HomeMy WebLinkAbout2003-253R d �
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CHILDREN'S SERVICES ADVISORY COMMITTEE ,
C/O Human th Services
1840 25 Street
Vero Beach , Florida 32960-3394
Phone : 561 -567-8000 (Ext. 467 or 524)
Fax: 978-1798
E-Mail : JcarlsonObcc.co. indian-dver.fl . us
Mmasterson(cDbcc.co. indian-dver.fl . us
To : Beth Jordan
From : Joyce Johnston-Carlson
Date : October 16 , 2003
Re : Grant Contracts 2003 - 04
The attached is a Children ' s Service Advisory Committee Grant Contract for :
Substance Abuse Council of IRC Right Choice Program
Please review the insurance certificate and verify that it is adequate by signing on the line
below . Contact me if you have any questions . Thank you .
Beth Jordan Date It 3/ -
v
Indian River County Grant Contract
This Grant Contract ( " Contract" ) entered into effective this 1st day of October 2003 by and between
Indian River County , a political subdivision of the State of Florida , 1840 25th Street, Vero Beach FL ,
32960 (" County" ) and Substance Abuse Council of IRC (" Recipient
of: (Address )
Substance Abuse Council of IRC
2501 27th Avenue , Suite A-7
Vero Beach , Florida 32960
Life Skills Training Program ( LST)
Background Recitals
A . The County has determined that it is in the public interest to promote healthy children in a
healthy community .
B . The County adopted Ordinance 99- 1 on January 19 , 1999 ( " Ordinance" ) and established the
Children ' s Services Advisory Committee to promote healthy children in a healthy community
and to provide a unified system of planning and delivery within which children 's needs can be
identified , targeted , evaluated and addressed .
C . The Children ' s Services Advisory Committee has issued a request for proposals from
individuals and entities that will assist the Children ' s Services Advisory Committee in fulfilling
its purpose .
D . The proposals submitted to the Children ' s Services Advisory Committee and the
recommendation of the Children ' s Services Advisory Committee have been reviewed by the
County .
E . The Recipient, by submitting a proposal to the Children ' s Services Advisory Committee , has
applied for a grant of money ( " Grant" ) for the Grant Period ( as such term is hereinafter
defined ) on the terms and conditions set forth herein .
F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period ( as
such term is hereinafter defined ) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and
other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged ,
the parties agree as follows:
1 . Background Recitals The background recitals are true and correct and form a material
part of this Contract.
2 . Purpose of Grant The Grant shall be used only for the purposes set forth in the
complete proposal submitted by the Recipient attached hereto as Exhibit "A" and
incorporated herein by this reference ( such purposes hereinafter referenced as " Grant
Purposes" ) .
3 . Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal
year 2003/2004 ( " Grant Period " ) . The Grant Period commences on October 1 , 2003
and ends on September 30 , 2004 .
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4 . Grant Funds and Payment The approved Grant for the Grant Period is Fifty Thousand
Dollars ( $ 50 , 000 ) . The County agrees to reimburse the Recipient from such Grant
funds for actual documented costs incurred for Grant Purposes provided in
accordance with this Contract. Reimbursement requests may be made no more
frequently than monthly . Each reimbursement request shall contain the information , at
a minimum , that is set forth in Exhibit " B" attached hereto and incorporated herein by
this reference . All reimbursement requests are subject to audit by the County . In
addition , the County may require additional documentation of expenditures , as it
deems appropriate .
5 . Additional Obligations of Recipient.
5 . 1 Records . The Recipient shall maintain adequate internal controls in order to
safeguard the Grant. In addition , the Recipient shall maintain adequate records fully
to document the use of the Grant funds for at least three ( 3 ) years after the expiration
of the Grant Period . The County shall have access to all books , records , and
documents as required in this Section for the purpose of inspection or audit during
normal business hours at the County ' s expense , upon five ( 5) days prior written
notice .
5 . 2 Compliance with Laws . The Recipient shall comply at all times with all applicable
federal , state , and local laws , rules , and regulations .
5 . 3 Quarterly Performance Reports . The Recipient shall submit Quarterly Performance
Reports to the Human Services Department of the County within fifteen ( 15 ) business
days following : December 31 , March 31 , June 30 , and September 30 .
5 .4 Audit Requirements . If Recipient receives $25 , 000 or more in the aggregate from
all Indian River County government funding sources , the Recipient is required to have
an audit completed by an independent certified public accountant at the end of the
Recipient's fiscal year. Within 120 days of the end of the Recipient' s fiscal year, the
Recipient shall submit the audit to the Indian River County Office of Management and
Budget. The fiscal year will be as reported on the application for funding , and the
Recipient agrees to notify the County prior to any change in the fiscal period of
Recipient. The Recipient acknowledges that the County may deny funding to any
Recipient if an audit required by this Contract for a prior fiscal year is past due and has
not been submitted by May 1 .
5 . 4 . 1 The Recipient further acknowledges that, promptly upon receipt of a
qualified opinion from its independent auditor, such qualified opinion shall
immediately be provided to the Indian River County Office of Management and
Budget. The qualified opinion shall thereupon be reported to the Board of
Commissioners and funding under this Contract will cease immediately . The
foregoing termination right is in addition to any other right of the County to
terminate this Contract .
5 . 4 . 2 The Indian River County Office of Management and Budget reserves
the right at any time to send a letter to the Recipient requesting clarification if
there are any questions regarding a part of the financial statements , audit
comments , or notes .
5 . 5 Insurance Requirements . Recipient shall , no later than September 23 , 2003 ,
provide to the Indian River County Risk Management Division a certificate or
certificates issued by an insurer or insurers authorized to conduct business in Florida
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that is rated not less than category A-: VII by A. M . Best, subject to approval by Indian
River County' s risk manager, of the following types and amounts of insurance :
( i ) Commercial General Liability Insurance in an amount not less than
$ 1 , 000 , 000 combined single limit for bodily injury and property damage ,
including coverage for premises/operations , products/completed operations ,
contractual liability , and independent contractors ;
( ii) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000
per occurrence combined single limit for bodily injury and property damage ,
including coverage for owned autos and other vehicles , hired autos and other
vehicles , non-owned autos and other vehicles ; and
( iii ) Workers ' Compensation and Employer's Liability (current Florida statutory
limit)
5 . 6 Insurance Administration . The insurance certificates , evidencing all required
insurance coverages shall be fully acceptable to County in both form and content,
and shall provide and specify that the related insurance coverage shall not be
cancelled without at least thirty ( 30) calendar days prior written notice having been
given to the County. In addition , the County may request such other proofs and
assurances as it may reasonably require that the insurance is and at all times
remains in full force and effect. Recipient agrees that it is the Recipient' s sole
responsibility to coordinate activities among itself, the County , and the Recipient's
insurer( s) so that the insurance certificates are acceptable to and accepted by
County within the time limits set forth in this Contract. The County shall be listed as
an additional insured on all insurance coverage required by this Contract, except
Workers ' Compensation insurance . The Recipient shall , upon ten ( 10 ) daysprior
written request from the County , deliver copies to the County, or make copies
available for the County's inspection at Recipient' s place of business , of any and all
insurance policies that are required in this Contract. If the Recipient fails to deliver or
make copies of the policies available to the County ; fails to obtain replacement
insurance or have previous insurance policies reinstated or renewed upon
termination or cancellation of existing required coverages ; or fails in any other regard
to obtain coverages sufficient to meet the terms and conditions of this Contract, then
the County may , at its sole option , terminate this Contract.
5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County , its
agents , officials , and employees from and against any and all claims , liabilities ,
losses , damage , or causes of action which may arise from any misconduct, negligent
act, or omissions of the Recipient , its agents , officers , or employees in connection
with the performance of this Contract.
5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter
119 , Florida Statutes ( Public Records Law) in connection with this Contract.
6 . Termination . This Contract may be terminated by either party , without cause , upon
thirty ( 30 ) days prior written notice to the other party . In addition , the County may
terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the
Recipient if the County determines that such termination is in the public interest.
