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Home My WebLink About2005-328q INDIAN RIVER COUNTYoe .. GRANT CONTRACT i This Grant Contract ("Contract") entered into effective this day of October 2005 , by and between Indian River County , a political subdivision of the State of Florida ; 1840 25th Street , Vero Beach , Florida , 32960- 3365 ; and The Center for Emotional and Behavioral Health ( Recipient) , of: The Center for Emotional and Behavioral Health (CEBH ) 119037 th Street Vero Beach , Florida 32960 Group Therapy Program for Children and Adolescents Background Recitals A . The County has determined that 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 proposal 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 (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 the Grant . The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient , attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as " Grant Purposes" ) . 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2005/2006 ("Grant Period" ) . The Grant Period commences on October 1 , 2005 and ends on September 30 , 2006 . - 1 - INDIAN RIVER COUNTYoe .. GRANT CONTRACT i This Grant Contract ("Contract") entered into effective this day of October 2005 , by and between Indian River County , a political subdivision of the State of Florida ; 1840 25th Street , Vero Beach , Florida , 32960- 3365 ; and The Center for Emotional and Behavioral Health ( Recipient) , of: The Center for Emotional and Behavioral Health (CEBH ) 119037 th Street Vero Beach , Florida 32960 Group Therapy Program for Children and Adolescents Background Recitals A . The County has determined that 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 proposal 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 (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 the Grant . The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient , attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as " Grant Purposes" ) . 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2005/2006 ("Grant Period" ) . The Grant Period commences on October 1 , 2005 and ends on September 30 , 2006 . - 1 - 4 . Grant Funds and Payment . The approved Grant for the Grant Period is : FIFTY FOUR THOUSAND , ONE HUNDRED FIFTY NINE DOLLARS ($54 , 159 . 00 ) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for the 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 Obligation 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 to written notice . 5 . 2 . Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws 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 . 5 .4 . Audit Requirements . If Recipient receives $25 , 000 , or more in 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 the prior fiscal year is past due and has not been submitted by May 1 . 5 .4 . 1 . The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from its independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget . The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately . The foregoing termination right is in addition to any other right of the County to terminate the Contract . 5 .4 . 2 . The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 . Insurance Requirements . Recipient shall , no later than September 21 , 2005 provide to 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 : - 2 - ( 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 , product/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 ) Worker's 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 the County. In addition , the County may request such other proofs and assurances as it may reasonable 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 Worker's 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 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 . - 3 - 4 . Grant Funds and Payment . The approved Grant for the Grant Period is : FIFTY FOUR THOUSAND , ONE HUNDRED FIFTY NINE DOLLARS ($54 , 159 . 00 ) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for the 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 Obligation 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 to written notice . 5 . 2 . Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws 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 . 5 .4 . Audit Requirements . If Recipient receives $25 , 000 , or more in 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 the prior fiscal year is past due and has not been submitted by May 1 . 5 .4 . 1 . The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from its independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget . The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately . The foregoing termination right is in addition to any other right of the County to terminate the Contract . 5 .4 . 