HomeMy WebLinkAbout20011339.tiff RESOLUTION
RE: APPROVE TASK ORDER FOR TOBACCO EDUCATION, PREVENTION, AND
CESSATION 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, Prevention, and Cessation 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 June 1, 2001, and ending June 30, 2002, 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, Prevention, and
Cessation 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 21st day of May, A.D., 2001.
BOARD OF COUNTY COMMISSIONERS
WELD CO NTY, COLORADO
ATTEST: {/ � AD / ��� ��� Jt)A i � ' %•"- �� ?!ileJhr
Weld County Clerk to 1�
1861 , aI EXCUSED
Y
Glenn Vaad, Pro-Tem
BY: • •� /
Deputy Clerk to th t: j. '�+�
Jerke
AP V DAST M: Cu, E C
D tJl\vi E. Long
\t\idou ty Attorney D
Robert D. Masden
2001-1339
HL0028
Memorandum
TO: M.J. Geile, Chair
W C Board of County Commiss}o}jers
FROM: Mark E. Wallace, MD, MPH, Director
COLORADO Department of Public Health and
Environment A
DATE: Mary 17, 2001
SUBJECT: Task Order for the Tobacco Education,
Prevention and Cessation Program
Enclosed for Board review and approval is a task order that, if approved, will become a part of
the master contract between the Colorado Department of Public Health and Environment
(CDPHE) and Weld County.
Again, 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). The task order will permit the continued efforts of 1.0 FTE Field
Coordinator, 1.0 FTE Youth Tobacco Health Education Specialist, .5 FTE office technician, and
increase from .5 to .75 FTE Cessation Health Education Specialist.
As part of the new work plan, WCDPHE staff will work towards reducing initiation of tobacco use
by youth, reducing exposure to environmental tobacco smoke and promoting quitting 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 $220,858 for the time period June 1,
2001 through June 30, 2002.
I recommend your approval of this task order.
2001-1339
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
01-00279
TASK ORDER
This TASK ORDER is made this 1ST day of MAY,2000,by and between:the State of Colorado,for the use and
benefit of 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.
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,and Object
Code 5781,under Contract Encumbrance Number PO FLA PPG0100279.and Master Contract contract routing
number 00 FAA 00008. All required approvals,clearances,and coordination have been accomplished from and
with all appropriate agencies.
NOW THEREFORE,in consideration of theft mutual promises to each other,stated below,the parties hereto agree
as follows:
A. PERFORMANCE PERIOD. In accordance with section 24-30-202(1),C.R.S.,as amended,the effective
date of this Contract is the date the State Controller approves this Contract. The initial term of this Task
Order shall commence on the effective date of this Task Order and continue through and including June 30,
2002,unless sooner terminated by the parties pursuant to the terms and conditions of the Master Contract
and this Task Order. The Contractor may commence performance under this Task Order as of its effective
date. The State shall have no financial obligation to the Contractor for any work or services or,any costs or
expenses,incurred by the Contractor prior to the effective date of this Task Order. The total term of this
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Task Order,including any renewals or extensions hereof,may not exceed five(5)years.
B. SCOPE OF WORK. The Contractor,in accordance with the terms and conditions of the Master Contract
and this Task Order,agrees as follows:
1. Build its capacity to implement a comprehensive tobacco control program in Weld County,
Colorado,designed to prevent and reduce tobacco use. The Contractor shall perform and
complete, in a timely and satisfactory manner,all work items described in the"Scope of Work",
which is incorporated herein by this reference,made a part hereof,and attached hereto as
"Attachment A".
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 for youth or adults; implement
cessation programs that are not based upon the guidelines of the Center for Disease Control and
Prevention;pay for individual cessation aids;nor fund capital improvements.
3. The Contractor shall submit a written program evaluation plan to the"State Tobacco Education
and Prevention Partnership"-(STEPP)office within thirty(30)calendar days after approval of this
Task Order by the State Controller. At a minimum,this plan shall describe how the Contractor
shall:measure the effects of its programs against the goals that plan is designed to accomplish;
and,determine how the results achieved by its program contribute to the overall achievement of
the program goals of reducing exposure to environmental tobacco smoke,promoting cesation
among youth and adults,and preventing initiation by youth. THE CONTRACTOR SHALL
PREPARE AND SUBMIT THREE(3)PLANS UNDER THIS TASK ORDER.
A. THE FIRST PLAN IS AN ANNUAL ACTION PLAN FOR STATE OF COLORADO
FISCAL YEAR 2001-2002,FOR THOSE SERVICES AND ACTIVITIES THAT
SHALL BE DELIVERED OR SHALL OCCUR DURING THE INITIAL TERM OF
THIS TASK ORDER(JUNE 1,2001,THROUGH JUNE 30,2002). THE FIRST PLAN
IS HEREINAFTER REFERRED TO AS THE"YEAR 1 PLAN" THE SECOND PLAN
IS AN ANNUAL ACTION PLAN FOR STATE OF COLORADO FISCAL YEAR 2002-
2003 FOR THOSE SERVICES AND ACTIVITIES THAT MAY BE DELIVERED OR
MAY OCCUR DURING THE PERIOD JUNE 1,2002,THROUGH JUNE 30,2003,IF
THIS TASK ORDER IS RENEWED. THE SECOND PLAN IS HEREINAFTER
REFERRED TO AS THE"PROPOSED YEAR 2 PLAN". THE THIRD PLAN IS AN
ANNUAL ACTION PLAN FOR STATE OF COLORADO FISCAL YEAR 2003-2004
FOR THOSE SERVICES AND ACTIVITIES THAT MAY BE DELIVERED OR MAY
OCCUR DURING THE PERIOD JUNE 1,2003,THROUGH JUNE 30,2004,IF THIS
TASK ORDER IS RENEWED. THE THIRD PLAN IS HEREINAFTER REFERRED
TO AS THE"PROPOSED YEAR 3 PLAN".
B. AS OF THE EFFECTIVE DATE OF THIS TASK ORDER,THE CONTRACTOR
SHALL COMMENCE PERFORMANCE OF THE YEAR 1 PLAN WHICH WAS
PREVIOUSLY SUBMITTED BY THE CONTRACTOR AND APPROVED BY THE
STATE. THE CONTRACTOR SHALL PERFORM AND COMPLETE,IN A TIMELY
AND SATISFACTORY MANNER,ALL WORK ITEMS DESCRIBED IN THE YEAR
1 PLAN AND THE SCOPE OF WORK.
C. ON OR BEFORE MARCH 1,2002,THE CONTRACTOR SHALL CONDUCT A
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PRELIMINARY EVALUATION OF THE EFFECTIVENESS OF ITS YEAR 1 PLAN
USING AN EVALUATION INSTRUMENT PROVIDED BY THE STATE.
D. ON OR BEFORE MARCH 15,2002,THE CONTRACTOR SHALL SUBMIT ITS
YEAR 2 PLAN TO THE STATE FOR REVIEW AND APPROVAL. THE YEAR 2
PLAN SHALL INCLUDE A REPORT OF THE PRELIMINARY EVALUATION OF
THE YEAR 1 PLAN. THE YEAR 2 PLAN SHALL BE BASED ON QUALITATIVE
AND QUANTITATIVE DATA. THE REQUIREMENTS AND FORMAT FOR THIS
PLAN SHALL BE PROVIDED TO THE CONTRACTOR BY THE STATE ON OR
BEFORE JANUARY 1,2002.
THE STATE SHALL REVIEW THE YEAR 2 PLAN WITHIN FIFTEEN(15)
CALENDAR DAYS AFTER THE DATE THE YEAR 2 PLAN IS SUBMITTED BY
THE CONTRACTOR. NO LATER THAN THIRTY(30)CALENDAR DAYS AFTER
THE YEAR 2 PLAN HAS BEEN SUBMITTED TO THE STATE BY THE
CONTRACTOR,PROGRAM STAFF FOR THE STATE AND THE CONTRACTOR
SHALL NEGOTIATE ANY ADDITIONS,DELETIONS,MODIFICATIONS,OR
CHANGES TO THE YEAR 2 PLAN. IF THIS TASK ORDER IS RENEWED,THEN
THE APPROVED YEAR 2 PLAN SHALL BE ATTACHED TO A TASK ORDER
RENEWAL LETTER WHICH HAS BEEN FULLY EXECUTED AND APPROVED
BEFORE THE EFFECTIVE DATE OF THE YEAR 2 PLAN.
E. WITHIN THIRTY(30)CALENDAR DAYS AFTER THE EXPIRATION OF THE
INITIAL TERM OF THIS TASK ORDER,THE CONTRACTOR SHALL SUBMIT A
WRITTEN REPORT TO THE STATE WHICH DESCRIBES ITS KEY
ACCOMPLISHMENTS IN IMPLEMENTING THE YEAR 1 PLAN. THIS WRITTEN
REPORT SHALL ALSO DESCRIBE ALL MEASURABLE OBJECTIVES AND THE
CONTRACTOR'S OVERALL ACHIEVEMENT OF THE GOALS OF ITS PLAN.
THE REQUIREMENTS AND FORMAT FOR THIS WRITTEN REPORT SHALL BE
PROVIDED TO THE CONTRACTOR BY THE STATE ON OR BEFORE MARCH 1,
2002.
F. IF THIS TASK ORDER IS RENEWED,THEN ON OR BEFORE MARCH 1,2003,
THE CONTRACTOR SHALL CONDUCT A PRELIMINARY EVALUATION OF THE
EFFECTIVENESS OF ITS YEAR 2 PLAN USING AN EVALUATION INSTRUMENT
PROVIDED BY THE STATE.
G. IF THIS TASK ORDER IS AGAIN RENEWED,THEN ON OR BEFORE MARCH 15,
2003,THE CONTRACTOR SHALL SUBMIT ITS YEAR 3 PLAN TO THE STATE
FOR REVIEW AND APPROVAL. THE YEAR 2 PLAN SHALL BE BASED ON
QUALITATIVE AND QUANTITATIVE DATA. THE REQUIREMENTS AND
FORMAT FOR THIS PLAN SHALL BE PROVIDED TO THE CONTRACTOR BY
THE STATE ON OR BEFORE JANUARY 1,2003.
THE STATE SHALL REVIEW THE YEAR 3 PLAN WITHIN FIFTEEN(15)
CALENDAR DAYS AFTER THE DATE THE YEAR 3 PLAN IS SUBMITTED BY
THE CONTRACTOR. NO LATER THAN THIRTY(30)CALENDAR DAYS AFTER
THE YEAR 3 PLAN HAS BEEN SUBMITTED TO THE STATE BY THE
CONTRACTOR,PROGRAM STAFF FOR THE STATE AND THE CONTRACTOR
SHALL NEGOTIATE ANY ADDITIONS,DELETIONS,MODIFICATIONS,OR
CHANGES TO THE YEAR 3 PLAN. IF THIS TASK ORDER IS AGAIN RENEWED,
THEN THE APPROVED YEAR 3 PLAN SHALL BE ATTACHED TO A TASK
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ORDER RENEWAL LETTER WHICH HAS BEEN FULLY EXECUTED AND
APPROVED BEFORE THE EFFECTIVE DATE OF THE YEAR 3 PLAN.
H. IF THIS TASK ORDER IS AGAIN RENEWED,THEN WITHIN THIRTY(30)
CALENDAR DAYS AFTER THE EXPIRATION OF THE FIRST RENEWAL TERM
OF THIS TASK ORDER,THE CONTRACTOR SHALL SUBMIT A WRITTEN
REPORT TO THE STATE WHICH DESCRIBES ITS KEY ACCOMPLISHMENTS IN
IMPLEMENTING THE YEAR 2 PLAN. THIS WRITTEN REPORT SHALL ALSO
DESCRIBE ALL MEASURABLE OBJECTIVES AND THE CONTRACTOR'S
OVERALL ACHIEVEMENT OF THE GOALS OF ITS PLAN. THE
REQUIREMENTS AND FORMAT FOR THIS WRITTEN REPORT SHALL BE
PROVIDED TO THE CONTRACTOR BY THE STATE ON OR BEFORE MARCH 1,
2003.
I. IF THIS TASK ORDER IS AGAIN RENEWED,THEN WITHIN THIRTY(30)
CALENDAR DAYS AFTER THE EXPIRATION OF THE SECOND RENEWAL
TERM OF THIS TASK ORDER,THE CONTRACTOR SHALL SUBMIT A WRITTEN
REPORT TO THE STATE WHICH DESCRIBES ITS KEY ACCOMPLISHMENTS IN
IMPLEMENTING THE YEAR 3 PLAN. THIS WRITTEN REPORT SHALL ALSO
DESCRIBE ALL MEASURABLE OBJECTIVES AND THE CONTRACTOR'S
OVERALL ACHIEVEMENT OF THE GOALS OF ITS PLAN. THE
REQUIREMENTS AND FORMAT FOR THIS WRITTEN REPORT SHALL BE
PROVIDED TO THE CONTRACTOR BY THE STATE ON OR BEFORE MARCH 1,
2004.
J. 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.
'1. Within fifteen(15)calendar days following the end of each month during which services were
rendered under this Task Order,the Contractor shall submit a monthly report to the State which
describes its key accomplishment as those accomplishments relate to the measurable objectives in
the Contractor's Scope of Work.
5. Within thirty(30)calendar day of the expiration of any term under this Task Order,the Contractor
shall submit an annual report to the State which describes: its key accomplishments as those
accomplishments related to the measurable objectives in the Contractor's Scope of Work; and,the
overall achievement of its program goals.
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,WHICH IS CREATED
UNDER THIS TASK ORDER.
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5. THE CONTRACTOR SHALL INSURE THAT THE FOLLOWING PUBLIC
ACKNOWLEDGMENT APPEARS ON ALL PRINTED MATERIALS,AND AT ALL
PROMOTIONAL OR EDUCATIONAL EVENTS PROVIDED UNDER THIS TASK ORDER:
"THIS(MATERIAL,PROJECT,EVENT)IS FUNDED BY THE COLORADO DEPARTMENT
OF PUBLIC HEALTH AND ENVIRONMENT THROUGH FUNDS FROM THE STATE OF
COLORADO'S TOBACCO SETTLEMENT."
6. The Contractor shall participate in State sponsored monthly conference calls,and meeting and
training sessions offered CONDUCTED BY THE STATE TO INFORM AND TRAIN
CONTRACTORS RECEIVING TOBACCO SETTLEMENT FUNDS.
7. THE CONTRACTOR SHALL PARTICIPATE IN STATE-LEVEL EVALUATION EFFORTS
AS REQUESTED BY THE STATE,TO INCLUDE BUT NOT LIMITED TO MONTHLY
REPORTS,TO BE DUE FIFTEEN(15)DAYS AFTER THE END OF EACH MONTH.
7. The Contractor shall notify the State in writing within fifteen(15)calendar days of the any change
in personnel in the Contractor's Coordinator position. The Contractor shall provide the State's
Program Manager with a copy of the proposed candidate's resume prior to filling a vacancy in the
Contractor's Field Coordinator position.
8. The Contractor shall participate in State level evaluation efforts as requested by the State.
9. The Contractor transfers any right it may have in all printed materials,graphic representations,
education materials,audiovisual products, or any other media created under this Task Order to the
State
-148. The Contractor IS NOT required to provide matching funds in order to be eligible to receive
funding under this contract.
C. DUTIES AND OBLICATIONS OF THE STATE.
1. In consideration for those services timely and satisfactorily performed by the Contractor under this
Task Order,the State shall cause to be paid to the Contractor an amount not to exceed TWO
HUNDRED TWENTY THOUSAND EIGHT HUNDRED FIFTY-EIGHT DOLLARS,
f$220,858.00). Of this total financial obligation of the State,$0.00 are identified as attributable to
a funding source of the United States government and$220,858.00 are identified as attributable to
a funding source of the state of Colorado. This Task Order involves the expenditure of federal or
state funds. This Task Order is subject to, and contingent upon,the continuing availability of those
funds for the purposes hereof.
2. 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
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Contractor may transfer funds between specific line items within the Program Operating category
without prior approval. Up to ten percent(10%)of the total funds originally set forth in each
budget category(Personnel,Fringe,Travel, Staff Development and Training,Consultants/
Trainers,Program Operating, and Data Collection) may be transferred to other categories without
prior approval by the State. Proposed transfers which exceed ten(10%)of the funds 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 WHICH SHOWS: showing the original amount(s),the
modification(s)made,and the new amount(s) within thirty(30)calendar days of
the modification(s).
3. The Contractor shall submit a"Task Order Reimbursement Statement"to the State to request
reimbursement under this Task Order. A sample task order reimbursement statement is
incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment B'.
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 contract TASK ORDER reimbursement statement. The Contractor shall maintain 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 MONTHLY REPORTS THEN DUE FROM THE CONTRACTOR
THE STATE'S REPRESENTATIVE UNDER THIS TASK ORDER FOR MATTERS
PERTAINING TO THE SCOPE OF WORK,BUDGET,TOTAL AMOUNT OF FUNDING
AVAILABLE,AND CONTRACTOR STAFF OR BUDGET CHANGES IS:
KAREN DELEEUW,PROGRAM MANAGER
STEPP, MAIL CODE HPDP-A5
4300 CHERRY CREEK DRIVE SOUTH
DENVER,CO 82046
TELEPHONE:303-692-2515
FACSIMILE: 303-758-3448
4. The State may prospectively increase or decrease the amount payable under this Task Order
through a"Task Order Change Order Letter". A sample letter is incorporated herein by this
reference,made a part hereof,and attached hereto as"Attachment C". To be effective,the 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,the 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 the affected paragraph number(s)of this Task Order;
B. The type(s)of service(s)increased or decreased and the new level of each service;
C. The amount of the increase or decrease in the level of funding for each service and the
new total financial obligation;
D. The intended effective date of the funding change;
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E. A provision stating that the Task Order Change Order Letter shall not be valid until
approved the State Controller or such assistant as he may designate.
Upon proper execution and approval,the Task Order Change Order Letter shall become an
amendment to this Task Order. Except for the General and Special Provisions of this Master
Contract,and the Additional Provisions, if any,of this Task Order,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 renewal 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 the proposed change,then the Contractor shall execute and
return the Task Order Change Order Letter to the State by the date indicated in the Task Order
Change Order Letter. If the Contractor does not agree to and accept the proposed change,or fails
to timely return the partially executed Task Order Change Order Letter by the date indicated in the
Change Order Letter,then the State may,upon written notice to the Contractor,terminate this Task
Order twenty(20)calendar days after the return date indicated in the Change Order Letter has
passed. This written notice shall specify the effective date of termination of this Task Order. In
the event of termination under this clause,the parties shall not be relieved of their respective duties
and obligations under this Task Order until the effective date of termination has occurred.