7 . Availability of Funds . The obligations of the County under this Contract are subject
to the availability of funds lawfully appropriated for its purpose by the Board of
County Commissioners of Indian River County .
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8 . Standard Terms . This Contract is subject to the standard terms attached hereto as
Exhibit C and incorporated herein in its entirety by this reference .
IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date
first above written .
INDIAN
RIVER UNTY BOARD OF COUNTY
COMMISSIO RS
By :
AAK R . a hairman
Attest: J . K. Barton , Clerk
6Y�33 L�Z4 Z4 i�
Deputy Clerk
Approved :
mes Ihandier, County Adm ' istrat
Ap a as to form and legal sGfficiency :
a n el ss stant County ttorn y
RECIPIENT :
Substance Abuse Council of IRC
2501 27th Avenue , Suite A-7
Vero Beach , Florida 32960
By :
Name
&/e �� re c r—
Title
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EXHIBIT A
[Copy of complete proposal/application ]
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
PROGRAM COVER PAGE
Organization Name: Substance Abuse Council of IRC
Executive Director: Colette Heid, MS . Ed, CAPP Email : sacirc@bellsouth. net
Address : 2501 27h Avenue, Suite A-7 Telephone : (772) 770-4811
Vero Beach F132960 Fax: X772) 7704822
Program Director: Colette Heid Email : sacirc@,bellsouth. net
Address: Telephone:
Fax:
Program Title : Life Skills Training Program (LST)
Priority Need Area Addressed: Mental Wellness Issues
Substance Abuse Education/Prevention LX-825 (According to the Taxonomy of Human Services)
Programs that provide a variety of services including individual, group and /or family counseling;
knowledge and skill enhancing activities; and structured groups which focus on family dynamics,
problem- solving, self-esteem and other similar issues, for people of all ages who are at risk for
substance abuse. Substance abuse education programs usually also offer presentations in schools and
agencies and to family groups regarding the dangers of alcoholism, drug abuse and smoking.
Brief Description of the Program : It is the LST program' s intent to provide a comprehensive,
research based proven effective substance abuse prevention program. LST is targeted at reducing and
preventing substance use/abuse among IRC middle school youth. There is a direct correlation
between delaying the age of onset of initial use to changing adolescent perceptions of the benefits vs.
the risks of Alcohol, Tobacco and other Drugs (ATOD). By increasing protective factors and
chan
ing attitudes towards ATOD, the age of initial use can be delayed or put off completely .
Amount Requested from Funder for 2003 /04 : $ 50 , 000
Total Proposed Program Budget for 2003/04 : $ 125 , 000
Percent of Total Program Budget : 40 . 0 %
Current Funding (2002/03 ) : $ 40 , 000
Dollar increase/(decrease) in request : $ 107000
Percent increase/(decrease) in request : 25 . 0 %
Unduplicated Number of Children to be served Individually : -
Unduplicated Number of Adults to be served Individually : -
Unduplicated Number to be served via Group settings : 3 , 900
Total Program Cost per Client : 32 . 05
Will these funds be used to match another source? YES
If yes , name the source : Florida Youth Incentive Grant
Amount : $ 751000 . 00
The Organization 's Board ofDirectors has approved this ap ' anon on (5
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0115
Carol Molloy
Name of President/Chair of the Board Si
Colette Heid
Name of Executive Director/CEO Signature
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
PROPOSAL NARRATIVE
A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page)
1 . Provide the mission statement and vision of your organization.
The Substance Abuse Council is committed to preventing the use of illicit drugs and abuse of
addictive, mind-altering substances.
It is the Council 's vision to increase community awareness concerning the levels of drug use in
Indian River County; empower the community with the belief that the level of substance and drug
use/abuse is directly related to the level of community interaction with prevention activities; and to
enlist the community 's participation in prevention related activities. Unless the community' s
emphasis is directed to substance and drug prevention educational programs, we can expect
negative social and economic impacts associated with substance and drug uselabuse to continue
2. Provide a brief summary of your organization including areas of expertise,
accomplishments and population served.
The Substance Abuse Council is dedicated to prevention education. It was founded in 1989 and
was incorporated as a not-for-profit agency in 1990 . Services are provided for all residents of IRC
regardless of age or race. The Council is the only agency focusing specifically on substance abuse
prevention education. The Council is licensed by the Department of Children and Families to
provide substance abuse information/referral, and universal, selective and indicated prevention
services. The Council has administered the Federal Bryne Block Grant for Indian River County
since 1990 . The Council has kept its pulse on the County' s constantly changing and emerging drug
use problem and carries out its goals through a variety of programs.
The following are a list of programs provided by the Council.
• Community Education and Information and Referral
• Drug-Free Workplace Education
• PRIDE Survey Administration & Planning
• Lending Library of videos, books & materials
• Deep Impact- PREVENT Improv Troupe
• Teen STEP After-School Program
• Right Choice Program
• Life Skills Training Program
• Tobacco Violators Education Classes
• HIV TARGET Program
• TIP ' S Truancy Program
• Dasie Hope Center
• Adult Court Ordered Community Service Coordination
• Program AWARE
• Drug Screening for Youth
• Drug-Free Events, ie : Say Boo to Drugs, Red Ribbon, Brown Ribbon,
Kick Butts Day
• Administration of the Federal Byrne Anti-Drug Abuse Grant for Indian River
County
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one e)
1 , a) What is the unacceptable condition requiring change? b) Who has the need? c) Where
do they live? d) Provide local, state or national trend data, with reference source, that
corroborates that this is an area of need.
According to the Florida Youth Substance Abuse (FYSA) and PRIDE Surveys, IRC youth exhibit
above average risk factors and levels of drug usage. These survey reveals the extent of substance
abuse occurring amongst our young in IRC . Even though there has been a downward pattern in
drug use trends over the past few years, IRC youth are still reporting drug use and delinquent
behavior that will negatively affect their lives and our society.
IRC youth key Dru& Use Trends from the FYSA Survey 2000 to the 2002 reflect the same
observed pattern of reduced ATOD use as in the statewide Survey .
• The "past-30-day use of alcohol' by surveyed IRC students declined from 39 . 3 % in 2000 to
37 . 1 % in 2002 .
• Marijuana use also appears to reflect the statewide pattern. "Past-30-day use " of marijuana by
surveyed IRC students declined from 17 . 2% in 2000 to 14. 3 % in 2002 .
• Cigarette use among IRC students declined sharply in the past two years. In 2000, 22 . 7% of surveyed
students reported some use of cigarettes over the "past 30 days ", compared to 14 . 1 % in 2002 .
Attitudes toward Drug Use
• Almost two-thirds of surveyed IRC students (62 . 9%) reported that daily use of cigarettes poses
a "great risk" of harm.
• Fear of marijuana use declines as students get older, while the fear of cigarette use actually
appears to increase. While 67 . 3 % of surveyed middle school students believe regular marijuana
use poses a "great risk" of harm, this number drops to 49 . 3% among high school students . In
contrast, perceptions of harm associated with daily use of cigarettes rise from 56. 8% among
middle school students to 67 . 4% among high school students.
• Disapproval of substance use appears to decline as students get older. For instance, disapproval
of alcohol use (76 . 2% in middle school and 52 . 2% in high school), disapproval of cigarette use
(84 . 9% in middle school and 66 . 5% in high school) and disapproval of marijuana use (90 . 0% in
middle school and 69. 3 % in high school) all decline between middle school and high school .
Risk and Protective Factors
• Surveyed students reported higher scores on the Personal Transitions and Mobility (63 ) and
Favorable Attitudes toward Antisocial Behavior (57) risk factor scales, compared to the
national average of 50 . This means that students in IRC are at greater risk for involvement in
drug use and other antisocial behaviors due to a lack of long-term neighborhood connection,
and due to students' acceptance of antisocial behaviors. Parental uselparental attitude towards
ATOD/use also correlates with adolescent attitudes towards/use of ATOD .
These key findings illustrate the complexity of drug use and antisocial behavior among IBC ' s youth
and the possible factors that may contribute to these activities. While some of the findings compare
favorably to the national findings, Indian River County youth are still reporting drug use and
delinquent behavior that will negatively affect their lives and our society.