2 . The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 . Insurance Requirements . Recipient shall , no later than September 21 , 2005 provide to 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 : - 2 - IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By : _ _ � Thomas S . Lowther, Chairman BCC Approved : �� ` �/ C✓ ' ' �'..� Attest : J . K. Barton , Clerk y By: Deputy Clerk Approved : Jos h A. Baird County Administrator Approved t form and legal s fficiency: By : /Mar& E . Fell , Assistant Cou torney RECIPIENT x- Bye TI40'Ce t for /Oticnal and Behavioral Health (CEBH ) - 4 - EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - ( 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 , product/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 ) Worker's 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 the County. In addition , the County may request such other proofs and assurances as it may reasonable 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 Worker's 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 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 . - 3 - LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC PROGRAM COVER PAGE Organization Name : Substance Abuse Council of Indian River County Executive Director: Colette Heid, Ex. Dir. , CAPP E-mail : sacirc@bellsouth.net Address : 1151 19th Street Telephone : (772) 770-4811 Vero Beach, Florida 32960 Fax : (772) 770-4822 Program Director: Colette Heid E-mail : Address : Telephone: Program Tit • ' fe Skills ' ng Program (LST) L �— Priority Need Area Addressed: Mental Wellness Issues �j q1 6 Substance Abuse Education/Prevention LX- 825 (According to the Taxonomy of Human Services) Brief Description of the Program: It is the LST program' s intent to provide a comprehensive, research based proven effective substance abuse prevention program. LST is targeted at reducing and preventing substance use/abuse among IRC middle school youth. There is a direct correlation between changing adolescent perceptions of the benefits vs. the risks of Alcohol, Tobacco and other Drugs (ATOD) to delaying the age of onset of initial use. By increasing protective factors and changing attitudes towards ATOD, the age of initial use can be delayed or put off completely . SUMMARY REPORT — (Enter Information In The Black C7:6 Amount Requested from Funder for 2005 / 06 : $ 500 . 00 Total --Proposed Program Budget for 2004 / 05 : $ 2 , 500 . 00 Percent of Total Program Budget : 100 . 0 % Current Program Funding ( 2004 / 05 ) : $ 60 , 000 Dollar increase / ( decrease ) in request : $ 2 , 500 Percent increase / ( decrease ) in request * * : 4 . 2 % Unduplicated Number of Children to be served Individually : - Unduplicated Number of Adults to be served Individually : - Unduplicated Number to be served via Group settings : 31900 Total Program Cost per Client : 16 . 03 * *If request increased 5 % or more, briefly explain why : 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 application on date). 4127105 Chief Hugh Cox, Chairman Name of President/Chair of the Board Signature ' Colette Heid, MS Ed., CAPP Name of Executive Director/CEO LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC Be 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. According to the Florida Youth Substance Abuse (FYSA) and PRIDE Surveys, IRC youth exhibit above average risk factors and levels of drug usage . These survey reveals the extent of substance abuse occurring amongst our young in IRC . Even though there has been a downward pattern in drug use trends over the past few years, IRC youth are still reporting drug use and delinquent behavior that will negatively affect their lives and our society . IRC youth key Drug- Use Trends from the FYSA Survey 2000 to the 2004 reflect the same observed pattern of reduced ATOD use as in the statewide survey. • The "past-30-day use of alcohol" by surveyed IRC students declined from 39 .3 % in 00 to 35 . 5 % in 04 . • Marijuana use also appears to reflect the statewide pattern. "Past-30-day use " of marijuana by surveyed IRC students declined from 17 .2% in 2000 to 12 .6% in 2004 . • Cigarette use among IRC students declined sharply in the past several years . In 2000 , 22 . 7% of surveyed students reported some use of cigarettes over the "past 30 days " , compared to 15 . 6% in 2004 , but up from 14 . 1 % in 2002 . Attitudes toward Dru-e Use • Almost two-thuds of surveyed IRC students (62 . 9%) reported that daily use of cigarettes poses a " great risk" of harm. • Fear of marijuana use declines as students get older, while the fear of cigarette use actually appears to increase. While 67 . 3 % of surveyed middle school students believe regular marijuana use poses a "great risk" of harm, this number drops to 49 . 3 % among high school students. In contrast, perceptions of harm associated with daily use of cigarettes rise from 56 . 8% among middle school students to 67 .4% among high school students . • Disapproval of substance use appears to decline as students get older. For instance, disapproval of alcohol use (76 . 