Increases or decreases in the level of funding made through this task order change order letter
process during the initial or renewal terms of this Task Order may be made under the following
circumstances:
F. If necessary to fully utilize appropriations of the state of Colorado and/or non-
appropriated federal grant awards;
G. Adjustments to reflect current year expenditures;
H. 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
this Task Order;
I. Closure of programs and/or termination of related contracts;
J. Delay or difficulty in implementing new programs or services;and,
K. Other special circumstances as deemed appropriate by the State
5. The State may renew this Task Order through a"Task Order Renewal Letter". A sample letter
is incorporated herein by this reference,made a part hereof, and attached hereto as"Attachment
D". To be effective,the Task Order Renewal Letter must be: signed by the State and the
Contractor;and, approved by the State Controller or an authorized designee thereof. Additionally,
the Task Order Renewal Letter shall include the following information:
A. Identification of this related Master Contract and this Task Order by their respective
contract routing numbers and the affected paragraph number(s)of the Task Order;
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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. The intended effective date of the renewal;and,
E. A provision stating that the Task Order Renewal Letter shall not be valid until approved
by the State Controller or such assistant as he may designate.
Upon proper execution and approval,the Task Order Renewal 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 this Task Order,the Task Order Renewal 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 renewal letter process may be used only to: renew this 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 this Task Order,other than those authorized by the change order letter process
described above,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 the proposed renewal term,then the Contractor shall
execute and return the Task Order Renewal Letter to the State by the date indicated in the Task
Order Renewal Letter. If the Contractor does not agree to and accept the proposed renewal term,
or fails to timely return the partially executed Task Order Renewal Letter by the date indicated in
the Task Order Renewal Letter,then the State may,upon written notice to the Contractor,
terminate this Task Order twenty(20)calendar days after the return date indicated in the Task
Order Letter has passed. This written notice shall specify the effective date of termination of this
Task Order. In the event of termination under this clause,the parties shall not be relieved of their
respective duties and obligations under this Task Order until the effective date of termination has
occurred.
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 8 of 9
:
IN WITNESS WHEREOF,the parties hereto have executed this Task Order on 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)
acting by and through the/for the use and benefit of the
Weld County Department of Public Health and Environment
By: i i/,U By:
Name: M. J. Celle For the Executi Director
Title: Chair (05/21/2001) DEPARTMENT OF PUBLIC
FEIN: 846000813 HEALTH AND ENVIRONMENT
ATTEST (Seal) `E�J ' 'OGRAM APPROVAL:
Nercl
Deputy Clerk
®U NI PROVALS:
COLORADO DEPARTMENT OF LAW COLORADO DEPARTMENT OF PERSONNEL
OFFICE OF THE ATTORNEY GENERAL OFFICE OF THE STATE CONTROLLER
Ken Salazar,Attorney General Arthur L.Barnhart,State Controller
By: By:
Date: .,;en/
WELD COUNTY DEPARTMENT OF
PUBLIC ANp ENVIRONMENT
By:_ MC HEALTH OWO-QUA
Mark E. Wallace, MD, MPH•Directo
Page 9 of 9
Attachment A
Executive Summary
Our strategy is to develop the role of Weld County Department of Public Health and
Environment as the lead agency for county tobacco control projects. With the focus shifting
more toward measuring outcomes instead of measuring individual activities, being well
connected at both the local level and state level is important for the lead agency. The health
department has been established and working in the community since 1938. It has been
coordinating tobacco programs with the state since the beginning of the ASSIST project in 1991.
With the strong community connections built over years of service, the health department can
coordinate existing community efforts, addressing tobacco issues, to build a solid foundation.
The health department has also collaborated regionally with Larimer and Boulder counties to
maximize resources and impact.
To ensure thoroughness of the tobacco control effort the health department would begin
by concentrating on the greater Greeley area(Greeley, Evans, Garden City, La Salle, Windsor
and Eaton). This is where 50% of the population of Weld County resides and/or works. This is
also the where the majority of major services for all county residents are provided. Once a solid
tobacco control foundation has been established in the greater Greeley area, expansion efforts
can begin in Weld County's outlying areas. By starting with a limited but highly populated area
of the county, the health department can identify specific gaps and barriers, evaluate existing
efforts, and reach a majority of Weld County residents.
The Weld County Department of Public Health and Environment has established strong
support for activities to prevent youth initiation of tobacco use. The initial ASSIST program
obtained passage of three ordinances regarding youth access and possession in Weld County.
They supported the Tobacco-Free Schools Law by providing signage and recognition of schools
in compliance. The project developed a youth coalition that provided educational presentations
to area schools and participated in SYNAR checks. These checks measured retailer=s
compliance with and understanding of the state access law. With this information, Tobacco Free
Weld County coalition was able to provide effective support and training for retailers. During
implementation of these activities, Tobacco Free Weld County developed many local partners
listed in part 2, section C of this document. In the future we will work more closely with many
of these agencies to develop several youth groups focusing on advocacy rather than peer
education activities. We will continue retailer training and education, compliance checks,
assessment of the Tobacco Free Schools Law, and provide health educators with presentation
tools and videos.
The Weld County Department of Public Health and Environment has developed a
coalition that has been politically active in decreasing the publics exposure to environmental
tobacco smoke. The Tobacco Free Weld County coalition was developed in 1991 and consisted
of many citizens motivated to make legal changes in the community. These changes consisted of
passing an ordinance to ban smoking in the Island Grove Arena and supporting a resolution that
banned smoking within 50 feet of all county buildings and vehicles. Information regarding the
harmful effects of second-hand smoke was distributed through various media channels.
Newspaper articles were published to recognize tobacco prevention efforts in the community.
To accomplish the objectives regarding second hand smoke, the coalition worked with many
county partners. They are listed in part 2, section C of this document. In the future Tobacco
Free Weld County would like to build stronger public support for cleaner in-door air. Our
strategy involves contacting individual business and meeting facilities in the greater Greeley area
2
to provide education that will lead to stronger indoor air policies. We are also focusing on
establishing enforcement and building support of policies already established. A multi-media
approach financed by Master Settlement Agreement funding will result in reaching a larger
target audience.
The Weld County Department of Public Health and Environment has identified some
gaps and barriers to cessation services in the community. There are services available through
North Colorado Medical Center, University of Northern Colorado, and the American Cancer
Society. These are well-run programs but they serve limited populations or are inconsistent. To
overcome this, the coalition has trained hundreds of medical care providers to implement short
cessation interventions with each visit. Past attempts to provide youth cessation services in 3
districts produced inconsistent results. Future plans for cessation begin with strengthening the
established programs. A coalition sub-group of providers and related health care professionals
started meeting in December of 2000. The first meeting resulted in development of a brochure
outlining local cessation services. The state cessation quit line will provide another valuable
resource for Weld County citizens and advertisement for local services. Tobacco Free Weld
County will also measure the effectiveness of the brief intervention training and institutionalize
the methods used by establishing office protocols. Youth cessation programs will be accredited,
eliminating the barrier of limited time in the school day and providing incentives for
participation in the program to both students and teachers. Our partners are listed in part 2,
section C of this document.
The Weld County Department of Public Health and Environment offers services to all
members of the community, including the hard to reach populations: unemployed, uninsured,
low income, agricultural and Latino population. Twenty-two coalition members, community
members and Health department staff attended the Latino culture diversity training held in
February. The importance of addressing the cultural barrier between Latinos and Anglos when
implementing a community-wide effort has become apparent to all services. The population we
need to include in the future is the agricultural community. Due to their location and attitudes,
especially surrounding spit tobacco, this population has not been addressed thoroughly enough.
3
2.A Program Staffing Report Form
A. Please list the current personnel dedicated to the tobacco control program (CDC & Tobacco
Settlement). Indicate "vacant"if the position is funded but not filled. Please provide an organizational
chart showing the location and staffing pattern of the tobacco control program.
Position Title Staff Name&Degree FTE Primary Responsibilities
1. Program Coord Ren Bedell, MPH 1.0 Program manager,budget
2. Youth Coord Mary Mallon, BS 1.0 Initiation, cessation
3. Cessation Coord To be filled .75 Adult cessation & ETS
4. Office Tech Griselda Still .5 Technical support
B. Please describe the status of any vacant positions including the duration of vacancy,
recruitment efforts, and planned start date.
No vacant positions at this time
C. Specify any major program responsibilities that are currently being completed by contractors.
Evaluation and media development
Responsibilities Contractor's Name&Degree Amount of Time on Project
1.Evaluation Cindy Kronague, MPH 115 hours
2. Media Kristin Williams, MPH 20 hours
D. Describe proposed changes in program staffing that are planned for FY 2001-02. For
new/additional positions,provide the same information as described in Question 1.
Position Title Staff Name & Degree FTE Primary Responsibilities
1. Cessation Coord To be filled .5 to .75 Adult/youth cessation
2.B Coalition Status Report Form
1. What is the name of your local tobacco control coalition?
Tobacco Free Weld County
2. How frequently does the coalition meet? Each month
How many times during the last eight months has the coalition met? 8
3. How many individual members belong to the coalition? 33
Of these, how many members consistently attend monthly coalition meetings? 5
4
4. How many organizations are active members of your coalition? Indicate the types of
organizations represented.
Business and/or Merchants Parent Teachers Association
Colleges and/or Universities Public Health Officials
Community -Based Organizations Public and/or Private Education (K-12)
Drug and Alcohol Agencies Religious/Faith Organizations
Health Care Organizations Dental Societies
Local Government Officials Law Enforcement and/or Agencies
Medical Societies Mass Media Agencies
Tobacco Control Programs in Military Groups
Other Counties Voluntary Health Organizations
Youth Serving Organizations Other
5. For each organization checked above, specify name of organization & representative
and any racial/ethnic group or other special population represented:
Business
Local lawyer-Ron Kingsford
Private Practice radiologist—Dr. Doug Armbrust
Engineer—John Leone
Local Business man—Frank Fronek
Massage Therapist—Alexander Johnson
Colleges/Universities
University of Northern Colorado —Bob Guthman/Public Health instructor, Kathy Zavela/Public
Health instructor, Laurie Struthers/Tobacco cessation counselor, Ann Quinn-Zobeck/Assistant
Director of Student Activities
Aims Community College -Ron Fay/Director of Student Life
Community Based Organizations
Community Outreach after school program -Ruben Flores (Latino)
Drug and Alcohol Agencies
Rocky Mountain Center for Health Promotion and Education—Ginger Maki
Island Grove Treatment Center- Scott Wykes
Health Care Organizations
North Colorado Medical Center—Barb Eckler/Tobacco cessation counselor, Bonnie
Piel/Pulmonary Rehab
Greeley Medical Clinic—Dr. Tom Deen
First Steps—Nancy Culbreath
Weld County Department of Public Health and Environment—Ren Bedell/Tobacco Free Weld
County (TFWC) Coordinator, Mary Mallon/TFWC Youth Coordinator, To be filled/TFWC
cessation coordinator, Olivia Martinez/Latino Health promotion coordinator
Local Government Officials
City Council member- Carol Anderson
Ault City Council member—Joe Sellers
Youth Serving Organizations
Youth Initiative—James Berg
Public Education
5
District 6 -Dave Steward, Carol Martens/CK DS coordinator
Weld Opportunity High School - John Carbajal/instructor(Latino)
Eaton District—Sheri Hannah-Ruh/CK1DS coordinator
Dental Societies
Dentist -Mark Smith
Dental Office staff-Laurie Chesler
Law Enforcement
Greeley PD - Doug Birdsall
Voluntary Health Organizations
American Lung Association- Bob Doyle
American Cancer Society -Montel Nicholson
6. Does the coalition have any active sub-committees or work groups? If so,please
describe.
Tobacco Free Weld County has developed a sub-group of cessation providers to help
guide us in planning solutions to gaps and barriers. This coming grant period we
hope to extend participation of this sub-group in activities that help us reach our
objectives.
7. Describe any training provided to coalition members during the last eight months.
Comprehensive program - to help staff, community and coalition members
understand the scope and goals of the STEPP program
Diversity -to increase awareness of coalition and community members regarding the
differences in cultures between Latinos and Anglos
Strategic planning—to increase staff knowledge in evaluation and use that
knowledge to revise 5-year plan
Leadership—to help community and coalition members identify ways to build
partnerships
Brief intervention—to increase the ability of prenatal health care providers to
counsel their clients
Peer Education—to increase youths understand of the negative health effects of
tobacco and increase their presentation skills
Coaches association—to increase coaches knowledge of the harmful effects of spit
tobacco use and policies about the Tobacco Free Schools Law
School Assessment—to increase community volunteers and coalition member's
ability to complete assessments of school compliance with the Tobacco Free Schools
Law
8. Describe any proposed changes in your coalition for FY2001-02. Include
membership recruitment, subcommittees, and training plans
The coalition will be restructured into 4 work groups addressing cessation,
environmental tobacco smoke, youth and media. All coalition members will sign up
for a year term. 2 people out of each work group with sit on a community
programming board that will organize and monitor work group activities. This will
begin at the March 2001 meeting where we will get input from current coalition
members and community members that have expressed an interest in the coalition.
6
By including their input into the new plan we will increase chances of buy in from
participants. At this meeting the initial sign-up will occur.
A brochure has been developed that includes a sign up sheet and list the various roles
of coalition members and time commitments. These are handed chit at all
presentations and trainings. In the FY2001-2002 these brochures will be
professionally produced to give the coalition more credibility.
A training manual including membership information will be distributed to all
coalition members. An orientation will be provided at the beginning of each year. As
outlined in the brochure, coalition members that sign up as community partners will
provide trainings. When there is a need for additional training it will be provided.
2. C Collaborations/Partnerships
1. Indicate the types of organizations represented on your coalitions or partnerships.
Business and/or Merchants Parent Teachers Association
Colleges and/or Universities Public Health Officials
Community -Based Organizations Public and/or Private Education (K-12)
Drug and Alcohol Agencies Religious/Faith Organizations
Health Care Organizations Dental Societies
Local Government Officials Law Enforcement and/or Agencies
Medical Societies Mass Media Agencies
Tobacco Control Programs in Military Groups
Other Counties Voluntary Health Organizations
Youth Serving Organizations Other
Describe the collaboration for each of the organizations checked.
Business and/or Merchants
Collaborate through: Compliance with sales restrictions,offer incentives to tobacco free youth, support
community activities advertised by the Greeley Chamber of Commerce.
Colleges/Universities
Provides volunteers,Summer College program for youth, student health services
Community Based Organizations
Weld Citizen Action Network(WeCAN)-strengthens community involvement of community leaders,
Weld County Social Services—promotes cessation programming,Island Grove Advisory Council—Supported
change in city ordinance restricting smoking in Island Grove Arena, City of Greeley Recreation Department
—supported change in city ordinance,Weld County Department of Environmental Health—provides
information on indoor air quality and completes school checks for compliance with the Tobacco Free
Schools Law
Drug and Alcohol Agencies
Island Grove Treatment Center—Provides educational events to distribute information to
low-income populations
7
Health Care Organizations
First Steps of Weld County—collaborates on prenatal cessation services,Colorado Helath Education
Center(CAHEC)—cessation services,North Colorado Family Medicine—prenatal cessation,NCMC-cessation
services,private physicians—cessation services
Local Government Officials
Greeley City Council- ordinance work—WeCAN community organization and ordinance work; and County
Commissioners keep up-to-date on activities and ordinances
Tobacco Control Programs in other Counties
Larimer County STEPP program-media collaboration&sharing of program information,Colorado
State University tobacco control program—training opportunities and sharing of information,
and Boulder County STEPP program—sharing of program information
Youth Serving Organizations
Alternative homes for youth—Educating high risk youth about tobacco use; City of Greeley
Youth Initiative—main connection with all other youth serve organizations;Boys&Girls Club
—interested in supporting advocacy program,Weld County 4-H—peer education program;
Weld County DARE.—youth outreach,Girl Scouts Mountain Prairie Council—Peer education group members,
Camp Fire Boys&Girls—Peer Education group members,City of Greeley Youth Commission—Keeping
up-to-date on activities and are interested in supporting youth advocacy groups,Weld County
Partners—support cessation programs and policy,Dream Team—Help us reach high risk population of
kids,Gear Up—Helps us reach Latino population of kids.
Public Health Officials
Director of the WCDPHE—connects coalition with physicians and medical providers
in community; and Board of Health members—Support community activities in areas they represent.
Public/Private Education K-12
District 6,Windsor,and Eaton school health educators—help educate youth on the hazards
of tobacco use and District 6 School Board President—helps provide support for offering
cessation programming in schools; CKIDS projects in Eaten and school district 6.
Law Enforcement/Agencies
Community Resource Officers—Help with community outreach, SYNAR officers completed compliance checks
Mass Media Agencies
Greeley Tribune,Windsor Beacon,Local radio station KFKA,KUNC,KGRE and AT&T local cable channel 8—
advertise events and issues
Voluntary Health Organizations
American Cancer Society and American Lung Association—collaboration on several
goals and objectives
Describe any collaborative efforts engaged in over the last eight months.
Highlighted under headings in bold above.
Please specify any proposed partnerships for FY 2001-02.