2 a) Identify similar programs that are currently serving the needs of your targeted population ; b)
Explain how these existing programs are under-serving the targeted population of your program.
Local Law enforcement provides the DARE program to all 5th grade students in IRC . No specific
substance abuse prevention programs are directed at the middle school populations. Additionally,
New Horizons and DATA provides Student Support Specialist and services in the public middle
schools. Both these agencies work with a very small, indicated population of students and do not
serve the entire population of youth. This remaining population of youth would receive no
additional program services if the LST program were not available. Collaboration is a part of the
services provided to universal populations. The LST program provides no duplication of services.
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
C. PROGRAM DESCRIPTION (Entire Section C, I — 6, not to exceed two pages)
1 . List Priorit
y Needs area addressed. Mental Wellness Issues Ages 642 and Ages 13- 15
2. Briefly describe program activities including location of services.
The LST program is a three year prevention program designed to be conducted in school
classrooms. Based on Theoretical framework, the LST program was developed to impact drug-
related knowledge, attitudes and norms; teach skills for resisting social influences to use drugs and
promote the development of general personal self-management skills and social skills . Consistent
with this, the LST program can be best conceptualized as consisting of management skills. The
second component focuses on teaching general social skills. The third component includes
information and skills that are specifically related to the problem drug abuse. The first two
components are designed to enhance overall personal competence and decrease both the
motivations to use drugs and vulnerability to drug related social influences. The problem specific
component is designed to provide students with materials relating directly to drug abuse (drug
resistance skills, anti-drug attitudes, and anti-drug norms). Services will be provided in Indian
River County Middle Schools.
The LST program is a primary prevention program that targets individuals who have not yet
developed drug abuse problems. The goal of the program is to prevent the use of gateway
substance use among adolescents by making an impact on risk and protective factors associated
with tobacco, alcohol, and marijuana use, particularly occasional and experimental use.
Simultaneously a systematic community awareness campaign is conducted . It is designed to impact
community norms and educate the community regarding the incidence of substance abuse. On the
FYSA Survey (2002), Indian River County scored higher than the State and other like Counties in
the following risk factors areas:
• Poor Family Supervision
• Poor Family Discipline
• Family History of Antisocial Behavior
• Parental Attitude Favorable to ATOD use
• Parental Attitude Favorable to Antisocial Behavior
• Friends Use of Drugs
• Peer Rewards for Antisocial Behavior
• Youth Attitude Favorable to Antisocial Behavior
• Youth Attitude Favorable to ATOD use
• Perceived Risks of Drug Use
• Early Initiation of Drug Use
• Sensation Seeking
According to Center for Substance Abuse prevention (CSAP), Selected Findings In Prevention, A
Decade of Results from the Center For Substance Abuse Prevention, 1997, the findings indicate
that the proposed strategies above are effective with this target population. They demonstrated
repeated documentation that adolescent risk perceptions were favorably impacted by reducing
favorable parental, peer and community attitudes towards ATOD.
We must take these facts and information and as with all knowledge, empower ourselves and
educate our youth and community. The LST program is a research based, proven effective
curriculum in the reduction of adolescent drug usage and has been endorsed by the Center for
Disease Control (CDC) . The LST program was selected by the Center for the Study and Prevention
of Violence (CSPV), University of Colorado at Boulder as a Blueprint 2000 program and OJJDP
selected the LST program for replication nation-wide and is 1 of only 11 programs that is
considered "exem 1 " by all program evaluators.
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
3. Briefly describe how your program intends to address the stated need/problem. Include
reference to any studies or evidence that indicate proposed strategies are effective with
target population.
The LST program is based on Theoretical framework. The LST program was developed to impact
• drug-related knowledge
• attitudes and norms
• teach skills for resisting social influences to use drugs
• promote the development of general personal self-management skills and social skills.
Since all of these skills are directly related and positively impact to Drug Use Trends, Attitudes
towards Drug Use and Risk and Protective Factors, the continuation of the LST program and it ' s
protective skill building framework should continue to contribute to the
• Decline in Drug Use Trends
• Increase in perceived risk or harm of substances
• Decrease risk factors such as Favorable attitudes to ATOD use
• Delay the age of onset for early initiation of drug use
4. List staffing needed for your program, including required experience and estimated hours
per week in program for each staff' member and/or volunteers (This section should
conform with the information in the Position Listing on the Budget Narrative Worksheet).
The LST program is currently staffed by three Council employees. The LST Coordinator assumes
primary responsibility for the LST program. One hundred percent (35 hours per week) of this
position is currently allocated to the program. Two LST (33 hours per week) instructors are also
assigned to this program and currently dedicated 100% of one position and 50% of the other .
The need now exists the need to increase staffing to three full time instructors help continue to
implement the program to the incoming 6th, 74 ' and 80' grades in the fall of 2003 .
During year 3 , all 8a' graders will continue with LST booster instruction, while we concurrently
implement the 1 and 2d year classes to the 6a' & 74h grades. Each year an estimated total of 3 , 900
students will receive
• 17 sessions in the a grade
With on going LST booster sessions, instruction will continue with
• 10 sessions in the 7a' grade
• 5 sessions in the 8'h grade
The LST Coordinator has had 3 years of experience in the substance abuse prevention field holds
BA and has a background in education. The other two LST instructors hold BA' s in education. All
LST instructors are nationally certified to teach the LST curriculum.
5. How will the target population be made aware of the program?
The LST program has been offered to all middle schools in Indian River County. In order to
qualify as an OJJDP site all middle schools had to agree to allow the Substance Abuse Council to
implement the LST program in a classroom period. The remaining private schools were also
invited to receive services from the Substance Abuse Council . They were made aware of the
program by letter with a fbllow-up face to face meeting.
6. How will the program be accessible to target population (i.e. location, transportation,
hours of operation)?
As previously stated, LST program is implemented during the school day in all Indian River
County Middle Schools. Instructors render themselves to the individual school sites.
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages)
OUTCOMES ACTIVITIES
Add all the elements or the Measurable Outcomes Add the tasks to accomplish the Outcome s)
1 . To decrease by 5% the "first use" numbers of 1 . To provide 3,900 youth weekly LST group
drug and alcohol use among middle school sessions to youth according to the following
students over a period of one year as reported by schedule :
the 2004 FYSA survey. ( Baseline 2002 FYSA • 17 sessions in the 6th grade
Survey) • 10 sessions in the 7'`
• 5 sessions in the a grades.
2 . To reduce by 2% the incidences of sixth gradc 2 . . To provide a total of seven-teen ( 17) weekly
adolescents reporting the use of tobacco, alcohol ongoing education sessions to sixth grade students
and marijuana following the first year of LST on the various substance abuse and resiliency skill
Program as reported by the 2004 FYSA Survey building topics
(Baseline 2002 FYSA Survey)
3 . To reduce by 21/o the incidences of seventh 3 . We will provide a total of ten ( 10) weekly
grade adolescents reporting the use of tobacco, ongoing booster education sessions to seventh
alcohol, and marijuana following the second grade students on the various substance abuse and
year of LST program as reported by the 2004 resiliency skills building topics
FYSA Survey (Baseline 2002 FYSA Survey)
4 . To reduce by 1 % the incidences of eight 4 . We will provide a total of five (5 ) weekly
grade adolescents reporting the use of tobacco, ongoing booster education sessions to seventh
alcohol, and marijuana following the third year grade students on the various substance abuse and
of LST program as reported by the 2004 FYSA resiliency skills building topics
Survey (Baseline 2002 FYSA Survey)
5 . To increase audience knowledge by 25% 5 . Provide factual, current and up-to-date
following educational presentation forums information concerning drugs and their harmful
concerning drugs and their harmful effects effects.
as reported by self-disclosure on pre-testing. . Pre/ post testing will be conducted and rated to
(Baseline: Individual and group indicate a change in knowledge.
administered Pre-tests of forum
participants . )
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Substance Abuse Council of Indian River County Life Skills Training Program Children 's Services Advisory Committee
OUTCOMES ACTIVITIES
Add all the elements or your Measurable Outcomes Add the tasks to accomplish the Outcome(s)
6 . To reduce by 20% self-reported high-risk 6 . Provide factual, current and up-to-date
behaviors responses reported by audience information concerning high-risk behaviors and
participants following educational resulting harmful effects .
presentation forums . (Baseline : Individual Pre/post evaluations of the KABPs to indicate a
and group administered KABP [Knowledge, change in participation in high-risk behaviors .
attitude, belief and practice] of forum
participants . )
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
G. COLLABORATION (Entire Section E not to exceed one page)
1 . List your program ' s collaborative partners and the resources they are providing to the
program beyond referrals and support. (See individual funder requirements for inclusion
of collaborative agreement letters.
