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Home My WebLink About20211572.tiffRESOLUTION RE: APPROVE TASK ORDER CONTRACT FOR COMMUNITIES THAT CARE YOUTH SUBSTANCE ABUSE PREVENTION PROGRAM AND AUTHORIZE CHAIR TO SIGN AND SUBMIT ELECTRONICALLY 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 Contract for the Communities that Care Youth Substance Abuse Prevention Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Health and Environment, and the Colorado Department of Public Health and Environment, Division of Prevention Services, commencing upon full execution of signatures, and ending June 30, 2022, with further terms and conditions being as stated in said contract, and WHEREAS, after review, the Board deems it advisable to approve said contract, 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 Contract for the Communities that Care Youth Substance Abuse Prevention Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Health and Environment, and the Colorado Department of Public Health and Environment, Division of Prevention Services, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to electronically sign and submit said contract. CC : 1-1 LCT&) 07/06,1-21 2021-1572 HL0053 TASK ORDER CONTRACT FOR COMMUNITIES THAT CARE YOUTH SUBSTANCE ABUSE PREVENTION PROGRAM PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 16th day of June, A.D., 2021. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: ' ' Weld County Clerk to the Board BY: Lk APPR• D AS T County Attorney Date of signature: JilI Z3/ Z� Deputy Clerk to the Board Steve Mgreno, Chair ames, Pro - Lori S reeman 2021-1572 HL0053 Con, z0 #t-1gc c Memorandum TO: FROM: DATE: SUBJECT: Steve Moreno, Chair Board of County Commissioners Mark Lawley, Executive Director Department of Public Health & Environment June 8, 2021 FY21-22 Communities That Care (CTC) Youth Substance Abuse Prevention Program Task Order Contract with CDPHE For the Board's approval is a task order contract between the Colorado Department of Public Health and Environment (CDPHE) and the Board of County Commissioners of Weld County for the use and benefit of the Weld County Department of Public Health and Environment (WCDPHE). CDPHE provides substance use prevention funding to support local public health agencies from monies received via marijuana tax revenues. The funding will be used to support staff and efforts to implement the "Communities that Care" model to address youth substance abuse prevention, including marijuana, opioids (including heroin or prescription drugs), and alcohol. With the approval of the Board, the WCDPHE will enter into a new contract with CDPHE. The contract becomes effective July 1, 2021 and ends June 30, 2022. The budget amount for year one is $167,000.00. Activities will be conducted by current staff; no additional FTE is being requested. Assistant Weld County Attorney, Karin McDougal, has reviewed this contract and determined that its terms are acceptable. The Board approved placement of this contract on the Board's agenda via pass -around dated June 7, 2021. I recommend approval of this FY21-22 Communities That Care (CTC) Youth Substance Abuse Prevention Program Task Order Contract with CDPHE. 2021-1572 E-1 L0053 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW TITLE: FY21-22 Communities That Care (CTC) Youth Substance Abuse Prevention Program Task Order Contract with CDPHE DEPARTMENT: PUBLIC HEALTH & ENVIRONMENT PERSON REQUESTING: Mark Lawley, Executive Director DATE: June 7, 2021 Brief description of the problem/issue: For the Board's review and approval is a task order contract between the Colorado Department of Public Health and Environment (CDPHE) and the Board of County Commissioners of Weld County for the use and benefit of the Weld County Department of Public Health and Environment (WCDPHE). CDPHE provides substance use prevention funding to support local public health agencies from monies received via marijuana tax revenues. The funding will be used to support staff and efforts to implement the "Communities that Care" model to address youth substance abuse prevention, including marijuana, opioids (including heroin or prescription drugs), and alcohol. With the approval of the Board, the WCDPHE will enter into a new contract with CDPHE. The contract becomes effective July 1, 2021 and ends June 30, 2022. The budget amount for year one is $167,000.00. Activities will be conducted by current staff; no additional FTE is being requested. Assistant Weld County Attorney, Karin McDougal, has reviewed this contract and determined that its terms are acceptable. What options exist for the Board? (include consequences, impacts, costs, etc. of options): Approving and signing the contract will enable the Health Department to better address youth drug use prevention and the emerging use of marijuana and opioids in Weld County and identify sustainable local or regional strategies for ongoing implementation of youth substance abuse prevention strategies. Declining this contract may result in increased drug use by youth, including the loss of $167,000.00 in drug use prevention funding. Recommendation: I recommend approval of this task order contract with CDPHE for our Communities that Care program. Perry L. Buck Mike Freeman Scott K. James, Pro-Tem Steve Moreno, Chair Lori Saine Approve Recommendation 4_ Schedule Work Session Other/Comments: cid vek DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1DlE536773 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT CONTRACT ROUTING NO. 2022*0168 APPROVED TASK ORDER CONTRACT - WAIVER #154 This task order contract is issued pursuant to master contract made on 11/23/2016, with routing number 13 FAA 00051. STATE: State of Colorado for the use & benefit of the Department of Public Health and Environment Prevention Services Division Injury and Violence Prevention - Mental Health Promotion 4300 Cherry Creek Drive South Denver, Colorado 80246 CONTRACT MADE DATE: 4/14/2021 TERM: This contract shall be effective upon approval by the State Controller, or designee, or on 7/1/2021, whichever is later. The contract shall end on 06/30/2022. PROCUREMENT METHOD: RFA 32714 BID/RFP/LIST PRICE AGREEMENT NUMBER N/A LAW SPECIFIED VENDOR STATUTE: N/A STATE REPRESENTATIVE: Ali Maffey, MSW Policy and Communication Unit Supervisor VIP-MHP Branch Prevention Services Division 4300 Cherry Creek Drive South Denver, Colorado 80246 CONTRACTOR: Board of County Commisioners of Weld County (a political subdivision of the state of Colorado) 1150 "O" Street, Greeley, Colorado 80631 for the use and benefit of the Weld County Department of Public Health and Environment 1555 North 17th Avenue Greeley, Colorado 80631 CONTRACTOR DUNS: 75757955 CONTRACTOR ENTITY TYPE: Political Subdivision BILLING STATEMENTS RECEIVED: Monthly STATUTORY AUTHORITY: Not Applicable CLASSIFICATION: Subrecipient CONTRACT PRICE NOT TO EXCEED: $167,000.00 FEDERAL FUNDING DOLLARS: STATE FUNDING DOLLARS: $167,000.00 OTHER FUNDING DOLLARS: Specify "Other": MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR: FY22: $167,000.00 PRICE STRUCTURE: Cost Reimbursement CONTRACTOR REPRESENTATIVE: Mark Lawley, Executive Director 1555 North 17th Avenue Greeley Colorado 80631 PROJECT DESCRIPTION: Implement the "Communities that Care" model to identify evidence -based or evidence -informed youth substance abuse prevention strategies and identify sustainable local or regional strategies for ongoing implementation of youth substance abuse prevention strategies Page 1 of 5 Ver 18.03.20 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1DlE53B773 EXHIBITS: The following exhibits are hereby incorporated: Exhibit A - Additional Provisions Exhibit B - Statement of Work Exhibit C - Budget Exhibit D - Sample Option Letter GENERAL PROVISIONS The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task Order Contract provide more specificity than these general clauses, the more specific provision shall control. 1. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall be performed according to the standards, terms and conditions set forth in the Master Contract. 