Greeley City Mayor—to help recognize schools,restaurants, and retailers that provide a tobacco
free environment
8
Childcare providers—to educate parents on the harmful effects of ETS on children
2.D Key Accomplishments
Capacity Building
O Increased staff from .5 FTE to 3 FTE
O Increased infrastructure to support additional FTE
O Contracted with an evaluations specialist to support the program
O Continue to meet with key stakeholders, local business leaders and representatives of
national organizations to: identify ways to collaborate with local programs, educate about
Tobacco Free Weld County, recruit volunteers/coalition members
O Trained staff, coalition, stakeholders, Health Department staff and community members
on comprehensive programming for tobacco control
O Revised the 5 year plan
O Provided Collaborative leadership training for staff, coalition members and stakeholders
O Created a written evaluation plan for the Tobacco Free Weld County Program
O Restructured coalition and created materials to train and update new members
O Made initial contacts with local cable station and maintained contacts with local
newspaper and radio
O Identified disparities in our community and addressed them under each goal
Barriers
✓ Limited funding - due to the geographical size and population size of our county Weld
falls between qualifiers (its not small enough or large enough)
✓ Finding dedicated volunteers to support program activities
✓ Lack of collaboration with local law enforcement (unsupportive)
Preventing Youth Initiation
O Built community support for preventing youth initiation by recruiting key community
youth leaders and participating in Youthnet a community support group made up of youth
service providers
O Established a peer education group
O Recruited a local youth peer education group to apply for advocacy group status
O Projected to complete 4 community activities and 10 school site activities
O Provided a presentation to coaches and athletic directors addressing the Tobacco Free
Schools Law and the importance of enforcement
O Completing an assessment of compliance with the Tobacco Free Schools Law in all Weld
County High schools and Middle schools is also projected—this may be limited to the
greater Greeley area due to time and money limitations
Barriers
✓ Not being accessible to youth during normal work day
9
Promoting Quitting Among Youth and Adults
O Trained prenatal nurses in brief intervention methods
O Identified 7 local businesses who are interested in on-site cessation services
O Provide services to 2 businesses who have someone on-site to facilitate classes
O Provide 1 school with youth cessation services
Barriers
✓ Physician's schedules are busy
✓ Finding facilitators for cessation classes
✓ School system administrators and teachers are so busy they often don't have time
for new training or collaboration
✓ Lack of substitutes to cover classes
✓ Administrators unsupportive of providing a place and facilitator for youth cessation
class
Reducing Exposure to ETS
O Surveyed 3 townships to determine beliefs surrounding clean in-door air and to establish
a baseline for the 2001-2002 grant
O Increase the number of smoke-free restaurants to 25% in the greater Greeley area
Barriers
✓ Community attitude toward infringing on smokers rights
to
Scope of Work Narrative
The following strategies will be used to prevent youth initiation of tobacco use in Weld
County: promote tobacco-free schools, promote youth advocacy and empowerment, decrease
youth access to tobacco products and decrease pro-tobacco influences.
In the CDC Guidelines for School Health Programs to Prevent Tobacco Use and
Addiction, seven recommendations are listed for well-developed school tobacco prevention
programs. Currently, tobacco education in Weld County School District Six is covered to a
limited degree in grades K-12. This leaves many areas open for communicating tobacco
prevention messages. Tobacco-Free Weld County will work to increase the comprehensive
strategies being used among the health and physical education teachers to address tobacco
prevention. In addition, the number of District Six middle/high schools who are using the seven
CDC recommendations for ensuring a quality school program to prevent tobacco use will
increase.
During the past year a youth peer education group Colorado Against Tobacco (CAT)was
sponsored by the Weld County Department of Public Health and Environment (WCDPHE). This
group was established to provide peer-to-peer tobacco prevention education in local schools and
community settings. With the challenges of trying to bring local youth into the health
department setting, coordinate student and teacher activity schedules, the WCDPHE will no
longer sponsor CAT. Community based efforts have been recommended as an effective tool by
the CDC for reducing tobacco use. Next year, WCDPHE will be recruiting and encouraging
current community youth groups to apply for advocacy group funding. Through this effort the
tobacco advocacy groups created will better represent Weld County's diverse youth population
and allow for expansion of youth advocacy throughout Weld County, which contains many small
communities. All of the advocacy groups will be trained on developing their skills in youth
advocacy allowing them to play a big role in each strategic area by participating in and
conducting activities.
In Weld County surveys have shown youth under 18 are able to purchase tobacco
products without a problem. In Colorado, youth are being targeted by the tobacco industry and
most are having their first cigarette before the age of 10. In Weld County most tobacco products
are found at gas stations and convenience stores, which also tend to have the highest number of
youth oriented tobacco-marketing materials. These tobacco retailers will be targeted, educated
and encouraged to participate in changing how their tobacco marketing materials are directed
towards youth. In addition, similar efforts targeting these retailers will reduce the number that
continue to sell tobacco products to youth. It has been approximately three years since any effort
has focused on retailer support and compliance in the Greeley area.
This year Festiva Days will be a new Hispanic/Latino community family event. Emphasis
will be placed on developing support among the organizers for a no tobacco advertising policy.
There has been tobacco advertising at past Hispanic/Latino events in Weld County. Additional
efforts will focus on the development of tobacco-free kid zones around Greeley city youth skate
parks and playgrounds where kids shouldn't have to deal with the pro-tobacco influences of
youth or adult tobacco users.
The following strategies will be used to promote quitting among youth and adults in
Weld County: promote availability of effective cessation services and resources, promote public
awareness for non-use and decrease social acceptability of tobacco use, promoting youth
cessation programs.
Tobacco use is one of the most significant risk factors for both oral cancers and
periodontal diseases. Results of the Behavior Risk Factor Surveillance System (BRFSS)
conducted between 1995-1997 indicate that edentulism (loss of all natural permanent teeth) is
twice as common in individuals between the ages of 65 —74 years old who are current every day
smokers when compared to non-smokers.2 Healthy People 2010 objective 21-4 is to reduce the
11
proportion of older adults who have had all their natural teeth extracted. Additionally, Objective
3-10 is to increase the proportion of physicians and dentists who counsel their at-risk patients
about tobacco cessation, physical activity, and cancer screening. In keeping with these
objectives, the Tobacco Free Weld County Coalition will collaborate with the Centennial Area
Health Education Center (CAHEC) and Weld County dental health professionals to design an
educational program to increase the knowledge and skills of local dental health providers to
provide brief tobacco cessation counseling to patients and to implement effective cessation
protocol in two dental clinics. TFWC and CAHEC will collaborate on needs assessment,
program development, marketing, implementation, evaluation and coordination in regards to this
objective. TFWC and dental clinics will collaborate to increase referrals to cessation resources
by 50%.
Prenatal plus providers in Weld County attended a 5A's training to enable them to do
brief intervention counseling with pregnant women who smoke. In April, TFWC and First Steps
will conduct a focus group with pregnant women who smoke or have quit during pregnancy.
Based on the results of this focus group, an incentive program will be developed. The incentive
program will increase knowledge of susceptibility/ severity of prenatal and post-partum smoking
(Health Belief Model), decrease barriers to quitting, and increase awareness of the benefits of
quitting. The combination of bolstered social support and direct financial incentives has been
shown to increase quit attempts among pregnant women. 3
To promote public awareness for non-use and to decrease social acceptability of tobacco
use, TFWC will focus its efforts on a summer media campaign. This media campaign will
include a float in the Stampede Parade, and booths at the Greeley Arts Picnic and Festiva Days.
A survey of registered voters in the greater Greeley area will be conducted to measure changes in
awareness regarding the hazards of tobacco use and the percentage of Weld County residents that
do not smoke.
TFWC will also promote public awareness for non-use and decreased social acceptability
of tobacco use through working with 3 local businesses that employ blue-collar workers. In
house media campaigns including posters, electronic and paper newsletter entries, and paycheck
inserts regarding the hazards of tobacco use will be used.
Research now shows that while it takes adults two years to become fully addicted to
tobacco, youth experience the same adult levels of addiction in only four weeks.4 Several
barriers have arisen in an attempt to provide youth under the age of 18 with cessation services.
Three of the most common are difficulty hiring substitute teachers to cover training dates, school
administration resistant to provide new programming, and lack of incentives for students and
facilitators. One activity outlines ways to educate the school board members, accredit the N.O.T
program, and eliminate school administration resistance while providing incentives for teachers
and students. After the programs are established with sites and facilitators, a marketing
campaign will promote the cessation class to students.
The following strategies will be used to reduce exposure to environmental tobacco
smoke: promote awareness on the hazards of ETS exposure and benefits of smoke-free
environments,promote smoke-free public places, promote smoke-free workplaces, and promote
smoke-free homes and autos.
The city of Greeley needs a stronger clean indoor air ordinance and surrounding towns
need to create regulations on indoor air. The current ordinance has not been updated since its
conception in 1985. The past coalition created changes to the ordinance (attachment 2),
introduced these changes to the city council, but unfortunately they were not adopted. In the
coming year TFWC would like to create more support for a stronger ordinance. In February
2000, 117-jury pool members and 32-key informants were surveyed to obtain an assessment of
Weld County regarding tobacco use. The top 3 noticeable changes identified in Weld County
where smoke-free buildings, facilities and restaurants; and 78% agreed these changes regarding
tobacco have been positive. During the past year TFWC staff have encountered many business
12
owners and public service employees that are supportive of smoke-free environments. In the
next year, the staff will start building more support for a stronger clean indoor air ordinance by
providing training for youth advocacy groups. The advocacy groups will then provide
presentations on the importance of eliminating ETS for the health of Weld County residents to
City Council, PTA and other local influential groups. The staff and ETS workgroups will
interview City Council members to assess their support of such an issue. A media campaign
regarding the harmful effects of ETS will run simultaneously with tobacco related contests
offered at popular summer events. Influential community members and professionals from fields
that treat tobacco-related illnesses will write newspaper articles.
Local community members will be recruited to promote smoke-free public places and
workplaces. Two community work-groups with a personal interest in protecting others from
environmental tobacco smoke will be created. One of these ETS workgroups will focus their
efforts on Greeley and the other will target Windsor, Eaton, Evans and LaSalle (WEEL) areas.
While the two groups will collaborate together, each will complete activities relevant to their
population. An indoor air quality hotline will be established in Greeley to provide the citizens a
place to report poor indoor air quality. The Greeley workgroup members and TFWC staff will
respond to these reports and help create policies and enforcement procedures to increase Greeley
public areas air quality. The ETS work-groups would also like to build public support by
recognizing schools and restaurants that acknowledge the importance of providing clean indoor
air. Educational information will be distributed to restaurants directly due to the lack of support
from the restaurant association. Some individual Greeley restaurant owners desire a stronger
clean indoor air ordinance but refuse to implement it on their own. By conducting personal
interviews to identify advocates from the restaurant industry, Tobacco-Free Weld County can
create a unified voice for this important population without the associations' involvement. The
final push will be for the passage of a stronger clean indoor air ordinance in Greeley and
regulations on indoor air in surrounding townships.
TFWC will reduce exposure of ETS in the home by educating working parents through
childcare centers and an industry with employees that have 1 or more indicators for probability
of high tobacco use (low education levels, low income). To further protect our children,
compliance with the Tobacco Free Schools law will be assessed annually. ETS exposure among
children increases the risk of lower respiratory tract infections, fluid build up in the middle ear,
frequency and severity of symptoms in asthmatic children, and instances of sudden infant death
syndrome.5 In Colorado there is double the risk of Sudden Infant Death Syndrome in households
with a smoking parent.6 In Colorado ETS also causes 2 million cases of chronic middle ear
infection, 436,000 cases of bronchitis and 190,000 episodes of pneumonia in children under the
age of 5.6 TFWC plans to reach parents through educational presentations, posters, brochures,
and community interventions designed to support their efforts to not smoke around their children
while providing information on where to find cessation services.
1.Centers for Disease Control and Prevention.National Center for Chronic Disease Prevention and Health Promotion,Guidelines for School
Health Programs to Prevent Tobacco Use and Addiction. 1994
2.Champeau,D.Donatelle,R.,Hudson,D.,&Prows,S.(2000). Randomised controlled trial using social support and financial incentives for
high risk pregnant smokers:Significant other supporter(SOS)program. Tobacco control(9)3.67-69.
3. MMWR Weekly.CDC. Total Tooth Loss Among Persons Aged Greater Than or Equal to 65 Years—Selected states,1995-1997,48(10),206-
210.
4.ABC News.com,Young Teens Hooked Quickly,2/16/00
5.EPA(January 1993). Fact Sheet.Respiratory Health Effects of Passive Smoking. http://www.epa.gov/iaq/pubs/etsfs.html
6.A report from the Colorado Department of Public Health and Environment,Behind the Smokescreen. 2000
13
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth.
Strategy# 1
Promote tobacco free schools
Outcome Objectives:
By June 30, 2002, 70% of District Six middle/high school health and physical education students will report a decreased
intention to use tobacco products.
Activities Lead Role Outputs Outcomes
• Conduct an assessment to Youth Coordinator • List of teachers and contact • Increased number of
determine who the health numbers. comprehensive tobacco
and P.E. teachers are in prevention strategies being
District Six middle/high taught in District Six
schools. middle/high schools.
• Review the current Youth Coordinator • Copy of current curriculum. • Increased knowledge of
curriculum that is being • List of strategies not being comprehensive tobacco
used by the teachers. covered. prevention strategies by
Determine which tobacco middle/high school health
prevention strategies are not and P.E. teachers.
being covered. • Decreased intention to use
• Develop/locate a self-report Youth Coordinator/Evaluator • Copy of self-report teacher tobacco products among
teacher feedback form or feedback form. middle school/high school
questionnaire to measure health and physical
which tobacco prevention education students.
strategies teachers use.
• Develop/locate a self-report Youth Coordinator/Evaluator • Copy of completed self-
questionnaire on intention report questionnaires.
to use tobacco products.
(Administer to randomly to
health and P.E. class
students at the start and end
of the school year)
• Develop an educational Youth Coordinator • Copy of educational packet.
packet/binder that includes • # of educational
information about the packet/binders created.
impact tobacco has on our
youth. Included will be a
list of comprehensive
15
strategies and ideas for
implementing tobacco
prevention messages into
their current classroom
curriculum.
• Obtain a current WCDPHE Youth Coordinator • Copy of current WCDPHE
tobacco resource library resource library directory.
directory for each teacher
• Contact the teachers and Youth Coordinator • #of teachers visited.
arrange to distribute the • # of educational packets
educational packet and distributed.
resource directory. Meet • # of current WCDPHE
with them for a short in- resource library directories
service about distributed.
comprehensive tobacco • List of strategies teachers
prevention strategies. Ask would like more
them which ones they information on.
would like to receive more
information on. (Provide
them lunch if appropriate).
• Mail a new comprehensive Youth Coordinator • Copy of all materials
tobacco prevention mailed.
strategy/activity to the • #of mailings.
teachers each month.
Encourage them to put
them in their educational
packets/binders. Provide
info on training or tobacco
prevention events.
• Work with health and P.E. Youth Coordinator • List of CEU/C that teachers
teachers to obtain need.
information about their • Record of assessments and
continuing education unit progress in developing
/credits(CEU/C)needs in CEU/C class.
the health and prevention
field. Work with the school
district to develop a CEU/C
class for teachers if need is
16 present.
present.
• Conduct/distribute self- Youth Coordinator • # of self reports completed.
report teacher feedback • #of teachers who report an
form near the end of the increase in the number of
school year. comprehensive tobacco
prevention strategies they
used during the school year.
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth.
Strategy# 1
Promote tobacco free schools
Outcome Objectives:
By June 30, 2002, increase by 30% the number of District Six middle/high schools that are implementing four or more of
CDC's seven recommendations for ensuring a quality school program to prevent tobacco use.
Activities Lead Role Outputs Outcomes
• Create a list of District Six Youth Coordinator • # of administrator and • Increased knowledge about
middle/high school health teacher names. the seven recommended
administrators and health guidelines for ensuring a
education teachers. Youth Coordinator quality school program to
• Copy CDC's Guidelines for • # of copies produced. prevent tobacco usage.
School and Community • Improved collaboration
Health Programs (includes between schools and the
seven recommendations). WCDPHE.
• Develop a packet/binder for Youth Coordinator • Copy of packet/binder. • Increase in the number of
each school. Include copy schools that have
17
of CDC's Guidelines and implemented four or more
recommendations. Include of CDC's seven
copies of the current recommended areas.
school/district policies on
tobacco.
• Develop/locate an Youth Coordinator • Copy and#of observation
observation checklist or checklist.
assessment tool to measure
how each school is
addressing CDC's seven
recommendations (Use at
the start and end of the
school year).
• Contact at least one Youth Coordinator • #of administrators
administrator and a health contacted.
or other teacher and • #of teachers contacted.
distribute a copy of the • #of packets/binders
packet/binder. (Provide distributed.
lunch if appropriate).
• Review the seven Youth Coordinator • # of CDC's
recommended strategies. recommendation copies
Seek out areas which distributed and reviewed.
administrators and teachers • Documentation of areas that
would like to see improved. need improvement.
• Review strengths and Youth Coordinator • Documentation of any
weaknesses with each suggestions or
administrator and offer recommendations given.
support and/or
recommendations for
improvements at each
school.
• Determine which schools Youth Coordinator • Record of communication
have internal channels for channels used at each
communicating information school.
(school newspaper, • Copy of any information
intercom, mailboxes..). Ask distributed over school
for permission to use the communication systems.
channels for distributing
18
tobacco prevention
messages.
• Establish mailing list for Youth Coordinator • Administrator mailing list.
each administrator who • #of mailings.
agrees to receive occasional • Copy of items mailed.
information about
preventing tobacco in
schools. (Document any
mailings and topics).
• Mail out thank you letters Youth Coordinator • #of letters mailed
to all participating
administrators and health
visited.
• Conduct observation Youth Coordinator • #of school observation
checklist at each school checklist completed.
near the end of the school • #of schools that have
year. Determine which implemented four or more
schools have implemented of CDC's seven
four or more of CDC's recommendations.
seven recommendations.
19
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth
Strategy# 2
Promote youth advocacy and empowerment
Outcome Objectives:
By June 30,2002,there will be 6 youth led tobacco prevention events in the greater Greeley area.
Activities Lead Role Outputs Outcomes
• Conduct a community Youth Coordinator • #of searches, contacts and • List of greater Greeley
assessment to determine phone calls. youth organizations will be
number of greater Greeley • List of greater Greeley developed.
youth organizations and youth organizations and • New knowledge among
their leaders. leaders. greater Greeley youth
• Develop a press release Youth Coordinator • # of press releases organization adult leaders
discussing tobacco developed. about tobacco prevention
prevention opportunities for opportunities for youth in
youth. Be sure to include Weld County.
why it is important. • Increase in the number of
• Distribute press release to Youth Coordinator • #of media outlets that greater Greeley youth
local newspapers and radio received press releases. organizations who applied
stations. for youth advocacy
• Develop educational • Copy of educational funding.
information on youth Youth Coordinator information • Increase in youth advocacy
tobacco prevention and • #of copies. organizations in greater
advocacy activities in Weld Greeley area.
County. Include • Increase in youth led
information on youth tobacco prevention events
advocacy group funding. in the greater Greeley area.
• Visit leaders and share Youth Coordinator • #of leaders educated.
educational material on • Amount of educational
youth tobacco prevention information distributed.
and advocacy activities in • # of leaders invited to start
Weld County. Invite them youth advocacy groups.
to consider starting a youth
advocacy group.
• Invite the interested youth Youth Coordinator/youth • # of follow-up visits to
leaders to participate in a advocacy group youth groups.
