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HomeMy WebLinkAbout2007-308M 9A - 01 Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this� of October 2007 b and between Indian River County, a political subdivision of the tate of Florida , 1801 27 Street , Vero Beach FL , 32960 ("County" ) and Substance Abuse Council of Indian River County , Recipient); of: 1151 19th Street, Vero Beach , FL . 32960 For: Right Choice Program 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'). - 1 - 9A - 01 Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this� of October 2007 b and between Indian River County, a political subdivision of the tate of Florida , 1801 27 Street , Vero Beach FL , 32960 ("County" ) and Substance Abuse Council of Indian River County , Recipient); of: 1151 19th Street, Vero Beach , FL . 32960 For: Right Choice Program 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'). - 1 - 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2007/2008 ("Grant Period ") . The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Ninety Thousand Dollars ($90 ,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, cumulative , 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 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program 's performance throughout the Grant Period . 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 it's 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. - 2 - t 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2007/2008 ("Grant Period ") . The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Ninety Thousand Dollars ($90 ,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, cumulative , 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 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program 's performance throughout the Grant Period . 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 it's 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. - 2 - 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 October 21 , 2006 , 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 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 ) days' prior 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 - 3 - 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. 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 COUNTY Attest: J . K. Ba n , Clerk BOARD OF COUNTY COMMISSIONERS By f Deputy C erk By L GaVWheeler, Chairman BCC Approved : V� l hseph ed : C11 t� A Baird Administrator e to form and le al sufficiency: rian E . ell , Asista6tt6untyAttorney RECIPIENT: By: Jane 'Bu4on, Lhairp2rson SUBSTANCE ABUSE COUNCIL OF fNDIAN RIVER COUNTY,,, <� 4 - 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 October 21 , 2006 , 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 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 ) days' prior 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 - 3 - EXHIBIT A [Copy of complete proposal/application] Substance Abuse Council of Indian River County Right Choice Program CSC IRC PROGRAM COVER PAGE C> Organization Name: Substance Abuse Council of Indian River County 'Vd Executive Director: Colette Heid E-mail : sacirc ellsouth.net Address: 1151 19`h Street Telephone: 772-770-4811 Vero Beach, Florida 32960 Fax: 772-770-4822 Program Director: Colette Heid E-mail : sacircAbellsouth.net Address : 1151 19th Street Telephone: 772-770-4811 Vero Beac 0 Fax: 772-770-4822 Program Title Right Choice Program Priority Need Area Addressed: DRUG ABUSE PREVENTION- Increase drug and alcohol abuse prevention programs aimed at the elementary and secondary populations especially older teens LX-65 . 800 Substance Abuse Counseling (According to the Taxonomy ofHuman Services) Brief Description of the Program : The Right Choice proZram is a comprehensive 26 week education and counseling program that is targeted at reducing and preventing substance use/abuse among older youth. This program is designed to change adolescent and parental perceptions of risk vs. benefits ofATOD use. Parental use or parental attitudes towards use of ATOD also correlates with adolescent attitudes. By impacting these factors a reduction in drug use/abuse promotes increased mental health of the individual. SUMMARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2007 /08 : $ 106 , 000 . 00 Total Proposed Program Budget for 2007 /08 : $ 106 , 000 . 00 Percent of Total Program Budget : 100. 0 % Current Program Funding ( 2006 /07 ) : $ 90 ,000 Dollar increase / ( decrease ) in request : $ 16 ,000 Percent increase /( decrease ) in request * * 17 . 8 % Unduplicated Number of Children to be served Individually : 355 Unduplicated Number of Adults to be served Individually : 50 Unduplicated Number to be served via Group settings : 355 Total Program Cost per Client : 139 . 47 **If request increased 5 % or more, briefly explain why: The Council continues to see an increase in the number of youth referred to and served by this program In the FY06-07 grant cycle, we have eenerienced a 18 % in crease in the number of youth served We anticipate that the current demand for services will continue if not increase The increase in funding will be used to provide additional program services. If these funds are being used to match another source, name the source and the $ amount: The Organization 's Board of Directors has approved this appli4'd 07Fred JonesName of President/Chair of the Board Colette Heid Name of Executive Director/CPO Signature 2 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. 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 COUNTY Attest: J . K. Ba n , Clerk BOARD OF COUNTY COMMISSIONERS By f Deputy C erk By L GaVWheeler, Chairman BCC Approved : V� l hseph ed : C11 t� A Baird Administrator e to form and le al sufficiency: rian E . ell , Asista6tt6untyAttorney RECIPIENT: By: Jane 'Bu4on, Lhairp2rson SUBSTANCE ABUSE COUNCIL OF fNDIAN RIVER COUNTY,,, <� 4 - Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC ORGANIZATION : Substance Abuse Council of Indian River County PROGRAM : Right Choice Program 2007/2008 CORE APPLICATION TABLE OF CONTENTS "X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located. X Section of the Proposal Page # TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 A. ORGANIZATION CAPABILITY (one page maximum) 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2. Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 B. PROGRAM NEED STATEMENT (one page maximum) 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 . Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 3. Evidence that program strategy will work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 4. Staffing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 6. Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . 7- 11 E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . .. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 F. UNDUPLICATED CLIENTS 1 . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 - 16 1 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page. 1 . Provide the mission statement and vision of your organization. MISSION STATEMENT: 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. The community needs to continue to place an emphasis on and dedicate resources to substance and drug prevention educational programs . We must strive to eradicate the negative social and economic impacts associated with substance and drug use/abuse. 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, Level 1 /Level 2 prevention services, Intensive Outpatient and Outpatient services for adults and youth. The Council has administered the Federal Bryne-JAG Grant for Indian River County since 1990. The Council has kept abreast of the County' s constantly changing and emerging drug use problem and carries out its goals through a variety of programs. The following is 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 • Program Success After-School Programs in Indian River and St Lucie Counties • Right Choice Program • Life Skills Training Program • Tobacco Violators Education Classes • Changing Alcohol Norms (CAN) Program • Adult Court Ordered Community Service Coordination • Program AWARE • Drug Testing Program • 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 3 EXHIBIT A [Copy of complete proposal/application] Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page. 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. Indian River County has a continuing need for a program that addresses drug and alcohol use committed by it ' s youth. Some of these youth are charged with misdemeanor drug or alcohol related charges. For others, their use is uncovered by a parent, without contact with law enforcement. This program was designed to reduce drug/alcohol use by youth by increasing protective factors thus reducing incidences of substance use and re-occurring juvenile offenses. Juvenile delinquency cases received in IRC within the six year period from FY99-00 to FY05-06 decreased from 946 to 803 cases (an increase of 4. 3 % from FY04-05 of 770 cases). Of these 74 cases were for misdemeanor drug and alcohol offenses and 30 were for felony drug and alcohol charges This represents a total of 12 .95% of drug related charges. (These stats are based upon statistical data collected and reported in the 2005-06 Profile of Delinquency Cases and Youths Referred, by the Office of Research & Planning, Florida Department of juvenile justice). These numbers only reflect the youth charged with misdemeanor offenses and not those identified by schools or family. The Florida Youth Substance Abuse Survey (FYSAS) provides scientifically sound information on the prevalence of alcohol, tobacco and other drug (ATOD) use, risk and protective factors. Risk and protective factors are characteristics of the community, school, family, individual and peer characteristics that are known to predict alcohol and other drug use, delinquency, and gang involvement. Besides measuring risk and protective factors, the FYSAS also assesses the current prevalence of these problem behaviors in the community. The FYSAS (2006), indicates that Indian River youth (35 .5%) continue to exceed the Florida State rate (32 .01/o) of youth reported drug use in their lifetimes. Even though IRC 's youth prevalence drug rate has shown a decrease in the past five (5) years, the prevalence rates for all drug use in Indian River County youth have historically been elevated above the state and national rates. Based upon FYSAS (2006) IRC ' s youth prevalence rates for past 30 use of Alcohol or any illicit drug use is recorded at 38.2% (down from 44.6% in 2000) verses the state rate of 35 .4%. The FYSAS 's findings illustrate the complexity of drug use and antisocial behavior among our youth and possible factors that may contribute to these activities. In addition, the FYSAS (2006), IRC scored higher than the State and other like Counties in the following risk factor areas Family: Peer and Individual: • Poor Family Management • Early Initiation of Drug Use • Family History of Antisocial Behavior • Favorable Attitude to ATOD use • Favorable Attitude to Antisocial Behavior • Current ATOD use among youth • Parental Attitude Favorable to ATOD use • Sensation Seeking It is important to note that the following two risk factors have shown a significant improvement: • Perceived Risks of Drug Use • Friends Use of Drugs 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. New Horizons provides Student Support Specialists in the middle schools. DATA also provides services to youth. Both these agencies work with a very small indicated population of students and can not serve the entire indicated population of youth. These youth would receive no program services if the Right Choice Program was not available. Right Choice provides no duplication of services. 4 Substance Abuse Council of Indian River County Right Choice Prog na CSAC of IRC B. