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Home My WebLink About20031218.tiff RESOLUTION RE: APPROVE TASK ORDER FOR TOBACCO EDUCATION AND PREVENTION 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 the Tobacco Education and Prevention 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 July 1, 2003, and ending June 30, 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 the Tobacco Education and Prevention 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 14th day of May, A.D., 2003. BOARD OF COUNTY COMMISSIONERS WEKTUNTY ORADO ATTEST: IL, ��; „� L— i v' E L g, Cha Weld County Clerk to . g :;R+ --.• 40. .' �(� • 1 Robert D. sden, Pro-Tem BY: CQ�1�i2 • „:i Deputy Clerk to the Bird: � _, M. J. Geile 77 APPR ED AS O FORM: l� C,, Wilh�. JerkQ oun y Attorney giete6 Glenn Vaad 5 Date of signature: a 2003-1218 HL0030 ( 'U ?� Lido `'(yr-,.,/y DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT DEPARTMENT OR AGENCY NUMBER FLA CONTRACT ROUTING NUMBER 04-00026 TASK ORDER Tobacco Education and Prevention Program This Task Order is made this 28th day of April,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 Tobacco use is the leading cause of premature death and disability in Colorado. The state of Colorado has received funds under a Master Settlement Agreement between several states,including Colorado,and certain tobacco companies. A portion of these funds has been appropriated to the State to implement a tobacco education, prevention and cessation grant program,to provide funding for community-based and statewide tobacco education programs. The Contractor has submitted a funding request which has been approved by the State Board of Health. This funding request shall be funded from the tobacco education,prevention and cessation grant program. 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.R.S.,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. 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 Number 13V,Organizational Unit Code 7370 Appropriation Code 775,Program Code 9011,Function Code XMPT Object Code 5120 and Grant Budget Line Code 8A4G under Contract encumbrance number 04 FLA 00026. All required approvals,clearances, and coordination have been accomplished from and with all appropriate agencies. Page 1 of 7 • 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 July 1,2003. However,in accordance with section 24-30-202(1),C.R.S.,as amended,this Contract is not valid until it has been approved by the State Controller,or an authorized designee thereof. The Contractor is not authorized to,and shall not,commence performance under this Contract until this Contract has been approved by the State Controller. The State shall have no financial obligation to the Contractor whatsoever for any work or services or,any costs or expenses,incurred by the Contractor prior to the effective date of this Contract. If the State Controller approves this Contract on or before its proposed effective date,then the Contractor shall commence performance under this Contract on the proposed effective date. If the State Controller approves this Contract after its proposed effective date,then the Contractor shall only commence performance under this Contract on that later date. The initial term of this Contract shall commence on the effective date of this Contract and continue through and including June 30,2004 unless sooner terminated by the parties pursuant to the terms and conditions of this Contract. In accordance with section 24-103- 503,C.R.S.,as amended,and Colorado Procurement Rule R-24-103-503,the total term of this Contract, including any renewals or extensions hereof,may not exceed five(5)years. B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR. The Contractor,in accordance with the terms and conditions of the Master Contract and this Task Order,shall perform and complete,in a timely and satisfactory manner,all work items described in the Statement of Work and Budget,which are incorporated herein by this reference,made a part hereof and attached hereto as"Attachment A". 1. Implement a comprehensive tobacco control program in Weld County,Colorado,designed to prevent and reduce tobacco use. 2. The Contractor shall not use funds provided under this Task Order to: supplant funding for any existing programs/models;develop new cessation programs/models or curricula for youth or adults;pay for individual cessation aids or nicotine replacement therapy;fund capital improvements,substitute funding for events previously funded by tobacco companies, or fund costs of enforcement of state or local laws and ordinances. 3. If the Contractor intends to subcontract any or all of its performance under this Task Order,then the Contractor shall provide to the State,for the State's prior review and written approval, a copy of any proposed subcontract between the Contractor and a subcontractor. All subcontractors are subject to all the terms and conditions of this Task Order and the related Master Contract. The Contractor remains ultimately responsible for any work performed by a subcontractor. 4. The State of Colorado, specifically the Department of Public Health and Environment,shall be the owner of all printed materials,graphic representations, educational materials, audio-visual products,or any other media,in whatever form, created under this Task Order. 5. The Contractor shall ensure staff is trained in the field of tobacco control. Newly hired staff shall participate in an orientation training conducted by the State and satisfactorily complete the STEPP learning modules within six(6)months of employment. Page 2 of 7 6. The Contractor shall participate in state-level evaluation efforts as requested by the State to include but not be limited to quarterly reports,to be due 15 days after each calendar quarter. Calendar quarters shall be July-September,October-December,January-March and April-June. 7. Within thirty(30)calendar days after the expiration of the term of this Task Order,the Contractor shall submit a written report to the State which describes its key accomplishments in implementing Attachment A. The report shall also describe all measurable objectives and the Contractor's overall achievement of it plan. 8. The Contractor IS NOT required to provide matching funds in order to be eligible to receive funding under this Task Order. 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 NINETY-NINE THOUSAND NINE HUNDRED SIXTY-NINE DOLLARS ($99,969.00)for the initial term of this Task Order. Of the total financial obligation of the State referenced above, $0.00 are identified as attributable to a funding source of the United States government and, $99,969.00 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 "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 Task Order Reimbursement Statement within sixty (60)calendar days of the end of the billing period for which services were rendered in a format either provided by or approved by the State. The Budget,which is included in the Scope of Work,shall govern the expenditure of funds by the Contractor under this Task Order as well as subsequent reimbursement by the State. The Contractor may transfer funds between specific line items within a major budget category without prior approval. Up to ten percent(10%)of the total funds originally set forth in each major budget category(Personal Services,Operating,Travel,Contractual and Indirect)may be transferred to other categories without prior approval by the State. Proposed transfers that exceed ten(10%)of the original amount budgeted in a category must be approved in writing by the State prior to the transfer. In all instances,the Contractor shall submit a revised budget to the State that shows: the original amount(s),the modification(s)made,and the new amount(s)within thirty(30)calendar days of the modification(s). All task order reimbursement statements: shall reference the Master Contract's contract routing number and this Task Order's contract routing number;shall be based upon the costs of the work and services performed during the term of this Task Order;and,shall be supplemented or accompanied by supporting data and subcontractor invoices,if any,covering the work shown on the Task Order reimbursement statement upon request of the State. The Contractor shall maintain Page 3 of 7 original documentation for all costs related to the Contractor's performance under this Task Order. The Contractor shall not be reimbursed unless and until the State has received any and all quarterly reports then due from the Contractor. Each Task Order Reimbursement Statement shall be sent to: David Smith Prevention Services Division Colorado Department of Public Health and Environment Mail Code PSD-STEPP-A5 4300 Cherry Creek Drive South Denver,CO 80246 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 B". 