20
follow-up visit in which the • #of current youth advocacy
youth will be educated group members who
about and invited to start a participated.
youth advocacy group.
Current youth advocacy
group members will be
invited to participate when
available.
• Assist interested youth Youth Coordinator/youth group • # of interested youth and
leaders and groups in leader and members leaders who complete the
completing the youth youth finding application
advocacy group funding to start a new advocacy
application. group.
• Develop and distribute a Youth Coordinator • #of press releases
press release about any new developed.
youth advocacy groups and • #of media outlets that
the activities they will received press releases
participate in.
• Organize a Weld County Youth Coordinator/youth • Copy of meeting agendas.
Advisory Group made up of advocacy group members and • #of meetings and youth • Increased collaboration
at least one youth member leaders. adults attending from each among youth advocacy
from each of the youth youth advocacy group. groups.
advocacy groups. Meet a
minimum of three times.
Invite leaders to attend.
• Nominate one youth Youth Coordinator • Name of youth nominated.
advocacy group member to
a State Advisory Group.
• Work with each group to Youth Coordinator/youth • Official records of events
develop at least six youth and youth/groups involved.
led tobacco prevention
events in the greater
Greeley area.
21
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth.
Strategy# 2
Promote youth advocacy and empowerment
Outcome Objectives:
By June 30, 2002 increase the tobacco prevention advocacy skills of funded youth advocacy groups in the greater Greeley area
by 40%.
Activities Lead Role Outputs Outcomes
• Record membership among Youth Coordinator • # of youth participating. • New knowledge about the
greater Greeley youth overall strength of greater
advocacy groups. Greeley youth advocacy
Determine who the groups.
participating youth are. • Record of meeting • Improved collaboration.
• Attend each monthly youth Youth Coordinator attendance,notes from • Increased youth advocacy
advocacy group meeting. meetings or agendas. skills among greater
• Develop/locate an Youth Coordinator/Evaluation • Copy of evaluation Greeley youth advocacy
evaluation Specialist questionnaire/tool. groups.
questionnaire/tool to • Copy of all evaluations • Documented results from
measure youth advocacy administered during the trainings and their
skills. (Administer at the grant cycle. effectiveness.
start of the grant cycle then
administer post trainings
during the cycle).
• Develop a training schedule Youth Coordinator/youth • Copy of training schedule
with each tobacco youth advocacy group for each youth advocacy
advocacy group according group.
to their needs and interest. Youth Coordinator
• Conduct or arrange at least • # of presentations offered
three trainings related to and youth attending.
tobacco prevention,per • #of evaluations completed.
youth advocacy group.
(Following are some
possible training's for youth
advocacy groups, the youth
will decide if these or
others are appropriate)
22
• Distribute information and Youth Coordinator/youth • #of informational handouts
arrange"Inside the Dark advocacy group/ALAC distributed.
Side"presentations to youth • #of youth who participated.
advocacy group. • # of evaluations completed.
Presentation by American
Lung Association Colorado.
(This can be one of the
three trainings).
• Distribute information and Youth Coordinator/youth • # of informational handouts
arrange"Targeting advocacy group distributed.
Hollywood"movie review • #of youth who participated.
activity on tobacco
marketing by American
Lung Association of
Colorado. (One youth
advocacy group or other
interested community youth
group will participate in the
10 week activity)
• Develop and release a press Youth Coordinator • Copy of press release.
release after significant • #of media outlets who
trainings or youth advocacy received the press release.
events.
• Invite youth to participate Youth Coordinator • Record of events and#of
in opportunistic events as youth advocacy group
they occur. members who participate.
• Develop an observational Youth Coordinator • Copy of observational
record of advocacy skills record and results recorded.
and progress each advocacy
group has made during the
grant cycle. (Complete at
start and end of the grant
cycle)
23
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth.
Strategy#3
Decrease youth access to tobacco products
Outcome Objectives:
By June 30,2002, 30% of greater Greeley gas station and convenience store tobacco retailers will move tobacco advertising
above three feet and away from candy or toy products.
Activities Lead Role Outputs Outcomes
• Conduct an assessment to Youth Coordinator • # of contacts or searches • Increased commitment
determine the number of conducted. among greater Greeley gas
greater Greeley gas station • List of greater Greeley gas station and convenience
and convenience store station and convenience stores to not target youth.
tobacco retailers. Youth Coordinator store tobacco retailers. • Reduction in tobacco
• Develop/locate a tobacco • Copy of assessment tool. advertising from ground up
retailer assessment tool for to three feet and not nearer
documenting tobacco than six feet from candy or
advertising and sign toy product aisles.
placement at each retailer
location. Youth Coordinator
• Develop an educational • Copy of educational packet.
packet for tobacco retailers.
Provide suggestions and
rational for relocating
tobacco advertising signs. Youth Coordinator
• Develop a retailer • Copy of retailer
commitment pledge on commitment pledge.
which tobacco retailers can
pledge their commitment to
not advertise tobacco
products below three feet
and near toys or candy. Youth Coordinator
• Develop and mail a letter to • #of invitations mailed.
each tobacco retailer
manager inviting them to
participate during
assessments. Youth Coordinator/youth
• Visit and assesses tobacco • # of tobacco retailer
advocacy group
24
retailer locations, document advocacy group locations visited.
how they advertise tobacco • #of assessments
products. (Record results on completed.
assessment tool). Try and • # of youth advocacy
determine who is in charge members participating.
of tobacco advertising and
sign placement at each
location. (Invite youth to
participate in retailer
assessments). Youth Coordinator/youth
• Distribute the educational advocacy group • #of educational packets
packet to the tobacco distributed.
retailers during the visit and
encourage them to remove
or replace any inappropriate
signage. Youth Coordinator/youth
• Ask receptive mangers to • # of managers contacted.
sign the commitment advocacy group • #of pledges signed.
pledge. Youth Coordinator/youth
• Invite youth to write letters advocacy group • Copy of letters.
commending tobacco • #of letters mailed.
retailers who took the • # of youth involved.
pledge or are currently
using appropriate
advertising. Include a short
list that defines appropriate
advertising and benefits. Youth Coordinator/youth
• Invite youth to write letters advocacy group • Copy of letters.
to tobacco retailers who are • # of letters mailed.
currently advertising • # of youth involved.
tobacco products below
three feet and near toys or
candy. Encourage them to
remove or replace any
inappropriate signage.
Include a short list that
defines appropriate
advertising and benefits.
25
• Develop and distribute a Youth Coordinator • Copy of press release.
press release article on • # of media outlets
tobacco marketing directed contacted.
towards our youth. Use
YTS data on youth tobacco
usage.
• Conduct follow-up visits to Youth Coordinator/youth • # of tobacco retailer
tobacco retailers and advocacy group locations visited.
determine if any changes • # of assessments
have been made in sign completed.
placement. Again offer • # of advertising changes.
managers who were not • #of youth advocacy
available during initial members participating.
visits an opportunity to sign • # of managers contacted.
the commitment pledge. • # of pledges signed.
• Offer or arrange for Youth Coordinator • #of request for additional
additional training or training or assistance.
assistance if tobacco
retailers request it.
• Provide signed certificates Youth Coordinator/youth Copy of certificates.
to each of the tobacco advocacy group • #of certificates distributed.
retailers who are not
currently advertising
tobacco products below
three feet and near toys or
candy. Thank those who
signed the commitment
pledge.
• Develop and distribute a Youth Coordinator • Copy of press release.
press release detailing the • #of media outlets
support from those retailers contacted.
who participated.
26
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth.
Strategy#3
Decrease youth access to tobacco products
Outcome Objectives:
By June 30,2002, at least 90% of greater Greeley gas station and convenience store tobacco retailers will refuse to sell tobacco
products to minors.
Activities Lead Role Outputs Outcomes
• Develop a list of youth ages Youth Coordinator • List of interested youth. • Behavior change, increase
14-16 who are interested in • Copy of parent permission in the number of tobacco
participating in tobacco forms. retailers refusing to sell
retailer compliance checks. tobacco to minors.
Contact their parents and • Increase in knowledge
obtain written permission to about preventing youth
participate and travel with a from purchasing tobacco
WCDPHE employee. among the retailers who
• Train youth for retailer Youth Coordinator • # of youth trained. participated in the retailer
compliance checks. (Seek training.
training advice from
SYNAR officers). Offer
incentives and/or stipend.
• Conduct retailer Youth Coordinator/youth • # of retailer compliance
compliance checks at local checks completed.
greater Greeley gas station • #of tobacco retailers that
and convenience store sold to minors.
tobacco retailers.
Compliance checks for
informational use only. Youth Coordinator
• Develop a tobacco retailer • Copy of educational packet.
education packet/binder. Youth Coordinator
• Develop a pre/post • Copy of questionnaire.
knowledge questionnaire Youth Coordinator
for the retailer training.
• Offer a tobacco retailer • Copy of class agenda.
education class covering • # and names of retailers
laws,penalties and tips for attending.
enforcing the law. Offer • # of knowledge
27
class at least twice. questionnaires completed.
(Collaborate with local law • # of classes taught.
enforcement and SYNAR • # of tobacco retailer
officers on class educational packets
development) Youth Coordinator distributed.
• Develop and distribute an • # of invitations distributed.
invitation to retailers for the • # of RSVP's.
tobacco retailer class.
(Request RSVP for those
attending Youth Coordinator
• Develop and distribute a • Copy of press release.
press release announcing • #of press releases
the tobacco retailer distributed.
education classes. (Provide • #of RSVP's.
RSVP number for
interested retailers). Youth Coordinator/youth
• Distribute and review advocacy group • # of tobacco retailer
tobacco retailer educational educational packets
packets/binders with distributed.
retailers who couldn't
attend the tobacco retailer
training. Use youth on visits
if possible. Youth Coordinator/youth
• Encourage youth advocacy advocacy group • #of retailer letters mailed.
group members or other • # of youth involved.
youth group members to
write letters to the tobacco
retailers encouraging them
not to sell tobacco products
to minors. Mail the letters
for the youth.
• Develop and distribute a Youth Coordinator • Copy of press release.
press release about youth • # of press releases
tobacco access using YTS distributed.
data.
• Conduct Follow-up tobacco Youth Coordinator/youth • # of tobacco retailer
retailer compliance checks. compliance checks.
(Compare results to • #of tobacco retailers that
28
baseline data) sold to minors.
• Develop certificates of • #of certificates of
recognition for compliant Youth Coordinator recognition produced.
tobacco retailers. (When • #of city mayors willing to
possible have the director sign letters.
of WCDPHE sign the
certificates and appropriate
mayors)
• Visit compliant retailers to Youth Coordinator/youth • #of certificates of
distribute the certificates of advocacy group recognition distributed.
recognition using youth • # of youth who participated.
advocacy group or other • # and type of media
youth group members. covering event and
(Invite media to follow the coverage produced.
youth on some of their
visits) Youth Coordinator
• Develop a press release • Copy of press release.
article detailing the youth • # of media outlets that
advocacy efforts (letter received press releases.
writing, visits, certificate
distribution). Also focus on
recognizing the tobacco
retailers who have been
compliant. Distribute to
local newspapers and radio
stations.
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth.
Strategy#4
Decrease pro-tobacco influences
Outcome Objectives:
By June 30, 2002, all 21 Greeley City park playground areas and/or 3 youth skate parks will have a 50-foot tobacco-free kid
zone around them.
Activities Lead Role Outputs Outcomes
• Develop/locate a self-report Youth Coordinator • Copy of self-report phone • Increased support from
29
phone poll assessment poll assessment Greeley City Council for a
questionnaire tool to questionnaire tool. tobacco-free kids zone.
measure support for • Increased support form
tobacco-free kid zones. community members and
• Obtain city council member Youth Coordinator • List of city council leaders.
names and meeting dates. members and meeting • Development of a tobacco-
Determine who has been dates. free kid zone around
supportive in the past. Greeley City playground
Determine the most areas and/or youth skate
appropriate way to parks.
communicate with and
when to survey them.
• Visit youth advocacy Youth Coordinator • #of letters sent.
groups and encourage them
to write letters to city
council supporting the
tobacco-free kid zone.
• Visit church groups and Youth Coordinator • #of churches contacted.
encourage them to write • #of letters sent.
letters to city council
supporting the tobacco-free
kid zone.
• Contact various city park Youth Coordinator • #of contacts.
officials and seek their • #of letters sent.
support. Encourage them to
write letters to city council
supporting the tobacco-free
kid zone.
• Visit youth skate parks and Youth Coordinator • #of parks visited.
playground areas and pick • # or cigarette butts
up cigarette butts. Save collected.
them to share with the city
council. Also observe and
report tobacco use.
• Develop press release on Youth Coordinator • Copy of press release
tobacco related health • #of press releases
issues and influences on distributed.
youth. Invite community
30
members to share support
on the issue.
• Seek letters of support from Youth Coordinator • #of letters sent.
other concerned citizens
and leaders in the
community. Encourage
them to send letters to city
council supporting the
tobacco-free kid zone.
• Contact the Greeley City Youth Coordinator • Meeting agenda copy.
Youth Commission and • #of youth who show
encourage them to support support.
tobacco-free kid zones.
Encourage them to share
support with the city
council.
• Ask to be on the Greeley Youth Coordinator • Meeting agenda copy.
city council meeting • #of city council members
schedule to seek support for who show support.
the tobacco-free kid zones.
Have other community
experts, citizens and youth
attend to show support.
• Conduct a self-report phone Youth Coordinator • #of phone poll assessments
poll assessment completed.
questionnaire to all city • #of city council members
council members. (Measure who support tobacco-free
support for tobacco-free kid kid zone.
zones).
• Send thank you letters to Youth Coordinator • Copy of letter.
each of the city council • #of letters sent.
members for their time and • Record of new policy.
support. Encourage them to
vote for a new policy.
• Assist with the process for Youth Coordinator • Record of parks with signs.
placing new signs at
playgrounds and/or skate
parks for the new tobacco-
31
free zones.
ANNUAL ACTION PLAN
Program Goal:
Prevent initiation of the use of tobacco products among youth.
Strategy#4
Decrease pro-tobacco influences
Outcome Objectives:
By June 30, 2002, the Northern Colorado Hispanic/Latino Chamber of Commerce members will adopt a no tobacco
advertising policy for the new Festiva Days Family Event.
Activities Lead Role Outputs Outcomes
• Develop list of Northern Youth Coordinator • Printed list of NCHLCC • Increased support among
Colorado Hispanic/Latino members. the Hispanic/Latino
Chamber of Commerce community for developing
(NCHLCC) members. Hispanic/Latino events free
Inquire about appropriate from tobacco industry
time for meeting with advertising.
chamber members. • Adoption of a no tobacco
• Develop/locate a self-report Youth Coordinator • Copy of self-report phone advertising policy for the
phone poll assessment poll assessment new Festiva Days Family
questionnaire tool to questionnaire tool. Event.
measure support for making
Festiva Days Family Event
free from tobacco industry
advertising.
• Develop press releases on Youth Coordinator • Copy of press releases.
tobacco marketing • #of press releases
strategies targeting distributed.
Hispanic youth. Distribute
press releases to local
newspapers and radio
stations.
• Visit community Youth Coordinator/community • #of community
Hispanic/Latino youth youth group members Hispanic/Latino youth
groups and encourage them groups visited.
to write letters supporting • #of letters mailed.
events free from tobacco
32
advertising. (Mail letters to
the NCHLCC).
• Develop English/Spanish • #and copy of
handouts on tobacco Youth Coordinator English/Spanish handouts
industry advertising and the created.
impact on Hispanic/Latino
youth. Include the benefits
of promoting events free
from tobacco industry
advertising.
• Distribute handouts to Youth Coordinator • # of English/Spanish
Greeley Hispanic/Latino handouts distributed.
business and community
leaders.
• Provide a letter for Youth Coordinator • #of Greeley business and
supportive leaders to sign community leaders signing
indicating their support for letters of support.
Hispanic/Latino events free
from tobacco advertising.
• Contact NCHLCC. Arrange Youth Coordinator • #of NCHLCC members
to share letters of support, attending the presentation.
distribute brochures and • # of handouts distributed.
discuss the benefits of
sponsoring events free from
tobacco advertising.
• Conduct self-report phone Youth Coordinator
poll assessment • #of phone poll assessments
questionnaire tool to completed.
measure support for making • # of NCHLCC members
Festiva Days Family Event who support the
free from tobacco industry development of a no
advertising, tobacco advertising policy
• Send letter to NCHLCC to at the new Festiva Days
thank them for support. Youth Coordinator Family Event.
Follow-up by encouraging • Copy of letter.
them to write a no tobacco • Official copy of new policy.
advertising policy. (Provide
sample policies if needed)
33
• Release press release on
new policy. Youth Coordinator • Copy of press release.
• Assist with the event if
needed. Youth Coordinator • Documentation of
assistance.
ANNUAL ACTION PLAN
Program Goal: Promote Quitting Among Youth and Adults
Strategy:
Promote availability of effective cessation services and/or resources.
Outcome Objectives':
2.1.1 By June 30, 2002, at least 2 dental clinics in Greeley will have effective tobacco cessation protocol in place based on the
AHQR clinical practice guidelines for treating tobacco use and dependence.
2.1.2 By June 30, 2002, increase to 50% the number of smoking patients at 2 local dental clinics who are referred to the state
tobacco cessation quit-line.
34
Activities Lead Role Outputs Outcome
Activities 2.1.1
Community Involvement> Research effective
strategies and Centennial Area Health Increased capacity to enable
techniques for Education Center, Weld County dental providers
addressing tobacco Cessation coordinator to address tobacco cessation in
cessation in the dental their practices.
office. Research articles on file.
> Research effective
strategies and Cessation Coordinator
techniques for
addressing tobacco
cessation in the dental
office specific to
minority populations.
> Compile database of CAHEC, Cessation coordinator Data on file
local dental clinics.
> Develop survey to CAHEC, Cessation coordinator Survey on file.
assess #of dental care
providers who are
providing tobacco
cessation counseling Increased knowledge of TFWC
and the protocol that is regarding dental care providers
in place to assure this. currently providing brief
intervention services and
> Survey to be sent to CAHEC, Cessation coordinator Number of surveys sent. current protocol.
Weld County dental Number of surveys returned.
care providers.
> Conduct random survey Coalition members, cessation Data on file.
of Weld County dental coordinator, CAHEC
clinics to assess current
# of referrals to
cessation services.
35
> Research state dental Cessation coordinator Information gathered will be on Increased knowledge of dental
association's position file. association's position will
on tobacco cessation. enable TFWC to tailor
interventions to needs of dental
community.
