of WAIT Training in the 2002-2003 school year at Greeley west high school. My full intention is to continue to teach WAIT Training lessons in my classes. Therefore,I gladly commit to implement at least ten sessions of WAIT Training per semester during the 2004-2005 school years. We look forward to continue this great partnership with the Weld County Dept.of Public Health&Environment's Abstinence program in the future. Sincerely, Brian Holmes Health and Physical Education Instructor Greeley West High School so $ 3 •% s 1025 9 Avenue • Greeley CO 80631 • (970;348-6000 ZOOS R+3 CP 9T 14011 COOS/6Z/TT Weld County—Scope of Work Appendix G 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 Dept. of Public Health & Environment, Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To pilot and evaluate a new training model of the FRIENDS FIRST Quinceanera (Rights of Passage) Mentoring Program for Hispanic adolescent females ages 11-14 years old. Objective(s): By December 31, 2004, provide at least one(1)parent recruitment/education session for the Quinceanera Program regarding abstinence and sexual behavior of Hispanic teens in Spanish to parents in Weld County. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Organize and advertise at least one December 31, Griselda Still, Bi- #of flyers, advertisements Completion of organization and (1)parent recruitment/education 2004 lingual Abstinence and contacts advertisement of session. session for the Quinceanera Program Educator Program to Hispanic parents of teens in Spanish. Implement at least one (1)parent December 31, Griselda Still, Bi- Unduplicated client counts, Number of Hispanic girls and recruitment/education session for . 2004 lingual Abstinence sign in sheets families enrolled in Quinceanera the Quinceanera Program to Program Educator program. Hispanic parents of teens in Spanish. "' ppendix G :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 Dept. of Public Health & Environment,Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To pilot and evaluate a new training model of the FRIENDS FIRST Quinceanera Mentoring (Rights of Passage) Program for Hispanic adolescent females ages 11-15 years old. Objective(s): By December 31, 2004, WCDPHE will increase by 25%the number of protective factors (Assets) in the lives of Hispanic adolescent females reached by the Quinceanera program Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Develop and disseminate January 31, Abstinence Staff # of mailings, #of contacts Complete advertising and information about Quinceanera 2004 in person and by phone promotion of Quinceanera program to at least 25 organizations program. and potential partners. Train at least ten (10) interested March 31, Griselda Still, Sign in sheets, unduplicated Complete organization and Weld County community members, 2004 Abstinence Staff client counts implementation of training including faith-based professionals in the Quinceanera program who will collaborate with WCDPHE. Facilitate two (2)training programs December 31, Griselda Still Sign in sheets, unduplicated Pre/post surveys, complete in Weld County for at least 40 2004 client counts organization and implementation Hispanic adolescent females aged of training 11-15, and their mothers and grandmothers. At least 40 Hispanic youth and their December 31, Griselda Still Unduplicated client counts, Asset families will have received 20 hours 2004 sign in sheets building worksheets, pre/post of abstinence education in _ surveys O cd Q a 16 Appendix G 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 Dept. of Public Health & Environment, Abstinence Education Program Year One Grant Period: January 1. 2004—December 31, 2004 GOAL: To pilot and evaluate a new training model of the FRIENDS FIRST Quinceanera (Rights of Passage)Mentoring Program for Hispanic adolescent females ages 11-14 years old. Objective(s): By December 31, 2004, 50% of the Hispanic adolescents attending the Quinceadera program will commit or recommit to sexual abstinence until marriage after participating in ten (10) sessions equaling 20 hours of abstinence until marriage education. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Develop and disseminate March 31, Abstinence Staff #of mailings, #of Complete advertising and information about Quinceanera 2004 girls/families contacted promotion of Quinceanera program to at least sixty(60) program. potential Quinceanera families. Partner with at least ten(10) Weld December 31, Griselda Still, #of partners, copies of List of participating partners County community members who 2004 Abstinence Staff information sheets, flyers, partner with WCDPHE, including and presentation materials faith-based professionals to provide information to the Quinceanera program participants. Facilitate two (2) training programs December 31, Griselda Still Sign in sheets, unduplicated Pre/post surveys, complete in Weld County for at least 40 2004 client counts organization and implementation Hispanic adolescent females aged of training 11-14, and their mothers and grandmothers. At least 20 Hispanic girls will sign December 31, Griselda Still Unduplicated client counts, Pre/post surveys, pledge sheets an abstinence pledge to commit or 2004 sign in sheets, #of pledges recommit to sexual abstinence until marriage after 20 hours of abstinence education in Quinceanera program. Appendix G 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 Dept. of Public Health & Environment,Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To pilot and evaluate a new training model of the FRIENDS FIRST Quinceanera (Rights of Passage)Mentoring Program for Hispanic adolescent females ages 11-14 years old. Objective(s): By December 31, 2004, host at least one (1) end of program celebration of abstinence commitment event for Quinceaneras, their families and the community. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Develop and advertise at least one December 31, Abstinence Staff, #of flyers, posters, Completion of planning and (1) end of program event for 2004 Quinceailera advertisements advertising of event Quinceaneras and their families to graduates and celebrate completion of program. family members Host at least one(1) end of the year December 31, Abstinence Staff Contracts, photographs of Post event survey, completion of program event for Quinceafieras 2004 event, host the event the event and their families to celebrate completion of program. Co Appendix G 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 Dept. of Public Health & Environment, Abstinence Education Program Year One Grant Period: January 1; 2004—December 31, 2004 GOAL: To train and equip health care providers in Weld County with necessary knowledge, skill and supportive material to counsel unmarried teens to maintain healthy sexual behaviors and change risky behaviors. Objective(s): By December 31, 2004, 50% of health care professionals trained in the medical model of sexual cessation (SAGE Advice) will apply the strategies in their medical practice with adolescents in Weld County. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Organize and advertise one SAGE March 31, Abstinence staff #of contacts, #of Complete organization and Advice training for youth medical 2004 advertisements and mailings advertising of SAGE Advice and mental health providers in training Weld County including nurses, school nurses and counselors. Host one SAGE Advice training for May 31, 2004 Abstinence staff sign up sheets, unduplicated Post evaluation after SAGE at least 30 Weld County youth client counts Advice training medical and mental health providers. At least 15 Weld County health December 31, Health care Unduplicated client counts, Interviews with SAGE Advice care professionals trained in the 2004 providers, tracking forms to track trainees,post year surveys of medical model of sexual cessation abstinence staff minutes of intervention implementation (SAGE Advice)will agree to implement intervention strategies to promote healthy sexual behaviors in at risk teens. Appendix G 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 Dept. of Public Health & Environment, Abstinence Education Program Year One Grant Period: January 1, 2004—December 31,2004 GOAL: To train and equip health care providers in Weld County with necessary knowledge, skill and supportive material to counsel unmarried teens to maintain healthy sexual behaviors and change risky behaviors. Objective(s): By December 31, 2004, the WCDPHE Abstinence Education program will implement a support group for at risk adolescents using the medical model of sexual cessation (SAGE Advice)to promote healthy sexual behavior. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Organize SAGE Advice support January 31, Abstinence staff, #of contacts, logistical Completion of organization of group meetings for sexually active 2004 counseled teens details of location and SAGE Advice support group youth to be held at WCDPHE. schedule of meetings Develop and disseminate reminder December 31, Copies of cards,mailing Attendance sheets from support cards for health care providers to 2004 Abstinence staff lists group meetings. distribute to teens who are receiving SAGE Advice counseling to attend support group. Advertise SAGE Advice support January 31, # of advertisements,posters, Completion of advertisements of group meetings to all adolescents in 2004 Abstinence staff flyers and information sent SAGE Advice support group Greeley District 6 schools. to providers Host 60 - 90 minute, SAGE Advice December 31, Unduplicated client counts, Post survey of support group support group meetings at least one 2004 WCDPHE SAGE sign in sheets, meeting time per month at WCDPHE. Advice counselor agendas N O Appendix G 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 Dept. of Public Health & Environment,Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To train and equip health care providers in Weld County with necessary knowledge, skill and supportive material to counsel unmarried teens to maintain healthy sexual behaviors and change risky behaviors. Objective(s): By December 31, 2004, at least 90% of the adolescents attending the SAGE Advice support group through the WCDPHE will indicate their knowledge, attitude, and healthy sexual behaviors have increased and or improved to embrace abstinence until marriage as a lifestyle choice. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Develop/create or utilize existing August 31, Abstinence Staff Completed survey tool, Survey data SAGE Advice survey tool to 2004 completed surveys determine knowledge and attitude change among adolescents attending SAGE Advice support group. N Appendix G 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 & Environment, Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To reduce teen sexual activity and the subsequent consequences of adolescent pregnancy, out of wedlock births, sexually transmitted diseases and reduce the emotional pain associated with early, uncommitted sexual involvement in Weld County. Objective(s): By December 31, 2004, , at least 60% of Weld County teens who complete (A-H compliant curriculum) WAIT Training course curriculum will consider remaining or committing to abstinence from sexual behavior as a result of implementation of WAIT Training. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Organize and advertise two (2) October 31, Abstinence Staff #of Flyers, advertisements, Complete organization and WAIT Training teacher trainings in 2004 and contacts implementation of two WAIT 14 high schools and 16 middle Training teacher trainings. schools in Weld County. Host two (2) WAIT Training October 31, Abstinence Staff Evaluation of WAIT Post training survey completed teacher trainings for at least 47 2004 Training, sign-in sheets, by trained teachers. interested classroom teachers, unduplicated client counts counselors, school nurses, youth pastors and health care professionals in Weld County. Provide technical assistance to 30 December 31, Abstinence Staff Number of technical Complete pre/post observation currently trained WAIT Training 2004 assistance visits. and conference with trained teachers. Unduplicated client counts teachers. N Provide assistance to trained WAIT June 31, 2004 Abstinence Staff WAIT Training lessons Teachers will use WAIT Training teachers who request help Training scope and sequence to scope and sequence at least ten information to plan lessons. (10) WAIT Training lessons. Trained teachers (Program Partners) December 31, Abstinence Staff Unduplicated client counts Pre/post classroom surveys will provide a minimum of 10, 50 2004 and Program Student attendance records conducted by Prime Solutions, minute curricula based abstinence Partners. Inc. education sessions to students ages 12-18. Provide at least ten(10) 90 minute, December 31, Abstinence Staff Unduplicated client counts, Post workshop surveys abstinence education parent 2004 sign-in sheets education workshops. N Appendix G 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 & Environment, Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To reduce teen sexual activity and the subsequent consequences of adolescent pregnancy, out of wedlock births, sexually transmitted diseases and reduce the emotional pain associated with early, uncommitted sexual involvement in Weld County. Objective(s): By December 31, 2004, host at least one(1) activity for adults and one for youth for Abstinence Awareness Week. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Plan and advertise at least one(1) March 31, Abstinence Staff # of flyers, advertisements Completion of organization and activity for youth during Abstinence 2004 and contacts, speaker advertisement of event. Awareness Week in Weld County. contract Implement at least one(1) activity March 31, Abstinence Staff Unduplicated client counts, Post survey of youth attending for youth during Abstinence 2004 sign in sheets event. Awareness Week in Weld County. Plan and advertise at least one(1) March 31, Abstinence Staff # of flyers, advertisements Completion of organization and parent education activity for parents 2004 and contacts advertisement of event. during Abstinence Awareness Week in Weld County. Implement at least one (1)parent March 31, Abstinence Staff Unduplicated client counts, Post survey of parents attending education activity for parents during 2004 sign in sheets event. Abstinence Awareness Week in Weld County. A Appendix G 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 & Environment,Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To reduce teen sexual activity and the subsequent consequences of adolescent pregnancy, out of wedlock births, sexually transmitted diseases and reduce the emotional pain associated with early, uncommitted sexual involvement in Weld County. Objective(s): By December 31, 2004, host at least one (1) community event for Talk To Your Kids About Sex Week in Weld County. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Organize and advertise at least one November 30, Abstinence Staff #of flyers, advertisements Completion of organization and (1) event for parents and their 2004 and contacts, speaker advertising of event. children for Teach Your Kids About contract Sex Month in Weld County. Implement at least one(1) event for November 30, Abstinence Staff Unduplicated client counts Post surveys after event. parents and their children for Teach 2004 Youth Kids About Sex Month in Weld County. tf, Appendix G 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 Dept. of Public Health & Environment,Abstinence Education Program Year One Grant Period: January 1, 2004—December 31, 2004 GOAL: To reduce teen sexual activity and the subsequent consequences of adolescent pregnancy, out of wedlock births, sexually transmitted diseases and reduce the emotional pain associated with early, uncommitted sexual involvement in Weld County. Objective(s): By December, 2004, 90% of middle/high school teachers who participate in the (A-H Compliant Curricula) The Art of Loving Well teacher training will agree to present at least ten (10) lessons as part of health education classes in Weld County schools at least one (1) time per semester to promote a reduction in sexual activity among students. Activities to Meet the Objective By When Person Monitoring Process Evaluation Process Responsible Organize and advertise one (1) December 31, Abstinence Staff # of flyers, advertisements Complete arrangement and Loving Well training for teachers, 2004 and contacts implementation of Art of Loving counselors, youth pastors, parents, Well Training. and youth providers in Weld County. Host one (1) Loving Well training December 31, Abstinence Staff Evaluation of training, sign- Post surveys completed by for at least 20 Weld County 2004 in sheets, unduplicated teachers trained. teachers, counselors, youth pastors, client counts parents and youth providers. At least 30 Weld County teachers December 31, Teachers trained in Unduplicated client counts, Pre/post survey provided by trained in the Loving Well 2004 the Art of Loving student attendance records Prime Solutions Inc. curriculum will implement at least Well. ten (10) lessons in conjunction with WAIT Training lessons in middle and high school health classes. STATE OF COLORADO Bill Owens,Governor Douglas H.Benevento,Executive Director �`; i Dedicated to protecting and improving the health and environment of the people of Colorado r`- • 4300 Cherry Creek Dr.S. Laboratory Services Division ' Denver,Colorado 80246-1530 8100 Lowry Blvd. t s Phone(303)692-2000 Denver,Colorado 80230-6928 ran TDD Line(303)691-n00 (303)692-3090 Colorado Department Located in Glendale.Colorado of Public Health http://www.cdphe.state.co.us and Environment November 18, 2003 Shelly Donahue Abstinence Education Coordinator Weld County Dept. of Public Health&Environment 1555 N. 17th Avenue Greeley, CO 80631 Dear Shelly: Thank you for your response to award conditions dated October 22,2003. Here are the findings from your responses: • Weld County has sufficiently identified how the curricula will be implemented in 10 sessions with a minimum of 5 additional contacts per participant. • A copy of the SAGE curriculum was provided and approved. However,it does appear that SAGE data are a bit date sensitive. Weld counselors need to be aware of the date sensitivity and plan for updating periodically. • A complete description of the Quinceanera program was provided and meets the condition for sufficient number of contacts. • The following conditions have been identified in this review process: o Please justify why Weld County budgeted$350 per participant for WAIT Training when the current rate is$295 per participant. o Although a letter of support and collaboration was received from Superintendent Anthony Pariso of Weld County School District#6,it does not identify where WAIT Training will be implemented and for how many sessions. Please provide either electronic notice from Anthony Pariso or a revised letter stating at what location(s)the curricula will be implemented and for how many sessions. Due to the nature of this grant,it is imperative that grantees provide evidence in advance that they have approval to implement the minimum number of sessions. Once the remaining conditions are met,Weld County will qualify for the$65,000 grant requested. —More— Contract implementation is dependent on the timing of Weld's response. Once the above conditions are satisfactorily completed,Lee Joseph,the program's fiscal officer,will begin the contract process. Lee may need additional information from you as he works through the contract development process. Please do not begin work on the project until you have received a complete,signed contract. If I can be of assistance in any way,please contact me at carla.beeson@state.co.us or 303-692-2376. Sincerely, C b ‘t-• /a1LCS2' ° Carla Beeson Program Director Colorado Abstinence Education Program cc: Lee Joseph DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 WEBSITE: www.co.weld.co.us ' ADMINISTRATION: (970) 304-6410 1 D FAX: (970) 304-6412 PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420 C FAX: (970) 304-6416 , ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 COLORADO FAX: (970) 304-6411 November 7, 2003 Carla Beeson Abstinence Education Director Colorado Department of Public Health &Environment 4300 Cherry Creek Drive South Denver, CO 80246-1530 Dear Carla, Thank you for conditional approval of Ale Weld County Department of Public Health and Environment Abstinence Education Program grant application. We have reviewed the comments made regarding the application and submit the following in responses. 1. Reviewer comments: The Project Narrative indicates only 5 sessions of curricula,thus the maximum award for which this application qualifies if$45,000. If Weld County can demonstrate 10 curricula-based sessions directly to the same set of participants,then the award amount may be increased to $65,000 at the discretion of the Colorado Department of Public Health and Environment. Response: The number of sessions for WAIT Training implementation is a minimum of 10, 50- minute sessions to the same youth ages 12-18 so this objective meets the requirement. The number of sessions for The Art of Loving Well was increased to meet this same requirement. Teachers who are trained in the curricula will agree to implement the full 10 sessions. Thus the objective regarding The Art of Loving Well on page 26 of the original application has been changed to read: By December, 2004, 90% of middle/high school teachers who participate in the (A-H Compliant Curricula) The Art of Loving Well teacher training will agree to present at least ten (10) lessons as part of health education classes in Weld County schools at least one(1)time per semester to promote a reduction in sexual activity among students. The number of sessions for the Quinceafiera Program also has been increased to meet the 10 session requirement. The objective on page 17 of the original application has been changed to read: By December 31, 2004, 50%of the Hispanic adolescents attending the Quinceafiera program will commit or recommit to sexual abstinence until marriage after participating in ten (10) sessions totaling 20 hours of abstinence until marriage education. The activities under this objective reflect the change in total hours. 