2. In accordance with section 24-30-202(1), C.R.S., as amended, this Task Order Contract is not valid until it has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not authorized to, and shall not; commence performance under this Task Order Contract until this Task Order Contract has been approved by the State Controller or delegee. The State shall have no financial obligation to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order Contract on or before its proposed effective date, then the Contractor shall commence performance under this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order Contract after its proposed effective date, then the Contractor shall only commence performance under this Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through and including the date specified on page one of this Task Order Contract, unless sooner terminated by the parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract. Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of the terms and conditions of this Task Order Contract. 3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated, the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event of conflicts or inconsistencies between the Master Contract and this Task Order Contract (including its exhibits Page 2 of 5 Ver 18.03.20 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1D1E53B773 and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 4) the Additional Provisions - Exhibit A, and its attachments if included, to this Task Order Contract; 5) the Scope/Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other exhibits/attachments to this Task Order Contract in their order of appearance. 4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and attached hereto as "Exhibit B" and "Exhibit C". 5. The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this Task Order Contract's Statement of Work through a contract amendment. To be effective, the amendment must be signed by the State and the Contractor, and be approved by the State Controller or an authorized delegate thereof. This contract is subject to such modifications as may be required by changes in Federal or State law, or their implementing regulations. Any such required modification shall automatically be incorporated into and be part of this Task Order Contract on the effective date of such change as if fully set forth herein. 6. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work - Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the Contractor shall also meet those standards of performance under this Task Order Contract. 7. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective Date is on or after July 1, 2009 and the maximum amount payable to Contractor hereunder is $100,000 or higher] By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the provisions of CRS §24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order Contract, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation of Contractor's performance shall be part of the normal contract administration process and Contractor's performance will be systematically recorded in the statewide Contract Management System. Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the performance of Contractor's obligations under this Task Order Contract shall be determined by the specific requirements of such obligations and shall include factors tailored to match the requirements of the Statement of Project of this Task Order Contract. Such performance information shall be entered into the statewide Contract Management System at intervals established in the Statement of Project and a final review and rating shall be rendered within 30 days of the end of the Task Order Contract term. Contractor shall be notified following each performance and shall address or correct any identified problem in a timely manner and maintain work progress. Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the performance measures established under the Statement of Project, the Executive Director of the Colorado Department of Personnel and Administration (Executive Director), upon request by the Colorado Department of Public Health and Environment and showing of good cause, may debar Contractor and Page 3 of 5 Ver 18.03.20 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1DlE53B773 prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS §24-105-102(6)), or (ii) under CRS §24-105-102(6), exercising the debarment protest and appeal rights provided in CRS §§24-109-106, 107, 201 or 202, which may result in the reversal of the debarment and reinstatement of Contractor, by the Executive Director, upon showing of good cause. 8. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and its agent(s) shall at all times during the term of this contract strictly adhere to all applicable federal laws, state laws, Executive Orders and implementing regulations as they currently exist and may hereafter be amended. Without limitation, these federal laws and regulations include the Federal Funding Accountability and Transparency Act of 2006 (Public Law 109-282), as amended by §6062 of Public Law 110-252, including without limitation all data reporting requirements required there under. This Act is also referred to as FFATA. Page 4 of 5 Ver 18.03.20 DocuSign Envelope ID:41902EEA-D080-4C92-A2F8-AD1D1E53B773 SIGNATURE PAGE Contract Routing Number: 2022*0168 THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT Each person signing this Contract represents and warrants that he or she is duly authorized to execute this Contract and to bind the Party authorizing his or her signature. CONTRACTOR Board of County Commissioners of Weld County for the use and benefit of the Weld County Department of Public Health and Environment �DocuSigned by: Slug, Itthrua `-E04467D642AE4A7 By: Signature STEVE MORENO Name of Person Signing for Contractor COUNTY COMMISSIONER CHAIR Title of Person Signing for Contractor Date: 2021-06-17 STATE OF COLORADO Jared S. Potts, Governor Colorado Department of Public Health and Environment Jill Hunsaker Ryan, MPH, Executive Director e—Docusigned by: Usti. kci,emulA, '-2EDF870A1A7D4FC By: Signature Lisa McGovern Name of Executive Director Delegate Procurement & Contracts Section Director ft Title of Executive Director Delegate Date: 2021-06-17 In accordance with §24-30-202 C.R.S., this Contract is not valid until signed and dated below by the State Controller or an authorized delegate. STATE CONTROLLER Robert Jaros, CPA, MBA, JD DocuSigned by: 368F8AFC06514C4... By: Signature Travis Yoder Name of State Controller Delegate Controller Title of State Controller Delegate Contract Effective Date: 2021-06-18 -- Signature Page End -- Page 5 of 5 Ver 18.03.20 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1 D1 E53B773 EXHIBIT A ADDITIONAL PROVISIONS To Original Contract Routing Number 2022*0168 These provisions are to be read and interpreted in conjunction with the provisions of the Contract specified above. 1. To receive compensation under the Contract, the Contractor shall submit a signed Monthly schedule CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website https://cdphe.colorado.gov/standardized-invoice-form and is incorporated and made part of this Contract by reference. CDPHE will provide technical assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form and Expenditure Details page must be submitted no later than forty-five (45) calendar days after the end of the billing period for which services were rendered. Expenditures shall be in accordance with this Statement of Work and Budget. Scan the completed and signed CDPHE Reimbursement Invoice Form into an electronic document. Email the scanned invoice with the Excel workbook containing the Expenditure Details page to: Alison Maffey, ali.maffey@state.co.us Final billings under the Contract must be received by the State within a reasonable time after the expiration or termination of the Contract; but in any event no later than forty-five (45) calendar days from the effective expiration or termination date of the Contract. Unless otherwise provided for in the Contract, "Local Match", if any, shall be included on all invoices as required by funding source. 2. Time Limit For Acceptance Of Deliverables. a. Evaluation Period. The State shall have thirty (30) calendar days from the date a deliverable is delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables that have a different time negotiated by the State and the Contractor. b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design specifications for that particular deliverable, or is otherwise deficient, then the State shall notify the Contractor of the failure or deficiencies, in writing, within fifteen (15) calendar days of: 1) the date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or deficiency. The above time frame shall apply to all deliverables except for those deliverables that have a different time negotiated by the State and the Contractor in writing pursuant to the State's fiscal rules. c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed deliverable, the Contractor shall have a reasonable period of time, not to exceed thirty (30) calendar days, to correct the noted deficiencies. 3. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this Contract does not constitute a Business Associate relationship under HIPAA. 4. This award does not include funds for Research and Development. 5. If Contractor indicates full expenditure of funds under this Contract by February 28 of each grant year and the full expenditure does not occur, CDPHE has the option to reduce current or upcoming Contract by said amount or a percent deemed reasonable by CDPHE. The State will notify the Contractor of the potential need to decrease the current or upcoming budget. If the Contractor indicates at a later date than February 28 of each grant year an expectation of surplus of funds or inability to fully expend said funds for unforeseen circumstances that Contractor had not anticipated by February 28, CDPHE will reallocate unspent funds without any penalties to the Contractor. Page 1 of 2 Original Contract Number2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1DlE53B773 EXHIBIT A Upon receipt of timely written notice of an objection by the State for inability to fully expend funds, the Contractor shall have a reasonable period of time not to exceed ten (10) calendar days to respond to the action. If no dispute is received by the State within ten (10) calendar days, the State has the option to reduce the current budget for the current year and any upcoming budget for future contractual agreements. 6. Contractor shall request prior approval in writing from the State for all modifications to the Statement of Work/Work Plan or for any modification to the direct costs in excess of twenty-five percent (25%) of the total budget for direct costs. Any request for modifications to the Budget in excess of twenty-five percent (25%) of the total budget for direct costs shall be submitted to the State at least ninety (90) days prior to the end of the contract period and may require an amendment in accordance with General Provisions, Section 16, Contract Modifications, of this Contract. 7. Contractor agrees to provide services to all Program participants and employees in a smoke -free environment in accordance with Public Law 103-227, also known as "the Pro -Children Act of 1994", (Act). Public Law 103-227 requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of eighteen (18), if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. 8. The State of Colorado, specifically the Colorado Department of Public Health and Environment, shall be the owner of all equipment as defined by Federal Accounting Standards Advisory Board (FASAB) Generally Accepted Accounting Principles (GAAP) purchased under this Contract. At the end of the term of this Contract, the State shall approve the disposition of all equipment. 9. Contractor shall not use State funds provided under this Contract for the purpose of lobbying as defined in Colorado Revised Statutes (C.R. S.) 24-6-301(3.5)(a). 10. The State, at its discretion, shall have the option to extend the term under this Contract beyond the Initial Term for a period or for successive periods, of 1 year at the same rates and under the same terms specified in the Contract. In order to exercise this option, the State shall provide written notice to Contractor in a form substantially equivalent to Exhibit D. If exercised, the provisions of the Option Letter shall become part of and be incorporated in the original contract. The total duration of this contract shall not exceed 5 years. 11. The State, at its discretion, shall have the option to increase or decrease the statewide quantity of Goods and/or Services based upon the rates established in this Contract, and increase the maximum amount payable accordingly. In order to exercise this option, the State shall provide written notice to Contractor in a form substantially equivalent to Exhibit D. Delivery of Goods and/or performance of Services shall continue at the same rates and terms as described in this Contract. Page 2 of Original Contract Number2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1DlE53B773 EXHIBIT B STATEMENT OF WORK Original Contract Routing Number: 2022*0168 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. I. Entity Name: Weld County Department of Public Health and Environment II. Project Description: This project uses Marijuana Tax Cash Funds to improve the health of all Coloradans by reducing substance misuse among youth. CDPHE prioritized funding to reach this outcome using an evidence - based community -organizing approach that reduces the risk and increases the protective factors that are also linked to long-term reductions in violence and suicide in addition to substance misuse. Special attention must be paid to focusing these efforts on addressing racial justice and other oppressive systems within each community, elevating all community voices and allowing community members to drive decision -making. During the scope of this project, grantees can expect to see reductions in risk factors and increases in protective factors. Under this model, funded community Coalition Member groups across the state implement the following: 1. Organize a group of youth, families, professional Coalition Members, and formal and informal leaders; 2. Build the capacity of Coalition Members to a. assess the specific and well -researched risk factors (factors that increase the likelihood of a problem behavior) and protective factors (factors that buffer someone from the risks of a problem behavior) among the youth in their communities; b. select from a menu of proven or evidence -informed Primary Prevention strategies (including programs) to address the factors most relevant among their local youth; c. identify funding for the selected strategies, implement those strategies aligned to best practices, and evaluate the impact of their strategies. Community Coalition Member groups will do this within their defined Geographic Areas of Focus. Colorado youth in each of the funded communities across the state will benefit from this project due to the increased presence of evidence -informed strategies and programs in their community as a result of organized Coalition Member efforts to impact gaps in preventing risk or promoting protective factors. III. Definitions: 1. Authentic Community Engagement: Authentic Community Engagement is a two-way exchange of information, ideas and resources. Community engagement should offer opportunities for communities to exercise power in decision -making. It should also consider the diversity of our communities, including culture and ethnicity, and see to create an inclusive and accessible process. 2. CDE: Colorado Department of Education 3. CDPHE: Colorado Department of Public Health and Environment 4. CMP: Collaborative Management Programs funded by CDHS 5. Coalition Members: Coalition members include all participants of the organized group engaged in the CTC Model representative of the many sectors recommended to be a part of local prevention decision -making: youth, parents, residents, public health, youth -serving organization, such as mentoring and after school programs, local education authority, community -based organization addressing prevention, local housing and human services, local community health and/or health care organization, local law enforcement, local business, and elected officials. These Coalition Members should represent the diversity of the community they represent. Coalition Members is inclusive of participants in the key leader board, community board, and workgroups as outlined in the CTC Model. Page 1 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1DlE53B773 EXHIBIT B 6. Community Action Plan (CAP): This comprehensive and community -wide action plan defines the community engagement process and Primary Prevention plan of CTC. Part 1 of this plan includes the Coalition Members engaged, existing Primary Prevention efforts within the community, the prioritization process of the data, the risk and protective factors that the community selected to address, and the selected Primary Prevention strategies and programs that the community, not the lead agency, has decided to prioritize to reduce those risk or improve those protective factors. The plan is ideally comprehensive when it includes strategies and practices that cross the Socio- Ecological Model, including programs for individuals and families, policy improvements for organization and local governance, and efforts to shift the community norms to reflect the Social Development Strategy. Part 2 of this plan, sometimes called the implementation and evaluation plan, ultimately specifies the steps that the community will take to implement the action plan, capacity building, funding, and outlines how those steps will be measured for success. Part 2 of the plan addresses gaps that exist within the community and is fluid as the Coalition Members shift their implementation strategies to adjust to an ever-changing environment. 