> Collaborate with the Coalition members, CAHEC, Description of program, fliers Increased knowledge of dental
Centennial Area Health Cessation coordinator. created and marketing efforts care providers regarding brief
Education Center will be on file. tobacco cessation intervention
(CAHEC) to develop counseling and effective
and plan an educational tobacco cessation protocol
program for dental care
providers in Weld
County regarding brief
intervention counseling
and effective dental
office protocol for
tobacco cessation.
> Host educational Cessation coordinator, CAHEC #Of attendees Increased capacity of dental
program for Weld #of presenters providers to identify, counsel
County dental # of training hours and refer smoking clients to
providers. appropriate resources.
> Recruit a minimum of CAHEC, cessation coordinator Names of clinics and clinic Increase in the number of
two dental clinics to representatives on file. patient referrals to available
collaborate on the cessation resources.
development and
implementation of
office protocol.
> Develop case records Cessation Coordinator Records on file
for interactions with
36
clinics.
> Distribute local tobacco Cessation coordinator #of brochures distributed,
cessation resource #of clinics brochures
brochures to Weld distributed to
County dental clinics Increased knowledge of dental
care providers regarding
available cessation resources.
> Distribute STEPP state Cessation coordinator #of brochures distributed,
quit-line media #of dental clinics receiving
materials to local dental brochures
clinics Names of clinics
> Distribute posters and Cessation coordinator # of posters Increased exposure to anti-
educational materials # of dental clinics tobacco messages
pertaining to the Names of dental clinics.
hazards of smoking and
spit tobacco for waiting
rooms.
> Develop system for Cessation coordinator, clinic Description of tracking system Increased capacity to track
tracking referrals to representative in case records. number of referrals for
state and local cessation cessation.
services.
> Provide technical Cessation coordinator Description of assistance in
assistance as needed to case records.
implement protocol and
tracking system.
> Identify dental clinic Cessation coordinator Name recorded in case records.
representative who will
be liaison for
communication of
information regarding
protocol and referrals.
Communications will be Increase in awareness of local
37
> Communicate with Cessation coordinator documented in case record. cessation providers of the
local cessation numbers of clients who are
providers to identify# being referred.
of referrals
Information will be
➢ Investigate and Cessation coordinator documented in case records. Increased knowledge of dental
distribute information providers regarding insurance
regarding insurance coverage.
coverage for tobacco
cessation.
Strategic Use of Media
> Enlist coalition Cessation coordinator, coalition Articles on file. Increased public awareness
members or community members regarding the effects of tobacco
partners to participate in on dental health.
the writing of 2 articles
on the effects of
tobacco on dental
health.
ANNUAL ACTION PLAN
Program Goal:
Promote Quitting Among Youth and Adults
Strategy:
Promote availability of effective cessation services and/or resources
Process Objectives:
2.1.3 By June 30, 2002,the Weld County Prenatal Plus Program and the First Steps Prenatal Care Program will implement a
program utilizing education, social support and financial incentives to increase quit attempts by pregnant smokers.
Outputs Outcomes
Activities Lead Role
Community Intervention # of participants, questions Increased knowledge of
38
> Hold a focus group with Cessation coordinator, coalition asked, and responses on file. bathers and incentives.
pregnant smokers to members, UNC intern, tobacco
identify incentives to cessation specialist, Prenatal
quit and perceived Plus and First Steps staff
barriers. representatives.
Increased capacity to address
the needs of pregnant smokers
➢ Collaborate to develop Description of program on file. pertaining to tobacco cessation.
and implement a Increased number of quit
program to increase quit attempts by pregnant smokers
attempts by pregnant in Prenatal Plus and First Steps
smokers through programs
education, incentives
and social support.
> Program to include
educational session or
sessions in addition to
regular clinic visits
referral to cessation
services, and incentives
for biochemically
confirmed cessation of
tobacco.
Increased resources for
Provide programs with self- Cessation coordinator #of booklets distributed pregnant smokers to help
help booklets for patients, themselves.
"If you Smoke and are
Pregnant".
Increased motivation for
Solicit incentives from Cessation coordinator, coalition List of incentives on file. participation of pregnant
community organizations to members, UNC intern smokers.
provide to women for
participation in the
program. i.e. Attendance,
quit attempts.
Effective use of media
39
> Distribute cessation Cessation coordinator, coalition #of materials distributed Increased knowledge of
resource brochures to members, UNC intern pregnant smokers regarding
Prenatal Plus Programs. cessation resources.
➢ Distribute state media # of materials distributed
materials regarding quit
line to above programs.
➢ A minimum of two Cessation coordinator, coalition # of articles published
articles will be members,UNC intern Increased public awareness of
submitted to Weld the effects of nicotine on a
County newspapers fetus.
regarding the effects of
nicotine on the fetus.
ANNUAL ACTION PLAN
Program Goal:
Promote Quitting Among Youth and Adults
Strategy:
Promote public awareness for non-use and decrease social acceptability of tobacco use.
Outcome Objectives:
2.2.1 By June 30,2002, public awareness of greater Greeley residents regarding the hazards of tobacco use will be raised by
70%.
2.2.2 By June 30, 2002, decrease the social acceptability of tobacco use by 50% among greater Greeley residents.
Activities Lead Role Outputs Outcome
Surveillance and Evaluation
➢ Develop survey to Program coordinator, Survey on file. Increased capacity to assess
assess public awareness evaluation consultant awareness of Weld County
of hazards of tobacco residents regarding hazards of
and % of non-users in tobacco and percentage of non-
Weld County users in our community.
40
Increased knowledge of TFWC
➢ Conduct mail or phone Program coordinator, #of surveys sent regarding public awareness.
survey to residents in evaluation consultant, # of surveys returned
the greater Greeley cessation coordinator
area.
Program
> Evaluate findings. coordinator/cessation Report of findings on file.
➢ Generate report of coordinator, coalition
findings. members,
Community intervention Increased public awareness
Cessation coordinator, regarding hazards of nicotine.
> Enlist coalition members or coalition members Minimum of 2 articles
community partners to submitted to local newspapers
participate in the writing of
a minimum of 2 articles on
hazards of tobacco use,
which will be submitted to
local newspapers.
Counter marketing and
Effective use of media Increased public awareness of
> Develop summer media TFWC staff, coalition Photographs of float and booths hazards of tobacco use and of
campaign To include members, community on file. the percentage of Weld County
consistent messages volunteers, media specialist #of brochures given out, residents who are non-smokers.
regarding hazards of # of messages displayed in
tobacco use and English and Spanish, # of
percentage of Weld events participated in by
County resident non- TFWC
smokers. Events will
include a minimum of
three of the following
events:
1. Float in the Stampede
Parade
41
2. Booth at the Greeley
Arts festival
3. Booth at Festiva days
4. County Fair Increased commitment to the
TFWC staff, coalition non-use of tobacco.
> Petitions will available members, community # of signatures obtained
at events and volunteers.
individuals encouraged
to become part/stay a
part of the 77% of Weld
County residents who
are smoke free. Increased public awareness of
hazards of tobacco use and of
➢ Incentives will be the percentage of Weld County
provided to residents TFWC staff, coalition #of participants, #of incentives residents who are non-smokers.
participating in contests members, and community given out, list of questions on
at events who can volunteers. file
answer tobacco related
questions correctly.
Effective presentation of
> Explore options for message.
creating message to
public regarding Cessation coordinator Log of contacts on file.
hazards of tobacco use
through collaboration
with local members of
the Pro-Rodeo Cowboy Increased public awareness of
Association or other hazards of tobacco and
cowboy organizations. percentage of Weld County
Cessation coordinator #of camps visited resident non-smokers.
➢ Explore options of
bringing this message Increased awareness of
into local summer TFWC's participation in
camps. community events.
Cessation coordinator List of programs and copies of
➢ TFWC will be programs on file.
represented in programs
42
for Arts Fair, County
Fair, and other events.
ANNUAL ACTION PLAN
Program Goal:
Promote Quitting Among Youth and Adults
Strategy:
Promote public awareness for non-use and decrease social acceptability of tobacco use.
Process Objective":
2.2.3 By June 30, 2002,5 local businesses in Weld County will disseminate information to their employees regarding the
hazards of tobacco use to their employees.
Outputs
Activities Lead Role Outcome
> Collaborate with Cessation coordinator,
representatives of three representatives from local Plan on file.
local businesses to businesses. Employees at 5 local
develop effective businesses will receive
methods to disseminate information regarding the
information to hazards of tobacco use
employees.
> Develop and submit a Cessation coordinator #of entries submitted.
minimum of 3 entries #of entries published
regarding hazards of
tobacco use for
publication in electronic
and paper newsletters
and paycheck inserts.
Cessation coordinator #of posters displayed
➢ Distribute posters #of businesses displaying
promoting awareness of posters
hazards and non-use to Increased capacity to
businesses for display in Cessation coordinator #of brochures distributed disseminate information.
employee areas.
43
> Distribute brochures
with local cessation Cessation coordinator
resource information. Increased knowledge of
> Distribute information businesses regarding local
regarding state quit line. Cessation coordinator, coalition options for tobacco cessation.
members Log of research on file.
> Continue to investigate Increased knowledge of
options for on-site businesses regarding options
cessation services, for cessation services.
Cessation coordinator.
List on file.
> Provide Human Increased knowledge of
Resource directors with business representatives
information regarding regarding insurance coverage.
insurance coverage for
cessation.
ANNUAL ACTION PLAN
Program Goal:
Promote cessation among youth and adults.
Strategy: 3
Promoting youth cessation programs.
Outcome Objectives:
2.3.1 By June 30,2002, increase the availability of youth cessation services from 0 to 2 in Greeley District 6 schools.
44
2.3.2 By June 30,2002,After completion of N.O.T program 20% of the youth participants will attempt to quit.
Activities Lead Role Outputs Outcomes
Community Intervention Increase services for youth who
o Train Youth Cessation coordinator,program # of youth advocacy members want to quit using tobacco
advocacy group members coordinator trained products.
to provide educational
presentations on reasons Increase positive movement of
to support an on-site youth through the stages of
tobacco cessation change.
program to school board
members and PTA Increase the number of youth
members accessing cessation.
o Provide an Youth advocacy group # of presentations provided
educational presentation members, cessation coordinator Increase quit attempt reports by
for 4 PTA groups on the youth.
importance of providing
on-site tobacco cessation Decrease tobacco use among
for teens youth.
o Provide an Youth advocacy group #of presentations provided
educational presentation members, cessation coordinator #of school board members
for the members of present
district 6 school board on
the effectiveness of on-
site youth cessation
programs
o Recruit college aged Cessation coordinator, UNC #of students recruited
and High school aged cessation provider
tobacco users that are
trying to quit to write
letters of support for
program
o Send letters to the Youth advocacy group # of letters mailed
district 6 school board
members and district 6
administrative staff
o Present to District 6 Cessation coordinator, coalition #Presentations made
school board and request
accreditation for N.O.T or
45
similar cessation program
o Get N.O.T Cessation coordinator, coalition
accredited by District 6 N.O.T program accredited in
school board as an District 6
alternative health
education class
o Collaborate with Cessation coordinator,UNC #role models recruited
UNC student cessation cessation coordinator
program to recruit former
smokers as role models in
an attempt to provide
support to H.S. students
that would like to quit and
help college students stay
quit by continuing to
focus on the benefits of
being smoke-free through
educating the H.S.
students.
o Provide training for ALA, cessation coordinator #teachers trained
teachers and student role #UNC role models trained
models (to work with
teachers) on N.O.T.
o Assign 1 role model Cessation coordinator, UNC #role models assigned to each
to each program cessation coordinator program
o Implement N.O.T. Cessation coordinator, N.O.T
in 2 district 6 schools, facilitator, role model
once per school year
o 1- 15 minute Role model # classes implemented
presentations at each site #of participants in classes
on the positive monetary
&health effects a role # of presentations given
model has experienced
since quitting smoking
given to class.
o Provide incentive
drawing for youth who Cessation coordinator #of incentives provided
participate in class, the #of entries in drawing=#of
46
more classes you attend youth in class that day
the more entries you can
make to win the incentive
o Provide N.O.T. Youth coordinator, cessation # of opportunities provided to
facilitators with advocacy coordinator facilitator
opportunities that class
participants can be
involved with outside of
class
o Have completion Cessation coordinator,N.O.T # of graduates at celebration
celebration to award facilitators, role model, school
incentive and recognize administration
student activities
o Provide ongoing Cessation coordinator, coalition #of meetings with program
Technical assistants Cessation coordinator, facilitators
o Have a debrief of facilitator, role models, # of participants at debrief
N.O.T program with all students, administration # of papers articles published in
facilitators and role
models to identify
achievements and
barriers.
Strategic Use of Media
o Publish article in Youth advocacy groups, youth # of papers articles published in
District 6 school paper coordinator
regarding lack of services
for youth
o 1 meeting to create Cessation coordinator #of complete poster ideas
3 promotional posters
with administration,
students and facilitators
o Send all teachers a Cessation coordinator, teachers #of votes for each posters
copy to posters and a tally #of tally cards received back
card and have class vote
on which poster they like
best
o Create 10 posters, 4 Cessation coordinator # of posters created
in Spanish, 6 in English
o Provide 5 Cessation coordinator # of posters provided
47
promotional posters
(English and Spanish)to
facilitator to post around
school
o Create school Flyer for Cessation coordinator, #of parents that were sent a
each school to be sent facilitator, administration flyer
home to all parents about
program and recognizing
accomplishments of
students in Spanish and
English(S/E)
ANNUAL ACTION PLAN
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: 1
Promote public awareness on the hazards of ETS exposure and benefits of smoke free environments
Outcome Objectives:
By June 30, 2002, increase the knowledge of greater Greeley residents regarding the harmful effects of ETS by 70%
Activities Lead Role Outputs Outcomes
Strategic Use of Media Tobacco-Free Weld County has
• Develop 3 messages TFWC staff, coalition #of messages developed a better understanding of
from CDC media ideas community knowledge about
and community the harmful effects of Second-
information hand smoke.
• Meet with graphic Program coordinator #of layouts created
person to create layout Resident's knowledge about the
decided on by staff and harmful effects of Second-hand
coalition smoke has increased.
• Meet with Latino Program coordinator # of messages translated
coalition to help There is stronger community
translate messages and support for a clean in-door air
assure cultural policy.
appropriateness for the
Latino population
48
• Offer incentives to Program coordinator #of participants in focus group
Weld County public
transportation users
who agree to participate
in a focus group and test
messages
• Select media channels Program coordinator #of media channels contacted
where message will be # of media channels used
delivered
Newspaper
Radio
Cable
Benches &bus
Panels
• Meet with media
channel representative Program coordinator #of placements agreed upon
to discuss placement
and dates
• Implement campaign Program coordinator,Public #of days campaign runs for
Transportation media
representative
Community Intervention
Collaborate with cessation Program coordinator, cessation #of events participated in
coordinator during summer
events to include messages coordinator
regarding the harmful effects of
ETS on non-smokers (youth&
adults) a minimum of three of
the following:
Float in the Stampede
Parade
Booth at the Greeley Arts
festival
Booth at Festiva days
County Fair
49
Petitions will be available at Program coordinator, Greeley # of petitions filled out
events to measure participant's ETS workgroup
support of smoke-free
environments.
Incentives will be provided to
residents participating in Program coordinator, Greeley #of contestants in
contests at events who can ETS workgroup contests/events
answer tobacco related # of incentives provided
questions correctly.
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: I
Promote public awareness on the hazards of ETS exposure and benefits of smoke free environments
Outcome Objectives:
By June 30, 2002,The majority of Greeley City Council members will vote for an improved City of Greeley smoking
ordinance
Activities Lead Role Outputs Outcomes
Community Intervention Increase Tobacco-Free Weld
• Meet with GASP Program coordinator #of meetings County knowledge of support
director to review among Greeley City Council
changes outlined and members.,
brainstorm other ways
of recruiting support Increase support for changing
• Newspaper articles ordinance 119 policy among
1 from medical professional Coalition, youth advocacy # of letters published Greeley City Council members.
(Dr. Armbrust) explaining groups
50
(Dr. Armbrust) explaining Create stronger clean indoor air
harmful effects of ETS and policy.
its impact on the medical
cost incurred by the
community
1 from employee working
in environment with high
concentration of ETS
1 from community member
(Carol Anderson) with
complications that prevent
them from entering an
environment with ETS
• Letter to the Greeley Program coordinator, Coalition #of letters sent
Mayor and Greeley City
Council members
stating support of Weld
County residents for a
stronger ordinance
addressing ETS
• Presentation to Latino Youth advocacy group #of coalition members present
coalition regarding the (preferably the local Latino # of Latino youth presenting
need for support of a youth group)
stronger clean
ordinance for the Latino
community
• Presentation by Lab Youth advocacy groups # of presentations given
school youth advocacy #of city council members
group members to present
Greeley City Council
requesting a stronger
ordinance addressing
ETS and why they
believe it is important
• Send letters of proposal Coalition, Advocacy group #of letters sent
to city council members #of interview conducted
for their review before
presentation. interview
51
presentation, interview
city council members to
clarify any questions or
rational to support
changes. Program coordinator #of people that attend
• Propose changes to presentation and their titles
ordinance 119 schedule
presentation to city
council by coalition
spokesperson, make
sure all coalition
members,youth
advocacy group
members, and
community partners
attend,.
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: 2
Promote smoke-free public places
Outcome Objectives:
By June 30, 2002, increase smoke-free restaurants in greater Greeley from 25% to 40%.
Activities Lead Role Outputs Outcomes
Community Intervention Increase the number of smoke-
• Update volunteer Coalition, program coordinator #of volunteer packets created free restaurants in the greater
packets from 2000 that Greeley area.
include restaurant name
and number, script Increase support for smoke-free
explaining event and restaurants
incentives, copies of
last year's Increase restaurant employees
advertisements. ability to enforce smoke-free
• Recruit volunteers from Coalition,program coordinator #of volunteers recruited policies.