2% in middle school and 52 .2% in high school), disapproval of cigarette use (84 . 9% in middle school and 66 . 5 % in high school) and disapproval of marijuana use (90 . 0% in middle school and 69 . 3 % in high school) all decline between middle school and high school. Risk and Protective Factors • Surveyed students reported higher scores on the Personal Transitions and Mobility (68) and Favorable Attitudes toward Antisocial Behavior (58) risk factor scales, compared to the national average of 50 . This means that students in IRC are at greater risk for involvement in drug use and other antisocial behaviors due to a lack of long-term neighborhood connection, and due to students' acceptance of antisocial behaviors . Parental use/parental attitude towards ATOD/use also correlate with adolescent attitudes towards/use of ATOD . These key findings illustrate the complexity of drug use and antisocial behavior among IBC ' s youth and the possible factors that may contribute to these activities . While some of the findings compare favorably to the national findings, Indian River County youth are still reporting drug use and delinquent behavior that will negatively affect their lives and our society . a) Identify similar programs that are currently serving the needs of your targeted population; b) Explain how these existing programs are under-serving the targeted population of your program. Local Law enforcement provides the DARE program to all 5`h grade students . No specific substance abuse prevention programs are directed at the middle schools . Additionally, New Horizons and DATA provide Student Support Specialist and services in the public middle schools . These agencies work with a very small , indicated population of students and do not serve the entire population. This remaining youth would receive no additional program services if the LST program were not available. Collaboration is a part of the services provided to universal populations . The LST program provides no duplication of services. 446 IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By : _ _ � Thomas S . Lowther, Chairman BCC Approved : �� ` �/ C✓ ' ' �'..� Attest : J . K. Barton , Clerk y By: Deputy Clerk Approved : Jos h A. Baird County Administrator Approved t form and legal s fficiency: By : /Mar& E . Fell , Assistant Cou torney RECIPIENT x- Bye TI40'Ce t for /Oticnal and Behavioral Health (CEBH ) - 4 - LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages) 1 . List Priority Needs area addressed . Error! Not a valid link. 2. Briefly describe program activities including location of services. The LST program is a three year prevention program designed to be conducted in school classrooms . Based on Theoretical framework, the LST program was developed to impact drug-related knowledge, attitudes and norms ; teach skills for resisting social influences to use drugs and promote the development of general personal self-management skills and social skills . Consistent with this, the LST program can be best conceptualized as consisting of management skills . The second component focuses on teaching general social skills. The third component includes information and skills that are specifically related to the problem drug abuse. The first two components are designed to enhance overall personal competence and decrease both the motivations to use drugs and vulnerability to drug related social influences . The problem specific component is designed to provide students with materials relating directly to drug abuse (drug resistance skills, anti-drug attitudes, and anti-drug norms) . Services are provided in Indian River County Middle Schools . The LST program is a primary prevention program that targets individuals who have not yet developed drug abuse problems. The goal of the program is to prevent the use of gateway substance use among adolescents by making an impact on risk and protective factors associated with tobacco , alcohol, and marijuana use, particularly occasional and experimental use. Simultaneously a systematic community awareness campaign is conducted. It is designed to impact community norms and educate the community regarding the incidence of substance abuse. On the FYSA Survey (2004), Indian River County scored higher than the State and other like Counties in the following risk factors areas : • Poor Family Supervision • Poor Family Discipline • Family History of Antisocial Behavior • Parental Attitude Favorable to ATOD use • Parental Attitude Favorable to Antisocial • Friends Use of Drugs Behavior • Peer Rewards for Antisocial Behavior • Youth Attitude Favorable to ATOD use • Youth Attitude Favorable to Antisocial • Perceived Risks of Drug Use Behavior • Early Initiation of Drug Use • Sensation Seeking According to Center for Substance Abuse prevention (CSAP), Selected Findings In Prevention, A Decade of Results from the Center For Substance Abuse Prevention, 1997, the findings indicate that the proposed strategies above are effective with