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. 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. Page 4 of 7 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 C". 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. 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 Page 5 of 7 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. ATTACHMENTS. All attachments to this Task Order 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 and conditions of this Task Order and those of any attachment hereto,the terms and conditions of this Task Order shall control. Page 6 of 7 '. t IN WITNESS WHFREOF,the parties hereto have executed this Task Order as of the day first above written. 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 Name: 05/14/03 For the Executive t ctor Title: loners DEPARTMENT rr F UBLIC HEACFH FEIN: 84-6000813 B AND ENVIRO � � 1p (Seal) A T ' srxJ PROGRAM APPROVAL: Weld County Clerk to t B &< H, I . J F. x By: Co �yA t By: City,City and Comm ! z' .r Special District,or To kiE • ent Deputy Clerk to the 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 By: /90/-e---12C-ca;-a----- Date: - /8_ Revised:11/30/02 Page 7 of 7 f [Date] SAMPLE TASK ORDER CHANGE ORDER LETTER Attachment B 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 paragraph*_*.of the Master Contract identified as contract routing number** *** *****and paragraph*.*. of the Task Order identified as 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,Mail Code***-***-**,Denver,Colorado 80246. One original of this Task Order Change Order Letter will be returned to you when fully approved. [LEGAL NAME OF CONTRACTOR] STATE OF COLORADO (a political subdivision of the state of Colorado) 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 C Task Order Option to Renew Letter Number**, Contract Routing Number********** State Fiscal Year 20**-20** ***************Program This Task Order Option to Renew Letter is issued pursuant to paragraph*_*.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(LEGAL 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,Mail Code***-*****,4300 Cherry Creek Drive South,Denver,Colorado 80246. 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 (a political subdivision of the state of Colorado) 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 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH A U ENVI ONM 4!T By: tj" ( Date: BY: *ll�5 a U Revised:08/30/02 Mark E. Wallace, MD, MPH-Director r-st ‘H- Memorandum ITO: David E. Long, Chair WI C Board of County Commissioners • COLORADO FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment OCCJ i � DATE: May 20, 2002 SUBJECT: Task Order for the Tobacco Education, Prevention and Cessation Program Enclosed for Board review and approval is a Task Order between the Colorado Department of Public Health and Environment(CDPHE) and Weld County for the Tobacco Education, Prevention and Cessation Program. Funds from the Master Settlement Agreement between several states and certain tobacco companies have been appropriated to the CDPHE. This appropriation is available for the continued implementation of the tobacco education and prevention grant that has funded the Tobacco-Free Weld County Program at the Weld County Department of Public Health and Environment(WCDPHE). This task order will permit the continued efforts of 1.5 FTE Health Promotion staff members who will work towards reducing initiation of tobacco use by youth, reducing exposure to environmental tobacco smoke and promoting cessation of tobacco use among youth and adults. Community collaboration and capacity building around these tobacco prevention efforts will continue in order to allow for the maximum outreach of the funds. For these activities, WCDPHE will receive a sum not to exceed $99,969.00 for the time period July 1, 2003 through June 30, 2004. I recommend your approval of this task order. Enclosure 2003-1218 • Attachment A Application Cover Page Competitive Applications for Comprehensive Tobacco Control Programs within Public Health Agencies July 1, 2003 —June 30, 2004 Date: March 12, 2003 Agency Name: Weld County Department of Public Health and Environment Address: 1555 North 17`h Avenue, Greeley, CO 80631 Agency Director: Mark Wallace, MD, MPH Tobacco Prevention and Control Program Manager: Ren Bedell, MPH, CHES Telephone: (970) 304-6420 Extension 2381 Fax: (970) 304-6416 E-Mail: rbedell@co.weld.co.us Total Funds Requested for Project Period (July 1, 2003 —June 30, 2004): $ 99, 969.00 Approximate Distribution of All Funds by Program Goals Prevent initiation of tobacco use by youth: 35% Promote cessation of tobacco use among youth and adults: 30% Reduce exposure to secondhand smoke: 35% (total should equal 100 percent) 100% Submitted By: Mark Wallace, MD,MPH x • SECTION 1: NARRATIVE Summarize the agency's overall approach to implement a comprehensive tobacco education, prevention and cessation program. County/Coalition.Overview: Vision and mission statements for the coalition/program. The Tobacco-Free Weld County Program (TFWCP) located at the Weld County Department of Public Health and Environment (WDPHE) in Greeley has had a working partnership with the Tobacco- Free Weld County Coalition (TFWCC), a group of concerned individuals and organizations since the early 1990's. Both staff of the TFWCP and volunteers from the TFWCC meet monthly to reduce the negative impact of tobacco. These partnerships share a vision, which is to create changes in our county that will lead to long lasting reductions in sickness and deaths related to or caused by tobacco use. It is with this vision that both the TFWCP and the TFWCC have developed a joint mission statement that guides all comprehensive researched based tobacco prevention efforts in the county. The mission is as follows: "Our mission is to empower the citizens of Weld County to support a smoke-free environment through prevention, education and commitment to the community." Having the combined vision and mission statements as mentioned has helped to both unite and drive the TFWCP and TFWCC in all efforts to reduce the initiation of tobacco use among youth, promote quitting among youth and adults and reduce exposure to secondhand smoke (SITS) in Weld County. This united partnership has also increased the level of capacity in which tobacco prevention efforts are now able to reach out and have an impact among diverse populations represented throughout Weld County. I 1 • Describe the community's overall population, identified priority populations and how these populations will be reached through this proposal. With 4,004 square miles, Weld County has an area greater than that of Rhode Island, Delaware, and the District of Columbia combined, and is the 3`d largest county in Colorado. It is bordered on the north by Wyoming and Nebraska and on the south by the Denver metropolitan area. Driving along interstate 25 from the top or northern section of the county starting at Wyoming to the bottom or southern part of the county by Denver takes approximately two hours. About one-third of the County's area is farmland along a corridor following Highway 85 where the South Platte, Cache la Poudre, and Saint Vrain rivers meet. Weld County has a population of 180,936 making it one of the most populous counties in the state, with a density of 45.3 people per square mile. Weld County's population has increased 37.3% since 1990 and is constantly growing, as it is fast becoming recognized as an affordable county to live in by many people who work in Denver, Boulder, Fort Collins and other front-range communities. The projected population for the year 2006 is 207,732. There are 26 incorporated cities or towns in Weld County. The county seat and principal city, Greeley, is located in the west central part of the county and contains almost half the county's population. Generally, most of the remaining population resides within a 20-30 mile radius of Greeley. Due to an increased need for services in the southern portion of the county, a south county health department building opened in 2001 to serve the population in that part of the county. The backbone of the county's economy is farming and raising cattle. Weld County is home of several large cattle feeding operations that are among the nation's largest. Swift, formerly