Collaborative Agency Resources provided to the program
Venue for program delivery,
School Board of IRC Encourage teacher training
Venue for on-going teacher training
University of Miami Provide technical assistance for program evaluation
Provide technical assistance in student progress evaluations
Office of Juvenile Justice Provide Technical assistance for program implementation
Delinquency Prevention Provide curriculum for student population receiving LST
instruction
Center for Violence Prevention, Provide Technical assistance for fidelity of program
University of Boulder delivery
Department of Children and Families Provide additional program funding
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
F. PROGRAM EVALUATION (Entire Section F not to exceed two pages)
1 . DEMOGRAPHICS: What information (data elements) will you need to collect in order to
accurately describe your target population including demographics (age, gender and
ethnic background) required by the funder in Section H? What are the pieces of
information that qualify them for your target population? How do you document their
need for services or their "unacceptable condition requiring change" from Section Bl ?
As a licensed substance abuse provider in the State of Florida, the Council is required to utilize the
State of Florida, Department of Children and Families, MA- SA (Mental Health-Substance Abuse)
Data Warehouse Database. Complete, detailed, but confidential information is complied an all
clients who request services of the Council. The demographic information required includes but is
not limited to :
Name Family composition and status
Age Living accommodation
Gender and ethnic background Drug of Abuse
Address Frequency of use
Social Security number Age of onset
Type of services needed Type of services provided
Duration of services Length of stay
In addition non-client specific data is also maintained. Time, duration, number of participants,
location of service delivery and date are maintained . Client and non-client specific data are
maintained in a confidential, password protected database.
Additionally the Council maintains statistics on the LST program The Council is also a part of the
State of Florida, Florida Youth Initiative Evaluation program. The University of Miami conducts
random, unannounced evaluation of both program process and content. Establishing performance
targets for strategy goals and objectives is a very important part of prevention program
implementation process. Ultimately they will also randomly sample our prelpost test and conduct
evaluations on their rate of change and validity.
This additional information helps the Council to track new trends of use or abuse, types of drugs
being used, types of services needed and provides information on the type of educational
development and continuing education needed for both staff and community.
The LST program utilizes several short term indicators to measure the impact on
achievement of this program ' s goals. The evaluation tools used are as follows :
• Pre and Post testing - Pre test are performed to measure the audience ' s basal knowledge
prior to the presentation. Following the presentation, post tests are conducted.
• Pride Survey
• Florida Youth Substance Abuse Surve YSA
2. MEASURES : What data elements will you need to collect to show that you have achieved
(or made progress toward) your Measurable Outcomes in Section D? What tools or items
are you using as measures (grades, survey scores, attendance, absences, skill levels) for
your program ? Are you getting baseline information from a source on your Collaboration
List in Section E? Are there results from your Activities in Section D that need to be
documented ? How often do you need to collect or follow-up on this data?
Pre test are administered to the entire population of cohorts simultaneously, prior to instruction.
Post testing is conducted following the completion of instruction. These pre and post test are
evaluated by the University of Miami to establish achievement of measurable outcomes . Other
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Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
program data elements such as program delivery and maintaining program fidelity are collected on
a weekly basis and sent to the University of Colorado for evaluation. Required demographic data
is complied and reported to the State of Florida monthly. PRIDE and FYSA Surveys are
conducted alternating every other year. The 2003 PRIDE Survey results are due in the summer of
2003 and the FYSA Survey is due in 2004 .
3. REPORTING: What will you do with this information to show that change has occurred?
How will you use or present these results to the consumer, the funder, the program, and
the community? How will you use this information to improve your program ?
Establishing performance targets for strategy goals and objectives is a very important part of
prevention program implementation process. These performance measures indicate the success of
the LST program by establishing the rate of change in perceived harm, level of drug use and the
validity of the program implantation.
This additional information helps the Council to track new trends of use or abuse, types of drugs
being used, types of services needed and provides information on the type of educational
development and continuing education needed for both the community and its staff.
All program data is complied via computer database programs. All program data and statistics are
shared with the community, funders and concerned parties, as the law allows.
12
Substance Abuse Council of Indian River County Life Skills Training Program Children's Services Advisory Committee
G. TEMETABLE (Section G not to exceed one page)
1 . List the major action steps, activities or cycles of events that will occur within the program
year. New programs should include any start-up planning that may occur outside the
fundingyear. In com letin the timetable, review information detailed in rior sections.
Month/Period Activities
August 2003 Pre grant year request operations of coordination of school, classroom and
teacher LST schedules for instruction.
September 2003 Implementation of all pre-testing on all cohorts simultaneously.
October 2003 - June Implementation of classroom instruction per coordinated schedules.
2004
December 2003 Compilation and evaluation of data for the I ' quarterly report
March 2004 Compilation and evaluation of data for the 2nd quarterly report
June 2004 Post testing on all cohorts simultaneously.
Compilation and evaluation of data for the 3 d quarterly report
July- August 2004 Ongoing Instructor training and technical assistance.
September 2004 Compilation and evaluation of data for the 4a' quarterly and annual
report
October 2003 - June Ongoing collaboration with all collaborating agency on program progress,
2004 obstacles and any other program responsibilities as they arise.
13
1 1 • 1 1 1 1 1 1 ' 1 ' 1 J 11 1 11 1 ' 1 1 1 1
II 1 I 11 1 1KIMI t\ 1 Eel 1 1
Budget I I I s . .- r of v p 1 B
WEA Om
1 1 1 I 1 1 1 I Ir1 mm,I1 1
S . Indian River County
1 , 1 &MM I I • :
1 1 ,
1 Hobe Sound
Port Saint Lucie
St Lucie 1Total
m Kill W41 1612ay2 1 . � � • � �
II I 1 I r, M 1 ' I KeI ! ,
-s 2- x'�
-s-u"�'^a. ✓�-a,s � � �` �,y e' `�'� �'a"$.x z"'� e`w`e ,,,� � � `
� F1
�. ����s: 1 1 1
is
im
Wei Wei DI AM Do 1 �
Substance Abuse Council of IRC
UNIFORM GRANT APPLICATION
BUDGET NARRATIVE WORKSHEET
IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for
your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder
Specific Budget Forms,
AGENCY/PROGRAM NAME : Substance Abuse Council of IRC
FUNDER: Children Services Advisory Committee
CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should On
� be used for calculations and to write information onlv. 1
i crurJWtEwsF= ,
REVENUES AGEWYUBEOIL. Proposed TOW Program Funder Spec Total Agemy
C
°E Budget Budget &idgo
1 Children's Services Council-SL Lucie 0.00 0.
00
2 Children's Services Coundl-Martin 0.00 0.
00
3 Children's Services Council-0keedrobee 0.00 0.
00
4 Advisory Committee-Indian River 50,000.00 509000.00 175,000.
S United Way-SL Lucie County 0.00 0.00
6 United Way-Martin County 0.00 0.00
7 United Way-Okeechobee County 0.00 0.
8 United Way4ndian River County000 W000.001
9 Department of Children & Families 759000.00 75,(x10.
001
10 County Funds 0.00 1 ,850.
21
11 Contributions-Cash 0.00 507000.
12 Program Fees 0.00 21 ,300.
13 Fund Raising Events-Net 0,00 25,000.
00
14 Safes to Public - Net 0.00 8,000.
13 Membership Dues 0.00 6,500.
16 Investment Income 000 800
17 Miscellaneous 0.00 0.
.001
18 Legacies & Bequests 0.00 0.
19 Funds from Other Sources 0.00 334279.
20a Reserve Funds Used for Operating 0.00 0.