ACS, coalition, UNC
52
public health students
and United way
• Have volunteers contact Coalition, volunteers # of restaurants contacted
at least 30 restaurants
(including at least 7
spanish speaking
establishments) that
offer smoking sections
to recruit participants
for trial event
• Implement a smoke-free Program Coordinator, #of restaurants participating
trial period volunteers
• Follow up for review Program Coordinator # of reviews completed
• Provide technical Program coordinator, coalition #of restaurants that receive
assistance to restaurants technical assistance
who would like to go # of policies developed
smoke-free in
developing policy and
enforcement strategies
• Train staff if requested
on enforcement Program coordinator, coalition #of staff trained to enforce
strategies (assertiveness policy
training)
• Distribute recognition
certificates signed by Coalition, program coordinator #of certificates distributed
the local Health
Department Director
and the Mayor
Strategic Use of Media
• Develop coupon for Program coordinator # of coupons developed
discount at restaurant
during smoke-free trial
event to recruit
community support for
event distribute in the
Tribune discount book
— ;_$ tryrnmm>>nily
53
and to community
partners
• Hold annual Program coordinator # of participants
recognition/review
dinner for coalition
members at a new
smoke-free restaurant
• Notify Channel 8 (local Program coordinator, collation # of PSA submitted
cable channel) and spokesperson
Greeley Tribune of
event
• Develop advertisement/
article recognizing Program coordinator, coalition # of advertisements/ articles
smoke-free restaurants published
and highlighting mayors
and Health Department
Directors support
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: 2
Promote smoke-free public places
Outcome Objectives:
By June 30, 2002, Follow up on 80% of indoor air quality complaints submitted to new indoor-air-quality hotline.
Activities Lead Role Outputs Outcomes
• Research City Councils Program coordinator Obtain copy of the mandate Tobacco Free Weld County
mandate for a odor will have a better
hotline pertaining to understanding of the
outside air community's compliance with
• Create argument for Program coordinator # of presentations created the Greeley city ordinance 119.
indoor air quality
hotline with facts Increase compliance with
54
outlined in Greeley city ordinance 119
Occupational Safety
and Health
Administration
(OSHA), American
College of Occupational
and Environmental
Medicine (ACOEM),
Journal of the American
Medical
Association(JAMA),
and City Ordinance 119
• Gain support of 2 Program coordinator #of meetings with
environmental health environmental health
inspectors by presenting
reasons for a indoor air
quality hot line address
any concerns that arise
• Contact Planning or
correct county division Program coordinator Document outlining
to establish investigation and enforcement
investigation and procedures
enforcement procedures
for Hot line entries
• Provide 1 joint
presentation with Program coordinator #of presentations given to
environmental health to County Commissioners
County Commissioners
and City Council on
providing a indoor air
quality hotline
• Have County
Commissioners and
City Council sign off on Program coordinator # of signatures on investigation
document outlining and enforcement document
investigation/enforceme
ntprocedures
55
• Train personnel on Program coordinator #of personnel trained
ordinance 119 and
investigation/enforceme
nt procedures
• Designate 1 phone line Program coordinator, Phone line designated for
for indoor air quality environmental health,health hotline
hot line department director
• Record message (S/E)
to collect location of Program coordinator Message recorded
complaint, air quality
contaminate, and name
&number of caller
• Provide 1 presentation
to introduce hotline,
investigation and Program coordinator Presentation provided to
enforcement procedures chamber of commerce
to chamber of
commerce members
• 1 Advertisement (S/E)
for hotline in Greeley Program coordinator #of advertisements in the
Tribune each month for Greeley Tribune over a 6
6 months month period
• 1 Advertise for hotline
in UNC newspaper each Program coordinator # of advertisements in the UNC
month for 6 months newspaper over a 6 month
• Distribute hotline period
Program coordinator, coalition # of hotline handouts
number in 1000
distributed in the Welcome
Welcome wagon gift
wagon gift baskets
baskets
• Include hotline number
on other program Program coordinator #of advertisements that include
advertisements the hotline number
• Collaborate with
outdoor odor code Program coordinator # of meetings with outdoor
enforcement officers on odor code enforcement officers
advertising at the same to collaborate advertising
time for the summer
months
56
months
• Meet with 80%of
businesses that are Program coordinator, Greeley % of businesses reported out of
reported out of ETS workgroup compliance met with, tally
compliance to evaluate quarterly
problem
• Provide technical
assistance in developing Program coordinator % of businesses reported out of
new policy or compliance met with, tally
enforcement protocols quarterly
to 60%of the
businesses that are
reported out of
compliance
• Do Follow up check of
all businesses that
develop new policy 3 Program coordinator, Greeley # of businesses re-contacted
months later to evaluate ETS workgroup after 3 months
how new policy is
working; make any
needed changes in
policy.
57
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: 3
Promote smoke-free workplaces
Outcome Objectives:
By June 30,2002, At least 30% of small businesses in Windsor,Eaton,Evans and LaSalle without an existing policy will
develop a smoke-free work place policy.
Activities Lead Role Outputs Outcomes
• Use Greeley chamber Program coordinator #of lists from chambers of Build grassroots workgroup to
members list and commerce and community work on ETS in the
business license list planning.departments workplaces issues for Windsor,
from Windsor, Eaton, Eaton, Evan, and LaSalle.
Evans and LaSalle
(WEEL)to identify Increase number of smoke-free
businesses without workplaces in Windsor, Eaton,
smoking policies to Evans, and LaSalle.
target, approximately 50
• Publish 1 article for all Program coordinator #of papers article is published
local WEEL community in
papers highlighting the
results of the
Community surveys and
facts on the effects of
ETS on non-smokers
Create WEEL grass roots workgroup
• Recruit WEEL Program coordinator # of community members
community members to recruited
participate on ETS work
group
• Make 4 presentations to Program coordinator #of presentations made
faith organizations
• Develop recruitment
posters/flyers distribute Program coordinator, Greeley # of posters/flyers distributed
to 4 faith organizations, ETS workgroup
3 medical/dental care
clinics, 3 local
enforcement agencies,
58
enforcement agencies,
and 5 schools (target
school employees)
redistribute where
needed each month for
4 months
• Write 3 short articles Program coordinator #of articles written
for newsletters/flyers
regarding recruitment of
workgroup members
• Distribute 1 a month to Greeley ETS workgroup, #of articles published/mailed
4 faith organization program coordinator to congregation or
congregations (bulletin medical/dental clients
board/newsletter) and 3
medical/dental clinic
staff and clients
(bulletin
board/newsletter)
• Meet with 5 Program coordinator, Greeley #of doctors/dentist met with
doctors/dentist to ETS workgroup
explain program and
recruit their help in
finding members for the
workgroup
• Design a schedule for Program coordinator Schedule designed
workgroup to help you
complete following
activities
• Develop a workgroup of
ETS advocates for Program coordinator #of ETS work group members
WEEL area to work
with Greeley ETS
workgroup
• Hold first workgroup
meeting to explain what Program coordinator # of participants at meeting
TFWC does, what the
objective is, why it is
important and a sign
59
important and assign
individual tasks,
schedule next meeting
Assess the interest of 40 WEEL
business owners in providing and/or
developing a smoke-free policy
• Develop an assessment Program coordinator, # of questions developed
tool to measure current evaluations specialist Final copy of assessment tool
policies in place (1
question), willingness to
offer policy(1
question), attitudes
around offering policies
(2-3 questions), and
implementing policy(1-
2 questions)
• Contact all WEEL
business owners to WEEL workgroup, program #of WEEL businesses
survey willingness to coordinator contacted
participate in
assessment
• Conduct assessment of WEEL workgroup,program # of assessments conducted
at least 25 WEEL coordinator
businesses
• Tally the results of Program coordinator Written report of assessments
assessment
• Meet with interested Program coordinator, WEEL #of businesses met with
businesses to establish workgroup
policy and protocol for
enforcement, provide
signage
• Put article in WEEL Program coordinator #of newspapers that print
newspapers to article
recognize businesses
that have gone smoke-
free
• Contact businesses by
Visit/Send educational WEEL workgroup, program #of businesses contacted
60
materials to businesses coordinator
who did not show an
interest in developing
policy regarding OHSA
standards (they are
trying to pass)/studies,
JAMA articles on
employees that have
filed class action law
suits against employers
because of exposure to
ETS, and American
College of Occupational
and Environmental
Medicine input on
effects of ETS
• Create interview
questions to measure Program coordinator #of questions created
town councils opinions Final copy of interview
on a clean in-door air
ordinance similar to
Greeley City's
• Interview at least 2
Town Council members WEEL workgroup members, #of Town council members
in each community to program coordinator interviewed
asses council support
for an ordinance
• Develop a written report
to establish a baseline Program coordinator Report of support for new clean
for town council indoor air ordinance in
support of passing clean Windsor, Eaton, Evans, and
indoor air ordinance LaSalle
61
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: 3
Promote smoke-free work places
Outcome Objectives:
By June 30, 2002,At least 60% of restaurant owners in Greeley will support an improved City of Greeley smoking ordinance.
Activities Lead Role Outputs Outcomes
Community Intervention
• 2 Newspaper letters to the Coalition, volunteers,program #of letters published Increase Tobacco-Free Weld
editor from restaurant coordinator County knowledge of support
employees addressing the among restaurant owners.
importance of smoke-free
workplace& 2 Newspaper Increase support for changing
letters (S/E)to the editor ordinance 119 among
from restaurant patrons restaurant owners/employees.
addressing the importance
of smoke-free dining
• Send packets requesting Coalition, program #of support packets sent
support which include coordinator
copy of letters to the
editor, a letter requesting
support and a meeting time
to discuss issue,
information why smoke-
free environments are
important and their effect
on profits for other
restaurants that have gone
smoke-free to Restaurant
Association president,
Mayor, and City Council
members
• Meet with Restaurant
Association president, Coalition,program # of meetings attended
Mayor and city council coordinator
members to go over
information in support
packet and answer any
62
packet and answer any
questions. (Bring extra
packet)
• Presentation on the effect Coalition,program #of presentations/educational
of a smoke-free coordinator flyers sent to restaurants
environment on profits,
include local statistics on
%of smokers vs. non-
smokers in Weld County
incase there is difficulty
getting on agenda, obtain
association mailing list and
send Educational flyers to
Restaurant association
members
Strategic Use of Media
• Add statement Program coordinator # of restaurants that agree to
(S/E) to 10 greater Greeley
smoke-free restaurant add statement/sticker to menus
menus about "proud to be
smoke-free" and
educational statistics
regarding the effects of
ETS on employees and
patrons
• Create a sticker Program coordinator #of stickers developed
that reads proud to be
smoke-free or other
statement agreed upon
with restaurant owner for
smoke-free restaurants that
have more permanent
menus
63
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: 4
Promote smoke-free homes and autos
Process Objectives:
By Tune 30, 2002, Provide educational interventions for child care patrons at 3 greater Greeley area child care centers
regarding the harmful effects of ETS on children
Activities Lead Role Outputs Outcomes
Community Intervention Increase knowledge regarding
• Provide 1 training for Program coordinator, coalition # of participants the harmful effects of ETS on
child care providers in 3 spokesperson # of trainings provided children of parents accessing
centers regarding childcare.
current facts on the
harmful effects of ETS Increase childcare employees
on children participation in educating
• Provide child care Program coordinator # of posters provided parents.
centers with posters and
educational information
regarding ETS and
children(S/E)
• Provide a 10-12 minute Coalition #of tapes provided
educational video on # of centers provided with
harmful effects of ETS tapes
on children to 3 child
care centers to be
implemented during
their orientation of new
patrons (S/E)
• Provide child care
centers with cessation Program coordinator, facility # of brochures provided
resource brochures director
(S/E) restock quarterly
Contract Event
• Meet with
facility to recruit Program coordinator, facility # of meetings with facilities
director # of participants
participation
64
participation
• Meet with Program coordinator Name and format developed
interested facilities to
develop name and
poster for event
• Create Large Program coordinator #of posters developed
poster(S/E) advertising
event, hang poster in
area where parents
come to pickup their
children
• Develop and Coalition, facility employees #articles published in
publish article about newsletter
event in each facilities
newsletter the month
before event(S/E)
• Have employees
promote event Facility employees #of employees assigned by
• Have parents facilitator to promote event
who would like to Facility employees # of participants signed up
participate sign their
children up for
presentation
• Give
presentation to children Youth Advocacy group # of children attended
about tobacco smoke #of presentations given
and their health provide
translator where
necessary
• Have parents Youth Advocacy group, facility # of contracts signed
and children sign a employees
contract stating they
will not expose their
children to ETS for 3
months
• Have children Facility employees # of poster boards designed for
keep track on poster
tracking program
board in classroom
65
board in classroom #of participants listed on
boards
• Have celebration Program coordinator, coalition, #of participants at celebration
at the end of the youth advocacy group
program for parents and
children where children
are recognized
Strategic Use of Media
• Articles in facility news Facility employees, program #of articles published in
letters about event both coordinator facility newsletter
promotion and results
(S/E)
• Recognizing special
efforts by parents Facility employees, program # of articles published in
during event in 1 article coordinator facility newsletter
at each site
• Advertising cessation #of articles published in
resources Program coordinator facility newsletter
Program Goal:
Reduce Exposure to Environmental Tobacco Smoke
Strategy: 4
Promote smoke free homes and autos
Process Objectives:
By June 30, 2002, Provide educational interventions for blue collar employees at 3 greater Greeley area manufacturing plants
regarding the harmful effects of ETS on children
Activities Lead Role Outputs Outcomes
Increase awareness of the
Strategic Use of Media harmful effects of second hand
• Stuff 50 paychecks at Program coordinator, Greeley #of educational pieces smoke on children.
each site twice. 1St with ETS workgroup distributed in paychecks
information for the"not Increase educational outreach
near me"program and to low-income populations.
2°a for the"tobacco
costs"presentation. Decrease tobacco use around
children among employees.
66
Both with children among employees.
program/presentation
information and Increase quit attempts by
pertinent facts about employees.
each subject matter.
(S/E)
• Hang posters regarding Greeley ETS workgroup #of posters hung
health effects of ETS on
children and cost of
tobacco use (S/E) in 2
break rooms of all 3
businesses, put up new
posters quarterly
• Provide cessation Greeley ETS workgroup #of brochures distributed
resource brochures in 2
break room of all 3
businesses, restock
quarterly
• Post flyers (S/E) for Program coordinator # of flyers posted
"not near me"program
and"tobacco costs"
presentation before
implementation of
programs
• Post flyers that
advertise local cessation
courses and when they Greeley ETS workgroup # of flyers posted
are offered, change
quarterly or as they are
offered
Community Intervention
• Create "not near me"
program cards (S/E) - Program coordinator, Greeley #cards created
will be used to track ETS workgroup
tobacco use near
children among
participants by marking
67
participants by marking
days when they used
tobacco products
around their children.
• Provide 2 brown bag Program coordinator, Greeley #of participants
lunch presentations 1 on ETS workgroup #of presentations given
Effects of ETS on
children and options for
smokers to use to
protect children bring
translator if necessary
• Begin the "not near me"
program by handing out Program coordinator # of program supplies handed
program cards and out
contract certificates to #of signed certificates received
be signed by parent and back
child pledging not
smoke near children in
their car or at home for
3 months. Signup is
monitored by
participant mailing
pledge back in self
stamped envelop to be
mailed back to TFWC
• Provide 2nd
presentation"tobacco Program coordinator, Greeley # of participants
costs" on Medical ETS workgroup # of presentations given
expense for households
with tobacco users vs.
households without
tobacco users and
cessation resources
available,bring
translator if necessary
• Check up with "not near
me"program Program coordinator # of program cards exchanged
participants to measure
68
participants to measure
progress and distribute
new cards for that
month. The concept is
each time they smoke
near their children they
mark a square on their
card representing a
money amount, the
person with the least
amount of marks wins
and the loosing
participants must pay
their card totals to the
winner. This challenge
requires honesty.
• Provide 1 support group Program coordinator
session at 6 week #of participants
marker to discuss how
program is going and
review amount of
money on everyone's
program cards
69
One Month Budget
b .. = r MSf '$f' �e �'k {${ §
,. . i A t y.- : .;.... 5
ts
LOCAL HEALTH DEPARTMENT: Weld County Department of Public Health &
Environment
TIME PERIOD: June 1, 2001 thru June 30, 2001
FISCAL OFFICER/CONTACT PERSON: Judy Nero PHONE: 970-304-6410
ext.2212
CATEGORY AND ANNUAL TIME ON PROJECT Amount Requested
LINE-ITEM SALARY No. of Hrs./Week
Months
1. Ren Bedell $36,947. 1 20 $1540.00
00
2.
3.
Subtotal Personnel
1. Ren Bedell $385.00
2.
3.
Total Personnel
In-State
Out-of-State
Total Travel
4 :Vi�� �.�l ii 4
y fry 2e } � Any +fit s +1� qtr H 11k .s€k 5�^ qtr z x +f rta z tk t _
+ ,Y. �s+7rn,'�_�i,.
1.
2.
Total Staff Development
?W ke
. 4
1.
2.
Total Consultants
70
Amount Requested
} { �tti
f .yy t IY S41 ft 3 'lf P F 4 f4
sytr.tm.P. t„ ' ' a9 .�a 4 d .1.;.; ..
1. Educational Materials
2. Printing
3. Postage
4. Meeting Expenses
5. Office Supplies
6. Equipment
7. Phone
8. Data Collection
9. Other (describe)
Total Operating Expense
G. 2 e�3 r3 Ct t "F+r°. : i� �„?
VY 4d1C1 � p r ° :�yi ; e f : d f`5itai �' ',t :. 'b t
{ t 4:14 % tf :r"t ;:c r.,r +�1* st r ,, U •
Total Grants
; � as } 7� t✓its T fit'i1071'a 1144�itiV 5Z' : s3
'st
1. Salaries and Fringe $433.00
2.
Total Indirect Costs $433.00
TOTAL BUDGET REQUEST $2358.00
71
Year 2�000.1�-2002 Budget
flt'Sir '!�
}k'�r'x'' fr a
tits PAG.Citir el r`Ye i '�i r C':2 p!aatgosit LOCAL HEALTH DEPARTMENT: Weld County Department of Public Health & Environment
TIME PERIOD: July 1, 2001 thru June 30, 2002
FISCAL OFFICER/CONTACT PERSON: Judy Nero PHONE: _970-304-6410, ext. 2122
CATEGORY AND ANNUAL TIME ON PROJECT Amount Requested
LINE-ITEM SALARY No. of Hrs./Week
Months
E i mittN.� P w A � lr RY!' '' ti!V t 5 '3 ! ( �
d6z&- `b eel i S 5 :74 { tto 1i i 3 1}�4 5 y ! k t
p S�tl• i c 1 ! �« !.,.,_,irj� 'x i P! d � ! r
1.Tobacco Program 38,562.00 12 40 $38562
Coordinator
2.Youth Program 35,730.00 12 40 $35730
Coordinator
3.Cessation Coordinator 35,816.00 12 32 $26862
4.Office Technician II 20,256.00 12 20 $10128
$111,282
Subtotal Personnel
�CiE'a@ 2t ! t k H5g x ui a
h�
e
1.Program Coordinator $9640
2.Youth Coordinator $8933
3.Cessation Coordinator $6715
4.Office Technician II $2532
Total Personnel $139,102
X30 p,43 1,,
!kAIL : togl, y'.; 13.11,` !.,, OP:',g:7)11141-4,,
In-State $2500
Out-of-State $3800
y¢y Total Travel $6300 ((pp
! q c:} ° 4 � � i P '', l N,rd�+!P m1'wdx!e oi }ir �" i S ! �t S r
'N i s s�'5 et �S i� �#iti � J � "}� Y'� 4a �. � t���
'htt;.s
1. Community Development Training/management training $1000
2. Conference registrations for out of state training $2000
Total Staff Development $3000
tJ � f!Til �
S' t i% kx glIA r ei
.,N aS g' ^. S 3 slit'h '! ,! i �'k da t t f
p p s !