Monfort of Colorado is the largest and employs 4,000 people in Weld County.Because the county has a large agricultural base, there is a large influx of low income Latino/Hispanic migrant farm workers, which are one of the priority populations identified in the five-year strategic tobacco prevention plan for Weld County. As part of this proposal, efforts to reach out to this population will continue to include r I 2 • the targeted distribution and placement of bilingual educational materials and media on smoking related health issues, SHS exposure hazards and benefits of quitting. Free cessation services such as the Colorado Quitline will be promoted along with the other free educational materials mentioned at businesses and health clinics where these migrant farm workers work or frequent. The population of the county is 81% Caucasian, with small percentages (under 1%) of Black or African American, American Indian, and Alaska native, Asian, and Native Hawaiian or other Pacific Islander. Persons reporting Hispanic or Latino origin on the 2000 census represent 27% of the population in Weld County. Greeley has a population of 76,930, with 29.5% Hispanic and 70.5% non- Hispanic. With nearly 30% of the population being Latino/Hispanic a key effort of the five-year strategic tobacco prevention plan for Weld County has been to develop and maintain a constant number of activities that will reach this population. In the current proposal bilingual media in Spanish will be used to promote the free resources found on the Colorado Quitline/Quinet, place educational messages for parents from the CDC on talking to your children about tobacco and finally media on the hazards of SHS and the benefits of smoke-free public places and workplaces. Additional bilingual materials will be used to promote the American Lung Association's (ALA) "Not On Tobacco" (NOT) youth cessation program, educate Spanish-speaking tobacco retailers about youth access laws, raise awareness about Colorado's Quitline/Quitnet and other low cost local cessation services, as well increase awareness on the hazards of SHS. Spanish businesses, newspapers, healthcare clinics/providers, worksites, groups and radio stations will be used to strategically run or disseminate all of the mentioned media and materials. In Weld County approximately 70% of the population is younger than 44 years old, with 32% of this group who are age 20 or younger. With such a young population it is one reason why Weld County has a college population of over 17,800 college students who attend either the University of Northern 3 • Colorado (UNC) or AIMS Community College on a yearly basis. Additionally in Grades K-12 there are 31,000 students (12,000 who are of Latino/Hispanic origin) who attend one of the 13 school districts scattered throughout the county. With the large college population and K-12 populations as identified above the TFWCP has identified both as priority populations. The College population, which has been identified as one of the fastest growing categories of new tobacco users, will be reached in the proposal thorough providing on campus media increasing awareness for quitting and free or low cost cessation resources on campus. Collaborative program partnerships have also been established with tobacco prevention programs funded through the Colorado State Tobacco Prevention Partnership (STEPP) program Collegiate Initiative grants at both UNC and AIMS. K-12 populations will continue to be addressed thorough promoting onsite cessation classes such as the NOT program, Alternative To Suspension (ATS) educational programs as part of enforcing tobacco-free school policies, maintaining a low number of tobacco retailers who sale to minors, and working with schools to increase tobacco prevention messages. Partnerships are also being established to provide technical assistance to five individual schools and one full school district in Weld County that have been awarded STEPP in Schools tobacco prevention grants to increase prevention messages in the school setting and enforcement of school tobacco policies. Describe the barriers and challenges to elimination/reduction of tobacco use as identified through the five-year strategic planning process and program work. Barriers and challenges in implementing the plan include: personal attitudes of residents where public policy is concerned, social acceptance of tobacco use and gaps in the membership of the TFWCP coalition, including membership of Hispanic/Latino representatives. Cultural language barriers also exists but have been reduced significantly since being identified in the five year strategic plant. i I 4 In working with youth and schools there are also barriers including: a lack of commitment from some adult sponsors for youth coalitions and a feeling by schools and school districts that tobacco use by students is not a priority. There are additional barriers in working with schools to increase enforcement and with tobacco retailers who do not readily participate in retailer training to decrease the number of youth sales of tobacco. There are also challenges-in providing retailer training for monolingual Spanish speaking establishments, and because of staffing changes by the Department of Revenue there are a limited number of retailer compliance checks conducted in Weld County. Cessation services also pose barriers and challenges because there are a limited number of resources residents can be given. There are challenges in serving our Latino population for cessation services. The schools that provide youth cessation are limited, and only offered in a few schools throughout the county. Agency/Applicant Capacity: Key accomplishments in tobacco control programs to date or other evidence of the agency's commitment to tobacco control. There are currently 85 members of the Tobacco Free Weld County Coalition. In addition the coalition was involved iri passing an ordinance to ban smoking in the outdoor Island Grove Arena, supporting a resolution that banned smoking within 50 feet of all county buildings and vehicles, development of tobacco vending machine restrictions and a number of small community youth access ordinances. Describe or list community partners and coalition members (organizations) who will support the implementation of this proposed annual action plan and the applicant as lead agency for implementation. Colleges/Universities: University of Northern Colorado (UNC), UNC BACCHUS GAMMA student peer education group, UNC health center, UNC Cesar Chavez Cultural Center, AIMS Community College, Eta Sigma Gamma honorary society at UNC. 5 • • Community Based Businesses and Organizations: Catholic Charities, Island Grove Regional . Treatment Center, The Greeley Tribune, The Greeley Latina Women's Organization, Eaton Bethel Family Praise Center Get R!EAL Coalition, Cache Bank and Trust(meeting facilities). Healthcare Organizations/Groups: North Colorado Medical Center, Weld County Department of Public Health and Environment,Weld County Board of Health. Local Government Officials: Pierce City Council member, past Greeley City Council member, retired Ault City Council members, Weld County Commissioners. Youth Serving Organizations: Greeley Youth Initiative, Partners program, Girl and Boy Scouts. Public Education: Greeley/Evans School District 6 School Board and Administration members, Weld Opportunity High School, Gilcrest RE-1 School District, Highland High School, Frederick High School, Meeker Elementary School, University School's Get R!EAL Coalition, Northridge High School, Keensburg Jr./Sr. High School. Dental Groups/Clinics: Gomez Dental Clinic, Ligon Dental Clinic, Sunrise Community Dental Health Center. Law Enforcement: Colorado Department of Revenue SYNAR officers, Erie Police, Ault Police. Voluntary Health Organizations: American Lung Association, American Cancer Society, American Heart Association. Other: Colorado Tobacco Education and Prevention Alliance (CTEPA), Group to Alleviate Smoking Pollution (GASP), Rocky Mountain Center for Health Education (RMC), retired radiologist, rotary members, retired research chemist, local lawyer, engineer, students from UNC and AIMS. • 6 • Summarize the major strengths and abilities of the applicant to successfully implement and evaluate tobacco education and prevention programs. Include the applicant's experience working with the community and conducting tobacco education, prevention and cessation programs. As an applicant for the 2003-2004 fiscal year funding, the TFWCP has a number of major strengths that help