20 M-Kind Donations (Not included in total) 0.00 0.00
21 TOTAL REVENUES (doesn't
include line 20b)_ 125,000.00 x50,000.00 $783,729.
EXPENDITURES aar � roB C D
POR
�crusEowr Proposed Total Program Funder Specific Total Agency
.cN.c� Budget Budget B
ud
22 Salaries - (must complete chart on next page) get
ONOWIL 44
76.362.00 46546.00 402,470.00
Salary
23 FICA - Total salaries x 0.0765 7.65'/e 5,842.00 31454.00 30.789.00
24 Retirement --Annual pension for qualified staff
901 .00 0.00 77626.00
25 Life/Flealth - Medical/Dental/Short-tern Disab. 11 ,400.00 0.00 29,400.00
26 Workers Compensation - # employees x rate 1 909.00 000 41790.
Flonda hemp oyme - pr
27 employees x $7,000 x UC T 6 rate 0.00 0.00 51000.00
5J2412M
15
substance Abuse Council or IRC
SALARIES A
B D
POSITION USTING "�wy Portion of Safwy on Proposed C Specflic BudgetFunder % otGross Annual
Posidon ride / Total HrsAvlc (Agency) Pyr Salary Requested(W)
ixampW iExecudveDkectorl40Ars 70rOOGLOOl 100000.00
Executive Director -40 hrs/ wk 54,724.00 0.00 0.00X000 %
00 0.00%
Prevention Program Coordinator-40 hrs ! wk 37,500.00 0.00 0.00%
LST Coordinator -35 hrs /wkl$16.5 309030.00 30,030.00 30,030.00 0.00
PREVENT Program Coordinator-40 hrs I wk 28,000.00 0.00 0.00
Peer Educator- 30 hrs /wk / $9 14,040.00 0.00i 0.00°
Lifeslalls Educator (1 ) - 33 hrs / wk/$13.75 23,595.0023.595.00 16.516.00 100.00
LiferJd9s Educator (2) -33 hrs / wk/$13.25 222737.00 22.737.00 100. 00%
Diversion Specialist -40 hrs / wk 27,500.00 0.00 0.00%
HN Program Coordinator-4o hrs / wk 28,500.00 0.00 0.00%
HIV Program Assistant -40 hrs / wk 259500.00 0.00 0.00
Information Specialist- 30 hrs / wk/ $11 .50 17,940.00 0.00 0.00
HIV Peer Educator- 24hrs / wk/ $10 12,480.00 0,00 0.00
Case Manager - 24 hrs / wk $14.00 17,472.00 0,00 0.00%
Dasie Hope Coordiantor - 40 hrs ! wk 32,500.00 0.00 0.00°'k
Dasie Hope Assistant (1 ) - 32 hrs ! wk/ $9 14,976.00 0.00 0. 00
Dasie Hope Assistant (2) - 32 hrs ! wk/ $9 14,976.00 0.00 0.00
0.00 0.00%
Remaining position throughout the agency
Total Safedes $402s470.001 $76,362.001 $46,546.001 11 .57°
FRINGE BENEFITS DETAIL A
(Funder Specific Budget Funder a Pension n @Yoeirer's unemproyne rotaf Funs Funder
Column C only, from line 22 to 27) Specific FICA 7.65% fA x 99Heaft Ins. Coopers nt Gompens Specific
Posigon Tide / Total H►sAv* Buck
fie: rase ManaW140 hrs 58000.00 3BL50 20000 500.00 300.00 200.00 $68Z.5D
Executive Director -40 hrs/ wk 0.00 0.00 0.
Prevention Program Coordinator-40 hrs / wk 0.00 0,00 0
LST Coordinator -35 hrs /wk/$ 16.5 30,030.00 26297,00 0.00 2 ,297.
PREVENT Program Coordinator-40 hrs / wk 0.00 0.00 0
Peer Educator- 30 hrs /wk / $9 0.00 0,00 0
Lifeskills Educator (1 ) - 33 hrs / wk/$ 13. 75 16,516.00 10157.00 11157.
Lifeskills Educator (2) -33 hrs / wk/$ 13.25 0.00 0.00 0.
#REF ! 0. 0.00 0.00 0.00 0.
Diversion Specialist -40 hrs / wk 0.00 0.00 0.
HIV Program Coordinator-40 hrs / wk 0.00 0.00 0 .
HIV Program Assistant -40 hrs / wk 0.00 0.00 0
Information Specialist- 30 hrs / wk/ $ 11 .50 0.00 0,00 0.
HIV Peer Educator- 24hrs / wk/ $ 10 0.00 0,00 0.
Case Manager - 24 hrs / wk $ 14 .00 0.00 0.00 0
Dasie Hope Coordiantor - 40 hrs / wk 0.00 0.00 0.
Dasie Hope Assistant (1 ) - 32 hrs / wk/ $9 0.00 0.00 0
Dasie Hope Assistant (2) - 32 hrs / wk/ $9 0.001 0,00 0.001
0 0.001 0.00 0.
001
0 0.001 0.00
0.
0 0.001 0.00 0.
In
Total Funder Request FtingeBenefrts $46, 546.00 $3,454.00 $0.00 11001), $0 .001 $0.00 $3,454 .
5/24/2003
16
Proposed Funder SpecfficTotal , .
ncy
Budget BLdget Budget
1 . -
1
/ 1
x .29=$1 ,015
SWAT 1 miles a month
LST 385 miles a month
DIV 300 miles a month
HIV 1 miles a month
Prevent 1 miles a month
RC 1 miles a month / . miles a
$5,933 Ex Director 15
' month x 12 months-- rle miles x
7iL-- -
FADDA regishation1 Hotel
$150 per night x 3 nights . 1
Y Y
/ t
Tolls ! $9000
1
ConferenceKids of TC 5 1 =$550
Hotel i .
rooms X 11 $21 Per them per
National Conference (cost per staff) day x 3 days = $63 x 11 empolyees
Training/Seminar (cost per staff) LK _ 1000milesx
' 1
Tolls $100 r .r : 1
i11 11 . 1 '1 11
• I . � r • 11 • 1
. . . ,
: lel
1 / . 1 / 1
1
month
1 : !
• - average_ - ham per month x izog ' Pagersmonth employees
,months = local phone cost !=96 x 12 = 1152
Average long distance calls x 12 months
I < 1 /
EStinlated h • . o • . distance
: 1 ' 11 1 11
Bulk Mail 3
11 per month
mon1hs-- I !
AirborneBulk mail permit $300
Post office Box Rental $200
Fed Ex or per month.
. 11
I I
Shmonths)
Water/Sewer ($ x 12 moryths)
Garbagex 12 monft) . . 111
lots
• ' a 1
Printing & Publications
Quarterty Newsletter ($ x 4) Newsletters
411 11
Letterheaft, Envelopes, etc.
Letterhead.etc $12W
FuMraising ' PRIDE '. 9111
Other . $30,000
• . • . . t # .=- T 71
Membership to National Organizationi
• e. 1
Subscriptions to Newspa-rz&kq�Tazines,
of
Copier
Meter lease ($ x 12 months)
Copier Maintenance • I
/ : 11
Computer Main - • - months) 11 1 t • 1 a - « -
• ' a 11 • - ' 1 • 1 . . 11
• • 1 • :�' 11 ' 11
• • 1 1 11
• I _ r_ h "" 111I • • - LW 111
J • • . •
bm �401 , 01 11 uca
. • � • • 1 ' 1 11 1 11 111 1 {
bjL* g Youth snacks $30 a week x 52 weeks
uc . •A` h - - c •
• r. - -
• 1 - • . . 111
: . .