,,.,h�.. .i,x !..i.*. �r! tk ...e,r-'�' .�ti.t..',�.„!'�a.; rke 1 ita.� _atr '.,
1.Cindy Kronague- Evalaution $7000
2.Kristin Williams—Media Consultant $2500
Total Consultants $9500
72
Amount Requested
W.PR OPERATING
'�₹ d x J Mt€ • rq' .F I t�� 4�₹ ,r� x I
a"�^vx �s�'i7.r�it ����a�i� � k+,{�� �Y - i��*(` R���t.x�� F f .'13 `'4:+ �
� ,,.�i `C�'�,r� tf�`�`�..;
1. Educational Materials and incentives $6000
2. Printing $1500
3. Postage $ 800
4. Meeting Expenses $3000
5. Office Supplies $1200
6. Equipment
7. Phone
8. Data Collection $2000
9. Media $10000
Total Operating Expense $24500
~a F't w„ 41 t s e'O4 lli �' ir
, `��t,^r`...,g,11.3apturaf,;ticiy.C;?:q!'41iirailt, siti a � ,,•sI t"{< s,:s ' "
Total Grants $4800
ec+.2 Cadv ft:/`s"`45.t 11 R{, `ii'a4 a t 5> }t ,0
N "Sioi t.¢ T.
# ate.,,k.P { 1-s ii: jeA 4s_s t etroo,a t Bilr= px `s {?'°...r
1.Salaries and fringe $31298
2.
Total Indirect Costs $31298
TOTAL BUDGET REQUEST $218,500
73
Year 2002-2003 Budget
iti 9
r'`l .�P° t.[1t
LOCAL HEALTH DEPARTMENT: Weld County Department of Public Health & Environment
TIME PERIOD: July 1, 2002 thru June 30, 2003
FISCAL OFFICER/CONTACT PERSON: Judy Nero PHONE: 970-304-6410, ext 2122
CATEGORY AND ANNUAL TIME ON PROJECT Amount Requested
LINE-ITEM SALARY No. of Hrs./Week
Months A
�vt mp ' F � -',%w Ptl'Ki b'f
isb� .fd 9rL ,4 , 44 .� 'i` snt;t ��t* .``i �� tzti{ ri 4j :
.,. n d5„ 9 f ,xrfi, 0.i il .A«" j+' hx'z r pfS<A. �# o-i'a {F ` { y e {"``� { r
1.Tobacco Program 40442 12 40 40442
Coordinator
2.Youth Coordinator 37564 12 40 37564
3.Cessation Coordinator 37564 12 32 28173
4. Office Technician II 21243 12 20 10621
116,800
Subtotal Personnel
f fh i' hr'n.>3 rr 1 �x S('1 rr r t t r rr f
,li a P r.4t �'S r 1, .! * :
}�°' {'' �III
! �' 'ylYl}�"#"�S++''i {�`�il �act'�}.: a i{M�,� ,c �i f 3 � ,� ,� a
i`„�sil 1{�h^.. �4., � { Nil'+., :.p +, t;
}Ut .1 1
1.Program Coordinator 12133
2.Youth Coordinator 11270
3.Cessation Coordinator 8451
4. Ofice Technician II 3186
Total Personnel 35040
ttt�� 151,840
i^ t r- a >}r ar �,r ��, +x�. It '�t� y ys "�` tt "'� ' ti �€
�s»3�x'� y94�t�t -I : i1'i�t�'�1r� R�` �F'Ir � �s('Ih{ 't�"'+�+
In-State 3000
Out-of-State 2000
Total Travel 5000
" '� ' NT { ' i w � l of ' io o r' r r ` 11/1'14s:474-T4. a+t t rr r
k'� �� ',ir.:y r,a{Aril r.�' ,+y 'Ct !, 4 aG {, �5 v s ix;{4 S a ."•'� t �' { ' "i'u ' ,
�
w v d ad.�'th, }.r 3+s air.�' a 1' �{ � t .. , ko.
1.Staff training and development 500
2.
Total Staff Development 500 t
�S �r �r «. ' ",z a{'.. s'rn� +g::-' 4 ¢F � `H'j'�� i'iga 0,4 ,.;r njfagmi`e,14 " P i ,.
1Y 'drr ° u ^ ,, �, ° 7§°e i 4 t3R�x � -zt �`2 "`,st; ,C i ', �j ' {v r a ax t'rt
k.r inn,_ _.a P: _.. l.sr, „.:041194;:,.a{ 3 n.:, ., se-., t4141P-M;:;}; t .7,:,, ,,,�-..: , .^u .�.: .x,t , . �I
1.Evaluation Specialist 3000
2. Media Specialist 1000
Total Consultants 4000
74
Amount Requested
t 11O01n zif 4 ,
�.5. g >R6 � "` 9"1,0; 7E� f k'-`Y h,� d,' p t +�y, yy s Lx
i r £�J t (� rr '}.,� N, 7,{� ,�i! " t s- a r+ - s I S } as t
„� t .4s5ti,i _f�,.�e«`� ��''',$,5=w�h.',5�<i� ',a l,� ..;') ,�i" ...��.dL, - � •�i�'e�.1a.. t S
1. Educational Materials and incentives 3500
2. Printing 1000
3. Postage 500
4. Meeting Expenses 2500
5. Office Supplies 1000
6. Equipment
7. Phone
8. Data Collection 1500
9. Other- Media 9500
Total Operating Expense 19500
VS?po W, 9i ,k 5 Ii • :° $ ' Ih, 4
t P t �y�+� Total Grants 10000
x ut s w �, r `s { ,.22`:5>� gx sr'� e a i p
La�,pp`a 'a,ar"� ��IM „I �i9 i§ } .r ,"
r'gm-S ..n: E �Y,t0Mif � :rPisWe „�. r z,5teF. ;� t,j h.,�'eT.,�,`1S3� ,,jS '' k''t ' , ;A
I.Salaries and fringe 34164
2.
Total Indirect Costs 34164
TOTAL BUDGET REQUEST 225,004
75
Year 2003-2004 Budget
t k' encig"{dt y i E tx
;� � < v E ..5��
LOCAL HEALTH DEPARTMENT: Weld County Department of Public Health & Environment
TIME PERIOD: July 1, 2003 thru June 30, 2004
FISCAL OFFICER/CONTACT PERSON: Judy Nero PHONE: 970-304-6410, ext
2122
CATEGORY AND ANNUAL TIME ON PROJECT Amount Requested
LINE-ITEM SALARY No. of Hrs./Week
Months
110, 1 ";a �E ni ;,r14,11, }E .`�E,i � .*'lt ' .� `1Eui E+ h �+ r
� E
k„t&itti+'° (i,1,$!e r' `g,`vi., E :uS 4„ `.'., _ 'r•'`
1.Tobacco Program 42958 12 40 42958
Coordinator
2. Youth Coordinator 39810 12 40 39810
3.Cessation Coordinator 39907 12 32 29930
4. Office Technician II 22017 12 20 11008
123,706
Subtotal Personnel
a+ s @ 40011e116110449,1'
1rPUI114.0379AillP� '�
1.Program Coordinator 12888
2.Youth Coordinator 11943
3.Cessation Coordinator 8980
4. Office Technician II 3303
Total Personnel 37114
( E " � *Mt 11 E ism liti 4 w "' �I E 'Ew 160,820
�i
--0„k4,4 >m 9 h ' i ' r a ' r i* i ,�s E +k
. �.+t9 �'� 3��'� k�'in�s s7 ( 4 r � � E fiat f.E f
ydp.,,i u' *:f,. .� .? th- � �li �I - l u � 'T, t ..vg ,�.... ..E,+.i�1.,<.§r,, ,.+uc,�.. " ;•.i,
In-State 3000
Out-of-State
Total Travel 3000
S ` � z �,
,,c£ rs r ell 4 v`' i llE irN $� ', �voE ttr t z�, E
d i f^ v y 4 �'�' t� 1 "E fit' Jf r5tCS .l 1° t {J Y+ §"
il'm... . E„5. E d >.z, .1�• _ r,:, �i h„d`4 t " ,,�._ ..
1. Staff development 500
2.
Total Staff Development 500
41141111: a !;"� 7z.a :. ,rye,y?rr u>•-ra. ..,.: �' ` `di t sE.
1.Evalaution Specialist 2500
Total Consultants 2500
76
,a p Amount Requested f4°, 4-44'4.44:74414,44,44.AT444:41:,:k1 P,41,4444,0144;4414 FjfU1z , , �� £41w J `G"Aii { . , 4{
J4" iU.�,..Si + a v 2¢,. F 44: a,',', a it ,r� ." {{ i r. 5y
1. Educational Materials and incentives 2500
2. Printing 500
3. Postage 500
4. Meeting Expenses 2500
5. Office Supplies 1000
6. Equipment
7. Phone
8. Data Collection 1000
9. Media 4000
Total Operating Expense 12000
TS/ ,�. � z e:HA 'i €€ �t£a f7,j A,� bz7 s�-2°"�,t�£,:� tt��fia ,£� ,�vr 'n"��z 'a
ill
Total Grants 10000
ICs s,Q3 f, P'aR' r`s. x £, :�+4.,F 3i „.
'.i R € 3 } 4 Ni ;�y C 4# ( ,ail f L�, 40k t x
psi ` . Ind;;. { , .,::4;,it ;llj3 s- $i �, tea sti ��aMTilli€'£r . .. ' A.L'
1.Salaries and fringe 36185
2.
Total Indirect Costs 36165
TOTAL BUDGET REQUEST $225,005
77
Budget Narrative
June 1, 2001 —June 30, 2001
Salary: Program Manager $1540 + 385 fringe (25%) 20 hours week
Indirect: 22.5 of salary $433 indirect
Total: $2358 1 month
* Salary for 20 hours per week for one month for program manager's salary that was funded by the
CDC through May 31, 2001.
July 1, 2001- June 30, 2002 budget
Salary: Program Manager $38,562 + 9640 fringe (25%) 40 hours week
Youth Coordinator $35,730 + 8933 40 hours week
Cessation Coordinator * $26,862 + 6715 32 hour week
Office Technician $10,128 + 2532 20 hours week
Total: $111,282 + 27820
* Hours for the cessation coordinator were increased from a .5 FTE to a .75 FTE to provide enough
staff time to complete additional plan objectives and for evaluation
Indirect: 22.5% of salaries 31,298.00
Indirect includes phone, utilities, office space, purchasing and accounting support, and computer
services support.
In state travel includes: $2500 for mileage at .305% for travel in Weld County for meetings,
presentations, and activities for 4 staff members, travel to regional and state meetings; hotel and
meals for staff to attend 3 grantee meetings with CDPHE staff; any other appropriate training that
become available during the year.
Out of state includes: $3800for airfare, hotel and meal expenses for each of the three
coordinators to attend an out of state conference. 1) 7th Annual Tobacco Use Prevention Training
Institute in Portland, August 19 — 24, 2001; 2) National Tobacco Conference in New Orleans,
November 26 — 29, 2001 and the third to be determined.
Staff development/ training includes: $3000 for Community development training, supervisory
training for the program manager, motivational interviewing; registration fees for conferences listed
above and other workshops.
Consultants includes: $7000 for Cindy Kronague, evaluation specialist, for 115 hours @ $60
per hour to develop and assist with implementation of the program evaluation plan
$2500 for Kristin Williams, 42 hours @ $60 to develop and assist with implementation of media
for local events included in the program plan, including graphic art design.
Program and Operating Expenses include:
$6000 for educational materials such as brochures on local resources, information for public
awareness campaign, cessation materials, packets for local officials, restaurant owners, etc and
incentives for youth for all activities, cash incentives for students at UNC Rodeo Club, women
participating in the cessation program along with cotinine testing for quitters, prizes for contests,
rewards for surveys and focus group incentives.
Printing $1500 for program and resource brochures; signs, copies for presentations, meetings,
activities, surveys.
Postage $800 for mailings to coalition, partners, organizations, and agencies: surveys.
Meeting Expenses $3000 for coalition and workgroups, city council members, school board
members, teachers, partners in local agencies and organizations, youth, business owners; includes
food and supplies as incentives for attending meetings during and after business and school hours.
78
Data Collection, $2000 includes time for collecting and analysis of local data used for evaluation
such as surveys, pre and posttests, and focus groups. This includes incentives for volunteers, such
as UNC graduate students and other WCDPHE staff, to collect and enter data.
Media, 10,000, includes supplies, signage, booths and supplies for Greeley Independence
Stampede Parade on Fourth of July, Greeley Arts Fair, Weld County 4H Fair, Festiva Days and Cinco
De Mayo; Bench ads for supporting of cessation; signs for Island Grove Park's new facility (smoke
free); newspaper adds.
Mini Grant $4800 —TFWC will collaborate with Centennial Area Health Education Center
(CAHEC) to develop and plan an educational program for dental care providers in Weld County
regarding brief intervention counseling and effective dental office protocol for tobacco cessation
based on AHQR clinical guidelines. This collaboration will enable TFWC to meet outcome objectives
2.1.1 and 2.1.2. The CAHEC will submit a detailed proposal with a line item budget. The proposal
will include a needs assessment, program development, marketing, implementation, and evaluation
of the program. CAHEC will determine the current level of intervention, the appropriate type of
training and trainer, market, implement and evaluate the training. They will develop and mail
program brochures, provide educational and evaluation materials for the training, pay trainer fees
and fee for venue. They will work with TFWC to assure the training that is developed and presented
meets the objectives of the grant.
79
Statement of Disclosure
By signing this statement, the grantee 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. �� . C
Signed: W' t ,i l Q NGQi20L ,C Date: 3(21-{ al
Title: Director
Organization: Weld County Department of Public Health & Environment
Tobacco Free Weld County 2001-2002 Evaluation Plan
Goal: PREVENT INITIATION OF TOBACCO USE AMONG YOUTH.
Strategy: Promote tobacco-free schools
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, 70% Proportion of Greeley District 6 Self-report student Start and end of Sample of N=80,
of District Six middle and high school health and feedback 2001-2002 school using a random self-
middle/high school physical education reporting a questionnaire year. report questionnaire.
health and P.E. students decreased intention to use tobacco developed by
will report a decreased products. TFWC staff.
intention to use tobacco
products.
By June 30, 2002, Proportion of Greeley District 6 Observation Beginning and end of All Greeley District 6
increase by 30%the middle and high schools with CDC checklist 2001-2002 school middle and high
number of District Six defined quality school tobacco use developed and year. schools.
middle/high schools prevention programs. conducted by
that are implementing TFWC staff.
four of CDC's seven
recommendations for
ensuring a quality
school program to
prevent tobacco use.
1
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: PREVENT INITIATION OF TOBACCO USE AMONG YOUTH.
Strategy: Promote youth advocacy and empowerment
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, there Number of youth led tobacco Official records. End of grant cycle. All youth led tobacco
will be 6 youth led prevention events in the greater prevention events in
tobacco prevention Greeley area. the greater Greeley
events in the greater area.
Greeley area.
By June 30,2002 Proportion of funded greater Greeley Observation by Start and end of grant All funded greater
increase tobacco youth advocacy groups staff. cycle. Greeley youth
prevention advocacy demonstrating improved public advocacy groups.
skills of funded youth speaking or letter writing skills.
advocacy groups in the
greater Greeley area by Proportion of participating youth Youth advocacy All training
40%. advocates reporting improved training Start of grant cycle participants.
tobacco prevention advocacy skills. evaluation forms. and post trainings.
2
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: PREVENT INITIATION OF TOBACCO USE AMONG YOUTH.
Strategy: Decrease youth access to tobacco products
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, 30% Proportion of greater Greeley area Observation by Beginning and end of All greater Greeley
of greater Greeley gas gas stations and convenience TFWC staff or grant cycle. area gas stations and
station and retailers displaying signage more their designated convenience retailers.
convenience store than three feet from ground level representative.
tobacco retailers will and not in the same aisle as candy
move tobacco and toy products.
advertising above three
feet and away from
candy or toy products.
By June 30, 2002, at Proportion of greater Greeley area Direct Beginning and end of All greater Greeley
least 90% of greater gas stations and convenience observation grant cycle. area gas stations and
Greeley gas station and retailers refusing to sell tobacco through retailer convenience retailers.
convenience store products to minors. compliance
tobacco retailers will checks.
refuse to sell tobacco
products to minors.
3
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: PREVENT INITIATION OF TOBACCO USE AMONG YOUTH.
Strategy: Decrease pro-tobacco influences
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, all Proportion of Greeley City park Official Record End of grant cycle. All Greeley City park
21 Greeley City park playground areas and/or 3 youth from city council playground areas
playground areas skate parks will have a 50-foot and posting of and/or 3 youth skate
and/or 3 youth skate tobacco-free kid zone around them. signs at parks. parks. Posting of
parks will have a 50- tobacco-free kid zone
foot tobacco-free kid signs.
zone around them.
By June 30, 2002, the Policy in place Official record End of grant cycle. Festiva Days Family
Northern Colorado Event no tobacco
Hispanic/Latino advertising policy.
Chamber of Commerce Official record from
members will adopt a Northern Colorado
no tobacco advertising Hispanic/Latino
policy for the new Chamber of
Festiva Days Family Commerce members
Event.
4
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: PROMOTE CESSATION AMONG YOUTH AND ADULTS.
Strategy: Promote availability of effective cessation services and/or resources.
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, at Number of greater Greeley area Official TFWC End of grant cycle. All greater Greeley
least 2 dental clinics in dental clinics with effective tobacco records. area dental clinics.