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages. List Priority Needs area addressed. DRUG ABUSE PREVENTION 1 . Briefly describe program activities including location of services. The Right Choice program is designed to engage and involve at-risk youth and their parents so they may gain the needed skills to resist the negative temptations associated with drugs and alcohol . The primary objectives are to help youth to abstain from negative peer pressures through prevention information and build resiliency skills . The overall goal is to decrease the impact and propensity for involvement in substance use and juvenile crime. We propose to deter a multitude of high-risk behaviors by providing a structured and positive environment, enhanced with information and positive alternative choices. In an effort to identify the elements of a strength-based approach to healthy development, the Search Institute developed the framework of developmental assets. This framework identifies 40 critical factors for young people ' s growth and development. These risk and protective factors offer a set of benchmarks for positive child and adolescent development. The Right Choice program is designed to reduce the level of drug and alcohol use by youth and also address the issue concerning re-occurring drug and alcohol offenses . This will be accomplished by: 1 . The juvenile will report to the Substance Abuse Council 's office for program registration for the Right Choice program. During this intake, all pertinent information will be collected; a psycho- social assessment with a licensed mental health counselor will be scheduled, the youth will also be informed of their responsibilities for completion of the educational component, where to register for community service and the sanctions that will be imposed if any component of the program is not completed. 2 . Registrants will be required to attend the 26-week educational component. The educational program utilizes the Adolescent Recovery Plan by Hazelden and consists of a four phase plan : ✓ Accepting Responsibility ✓ Deciding to Make Change ✓ Successful Relationships ✓ Getting Honest ✓ Learning to Trust Again ✓ The Miracle of Forgiveness ✓ The Cost of Drugs ✓ I'm Not Perfect, So ✓ Preventing Relapse What? ✓ The Disease of Addiction ✓ Getting the Stink ✓ Bridging the Gulf of Relapse ✓ Upward Pathways ✓ Out of My Mind ✓ Getting Real About How I Feel 3 . Parents will be asked to attend the 5-week Parent to Parent educational component of the program. This will consist of. • Getting Started : How to Prevent Drug Abuse in Your Family • Setting Guidelines : Developing Healthy Beliefs and Clear Standards • Avoiding Trouble: How to Say No to Drugs • Managing Conflict: How to Control and Express Anger Involving Everyone : How to Strengthen Family Bonds On the FYSA Survey (2006), Indian River County scored higher than the State and other like Counties in the following risk factor areas that effect family life: ✓ Poor Family Management ✓ Attitude Favorable to Antisocial Behavior ✓ Family History of Antisocial Behavior ✓ Parental Attitude Favorable to ATOD use 5 Substance Abuse Council of Indian River County Right Choice Program CSC IRC PROGRAM COVER PAGE C> Organization Name: Substance Abuse Council of Indian River County 'Vd Executive Director: Colette Heid E-mail : sacirc ellsouth.net Address: 1151 19`h Street Telephone: 772-770-4811 Vero Beach, Florida 32960 Fax: 772-770-4822 Program Director: Colette Heid E-mail : sacircAbellsouth.net Address : 1151 19th Street Telephone: 772-770-4811 Vero Beac 0 Fax: 772-770-4822 Program Title Right Choice Program Priority Need Area Addressed: DRUG ABUSE PREVENTION- Increase drug and alcohol abuse prevention programs aimed at the elementary and secondary populations especially older teens LX-65 . 800 Substance Abuse Counseling (According to the Taxonomy ofHuman Services) Brief Description of the Program : The Right Choice proZram is a comprehensive 26 week education and counseling program that is targeted at reducing and preventing substance use/abuse among older youth. This program is designed to change adolescent and parental perceptions of risk vs. benefits ofATOD use. Parental use or parental attitudes towards use of ATOD also correlates with adolescent attitudes. By impacting these factors a reduction in drug use/abuse promotes increased mental health of the individual. SUMMARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2007 /08 : $ 106 , 000 . 00 Total Proposed Program Budget for 2007 /08 : $ 106 , 000 . 00 Percent of Total Program Budget : 100. 0 % Current Program Funding ( 2006 /07 ) : $ 90 ,000 Dollar increase / ( decrease ) in request : $ 16 ,000 Percent increase /( decrease ) in request * * 17 . 8 % Unduplicated Number of Children to be served Individually : 355 Unduplicated Number of Adults to be served Individually : 50 Unduplicated Number to be served via Group settings : 355 Total Program Cost per Client : 139 . 47 **If request increased 5 % or more, briefly explain why: The Council continues to see an increase in the number of youth referred to and served by this program In the FY06-07 grant cycle, we have eenerienced a 18 % in crease in the number of youth served We anticipate that the current demand for services will continue if not increase The increase in funding will be used to provide additional program services. If these funds are being used to match another source, name the source and the $ amount: The Organization 's Board of Directors has approved this appli4'd 07Fred JonesName of President/Chair of the Board Colette Heid Name of Executive Director/CPO Signature 2 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC 2. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population. 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 target population. They demonstrated repeated documentation that adolescent risk perceptions were favorably impacted by reducing favorable parental, peer and community attitudes towards ATOD. 3. 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 to the information in the Position Listing on the Budget Narrative Worksheet) . The Right Choice program is currently staffed by two Council employees and one Licensed Mental Health Counselor. The Prevention Program Coordinator assumes primary responsibility for the Right Choice program. Ninety percent (90%) of this position is currently allocated to the program. An Information Specialist is also assigned to this program and currently dedicates 100% of her time to the program. The Prevention Program Coordinator has had nine (9) years of experience in the substance abuse prevention field with extensive background in administration. The Information Specialist has an extensive background in program coordination and evaluation. The Licensed Mental Health Counselor holds a Masters Degree in Mental Health and is licensed by the State of Florida as a Clinical Certified Forensics Counselor with a specialty in criminal offender counseling and youthful offender counseling 4. How will the target population be made aware of the program? The Right Choice program awareness was designed with the target population in mind. Many different marketing campaigns are utilized to make the community at large aware the services are available. The program is open to all residents of Indian River County. The Council promotes the use of the Right Choice program via it' s newsletters and brochures. Law enforcement, school personnel, probation officers, student support specialists have all been briefed on the Right Choice program . The Council also recommends the Right Choice program to parents. Juveniles can be referred to the Right Choice program. Each juvenile referred to the program must complete the 26-week education program in order to achieve successful completion. Juveniles may be referred to the program as follows: 1 ) Any Juvenile Justice Intake Counselor or Case Manager may include a recommendation to the State Attorney' s Office for the Right Choice program as part of a disposition report on a juvenile arrested for a first time misdemeanor offense of: • Misdemeanor non-marijuana drug • Possession of alcohol • Marijuana misdemeanor • Other Alcohol Offenses The jurisdiction of the court may sentence a juvenile to the Right Choice program, any law enforcement agency, any school personnel or any parent. 5. How will the program be accessible to target population (i.e., location, transportation, hours of operation) ? The Council attempts to be very accommodating in service offering times / hours for the community. Currently group sessions are held Monday through Thursday at 4 : 30pm and 6 :00 pm. Times do vary throughout the year. Individual sessions are scheduled according to need, Monday through Saturday. 6 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC D. PROGRAM OUTCOMES AND ACTIVITIES MATRIX. 3 - 4 program outcomes only. One matrix table per outcome. Each matrix table must not exceed two (2) pages. (NOTE: Boxes for Outcomes and cells in Matrix tables will expand as you type.) �axto�i;t���ttd� Ilii: descxt" trpa;�� th� srz�ixrtat2e� pfsnd�r�l{F Outcomes : In general, a program should have 3 -4 program outcomes. The Outcome indicates the measurable impact or change the program will have on the clients its serves. The outcome should detail the results of the services provided, not the services provided. Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. Please incorporate the following into the outcome description: * Direction of change * Time frame * Area of change * As measured by * Target population * Baseline: the number you will be measuring against * Degree of change Example Outcome: To decrease (direction of change) number of unexcused absences (area of change) of enrolled boys and girls (target population) by 75 % (degree of change) in one year (timeframe) as reported by the 2006-2007 School Board attendance records (as measured by). Baseline: 2005-06 School Board attendance records for enrolled boys and girls. Activities Matrix : The matrix is designed to identify specific activities the program will provide to achieve the stated outcomes. The matrix identifies : 1 ) the specific activity; 2) how often the service/activity is provided; 3) who, by position, is responsible to deliver the service/activity; and 4) expected change in client from providing service/activity. In addition, the matrix is designed to capture the evaluation of services provided : 5) indicator or measurement of change; 6) source of measurement; and 7) how frequently it is measured. A separate PROGRAM OUTCOMES AND ACTIVITIES MATRIX needs to be completed for each outcome. Use a separate row for each activity and group activities under their related outcomes. To add more rows, if needed, simply locate the cursor at the last cell in the last row and press the "TAB" button on the keyboard. See examples provided in the instructions. IMPORTANT NOTE : Keep in mind when developing PROGRAM OUTCOMES that, if funded, these will be what you are accountable to accomplish. Also, the PROGRAM OUTCOMES should reflect the information described in the PROGRAM NEED STATEMENT (B . 1 .) . All PROGRAM NEED STATEMENTS should flow from the MISSION & VISION. MEASURABLE OUTCOMES should be based on and measure program needs. Activities are the tasks you do to influence the outcome and impact the unacceptable condition in your PROGRAM NEED STATEMENT. (B . 1 .) . 7 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC ORGANIZATION : Substance Abuse Council of Indian River County PROGRAM : Right Choice Program 2007/2008 CORE APPLICATION TABLE OF CONTENTS "X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located. X Section of the Proposal Page # TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 A. ORGANIZATION CAPABILITY (one page maximum) 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2. Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 B. PROGRAM NEED STATEMENT (one page maximum) 1 . Program Need Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 . Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 3. Evidence that program strategy will work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 4. Staffing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 6. Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . 7- 11 E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . .. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 F. UNDUPLICATED CLIENTS 1 . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 2 . Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 - 16 1 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page. 1 . Provide the mission statement and vision of your organization. MISSION STATEMENT: 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. The community needs to continue to place an emphasis on and dedicate resources to substance and drug prevention educational programs . We must strive to eradicate the negative social and economic impacts associated with substance and drug use/abuse. 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, Level 1 /Level 2 prevention services, Intensive Outpatient and Outpatient services for adults and youth. The Council has administered the Federal Bryne-JAG Grant for Indian River County since 1990. The Council has kept abreast of the County' s constantly changing and emerging drug use problem and carries out its goals through a variety of programs. The following is 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 • Program Success After-School Programs in Indian River and St Lucie Counties • Right Choice Program • Life Skills Training Program • Tobacco Violators Education Classes • Changing Alcohol Norms (CAN) Program • Adult Court Ordered Community Service Coordination • Program AWARE • Drug Testing Program • 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 3 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC (Boxes will expand as you type.) Outcome # 1 : To decrease the number of positive drug screens among enrolled Right Choice participants. Baseline: Initial drug screening results prior to admission to Right Choice program. Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 1 001 4 5 Program Activities Frequency Responsible Expected Outcomes/change (why) Indicator Data Source Time of (what) (how often) Parties Measurements (where) Measurennent (who) (evidence) (when) Conduct random Once or twice a Right Decrease in positive drug screens Report a 75% SAC 8 panel Measurement sampling of program week, or more Choice staff, among program participants. decrease in positive �g test starts at four often as needed, LMHC and (includes weeks of participants results over a 26 for 26 weeks SAC adulterants program (6 months) . Clinical weeks as measured for validity participation and staff by random drug testing) continues until screen. completion. To provide Right Choice Twenty six Right Increase in the following As reported by self - Pre and Post Twenty six psycho-education group (26) weekly Choice staff, protective factors : Social Skills disclosure from youth tests, family weeks LMHC and family, school interviews to youth utilizing the 1 - 1 /2 hour and Family Attachment Decrease personnel contacts and and individual Adolescent Recovery Plan ongoing in the following risk factors : arrest reports and post client Program by Hazelton on education Favorable Attitudes towards Anti- testing. interviews. various substance abuse sessions social Behavior, ATOD use and and resiliency skills Sensation Seeking building topics To provide Right Choice A minimum of LMHC Increase in the following As reported by self - Pre and Post Twenty six 12 to a individual sessions to protective factors : Social Skills, disclosure from youth tests, family weeks youth and family as maximum of 25 Family Attachment and Family and family, school interviews individual personnel contacts and and individual determined by initial sessions Conflicts. Decrease in the following arrest reports. client evaluation risk factors : Favorable Attitudes interviews, and drug test results. towards Anti-social Behavior, ATOD use and Sensation Seeking. 8 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC (Boxes will expand as you type.) Outcome # 2 : To increase knowledge of program participants concerning drugs and their harmful effects , (Baseline: Individual and group administered Pre-tests of forum participants.) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5 -7) I � 0 4 5 7 —� Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties Outcomes/change (why) Measurements (where) Measurement (who) (evidence) (when) To provide factual, once a week for Right Choice Increase in knowledge of A 25 % increase in Pre/ post Pre and post current and up-to-date 26 weeks staff, LMHC harmful effects of knowledge following testing will through program information via on- (6 months). substance use thus educational be conducted participation of 26 going sessions resulting in a decrease in presentation, and an and rated to weeks , the concerningdrugs and the risk factor of FYSAS and g Favorable attitude of decrease in Favorable indicate a PRIDE Survey ATOD use and a reduction in use asannually. reduction in use. knowledge reported by the and self- FYSAS and PRIDE Surveys. disclosure. To provide Right Twenty six Right Choice Increase in the As reported by self - Pre and Post Twenty six weeks Choice psycho- (26) weekly staff, LMHC following protective disclosure from youth tests, family education group to 1 - 1 /2 hour factors : Social Skills and family, school interviews and personnel contacts and individual youth utilizing the ongoing and Family arrest reports and post client Adolescent Recovery education Attachment. Decrease testing. interviews. Plan Program by sessions in the following risk Hazelton on various factors : Favorable substance abuse and Attitudes towards resiliency skills Anti-social Behavior, building topics ATOD use and Sensation Seek!W 9 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one page. 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. Indian River County has a continuing need for a program that addresses drug and alcohol use committed by it ' s youth. Some of these youth are charged with misdemeanor drug or alcohol related charges. For others, their use is uncovered by a parent, without contact with law enforcement. This program was designed to reduce drug/alcohol use by youth by increasing protective factors thus reducing incidences of substance use and re-occurring juvenile offenses. Juvenile delinquency cases received in IRC within the six year period from FY99-00 to FY05-06 decreased from 946 to 803 cases (an increase of 4. 3 % from FY04-05 of 770 cases). Of these 74 cases were for misdemeanor drug and alcohol offenses and 30 were for felony drug and alcohol charges This represents a total of 12 .95% of drug related charges. (These stats are based upon statistical data collected and reported in the 2005-06 Profile of Delinquency Cases and Youths Referred, by the Office of Research & Planning, Florida Department of juvenile justice). These numbers only reflect the youth charged with misdemeanor offenses and not those identified by schools or family. The Florida Youth Substance Abuse Survey (FYSAS) provides scientifically sound information on the prevalence of alcohol, tobacco and other drug (ATOD) use, risk and protective factors. Risk and protective factors are characteristics of the community, school, family, individual and peer characteristics that are known to predict alcohol and other drug use, delinquency, and gang involvement. Besides measuring risk and protective factors, the FYSAS also assesses the current prevalence of these problem behaviors in the community. The FYSAS (2006), indicates that Indian River youth (35 .5%) continue to exceed the Florida State rate (32 .01/o) of youth reported drug use in their lifetimes. Even though IRC 's youth prevalence drug rate has shown a decrease in the past five (5) years, the prevalence rates for all drug use in Indian River County youth have historically been elevated above the state and national rates. Based upon FYSAS (2006) IRC ' s youth prevalence rates for past 30 use of Alcohol or any illicit drug use is recorded at 38.2% (down from 44.6% in 2000) verses the state rate of 35 .4%. The FYSAS 's findings illustrate the complexity of drug use and antisocial behavior among our youth and possible factors that may contribute to these activities. In addition, the FYSAS (2006), IRC scored higher than the State and other like Counties in the following risk factor areas Family: Peer and Individual: • Poor Family Management • Early Initiation of Drug Use • Family History of Antisocial Behavior • Favorable Attitude to ATOD use • Favorable Attitude to Antisocial Behavior • Current ATOD use among youth • Parental Attitude Favorable to ATOD use • Sensation Seeking It is important to note that the following two risk factors have shown a significant improvement: • Perceived Risks of Drug Use • Friends Use of Drugs 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. New Horizons provides Student Support Specialists in the middle schools. DATA also provides services to youth. Both these agencies work with a very small indicated population of students and can not serve the entire indicated population of youth. These youth would receive no program services if the Right Choice Program was not available. Right Choice provides no duplication of services. 4 Substance Abuse Council of Indian River County Right Choice Prog na CSAC of IRC B. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages. List Priority Needs area addressed. DRUG ABUSE PREVENTION 1 . Briefly describe program activities including location of services. The Right Choice program is designed to engage and involve at-risk youth and their parents so they may gain the needed skills to resist the negative temptations associated with drugs and alcohol . The primary objectives are to help youth to abstain from negative peer pressures through prevention information and build resiliency skills . The overall goal is to decrease the impact and propensity for involvement in substance use and juvenile crime. We propose to deter a multitude of high-risk behaviors by providing a structured and positive environment, enhanced with information and positive alternative choices. In an effort to identify the elements of a strength-based approach to healthy development, the Search Institute developed the framework of developmental assets. This framework identifies 40 critical factors for young people ' s growth and development. These risk and protective factors offer a set of benchmarks for positive child and adolescent development. The Right Choice program is designed to reduce the level of drug and alcohol use by youth and also address the issue concerning re-occurring drug and alcohol offenses . This will be accomplished by: 1 . The juvenile will report to the Substance Abuse Council 's office for program registration for the Right Choice program. During this intake, all pertinent information will be collected; a psycho- social assessment with a licensed mental health counselor will be scheduled, the youth will also be informed of their responsibilities for completion of the educational component, where to register for community service and the sanctions that will be imposed if any component of the program is not completed. 