7. Communities That Care (CTC) Model: The CTC Model is an evidence -based community engagement and Prevention Science approach identified as a promising program by the Blueprints for Healthy Youth Development evidence -based registry. CTC includes 5 phases of implementation with milestones outlined for each phase: phase 1: Get Started phase 2: Get Involved phase 3: Develop Community Profile phase 4: Create a Plan phase 5: Implement and Evaluate 7. CTC Community Mobilizer: The CTC Community Mobilizer is responsible for supporting the community Coalition groups to help them understand and implement the CTC Model. This position will encourage the use of evidence -based approaches as the local Coalition plans, develops, implements, monitors, and sustains prevention strategies aligned to community needs. The Community Mobilizer's guidance and support throughout CTC implementation will advocate for community -driven practices and emphasize capacity building of Coalition Members. This role will have various responsibilities, and will also be tasked with sharing responsibility, leadership, and ownership with the community Coalition Members. There is one CTC Community Mobilizer per Grantee. 8. CU Anschutz: University of Colorado Anschutz Medical Campus 9. DCJ: Division of Criminal Justice 10. DfC: Drug Free Communities Grant recipients from the Office of National Drug Control and Policy 11. External Evaluation Entity: CDPHE will hire an external evaluation agency to conduct cross -site evaluation of implementation across the state, as well as to provide subject matter expertise and technical assistance to improve data -driven decision -making and local evaluation planning for CAPs. 12. FTE: Full Time Equivalent staff. 13. Geographic Area of Focus: the boundaries of the community selected for intervention by the Contractor. Defined geographic boundaries support the External Evaluation Entity in identifying data sources to monitor for outcome evaluation over time. 14. HKCS: Healthy Kids Colorado Survey 15. MCH: Maternal Child Health programs funded at local public health agencies throughout the state. 16. OBH: Office of Behavioral Health at the Colorado Department of Human Services 17. Prevention Science: Prevention Science focuses on the development of evidence -based strategies that reduce risk factors and enhance protective factors to improve the health and wellbeing of individuals, families, and communities. A central tenet of Prevention Science is the promotion of health equity and reduction of disparities by studying how social, economic and racial inequalities and discrimination influence healthy development and wellbeing. The application of well -tested practices, strategies and policies generated by Prevention Science can lead to substantial cost - Page 2 of 9 Original Contract Ntunber:2022*0168 Ver. 01.11.19 DocuSign Envelope ID:41902EEA-D080-4C92-A2F8-AD1DlE53B773 EXHIBIT B savings by investing in upstream strategies to avoid downstream costs. An integrated delivery system of comprehensive evidence -based prevention strategies that crosses many public sectors with scientifically -based guidance and resources to legislative and administrative decision -makers will facilitate the integration of best practices from Prevention Science into policy. 18. Primary Prevention: As defined by the Centers for Disease Control's (CDC) Principles of Prevention Guide, Primary Prevention takes place BEFORE substance misuse (or other health behavior) initially occurs. It involves programs and strategies designed to reduce the factors that put people at risk for substance misuse or exposure. Or, they encourage the factors that protect or buffer people from substances. 19. Positive Youth Development (PYD): PYD is an approach that guides communities and organizations in the way that they organize services, opportunities and supports. In practice, this approach incorporates the development of skills, opportunities and authentic relationships into programs, practices and policies, so that young people reach their full potential. 20. SB94: Programs funded by CDHS authorized through Senate Bill 94. 21. Shared Risk and Protective Factors: Research from the Centers of Disease Control and Prevention shows that many forms of violence and injury are connected and share many of the same risk and protective factors. These factors can put someone more or less at risk of experiencing substance misuse, poor educational attainment, violence and injury. 22. Social Development Strategy (SDS): Providing young people with opportunities, skills and recognition strengthens bonding with family, school, and community. Strong bonds motivate young people to adopt healthy standards for behavior. The strategy has five key components: 1) Opportunities: Provide developmentally appropriate opportunities to young people, for active participation and meaningful interaction with prosocial others. 2) Skills: Teach young people the skills they need to succeed. 3) Recognition: Provide consistent specific praise and recognition for effort, improvement, and achievement. 4) Bonding: Acknowledge a young person's effort and promote positive bonding — a sense of attachment, emotional connection and commitment to the people and groups who provide that recognition. Bonding can occur with a family member, teacher, coach, employer or neighbor. 5) Clear Standards for Behavior: Through the process of bonding, young people become motivated to live according to the healthy standards of the person or group to whom they are bonded. 23. Socio-Ecological Model: CDC uses a four -level Social -Ecological Model to better understand domains that influence decisions, behaviors, and outcomes and the effect of potential prevention strategies in influencing positive changes in these domains. This model considers the complex interplay between individual, relationship, community, and societal factors. 24. State -funded programs: Examples of state -funded prevention programs include the Tony Grampsas Youth Services projects, sexual violence prevention programs, communities funded by the Office of Suicide Prevention, Maternal Child Health, CDE grantees, collaborative management programs, community substance misuse treatment programs funded by OBH, Senate Bill 94 programs, Regional Accountable Entities funded by Health Care Policy and Financing, and other Division of Criminal Justice programs. 25. Substance misuse: substance misuse among youth includes underage use of marijuana and alcohol and the misuse of prescription drugs/opioids. Additional substances may be included in the definition of substance misuse by a community if they have documented data of misuse or abuse among youth in their community, excluding tobacco. 26. TGYS: Tony Grampsas Youth Services grants for Primary Prevention programs in communities. IV. Work Plan: Goal #1: Create healthy, thriving and resilient communities, free from violence and injury. Page 3 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1D1E53B773 EXHIBIT B Objective #1: No later than the expiration date of this contract, maintain an organized group of Coalition Members who are prepared to use Prevention Science to impact Shared Risk and Protective Factors in the lives of youth in their Geographic Area of Focus. The Contractor shall facilitate a group of Coalition Members that represent the Primary Geographic Area of Focus through the milestones and phases 1 and 2 of the CTC Activity #1 Model, in order to develop their capacity to drive decisions that promote Prevention Science within their community. 1. The Contractor shall provide a CTC Community Mobilizer that is 0.75 FTE or greater. 