11
• 1773
► 1 11
. - • °' . • . _;F1fW � • - - 111 11
• •. • • . •
• 1 �
� 1 . - • 1 11 . 11
• : 111
• M
1 11 fill
Program91 per session
session per 1 II
sessionsRight Choice $ 90 per session x2
t $92000
1
Uleskift • 1 per • ,
training $3000
1
Prevent 1 psychosocials x $60= 111
300 Individuall Family sessions x
• h • • • ' • • _ h $60=9000
ME 0 / J'/1711 z
' 1.t
Type Ne Orgavzebm aM Provre mane
UNIFORM GRANT APPLICATION
TOTAL AGENCY BUDGET
AGENCY/PROGRAM NAME: Substance Abuse Council 1 Life Skins TrainingProram
FY 01102 FY 02!03 FY 03A4 % INCREASE
FYE Sept 30,2003 FYE Sept 30,2004 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (cat C-ca epees. B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0.00 0.00 0.00 0.00%
2 Children's Services Council-Martin 0.00 0.00 0.00 0.00%
3 Children's Services Council-Okeechobee 0.00 0.00 0.00 0.00%
4 Advisory Committee-Indian River 7500000 110000.00 175 000.00 59.09%
5 United Way-St Lucie County 0,00 0.00 0.00 0.00%
6 United Way-Martin County 0.00 0.00 0.00 0.00%
7 United Way-Okeechobee County 0.00 0.00 0.00 0.00%
a United Way4ndian River County 40 419.00 62 000.00 86 000.00 38.71 %
9 Departrnent of Children & Families 75 000.00 769000.001 75 000.00 0.00%
to County Funds 19850,00 19850,0010 11860.00 0.00%
11 Contributkms-Cash 47 594.00 50 000.00 60 000.00 0.00%
12 Program Fees 45 754.00 15 000.00 21 300.00 42,00%
13 Fund Raising Events-Net 35 56.00 M 25 000.00 25 000.00 0.00%
14 Sales to Public-Net 81071 .001 M 82000100 89000.00 0.00%
15 Membership Dues GAOO.00 67500,001 E 61500.001 0.00%
16 Investment Income 0.00 800.00 800.00 0.00%
17 Miscellaneous 0.00 0.00 0.00 0.00%
19 Legacies & Bequests 0.00 0.00 0.00 0.00%
19 Funds from Other Sources 282M8.00 31 19.00 N 334 279.00 6.38%
20a Reserve Funds Used for Operating 0.00 0.00 0.00 0.00%
In4Gnd Donations P&* hwkwed in twA 0.00 0.00 0.00 0.00%
21 TOTAL 618192.00 668 369.00 783 729.00 17.26%
EXPENDITURES
22 Salaries 320 928.00 333 .00 402 470.00 20.69%
2a FICA 27 .0027 926.00 30 789.00 10.25%
24 Retirement 61831 ,00 488200 7p626.00 66.21 %
25 LifelHealth 20 1 .00 43y200.00 2940000 31 .94%
26 Workers Compensation 31819,001 39967.001 41790.00 20.75%
27 Florida Unemployment 0.00 11500.00 61000.00 233.337
2s Travel-Daily 16152.00 1502800 21 t380.00 42.27%
29 TravellConferences/rrainin 161"1 .00 15 6.00 2456600 57.82%
30 Office Supplies 51778.00 62600,00 6600.00 0.00%
M Telephone 109968,001 91600.001 8,460.001 -11 .88%
32 PostagelShipping 25599.00 31000.00 422000 40.67%
33 Utilities 3 629.003 640.00 4,000.00 9.89%
34 Occupancy Buildin & Grounds 23147.00 23 028.00 23w028.00 0ffl44.476%/o
00%
35 Printing & Publications 18 936.00 41 ,00 4140000
36 Subscri tioNDues/IMembershi s 599.00 100000 1 000.00
37 Insurance 59698.00 69971 .00 10 071 .0038 E ui t:Rentai & Maintenance 2 76.00 5
.00 6 000.0039 Advertise 14 870.00 14 .00 14 419.00
40 Equipment Purchases:Ca ital Expense 0.00 17500.00 3y000.00 100.00%
41 Professional Fees (Legal, Consulti0.00 29000.9D 200000 0.00%
42 Books/Educational Materials 50 518.00 51 5.00 5096800 -1 .77%
43 Food & Nutrition 0.00 11560.00 1 ,560,00w 0.00%
44 Administrative Costs 0.00 0,00 0.00 0.00%
45 Audit Expense 8 334.00 8000.00 900
00.00 12.50%
46 S 'fic Assistance to individuals 4108.00 31000.001 51000.00 66.67%
47 Othertl3epreciatiordMiscellaneous 16 951 .00 61350.001 67350 .0001 0.007
46 OthedCuntract 39120.00 28 500.00 31 500.00 10.53%
49 TOTAL 619 687.00 663 369 .00 753 729.00 13.62%
50 REVENUES OVER/ UNDER EXPENDITURES
-1495.00 5,000 .00 30 ,000.00 500.00%
ea4noos
19
d TWe ft Or9QQ8bm � • rogrw SIR
UNIFORM GRANT APPLICATION
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME: Substance Abuse Council / Life Skills TrainingPr ram
FY 01102 FY 02103 FY 0=4 % INCREASE
FYESept 30, 2002 FYESW 30 2003 FYESept 30, 2004 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (COL C.e°L Byea B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0.00 0.00 0.00 #DIV/O!
2 Children's Services Council-Martin 0.00 0.00 0.00 #DIV/O!
3 Children's Services Council-Okeechobee 0.00 0.00 0.00 #DIV/O!
4 Advisory Committee-Indian River 35 000.00 40 000.00 60 000.00 25.00%
5 United WaywSt Lucie County 0.00 0.00 0.00 #DIV/O!
6 United Way-Martin County 0.00 0.00 0.00 #DIV/O!
7 United Way-Okeechobee County 0.00 0.00 0.00 #DIV/01
9 United Way4ndian River County 0.00 0.00 0.00 #DIV10!
9 Departinent of Children & Families 37 500.00 75 000.00 75 000.00 0.00%
to County Funds 0.00 0.00 0.00 #DIV/O!
11 Contributions-Cash 0.00 0.000.00 #DIV/O!
12 Program Fees 0.00 0.00 0.00 #DIV/01
13 Fund Raise Events-Met 0.00 0.00 0.00 #DIV10!
14 Sales to Public-Net 0.00 0.00 0.00 #DIVIO!
15 MembershipDues 0.00 0.00 0.00 #DIV/O!
16 Investment Income 0.00 0.00 0.00 #DIV/01
17 Miscellaneous 0.00 0.00 0.00 #DIV10!
19 Legacies & Bequests 0.00 0.00 0.00 #DIV/O!
19 Funds from Other Sources 0.00 0.00 0.00 #DIV/O!
20a Reserve Funds Used for Operating 0.00 0.00 0.00 #DIV/O!
Mb In-Kind Donations (mat rwkm°a : tot* 0.00 0.00 0.00 #DIV/O!