to highlight it as a well-established and effective tobacco prevention program capable of continued tobacco prevention and reduction efforts. Major strengths include a well-established coalition and community partnerships that help in forwarding the work of the TFWCP. The program also has bilingual English/Spanish capabilities for working with the monolingual Spanish-speaking residents in the County. The WCDPHE also provides full support to the program. The TFWCP staff reside in and are familiar with Weld County. Staff includes a Program Coordinator who has a master's level degree in the field of Public Health (MPH) and is nationally certified as a Community Health Education Specialist (CHES) with past experience in tobacco prevention and one Tobacco Office Technician with extensive office and public experience who provides program and coalition support. The internal infrastructure of WCDPHE, which was established in 1938,provides the ideal location for the TFWCP. Both currently and historically the WCDPHE has managed a number of public health grants. It has been providing management support for TFWCP grants since 1991. Monthly fiscal reporting is one of the infrastructure duties that WCDPHE has streamlined. TFWCP staff are familiar with and trained in developing and meeting monthly/annual program progress reporting and monitoring requirements. Computer software, workstations, Internet access and technical support are available to each staff member. Meeting facilities are available onsite in Greeley and additionally at the south county health department location. The WCDPHE also provides a broad array of other health professionals including the director who is a medical doctor, nurses, health educators, dieticians, environmental health experts and assorted administrative support personnel who are willing to provide 7 • program and technical support on an ongoing basis. The TFWCP has past'experience in organizing community members to assist in changing or implementing health related policies and a history of assessing, educating, implementing and evaluating tobacco programming since the early 1990's. The TFWCP as mentioned has a diverse coalition of community members with a broad assortment of backgrounds and abilities. This coalition has a record of being politically active in decreasing public exposure to environmental tobacco smoke and reducing youth access to tobacco products. Consisting of many motivated citizens, they have accomplished a number of policy related changes in the community. These changes consist of passing an ordinance to ban smoking in the outdoor Island Grove Arena; supporting a resolution that banned smoking within 50 feet of all county buildings and vehicles; development of tobacco vending machine restrictions and a number of small community youth access ordinances. The coalition is a major strength of the TFWCP and with their support the TFWCP has the increased ability to accomplish more long-term results. Having this strength will be crucial to achieving many key activities in the proposed plan. The track record of working successfully with the partnerships as listed above gives more credibility and support for the program within the community, as well as, recognition when recruiting new partnerships. Summarize the applicant's capability to comply with the application requirements and monitor the proposed program activities. The TFWCP is housed at the WCDPHE in the health promotion and nursing division where there is already adequate internal structure in place to monitor program activities and keep track of program expenses and activities. All equipment and resource needs have been addressed previously. The staff of the TFWCP also meets regularly to provide updates to each other and staff of the WCDPHE and STEPP on program activities and progress. The TFWCP staff will be responsible for quarterly reporting procedures as requested by STEPP. 8 Provide an overview of the tobacco related priorities that will be addressed during the funding period. The major tobacco related priority areas for the 2003-04 fiscal year will be reducing exposure to SHS, preventing the initiation of tobacco use by youth and promoting cessation of tobacco use among youth and adults. The TFWCP will implement appropriate activities in each of these priority areas to reach the priority populations previously identified. The TFWCP staff and community coalition will focus on decreasing the number of public places and worksites where people are exposed to SHS and educating the public and key policy makers about the dangers of SHS and the benefits of smoke-free public places and worksites. TFWCP staff and community coalition wilt be addressing SHS issues in Greeley, Windsor and other communities as needed in Weld County. Additionally the Program will be completing a survey of Windsor residents on SHS policies and issues. The TFWCP staff will address preventing the initiation of tobacco use by youth by continuing to offer alternative to suspension programs to Weld County schools; offering parental information and involvement opportunities and by presenting available tobacco prevention programs to Weld County schools. The program will continue to offer educational opportunities to tobacco retailers to encourage compliance with Colorado State laws on tobacco sales to minors. Because of a reduction in staff the TFWCP will not include an objective\regarding youth advocacy, staff will however continue to provide technical assistance and encourage Weld County youth to participate in Get R!EAL coalitions and activities. The TFWCP will also address cessation among youth and adults by promoting the Quitline/Quitnet and other local quit resources such as the American Cancer Society's "You Can Quit" class to healthcare providers, and residents of Weld County. In addition staff will continue to offer technical assistance to schools that have provided youth cessation programs like the NOT program for 9 students during the current school year. Maintaining youth cessation services in light of losing the NOT grants available to schools will be a key goal. All adults will be targeted in a single objective this year for quitting, this will include pregnant and non-pregnant smokers combined. List the personnel that will be dedicated to the tobacco control program in this funding period. Position Title Staff Name & Degree FTE Primary Responsibilities Coordinator/HE Specialist II Ren Bedell, MPH 1.0 Program coordination/objectives Office Technician II Penny Duell .50 Technical support/coalition Describe any major program responsibilities that will be completed by subcontractors. For the 2003-2004 fiscal year the program will be using an outside sub-contractor (Cindy Kronague - Prime Solutions) tO assist with data collection and analysis services as part of completing one random survey of Windsor residents to determine their level of support for prohibiting smoking in public places and workplaces. Cindy Kronague the owner of Prime Solutions a measurement and evaluation consulting business has over twenty years experience working in a variety of capacities with nonprofit agencies. She belongs to the American Evaluation Association, American Public Health Association, Colorado Public Health Association, Society of Public Health Educators and maintains certification as a public health educator. Additionally Cindy has a Master of Public Health Degree and is working on completing a doctorate degree in statistical evaluation. She has been involved on a yearly bases as a consultant for a number of different evaluation project at the WCDPHE including two SHS community surveys. All additional program evaluation will be completed as needed by program and department staff this year. 10 • SECTION 2: ANNUAL ACTION PLAN • See Annual Action Plan - Attachment 2 SECTION 3: EVALUATION NARRATIVE FOR OUTCOME OBJECTIVES Objective By 6/30/04, increase to 23% (3/13) the proportion of Weld county school districts with one or more schools offering an Alternative to Suspension (ATS) Program for students facing suspension for violating their schools tobacco policy. (BASELINE: One Weld county school district had an Alternative to Suspension program during the 2002-2003 school year) An internal program document called the Weld County School District ATS Program Log Sheet will be developed and maintained by program staff. Progress and status of efforts to establish ATS programs will be noted as they occur throughout the year and reviewed at year end. A complete census of Weld county school districts