Greeley will have cessation protocol in place.
effective tobacco
cessation protocol in
place based on the
AHQR clinical practice
guidelines for treating
tobacco use and
dependence.
By June 30, 2002, Proportion of dental clinic smoking Dental clinic Ongoing, every six All smoking patients
increase to 50%the patients referred to local or state referral feedback months. at identified dental
number of smoking cessation services. form developed by clinics.
patients at 2 local staff
dental clinics who are
referred to the state
quit-line.
5
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: PROMOTE CESSATION AMONG YOUTH AND ADULTS.
Strategy: Promote availability of effective cessation services and/or resources.
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, the Number of participants in Official TFWC, End of grant cycle. All participants.
Weld County Prenatal established program. First Steps
Plus Program and the Prenatal Plus, and
First Steps Prenatal WCDPHE
Care Program will Prenatal Plus
implement a program records
utilizing education,
social support and
financial incentives to
increase quit attempts
by pregnant smokers.
6
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: PROMOTE CESSATION AMONG YOUTH AND ADULTS.
Strategy: Promote public awareness for non-use and decrease social acceptability of tobacco use.
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, Proportion of Weld County residents Survey Before and after the Use of phone and/or
public awareness of who report learning a new hazard to Summer 2001 Public mail surveys among
greater Greeley tobacco use from the Summer 2001 Awareness greater Greeley
residents regarding the Public Awareness Campaign. Campaign. residents (n=96).
hazards of tobacco use
will be raised by 70%.
By June 30, 2002, Proportion of Weld County residents Survey Before and after the Use of phone and/or
decrease the social who are aware of the percent of Summer 2001 Public mail surveys among
acceptability of tobacco Weld County resident non-smokers. Awareness greater Greeley
use by 50% among Campaign. residents (n=96).
greater Greeley
residents.
By June 30, 2002, five Number of Weld County businesses Official TFWC End of grant cycle. All Weld County
businesses in Weld that distribute information about records. businesses.
County will hazards of tobacco use to their
disseminate employees.
information to their
employees regarding
the hazards of tobacco
use to their employees.
7
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: PROMOTE CESSATION AMONG YOUTH AND ADULTS.
Strategy: Promoting youth cessation programs.
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, Proportion of Greeley District 6 Official TFWC End of grant cycle. 8 District 6 (high)
increase the availability (high) schools with youth cessation records. schools.
of youth cessation services.
services from 0 to 2 in
Greeley District 6
schools.
By June 30, 2002, after Proportion of smoking youth in School cessation Ongoing, every All participating
completion of N.O.T participating cessation programs program report semester. school cessation
program 20% of the reporting quit attempts. forms. programs.
youth participants will
attempt to quit.
8
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: REDUCE EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE.
Strategy: Promote public awareness on the hazards of ETS exposure and benefits of smoke-free environments.
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, Proportion of greater Greeley Survey Before and after "n"=96 phone and/or
increase the residents who can identify at least 1 Summer 2001 Public mailing surveys (90%
knowledge of greater harmful effect of ETS. Awareness confidence level).
Greeley residents Campaign.
regarding the harmful
effects of ETS by
70%.
By June 30, 2002, The Proportion of Greeley City Council Number of votes End of grant cycle. 7 Greeley city council
majority of Greeley members who vote for an improved cast. members.
City Council members City of Greeley smoking ordinance.
will vote for an
improved City of
Greeley smoking
ordinance.
9
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: REDUCE EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE.
Strategy: Promote smoke-free public places
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, Proportion of greater Greeley area Official TFWC Beginning and end of All greater Greeley
increase smoke-free restaurants that are smoke-free. records. grant cycle. area restaurants.
restaurants in greater
Greeley from 25%to
40%.
By June 30, 2002, Proportion of hotline reports WCDPHE End of grant cycle. All hotline reports for
Follow up on 80% of resulting in improved indoor smoke- official records Greeley area enclosed
indoor air quality free policies. documenting public places.
complaints submitted complaint and
to new indoor-air- policy created to
quality hotline. resolve
complaint.
Proportion of hotline reports WCDPHE End of grant cycle. All hotline reports for
resulting in increased compliance official records Greeley area enclosed
with indoor smoke-free policies. documenting public places.
changes made to
environment or
policy.
Proportion of greater Greeley area WCDPHE End of grant cycle. All hotline reports for
enclosed public places with reported official records Greeley area enclosed
complaints who are found to be documenting public places.
compliant at 3 month follow-up. indoor air quality
on follow-up
visits
10
Tobacco Free Weld County 2001-2002 Evaluation Plan (continued)
Goal: REDUCE EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE.
Strategy: Promote smoke-free workplaces
Outcome Indicators Data Collection Frequency/Schedule Sample Size and
Objective Methods/Tools of Data Collection Sample Strategy
By June 30, 2002, at
least 30%of small Proportion of small businesses in Observation by End of grant cycle. All Windsor, Eaton,
businesses in Windsor, Windsor, Eaton, Evans, and LaSalle staff and Evans, and LaSalle
Eaton, Evans, and with smoke-free workplace WCDPHE official small businesses.
LaSalle without an policies. records.
existing policy will
develop smoke-free
workplace policies.
By June 30, 2002, at Proportion of Greeley area Restaurant owner End of grant cycle. All Greeley area
least 60% of restaurant restaurant owners who support an survey/petition restaurant owners.
owners in Greeley will improved City of Greeley smoking developed by staff
support an improved ordinance. (will use existing
City of Greeley if possible).
smoking ordinance.
11
Attachment B
CONTRACT REIMBURSEMENT STATEMENT
To: Colorado Department of Public Health&Environment From:
Health Promotion and Disease Prevention Division
State Tobacco Education&Prevention Partnership
HPDP-STEPP-A5
4300 Cherry Creek Dr. South
Denver,CO 80246-1530 Federal Tax ID #:
Attn: Karen DeLeeuw,Program Manager
TOBACCO EDUCATION,PREVENTION AND CESSATION GRANT—SETTLEMENT FUNDS
Time Period Covered by this Statement From: To:
Final Billing? Yes No
Reimbursement Match
EXPENDITURES Requested Provided
Personnel(Name): $ $ Not Required
Fringe Benefits @(%): $ $ Not Required
Travel—Local and In-state $ $ Not Required
Travel—Out-of-state $ $ Not Required
Program Supplies and Operations $ $ Not Required
Staff Development $ $ Not Required
Other:
Consultants/Trainers $ $ Not Required
Data Collection $ $ Not Required
Media Purchase $ $ Not Required
$ $ Not Required
$ $ Not Required
Total Direct Costs: $ $ Not Required
Indirect Costs @(%): $ $ Not Required
Total Reimbursement Requested $ $ Not Required
This is to certify that the above expenses were incurred per Contract# during the time period stated
above.
CONTRACTOR SIGNATURE: Date:
I hereby certify that all contract requirements have been met and the amounts billed are correct. Payment
is authorized.
CDPHE Program Director
or Authorized Designee: Date:
STATE OF COLORADO
Bill Owens,Governor Jane E. Norton,Executive Director 4.;Or cp z0.
.py,
Dedicated to protecting and improving the health and environment of the people of Colorado at
p\i
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division ':*, *•/
Denver,Colorado 80246-1530 8100 Lowry Blvd. line
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.coms and Environment
[Date] Sample Task Order Change Order Letter Attachment C
State Fiscal Year**** -***!`**, Task Order Change Order Letter Number**,
Contract Routing Number** *0* ***** **********Program
This Task Order Change Order Letter is between the Colorado Department of Public Health and Environment and the Legal
Name of the Contractor. This Task Order Change Order Letter is issued in accordance with paragraph F. 3. of the Master
Contract with contract routing number** *** ***** and,paragraph C3. of the Task Order with contract routing number**
*** *****and contract encumbrance number** *** **********. That Task Order has been amended by Task Order
Change Order Letter**,contract routing number** *** *****, and/or Task Order Renewal Order Letter**,contract routing
number** ********. (Strike or modify as appropriate.) The Task Order, as amended,is hereinafter referred to as the
"Original Task Order". The Original Task Order is incorporated herein by this reference,made a part hereof, and attached
*„ ********* ** **** through********* ** ****
hereto as"Attachment The parties hereto agree that for the term from g •
the maximum amount payable by the State for the work referenced in Part B. of the Original Task Order is
increased/decreased by*Dollars, ($*.**) for an amended total financial obligation of the State to the Contractor of
DOLLARS, ($*.**). The revised Scope of Work and the revised Budget are incorporated herein by this reference, made a
part hereof and attached hereto as"Attachment 1" and"Attachment 2", respectively. The first sentence in paragraph CC1 of
the Original Task Order is hereby modified accordingly. All other terms and conditions of the Original Task Order are
hereby reaffirmed. The proposed effective date of this Task Order Change Order Letter is ********* **, ****. However,
in accordance with section 24-30-202(1),C.R.S.,as amended,the effective date of this Task Order Change Order Letter is the
date it is approved by the State Controller. In no event shall this Task Order Change Order Letter be deemed valid until it
shall have been approved by the State Controller or such assistant as he may designate. 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.
Contractor's Legal Name STATE OF COLORADO
(legal type of entity) Bill Owens,Governor
By: SAMPLE ONLY By: SAMPLE ONLY
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC HEALTH
FEIN: AND ENVIRONMENT
APPROVALS:
FOR THE STATE CONTROLLER: PROGRAM:
Arthur L.Barnhart, State Controller
By: SAMPLE ONLY By: SAMPLE ONLY
STATE OF COLORADO
Bill Owens,Governor pF•Co�
Jane E.Norton,Executive Director ,�W = R
Dedicated to protecting and improving the health and environment of the people of Colorado cn
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division
Denver,Colorado 80246-1530 8100 Lowry Blvd. ' s`/876"..'
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
[Date] Sample Task Renewal Letter Attachment D
State Fiscal Year**** - ****, Task Order Change Renewal Letter Number**,
ram
** *** ***** ***am**Pro
Contract Routing Number g
This Task Order Renewal Letter is between the Colorado Department of Public Health and Environment and the Legal Name
of the Contractor. This Task Order Renewal Letter is issued in accordance with paragraph F.4.of the Master Contract with
contract routing number** *** ***** and,paragraph C. 3. of the Task Order with contract routing number** *** *****
and contract encumbrance number** *** **********. That Task Order has been amended by Task Order Change Order
Letter**,contract routing number** *** *****, and/or Task Order Renewal Order Letter*",contract routing number**
********. (Strike or modify as appropriate.) The Task Order, as amended, is hereinafter referred to as the"Original Task
Order". The Original Task Order is incorporated herein by this reference, made a part hereof, and attached hereto as
"Attachment*". The parties hereto agree that the Original Task Order is renewed for the term from********* ** ****,
through********* ** ****.The maximum amount payable by the State for the continued performance of the work
referenced in Part B. of the Original Task Order for this renewed term is *Dollars,($*.**). The amended total financial
obligation of the State to the Contractor is *DOLLARS,($*.**). The Budget for the renewed term is incorporated herein by
this reference,made a part hereof and attached hereto as"Attachment 1". The first sentence in paragraph CC1 of the
Original Task Order is hereby modified accordingly. All other terms and conditions of the Original Task Order are hereby
reaffirmed. The proposed effective date of this Task Order Renewal Letter is ********* **, ****. However, in accordance
with section 24-30-202(1), C.R.S., as amended,the effective date of this Task Order Renewal Letter is the date it is approved
by the State Controller. In no event shall this Task Order Renewal Letter be deemed valid until it shall have been approved
by the State Controller or such assistant as he may designate. Please sign,date,and return all**originals of this Task Order
Renewal 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 Renewal Order Letter will be returned to you when fully approved.
Contractor's Legal Name STATE OF COLORADO
(legal type of entity) Bill Owens,Governor
By: SAMPLE ONLY By: SAMPLE ONLY
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC HEALTH
FEIN: AND ENVIRONMENT
APPROVALS:
FOR THE STATE CONTROLLER: PROGRAM:
Arthur L.Barnhart, State Controller
By: SAMPLE ONLY By: SAMPLE ONLY
nuacnment 13
CONTRACT REIMBURSEMENT STATEMENT
• To: Colorado Department of Public Health&Environment Front
Health Promotion and Disease Prevention Division
State Tobacco Education&Prevention Partnership
HPDP-STEPP-A5
4300 Cherry Creek Dr.South
Denver,CO 80246-1530 Federal Tax ID#:
Attn: Karen DeLeeuw, Program Manager
TOBACCO EDUCATION,PREVENTION AND CESSATION GRANT-SETTLEMENT FUNDS
Time Period Covered by this Statement From: To:
Final Billing?_Yes No
Reimbursement Match
EXPENDITURES Requested Provided
Personnel(Name): $ $ Not Required
Fringe Benefits @(%): $ $ Not Required
Travel—Local and In-state $ $ Not Required
Travel—Out-of-state $ $ Not Required
Program Supplies and Operations $ $ Not Required
Staff Development $ $ Not Required
Other:
Consultants/Trainers $ S Not Required
Data Collection $ S Not Required
Media Purchase $ $ Not Required
•
$ $ Not Required
$ $ Not Required
Total Direct Costs: $ $ Not Required
Indirect Costs @(%): $ $ Not Required
Total Reimbursement Requested $ $ Not Required
This is to certify that the above expenses were incurred per Contract# during the time period stated
above.
CONTRACTOR SIGNATURE: Date:
/hereby certify that all contract requirements have been met and the amounts billed are correct. Payment
is authorized.
CDPHE Program Director
or Authorized Designee: Date:
STATE OF COLORADO
Bill Owens,Governor
lane E.Norton,Executive Director R4.oF'C
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division
*
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
[Date] Sample Task Order Change Order Letter Attachment C
State Fiscal Year****- '****, Task Order Change Order Letter Number",
Contract Routing Number** *** ***** ********** Program
This Task Order Change Order Letter is between the Colorado Department of Public Health and Environment and the Legal
Name of the Contractor. This Task Order Change Order Letter is issued in accordance with paragraph F_3.of the Master
Contract with contract routing number•• *** and,paragraph C. of the Task Order with contract routing number "
*** and contract encumbrance number** *** **•*•****'. That Task Order has been amended by Task Order
Change Order Letter!*,contract routing number** *** *'*** and/or Task Order Renewal Order Letter** contract routing
number'* ********. (Strike or modify as appropriate.) The Task Order,as amended, is hereinafter referred to as the
"Original Task Order". The Original Task Order is incorporated herein by this reference,made a part hereof,and attached
hereto as"Attachment*". The parties hereto agree that for the term from********* *« **** through'«****«** ** ****
the maximum amount payable by the State for the work referenced in Part B. of the Original Task Order is
increased/decreased by* Dollars,($*.**) for an amended total financial obligation of the State to the Contractor of
DOLLARS,($*.**). The revised Scope of Work and the revised Budget are incorporated herein by this reference,made a
part hereof and attached hereto as"Attachment 1"and"Attachment 2",respectively. The first sentence in paragraph C_1 of
the Original Task Order is hereby modified accordingly. All other terms and conditions of the Original Task Order are
hereby reaffirmed. The proposed effective date of this Task Order Change Order Letter is '*****'** ** ***« However,
in accordance with section 24-30-202(1),C.R.S.,as amended, the effective date of this Task Order Change Order Letter is the
date it is approved by the State Controller. In no event shall this Task Order Change Order Letter be deemed valid until it
shall have been approved by the State Controller or such assistant as he may designate. 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.
Contractor's Leal Name STATE OF COLORADO
(legal type of entity) Bill Owens,Governor
By: SAMPLE ONLY By: SAMPLE ONLY
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC HEALTH
FEIN: AND ENVIRONMENT
APPROVALS:
FOR THE STATE CONTROLLER: PROGRAM:
Arthur L.Barnhart,State Controller
By: SAMPLE ONLY By: SAMPLE ONLY
7 .
STATE OF COLORADO
Bill Owens,Governor
Jane E.Norton,Executive Director lerg
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division * *
Denver,Colorado 80246-1530 8100 Lowry Blvd.
Phone(303)692-2000 Denver,Colorado 80230-6928 .1876•
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado
htrpJ/www.cdphe.state.co.os of Public Health
and Environment
[Date] Sample Task Renewal Letter Attachment D
State Fiscal Year**** - ****, Task Order Change Renewal Letter Number**,
Contract Routing Number** *** ***** Program
s*srss*sss
This Task Order Renewal Letter is between the Colorado Department of Public Health and Environment and the Legal Name
of the Contractor. This Task Order Renewal Letter is issued in accordance with paragraph F.4. of the Master Contract with
contract routing number** *** and,paragraph C. of the Task Order with contract routing number** s*s sss**
and contract encumbrance number** *** *********s That Task Order has been amended by Task Order Change Order
Letter!*,contract routing number** *** ****s and/or Task Order Renewal Order Letter**,contract routing number**
********. (Strike or modify as appropriate.) The Task Order,as amended,is hereinafter referred to as the"Original Task
Order". The Original Task Order is incorporated herein by this reference, made a part hereof,and attached hereto as
"Attachment*". The parties hereto agree that the Original Task Order is renewed for the term from********* ** ****
through********* **, ****,The maximum amount payable by the State for the continued performance of the work
referenced in Part B. of the Original Task Order for this renewed term is*Dollars, ($*.**). The amended total financial
obligation of the State to the Contractor is*DOLLARS,($*.**). The Budget for the renewed term is incorporated herein by
this reference, made a part hereof and attached hereto as"Attachment 1". The first sentence in paragraph C_1 of the
Original Task Order is hereby modified accordingly. All other terms and conditions of the Original Task Order are hereby
reaffirmed. The proposed effective date of this Task Order Renewal Letter is ********* ** **** However,in accordance
with section 24-30-202(1),C.R.S.,as amended,the effective date of this Task Order Renewal Letter is the date it is approved
by the State Controller. In no event shall this Task Order Renewal Letter be deemed valid until it shall have been approved
by the State Controller or such assistant as he may designate. Please sign,date,and return all**originals of this Task Order
Renewal 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 Renewal Order Letter will be returned to you when fully approved.
Contractor's Legal Name STATE OF COLORADO
(legal type of entity) Bill Owens,Governor
By: SAMPLE ONLY By: SAMPLE ONLY
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC HEALTH
FEIN: AND ENVIRONMENT
APPROVALS:
FOR THE STATE CONTROLLER: PROGRAM:
Arthur L. Barnhart,State Controller
By: SAMPLE ONLY By: SAMPLE ONLY
Hello