2 . Registrants will be required to attend the 26-week educational component. The educational program utilizes the Adolescent Recovery Plan by Hazelden and consists of a four phase plan : ✓ Accepting Responsibility ✓ Deciding to Make Change ✓ Successful Relationships ✓ Getting Honest ✓ Learning to Trust Again ✓ The Miracle of Forgiveness ✓ The Cost of Drugs ✓ I'm Not Perfect, So ✓ Preventing Relapse What? ✓ The Disease of Addiction ✓ Getting the Stink ✓ Bridging the Gulf of Relapse ✓ Upward Pathways ✓ Out of My Mind ✓ Getting Real About How I Feel 3 . Parents will be asked to attend the 5-week Parent to Parent educational component of the program. This will consist of. • Getting Started : How to Prevent Drug Abuse in Your Family • Setting Guidelines : Developing Healthy Beliefs and Clear Standards • Avoiding Trouble: How to Say No to Drugs • Managing Conflict: How to Control and Express Anger Involving Everyone : How to Strengthen Family Bonds On the FYSA Survey (2006), Indian River County scored higher than the State and other like Counties in the following risk factor areas that effect family life: ✓ Poor Family Management ✓ Attitude Favorable to Antisocial Behavior ✓ Family History of Antisocial Behavior ✓ Parental Attitude Favorable to ATOD use 5 Substance Abuse Council of Indian River County Right Choice Progzm CSAC of DRC To provide Right A minimum of LMHC Increase in the As reported by self - Pre and Post Twenty six weeks Choice individual 12 to a following protective disclosure from youth tests, family maximum of and family, school interviews and sessions t0 youth and factors : Social Skills 25 individual Personnel contacts and individual family as determined sessions and Family arrest reports. client by initial evaluation Attachment. Decrease interviews. and drug test results . in the following risk factors : Favorable Attitudes towards Anti-social Behavior, ATOD use and Sensation Seeking, To provide Right Twenty six Right Choice Increase in the A 20% reduction in Pre and Post Four to six weeks Choice psycho- (26) weekly staff, LMHC following protective self-reported high risk tests, family following entry into education group to 1 - 1 /2 hour factors : Social Skills. behaviors following 6 interviews and the program and to gr p individual continue through youth to reduce past 30 ongoing Decrease in the weeks of program y p g g participation As client program day use of marijuana. education following risk factor : reported by self - interviews. participation. sessions Favorable Attitudes disclosure from youth towards Anti-social and family, school Behavior, ATOD use personnel contacts and and Sensation arrest reports. Seeking. 10 Substance Abuse Council of Indian Rica, County Right Choice Program CSAC of IRC (Boxes will expand as you type.) Outcome #3 : To provide the Parent to Parent educational component to the parents of the youth participating in the program. Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) I 0 � 4 L J © � Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how Parties Outcomes/change Measurements (where) Measurement often) (who) (why) (evidence) (when) To provide Right Choice psycho- Five Right Increase in the A 20% Pre and Post Five weeks education 5 -week Parent to Parent weekly 1 Choice staff, following protective reduction in tests, family educational component of the program hour LMHC factors: Family self-reported interviews and on various substance abuse and ongoing Attachment Family Family individual client resiliency skills building topics. education Rewards for Pro- conflicts interviews. following 5 sessions . social Involvement weeks n ✓ Getting Started : How to Prevent Decrease in the of program Drug Abuse in Your Family following risk participation factors : Poor As reported by ✓ Setting Guidelines Developing Family self - Healthy Beliefs and Clear Management and disclosure Standards Family Conflicts from youth and family. ✓ Avoiding Trouble : How to Say No to Drugs ✓ Managing Conflict: How to Control and Express Anger ✓ Involving Everyone: How to Strengthen Family Bonds 11 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC 2. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population. 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 target population. They demonstrated repeated documentation that adolescent risk perceptions were favorably impacted by reducing favorable parental, peer and community attitudes towards ATOD. 3. 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 to the information in the Position Listing on the Budget Narrative Worksheet) . The Right Choice program is currently staffed by two Council employees and one Licensed Mental Health Counselor. The Prevention Program Coordinator assumes primary responsibility for the Right Choice program. Ninety percent (90%) of this position is currently allocated to the program. An Information Specialist is also assigned to this program and currently dedicates 100% of her time to the program. The Prevention Program Coordinator has had nine (9) years of experience in the substance abuse prevention field with extensive background in administration. The Information Specialist has an extensive background in program coordination and evaluation. The Licensed Mental Health Counselor holds a Masters Degree in Mental Health and is licensed by the State of Florida as a Clinical Certified Forensics Counselor with a specialty in criminal offender counseling and youthful offender counseling 4. How will the target population be made aware of the program? The Right Choice program awareness was designed with the target population in mind. Many different marketing campaigns are utilized to make the community at large aware the services are available. The program is open to all residents of Indian River County. The Council promotes the use of the Right Choice program via it' s newsletters and brochures. Law enforcement, school personnel, probation officers, student support specialists have all been briefed on the Right Choice program . The Council also recommends the Right Choice program to parents. Juveniles can be referred to the Right Choice program. Each juvenile referred to the program must complete the 26-week education program in order to achieve successful completion. Juveniles may be referred to the program as follows: 1 ) Any Juvenile Justice Intake Counselor or Case Manager may include a recommendation to the State Attorney' s Office for the Right Choice program as part of a disposition report on a juvenile arrested for a first time misdemeanor offense of: • Misdemeanor non-marijuana drug • Possession of alcohol • Marijuana misdemeanor • Other Alcohol Offenses The jurisdiction of the court may sentence a juvenile to the Right Choice program, any law enforcement agency, any school personnel or any parent. 5. How will the program be accessible to target population (i.e., location, transportation, hours of operation) ? The Council attempts to be very accommodating in service offering times / hours for the community. Currently group sessions are held Monday through Thursday at 4 : 30pm and 6 :00 pm. Times do vary throughout the year. Individual sessions are scheduled according to need, Monday through Saturday. 6 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC D. PROGRAM OUTCOMES AND ACTIVITIES MATRIX. 3 - 4 program outcomes only. One matrix table per outcome. Each matrix table must not exceed two (2) pages. (NOTE: Boxes for Outcomes and cells in Matrix tables will expand as you type.) �axto�i;t���ttd� Ilii: descxt" trpa;�� th� srz�ixrtat2e� pfsnd�r�l{F Outcomes : In general, a program should have 3 -4 program outcomes. The Outcome indicates the measurable impact or change the program will have on the clients its serves. The outcome should detail the results of the services provided, not the services provided. Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. Please incorporate the following into the outcome description: * Direction of change * Time frame * Area of change * As measured by * Target population * Baseline: the number you will be measuring against * Degree of change Example Outcome: To decrease (direction of change) number of unexcused absences (area of change) of enrolled boys and girls (target population) by 75 % (degree of change) in one year (timeframe) as reported by the 2006-2007 School Board attendance records (as measured by). Baseline: 2005-06 School Board attendance records for enrolled boys and girls. Activities Matrix : The matrix is designed to identify specific activities the program will provide to achieve the stated outcomes. The matrix identifies : 1 ) the specific activity; 2) how often the service/activity is provided; 3) who, by position, is responsible to deliver the service/activity; and 4) expected change in client from providing service/activity. In addition, the matrix is designed to capture the evaluation of services provided : 5) indicator or measurement of change; 6) source of measurement; and 7) how frequently it is measured. A separate PROGRAM OUTCOMES AND ACTIVITIES MATRIX needs to be completed for each outcome. Use a separate row for each activity and group activities under their related outcomes. To add more rows, if needed, simply locate the cursor at the last cell in the last row and press the "TAB" button on the keyboard. See examples provided in the instructions. IMPORTANT NOTE : Keep in mind when developing PROGRAM OUTCOMES that, if funded, these will be what you are accountable to accomplish. Also, the PROGRAM OUTCOMES should reflect the information described in the PROGRAM NEED STATEMENT (B . 1 .) . All PROGRAM NEED STATEMENTS should flow from the MISSION & VISION. MEASURABLE OUTCOMES should be based on and measure program needs. Activities are the tasks you do to influence the outcome and impact the unacceptable condition in your PROGRAM NEED STATEMENT. (B . 1 .) . 7 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that 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 Juvenile Court Referrals to program Department of Juvenile Justice Referrals to program Case management of Client Progress Venue for presentation Indian River School District Referrals to program Case management of Client Progress Venue for presentation Mental Health Association Referrals to program Case management of Client Progress Children 's Home Society Referrals to program Case management of Client Progress Vero Beach School Resource Venue for Presentations, volunteers as guest Officers speakers and instructors for program service Sebastian Police Resource Officers delivery IRC Clerk of Court Referral of clients HRC Sheriffs Office Program collaboration and support Boys and Girls Club Referral of clients Venue for presentation Eckert Leadership Program Referral of clients Venue for presentation United for Families Referral of clients 12 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC F. UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location Current Fiscal Year Location Budget 2006/07 Unduplicated Clients Unduplicated Clients Unduplicated Clients North Indian River Co. 120 140 South Indian River Co. - 180 215 Indian River Co Total - 300 355 Greater Stuart - Hobe Sound - Indiantown Jensen Beach Palm City Martin County Total - _ Fort Pierce _ Port Saint Lucie _ St. Lucie Co. Total - Other Locations _ _ TOTAL SERVED 3001 355 Number of Unduplicated Clients by Age Current Fiscal Year rr Location Budget 2006/07 I' ll ILI Individuals Group 0 to 4 - (Pre-school) - 5 to 10 - (Elementary) - - _ _ 11 to 14 - (Middle) - - 80 80 15 to 18 - (High School) - 220 275 Total Children - - 300 355 19 to 59 - (Adults) - - - 50 60 + (Seniors) - _ Total Adults - - 50 TOTAL SERVED - - - 300 - 405 13 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC (Boxes will expand as you type.) Outcome # 1 : To decrease the number of positive drug screens among enrolled Right Choice participants. Baseline: Initial drug screening results prior to admission to Right Choice program. Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 1 001 4 5 Program Activities Frequency Responsible Expected Outcomes/change (why) Indicator Data Source Time of (what) (how often) Parties Measurements (where) Measurennent (who) (evidence) (when) Conduct random Once or twice a Right Decrease in positive drug screens Report a 75% SAC 8 panel Measurement sampling of program week, or more Choice staff, among program participants. decrease in positive �g test starts at four often as needed, LMHC and (includes weeks of participants results over a 26 for 26 weeks SAC adulterants program (6 months) . Clinical weeks as measured for validity participation and staff by random drug testing) continues until screen. completion. To provide Right Choice Twenty six Right Increase in the following As reported by self - Pre and Post Twenty six psycho-education group (26) weekly Choice staff, protective factors : Social Skills disclosure from youth tests, family weeks LMHC and family, school interviews to youth utilizing the 1 - 1 /2 hour and Family Attachment Decrease personnel contacts and and individual Adolescent Recovery Plan ongoing in the following risk factors : arrest reports and post client Program by Hazelton on education Favorable Attitudes towards Anti- testing. interviews. various substance abuse sessions social Behavior, ATOD use and and resiliency skills Sensation Seeking building topics To provide Right Choice A minimum of LMHC Increase in the following As reported by self - Pre and Post Twenty six 12 to a individual sessions to protective factors : Social Skills, disclosure from youth tests, family weeks youth and family as maximum of 25 Family Attachment and Family and family, school interviews individual personnel contacts and and individual determined by initial sessions Conflicts. Decrease in the following arrest reports. client evaluation risk factors : Favorable Attitudes interviews, and drug test results. towards Anti-social Behavior, ATOD use and Sensation Seeking. 