will be done. An end of year assessment of the number and percent of school districts that have begun to offer the program to students will be calculated. Objective By 6/30/06, maintain a 5% or less illegal buy rate among minors in all Weld County jurisdictions. (BASELINE: 0% of tobacco retailers in Weld County sold during 2002 SYNAR compliance checks) (Healthy People 2010 Objective:Increase to 100% the proportion ofjurisdictions with a 5% or less illegal buy rate among minors) (Colorado Health People 2005 Objective: Increase to 64 counties the number ofjurisdictions with a 5% or less illegal buy rate among minors) SYNAR Compliance Check Reports created and maintained by the State of Colorado will be used to monitor Weld County tobacco retailer compliance rates. Program staff receives and reviews these reports'quarterly or as available. Random sampling of Weld County tobacco retailers is done each fiscal year. A comparison with previous year annual compliance rates will analyze status of this objective. Objective By 6/30/04, maintain at least three schools that offer tobacco cessation services in Weld County schools. (BASELINE: Three Weld County schools offered tobacco cessation services to students during the 2002-2003 school year.) An internal program document called the Weld County School Tobacco Cessation Program Log Sheet will be maintained by program staff. Progress and status of current tobacco cessation programs will be logged throughout the year and reviewed at year end. A complete census of Weld county schools will be the sample. An end of year assessment of the number of schools with tobacco cessation programs and the number of students served will be calculated. 11 • Objective By 6/30/04, increase by 150 the number of adult Weld County Smokers making quit attempts. (BASELINE: 473 adult Weld County smokers used the Colorado Quitnet, Quitline or local American Cancer Society's "You Can Quit" classes in 2002. TARGET: Increase number by 30%) Several outside sources collect data monthly. Quitline and Quitnet monthly database reports and local American Cancer Society"You Can Quit" class information will be used. Convenience samples of adults requesting Quitline, Quitnet, and local ACS quit class services will be used as the primary sources. An end of year duplicated count will be calculated using all three data sources to estimate the number of adults making quit attempts. Objective By 6/30/06, increase to one (1/26) the number of incorporated communities in Weld County that have a comprehensive clean indoor air ordinance which protects the public from secondhand smoke (SHS) in public places and the workplace. (BASLINE: No incorporated communities listed in the 2002 Greeley/Weld Economic Development Action Partnership demographic profile for Weld County have comprehensive clean indoor air ordinances which protect the public from SHS in public places and workplaces.) Internal records and progress notes regarding progress of community-level secondhand smoke policy work will be maintained by program staff. A complete census of Weld county communities will be considered. A year end internal document review will be done by program staff counting the number of communities with new secondhand smoke policies. 12 SECTION 4: BUDGET AND BUDGET NARRATIVE • See Administration Budget Form signed—Attachment 3 BUDGET NARRATIVE Personal Services As part of the reduction in funding ranges for the 2003-2004 fiscal year the TFWCP is reducing staffing in order to allow for sufficient funding to carry out the scope of work submitted in the annual action plan. Currently the program has three 1.0 FTE positions (Program Supervisor/SHS Health Educator, Youth Health Educator, Cessation Health Educator) and one .50 FTE position(Office Technician). The changes will include reducing staffing to one 1.0 FTE Coordinator/Health Educator position and maintaining the .50 FTE Office Technician position. The Program Coordinator/Health Educator will have full responsibility for carrying out the work submitted in the annual action plan, managing budget expenditures and providing technical assistance to volunteers and partners who assist with the work. The Office Technician will assist in providing office support as needed to help carry out the work and also assist with coordinating volunteers from the tobacco prevention coalition. The salary for the 1.0 FTE Coordinator/Health Educator has been reduced from a supervisor level (Grade 39) to a Health Educator II (Grade 34). The amount requested is $55,858.76. This includes the base salary of$42,326.86 for a 12-month period and $13,531.90 in benefits at the 31.97% Weld County fringe benefit rate. All cost of living and performance increases are included. The salary amount requested for the .50 FTE Office Technician II position is $14,577.99. This includes the base salary of$11,046.44 for a 12-month period and $3,531.55 in benefits at the 31.97%Weld County fringe benefit rate. All cost of living and performance increases are included. 13 Operating Expenses The TFWCP relies on having a sufficient quantity of office supplies to carry out the daily functions associated with completing the scope of work in the annual action plan. The office supplies being requested are envelopes, brochure paper, replacement printer cartridges, paperclips, pens, pencils, staples, file folders, binders, tape, dry erase markers, corrective tape, scissors, sticky notes, notepads, CD and floppy disks and colored paper. Quantities were estimated from previous usage for similar activities. Envelopes, brochure paper and stationary will be used for developing and sending correspondence and other educational materials on a monthly basis. Key educational projects which will require a significant quantity of office products include the Windsor SHS survey, educational packets in Spanish for tobacco retailers, cessation information materials for health care providers, prenatal providers, local businesses that are English and Spanish speaking, and SHS educational materials. $1740.00 has been requested for office supplies. Postage and shipping have been estimated on last year's mailings in combination with this years proposed activities. Postage has been estimated for 3500 items at .37 cents each for a total of $1295.00. The largest mailing would include a random mail survey of 1500+ surveys on SHS in Windsor. Newsletters to 80 coalition members on a bi-monthly basis is another one of the larger ongoing mailings. Additionally postage will be used for distributing a number of cessation and SHS educational materials. Shipping costs are for 15 mailings at $4.00 each to distribute educational videos and brochures to outlying community members and teachers who borrow them. The TFWCP has the equipment to do most of the printing and copying for the program educational materials onsite. In the budget a total of$905.00 has been requested for outside printing and copying. $800.00 will be used for printing higher quality educational materials such as educational posters and brochures on cessation and SHS. Mass copying, such as for the Windsor SHS survey will 14 be done at 3.5 cents per copy through the county print shop. At least 1500 copies are anticipated for this survey. Rent/utilities are covered as part of the county indirect charge to the program and are not paid on a separate basis, no additional funds are being requested for this category. The program has no office equipment needs and no additional funds are being requested in this category. Each staff member will have full access to needed software, computers, printers and copiers. In the past the TFWCP has received valuable support, updates, materials, technical advice and training on tobacco prevention related issues through program memberships with the Colorado Tobacco Education and Prevention Alliance(CTEPA) and the Group to Alleviate Smoking Pollution (GASP). Membership renewal costs have been included in the budget for a combined total of$125.00. Additionally the annual subscription renewal cost of$150.00 has been included in the budget to pay for receiving a daily copy of the Greeley Tribune (the largest print news source in the county). No staff registration fees are anticipated and have not been included in the budget. The budget requested for educational materials and meeting expenses that will be required by staff and coalition members to complete the scope of work in the annual action plan requires a combined budget of$4800.00. Educational materials costs have been based on similar activities from last years budget and tailored to.meet the needs of the proposed activities. 