2. Reviewer Comments: The SAGE program is unfamiliar to the grant reviewers and not on the approved list of curricula. Please provide detailed information about the program's design, how it will compliment other abstinence education efforts through WCDPHE. Response: A packet of information regarding SAGE Advice is included with this letter. The abstinence education program recently hired and trained a sexual cessation counselor to meet one-on-one with sexually active male and female teens that visit the Weld County Department of Public Health family planning clinic for pregnancy and STD screening tests. Positive counseling for behavior change regarding tobacco, alcohol and diet has been positively influenced by nurses,physicians and counselors for years. Healthcare professionals, school nurses and counselors can influence successful behavior change through personal interventions using the SAGE Advice medical model of sexual cessation to move teens to optimum sexual health choices as well. SAGE Advice was developed by Dr. Alma Golden, a pediatrician, currently at the Dept. of Health&Human Services in Washington, DC. SAGE is an acronym for the four steps involved that address risk behaviors in one-on-one encounters. The acronym stands for Set a safe, attentive environment, Ask questions in a non-threatening sequence, Guide goal-setting, and Educate in a non-threatening sequence. The program addresses and promotes sexual abstinence and follows the belief that sexual activity is costly financially, educationally, socially, emotionally and physically. The SAGE model helps to improve sexual health by guiding youth through information, motivation, skills and support to maintain sexual abstinence. Eight WCDPHE nurses were recently trained in the SAGE program and will implement it through their appointments with adolescents in family planning clinics at the health department. The Abstinence Education Program counselor provides support and assistance to the nurses. 3. Reviewer Comments: This structure appears to be a training-of-trainers model without guaranteed implementation. This award is contingent on WCDPHE's ability to demonstrate a structure through which the curricula will be implemented. Please provide letters of commitment from local partners through which the curricula will be implemented. Response: The Abstinence Education Program will implement a requirement into WAIT Training,The Art of Loving Well Training and SAGE Advice Training to address guaranteed implementation. A form will be signed by those trained indicating they will implement the programs for a minimum of ten(10) sessions each of WAIT Training and The Art of Loving Well, and a commitment to implement SAGE Advice will be required at the follow-up training. The Greeley/Evans School District RE-6 has recently approved the WAIT Training and The Art of Loving Well curriculums for all middle/high schools in the district. They are already committed to providing this education as part of the health education required for students. A letter of support is included with this letter from Mr. Anthony Pariso, Superintendent of school district 6. Additionally, a letter of support from Linda Henry, Director of WCDPHE Nursing Division is included to indicate their support of the Abstinence Education Program. 4. Reviewer Comments: It is unclear who will be conducting the Quinceafiera program. Please provide greater detail regarding the recruitment of youth,program development and implementation at the local level. Response: The Quinceafiera program will be implemented by Griselda Archuleta-Still, a health educator with the WCDPHE. Griselda has been with the WCDPHE for three years and is bilingual and bicultural. She is a graduate of the University of Northern Colorado and resides in Weld County where she was raised and thus has built relationships and collaborations with many organizations, schools and people in Weld County. Through these connections Griselda has been able to forge relationships with local priests and will implement the Quinceafiera program through the local churches. She will deliver the education on abstinence and health related matters, and the priest will partner with her to provide the faith-based component of the program. Youth between the ages of 11-14 will be recruited through the church organizations. The abstinence education piece will be added to already existing structure. Implementation will begin at the beginning of the year, and two sessions will be offered. The program is based on the FRIENDS FIRST model and WCDPHE will partner with FRIENDS FIRST to implement and evaluate the program. The Quinceafiera traditional rite of passage has been celebrated in Mexico for over 400 years. Because the roles of Hispanic men and women have changed when they immigrated to America, the time-honored traditions have lost their true meaning as a family celebration honoring purity at the girl's fifteenth birthday. Hispanic teens with their mothers and grandmothers as mentors, will set family dating expectations, communicate sexuality information and promote the benefits of virginity and abstinence until marriage. Padrinos or male adult accountability partners also play a significant role at the Quinceafiera as well. In developing their sense of personhood,it is important for Hispanic young people to know,to understand, to accept, and to celebrate their culture, language, faith expressions, family values and traditions. Preparing young people to celebrate their Quinceafiera gives the occasion to encourage them and their families in following their hopes and dreams for their future. A flyer has been included regarding the overview of the Quinceafiera program as well as an updated program outline. Reviewer Comments: In addition to the above,there are budget elements that are not correct. Please contact Lee Joseph at 303-692-2318 for assistance in submitting a revised budget and budget justification. Response: Mr. Joseph was contacted,the changes he requested have been completed and a new copy of the budget has been included with this letter. Further changes may need to be made with the final decision of the CDPHE Abstinence Education Director regarding funding level and will be completed as needed as well as a new budget justification if needed. Thank you for considering the WCDPHE abstinence grant application. Please contact Shelly Donahue or Megan Martinez for any additional information needs at(970)304-6420 ext. 2386 or 2385. Sincerely, 4Meganartinz, Health Educa Weld County Department of Public Health &Environment The Quinceanera Program Overview ,n r The Quinceafiera Program is a Nine week Culture and Health Education program for Hispanic parents and their teenage daughters. This unique program will promote the true meaning and value of a Quinceafiera, as well as the Hispanic family and society values. It will include Quinceafera planning and preparing, in conjunction with sexual abstinence until marriage skills, healthy relationship education. It is also meant to empower young Hispanic girls to continue their education and follow their dreams and goals, by avoiding risky behaviors. The program will cover topics like How to talk to children about sex, Consequences of premarital sex, Steps of Intimacy and what is reserved for marriage, Hopes and dreams, Bonding and Intimacy, Purpose of marriage, Woman and the media, Love concept, and Refusal skills, just to name a few. This program is intended to serve girls age 11-15 who are planning to have a Quinceafiera in the future. The weekly sessions are designed for Quinceafleras, Parents, and family, with an opportunity for Health and • • religious leaders to educate and support the Hispanic community. The sessions are an Hour and 40 min. long, for 9 weeks, with a Quinceafiera show and commitment to abstinence Ceremony, as the 10`h and