this target population. They demonstrated repeated documentation that adolescent risk perceptions were favorably impacted by reducing favorable parental, peer and community attitudes towards ATOD . We must take these facts and information and as with all knowledge, empower ourselves and educate our youth and community. The LST program is a research based, proven effective curriculum in the reduction of adolescent drug usage and has. been endorsed by the Center for Disease Control (CDC) . The LST program was selected by the Center for the Study and Prevention of Violence (CSPV), University of Colorado at Boulder as a Blueprint 2000 program and OJJDP selected the LST program for replication nation-wide and is 1 of only 11 programs that is considered "exemplary" by all program evaluators. LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC 3 . 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. The LST program is based on Theoretical framework. The LST program was developed to impact • drug-related knowledge • attitudes and norms • teach skills for resisting social influences to use drugs • promote the development of general personal self-management skills and social skills . Since all of these skills are directly related and positively impact Drug Use Trends ; Attitudes towards Drug Use and Risk and Protective Factors, the continuation of the LST program and it' s protective skill building framework should continue to contribute to the : • Decline in Drug Use Trends • Increase in perceived risk or harm of substances • Decrease risk factors such as Favorable attitudes to ATOD use • Delay the age of onset for early initiation of drug use 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform with the information in the Position Listing on the Budget Narrative Worksheet). The LST program is currently staffed by three Council employees . The LST Coordinator assumes primary responsibility for the LST program. One hundred percent (33 hours per week) of this position is currently allocated to the program . One additional LST instructor (30 hours per week) is also assigned to this program and currently dedicated 100% of the position. The need now exists the need to increase staffing to three full time instructors help continue to implement the program to the incoming 6`h, 7th and 8th grades in the fall of 2004 . During year 3 , all 8a` graders will continue with LST booster instruction, while we concurrently implement the 1s' and 2nd year classes to the 6th & 7th grades . Each year an estimated total of 3 ,900 students will receive • , 17 sessions in the 6th grade With on going LST booster sessions, instruction will continue with • 10 sessions in the 7`h grade • 5 sessions in the 80' grade The LST Coordinator has had 6 years of experience in the substance abuse prevention field. The other two LST instructors require a BA. All LST instructors are nationally certified to teach the LST curriculum. 5. How will the target population be made aware of the program ? The LST program has been offered to all middle schools in Indian River County. In order to qualify as an OJJDP site all middle schools had to agree to allow the Substance Abuse Council to implement the LST program in a classroom period. The remaining private schools were also invited to receive services from the Substance Abuse Council . They were made aware of the program by letter with a follow-up face to face meeting. 6. How will the program be accessible to target population (i.e. , location, transportation, hours of operation) ? As previously stated, LST program is implemented during the school day in all Indian River County Middle Schools . Instructors render themselves to the individual school sites . 48 EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC D. MEASURABLE OUTCOMES (Description of Intent) Use the Measurable Outcomes form. This description pgge does not need to be included in the proposat In order to show the impact that your program is having on the target population and the community, the funders are requiring measurable outcomes . Please review the examples and summaries below to insure your understanding of what is expected . OUTCOMES : Describes what you want to achieve with the target population. Indicates the results of the services you provide, not the services you provide . Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. ACTIVITIES : Describes the tasks that will be accomplished in the program to achieve the results stated in the outcomes . Activities utilize action words such as complete, establish, create, provide , operate , and develop. The activities should reflect the services described in the PROGRAM DESCRIPTION (C2) . Use the following elements to develop your outcomes. All elements must be included: • Direction of change • Timeframe • Area of change • As measured by • Target population • Baseline: The number that you will be measuring • Degree of chane against Example 1 (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 2003 School Board attendance records (as measured by). Baseline : 2003 School Board attendance records for enrolled boys and girls . Example 1 (Activity) , To provide anger management classes to enrolled boys and girls 2 times a week for 12 weeks . Example 2 (Outcome) : 75 % (degree of change) of youth (target population) who have participated in the academic enrichment activities (as measured by) for 6 months or more (time frame), will improve (direction of change) their scores in one or more subject area (area of change) . 