8 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC (Boxes will expand as you type.) Outcome # 2 : To increase knowledge of program participants concerning drugs and their harmful effects , (Baseline: Individual and group administered Pre-tests of forum participants.) Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5 -7) I � 0 4 5 7 —� Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties Outcomes/change (why) Measurements (where) Measurement (who) (evidence) (when) To provide factual, once a week for Right Choice Increase in knowledge of A 25 % increase in Pre/ post Pre and post current and up-to-date 26 weeks staff, LMHC harmful effects of knowledge following testing will through program information via on- (6 months). substance use thus educational be conducted participation of 26 going sessions resulting in a decrease in presentation, and an and rated to weeks , the concerningdrugs and the risk factor of FYSAS and g Favorable attitude of decrease in Favorable indicate a PRIDE Survey ATOD use and a reduction in use asannually. reduction in use. knowledge reported by the and self- FYSAS and PRIDE Surveys. disclosure. To provide Right Twenty six Right Choice Increase in the As reported by self - Pre and Post Twenty six weeks Choice psycho- (26) weekly staff, LMHC following protective disclosure from youth tests, family education group to 1 - 1 /2 hour factors : Social Skills and family, school interviews and personnel contacts and individual youth utilizing the ongoing and Family arrest reports and post client Adolescent Recovery education Attachment. Decrease testing. interviews. Plan Program by sessions in the following risk Hazelton on various factors : Favorable substance abuse and Attitudes towards resiliency skills Anti-social Behavior, building topics ATOD use and Sensation Seek!W 9 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC G. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below. In the Excel portion of this RFP you will find the following pages/tabs : 1 . Budget Narrative Worksheet (4 pages) 2 . Total Agency Budget 3 . Total program Budget 4. Funder Specific Budget 5 . Explanation for Variances Make sure to print all the forms by going to each tab and selecting the Print icon. I — . Microsoft Office Excel Worksheet 14 Type the Organization and Program Name 2007-2008 CORE 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 / Right Choice Program FUNDER: Children Services Advisory Committee of IRC . . . . . . . . . . . . . . . . . . _ . . _ . . _ . . _ . . _ . . _ . . _ . . _ . . . . . . . . . . . . . . - - . . _ . . _ . . _ . . _ . . _ . . - - - . . _ . . _ . . _ . . _ . . _ . . _ . I CA UTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should be I used for providing information and calculations only. 7�REVENUES Proposed Total Program Budget Funder Specific Budget -.Total Agency _. Budget 1 Children's Services Council-St. Lucie 0.00 0.00 2 Children's Services Council-Martin 0.00 3 Advisory Committee-Indian River 106,000.00 106,000.0 2965000.00 4 United Way-St. Lucie County 0.00 0. 00 5 United Way-Martin County 0.00 0. 00 6 United Way-Indian River County 0. 00 0.00 433000.00 7 Department of Children & Families 0.00 903000.00 8 County Funds 0.00 0. 00 9 Contributions-Cash 0.00 25,000.00 10 Program Fees 0.00 76,400.00 11 Fund Raising Events-Net 0.00 25,000.00 12 Sales to Public - Net 0.00 0.00 13 Membership Dues 0.00 30,000.00 14 Investment Income 0.00 200.00 15 Miscellaneous 0.00 0.00 16 Legacies & Bequests 0.00 0.00 17 Funds from Other Sources 0.00 241 ,561 . 00 18 Reserve Funds Used for Operating 0.00 0.00 19 In-Kind Donations (Not imiuded in total) 0.00 0.00 20 TOTAL REVENUE do Wt inclWe line 19 $106,000.00 $106,000.00 $827, 161 .0 C EXPENDITURES A Total Program Budget Propos Funder Specific Budget ;TotalAgency Budget 21 Salaries - must complete chart on next page 65,070.00 65,070.00 383,576.0 22 FICA - Total salaries x 0.0765 4,977.86 4,977.86 29, 343.5 Retirement - Annual pension for qualified 23 staff 1 ,952. 10 1 ,952. 10 5,212.26 Life/Health - Medical/Dental/Short-term 24 Disab. 8,400.00 8,400.00 42, 000.0 Workers Compensation - # employees x 25 rate 1 ,015.09 1 ,015.09 5, 983.79 ori a u nemploymenl - # projected 26 employees x $7,000 x UCT-6 rate 0.00 0.00 0.00 ! 4 ' " ` 5/712007 B-1 Substance Abuse Council of Indian River County Right Choice Progzm CSAC of DRC To provide Right A minimum of LMHC Increase in the As reported by self - Pre and Post Twenty six weeks Choice individual 12 to a following protective disclosure from youth tests, family maximum of and family, school interviews and sessions t0 youth and factors : Social Skills 25 individual Personnel contacts and individual family as determined sessions and Family arrest reports. client by initial evaluation Attachment. Decrease interviews. and drug test results . in the following risk factors : Favorable Attitudes towards Anti-social Behavior, ATOD use and Sensation Seeking, To provide Right Twenty six Right Choice Increase in the A 20% reduction in Pre and Post Four to six weeks Choice psycho- (26) weekly staff, LMHC following protective self-reported high risk tests, family following entry into education group to 1 - 1 /2 hour factors : Social Skills. behaviors following 6 interviews and the program and to gr p individual continue through youth to reduce past 30 ongoing Decrease in the weeks of program y p g g participation As client program day use of marijuana. education following risk factor : reported by self - interviews. participation. sessions Favorable Attitudes disclosure from youth towards Anti-social and family, school Behavior, ATOD use personnel contacts and and Sensation arrest reports. Seeking. 10 Substance Abuse Council of Indian Rica, County Right Choice Program CSAC of IRC (Boxes will expand as you type.) Outcome #3 : To provide the Parent to Parent educational component to the parents of the youth participating in the program. Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) I 0 � 4 L J © � Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how Parties Outcomes/change Measurements (where) Measurement often) (who) (why) (evidence) (when) To provide Right Choice psycho- Five Right Increase in the A 20% Pre and Post Five weeks education 5 -week Parent to Parent weekly 1 Choice staff, following protective reduction in tests, family educational component of the program hour LMHC factors: Family self-reported interviews and on various substance abuse and ongoing Attachment Family Family individual client resiliency skills building topics. education Rewards for Pro- conflicts interviews. following 5 sessions . social Involvement weeks n ✓ Getting Started : How to Prevent Decrease in the of program Drug Abuse in Your Family following risk participation factors : Poor As reported by ✓ Setting Guidelines Developing Family self - Healthy Beliefs and Clear Management and disclosure Standards Family Conflicts from youth and family. ✓ Avoiding Trouble : How to Say No to Drugs ✓ Managing Conflict: How to Control and Express Anger ✓ Involving Everyone: How to Strengthen Family Bonds 11 Type the Organization and Program Name SALARIES 1 Gross Iv Annual Salary H Funder % of Gross Annual POSITION LISTING Portion of Salary on Proposed Program Specific Budget Salary Position Title / Total Hmlwk (Agency) Requested(CIA) Example: Executive Director/40 hrs 70,000.00 10,000.00 5,000.00 7.14% Executive Director 75,000.00 0.00 0.00% Prevention Program Coordiantor 45,000.00 40,500.00 40,500.00 90.00°/ Information Specialist $13.5 x 35 /w x 52wk 24,570.00 24, 570.00 24,570.00 100.00% Prevention Program Coordiantor $22.71xl5hi 17,714.00 0.00% Prevent Program Assistant $14 x 40hr/wk x 5 29, 120.00 0.00% LST Program Coord $17 x 33 /w x52 wk 29, 172.00 0.00% LST Educator 1 $14x 30hr p1w x 52 21 ,840.00 0.00% LST Educator 2 $14x 30hr /w x 52 21 ,840.00 0.00% Pro r am Success Coord STLucie 30,000.00 0.00°/ Program Success IRC Coord IRC 28,000.00 0.00% Program Success IRC $14x 20hr p1w x 52 14,560.00 0.00% Program SuccessSt Lucie $14x 20hr p1w x 5 14,560.00 0.00% Drug Testing Pro Coord CMA 25,OGO.001 0.00% JJCRISP Coord 7,200.00 0.00% #VALUE! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! Remaining positions throughout thea enc Total Salaries $383,576.00 $65,070.00 $65,070.00 16.96°/ FRINGE BENEFITS DETAIL (Funder Specific Budget I Fonder If Ifl nr v yr vn Pension Wortlels Unemployme-. Total Fringes Funder Column C onl , from line 21 to 26 Specific Budget 'FICA z55% Heaftn fns. y � (Ax %) Compens. of Compens: Specific Position Title / Total Hrs/wk I - Example: .Case Manager140hrs 5,000.00 382.50 206.00 500.00 300.00 " 200.00 1,582.50 Executive Director 0.00 0.00 0.00 0.00 0.00 0.00 0.0 Prevention Program Coordiantor 40,500.00 3,098.25 1 ,215.00 4,200.00 631 .80 0.00 9,145.0 Information Specialist $13.5 x 35 /w x 52wk 24,570.00 1 ,879.61 737.10 4,200.00 383.29 0.00 7,200.D Prevention Program Coordiantor $22.71xl5hi 0.00 0.001 0.0 PreventPro ram Assistant $14 x 40hr/wk x 5 0.00 DAO 0.00 LST Pro ram Coord $ 17 x 33 /w x52 wk 0.00 0.00 0.00 LST Educator 1 $14x 30hr ptw x 52 0.00 0.00 0.00 LST Educator 2 $14x 30hr /w x 52 0.00 0.00 0.00 Pro r am Success Coord STLucie 0.00 0.00 0.00 Program Success IRC Coord IRC 0.00 0.00 0.00 Program Success IRC $14x 20hr plw x 52 0.00 0.00 0.00 Program SuccessSt Lucie $14x 20hr plw x 5 0.00 0.00 0.00 Drug Testing Pro Coord CMA 0.00 0.00 0.00 JJCRISP Coord 0.00 0.00 0.00 0.001 0.00 0.00 0 0.00 0.00 0.0 0 omj 0.001 1 1 1 0.00 0 0.00 0.00 0.0 0 D.0 0.00 0.00 0 0.001 0.00 1 1 0.00 Total Funder Request Fringe Benerit: $bb,UtL).0Lj $4,91t.8til5 . 0 . 0345.05 C A Proposed B EXPENDITURES Total Agency Total Program Budget Funder Specific Budget Budget 27 Travel-Daily 750.001 750.001 15,000.00 # of Staff x average # of miles/wk x50 wks x $ - Estimated Daily Travel/Mileage Reimb. 28 Travel/C500.00 5000 15,000.00 a na per s a • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, re istration, food 291 =Supplies'- lies 1 ,000.0 1 , 000-001 15,000.00 5(12D0] B-1 Type the Organizalion and Program Name Office supplies mont y average x months = estimated cost of office supplies based on present history. 30 Tele hone 1 ,200.00 1 ,200.00 12,319. 00 17 Pone Ines x average cos per mon x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance 31 Posta elShi in 0.0010.00 5,000.00 ua a al Ing O ews a er • Special events, etc. Bulk. mailings - aeals 32 Utilities 1 ,200.001 1 ,200.0 6,000.0 • ecncl x .12mon s - • WatedSewer ($ x 12 months) • Garbage ($ x 12 months . 33 Occu ane Buildin & Grounds 7,200.001 7,200.00 38,856.00 • Janitorial ($ x 12 months) •. Grounds Maint. ($ x 12 months). • Real Estate Taxes 3 Printin 8 PublWeWications 200.00 200.00 25,000.00 • Letterheads, Envelopes, etc. • Fundraising materials - • Other. - 35 Subscription/Dues/Memberships 0.00 0.00 1 ,000.00 • Membership to National Organization - - - - • Dues • Subscriptions to Newspapers/magazines, etc. p. ' _ 36 Insurance 0.001 0.00 12,000.00 • Commercial/General Insurance r Bond Ins • Auto. Insurance 37 E ui ment:Rental 8 Maintenance 0.00 0.00 8 ,000.00 Copierlease ( :x 12' months) - • Meter lease ($ x 12 months) _ Copier Maintenance ($ x 12 months) - Computer Maintenance ( $ x 12 months) Other : 3B Advertisin 0.00 0.00 25,000.0 ewspaperads • Fundraising adstpromotions • Other. vacancies 39 E ui ment Purchases:Ca ital Expense 0.00 0 00 5,000.00 omputer monitor x - - - - -Laser Printer 40 Professional Fees Le al, Consultin 0.00 0.0 30,000.00 ega a vrce es ma rs x: • Consultant fees ;Other 41 Books/Educational Materials 1 ,535.00 1 ,535.00 30, 000.0 • Bookstvideos • Materials - $ x staff) - 42 Food 8 Nutrition 0.00 0.00 5,000. 