final session. For more information or to start the Quinceafera program in your area Call Griselda Archuleta-Still 304-6420 Ex 2388. Attachment C. . rer I/l/NN//I9/OGMN a / N AID I N/ IIMi Quinceaiiera Abstinence Program tirannernavassesseisannamarnarnenavarmenemaresmemormarnvraawasA Session 1 1 hour: 40 minutes Quinceafiera 1 hour Religious Educator Or Community Member Religious piece or 15atiera Portfolio &Journal Parents 1 hour Abstinence Health Educator Worth the wait (short Spanish Version) Protective and Risk Factors 40 Fundamental Assets How to talk to your children about sex Let's discover why 15ariera is a positive choice. Everybody 10 min. Introduction& Getting to know you-Activity 10 min. 1 page Journal entry/what does a 15anera mean to you? Discussion about journal entries 20 min. 15afera presentation-what does it really all mean? (Traditional roles, symbols, and gifts) Session 2 1 hour: 40 minutes Quinceanera 30 min. Religious Educator Or Community Member Religious piece or 15atiera Portfolio &Journal Parents 30 min. Letter to Quinceafieras (your hopes and dreams for her) Everybody 10 min. getting to know you-Activity 1 hour Character Unit 2 STARS Manual Sex Components in a relationship Select the Male for Panel Discussion 35 Attachment C • Session 3 1 hour: 40 min. Quinceadera 30 min. Religious Educator or Community Member Religious piece or 15afiera Portfolio &Journal Parents Planning Session/ 15adera details 30 min. Everybody 30 min. Panel Discussion or the Family Feud/Moral Reasoning-Activity 40 min. Bonding and Intimacy Purpose of Marriage Renewed Abstinence Session 4 1 hour: 40 min. Quinceanera 30 min. Religious Educator or Community Member Religious piece or 15aflera Portfolio &Journal Everybody 1 hour 10 min.Woman Identity&the Media Diamond Activity Love Concept Attainment Activity Do You Know the Real Thing? Love Collage 15aderas bring their pictures for the next session 36 Attachment C Parents 30 min. Planning Session/ 15aflera details Session 5 1 hour: 40 min. Quinceaftera 30 min. Religious Educator or Community Member Religious piece or 15aflera Portfolio &Journal Parents 30 min. Planning Session/ 15afiera details Everybody 10 min Photo Album Activity 1 hour Cooperative Learning Activity Family Group Activity Session 6 l hour: 40 min. Quinceafiera 30 min. Steps of Intimacy Cake Analogy Parents 30 min. Planning Session/ 15afiera details 37 • Attachment C Everybody 10 min Story,Family Group Activity 1 hour Sexual Abuse Story of a Single Mother HIV Story Session 7 ihour: 40min. Quinceafiera 1 hour 40 min.Hopes and Dreams How do you spell Love(love vs. lust) 10 keys to successful dating Dating Bill of Rights Session 8 ihour: 40min. Quinceafiera 1 hour Friendship and Dating Dating Game :Good date/Bad date Love vs. Infatuation Appointment with love Parents 1 hour Parenting Planning Session/Quinceafiera details Everybody Dating Skills 40 min. 38 Attachment C • Session 9 1 hour:40min. Quinceaiiera 1 hour Assertiveness Refusal Skills Write Letter to Future Husband Commitment to Abstinence Parents • 1 hour Parenting Planning Session Everybody 40 min Parent present Letters to 15afIeras Session 10 5 hours FINAL EVENT Everybody Quinceanera Fair Community Members Business Merchant 1 hour 15afera Abstinence Program Completion Award Abstinence pledge and Purity Rings presentation 39 Attachment C 20 TOTAL HOURS FOR QUINCEANERA PROGRAM 16 TOTAL HOURS FOR QUINCEANERA ABSTINENCE EDUCATION 7 hours Combined Family Abstinence Education 5 hours 15anera Abstinence Education 4 hours Parent Abstinence Education 4 TOTAL HOURS OF QUINCEANERA COMMUNITY EDUCATION 3 hours Religious or Community Education 1 hour Community Presentation/Recruitment session at fmal event 40 Appendix H Colorado Abstinence Education Program BUDGET REQUEST (Page 1) APPLICANT: Weld County Department of Public Health & Environment,_Abstinence Education Proq. PROJECT: Comprehensive Model Abstinence Education Program Grant Source of Funds Detailed Budget Total Applicant Requested For the Period Amount and from 01/01/04 Annual Number Required Other CDPHE to Salary Months 12/31/04 Rate Budget %Time DIRECT COST Personal Services: $ $ $ .75 FTE Coordinator/Bilingual Health Specialist 31,842.34 31,842.34 0 .50 FTE Health Education Specialist 18,344.58 18,344.58 .25 FTE Health Education Specialist 10,614.11. 10,614.11 0 .05 Office Tech 1,326.70 1,326.70 0 Contractual/Fee-for-service: 2,500 2,500 Sub-Total $64,627.73 $64,627.73 $0.00 Supervising Personnel: .05 FTE Health Promotion Supervisor 2,690.70 2,690.70 0 Sub-Total $2,690.70 $2,690.70 $0.00 Fringe Benefits: 31.97% $18,501.98 $18,501.98 $0.00 Total Personal Services $85,820.41 $85,820.41 $0.00 • • • 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 Quinceanera handbooks @$37.50 X 40 1500 1500 Meeting expenses/class materials 1000 1000 Purity Rings 1300 1300 Educational Incentives 900 900 DJ &sound system 500 500 Stage rental 500 500 Media/advertising/promotion materials/recruitment materials 1200 1200 Decorations 1000 1000 Video recording materials 200 200 SAGE Advice Cessation Training @ 30 participants Trainer fee/expenses @$2,700/day 2,550 2,550 SAGE Advice Training materials @ 30 participants X$15.00/pp 600 600 Substitute Teachers X 15 participants X $80.00/day 1200 1200 Conference food X 30 participants @ $15.00/pp 450 450 2 X WAIT Trainings @ 20 participants each WAIT Training Curricula X 40 @$350.00 14,000 14,000 Trainer fee X 4 days @$1,250 5,000 5,000 Substitute teachers @ 20 teachers X 2 days @$80.00/day 6,400 6,400 Conference food X 4 days X 20 participants @ $15.00 pp 1,200 1,200 1 Art of Loving Well Teacher training @ 20 participants 1 X trainer fee @ $1,250/day 1,250 1,250 Loving Wells Training materials &curricula @ $90.00ea.X 20 1,800 1,800 Substitute teachers @ $80.00/day X 20 teachers 1,600 1,600 Conference food X 20 participants @ $15.00 pp 300 300 1 Abstinence Awareness Week Event Speaker fee and expenses 1,500 1,500 Promotion, publicity, materials for event 600 600 1 Talk to Your Kids About Sex Week event Speaker fee @ $1,250/day 1,500 1,500 Promotion, publicity, materials for event 600 600 • • Parent Education Workshops X 10 events Trainer fee @ $100/event X 10 1,000 1,000 Materials and food X 30 participants X 10 @ $15.00/pp 1,500 1,500 Abstinence Education Incentives/Promotional Items 1,560 1,560 Office Supplies 500 500 Operating Supplies 500 500 Postage 500 500 Copying/Printing 500 500 Subscriptions 250 250 Phones 400 400 Meeting Expenses 1,000 1,000 Sub-Total $56,360 $3,650.00 $52,710 Travel: National Abstinence Education Conference National Abstinence Clearinghouse Conference @$1,100 X 1 1,300 1,300 Smart Marriages Conference @$1,100 X 1 1,300 1,300 Medical Institute for Sexual Health Conference @$1,100 X 1 1,300 1,300 Colorado State Abstinence Education Bi-annual Meetings Mileage to Denver @.340/miles X 160 miles X 2 meetings 108.00 108.00 Per Diem for staff @ $35.00/day X 3 staff 105 105 Local Travel 500 500 0 Sub-Total $4,613.00 $500.00 $4,113.00 Equipment: Sub-Total $ $ $ TOTAL DIRECT COST $146,793.41 $89,970.41 $56,823.00 Colorado Abstinence Education Program BUDGET REQUEST (Page 3) Colorado Abstinence Education Program BUDGET REQUEST (Page 4) APPLICANT:Weld County Department of Public Health & Environment, Abstinence Education Proq. PROJECT: Comprehensive Model Abstinence Education Program Grant , Source of Funds Requested Total Applicant from Amount and CDPHE Required Other ADMINISTRATIVE/INDIRECTCOST $ $ $ Indirect Approved County Rate 14.39% 8,177 8,177 Sub-Total $8,177 $ $8,177 TOTAL PROJECT COST $154,970.41 $89,970.41 $65,000.00 *Local County BOCC *SOURCE OF FUNDING FOR THE MATCH, i.e. State, Local,in-kind, etc. Local: Board of County Commissioners (BOCCI, County funding $ 89.970.41 In-kind: Other(Itemize): Total $89,970.41 *May the non-Federal funds be used to match this grant? Yes X No nature of Direr Autb - Re ntative: Director Dr.Mark E.Wallacey,,Director Weld County Department of Public Health&Environment 30 • • • fl DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 WEBSITE: www.co.weld.co.us ' ADMINISTRATION: (970) 304-6410 FAX: (970) 304-6412 C PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420 O FAX: (970) 304-6416 ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 COLORADO FAX: (970) 304-6411 November 5,2003 Shelly Donahue,Abstinence Education Coordinator Weld County Department of Public Health& Environment 1555 N. 17th Avenue Greeley, Co 80631 Dear Ms.Donahue, I am pleased to provide this letter of support for the Weld County Department of Public Health and Environment's application for the Colorado Abstinence Education Grant. The Weld County Department of Public Health and Environment has benefited greatly from the leadership and collaborative effort the program provides the nursing division. We have been able to successfully implement the SAGE Advice model within some of the clinics the nursing division provides to the community.The nursing staff has been able to work collaboratively with the Abstinence Education program staff to implement the program and there is enthusiastic support among the clients, staff and others to sustain and expand this program. The Weld County Department of Public Health and Environment Abstinence Education Program has always been a leader in the implementation of new and innovative strategies to improve the health of the residents in Weld County. It has a proven track record for providing successful community and school-based youth programs and has developed strong alliances with the schools, agencies,youth and nursing staff. The nursing division at the Weld County Department of Public Health and Environment supports the Abstinence Education Program in its goal to increase the knowledge, skills, and support needed for youth to choose to be sexually abstinent in preparation for marriage. Your consideration of Colorado Abstinence Education Program funding for the Weld County Department of Public Health and Environment Abstinence Education Program will strengthen efforts to significantly impact the lives of thousands of young people and families in our county. Thanks you for your consideration of this valuable program Sincerely, d..-(2;11(-2 Linda Henry, Director of N g and Health Promotion Weld County Department of Public Health and Environment o0p1Y SCHoO O • W9 Np g. GREELEY EVANS llaicapa,freascto&Cad efira Anthony Pariso, Superintendent 1025 Ninth Avenue ♦ Greeley, Colorado 80631 ♦ (970) 348-6012 October 14, 2003 Shelly Donahue,Abstinence Education Coordinator Weld County Department of Public Health&Environment 1555 N. 17th Ave. Greeley, CO 80631 Dear Ms. Donahue, I am pleased to provide this letter of support for the Weld County Dept. of Public Health & Environment's application for the Colorado Abstinence Education Grant. Greeley District#6 has benefited greatly from the funding, leadership and collaborative effort the Health Department provides for us. We have implemented very successful education programs in the middle school and high school due to the availability of WAIT Training teacher training and The Art of Loving Well teacher training for our staff. We also appreciate the availability of WAIT Training guest speakers for classroom instruction and parent education workshops. There is enthusiastic support among the students, staff and parents to sustain and expand this program. The Weld County Health Department has always been a leader in the implementation of new and innovative strategies to improve the health of the residents in Weld County. It has a proven track record for providing successful community and school-based youth programs and has developed strong alliances with the schools, agencies, parents, teens, teachers and administrators. Greeley School District#6 administrators support the Weld County Public Health Department in its goal to increase the knowledge, skills, and support needed for youth to make good decisions. Your consideration of Colorado Abstinence Education Program funding for the Weld County Department of Public Health &Environment Abstinence Education Program will strengthen efforts to significantly impact the lives of thousands of young people in our county. Thank you for your consideration of this valuable program. Sin PILE COPY STATE OF COLORADO Bill Owens,Governor Douglas H.Benevento,Executive Director *it C% Dedicated to protecting and improving the health and environment of the people of Colorado rS 4300 Cheny Creek Dr.S. Laboratory Services Division ' 4;9 Denver,Colorado 80246-1530 8100 Lowry Blvd. *1876• Phone(303)692-2000 Denver,Colorado 80230-6928 TDD Line(303)691-7700 (303)692-3090 Colorado Department Located in Glendale,Colorado of Public Health http://www.cdphe.state.co.us and Environment October 22,2003 Shelly Donahue Abstinence Education Coordinator Weld County Dept. of Public Health&Environment 1555 N. 17th Avenue Greeley,CO 80631 Dear Shelly: Thank you for your application for a Community-based Abstinence Education Program Grant through the Colorado Abstinence Education Program. The Application Review Team has assessed your submission and is pleased to grant an award of$45,000 with the following conditions: • The Project Narrative indicates only 5 sessions of curricula,thus the maximum award for which this application qualifies is$45,000. If Weld County can demonstrate 10 curricula-based sessions directly to the same set of participants,then the award amount may be increased to$65,000 at the discretion of the Colorado Department of Public Health and Environment. • The SAGE program is unfamiliar to the grant reviewers and not on the approved list of curricula. Please provide detailed information about the program's design,how it will compliment other abstinence education efforts through WCDPHE. • This structure appears to be a training-of-trainers model without guaranteed implementation. This award is contingent on WCDPHE's ability to demonstrate a structure through which the curricula will be implemented. Please provide letters of commitment from local partners through which the curricula will be implemented. • It is unclear who will be conducting the Quincenera program. Please provide greater detail regarding the recruitment of youth,program development and implementation at the local level. • In addition to the above,there are budget elements that are not correct.Please contact Lee Joseph at 303-692-2318 for assistance in submitting a revised budget and budget justification. • Please respond to the above conditions by no later than November 7,2003.Once above conditions are met,Lee Joseph, the program's fiscal officer,will contact you to begin the contract process. Lee may need additional information from you as he works through the contract development process. Please do not begin work on the project until you have received a complete,signed contract,which should be by January 1,2004. Weld County Department of Health,Page 2 To assist you in preparing for implementation in January,we have arranged a"Pre-contract Teleconference"from 1:30—3:00 on November 20. Additional information will be available within the next few weeks. All grantees are welcome