1,150 educational materials are required at a total cost of$2300.00. This includes ordering pre-printed educational brochures, videos and posters that will be used for educating on youth and adult cessation, youth access issues and SHS hazards. The required total cost for meeting expenses is $2,500.00, which includes providing some food for lunch hour volunteers who participate in at least 12 monthly coalition meetings and steering committee meetings, food for healthcare provider educational meetings, CDC "Got A Minute" 15 parent trainings, school administrator meetings and tobacco retailer trainings. Also cost for an occasional meeting room rental has been included based on the current years costs. With a reduction in staffing the TFWCP will rely more on media as a source of educating the public this year. Due to costly limitations associated with using electronic media that is mainly based out of the Denver market, printed media will continue to be the main media channel. Staff will seek out opportunities to earn media coverage, release Public Service Announcements and press releases to reduce cost, however the requested funding for additional media coverage that will be required is $6200.00. This includes a total of 29 printed media ads at a total cost of$ 2,500.00 and 2 electronic media ads on local radio stations. The media cost are required to support, promote and educate about the Colorado Quitline, Quitnet, local "You Can Quit" class, SHS hazards, youth access issues, the NOT and ATS programs and the CDC's "Got A Minuet Campaign". The Greeley Tribune, UNC Minor, and local high school papers will be the key print media resources and K99, KGRE and KUNC will most likely be the electronic radio media sources. Travel With Weld County being one of the largest counties in Colorado covering over 4,000 square miles traveling to some of the smaller communities east of Greeley and south of Greeley often requires staff to travel many miles. It is estimated that local travel needed to completed the scope of work in the annual action plan will require staff to travel 180 miles each month @ .34 cents per mile, for a total cost of$734.40 for a 12-month period. No out of state travel needs will be required by staff to complete the scope of work. All in-state travel by staff to conferences is usually within a reasonable driving distance so no overnight lodging is anticipated as noted in the budget. Local travel to an anticipated 4 STEPP training conferences and/or other tobacco prevention trainings in Denver will require staff to travel 480 miles @ .34 cents per mile. 16 Additionally staff estimate that an additional 240 miles @ .34 cents per mile will be required to attend 4 additional regional tobacco prevention trainings or collaborative meetings, such as with other organizations within or without the county. The combined cost for 720 in-state miles @ .34 cents per mile is $244.80. All local travel estimates in the budget include travel for both staff. Contractual A contractual/consultant fee of$500.00 has been included in this year's budget for data collection and analysis services by Cindy Kronague (Prime Solutions). This will be used as part of completing one random survey of Windsor residents to determine their level of support for prohibiting smoking in public places and workplaces. Program staff will complete all other services for the program. Indirect Weld County Department of Public Health and Environment has a negotiated rate with the Colorado Department of Public Health and Environment, which currently stands at 14.39%. This indirect rate has been calculated by charging 14.39% to the total direct cost (personal services + operating+travel + contractual) of the grant. The total indirect cost is $12,576.00. Y 17 ATTACHMENT 1: Statement of Disclosure By signing this statement, the applicant states that no affiliation or contractual relationships, direct or indirect, exists with tobacco companies or owners, affiliates, subsidiaries, holding companies or companies involved in any way in the production, distribution, promotion, sales or use of tobacco products. The Agency Director must sign this statement. • Signed: ---17\40k-k-, ICk/ Title: D;1`ta'v✓" Organization: a)cicJ ,m,, © �lu � 1 „3/J ,4e✓r�' Date: 4403 18 • ATTACHMENT3 i• STATE TOBACCO EDUCATION AND PREVENTION PARTNERSHIP • APPLICATION BUDGET AND/OR EXPENDITURE REPORT FORM FOR THE PERIOD: 7/01/03 through 6/30/04 Weld County Dept.of Public Health Annual #of FTEI Total _ SOURCE OF FUNDS Fringe! Requested/ Salary months Ind Amount Received Rate Budget Pct Required OTHER* from CDPHE PERSONAL SERVICES: Coordinalor/HE Specialist II $42,326.86 12 100.00% $42,327.00 $42,327.00 Office Technician II $22,492.88 12 50.00% $11,047.00 $11,047.00 Fringe Benefits: $17,064.00 $17,064.00 Total Personal Services�—� $70 438.00 $70,438.00 DIRECT OPERATING EXPENSES Prinling/Copying $905.09 $905.00 Postage/Shipping $1,355.00 51,355.00 Rent/Utilities Telephone,Fax,Internet Access Office Supplies $1,740.00 $1,740.00 Office Equipment Computer Equipment Meeting Expense $2,500.00 $2,500.00 Media Expense(Program Cost) $6,200.00' $6,200.00 Staff Development-Registrations Staff Development-MembershIps/Subscriptions $275.00 $275.00 Educational Materials(Program Cost) $2,300.00 $2,300.00 Miscellaneous Expense Total Operating $15 275.00 _ $15 275.00 TRAVEL In-State $1,180.00 $1,180.00 Oul-of-State Total Travel $1,180.00 $1,180.00 CONTRACTUAL Consultant Costs(Program Cost) Contract Tralners/Speakers(Program Cost) Data Collection(Program Cost) $500.00 $500.00 Total Contractual 1500.00 $500.00 Total Direct Costs(Personal Services+Operating+Travel+Contractual) $87,393.00 $87,393.00 ADMINISTRATIVE INDIRECT COSTS Pcl • Indirect Percentage I 14,4% $12,576.00 $12,578.00 Total Indirect Costs $12,576.00 $12,576.00 TOTAL PROJECT COST $99,969.00 $99,969.00 "'Other"Funding Sources(Matching Funds)Not required for this grant. Do Not Use. TOTAL ' !/"}et99 'c 7j - 1O --O Signature of Authorized Representative Dale Budget - Personal Services Worksheet • �X u-�-- � ax-2<-. ��"�..-�-� "�< .zs 1 r �'..� 's i k`\� lTbtal -2;q'ezi'a h y�tt� M P .r ih 1Y a , 8 �'� m <7 4. A a"�'', " "h •vz Position„itl ,- ta- . .C rBQse � em6:21oo,,Me jcarca1.45at f�eajfr/Life wRefi gig: /. l Ptgl gtlfr !ge Mai . , Coordinator/HE Specialist IT $42,326.86 31.97% $13,531.90 $55,858.76 100.00% $55,858.76 Office Technician II $22,092.88 31.97% $7,063.09 $29,155.9/ 50.00% $14,577.99 Totals $64,419.74 $20,594.99 $85,014.73 1.50 $70,436.74 Budget - Operating Expenses Worksheet '•'QUtgnt'fy;' 4�p,It Price's " kTotgi Office 5 7ies•, , .` Stationery, Envelopes, etc 10 $19.00 $190.00 Computer/Printer Paper Computer/Printer Supplies 2 $100.00 $200.00 General Office Supplies 900 $1.50 $1,350.00 Total �, ,j; ,xfts { i $1,740.00 Postage/Shipping " , ,"' Quantity Unit-Price, _ ;`f, Total Postage 3,500 $0.37 $1,295.00 Bulk Mailings Shipping Costs 15 $4.00 $60.00 Total AgiNr- '7.11 $1,355.00 N t; � .�2 �1 1 ,.,ieta' s .W! 1 Y 'JIB dry• ^ ,s��,-bmdf'f p�ah ��ir .� � .b�. aF� e "�fh� �" r P•rin,in / o In y' t'` ^ *°t �.Q uanti't Y' "'Umt P "ice Total r Printing (Forms, brochures) 400 $2.00 $800.00 Copying Costs 3,000 $0.04 $105.00 Total "�' 'ir jai z $905.00 la r € m4h ,JE tefid e . ? 1A' kd da a ��, ��' dr�. ��.�t,.��a a`�tr ,.'R id�J'�ti�n sx br�N �, Rent UtiUties"' . , '"a %Quantify"',Unr Price Total Space Rental Utilities (Gas/Electric) Telephone/Fax Internet Access Fee Total littitaft, Af f€ Equipn en-f � 4 " , , °Quantity'`r,tJh t Price ' a' Total Puter,�Auip � , ,r Computers Printers Software General Office Equipment Total ,.�u �,,." ;� ,• • Budget - Operating Expenses Worksheet Staf beveloprtient r T" i p Qtlankshtrty, Unit Price ` ' ' Total Memberships: CTEPA 1 $100.00 $100.00 GASP 1 $25.00 $25.00 Subscriptions: Greeley Tribune 1 $150.00 $150.00 • Registrations: ii n� a,=,..i ,e•s{ er.��r '{ 15,q Total _F s ` $275.00 :ra , 'r d -.',4-T1-441-4M�'' d��;'MVE �, �r':� .Qt�pntt#Y rrUniti��ricef Educational Materials 1,150 $2.00 $2,300.00 Meeting Costs 25 $100.00 $2,500,00 Media Expense ; ;, rrs !a"' ry, ra Print 29 $200.00 $5,800.00 Electronic 2 $200.00 $400.00 m t ye Total L ;45' fi��Y $11,000.00 i+ v1d i@@lrr�,,��LL-- d6fi!?�°� 9�d__'��{{:. J , .c4t,alwrfowMrd,�f .y,KiNF(4Y+3Gf �'.,a li'fut„t,•Ik`-.Xw .#s� 1:. Mt. r 4'31' '��. i �� HV',. !. Mis eiianegus'�:ERpens�r,« 'z ?.Quantity `'iUnit Price, x a a Total Misc Operating Total "pis;e t VW �se tk,AS°r ��''t' }rt' fa,,y�k�.ti iaa�n1 y'+r" °.b,w3` G • r. r,, i6ry .