25 % of participants in academic enrichment activities will maintain the initial level of performance assessed at entry. Baseline : Pre-test scores from the academic enrichment test. Example 2 (Activity) . 1 ) Provide pre and post-test exercises on the Advanced Learning System software ; 2) Participants will go through the one lesson per week and be graded for 10 weeks . IMPORTANT NOTE : Keep in mind when developing your PROGRAM OUTCOMES , that if funded, this will be what you are held 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 that are going to influence the outcome and impact the unacceptable condition in your Program Need Statement. LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements or the Measurable Outcomes Add the tasks to accomplish the Outcome(s) 1 . To decrease by 5 % the "first use" numbers of 1 . To provide 3 ,900 youth weekly LST group sessions drug and alcohol use among middle school (6`I', to youth according to the following schedule : 7t`, 8t' grade) students over a period of one year . 17 sessions in the 6t' grade as reported by the 2006 FYSAS survey. . 10 sessions in the 7th (Baseline 2004 FYSAS Survey) . 5 sessions in the 8th grades. 2 . To provide a total of seven-teen ( 17) weekly ongoing 2 . To reduce by 2% the incidences of sixth grad education sessions to sixth grade students on the various adolescents reporting the use of tobacco, alcohol substance abuse and resiliency skills building topics and marijuana following the first year of LST Program as reported by the 2006 FYSAS survey (Baseline 2004 FYSAS Survey) 3 . To reduce by 2% the incidences of seventh 3 . We will provide a total of ten ( 10) weekly ongoing grade adolescents reporting the use of tobacco, booster education sessions to seventh grade students on alcohol, and marijuana following the second the various substance abuse and resiliency skills building year of LST program as reported by the 2006 topics FYSAS survey (Baseline 2004 FYSAS Survey) 4 . To reduce by 1 % the incidences of eight 4. We will provide a total of five (5) weekly ongoing grade adolescents reporting the use of booster education sessions to seventh grade students on tobacco, alcohol, and marijuana following the various substance abuse and resiliency skills building the third year of LST program as reported topics by the 2006 FYSAS survey (Baseline 2004 FYSAS Survey) 5 . To increase audience knowledge by 25 % 5 . Provide factual, current and up-to-date information following educational presentation forums concerning drugs and their harmful effects . concerning drugs and their harmful effects Pre/ post testing will be conducted and rated to as reported by self-disclosure on pre-testing. indicate a change in knowledge . (Baseline : Individual and group administered Pre-tests of forum participants .) TO LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC PROGRAM COVER PAGE Organization Name : Substance Abuse Council of Indian River County Executive Director: Colette Heid, Ex. Dir. , CAPP E-mail : sacirc@bellsouth.net Address : 1151 19th Street Telephone : (772) 770-4811 Vero Beach, Florida 32960 Fax : (772) 770-4822 Program Director: Colette Heid E-mail : Address : Telephone: Program Tit • ' fe Skills ' ng Program (LST) L �— Priority Need Area Addressed: Mental Wellness Issues �j q1 6 Substance Abuse Education/Prevention LX- 825 (According to the Taxonomy of Human Services) Brief Description of the Program: It is the LST program' s intent to provide a comprehensive, research based proven effective substance abuse prevention program. LST is targeted at reducing and preventing substance use/abuse among IRC middle school youth. There is a direct correlation between changing adolescent perceptions of the benefits vs. the risks of Alcohol, Tobacco and other Drugs (ATOD) to delaying the age of onset of initial use. By increasing protective factors and changing attitudes towards ATOD, the age of initial use can be delayed or put off completely . SUMMARY REPORT — (Enter Information In The Black C7:6 Amount Requested from Funder for 2005 / 06 : $ 500 . 00 Total --Proposed Program Budget for 2004 / 05 : $ 2 , 500 . 00 Percent of Total Program Budget : 100 . 0 % Current Program Funding ( 2004 / 05 ) : $ 60 , 000 Dollar increase / ( decrease ) in request : $ 2 , 500 Percent increase / ( decrease ) in request * * : 4 . 