00 • Meals. ( # meals x clients x 5days x 50 wks) • Snacks 43 Administrative Costs 0.001 0.001 0.00 Admin. Cost % of total budget) 44 Audit Expense 1 ,000.00 1 ,000.00 9, 000.00 Indel2endent Audit Review 45 S ecific Assistance to Individuals 0.00 0. 001 2 ,000. 00 • Meals/Food • Rent Assistance • Other 51712001 B4 I Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that 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 Juvenile Court Referrals to program Department of Juvenile Justice Referrals to program Case management of Client Progress Venue for presentation Indian River School District Referrals to program Case management of Client Progress Venue for presentation Mental Health Association Referrals to program Case management of Client Progress Children 's Home Society Referrals to program Case management of Client Progress Vero Beach School Resource Venue for Presentations, volunteers as guest Officers speakers and instructors for program service Sebastian Police Resource Officers delivery IRC Clerk of Court Referral of clients HRC Sheriffs Office Program collaboration and support Boys and Girls Club Referral of clients Venue for presentation Eckert Leadership Program Referral of clients Venue for presentation United for Families Referral of clients 12 Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC F. UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location Current Fiscal Year Location Budget 2006/07 Unduplicated Clients Unduplicated Clients Unduplicated Clients North Indian River Co. 120 140 South Indian River Co. - 180 215 Indian River Co Total - 300 355 Greater Stuart - Hobe Sound - Indiantown Jensen Beach Palm City Martin County Total - _ Fort Pierce _ Port Saint Lucie _ St. Lucie Co. Total - Other Locations _ _ TOTAL SERVED 3001 355 Number of Unduplicated Clients by Age Current Fiscal Year rr Location Budget 2006/07 I' ll ILI Individuals Group 0 to 4 - (Pre-school) - 5 to 10 - (Elementary) - - _ _ 11 to 14 - (Middle) - - 80 80 15 to 18 - (High School) - 220 275 Total Children - - 300 355 19 to 59 - (Adults) - - - 50 60 + (Seniors) - _ Total Adults - - 50 TOTAL SERVED - - - 300 - 405 13 Type me Organization and Program Name 46OtherfMiscellaneous 0.00 a001 28,410.00 • Background check/drug test • Other 47 Other/Contract 10,000.00 10,000.00 60, 000.00 Sub-contract for program services LMHC 48 TOTAL EXPENSES $106,000.05 $106,000.05 $813,700.61 snrzoo7 e-i 14D • 2007-2008 CORE GRANT APPLICATION TOTAL AGENCY BUDGET AGENCYIPROGRAM NAME: Substance Abuse Council Right Choice Program FY 05/06 FY 06/01 FY 07108 , INCREASE FYE FYE_9/30107 FYE 9130108 CURRENT VS. NEXT FY BUDGET AB C D ACTUAL TOTAL PROPOSED (cal. C<01. BPCOL 9 REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 0.00 3 !Advisory Committee4ndian River 260,000.00 260,000.00 296,000.00 13.850/o 4 United Way-St Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 41,000.00 41,000.00 43,000.00 4.88% 7 Department of Children & Families 0.00 30,000.00 90,000.00 200.00 8 County Funds 0.00 0.00 0.00 9 Contributions-Cash 25,000.00 25,000.00 25,000.00 0.00% 10 Program Fees 126,308.00 67,000.00 76,400.00 14.03% 11 Fund Raising Events- let 51 ,729.00 . 25,000.00 25,000.00 0.00% 12 Sales to Public-Net 0.00 0.00 0.00 13 Membership Dues 3,265.00 3,000.00 30,000.00 900.00% 14 Investment income 0.00 500.00 200.00 -00.00% 15 Miscellaneous 18,000.00 0.00 0.00 16 Le acies 8 Be nests 0.00 0.00 0.00 17 Funds from Other Sources 181,134.00 243,082.00 241,561 .00 -0.63% 18 Reserve Funds Used for Operating 0.00 0.00 1s In-Kind Donations (Not ncluam In lma01 0.00 0.00 2p TOTAL 706,436.00 694,582.00 827,161 .00 19.09% EXPENDITURES 21 Salaries 323,913.00 351,696.00 383,576.00 9.06% 22 FICA 24,779.00 26,904.00 29,343.56 9.07% 23 Retirement 4,858.00 5,566.00 5,212.26 -6.36% 24 Life/1lealth 23,821 .00 37,800.00 42,000.00 11 .11 % 25 Workers Compensation 4,178.00 51486.00 5,983.79 9.07% zb Florida Unemployment 0.00 0.00 0.00 27 Travel-Dail 12,020.00 23,500.00 15,000.00 36.177 28 Travel/Conferences/Tramin 28,088.00 24,000.00 15,000.00 37.50% 29 Office Supplies 14,000.00 7,832.00 15,000.00 91.52% 30 Telephone 14,858.00 13,000.0012,319.00 -5.24% 31 Posta e/Shi in 3,804.00 7,500.00 5,0W00 100.00 32 Utilities 7,924.00 9,000.00 6,000.00 33.33% 33 Occupancy (Building & Grounds 52,437.00 42,000.00 38,856.00 -7.49% M Printing & Publications 6,500.00 5,000.00 25,000.00 400.00% 35 Subscri tion/Dues/Membershi s 1,051.00 750.00 1 ,000.00 33.33% 36 Insurance 3,956.00 61000.00 12,000.00 100.007 37 E ui ment:Rental & Maintenance 8,509.00 13,000.00 8,000.00 38.46% 38 Advertising 7,841 .00 7,500.00 25,000.00 233.33% 39 Equipment Purchases:Ca ital Expense 0.00 0.00 5,000.00 m Professional Fees (Legal, Consulting2,898.00 3,000.00 30,000.00 900.00% 41 Books/Educational Materials 15,799.00 10,000.00 30,000.00 200.00% Q Food & Nutrition 0.00 0.00 5,000.00 a3 Administrative Costs 0.00 0.00 0.00 44 Audit Expense 9,000.00 9,000.00 9,000.00 0.00% 45 Specific Assistance to Individuals 500.00 3,500.00 2,000.00 -02.86 46 Other/Miscellaneous 104,509.00 30,549.00 28,410.00 -7.00% 47 Other/Contract 43,235.00 50,000.00 60,000.00 20.00% m TOTAL 718,478.00687,583.00 813,700.61 18.34% 49 REVENUES OVERT UNDER EXPENDITURES -12,042.001 6,999.00 13,460.39 92.32% Substance Abuse Council of Indian River County Right Choice Program CSAC of IRC G. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below. In the Excel portion of this RFP you will find the following pages/tabs : 1 . Budget Narrative Worksheet (4 pages) 2 . Total Agency Budget 3 . Total program Budget 4. Funder Specific Budget 5 . Explanation for Variances Make sure to print all the forms by going to each tab and selecting the Print icon. I — . Microsoft Office Excel Worksheet 14 Type the Organization and Program Name 2007-2008 CORE 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 / Right Choice Program FUNDER: Children Services Advisory Committee of IRC . . . . . . . . . . . . . . . . . . _ . . _ . . _ . . _ . . _ . . _ . . _ . . _ . . . . . . . . . . . . . . - - . . _ . . _ . . _ . . _ . . _ . . - - - . . _ . . _ . . _ . . _ . . _ . . _ . I CA UTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should be I used for providing information and calculations only. 7�REVENUES Proposed Total Program Budget Funder Specific Budget -.Total Agency _. Budget 1 Children's Services Council-St. Lucie 0.00 0.00 2 Children's Services Council-Martin 0.00 3 Advisory Committee-Indian River 106,000.00 106,000.0 2965000.00 4 United Way-St. Lucie County 0.00 0. 00 5 United Way-Martin County 0.00 0. 00 6 United Way-Indian River County 0. 00 0.00 433000.00 7 Department of Children & Families 0.00 903000.00 8 County Funds 0.00 0. 00 9 Contributions-Cash 0.00 25,000.00 10 Program Fees 0.00 76,400.00 11 Fund Raising Events-Net 0.00 25,000.00 12 Sales to Public - Net 0.00 0.00 13 Membership Dues 0.00 30,000.00 14 Investment Income 0.00 200.00 15 Miscellaneous 0.00 0.00 16 Legacies & Bequests 0.00 0.00 17 Funds from Other Sources 0.00 241 ,561 . 00 18 Reserve Funds Used for Operating 0.00 0.00 19 In-Kind Donations (Not imiuded in total) 0.00 0.00 20 TOTAL REVENUE do Wt inclWe line 19 $106,000.00 $106,000.00 $827, 161 .0 C EXPENDITURES A Total Program Budget Propos Funder Specific Budget ;TotalAgency Budget 21 Salaries - must complete chart on next page 65,070.00 65,070.00 383,576.0 22 FICA - Total salaries x 0.0765 4,977.86 4,977.86 29, 343.5 Retirement - Annual pension for qualified 23 staff 1 ,952. 10 1 ,952. 10 5,212.26 Life/Health - Medical/Dental/Short-term 24 Disab. 8,400.00 8,400.00 42, 000.0 Workers Compensation - # employees x 25 rate 1 ,015.09 1 ,015.09 5, 983.79 ori a u nemploymenl - # projected 26 employees x $7,000 x UCT-6 rate 0.00 0.00 0.00 ! 4 ' " ` 5/712007 B-1 Twetlrc Lyyvmfen atl rtgram Name 2007-2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME : Substance Abuse Council of IRC I RIGHT CHOICE Program FY 05/06 FY 06/07 FY 07100 % INCREASE FYE_9/30N6 FYE_9/30/07 FYE 9130100 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED IC01. C<01. Byc01. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 O.DO 3 Advisory Committee-Indian River 67,248.00 90,000.00 106,000.00 1778% 4 United Way-St. Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 0.00 0.00 0.00 7 Department of Children & Families 0.00 0.00 0.00 a County Funds 0.00 0.00 0.00 9 Contributions-Cash 0.00 0.00 0.00 10 Program Fees 0.00 0.00 30,000.00 11 Fund Raising Events-Net 0.00 10,765.00 0.00 -100.00% 12 Sales to Public-Met 0.00 0.00 0.00 13 Membership Dues D.00 0.00 0.00 14 Investment Income 0.00 0.00 0.00 15 Miscellaneous 11.00 0.00 0.00 16 Le acies & Bequests 0.00 0.00 0.00 17 Funds from Other Sources 0.00 0.00 0.00 la Reserve Funds Used for Operating 0.00 0.00 0.00 191n-Kind Donations (NN inclue4 In tuta8 0.00 0.00 0.00 20 TOTAL 67,248.00 100,765.00 136,000.00 34.97% EXPENDITURES 21 Salaries 38,042.00 64,260.00 65,070.00 1 .26% 22 FICA 3,314.00 4,915.00 4,977.86 1 .28% 23 Retirement 1 ,299.00 1 ,927.00 1,952.10 1 .30% 24 Life/Health 6,300.00 8,400.00 8,400.00 0.00% 25 Workers Compensation 558.00 563.00 1,015.09 80.30% 26 Florida Unemployment 0.00 0.00 0.00 27 Travel -Dail 500.00 1 ,200.00 750.00 -37.50% 2a Travel/Conferences/rrainin 0.00 500.00 29 Office Supplies J72 0 1,000.00 1,000.00 0.00% 30 Telephone 0 1,200.00 1 ,200.00 0.00% 31 Postage/Shipping0 0.00 0.00 32 Utilities 00 1,200.00 1 ,200.00 0.00% 33 Occupancy (Building & Grounds 00 6,000.00 7,200.00 20.00% 3a Printing8 Publications 00 100.00 200.00 100.00 3s Subscrt tion/DuesRAembershi s 00 0.00 0.00 36 Insurance 00 0.00 0.00 37 E ui ment:Rental 8 Maintenance 00 0.00 0.00 38 Advertising 00 0.00 0.00 39 Equipment Purchases:Ca itai Expense 00 0.00 0.00 U Professional Fees (Legal, Consulting) 00 0.00 0.00 41 BookslEducational Materials 00 0.00 1,535.00 42 Food & Nutrition DO 0.00 0.00 43 Administrative Costs 00 0.00 0.00 Audit Ex ense 00 1,000.00 1 ,000.00 0.00% 45 5 ecific Assistance to Individuals00 0.00 0.00 46 Other/Miscellaneous 00 9,000.00 0.00400.00% 47 Other/Contract 00 0.00 10,000.00 4s TOTAL i 67,248.001 100,765.00 106,000.05 5.20 0 REVENUES OVER/ UNDER EXPENDITURES 0.001 0.00 29,999.95 14 F Type the Organization and Program Name 2007-2008 CORE GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : FUNDER : A B C FY 07108 FY 07108 % OF TOTAL FUNDER TOTAL VS . PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A) EXPENDITURES 21 Salaries 65,070.00 65,070. 00 100.00% 22 FICA 4, 977.86 4,977.86 100 .00% 23 Retirement 19952.10 1 ,952. 10 100.00% 24 Life/Health 8,400.00 8,400. 00 100.00% 25 Workers Compensation 1 ,015.09 1 ,015.09 100.00% 26 Florida Unemployment 0.00 0 .00 #DIV/O ! 27 Travel-Daily 750. 00 750.00 100.00% 28 Travel/Conferences/Training 500.00 500.00 100. 00% 29 Office Supplies 1 ,000. 00 11000.00 100.00% 30 Telephone 1 ,200.00 1 ,200.00 100.00% 31 Postage/Shipping 0.00 0.00 #DIV/O! 32 Utilities 17200.00 15200. 00 100.00% 33 Occupant Building & Grounds 7,200.00 75200. 00 100 .00% 34 Printing & Publications 200.00 200. 00 100 .00% 35 Subscription/Dues/Memberships 0.00 0.001 #DIV/01 36 Insurance 0.00 0.00 #DIV/O ! 37 Equipment: Rental & Maintenance 0.00 0.00 #DIV/01 38 Advertising 0.00 0.00 #DIV/OI 39 Equipment Purchases : Capital Expense 0.00 0.00 #DIV/01 40 Professional Fees ( Legal, Consulting) 0.00 0.00 #DIV/0 ! 41 Books/Educational Materials 1 ,535.00 11535.00 100.00% 42 Food & Nutrition 0.00 0 .00 #DIV/O ! 43 Administrative Costs 0. 00 0.00 #DIV/0! 44 Audit Expense 11000. 00 11000.00 100.00% 45 Specific Assistance to Individuals 0.00 0.00 #DIV/01 46 Other/Miscellaneous 0. 