�.9,1l Mr.h, w.-., i ter. lotali'Operating C� str i p 'a X $15,275.00 r,�� .'c, pri i..ttu fl,� rs�.£,xz..t. * - An itemized inventory must be'fiaintained for all computer equipment purchased. I Budget - Contracts/Consultants Expenses Worksheet Ql�antjtyt' Unit Prue, , Total_ 4iiiiMu 5St °ll s 9karr mVG yar i ip N "xf 4 4,4'41';',1(e15.!:61./ Consultant Costs* Contract Trainers/Speakers* Data Collection 1 $500.00 $500.00 Total M'n" r. ' ` "'' ti " $500.00 * - List all consultants and related activities in the budget narrative. • Budget - Travel Expenses Worksheet IN-STATE TRAVEL Local Travel - Mileage Costs WilS''4 .F3 A s4' _ ; . #i Mies' ? Rate : 'Cost: Administrative Local Meetings, etc 2160 $0.34 $734.40 Totals iglagiefqmpigs;:, $735.06 In-State Travel Costs Rat_V� ` . TOtgl.egtorj�4Jtpt�°Mi"e#ap9sE�„,�;;�. ;Number, Mileage 720 $0.34 $244.80 Air Fare Lodging Meals/Per Diem 20 $10.00 $200.00 Miscellaneous Totals Seat ` 4S e• $445.00 s.,(,ek[pa, aci MI SA*wky. r. ran txBaa ilit Total In-State Travel torigg ' t,,g# $1,180.00 * - List meetings to be attended and number of staff attending each meeting in the budget narrative. OUT OF STATE TRAVEL bout tialati :gat` .i= s*a,S3:Numbttt R..ateJeric' ,r otal Mileage Air Fare Lodging Meals/Per Diem Miscellaneous v,�e,A,r + rray „ Totals * - List meetings to be attended and number of staff attending each conference in the budget narrative. ATTACHMENT 2 -Annual Action Plan County Name: Weld County Program Goal: Prevent initiation Strategy: Promote tobacco-free schools County Outcome Objective: By 6/30/04, increase to 23% (3/13) the proportion of Weld County School Districts with one or more schools offering an Alternative to Suspension (ATS)program for students facing suspension for violating their schools tobacco policy. (BASELINE: 1 Weld County School District had an Alternative to Suspension program during the 2002-2003 school year.) S.M.A.R.T. Process Objectives Lead Role Outputs Anticipated Short-term Results Community Intervention: 1. By 6/30/04, provide at least 1 technical - Tobacco Staff #of technical assistance Increased collaboration with RMC assistance visit to Rocky Mountain Center visits completed funded projects/schools. (RMC) funded schools or districts to promote Increased knowledge of local resources. Tobacco Free Schools Law. 2. By 6/30/04, conduct at least 5 Centers for Tobacco Staff # of presentations Increased knowledge of parents on teen Disease Control (CDC) "Got A Minute" completed tobacco use. presentations at various schools,parent #of individuals organizations or community organizations in presented to Greeley, Windsor, Ault, Johnstown and Eaton. 3. By 5/30/04,Present"Tobacco Free Weld Tobacco Staff #of presentations Increased knowledge of local tobacco County"presentation to at least 4 Educational completed prevention resources by teachers. staff development meetings regarding Alternative to Suspension (ATS), Not On Tobacco (NOT), video resource library, and other programs at Weld County Department of Public Health &Environment(WCDPHE) in Greeley, Windsor, Ault,Johnstown and Eaton. Media/Marketing: 1. By 6/30/04, place at least 5 CDC "Got A Tobacco Staff #of print ads printed Increased awareness by communities Minute" ads in 3 community newspapers, and #of radio ads regarding youth tobacco prevention and send radio ads to at least 3 Weld County radio broadcasted parental involvement. stations. At least 1 will be in Spanish. #of Spanish ads 2. By 6/30/04, conduct 1 media campaign Tobacco Staff #of print ads printed Increased knowledge by school targeting school administrators teachers #of District Six administrators and SRO/CRO's School Resource Officers/Community television spots aired regarding Tobacco Free Schools Law Resource officers (SRO/CRO's)providing and enforcement. information on TFSL enforcement in district 1 newsletters, newspapers, District 6 television. S.M.A.R.T. Process Objectives Lead Role Outputs Anticipated Short-term Results Policy/Environmental Change: 1. By 12/31/03, contact at least 5 school Tobacco Staff #of school Increased awareness by school administrators to encourage them to add ATS & Coalition administrators contacted administrators of ATS programs. programs to their school tobacco policy. Members Evaluation: 1. By 5/01/04, conduct 1 record review of all 13 Weld County School Districts to assess how Tobacco Staff #of records 1-eviewed Increased number of schools with ATS many have implemented an ATS type #of school districts that programs in Weld County School program for students violating tobacco policy - have implemented an Districts. as part of enforcement of TFSL. ATS type program — 2 County Name: Weld County Program Goal: Prevent initiation Strategy: Decrease youth access to tobacco products County Outcome Objective: By 6/30/06, maintain a 5% or less illegal buy rate among minors in all Weld County jurisdictions. (BASELINE: 0%of tobacco retailers in Weld County sold during 2002 SYNAR compliance checks)(Healthy People 2010 Objective:Increase to 100%the proportion ofjurisdictions with a 5%or less illegal buy rate among minors.)(Colorado Health People 2005 Objective:Increase to 64 counties the number of jurisdictions with a 5%or less illegal buy rate among minors) S.M.A_R.T. Process Objectives Lead Role Outputs Anticipated Short-term Results Community Intervention: 1. By 6/30/04, offer at least 1 tobacco Tobacco Staff #of training completed Increased awareness of youth tobacco retailer training to any retailer who laws in Colorado by retailers who violates youth tobacco sales laws. violated. 2. By 6/30/04, visit at least 50 Weld Tobacco Staff& #of tobacco retailer visits Increased awareness of youth tobacco County tobacco retailers to Youth Coalitions completed laws in Colorado. disseminate educational information # of educational materials about youth access laws. distributed Media/Marketing: 1. By 6/30/04, write 1 article or place 1 Tobacco Staff #of advertisements or articles Increased awareness by community advertisement in at least 2 Weld written ' members regarding youth and tobacco County newspapers regarding youth access la,ws in Colorado. access. 2. By 6/30/04, conduct at least 1 print Tobacco Staff #of print ads placed Increased knowledge by community media campaign surrounding those members of which retailers refuse to retailers who refused to sell to sell tobacco to minors. minors during compliance checks. 3. By 6/30/04, place 1 article or Tobacco Staff& #of articles or advertisements Increased knowledge of the advertisement at least 2 times in Coalition association between price and use of Weld County newspapers regarding Members tobacco by youth. raising the price of tobacco as an effective tool to reduce youth tobacco use. 3 S.M.A.R.T. Process Objectives Lead Role Outputs Anticipated Short-term Results Media/Marketing: 4. By 6/30/04, provide at least 1 Tobacco Staff #of packets distributed Increased knowledge of youth access 1 Spanish educational packet on laws by Spanish-speaking tobacco tobacco youth access and sales to retailers. minors to Spanish-speaking tobacco retailers. Policy/Environmental Change: 1. By 6/30/04, at least 1 time notify the Tobacco Staff& #of town boards notified Increased community awareness of town boards in any community that Youth Coalitions tobacco retailers who violate youth has tobacco violations to encourage access laws. community awareness. 2. By 6/30/04, send at least 25 letters or Youth&Adult #of letters Increased support for raising the price— place 25 phone calls to key policy Coalition #of phone calls of tobacco as an effective tool in makers regarding raising the price of Members reducing youth access. tobacco as an effective tool in reducing youth access. ' Evaluation: 1. By 6/30/04, conduct 1 record review Tobacco Staff #of records reviewed increased awareness of tobacco of SYNAR compliance checks to #of compliance checks retailers who are selling tobacco to determine the percentage of minors. underage sales in Weld County jurisdictions during the 2003-2004 Increased support for raising the price fiscal year. of tobacco as an effective tool in reducing youth access. 4 County Name: Weld County Program Goal: Promote quitting Strategy: Promote youth cessation programs County Outcome Objective: By 6/30/04,maintain at least 3 schools that offer tobacco cessation services in Weld County schools. (BASELINE: 3 Weld County schools offered tobacco cessation services to students during the 2002-2003 school year.) S.M.A.R.T. Process Objectives Lead Role Outputs Anticipated Short-term Results Community Intervention: 1. By 9/30/03, meet at least 1 time with Tobacco staff& #of meetings completed Continued collaboration with NOT all current NOT facilitators of 2002- NOT facilitators facilitators and schools. 