2 % Unduplicated Number of Children to be served Individually : - Unduplicated Number of Adults to be served Individually : - Unduplicated Number to be served via Group settings : 31900 Total Program Cost per Client : 16 . 03 * *If request increased 5 % or more, briefly explain why : 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 application on date). 4127105 Chief Hugh Cox, Chairman Name of President/Chair of the Board Signature ' Colette Heid, MS Ed., CAPP Name of Executive Director/CEO LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC Be 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. According to the Florida Youth Substance Abuse (FYSA) and PRIDE Surveys, IRC youth exhibit above average risk factors and levels of drug usage . These survey reveals the extent of substance abuse occurring amongst our young in IRC . Even though there has been a downward pattern in drug use trends over the past few years, IRC youth are still reporting drug use and delinquent behavior that will negatively affect their lives and our society . IRC youth key Drug- Use Trends from the FYSA Survey 2000 to the 2004 reflect the same observed pattern of reduced ATOD use as in the statewide survey. • The "past-30-day use of alcohol" by surveyed IRC students declined from 39 .3 % in 00 to 35 . 5 % in 04 . • Marijuana use also appears to reflect the statewide pattern. "Past-30-day use " of marijuana by surveyed IRC students declined from 17 .2% in 2000 to 12 .6% in 2004 . • Cigarette use among IRC students declined sharply in the past several years . In 2000 , 22 . 7% of surveyed students reported some use of cigarettes over the "past 30 days " , compared to 15 . 6% in 2004 , but up from 14 . 1 % in 2002 . Attitudes toward Dru-e Use • Almost two-thuds of surveyed IRC students (62 . 9%) reported that daily use of cigarettes poses a " great risk" of harm. • Fear of marijuana use declines as students get older, while the fear of cigarette use actually appears to increase. While 67 . 3 % of surveyed middle school students believe regular marijuana use poses a "great risk" of harm, this number drops to 49 . 3 % among high school students. In contrast, perceptions of harm associated with daily use of cigarettes rise from 56 . 8% among middle school students to 67 .4% among high school students . • Disapproval of substance use appears to decline as students get older. For instance, disapproval of alcohol use (76 . 2% in middle school and 52 .2% in high school), disapproval of cigarette use (84 . 9% in middle school and 66 . 5 % in high school) and disapproval of marijuana use (90 . 0% in middle school and 69 . 3 % in high school) all decline between middle school and high school. Risk and Protective Factors • Surveyed students reported higher scores on the Personal Transitions and Mobility (68) and Favorable Attitudes toward Antisocial Behavior (58) risk factor scales, compared to the national average of 50 . This means that students in IRC are at greater risk for involvement in drug use and other antisocial behaviors due to a lack of long-term neighborhood connection, and due to students' acceptance of antisocial behaviors . Parental use/parental attitude towards ATOD/use also correlate with adolescent attitudes towards/use of ATOD . These key findings illustrate the complexity of drug use and antisocial behavior among IBC ' s youth and the possible factors that may contribute to these activities . While some of the findings compare favorably to the national findings, Indian River County youth are still reporting drug use and delinquent behavior that will negatively affect their lives and our society . a) Identify similar programs that are currently serving the needs of your targeted population; b) Explain how these existing programs are under-serving the targeted population of your program. Local Law enforcement provides the DARE program to all 5`h grade students . No specific substance abuse prevention programs are directed at the middle schools . Additionally, New Horizons and DATA provide Student Support Specialist and services in the public middle schools . These agencies work with a very small , indicated population of students and do not serve the entire population. This remaining youth would receive no additional program services if the LST program were not available. Collaboration is a part of the services provided to universal populations . The LST program provides no duplication of services. 446 Substance Abuse Council of Indian River County SALARIESIV 1 Gross 11 Portion /it Funder % of Gross Annual POSITION LISTING Annual Salary of Salary on Proposed Program Speck Budget Salary (Agency) Position Title / Total Hrs/wk Requested(CIA) Example: Executive Director / 40 hrs 70,000.00 10,000.00 51000.00 7. 14% Executive Director -40 hrs/ wk 65,000.00 0.00 0 .00 0 . 00% Prevention Program Coordinator-40 hrs / wk 42 , 000.00 0.00 0.00 0 . 00 % PREVENT Program. Coordinator-40 hrs / wk 29, 000 .00 0.00 0.00 0 . 