2. The Contractor shall define the parameters of the Geographic Area of Focus in order to recruit Coalition Members from the area. 3. The Contractor shall retain diverse Coalition Members to serve on the key leader board and community board. 4. The Contractor shall provide a list of middle and high schools in their Geographic Area of Focus to the CU Anschutz HKCS team to encourage focused recruitment of those schools in the HKCS. 5. The Contractor shall retain leaders of state -funded upstream prevention projects within the Geographic Area of Focus to participate in the CTC process. 6. The Contractor shall retain leaders of state -funded opioid prevention and intervention projects within the Geographic Area of Focus to participate in the CTC process. 7. The Contractor shall act as a liaison linking CU Anschutz HKCS staff to schools for recruitment for survey administration. 8. The Contractor shall request a report sharing agreement with local schools to receive HKCS scaled risk and protective factor reports once every two Sub -Activities years. #1 9. The Contractor shall provide professional development opportunities to support the CTC Community Mobilizer's ability to effectively facilitate Coalition Member growth and sustainability to address Prevention Science. 10. The Contractor shall use group facilitation skills and tools, provided by CDPHE, to guide the Coalition Members through the CTC process. 11. The Contractor shall facilitate the Coalition Member's development through the milestones of phases 1 and 2 in the CTC Model. 12. The Contractor shall increase Coalition Members' capacity to implement Prevention Science approaches within the community. 13. The Contractor shall implement milestones from phases 1 and 2 needed to support Coalition Member progress in achieving milestones from phases 3-5. 14. The Contractor shall hold a minimum of one (1) Coalition Member meeting per month. 15. The Contractor shall complete the CTC milestones tool. 16. The Contractor shall send community Coalition Members agendas, resources, and updates in advance to prepare for meetings. 17. The Contractor shall facilitate delegation of CTC Model, workgroup, and phase tasks. Page 4 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1D1E53B773 EXHIBIT B 18. The Contractor shall train Coalition Members to expand community outreach. 19. The Contractor shall participate in all required technical assistance meetings conducted by the CDPHE CTC team. 20. The Contractor shall complete an equity assessment to identify the ways in which CTC community mobilizing contributes to oppression in the community. 21. The Contractor shall implement changes identified in the equity assessment. 22. The Contractor shall participate in all cross -site evaluation activities required by the External Evaluation Entity. 23. The Contractor shall request training and technical assistance from the External Evaluation Entity on how to use local data to drive decision - making. 24. The Contractor shall document progress on this primary activity and alignment to the CTC Model in the regular progress reports, using the CDPHE provided template. Primary The Contractor shall document progress on the CAP part 2. Activity #2 1. The Contractor shall monitor implementation of any Primary Prevention strategies focused on risk or protective factors within the community to avoid duplication. 2. The Contractor shall document implementation of specific action steps and related evaluation measures, using the CDPHE provided template. 3. The Contractor shall document successes and challenges encountered by Coalition Members while implementing CAP part 2 strategies. 4. The Contractor shall reassess CAP part 2 activities to identify appropriate lead agency involvement and funding needs for sustainability. 5. The Contractor shall track Coalition Member progress toward implementation of the steps outlined in the CAP. 6. The Contractor shall document Primary Prevention strategy and program updates in the CAP part 2. Sub -Activities 7. The Contractor shall make quality improvements to the CAP Part 2 that align #2 with outcome -focused planning. 8. The Contractor shall complete an equity assessment to identify the ways in which CAP implementation contributes to oppression in the community. 9. The Contractor shall adjust the CAP part 2 implementation to adjust for issues identified through an equity impact assessment. 10. The Contractor shall update the CTC milestones tool for phase 5. 11. The Contractor shall complete the evaluation portions of the CAP Part 2, using the CDPHE provided template. 12. The Contractor shall request training and technical assistance from the External Evaluation Entity on how to complete the evaluation portions of the CAP Part 2. 13. The Contractor shall document progress on this primary activity and alignment to the CTC Model in the regular progress reports, using the CDPHE provided template. Page 5 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1DlE53B773 EXHIBIT B Standards and Requirements 1. The content of electronic documents located on CDPHE and non-CDPHE websites and information contained on CDPHE and non-CDPHE websites may be updated periodically during the contract term. The Contractor shall monitor documents and website content for updates and comply with all updates. 2. CDPHE will provide the Contractor with a list of all required technical assistance meetings. 3. CDPHE will provide the Contractor with a list of all cross -site evaluation activities required by the External Evaluation Entity. 4. CDPHE will provide the Contractor with the template to document implementation of specific action steps and related evaluation measures. 5. The Contractor shall retain Coalition Members from state- and federally - funded programs that exist within their Geographic Area of Focus, including other funded prevention programs from CDE, MCH, TGYS, CMPs, SB94, DfCs, OBH, AG, or DCJ. 6. The Contractor shall adhere to the CTC Model for all activities. The CTC Model is available at the following website: http://www.communitiesthatcare.net/how-ctc-works/, which is incorporated and made part of this Contract by reference. 7. CDPHE will provide a CTC milestones tool on which the Contractor can track implementation of relevant activities. 8. The Contractor shall provide CDPHE with all information on any adjustments made to the CTC Model. 9. CDPHE will provide the Contractor with the template for the implementation and evaluation portions of the CAP Part 2. 10. The Contractor shall update the CTC milestones tool with input from the workgroups, boards, and other Coalition Members engaged in CTC and with guidance from the CDPHE Staff. 11. CDPHE will provide the Contractor with a program manual that outlines CTC Model implementation expectations. 12. The Contractor shall require the CTC Community Mobilizer demonstrate the skills identified in the CTC Community Mobilizer job description and skill assessment. 13. CDPHE will provide the Contractor with group facilitation skills and tools to help guide the Coalition Members engaged in the CTC Model. 14. The Contractor shall have a minimum of one (1) trained CTC Community Mobilizer present at each Coalition Member meeting. 15. The Contractor shall require that all CTC Community Mobilizers using the CTC Model have successfully completed the Community Mobilizer Training, content mastery assignment, and working with a CTC coach, in advance of launching CTC Model in their communities. 16. The Contractor shall adhere to all CTC Plus license agreement requirements. 17. The Contractor shall facilitate the CTC Coalition toward implementation and improvement across all six of the Elements of Effective Coalitions, found at https://drive.google.com/file/d/ l 0pk- oiLdexeUbaGEomGg6DGc5dljpGG7/view, incorporated and made part of this Contract by reference. 18. The Contractor shall include a CTC Community Mobilizer for all required technical assistance meetings. Page 6 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1D1E53B773 EXHIBIT B 19. The Contractor shall assist in all data collection efforts from the External Evaluation Entity in order to help with continuous program quality improvement, upon request by CDPHE. 20. The Contractor shall use training and technical assistance from the External Evaluation Entity to complete the evaluation portions of the CAP Part 2. 