2003 school year for maintenance meeting and promotion of NOT for 2003-04 school year. 2. Present NOT Curriculum to at least 1 Tobacco Staff #of Presentations completed Provide ESL students and teachers English as a Second Languauge with new knowledge about youth (ESL) classroom in Dist. 6. ' cessation programs available Media/Marketing: 1. By 06/30/04,place at least 3 advertisements in high school Tobacco Staff #of advertisements placed Increased numbers of youth newspapers that have the NOT participating in NOT programs. programs in place, to promote youth cessation and the risks of tobacco . use. Policy/Environmental Change: 1. By 6/30/04, meet at least 1 time with Tobacco Staff #of meetings completed Increased number of NOT facilitators current NOT facilitators to NOT facilitators who commit to provide NOT at least encourage them to commit to provide once per year. NOT programs at least 1 time per school year. Evaluation: 1. By 6/30/04, complete 1 assessment Tobacco Staff #of assessments Increase knowledge of how many to determine the number of schools #of school youth cessation youth cessation programs are that continued to implement youth programs available in Weld County Schools. cessation programs in Weld County schools during 2003-04 school year. 5 • County Name: Weld County Program Goal: Promote quitting Strategy: Promote quitting among adults County Outcome Objectives: By 6/30/04, increase by 150 the number of adult Weld County Smokers making quit attempts. (BASELINE:473 adult Weld County smokers used the Colorado Quitnet,Quitline or Local American Cancer Society(ACS)"You Can Quit"classes in 2002. TARGET:Increase number by 30%) S.M.A.RT. Process Objectives Lead Role Outputs Anticipated Short-term Results Community Intervention: 1. By 6/30/04, arrange 3 American Cancer Tobacco Staff . # of ACS You Can Quit Increased cessation resources. Society(ACS) "You Can Quit"classes Coalition members Classes offered. in Weld County. 2. By 6/30/04, at least 1 time disseminate Tobacco Staff # of providers reached Increased knowledge and skills. 5A's information to a minimum of 5 health care providers in Weld County. 3. By 6/30/04, at least 1 time disseminate Tobacco Staff # of providers reached Increased knowledge and skills. 5A's information to a minimum of 3 prenatal providers in Weld County. Media/Marketing: 1. By 6/30/04, at least 1 time promote local Tobacco Staff # of worksite/businesses Increased knowledge of cessation and state cessation resources to 30 that receive cessation resources. worksite/businesses in Weld County. At resource information. least 5 will be Latino businesses. 2. By 6/30/04, place 6 bilingual Tobacco Staff # of bilingual cessation ads Increase knowledge of cessation-- advertisements in local newspapers placed in local Weld resources. throughout Weld County promoting newspapers local and state cessation resources 3. By 6/30/04, place 2 advertisements in Tobacco Staff # of cessation ads placed in Increase knowledge of campus the University of Northern Colorado UNC Health Care Center the UNC Mirror cessation and state cessation (UNC)Mirror promoting local campus resources. and state cessation resources. 6 S.M.A.RT. Process Objectives Lead Role Outputs Anticipated Short-term Results Policy/Environmental Change:. 1. By 6/30/04, contact a minimum of 8 Tobacco Staff #of health care providers that Increased number of health care health care providers at least 1 time to include referral of adults to providers referring tobacco-using encourage them to include referral of cessation resources as part of patients to quit resources. adults to local and state cessation their intake process resources as part of their intake process. Evaluation: 1. By 6/30/04, conduct at least 1 review of Tobacco Staff #of records reviewed Increased number of adult quit Quitline/Quitnet and local ACS "You #of adult quit attempts attempts. Can Quit"class records to determine the — number of adult quit attempts in Weld County. 7 County Name: Weld County Program Goal: Reduce exposure to secondhand smoke ` • Strategy: Promote smoke-free public places/workplaces County Outcome Objectives: By 6/30/06, increase to 1 (1/26) the number of incorporated communities in Weld County that have a comprehensive clean indoor air ordinance which protects the public from secondhand smoke (SHS)in public places and the workplace. (BASLINE:No incorporated communities listed in the 2002 Greeley/Weld Economic Development Action Partnership demographic profile for Weld County have comprehensive clean indoor air ordinances which protect the public from SHS in public places and workplaces.) S.M.A.R.T. Process Objectives Lead Role Outputs Anticipated Short-term Results Community Intervention: 1. By 6/30/04, complete at least 12 Tobacco Staff& #of educational visits Increased knowledge by business educational visits to business owners Coalition completed owners of the benefits of smoke-free to educate on the benefits of having Members # of business owners workplaces. �. smoke-free workplaces. educated 2. By 6/30/04, conduct at least 6 Tobacco Staff& # of informal educational Increased awareness by community informal educational visits to Coalition visits completed leaders of the benefits of smoke-free community leaders to educate on the Members # of community leaders workplaces. benefits of smoke-free community educated policies. 3. By 6/30/04, complete at least 4 Tobacco Staff& #of educational visits to Increased knowledge by Latino educational visits to business owners- Coalition businesses serving the Latino serving business owners of the who mainly serve the Latino Members population benefits of smoke-free workplaces. population to educate on the benefits #of business owners of having smoke-free workplaces. educated 4. By 12/31/03, conduct at least 2 Tobacco Staff& #of educational presentations Increased awareness of SHS hazards educational presentations on the Coalition completed and ventilation system reliability by hazards of SHS and reliability of Members communitymembers. ventilation systems to Weld County Chambers of Commerce, Rotary Clubs or other key community organizations. 8 S.M.A.R.T. Process Objectives Lead Role Outputs Anticipated Short-term Results Community Intervention: 5. By 6/30/04, complete one random Tobacco Staff #of surveys completed Assessed number of Windsor survey of Windsor residents to residents to support prohibiting determine their level of support for smoking in public places and prohibiting smoking in public places workplaces in Windsor. and workplaces in Windsor. Media/Marketing: 1. By 1/31/04, place at least 5 Tobacco Staff #of educational ads printed Increased knowledge of smoke free educational advertisements in two - #of Major Weld County public places and hazards of SHS. major Weld County newspapers on newspapers utilized the hazards of SHS and the benefits # of Spanish ails of smoke free public places and workplaces. At least 1 will be a Spanish advertisement. Tobacco Staff #of educational articles/fact Increased availability of facts and 2. By 6/30/04, provide at least 4 sheets completed information regarding SHS. educational articles/fact sheets on #of articles/fact sheets Increased knowledge of SHS hazards SHS that the local Tobacco-Free displayed online to the public by web site viewers. Weld County Coalition may utilize #of articles/fact sheets in on their Community Website. At Spanish least 1 will be in Spanish. Policy/Environmental Change: 1. By 6/30/04, provide at least 2 Tobacco Staff& # of technical assistance / Increased knowledge of the benefits technical assistant visits to Coalition visits completed of smoke-free policies by policy community policy makers to provide Members # of community policy makers. educational materials on the benefits makers who were visited and of smoke-free policies. received educational Evaluation materials - -- 1. By 6/30/04, conduct a record review Tobacco Staff #of records reviewed Increased knowledge of tobacco staff of all incorporated Weld County #of communities with and coalition members of the number communities to assess how many comprehensive clean indoor of Weld County communities that have a comprehensive clean indoor air ordinances have comprehensive clean indoor air air ordinance that protects the public ordinances. from SHS in public places and the workplace. 9 Hello