21 TOTAL 72r500,00 115 000.00 125 000.00 8.70%
EXPENDITURES
22 Salaries 43 600.00 7498600 76 362.00 1 .84%
23 FICA 39328.00 6t736.00 55842.00 1 .85%
24 Retirement 0.00 0.00 901 .00 #DIV/O!
25 LifeMealth 600.00 4j200.00 11 A00.00 171 .43%
26 Workers Compensation 517.00 3t272.00 909.00 -72.22%
27 Florida Unemployment 0.00 0.00 0.00 #DIV/O!
29 Travel-Daily 860.00 990.00 12015.001 2.53%
29 Travel/Conferences7Train" 49765,00 5156.00 79273.00 41 .06%
30 Office Supplies 400.00 600.00 600.00 20.00%
31 Telephone 890.00 11000.00 111300 11 .30%
32 Pos hi 260.00 600.00 608.00 21 .60%
33 Utilities 250.00 250.00 264.00 5.60%
34 Occupancy (Building & Grounds 11 160.00 11 160.00 11 160.00 0.00%
35 Printing & Publications 0.00 0.00 0.00 #DIV/O!
36 SubscriptionlDuestMemberships 250.00 250.00 250.00 0.00%
37 Insurance 1000.00 1000.00 1001 .00 0.10%
39 EquipmentaRental & Maintenance 600.00 500.00 588.00 17.60%
39 Advertise 11250.00 21W0.00 2 897.00 15.88%
40 Equipment Purchases:Ca 'tal Expense 0.00 0.00 0.00 #DIV10!
41 Professional Fees al Consulting) 0.00 0.00 0.00 #DIV10!
42 Books/Educational Materials 1500,00 IrS00,00 11317.00 -12.20%
43 Food & Nutrition 0.00 0.00 0.00 #DIV/O!
44 Administrative Costs 0.00 0.00 0.00 #DIV/O!
45 Audit Expense 19500.00 11500.00 150000 0.00%-
46 Specific Assistance to Individuals 0.00 0.00 0.00 #DIV/O!
47 Otim Miscellaneous 0.00 0.00 0.00E#DIV/O!
49 OthedContract 0.00 0.00 0.0049TOTAL 72 500.00 115000.00 125 000.00 .70%50
REVENUES OVE UNDER EXPENDITURES 0.00 0.00 0.00
Sn4 2003 20
• Type th Organization and Program Name
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
AGENCYIPROGRAM NAME : Substance Abuse Council / LifeSkills Training Program
FUNDER: Children Services A B C
FY 03104 FY 03/04 % INCREASE
TOTAL FUNDER TOTAL VS,
PROGRAM SPECIFIC FUNDER REQUEST
BUDGET BUDGET col. B/col. A
EXPENDITURES
22 Salaries 769362.00 469546 .00 60.95%
23 FICA 5,842.00 3 454.00 59. 12%
24 Retirement 901 .00 0.00 0.00%
25 Life/Health 11 ,400m00 0 .00 0 .00%
26 Workers Compensation 909 .00 0.00 0 .00%
27 Florida Unemployment 0.00 0.00 #DIV/01
28 Travel4Daily 10015000 0 .00 0 .00%
29 Travel/Conferences/Training 7927100 0.00 0.00%
30 Office Supplies 600.00 0.00 0.00%
31 Telephone 1111100 0.00 0 .00%
32 Postage/Shipping 608 .00 0 .00 0 .00%
33 Utilities 264.00 0.00 0.00%
34 Occupancy (Building & Grounds 11 , 160 .00 0 .00 0.00%
35 Printing & Publications 0.00 0.00 #DN/01
36 Subscription/Dues/Memberships 250.00 0 .00 0 .00%
37 Insurance 19001 .00 0.00 0.00%
38 E ui ment: Rental & Maintenance 588 .00 0 .00 0.00%
39 Advertising21897,00 0 .00 0.00%
40 Equipment Purchases:Ca ital Expense 0 .00 0 .00 #DIV/0!
41rFood
ssional Fees (Legal, Consultin 0 .00 0 .00 #DN/0 !
42 /Educational Materials 19317 .00 0.00 0 .00%
43 & Nutrition 0 .00 0 .00 #DIV/0!
44 mnistrative Costs 0.00 0 .00 #DN/01
45 Audit Expense 11500,00 0 .00 0.00%
46 Specific Assistance to Individuals 0 .00 0 .00 #DN/0!
47 Other/Miscellaneous 0 .00 0 .00 #DN/0!
48 Other/Contract 0 .00 0.00 #DN/0 !
49 TOTAL $ 125,000 .00 $ 509000 .00 40 .00%
5242003
21
- ��-g'sa'ma� s -�_ � a�ms^���m�.m-s» - .y -�-r s•ca•�.".� y:x_ �+ � �r�+c� � s ^mss. . �
�.zY'^�,a
,,,{� ��m %� f ggm Fu's+ x` "z-,�' {�+ '` "+5S v, u..:r �» .-�'c s�£g?"''Y u' '�£ a J � d � � • @ 3 i f�
a'h � }.;e 3 i s r �.,r. `{3 � £
���,��ro', �-�✓c - _;' � '"'4h�*�. [i,?t;�� .�sw'"�s.� �.��...�, .�`:�.v�.....t_.v`Y-�a �+�'�:�s � 1r.� d�€tf . 1 � .t ��:,�°J'?a'.,�5
6w`�:rsT,�` � . r 'c�"<. �k-�,.'c�Y
• • 1
. • 1
: ■ 1
a 1
• . 1
: • 1
a . ' 1
. . 1
, • 1
� • 1
: • 1
. ■ 1
♦ - mac.I I Tom I ✓. U - - • . . • i 1 . r TY I• . f 1
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J � • • IIC - Ti. • • • 1 •: • P - • • 1 .� . • • . • - f
Mo y
^ . 1
• I 1
. • 1
- .
• • 1
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UNIFORM • • •
EXPLANATION • OF OR •
FUNDERI
AGENCYIPROGRAM
� �����.:�N,:�.S ."��� �'�yz� � �:.'v'� �hv* �`k.,' �i -§..f.i ....a%t.7�. Y wt.-�.�.. cz�.j, � �'� `#' �' e .-•� - / r s
_. � _. 3 Salaries Addifional student services require increased hourly salary expenses
FlrA
�.,-.'...�,f.
WjTftmi studentservices require increased hourty salary expenses • respective FICA
#DIVAY
amlo!
:D
#DIVIM
: •
#DIVIOf
I#DlV1W
ND
EXHIBIT B
[ From policy adopted by Indian River County Board Of County Commissioners on February 19 ,
2002 ]
" D . Nonprofit Agency Responsibilities After Award of Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis
only .
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check . Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the
Board of Commissioners . In the event an agency provides inadequate documentation on a
consistent basis , funding may be discontinued immediately . Additionally , this may adversely
affect future funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example , no expenditures prior to October 1St may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners .
All requests for reimbursement at fiscal year end ( September 30th ) must be submitted on a timely
basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies
advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early
to mid October, since the Finance Department does not process checks for the prior fiscal year
beyond that point.
Each reimbursement request must include a summary of expenses by type . These summaries
should be broken down into salaries , benefits , supplies , contractual services , etc. If Indian River
County is reimbursing an agency for only a portion of an expense ( e . g . salary of an employee) , then
the method for this portion should be disclosed on the summary . The Office of Management &
Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures . These expenditure types are
listed below .
a . Travel expenses for travel outside the County including but not limited to ; mileage reimbursement,
hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel
(within Indian River County) is allowable .
b . Sick or Vacation payments for employees . Since agencies may have various sick and vacation
pay policies , these must be provided from other sources .
c . Any expenses not associated with the provision of the program for which the County has awarded
funding .
d . Any expense not outlined in the agency' s funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary . "
- 1 -
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices : Any notice , request , demand , consent , approval or other
communication required or permitted by this Contract shall be given or made
in writing , by any of the following methods : facsimile transmission ; hand
delivery to the other party ; delivery by commercial overnight courier service ;
or mailed by registered or certified mail ( postage prepaid ) , return receipt
requested at the addresses of the parties shown below:
County : Joyce Johnston -Carlson , Director
Indian River County Human Services
184025 th Street
Vero Beach , Florida 32960-3365
Recipient : Colette Heid , Director
Substance Abuse Council of IRC
2501 27th Avenue , Suite A-7
Vero Beach , Florida 32960
2 . Venue ; Choice of Law: The validity , interpretation , construction , and effect
of this Contract shall be in accordance with and governed by the laws of the
State of Florida , only . The location for settlement of any and all claims ,
controversies , or disputes , arising out of or relating to any part of this
Contract , or any breach hereof, as well as any litigation between the
parties , shall be Indian River County , Florida for claims brought in state
court , and the Southern District of Florida for those claims justifiable in
federal court .
3 . Entirety of Agreement : This Contract incorporates and includes all prior and
contemporaneous negotiations , correspondence , conversations ,
agreements , and understandings applicable to the matters contained herein
and the parties agree that there are no commitments , agreements , or
understandings concerning the subject matter of this Contract that are not
contained herein . Accordingly , it is agreed that no deviation from the terms
hereof shall be predicated upon any prior representations or agreements ,
whether oral or written . It is further agreed that no modification ,
amendment or alteration in the terms and conditions contained herein shall
be effective unless contained in a written document signed by both parties .