21. The Contractor shall use the Office of Health Equity's Sweet Tool on Authentic Community Engagement to move through the spectrum of engagement toward Shared Leadership with Coalition Members. This information is incorporated and made part of this Contract by reference, and is available at the following website: https://drive.google.com/file/d/119IenKB- zvTeOHUj anB0MS7rkx-Wr-UJ/view 22. The Contractor shall provide Coalition Member meetings with access to these items: a. convenient location, b. meetings held at a convenient time that does not conflict with work and school schedules, c. available public transportation, d. childcare accessibility, e. interpretation needs, and f. food. 23. The Contractor shall reimburse Coalition Members for their time and expertise if they participate outside of their employment or paid time. 24. The Contractor shall provide language interpretation at CTC Coalition Member meetings when there are non-English speaking community members participating. 25. The Contractor shall use annual feedback from cross -site evaluation activities required by the External Evaluation Entity to identify opportunities for development and quality improvement that will support program outcomes. 26. The Contractor shall require staff to participate in professional development opportunities, including grantee meetings, the Community Mobilizer training, effective facilitation strategies, positive youth development, accessing data resources, prevention -science, and other trainings as identified by CDPHE. 27. The Contractor shall use the positive youth development in action rubrics (adult and youth version) to build capacity and evaluate effective youth involvement. This document is incorporated and made part of this Contract by reference and is available at the following website: https://sites.google.com/state.co.us/pydinaction/resources 28. CDPHE will provide the Contractor with a menu of Primary Prevention strategies across the Socio-Ecological Model for Coalition Member's implementation within the CAP. 29. The Contractor shall comply with the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards) website for all health related communications. This document is incorporated and made part of this Contract by reference and is available at the following website: .http://www.integration.samhsa.gov/EnhancedCLASStandardsBlueprint.pdf 30. The Contractor shall not use CTC funds to purchase ad space for existing statewide social marketing campaigns. 31. The Contractor shall use only marijuana research or statements on the health effects outlined by the Retail Marijuana Public Health Advisory Committee. These approved health statements and factsheets are incorporated and made Page 7 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1D1E53B773 EXHIBIT B part of this Contract by reference and are available on the following website https://marijuanahealthinfo.colorado.gov/. 32. The Contractor shall use the CDPHE-approved progress and final report templates, to be provided by CDPHE. 33. The Contractor shall provide to CDPHE upon request written procedures related to gift card purchase and handling. At a minimum, the procedures must include the following: a. How the gift card inventory is tracked and maintained; b. Gift card storage and safeguards against theft; c. The primary person responsible for securing and distribution gift cards; d. A gift card distribution log that records each gift card number, dollar amount, reason for receiving the gift card, and the printed name and signature of each gift card recipient. 34. The Contractor shall provide CDPHE with an updated staff roster of CTC Community Mobilizers and other staff within two (2) weeks of any staffing change. 35. The Contractor shall consult with their CDPHE Staff prior to making changes to Parts 1 or 2 of the Community Action Plan that would alter the objectives of either plan in order to maintain alignment to best practices. 36. CDPHE will review and provide feedback on best practices for Parts 1 and 2 of the Community Action Plan within 20 business days. 37. The Contractor shall consult with their CDPHE Staff on feedback for Parts 1 and 2 of the Community Action Plan prior to strategy and program implementation. 38. The Contractor shall use current social marketing campaign materials provided by CDPHE, when social norms change is selected as part of the CAP. Expected Results of Activity(s) Maintain high capacity groups of Coalition Members including residents, youth, and professionals who are ready to drive decision -making throughout the community to support the Social Development Strategy, Positive Youth Development approaches, address equity and racial justice, and to implement Prevention Science approaches in subsequent years of funding using the CTC Model across Colorado. Measurement of Expected Results 1. Progress report on primary activities using a CDPHE approved template. Completion Date Deliverables 1. The Contractor shall submit a progress report on primary activities using a CDPHE approved template. No later than 9/30, 12/31, 3/31, 6/30 annually Page 8 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID:41902EEA-D080-4C92-A2F8-AD1DlE53B773 EXHIBIT B V. Monitoring: CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout the contract period by the CDPHE Staff. Methods used will include a review of documentation determined by CDPHE to be reflective of performance to include progress reports and other fiscal and programmatic documentation as applicable. The Contractor's performance will be evaluated at set intervals and communicated to the contractor. A Final Contractor Performance Evaluation will be conducted at the end of the life of the contract. VI. Resolution of Non -Compliance: The Contractor will be notified in writing within 15 calendar days of discovery of a compliance issue. Within 30 calendar days of discovery, the Contractor and the State will collaborate, when appropriate, to determine the action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed. The action(s) and timeline for completion will be documented in writing and agreed to by both parties. If extenuating circumstances arise that requires an extension to the timeline, the Contractor must email a request to the CDPHE Staff and receive approval for a new due date. The State will oversee the completion/implementation of the action(s) to ensure timelines are met and the issue(s) is resolved. If the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State may exercise its rights under the provisions of this contract. Page 9 of 9 Original Contract Number:2022*0168 Ver. 01.11.19 DocuSign Envelope ID: 41902EEA-D080-4092-A2F8-AD1D1E53B773 Exhibit C Budget COLORADO Department of Public Health. Et Environment PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION F'' `RM Original Contract Routing # 2022*0168 Contractor Name Weld County Department of Public Health and Environment Program Contact Name, Title, Phone and Email Melanie Cyphers, CTC Supervisor, 970.400.2385, mcyphers@weldgov.com Budget Period July 1, 2021 -June 30, 2022 Fiscal Contact Name, Title, Phone and Email Tanya Geiser, Finance Director (970) 400-2122; tgeiser@weldgov.com Project Name Shared Risk and Protective Factor Approach to Substance Misuse Prevention: Milliken -Johnstown Communities That Care P®) Number CT FHLA 2022*0168 Contract (CT or Expenditure Categories Personal Services Salaried Employees Position Title Description of Work Gross or Annual Salary Fringe Percent of Time on Project Total Amount Requested from CDPHE Health Ed Specialist I (Communities That Care Mobilizer) This position is responsible for coordinating the Communities That Care project (CTC) with fidelity, including Community Board and Key Leader Board member engagement; communication; meetings; reporting on the project; maintaining communication with community members; and coordinating implementation of evidence -based youth substance abuse prevention strategies. This position is .98 FTE. $ 60,489.20 $ 23,548.45 98.0% $ 82,356.90 CTC Program Supervisor This position is responsible for championing the project with leadership, supervising personnel on the project, managing budget development and project expenditures, and reviewing contract deliverables..15 FTE $ 83,621.03 $ 32,553.67 15.0% $ 17,426.21 Division Director Provide overall program administration, budget management, and supervision of staff..01FTE $ 116,258.86 $ 45,259.57 1.0% $ 1,615.18 Fringe Fringe benefits are 38.93%. Components included are: 1.45% Medicare, .09% unemployment, .08% worker's compensation, 13.7% PERA, .33% life insurance, 12.13% health insurance, 4.6% vacation, 4.23% holidays and 2.3% sick leave. $ Personal Services Hourly Employees Position Title Description