001 0.001 #DIV/0! 47 Other/Contract 10,000. 00 10,000.00 100.00% 48 TOTAL $106,000.05 $1069000.05 100. 00 % 50/200] Bd i4! 6 Type the Organization and Program Name SALARIES 1 Gross Iv Annual Salary H Funder % of Gross Annual POSITION LISTING Portion of Salary on Proposed Program Specific Budget Salary Position Title / Total Hmlwk (Agency) Requested(CIA) Example: Executive Director/40 hrs 70,000.00 10,000.00 5,000.00 7.14% Executive Director 75,000.00 0.00 0.00% Prevention Program Coordiantor 45,000.00 40,500.00 40,500.00 90.00°/ Information Specialist $13.5 x 35 /w x 52wk 24,570.00 24, 570.00 24,570.00 100.00% Prevention Program Coordiantor $22.71xl5hi 17,714.00 0.00% Prevent Program Assistant $14 x 40hr/wk x 5 29, 120.00 0.00% LST Program Coord $17 x 33 /w x52 wk 29, 172.00 0.00% LST Educator 1 $14x 30hr p1w x 52 21 ,840.00 0.00% LST Educator 2 $14x 30hr /w x 52 21 ,840.00 0.00% Pro r am Success Coord STLucie 30,000.00 0.00°/ Program Success IRC Coord IRC 28,000.00 0.00% Program Success IRC $14x 20hr p1w x 52 14,560.00 0.00% Program SuccessSt Lucie $14x 20hr p1w x 5 14,560.00 0.00% Drug Testing Pro Coord CMA 25,OGO.001 0.00% JJCRISP Coord 7,200.00 0.00% #VALUE! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! Remaining positions throughout thea enc Total Salaries $383,576.00 $65,070.00 $65,070.00 16.96°/ FRINGE BENEFITS DETAIL (Funder Specific Budget I Fonder If Ifl nr v yr vn Pension Wortlels Unemployme-. Total Fringes Funder Column C onl , from line 21 to 26 Specific Budget 'FICA z55% Heaftn fns. y � (Ax %) Compens. of Compens: Specific Position Title / Total Hrs/wk I - Example: .Case Manager140hrs 5,000.00 382.50 206.00 500.00 300.00 " 200.00 1,582.50 Executive Director 0.00 0.00 0.00 0.00 0.00 0.00 0.0 Prevention Program Coordiantor 40,500.00 3,098.25 1 ,215.00 4,200.00 631 .80 0.00 9,145.0 Information Specialist $13.5 x 35 /w x 52wk 24,570.00 1 ,879.61 737.10 4,200.00 383.29 0.00 7,200.D Prevention Program Coordiantor $22.71xl5hi 0.00 0.001 0.0 PreventPro ram Assistant $14 x 40hr/wk x 5 0.00 DAO 0.00 LST Pro ram Coord $ 17 x 33 /w x52 wk 0.00 0.00 0.00 LST Educator 1 $14x 30hr ptw x 52 0.00 0.00 0.00 LST Educator 2 $14x 30hr /w x 52 0.00 0.00 0.00 Pro r am Success Coord STLucie 0.00 0.00 0.00 Program Success IRC Coord IRC 0.00 0.00 0.00 Program Success IRC $14x 20hr plw x 52 0.00 0.00 0.00 Program SuccessSt Lucie $14x 20hr plw x 5 0.00 0.00 0.00 Drug Testing Pro Coord CMA 0.00 0.00 0.00 JJCRISP Coord 0.00 0.00 0.00 0.001 0.00 0.00 0 0.00 0.00 0.0 0 omj 0.001 1 1 1 0.00 0 0.00 0.00 0.0 0 D.0 0.00 0.00 0 0.001 0.00 1 1 0.00 Total Funder Request Fringe Benerit: $bb,UtL).0Lj $4,91t.8til5 . 0 . 0345.05 C A Proposed B EXPENDITURES Total Agency Total Program Budget Funder Specific Budget Budget 27 Travel-Daily 750.001 750.001 15,000.00 # of Staff x average # of miles/wk x50 wks x $ - Estimated Daily Travel/Mileage Reimb. 28 Travel/C500.00 5000 15,000.00 a na per s a • Training/Seminar (cost per staff) • Other Trainings (cost of travel, lodging, re istration, food 291 =Supplies'- lies 1 ,000.0 1 , 000-001 15,000.00 5(12D0] B-1 Type the Organizalion and Program Name Office supplies mont y average x months = estimated cost of office supplies based on present history. 30 Tele hone 1 ,200.00 1 ,200.00 12,319. 00 17 Pone Ines x average cos per mon x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance 31 Posta elShi in 0.0010.00 5,000.00 ua a al Ing O ews a er • Special events, etc. Bulk. mailings - aeals 32 Utilities 1 ,200.001 1 ,200.0 6,000.0 • ecncl x .12mon s - • WatedSewer ($ x 12 months) • Garbage ($ x 12 months . 33 Occu ane Buildin & Grounds 7,200.001 7,200.00 38,856.00 • Janitorial ($ x 12 months) •. Grounds Maint. ($ x 12 months). • Real Estate Taxes 3 Printin 8 PublWeWications 200.00 200.00 25,000.00 • Letterheads, Envelopes, etc. • Fundraising materials - • Other. - 35 Subscription/Dues/Memberships 0.00 0.00 1 ,000.00 • Membership to National Organization - - - - • Dues • Subscriptions to Newspapers/magazines, etc. p. ' _ 36 Insurance 0.001 0.00 12,000.00 • Commercial/General Insurance r Bond Ins • Auto. Insurance 37 E ui ment:Rental 8 Maintenance 0.00 0.00 8 ,000.00 Copierlease ( :x 12' months) - • Meter lease ($ x 12 months) _ Copier Maintenance ($ x 12 months) - Computer Maintenance ( $ x 12 months) Other : 3B Advertisin 0.00 0.00 25,000.0 ewspaperads • Fundraising adstpromotions • Other. vacancies 39 E ui ment Purchases:Ca ital Expense 0.00 0 00 5,000.00 omputer monitor x - - - - -Laser Printer 40 Professional Fees Le al, Consultin 0.00 0.0 30,000.00 ega a vrce es ma rs x: • Consultant fees ;Other 41 Books/Educational Materials 1 ,535.00 1 ,535.00 30, 000.0 • Bookstvideos • Materials - $ x staff) - 42 Food 8 Nutrition 0.00 0.00 5,000. 00 • Meals. ( # meals x clients x 5days x 50 wks) • Snacks 43 Administrative Costs 0.001 0.001 0.00 Admin. Cost % of total budget) 44 Audit Expense 1 ,000.00 1 ,000.00 9, 000.00 Indel2endent Audit Review 45 S ecific Assistance to Individuals 0.00 0. 001 2 ,000. 00 • Meals/Food • Rent Assistance • Other 51712001 B4 I 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 1s` 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 30`h) 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: Brad E. Bernauer, Indian River County Human Services Director 1801 27"' Street, Vero Beach , Florida 32960 . Recipient: Substance Abuse Council of Indian River County, 1151 19`h Street, Vero Beach , FL 32960 ; Attention : Colette Heid , Director 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 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. 1 Type me Organization and Program Name 46OtherfMiscellaneous 0.00 a001 28,410.00 • Background check/drug test • Other 47 Other/Contract 10,000.00 10,000.00 60, 000.00 Sub-contract for program services LMHC 48 TOTAL EXPENSES $106,000.05 $106,000.05 $813,700.61 snrzoo7 e-i 14D • 2007-2008 CORE GRANT APPLICATION TOTAL AGENCY BUDGET AGENCYIPROGRAM NAME: Substance Abuse Council Right Choice Program FY 05/06 FY 06/01 FY 07108 , INCREASE FYE FYE_9/30107 FYE 9130108 CURRENT VS. NEXT FY BUDGET AB C D ACTUAL TOTAL PROPOSED (cal. C<01. BPCOL 9 REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 0.00 3 !Advisory Committee4ndian River 260,000.00 260,000.00 296,000.00 13.850/o 4 United Way-St Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 41,000.00 41,000.00 43,000.00 4.88% 7 Department of Children & Families 0.00 30,000.00 90,000.00 200.00 8 County Funds 0.00 0.00 0.00 9 Contributions-Cash 25,000.00 25,000.00 25,000.00 0.00% 10 Program Fees 126,308.00 67,000.00 76,400.00 14.03% 11 Fund Raising Events- let 51 ,729.00 . 25,000.00 25,000.00 0.00% 12 Sales to Public-Net 0.00 0.00 0.00 13 Membership Dues 3,265.00 3,000.00 30,000.00 900.00% 14 Investment income 0.00 500.00 200.00 -00.00% 15 Miscellaneous 18,000.00 0.00 0.00 16 Le acies 8 Be nests 0.00 0.00 0.00 17 Funds from Other Sources 181,134.00 243,082.00 241,561 .00 -0.63% 18 Reserve Funds Used for Operating 0.00 0.00 1s In-Kind Donations (Not ncluam In lma01 0.00 0.00 2p TOTAL 706,436.00 694,582.00 827,161 .00 19.09% EXPENDITURES 21 Salaries 323,913.00 351,696.00 383,576.00 9.06% 22 FICA 24,779.00 26,904.00 29,343.56 9.07% 23 Retirement 4,858.00 5,566.00 5,212.26 -6.36% 24 Life/1lealth 23,821 .00 37,800.00 42,000.00 11 .11 % 25 Workers Compensation 4,178.00 51486.00 5,983.79 9.07% zb Florida Unemployment 0.00 0.00 0.00 27 Travel-Dail 12,020.00 23,500.00 15,000.00 36.177 28 Travel/Conferences/Tramin 28,088.00 24,000.00 15,000.00 37.50% 29 Office Supplies 14,000.00 7,832.00 15,000.00 91.52% 30 Telephone 14,858.00 13,000.0012,319.00 -5.24% 31 Posta e/Shi in 3,804.00 7,500.00 5,0W00 100.00 32 Utilities 7,924.00 9,000.00 6,000.00 33.33% 33 Occupancy (Building & Grounds 52,437.00 42,000.00 38,856.00 -7.49% M Printing & Publications 6,500.00 5,000.00 25,000.00 400.00% 35 Subscri tion/Dues/Membershi s 1,051.00 750.00 1 ,000.00 33.33% 36 Insurance 3,956.00 61000.00 12,000.00 100.007 37 E ui ment:Rental & Maintenance 8,509.00 13,000.00 8,000.00 38.46% 38 Advertising 7,841 .00 7,500.00 25,000.00 233.33% 39 Equipment Purchases:Ca ital Expense 0.00 0.00 5,000.00 m Professional Fees (Legal, Consulting2,898.00 3,000.00 30,000.00 900.00% 41 Books/Educational Materials 15,799.00 10,000.00 30,000.00 200.00% Q Food & Nutrition 0.00 0.00 5,000.00 a3 Administrative Costs 0.00 0.00 0.00 44 Audit Expense 9,000.00 9,000.00 9,000.00 0.00% 45 Specific Assistance to Individuals 500.00 3,500.00 2,000.00 -02.86 46 Other/Miscellaneous 104,509.00 30,549.00 28,410.00 -7.00% 47 Other/Contract 43,235.00 50,000.00 60,000.00 20.00% m TOTAL 718,478.00687,583.00 813,700.61 18.34% 49 REVENUES OVERT UNDER EXPENDITURES -12,042.001 6,999.00 13,460.39 92.32% ACORD !� DATE (MM/DD/YYV1� TM. CERTIFICATE OF LIABILITY INSURANCE 10124/2007 PRODUCER Phone: (772) 562-3369 Fax (772) 562-3466 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HILB ROGAL & HOBBS OF FLORIDA, INC. - VERO BEACH ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Gua Be Insurance Co _ _ . SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY, INC. INSURER B: P.O. BOX 6460 - - - — - - -- VERO BEACH FL 32960 INSURER C: ! INSURER D: INSURER E: _ COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO A-1- THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ''�� INSR IIADO'L: POLICY EFFECTIVE POLICY E%PIRNTION LIMITS LTR INSRp TYPE OF INSURANCE POLICY NUMBER onre MMMD!w DATE V WDD GENERAL LIABILITY EACH OCCURRENCE $ - - DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea ocaunnce) I $ CLAIMS MADE —�; OCCUR .MED. EXP (Anyone person) : $ — PERSONAL B ADV INJURYI $ GENERAL AGGREGATE _-- GENT AGGREGATE LIMIT APPLIES PER : I. PRODUCTS-COMP/OP AGG. ! $ PRO- - POLICY JECT . LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - ANY AUTO HER amIdenl) i $ ALL OWNED AUTOS BODILY INJURY I (Per Person) $ SCHEDULED AUTOS HIRED AUTOSBODILY INJURY NON-OWNED AUTOS (Per accident $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ -- -- - i AUTO ONLYAGG: $ - - EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE 1 $ OCCUR � CLAIMS MADE AGGREGATE is DEDUCTIBLE ' $ RETENTION $ ' $ ATU- WORKERS COMPENSATION AND we Y LIMIT OTHER EMPLOYERS' LIABILITY GWGC100002483-107 01 /10107 01/10/08 ' ACH CCI 1 E. L. EACH ACCIDENT $ 100,000 A ANY PROPRIETOILPXCLUDE EXECUTIVE " — E - - 10 - 0 oFF¢:ER/mEMEER EXCLUDED? ', E. L. DISEASE-EA EMPLOYEE IS 100,000 N yes, descnbe under E.L. DISEASE-POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER. DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, INDIAN RIVER COUNTY - BOARD OF COUNTY ITS AGENTS OR REPRESENTATIVES. COMMISSIONERS AUTHORIZED REPRESENTATIVE 1801 27TH STREET VERO BEACH, FL 32960 e Attention : Robert Sls ACORD 25 (2001108) Certificate # 109167 © ACORD CORPORATION 1988 IN, � ; , •P111MUCER (772)231-2923 FAX (772) 231-4413 1t h ti 71 . f • .. • . • , • • - 10, .l . f • . • • . 7Felten & Associates ' 1 • . • I • • ' Z911 Cardinal Drive (3Z963) Box 3499 vero Beach , FL 3Z964-3493 q • MEN -11740141 W1 .111R.-ARGORAR yr , • • • I 1 : ' • I • • • • • •I • 2 !'.1q1 � - i i1 i ai : .« •. — _. ire I I i ■ i i11 FAR Z" � . Twetlrc Lyyvmfen atl rtgram Name 2007-2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME : Substance Abuse Council of IRC I RIGHT CHOICE Program FY 05/06 FY 06/07 FY 07100 % INCREASE FYE_9/30N6 FYE_9/30/07 FYE 9130100 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED IC01. C<01. Byc01. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0.00 0.00 0.00 2 Children's Services Council-Martin 0.00 0.00 O.DO 3 Advisory Committee-Indian River 67,248.00 90,000.00 106,000.00 1778% 4 United Way-St. Lucie County 0.00 0.00 0.00 5 United Way-Martin County 0.00 0.00 0.00 6 United Way-Indian River County 0.00 0.00 0.00 7 Department of Children & Families 0.00 0.00 0.00 a County Funds 0.00 0.00 0.00 9 Contributions-Cash 0.00 0.00 0.00 10 Program Fees 0.00 0.00 30,000.00 11 Fund Raising Events-Net 0.00 10,765.00 0.00 -100.00% 12 Sales to Public-Met 0.00 0.00 0.00 13 Membership Dues D.00 0.00 0.00 14 Investment Income 0.00 0.00 0.00 15 Miscellaneous 11.00 0.00 0.00 16 Le acies & Bequests 0.00 0.00 0.00 17 Funds from Other Sources 0.00 0.00 0.00 la Reserve Funds Used for Operating 0.00 0.00 0.00 191n-Kind Donations (NN inclue4 In tuta8 0.00 0.00 0.00 20 TOTAL 67,248.00 100,765.00 136,000.00 34.97% EXPENDITURES 21 Salaries 38,042.00 64,260.00 65,070.00 1 .26% 22 FICA 3,314.00 4,915.00 4,977.86 1 .28% 23 Retirement 1 ,299.00 1 ,927.00 1,952.10 1 .30% 24 Life/Health 6,300.00 8,400.00 8,400.00 0.00% 25 Workers Compensation 558.00 563.00 1,015.09 80.30% 26 Florida Unemployment 0.00 0.00 0.00 27 Travel -Dail 500.00 1 ,200.00 750.00 -37.50% 2a Travel/Conferences/rrainin 0.00 500.00 29 Office Supplies J72 0 1,000.00 1,000.00 0.00% 30 Telephone 0 1,200.00 1 ,200.00 0.00% 31 Postage/Shipping0 0.00 0.00 32 Utilities 00 1,200.00 1 ,200.00 0.00% 33 Occupancy (Building & Grounds 00 6,000.00 7,200.00 20.00% 3a Printing8 Publications 00 100.00 200.00 100.00 3s Subscrt tion/DuesRAembershi s 00 0.00 0.00 36 Insurance 00 0.00 0.00 37 E ui ment:Rental 8 Maintenance 00 0.00 0.00 38 Advertising 00 0.00 0.00 39 Equipment Purchases:Ca itai Expense 00 0.00 0.00 U Professional Fees (Legal, Consulting) 00 0.00 0.00 41 BookslEducational Materials 00 0.00 1,535.00 42 Food & Nutrition DO 0.00 0.00 43 Administrative Costs 00 0.00 0.00 Audit Ex ense 00 1,000.00 1 ,000.00 0.00% 45 5 ecific Assistance to Individuals00 0.00 0.00 46 Other/Miscellaneous 00 9,000.00 0.00400.00% 47 Other/Contract 00 0.00 10,000.00 4s TOTAL i 67,248.001 100,765.00 106,000.05 5.20 0 REVENUES OVER/ UNDER EXPENDITURES 0.001 0.00 29,999.95 14 F Type the Organization and Program Name 2007-2008 CORE GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : FUNDER : A B C FY 07108 FY 07108 % OF TOTAL FUNDER TOTAL VS . PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A) EXPENDITURES 21 Salaries 65,070.00 65,070. 00 100.00% 22 FICA 4, 977.86 4,977.86 100 .00% 23 Retirement 19952.10 1 ,952. 10 100.00% 24 Life/Health 8,400.00 8,400. 00 100.00% 25 Workers Compensation 1 ,015.09 1 ,015.09 100.00% 26 Florida Unemployment 0.00 0 .00 #DIV/O ! 27 Travel-Daily 750. 00 750.00 100.00% 28 Travel/Conferences/Training 500.00 500.00 100. 00% 29 Office Supplies 1 ,000. 00 11000.00 100.00% 30 Telephone 1 ,200.00 1 ,200.00 100.00% 31 Postage/Shipping 0.00 0.00 #DIV/O! 32 Utilities 17200.00 15200. 00 100.00% 33 Occupant Building & Grounds 7,200.00 75200. 00 100 .00% 34 Printing & Publications 200.00 200. 00 100 .00% 35 Subscription/Dues/Memberships 0.00 0.001 #DIV/01 36 Insurance 0.00 0.00 #DIV/O ! 37 Equipment: Rental & Maintenance 0.00 0.00 #DIV/01 38 Advertising 0.00 0.00 #DIV/OI 39 Equipment Purchases : Capital Expense 0.00 0.00 #DIV/01 40 Professional Fees ( Legal, Consulting) 0.00 0.00 #DIV/0 ! 41 Books/Educational Materials 1 ,535.00 11535.00 100.00% 42 Food & Nutrition 0.00 0 .00 #DIV/O ! 43 Administrative Costs 0. 00 0.00 #DIV/0! 44 Audit Expense 11000. 00 11000.00 100.00% 45 Specific Assistance to Individuals 0.00 0.00 #DIV/01 46 Other/Miscellaneous 0. 001 0.001 #DIV/0! 47 Other/Contract 10,000. 00 10,000.00 100.00% 48 TOTAL $106,000.05 $1069000.05 100. 00 % 50/200] Bd i4! 6 Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 17000 , 000 Medical Expense 51000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 210009000 500 Basis : Per Claim ; Applies : Both BI & PD Fire Damage 507000 Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim OCT . 25. 2001 1 : 48PM NATE CITY INSURANCE NO, 735 P . 2 NATIONAL CRY INS 6076 20TH ST VERO BEACH, FL32966 772-569-2626 Policy number, 056626320 Underwritten by: PROGRESSIVE EXPRESS INS COMPANY 000ber 25, 2007 Page i of 1 Certificate of insurance C�MRlcaee Inured Additional Insured.. .. ... . .. . ... .. ... .. ... . . .. . .. . . . .. . . ......... . . .. . . ... .. . .. . .. . ..... . ... . SU85TANCEABUSECOUNCIL. . . ...... .... . ... . . . ... . ?.9."... . . ... ... . . . , . ... ... .. .... , . . .. . . NATIONAL CITY INS IRC BRD OF CO COMM 1151 19TH STREET } gpi 27TH S7 607820TH ST VERO BEACH, FL 32960 VERO REACH, FL32950 VERO BEACH, FL 32966 This docurnern certifles that insurance policies idedfied below have been issued by the designated Insurer to the insured named above for the periods) indicated. This Certificate is issued for informadon purposes only, h confers no rights upon the certificate holder and does not change, after, modify, or extend dw coverages afforded by the policies listed below, The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations. endorsements, and conditions of these policies. ... ...,....I........ . .. . .. . . .. . . ... .. . . . . Policy Fffedve Date; Mar i , 2007 ... . .... . . .. Policy Fxpirafion D,7e; Mar f, 2008 . " . .. ' ... ' . ' Insutglwa aW Aman . . 1'Ci. . .... . ... ...... ...E ... .. ... ... . ., . .. .... .. ...... , .... , , .. . . .. . �.. ... ... ..... . .. .� . ... .... . .... , �.. , .. . . ..... . . .I. BODILY ..... . ROPERIY DAMAGE 41,000,000 COMBINED SINGLE LIMIT " " " " """""" U , INSU...... . .. ... . .. ... . . . . . . . .. .. ..... .. ... . . .. ... ... .. . ..... .... . .... . .. . . . . .. . .. . .. . .. ... .. . . ......... ... ....... ........ ..... ... . .. ... . .. . .. . ... .. . .. .. . I. .. ..... .. . ... UNINSURED MOTORIST 41 .000,000 CSL NON•STACKED PERSONAL INIURY PRQTECrlON .. .01. .0. .6. .. .. .... . ' $ 10,000 WI$O DED - NAMED INSURED 't)NLY.. ..... .. . .. . Description of t,ocation/Vehicles5pecial Items Scheduled autos only 1999 FORD EC ON E350 SUPR iFB5531S2XHC31fi95 MEDICAL PAYMENTS $50000 Stated Amount $20,D00 COMPREHENSIYE $ 1 ,000 DED COLLISION $ 1 ,000 DED Ceftificate number 29807NEf632 Please be advised that additional insureds and loss payees will be notified In the event of a midterm cancellation,_ I Fmn 5241 nQ'01J - 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 1s` 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 30`h) 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 ..��.. . � .. .. a , vv .. . � a�w . � . ..a va •v . v iio aocc cuy e . ovs Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 1 , 0009000 Medical Expense 5 , 000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 230009000 500 Fire Damage SO , ODO Basis : Per Claim ; Applies : Both BI & PD Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim 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: Brad E. Bernauer, Indian River County Human Services Director 1801 27"' Street, Vero Beach , Florida 32960 . Recipient: Substance Abuse Council of Indian River County, 1151 19`h Street, Vero Beach , FL 32960 ; Attention : Colette Heid , Director 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 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. 1 ACORD !� DATE (MM/DD/YYV1� TM. CERTIFICATE OF LIABILITY INSURANCE 10124/2007 PRODUCER Phone: (772) 562-3369 Fax (772) 562-3466 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HILB ROGAL & HOBBS OF FLORIDA, INC. - VERO BEACH ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Gua Be Insurance Co _ _ . SUBSTANCE ABUSE COUNCIL OF INDIAN RIVER COUNTY, INC. INSURER B: P.O. BOX 6460 - - - — - - -- VERO BEACH FL 32960 INSURER C: ! INSURER D: INSURER E: _ COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO A-1- THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ''�� INSR IIADO'L: POLICY EFFECTIVE POLICY E%PIRNTION LIMITS LTR INSRp TYPE OF INSURANCE POLICY NUMBER onre MMMD!w DATE V WDD GENERAL LIABILITY EACH OCCURRENCE $ - - DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea ocaunnce) I $ CLAIMS MADE —�; OCCUR .MED. EXP (Anyone person) : $ — PERSONAL B ADV INJURYI $ GENERAL AGGREGATE _-- GENT AGGREGATE LIMIT APPLIES PER : I. PRODUCTS-COMP/OP AGG. ! $ PRO- - POLICY JECT . LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - ANY AUTO HER amIdenl) i $ ALL OWNED AUTOS BODILY INJURY I (Per Person) $ SCHEDULED AUTOS HIRED AUTOSBODILY INJURY NON-OWNED AUTOS (Per accident $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ -- -- - i AUTO ONLYAGG: $ - - EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE 1 $ OCCUR � CLAIMS MADE AGGREGATE is DEDUCTIBLE ' $ RETENTION $ ' $ ATU- WORKERS COMPENSATION AND we Y LIMIT OTHER EMPLOYERS' LIABILITY GWGC100002483-107 01 /10107 01/10/08 ' ACH CCI 1 E. L. EACH ACCIDENT $ 100,000 A ANY PROPRIETOILPXCLUDE EXECUTIVE " — E - - 10 - 0 oFF¢:ER/mEMEER EXCLUDED? ', E. L. DISEASE-EA EMPLOYEE IS 100,000 N yes, descnbe under E.L. DISEASE-POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER. DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, INDIAN RIVER COUNTY - BOARD OF COUNTY ITS AGENTS OR REPRESENTATIVES. COMMISSIONERS AUTHORIZED REPRESENTATIVE 1801 27TH STREET VERO BEACH, FL 32960 e Attention : Robert Sls ACORD 25 (2001108) Certificate # 109167 © ACORD CORPORATION 1988 IN, � ; , •P111MUCER (772)231-2923 FAX (772) 231-4413 1t h ti 71 . f • .. • . • , • • - 10, .l . f • . • • . 7Felten & Associates ' 1 • . • I • • ' Z911 Cardinal Drive (3Z963) Box 3499 vero Beach , FL 3Z964-3493 q • MEN -11740141 W1 .111R.-ARGORAR yr , • • • I 1 : ' • I • • • • • •I • 2 !'.1q1 � - i i1 i ai : .« •. — _. ire I I i ■ i i11 FAR Z" � . Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 17000 , 000 Medical Expense 51000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 210009000 500 Basis : Per Claim ; Applies : Both BI & PD Fire Damage 507000 Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim OCT . 25. 2001 1 : 48PM NATE CITY INSURANCE NO, 735 P . 2 NATIONAL CRY INS 6076 20TH ST VERO BEACH, FL32966 772-569-2626 Policy number, 056626320 Underwritten by: PROGRESSIVE EXPRESS INS COMPANY 000ber 25, 2007 Page i of 1 Certificate of insurance C�MRlcaee Inured Additional Insured.. .. ... . .. . ... .. ... .. ... . . .. . .. . . . .. . . ......... . . .. . . ... .. . .. . .. . ..... . ... . SU85TANCEABUSECOUNCIL. . . ...... .... . ... . . . ... . ?.9."... . . ... ... . . . , . ... ... .. .... , . . .. . . NATIONAL CITY INS IRC BRD OF CO COMM 1151 19TH STREET } gpi 27TH S7 607820TH ST VERO BEACH, FL 32960 VERO REACH, FL32950 VERO BEACH, FL 32966 This docurnern certifles that insurance policies idedfied below have been issued by the designated Insurer to the insured named above for the periods) indicated. This Certificate is issued for informadon purposes only, h confers no rights upon the certificate holder and does not change, after, modify, or extend dw coverages afforded by the policies listed below, The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations. endorsements, and conditions of these policies. ... ...,....I........ . .. . .. . . .. . . ... .. . . . . Policy Fffedve Date; Mar i , 2007 ... . .... . . .. Policy Fxpirafion D,7e; Mar f, 2008 . " . .. ' ... ' . ' Insutglwa aW Aman . . 1'Ci. . .... . ... ...... ...E ... .. ... ... . ., . .. .... .. ...... , .... , , .. . . .. . �.. ... ... ..... . .. .� . ... .... . .... , �.. , .. . . ..... . . .I. BODILY ..... . ROPERIY DAMAGE 41,000,000 COMBINED SINGLE LIMIT " " " " """""" U , INSU...... . .. ... . .. ... . . . . . . . .. .. ..... .. ... . . .. ... ... .. . ..... .... . .... . .. . . . . .. . .. . .. . .. ... .. . . ......... ... ....... ........ ..... ... . .. ... . .. . .. . ... .. . .. .. . I. .. ..... .. . ... UNINSURED MOTORIST 41 .000,000 CSL NON•STACKED PERSONAL INIURY PRQTECrlON .. .01. .0. .6. .. .. .... . ' $ 10,000 WI$O DED - NAMED INSURED 't)NLY.. ..... .. . .. . Description of t,ocation/Vehicles5pecial Items Scheduled autos only 1999 FORD EC ON E350 SUPR iFB5531S2XHC31fi95 MEDICAL PAYMENTS $50000 Stated Amount $20,D00 COMPREHENSIYE $ 1 ,000 DED COLLISION $ 1 ,000 DED Ceftificate number 29807NEf632 Please be advised that additional insureds and loss payees will be notified In the event of a midterm cancellation,_ I Fmn 5241 nQ'01J - ..��.. . � .. .. a , vv .. . � a�w . � . ..a va •v . v iio aocc cuy e . ovs Additional Coverages and Factors 04/09/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor Each Occurrence 1 , 0009000 Medical Expense 5 , 000 Personal & Advertising EXCLUDED Injury Basis : Per Claim General Aggregate 230009000 500 Fire Damage SO , ODO Basis : Per Claim ; Applies : Both BI & PD Basis : Per Claim Products/Completed Ops EXCLUDED Aggregate Basis : Per Claim Professional liability EXCLUDED Basis : Per Claim i i