to participate. Again,congratulations on your successful application. I look forward to working with you in the upcoming months.If I can be of assistance in any way,please contact me at carla.beesonOstate.co.us or 303-692-2376. Si ely, aria Beeson Program Director Colorado Abstinence Education Program cc:Lee Joseph Vce ATTACHMENT C PREVENTION SERVICES DIVISION APPLICATION BUDGET AND/OR EXPENDITURE REPORT FORM APPLICANT: FOR THE PERIOD: 1/20/2004 To 12/31/3004 PROJECT:Abstinence Education BUDGET EXPENDITURE REPORT Annual #of Total SOURCE OF FUNDS Requested/ Salary months Amount Received Rate Budget FTE Required OTHER" from CDPHE PERSONAL SERVICES: J Contractual/Fee for Service Supervising Personnel Fringe Benefits: Rate= Total Personal Services OPERATING EXPENSES(which are not part of indirect): Total Operating $ $ S - TRAVEL(In-state/Out-state) Total Travel $ $ $ l Equipment Total Equipment $ $ $ Total Direct Costs(Personal Services+Operating+Travel+Equipment) $ $ $ INDIRECT COST Total Indirect Costs $ $ $ TOTAL PROJECT COST $ $ $ 'Source of funding for"Other"(Match or In-kind)i.e.for Abstinence Education Program Local/county funding $ Medicaid(wll not be used to match) $ Patient fees $ Other(list) $ $ TOTAL $ May the NON FEDERAL funds be used as match? YES NO Signature of Authorized Representative Date Anatl.npre C•Final Eapen: .Report Pape 1 of 1 ATTACHMENT D Contractor Name: Director Name: For the Time Period: From: To: Colorado Abstinence Education Program Table I TOTAL ENCOUNTERS BY CLIENTS* <10 10-14 15-17 18-19 20-24 >24 Parents TOTAL MALES Non-Hispanic White Black Hispanic Other FEMALES Non-Hispanic White Black Hispanic Other TOTAL *Client may include program participants, as well as adult stakeholders. Page 1 of 2 ATTACHMENT D Contractor Name: Director Name: For the Time Period: From: To: Colorado Abstinence Education Program Table II TOTAL UNDUPLICATED COUNT OF CLIENTS* <10 10-14 15-17 18-19 20-24 >24 Parents TOTAL MALES Non-Hispanic White Black Hispanic Other FEMALES Non-Hispanic White Black Hispanic Other TOTAL *Client may include program participants, as well as adult stakeholders. • Page 2 of 2 Invoice Number: Attachment E Task Order Reimbursement Statement To: Colorado Abstinence Education Program From: Colorado Department of Public Health & Environment 4300 Cherry Creek Drive, South Denver, CO 80246 Fax: (303)691-7852 Federal ID Number: Date of Expenditure: Type of Program: Abstinence Education From: To: Final Bill? Yes_No t€ e ; r q 4 a r w e..._! S°.. �`.. 44-£,:w.:, c+,�L'wra :"-nb <t ;�Aw et �..s.P ,.h -24'; 3 - Personnel Salaries $ Personnel Fringe $ Operating $ Travel $ Equipment $ Subtotal Direct Costs $ Indirect Costs $ GRAND TOTAL $ $ $ This is to certify that the above expenses were incurred per Contract#or Purchase Order# and we are requesting reimbursement for the same. SIGNATURE (CONTRACTOR) DATE: I hereby certify that all contract requirements have been met and the amounts are correct. Payment is authorized. AUTHORIZED DESIGNEE (STATE) DATE: Contractor Notified of Reimbursement Amount Change? Yes No Initial: Attachment F ' CtPREVENTION SERVICES DIVISION C'' APPLICATION BUDGET FORM APPLICANT:Weld County Department of Public Health'$Environment FOR THE PERIOD: 1/1/2004 To 12/31/2004 PROGRAM: Abstinence Education - ' BUDGET EXPENDITURE REPORT -AAnnual #of Total SOURCE OF FUNDS- ' Requested I `'7:Saiary months Amount Applicant and Received Rate Budget FTE Required Other-Match from CDPHE PERSONAL SERVICES: Abstinence Ed.Project Coordinator/Bilingual Health Spec. $ 42,456.45 12 0.75 $ 31,842.34 $ 31,842.34 $ (0.00) Health Education Specialist $ 36,689.16 12 0.5 $ 18,344.58 $ 18,344.58 $Health Education Specialist $ 42,456.44 12 0.25 $ 10,614.11 $ 10,614.11 $ - Office Tech. $ 26,534.00 12 0.05 $ 1,326.70 $ 1,326.70 $ - Contractual Services Evaluator $ 2,500.00 $ 2,500.00 $ - Supervising Personnel Health Promotion Supervisor $ 2,690.70 $ 2,690.70 $ - Fringe Benefits: Rate e 31.97% $ 18,501.98 $ 18,501.98 $ - Total Personal Services $ 85,820.41 $ 85,820.41 $ (0.00) OPERATING EXPENSES(which are not part of indirect): Oper.&Meeting Expenses $ 5,210.00 $ 3,650.00 $ 1,560.00 Quinceanera Program $ 8,235.00 $ - $ 8,235.00 SAGE Advice Training-30 participants $ 4,800.00 $ - $ 4,800.00 WAIT Trainings $ 26,465.00 $ - $ 26,465.00 Art of Loving Well Training $ 4,950.00 $ - $ 4,950.00 Abstinence Awareness Week Event&Talk to Kids Event $ 4,200.00 $ - $ 4,200.00 Parent Ed.Workshops $ 2,500.00 $ - $ 2,500.00 Total Operating $ 56,360.00 $ 3,650.00 $ 52,710.00 TRAVEL(In-state/Out-state) 0 0 - Local Mileage $ 500.00 $ 500.00 $ - Mileage $ - $ - $ Nalt.Abstin.Conference $ 3,900.00 $ - $ 3,900.00 Colorado State Abstinence Meetings 213 $ - $ 213.00 Total Travel $ 4,613.00 $ 500.00 $ 4,113.00 Equipment $ - $ - $ - Total Equipment $ - $ - $ - Total Direct Costs(Personal Services+Operating+Travel+Contractual) $ 146,793.41 $ 89,970.41 $ 56,823.00 INDIRECT COST $ - • g $ Indirect 14.39%of TDC $ 8,177.00 $ 8,177.00 Total Indirect Costs $ 8,177.00 $ - $ 8,177.00 TOTAL PROJECT COST $ 154,970.41 $ 89,970.41 $ 65,000.00 'Source of funding for"Other"(Match or In-kind)i.e.For Abstinence Ed.Program Local/Board of County Commissioners(BOCC)County Funding 89,970.41 In-Kind Other(list) �p TOTAL 89,970.41 May the NON FEDERAL be used NO kiA"CLCSignature of Authorized Representative Date Rev:11/24/2003 BUWETAPPLFORMM$ BYNa Weld County Revised Budget Justification b. Budget Justification: Total Project Cost=$154,970.41. Direct Costs=$56,823.00. Personal Services and Fringe Benefits- $85,820. 41: There are three positions, a .75 FTE, a .50 FTE and a .25 FTE employed with the AEP. 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. Quinceaiiera Rite of Passage Mentoring Program- $8,235: Two twenty-hour rites of passage programs targeted for at least 40 Hispanic females ages 11-14 and their families. Development, advertising, recruitment and promotion for program and final event costs $1335. Forty Quinceanera handbooks/CD that provide abstinence education information and relationship building information @ $37.50 cost $1500. Eight meeting room rentals and class materials/food cost$1000. Forty purity rings @ $32.50 cost $1300. Education incentives cost $900. Stage rental, DJ/sound system, decorations, and video recording cost for sessions and end of program event $2200. SAGE Advice Medical Model of Sexual Cessation Healthcare Training- $4,800: One SAGE Advice training for at least 30 Weld County Healthcare professionals. Trainer fee/expenses cost $2,550. Thirty SAGE Advice training manuals cost $600. Fifteen substitute teacher stipends for school teachers/counselors x $80/day cost $1200. Conference food x 30 participants @ $15.00/day costs $450. Two WAIT Training Teacher Trainings - $26,465: 47 scholarships for(Ft. Lupton, Johnstown, Windsor middle/high school teachers, counselors and nurses) a 2-day WAIT Training teacher training &curricula @ $295.00 each costs $13,865. Trainer fees/expenses x 4 days @ $1,250/day costs $5,000. Twenty substitute teacher stipends for school teachers/counselors/nurses x 2 days @ $80.00/day costs $6,400. Conference food x 4 days x 40 @ $15.00/day costs $1,200. One The Art of Loving Well Teacher Training- $4,950: 20 scholarships for The Art of Loving Well teacher training&curricula for Greeley Dist. #6 middle school health ed. teachers @ $90.00 each costs $1,250. Trainer fee/expenses cost $1,250. Twenty substitute teacher stipends @ $80.00/day costs $1,600. Conference food x 20 @ $15.00/day costs $300. Abstinence Awareness Week Events - $2,100: Motivational speaker for Latina/Latino Youth Leadership Conferences and middle/high school assemblies costs $1,500. Promotion,publicity,materials for the events costs $600. Talk to Your Kids about Sex Week Events- $2,100: Parent educator and/or speaker for"Puberty: Pointers for Parents"parent events and youth event costs $1,500. Promotion, publicity, materials for events costs$600. Ten Parent Education Workshops - $2,500: Ten Trainer fees @ $100/workshop costs $1000. Workshop materials/food costs $1,500. Travel - $4,613.00 National Abstinence & Relationship Education Conferences - $3,900: One WCDPHE staff to attend National Abstinence Clearinghouse Conference costs $1,100. One WCDPHE staff to attend Smart Marriages Conference costs $1,100. One WCDPHE staff to attend Medical Institute of Sexual Health costs $1,100. Funds requested by CDPHE. Colorado State Abstinence Education Bi-annual Meetings - $213.00: Mileage and per diem for WCDPHE staff to attend 2 meetings in Denver area costs $213.00. Funds requested from CDPHE. Local Travel- $500.00 -Funds provided by WCDPHE Incentives for programming- $1,560— requested from CDPHE Office Supplies- $ 3,650: Includes office supplies $500, operating supplies $500, postage$500, copying/printing $500, subscriptions $250, phones $400 and meeting expenses $1,000. Funds provided as matching from WCDPHE. Equipment- $ .00 requested from CDPHE ADMINISTRATIVE/INDIRECT COST—TOTAL= $8,177 1. Indirect Approved County Rate @ 14.39%costs $8,177 TOTAL FUNDS REQUESTED FROM CDPHE = $65,000 Source of Funding for the Match—Board of Weld County Commissioners - County Funding=$89,970.41 [Date] SAMPLE TASK ORDER CHANGE ORDER LETTER Attachment G Task Order Change Order Letter Number**. Contract Routing Number** ******** State Fiscal Year 20**-20** *************** Program This Task Order Change Order Letter is issued pursuant to Part*.*.of the Master Contract identified by contract routing number***** *****and paragraph** of the Task Order identified by contract routing number** *** *****and contract encumbrance number***** **********. This Task Order Change Order Letter is between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and JLEGAL NAME OF CONTRACTOR). The Task Order has been amended by Task Order Option to Renew Letter**,contract routing number** ********,and/or Task Order Change Order Letter**,contract routing number** ******** if any. The Task Order,as amended,if applicable,is referred to as the"Original Task Order". This Task Order Change Order Letter is for the current term of********* ** ****,through********* **, ****: The maximum amount payable by the State for the work to be performed by the Contractor during this current term is increased/decreased by**********Dollars,($*.**)for an amended total financial obligation of the State of**********DOLLARS, ($*.**). The revised specifications to the original Scope of Work and the revised Budget are incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment*"and"Attachment*". The first sentence in paragraph_*.of the Original Task Order is modified accordingly. All other terms and conditions of the Original Task Order are reaffirmed. This change to the Task Order shall be effective upon approval by the State controller, or designee,or on ***********,****,whichever is later. Please sign,date,and return all**originals of this Task Order Change Order Letter by********* **,**** to the attention of: ************************,Colorado Department of Public Health and Environment,4300 Cherry Creek Drive South,Denver,Colorado 80246,Mail Code: *******. One original of this Task Order Change Order Letter will be returned to you when fully approved. [LEGAL NAME OF CONTRACTOR] STATE OF COLORADO (legal type of entity) Bill Owens,Governor By: By: Name: For the Executive Director Title: DEPARTMENT OF PUBLIC HEALTH FEIN: AND ENVIRONMENT (Seal) ATTEST: PROGRAM APPROVAL: By: By: 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 the goods and/or services provided. STATE CONTROLLER: Arthur L.Barnhart By: Date: Revised:08/30/02 [Date] SAMPLE TASK ORDER OPTION TO RENEW LETTER Attachment H Task Order Renewal Letter Number**. Contract Routing Number** ******** State Fiscal Year 20**-20** *************** Program This Task Order Option to Renew Letter is issued pursuant to Part**.of the Master Contract identified by contract routing number**********and paragraph*_.of the Task Order identified by contract routing number***** ***** ***** ********** and contract encumbrance number This Task Order Option to Renew Letter is between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and JLEGAL NAME OF CONTRACTOR!. The Task Order has been amended by Task Order Change Order Letter**,contract routing number** ********, and/or Task Order Option to Renew Letter**,contract routing number** ********,if any. The Task Order,as amended,if applicable,is referred to as the"Original Task Order". This Task Order Option to Renew Letter is for the renewal term of********* ** **** through********* ** ****. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is********** Dollars,(*.**)for an amended total financial obligation of the State of**********DOLLARS, This is an increase/decrease of($*.**)of the amount payable from the previous term. The Budget for this renewal term is incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment*". The first sentence in paragraph_*.of the Original Task Order is modified accordingly. All other terms and conditions of the Original Task Order are reaffirmed. This Task Order Option to Renew Letter is effective upon approval by the State Controller, or designee,or on***********,****,whichever is later. Please sign,date, and return all"originals of this Task Order Option to Renew Letter by***********,****,to the attention of ************************,Colorado Department of Public Health and Environment,4300 Cherry Creek Drive South,Denver,Colorado 80246,Mail Code: *******. One original of this Task Order Option to Renew Letter will be returned to you when fully approved. [LEGAL NAME OF CONTRACTOR] STATE OF COLORADO (legal type of entity) Bill Owens,Governor By: By: Name: For the Executive Director Title: DEPARTMENT OF PUBLIC HEALTH FEIN: AND ENVIRONMENT (Seal) ATTEST: PROGRAM APPROVAL: By: By: 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 the goods and/or services provided. STATE CONTROLLER: Arthur L.Barnhart By: Date: Revised:08/30/02 Memorandum ' CTO: Robert D. Masden, Chair Board of County Commissioners • COLORADO FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment DATE: January 5, 20045 0t b SUBJECT: Task Order for Abstinence Education Program Enclosed for Board review and approval is a task order between Weld County and the Colorado Department of Public Health and Environment for a Comprehensive Model Abstinence Education Program Grant in the amount of$65,000. The program goals are to increase the number of adolescents who are making positive choices to remain sexually abstinent in preparation for marriage and for sexually active teens to commit to renewed virginity. To accomplish these goals, the abstinence education program staff will: • Pilot and evaluate a new training model, the Friends First Quinceafiera Mentoring Program, for Hispanic adolescent females • Train local health care providers to counsel their unmarried teen clients to maintain healthy sexual behaviors • Host WAIT Training for at least 40 additional teachers in Weld County. The term of the task order is from January 26, 2004 through December 31, 2004. I recommend your approval. Enclosure 2004-0063 Hello