of Work Hourly Wage Hourly Fringe Total # of Hours on Project Total Amount Requested from CDPHE Health Communication Specialist Will provide desktop publishing, design, and video editing as needed to assist CTC coalition in promotion and marketing of community outreach activities and community action plan implementation activities. $ 26.98 $ 10.50 52.0 $ 1,948.96 < .. g , � � ,zr g Y .. ,„ otal Personal tent e n vding fri igibenefits) r.: ,..ti 103,347,25 Supplies & Operating Expenses Item Description of Item Rate Quantity Total Amount Requested from CDPHE Printing/Copies Printing and photocopying: black & white $0.02 cents per copy x 4,500 = $90; color @ $0.06 cents per copy x 1000= $60.00 [avg $12.50/month] $ 12.50 12.0 $ 150.00 Original Contract Number: 2022*0168 Page 1 of 5 Docu5ign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1D1E53B773 Exhibit C Budget PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM Original Contract Routing # 2022x0168 Contractor Name Weld County Department of Public Health and Environment Program Contact Name, Title,. Phone and Email Melanie Cyphers, CTC Supervisor, 970.400.2385, mcyphers@weldgov.com Budget Period July 1, 2021 -June 30, 2022 Fiscal Contact Name, Title, Phone and Email Tanya Geiser, Finance Director (970) 400-2122; tgeiser@weldgov.com - Project Name Shared Risk and Protective Factor Approach to Substance Misuse Prevention: Milliken -Johnstown Communities That Care Contract (CT or PO) Number CT FHLA 2022"0168 Office Supplies Office supplies and materials for 12 community coalition and workgroup meetings. ($10 x 12 meetings =$132.00) $ 10.00 12.0 $ 120.00 Phone 15% of Monthly cell phone usage ($60.00 monthly charge) for CTC Program Supervisor (12 x $9.00= $72.00) $ 9.00 12.0 $ 108.00 Shared Risk and Protective Factor (SRPF) Conference Registration Registration cost for CTC Mobilizer and 3 adult coalition members to attend the Shared Risk and Protective Factors (SRPF) Conference with the intent to build skills and increase knowledge that will enhance implementation of evidence -based prevention practices, policies, and programs. ($250/registration x 4 adult =$250.00). $ 250.00 4.0 $ 1,000.00 Shared Risk and Protective Factor (SRPF) Conference Registration -Youth Coalition Members Registration cost for 3 youth coalition members to attend the Shared Risk and Protective Factors (SRPF) Conference with the intent to build skills and increase knowledge that will strengthen collaboration efforts and assist in the implementation and sustainability of the CTC SOW. ($150/registration x 3 = $450.00) $150.00 3.0 $ 450.00 Montana Summer Institute (MSI) Conference Registration Registration cost for CTC Mobilizer, 2 adult coalition members and 2 youth coalition members to attend the Montana Summer Institute (MSI) with the intent to build skills and increase knowledge in leadership, community outreach and implementation of evidence -based prevention practices, policies, and programs which strengthen implementation and sustainability of the CTC program. ($799/registration x 5 people = $3995.00) $799.00 5.0 $ 3,995.00 Youth Diversity Conference Registration cost for youth coalition members to attend training such LaRaza Youth Leadership Conference with the intent to offer culturally sensitive programming to enhance youth's social, education, andpersonalgrowth for our Chicanx/Latinxyouth and / build leadership skills and capacity to address our risk and protective factors with an equity lens. (LaRaza- 10 youth x $25 = $250. No charge for staff.) $25.00 10.0 $ 250.00 Professional Development for Staff Registration fees for CTC Community Mobilizer to attend professional development training such as Diversity University (2 classes available at $80.00 and $100.00), TOPS (Technology of Participation at $500.00) or Public Health in the Rockies ($400.00) to build skills and increase knowledge in equity and coalition and community engagement work to enhance implementation of evidence -based prevention practices, policies, and programs relevant to CTC SOW. (Specific training/trainings TBD and is dependent on location and if training will be offered in person or virtual.) $ 500.00 2.0 $ 1,000.00 Promotional Materials Promotional materials used to promote youth participation and engagement in positive youth development activities and enhance work described in CTC implementation plan such as t -shirts for youth group (MYCL) and items such as lip balm, imprinted water bottles, pens, stress balls, and draw string bags to be used at community marketing and recruitment events for CTC. 50 shirts x $10.00 = $500.00, items for 5 events x $100.00=$500.00. Total estimated at = $1000.04.) $ 1,000.04 1.0 $ 1,000.04 Original Contract Number: 2022°0168 Page 2 of 5 DocuSign Envelope ID: 41902EEA-D080-4O92-A2F8-AD1 D1 E538773 Exhibit C Budget PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM Original Contract Routing # 2022*0168 Contractor Name Weld County Department of Public Health and Environment Program Contact Name, Title, Phone and Email Melanie Cyphers, CTC Supervisor, 970.400.2385, mcyphers@weldgov.com Budget Period July 1, 2021 -June 30, 2022 Fiscal Contact Name, Title, Phone an€! Email Tanya Geiser, Finance Director (970) 400-2122; tgeiser@weldgov.com Project Name Shared Risk and Protective Factor Approach to Substance Misuse Prevention: Milliken -Johnstown Communities That Care PO) Number CT FHLA 2022*0168 Contract (CT or Coalition Incentives CTC Coalition incentives used to acknowledge community members (parent, youth, or resident) time and expertise to contribute to the goals of the coalition, retain support at coalition meetings, workgroup meetings, and annual strategic reflection meeting . Items such as gift cards to provide incentives for at least 25 community members or youth. ($25 x 25 people = $625.00.) $ 25.00 25.0 $ 625.00 Community Coalition and Youth Workgroup: Snacks Beverage and snacks for 24 Youth Workgroup in person meetings during the year to incentivize meeting attendance and participation for students especially when meetings occur immediately after school. (estimated $5.00/person x 25 youth x 24 meetings = $3000.00.) $ 5.00 600.0 $ 3,000.00 Community Coalition Meals Food for adult Community Coalition in person meetings to incentivize meeting attendance and participation especially when $ 11.00 290.0 $ 3,190.00 $ - Total Supplies & Operating $ 14,888.04 Original Contract Number: 2022*0168 Page 3 of 5 DocuSign Envelope ID: 41902EEA-D080-4O92-A2F8-AD1D1E538773 Exhibit C Budget PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM Original Contract Routing # 2022*0168 Contractor Name Weld County Department of Public Health and Environment Program Contact Name, Title, Phone and Email Melanie Cyphers, CTC Supervisor, 970.400.2385, mcyphers@weldgov.com Budget Period July 1, 2021 -June 30, 2022 Fiscal Contact Name, Title, Phone and Email Tanya Geiser, Finance Director (970) 400-2122; tgeiser@weldgov.com Project Name Shared Risk and Protective Factor Approach to Substance Misuse Prevention: Milliken -Johnstown Communities That Care PO) Number CT FHLA 2022*0168 Contract (CT or Travel Item Description of Item Rate Quantity Total Amount Requested from CDPHE Mileage Reimbursement - Staff Mileage for CTC Community Mobilizer to facilitate community engagement and coalition work within Weld County and travel to trainings and or conferences including the SRPF Conference. Mileage is paid at the county rate of $0.54 per mile. $ 0.540 1075.1 $ 580.55 Conference Lodging: SRPF Hotel cost for CTC Community Mobilizer, 3 adult coalition members and 3 youth coalition members to attend 4 days at the Shared Risk & Protective Factor (SRPF) Conference. ($225/night x 3 nights x 4 rooms = $675.00). $ 225.00 12.0 $ 2,700.00 Conference Meals: SRPF Off -site meal costs for CTC Community Mobilizer, 3 adult coalition members and 3 youth coalition members to attend 4 days at the Shared Risk & Protective Factor (SRPF) Conference. ($40/day/person x 3 days x 7 people = $120). $ 40.00 21.0 $ 840.00 Conference Lodging: MSI Hotel cost for CTC Community Mobilizer, 2 adult coalition members and 2 youth coalition members to attend the Montana Summer Institute (MSI) Conference. ($250/night x 4 nights x 3 rooms = $3000.00) $ 250.00 12.0 $ 3,000.00 Conference Meals: MSI Off -site meal costs for CTC Community Mobilizer, 2 adult coalition members and 2 youth coalition members to attend 4 days to attend the Montana Summer Institute (MSI) conference. ($40/day/person x 4 days x 5 people = $800.00). $ 40.00 20.0 $ 800.00 Conference Airfare: MSI Airfare cost for CTC Community Mobilizer, 2 adult coalition members, and 2 youth coalition members to attend the Montana Summer Institute (MSI) Conference. (approximately $500 roundtrip airfare x 5 people = $2500.00) $ 500.00 5.0 $ 2,500.00 Conference ground transportation: MSI Ground transportation costs for CTC Community Mobilizer, 2 adult coalition members, and 2 youth coalition members to attend the $ 70.00 5.0 $ 350.00 Total Travel $ 10,77035 Contractual Subcontractor Name Description of Item Rate Quantity Total Amount Requested from CDPHE Community Champion/Advisor This RFA recommended position supports the CTC Community Mobilizer and the Johnstown/Milliken CTC Coalition to include: capacity building and recruitment activities to address gaps in coalition participation and representation in parents and school staff; promoting and building public support for strategy implementation; collaborating with community partners to develop equitable population reach. (20 hours/month x $22/hour x 12 months = $5280.00) $22.00 240.0 $5,280.00 Original Contract Number: 2022*0168 Page 4 of 5 DocuSign Envelope ID: 41902EEA-O080-4O92-A2F8-AD1 D1 E53B773 Exhibit C Budget PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM Original Contract Routing # 20221(01 68 Contractor Name Weld County Department of Public Health and Environment Program Contact Name, Title, Phone and Email Melanie Cyphers, CTC Supervisor, 970.400.2385, mcyphers@weldgov.com Budget Period July 1, 2021 -June 30, 2022 Fiscal Contact Name, Title, Phone and Email Tanya Geiser, Finance Director (970) 400-2122; tgeiser@weldgov.com Project Name Shared Risk and Protective Factor Approach to Substance Misuse Prevention: Milliken -Johnstown Communities That Care PO) Number CT FHLA 20220168 Contract (CT or Youth Advisors Two youth coalition members (one middle school and one high school age) who advise the implementation of the CTC process, participate in strategy team meetings, co -lead workgroups, provide a bridge to the youth community, help recruit youth participants, promote the efforts of strategy teams and the Johnstown/Milliken CTC Coalition, promote Positive Youth Development and prevention principles, and support action planning and implementation of youth community involvement activities and youth skill building opportunities. (2 advisors x 2 hours/week x 42 weeks during the school year x $15/hour = $2520.00 + 2 advisors x 20 hours/week x 10 weeks during the summer x $15/hour = $6000.00. Total = $8,520.00) $15.00 568.0 $8,520.00 TBD Capacity building training and support for coalition and community members engaged in the project to receive focused and relevant professional development that will address gaps identified in the CU Boulder coalition surveys, support of community partners to address risk and protective factors and coalition sustainability, capacity assessments, or work plan creation such as grant writing training, or equity training. Specific contractor(s) will be determined once training needs are identified by the coalition. $ 2,500.00 1.0 $ 2,500.00 ., , Total Contractual . , $16,300.00 SUB -TOTAL OF DIRECT COSTS $ 145,305.84 Indirect . Item Description of Item Total Amount Requested from C0PHE Federally -Negotiated Indirect Cost Rate CDPHE-Negotiated Indirect Cost Rate CY 2021 rate of 14.93% Modified Total Direct Costs excluding capital p expenditures. $ 21,694.16 De minimis Indirect Cost RateI A z • . ' . .. . " . . tt •.' " # • x ' • • • #: ota! indirect . . 21,694.16 /.[%jp� , t��'°�•�'%'�0`kotl'�d!if�r 'r 'S.:' -t Y lY /'� N� .� ..- .tWPY"+"t`fi� i ... ". 6 Y'?(� . , .. i. i..RM In b�i�.�a.. Sin. D�=PJP �%'!� �., x. Y��_iY.' .'6fi ✓ S iY.. 'f�^Ffb /.I n. � r -. ::.. � ., s �I '��a°'SJF) ff" . %Y(..t Original Contract Number: 2022*0168 Page 5 of 5 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1 D1 E53B773 EXHIBIT D PTION LETTER #: Click here to enter text. State Agency Colorado Department f Public + calth and Environment 4300 Cherry Creek Dr S Denver, CO 80246 Original Contract # Click here to enter text. Contractor (Name and Address) Click here to enter text® Option Contract Number Click here to enter text. Contract Performance Beginning Date Click here to enter a date. Current Contract Expiration Date Click here to enter a date. CONTRACT MAXIMUM AMOUNT TABLE Document Type Contract Routing # Federal Funding Amount* State Funding Amount Other Funding Amount Tenn (dates) Total OL !I1 Original Current Contract Maximum Amount (YTD) 1) OPTIONS A. Option to extend for an Extension Term B. Option to change quantity of goods under the Contract Cm Option to change quantity of services under the Contract IX Option to change Contract rates K Option to initiate next phase of Contract 2) REQUIRED PROVISIONS: A. In accordance with Section(s) Click here to enter text° of the Original Contract referenced above the State hereby exercises its option for an additional term, beginning Click here to enter a dates and ending on the current contract expiration date shown above, at the rates stated in the Original Contract, as amended. B. In accordance with Section(s) Click here to enter text. of the Original Contract referenced above, the State hereby exercises its option to Cho-: se an item. the quantity of Choose an ite O at the rates stated in the Original Contract as amended for the following reason: Click here to enter text®. Co In accordance with Section(s) Click here to enter text. of the Original Contract referenced above the State hereby exercises its option to modify the Contract rates specified in Click here to enter text® for the following reason: Click here to enter text.. The Contract rates attached to this Option Letter replace the rates in the Original Contract as of the Option Effective Date of this Option Letter. D. In accordance with Section(s) Click here to enter text. of the Original Contract referenced above, the State hereby exercise its option to initiate Phase Click here to enter text., which shall begin on Click here to enter a date. and end on Click here to enter a date. at the cost/price specified in Section Click here to enter text.. E The Contract Maximum Amount table is deleted and replace with the Current Contract Maximum Amount Maximum Amount table shown above. 3) OPTION EFFECTIVE DATE: A. The effective date of this Option Letter is upon approval of the State Controller or Click here to enter a date. whichever is later. Original Contract Number: 2022 *0168 Page 1 of 2 Ver. 13.2.19 DocuSign Envelope ID: 41902EEA-D080-4C92-A2F8-AD1 D1 E53B773 EXHIBIT D PROGRAM APPROVAL By: Date: STATE OF COLORADO Jared S. Polis, Governor Department of Public Health and Environment Jill Hunsaker Ryan MPH, Executive Director By: Lisa McGovern, Purchasing & Contracts Section Director, CDPHE Date: ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Date: Original Contract Number: 2022*0168 Page 2 of 2 Ver. 13.2.19 Entity Name COLORADO DEPT OF PUBLIC HEALTH /ENVIRONMENT Entity ID* @0O0©1926 New Contract Request Contract Name* Contract ID CDPHE COMMUNITIES THAT CARE - YOUTH SUBSTANCE 4849 ABUSE PREVENTION FY21-22 CONTRACT Contract Status CTB REVIEW Contract Lead* TC EISER Contract Lead Email tgeiser@ca.weld.co.us Parent Contract ID Requires Board Approval YES Department Project t Contract Description CDPHE FY21-22 COMMUNITIES THAT CARE - YOUTH SUBSTANCE ABUSE PREVENTION CONTRACT 2022*0168 Contract Description 2 PREVIOUS CONTRACT NUMBER: 201 7*0142A2, 19 FHLA 109753 ORIGINAL CONTRACT NUMBER: 17 FHLA 89340 Contract Type CONTRACT Amount* $167,000.00 Renewable* NO Automatic Renewal NO Grant ;DES IGA NO Department HEALTH Department Email CM -Health weldg€ ;.tarn Department Head Email CM -Health- Does Contract require Purchasing Dept_ to be included? DeptHeadeweldgov.com NO Requested BOCC Agenda Date* 06114J2021 Due Date 06/10/2021 Will a work session with BOCC be required? NO County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYA 1 I ORNEYOW LDG OV.COM Grant Deadline Date If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in On Base Contract Dates. e Date 6710112021 Termination N Contact atn Dnfo Approval oval Process Det He TANYA GEISER D1i a pr 06/10/2021 Final r BOCC Appr d C Signed Date e Originator TGEISER Review Date 03/31;2022 Fin Approver CHRIS D`©VID1O Renewal Date iration Dates 06/3012022 Purchasing ed Date al Counsel BOB CHOATE Contact Phone 2 Fi ce Appr d Date al Counsel Approved Date 06/1032021 Tyler Ref It AG 0616.21 06/14/2021 Hello