4 . Severability : In the event any provision of this Contract is determined to be
unenforceable or invalid , such unenforceability or invalidity shall not affect
the remaining provisions of this Contract , and every other term and
provision of this Contract shall be deemed valid and enforceable to the
extent permitted by law . To that extent , this Contract is deemed severable .
5 . Captions and Interpretations : Captions in this Contract are included for
convenience only and are not to be considered in any construction or
interpretation of this Contract or any of its provisions . Unless the context
indicates otherwise , words importing the singular number include the plural
- 1 -
s
number, and vice versa . Words of any gender include the correlative words
of the other genders , unless the sense indicates otherwise .
6 . Independent Contractor. The Recipient is and shall be an independent
contractor for all purposes under this Contract . The Recipient is not an
agent or employee of the County , and any and all persons engaged in any
of the services or activities funded in whole or in part performed pursuant to
this Contract shall at all times and in all places be subject to the Recipient' s
sole direction , supervision , and control .
7 . Assignment . This Contract may not be assigned by the Recipient without
the prior written consent of the County .
- 2 -
10 .' 09 ; 03 THU 08 : 59 FAX 7722314413 FELTEI` & ASSOCIATES Q.I001
' DATE ?AMtDVffmI
ACORIQ CERTIFICATE OF LIABILITY INSURANCE 10/08/2003
— 2825 FAX (772) 231 -4413 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
P�DucEa ( 772 ) 231
Felten & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER . THIS CERTIFICATE DOES NOT AMEND , EXTEND OR
2911 Cardinal Drive (32963 ) ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
P . O . Bax 3485
Vero Beach , FL 32964 - 3488 INSURERS AFFORDING COVERAGE NAI( ;¢
INSURED Substance Abuse Council— Indian River County INSURER A; Colony Insurance
2501 27th Ave Ste A - 7 INSURER B: Progressive Express __, 1019 '•
Vere Beach , FL 32960 INSUREPC: Conmrce & Industry_ Insurance
INSURER D:
COVERAGES — -- -
THE POLICIES OF INSURANCE L:STE'D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IPiDICATED NOT'NITHS TAND!N1
ANY REQUIREMENT , TERGA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
N(AY PERTAW, THE INSURANCE AFFORDED eY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSI'DNS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REOLICED BY PAID CCWMS .
INSR DD' TYPe OF INSURANCE POLICY NUMBER I �"LICY EFFECTIVE POULY EXPIRATION LIMITS _
,,,� 1lATE 7LIL1/D j ( .
GFI�ERALLIABILtTY MP714134 04/01/2003 04/01/ 2004 EACHOCCURRENCL -- 5 I , OUo , 000
X COMMERCIAL GENERAL LIABIUTY DAMAGE 70 REN � 5 5D OO
RCpA1Gcc [E TEO •� �
CLAIMS MADE a OCCUR MED EXP IAr:y one person)
A PERSONAL & ADV INJURY S 19000 , 000
GENERALAGwRrdGATE 5 210DO300
GEN'L !M'vGREG«TEI.IrA17APPll?=S PER: PRODUCTS - COMPIOPAGG I$ EXCLUDED
POLICY JEC r, LOC - - --
j AUTOMOSILELIABILITY CA044377463 02/05 /2003 02/05/2004 COMBINED SINGLELIAIT i
ANY AUTO (Ea accident) 1 , 1000 , 00
AV. OWNED AUTOS EODILY INJURY S
(Per perscnl
X sCNCDULEO ALnos
B
KIREC AUTOS 80DILYINJURY
(Por 8G0dentj
MOAT-OWNED AUTOS —moi
PROPERTY DAUAGE I s
— (Per awdent) �
GARAGE LIAB:LIYY _-- AUTO GNLY . EA ACCIDENT
ANY AUTO OTh+ERTHAN FA ACC S —_
AUTO ONLY: AGG S
– ----
j EXMS•'UMBRELLA LIABILITY EACH OCCURREI•iCr b --
OCCUR CLAIMS MADE AGGREGATE S
S
I DEDGGTIBLE
5
RETENTION S
s
WC3148705 01 10 2003 03 / 10/2004 wesTAru. orH•
WORKERS COMPENSATION AND / / —
EMPLOYERS' LIASILITY E•L. EACH AXPQF;NT S XOO , OI
C ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUKO? E.L. DISEASE , EA EMPLOYEES 100 00
It yye�s, desabe under i EJ . DISEAs= - POLICY LIMITS S0010
SPECULL PROVISIONS bMOW '
OTHER I
f
I �
DPW CRIPTION OF CKRA TIONS ( LOCATIONS / Y_HIOLES : EXCLUSIONS ADDED BY ENOORSEMENT I SPEGAL PR.7VMKM
ERTIFICATE HOLDER NAMED BELOW IS LISTED AS ' ADDITIONAL INSURED ' AS RESPECTS TO GENERAL LIABILITY AND
UTOMOSILE LIABILITY POLICIES LISTED ABOVE .
= 30 days notice of cancellation applies to Workers CoMensation only"
TIFICA - HOLDER _ _ CANCF 71r�JN
SHOULD ANY OF THE ABOVE DESCRIBED POLMIPS BE CD.NCELLED BEFORE THE
EXPAATION DATE THEREOF, THE ISSUJJG INSURER WILL. ENDFAVOR TO MAIL
,� ITT
_ DAYS WREN NOTICE TO THE CERTIFICATE HOLDER NAMED 70 THE LEFT,
Indian River County , Florida
Attn : Beth Jordan , Risk Manager BUT PAlLURF TO hWLSUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
1840 25th Street OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRRFSENI ATIVES
Vero Beach , FL 32960 - 3365 AUTHORIZEDREPftSENTATIVE
Kenneth D . Felten , LUTCF/ L-B
ACORD 25 (2001108) tACORD CORPORATION 1988
{ ' INTERNAL REVENUE SERV '
DISTRICT DIRECTOR
DI RTMENT OF THE TREASURY
- � --
401 W . PEACHTREE ST . NW
ATLANTA + OA 30365
Date =
JAN 27 1995 Emp l oyer Ident i f-icat i on Number :
65 - 0202835
Case Number :
535009038
SUBSTANCE ABUSE COUNCIL OF INDIAN Contact Person :
RIVER COUNTY INC LORETTA HAMILTON
PO BOX 6460 Contact Telephone Number :
VERO BEACH , FL 32961 - 6460 ( 404 ) 331 - 0927
Our Letter Dated :
April 25 , 1991
Addendum Applies :
No
Dear. App Icant :
This modifies our letter of the above date in which we stated that you
would be treated as an organization that is not a . private foundation until the
expiration of your advance ruling period .
Your exempt status under section 501 ( a ) of the Interna • ( Revenue Code as an .
organization described in section 501 ( c ) ( 3 ) is still in effect . Erased on the *
information you submitted , we have determined that you are not a private
foundation within the meaning of section 509 ( a ) of the Cade because you are an
organization of the type described in section . 509 ( a ) ( 1 ) and 170 ( b ) ( 1 ) ( A ) ( vi ) .
Grantors and contributors may rely on this determination unless the
Internal Revenue Service publishes notice. to the contrary . However , if you
lose your section 509 ( a ) ( 1 ) status , a grantor or contributor may not rely on
this determination if he or she was in part responsible fur , or was aware of ,
the act or failure to act , or the substantial or material change on the part of
the organization that resulted in your loss of such status , or if he or she acquired knowledge that the Internal Revenue
Service had given notice that you
would no longer be classified as a section 509 ( a ) ( 1 ) • organization .
If we have Indicated in the heading of this letter that an addendum
applies , the addendum enclosed is an Integral part of this letter .
Because this letter could help resolve any questions about your private
foundation status , please keep it In ' your permanent records .
If you have any questions , please contact the person whose name and
telephone number are shown above .
Sincerely yours ,
C
Nelson A . Brooke
District Director
�FS'i � •