00 % Lifeskills Educator ( 1 ) - 33 hrs / wk/$ 16 271456.00 27 ,456.00 27,456.00 94 . 68 % Lifeskills Educator (2) -33 hrs / wk/$ 13 22,300.00 22 ,300.00 22,300.00 0 . 00% Diversion Specialist -40 hrs / wk 28,000.00 0.00 0.00 0 . 00% Diversion Assistant ( 1 ) 20 hrs/wk /$ 12 12,480.00 0.00 0.00 0 . 00 % Information Specialist- 35 hrs / wk/ $ 13 231660.00 0.00 0.00 0 . 00 % Case Manager - 25 hrs / wk $ 16 . 00 20,800. 00 0.00 0.00 0 . 00% Under Age Prog Coord 20hrs/ wk $ 15 15 ,600.00 0.00 0.00 0 . 00 % Lab Techician 30 hrs/ wk/ $ 13 20,280.00 0.00 0-00 0 . 00 % Diversion Assistant 20 2) hrs/wk /$ 12 12,480. 00 0.00 0.00 0 . 00% Diversion Assistant 20(3) hrs/wk /$ 12 122480. 00 0.00 0.00 0 . 00% 0.00 0.00 0 . 00 % 0.00 0.00 #VALUE ! 0.00 0.00 #VALUE ! 0.00 0.00 #VALUE ! #VALUE ! #VALUE ! #VALUE ! Remaining positions throughout the agency Total Salaries $331 , 536 .001 $49 , 756 .00 1 $49 , 756 .00 15 . 010/6 FRINGE BENEFITS DETAIL (Funder Specific Budget I Funder It 111 IV V IA Vll Column C only, from line 21 to 26) Specific FICA 7.65% Pension Worker's Unemp/oyme Total Fringes Funder S cffic Bu Health Ins. Compens. nt Compens. Speck Position Title / Total Hrs/wk Example: Case Manager/ 40 hrs 5,000.00 382.50 200.001 500.00 300.00 200.00 11582.50 Executive Director -40 hrs/ wk 0. 00 0. 00 0.00 0. 00 0. 00 0 . 00 Prevention Program Coordinator-40 his / wk 0 . 00 0 . 00 0.00 0.00 0 .00 0.00 0.00 PREVENT Program Coordinator-40 hrs / wk 0 . 00 0:00 0 . 00 Lifeskills Educator (1 ) - 33 hrs / wk/$ 16 27 ,456. 00 21100. 38 823 .68 0.00 354. 18 37278. 25 Lifeskills Educator (2) -33 hrs / wk/$ 13 22 , 300 .00 11705 . 95 669.00 21100.00 287.67 4 , 762 . 62 Diversion Specialist -40 hrs / wk 0 . 00 0. 00 1 0 . 00 Diversion Assistant ( 1 ) 20 hrs/wk /$ 12 0 . 00 0. 00 0 . 00 Information Specialist- 30 hrs / wk/ $ 13 0. 00 0 . 00 0. 00 0.00 0. 00 0 . 00 Case Manager - 25 hrs / wk $16. 00 0 . 00 0. 00 0 . 00 Under Age Prog Coord 20hrs/ wk $ 15 0. 00 0. 00 0 . 00 Lab Techician 30 hrs/ wk/ $13 0 .00 0 . 00 0 . 00 Diversion Assistant 20 (2) hrs/wk /$12 0. 00 0 . 00 0 . 00 Diversion Assistant 20(3) hrs/wk /$12 0 . 00 0 . 00 0 . 00 Case Manager - 25 hrs / wk $ 16 . 00 0. 00 0. 00 0 . 00 0. 00 0 . 00 0 . 00 0 . 00 0. 00 0 . 00 0 . 00 0 . 000 . 0 0. 00 0 . 00 0 . 00 0 . 00 0 . 000 1 1 0 . 00 0 . 001 0 . 001 0 . 00 Total Funder Request Fringe Benefits 1 $49 ,756 . 001 $3, 806 . 33 $ 11492.68 $2J00 . 001 $641 . 851 $0 . 00 $8 , 040. 87 B C EXPENDITURES A Proposed Total Program Budget Funder Specific Total Agency Budget Budget 5/16/2005 tan Substance Abuse CouncA of Indian River County 27 Travel-Daily 500 .001 500 . 001 21 ,400 . 00 WV # of Staff x average # of miles/wk x 50 wks x SWAT 310 miles a month $ = Estimated Daily Travel/Mileage Reimb. LST 385 miles a month 28 Travel/Conferences/Training 0 . 001 0 . 001 34 , 600 .03 • National Conference (cost per staff) FADDA registration $250 • Training/Seminar (cost per staff) Hotel $ 150 per night x 3 nights = $450 $21 Per diem per day x 3 days = $63 • Other Trainings (cost of travel, lodging , 250 miles x .29 = $72.50 registration , food) Tolls $ 15 PRIDE $9000 29 Office Supplies 250 .001 250 .001 261600 .00 . Office supplies (monthly average x 12 Other Programs $500 a month x 12 months = $6000 months = estimated cost of office supplies $50 x 12 months for UW = based on present history. Other Programs $500 a month x 12 months = $6000 30 Telephone 0 .001 o .001 81460 .00 # Phone lines x average cost per month x Long distance charges $ 120 per month x 12 months= 1440 12 months = local phone cost Cell phones 4 phones x $60 per line per month =240x 12 months= 2880 . Average long distance calls x 12 months = Pagers $8 per month x 12 employees =96 x 12 = 1152 Estimated cost of long distance Internet connection $ 25 per month x 12 months= $300 31 Postage/Shipping 100. 001 loo . 001 41250 .00 • Quarterly Mailing of Newsletter Bulk Mail $ 200 per month x 12 months= 2400 • Special events , etc. Bulk mail permit $300 • Bulk mailings - appeals Post office Box Rental $200 32 Utilities 0 .001 0 .001 4 , 500 .00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) - Garbage ($ x 12 months) Utilities $375 per month x 12 months+ $4500 33 Occupancy (Building & Grounds) 21854 . 00 21854 .00 39 ,000 .00 • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes Rent $13058 a month x 12 months 36,696 34 Printing & Publications 0.001 0.001 46 , 200.00 Quarterly Newsletter ($ x 4) Letterheads , Envelopes, etc. Fundraising materials Other 35 Subscription/Dues/Memberships 0.001 0.001 11000 .00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines , etc. 36 Insurance 0.001 0. 001 14 , 328 .00 • Directors/Officers Liab . • Commercial/General Insurance • Bond Ins . • Auto Insurance 37 Equipment: Rental & Maintenance 0.001 0.001 71400 .00 • Copier lease ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) • Computer Maintenance ( $ x 12 months) • Other 38 Advertising 0 . 00 0 .001 91000.00 • Newspaper ads • Fundraising ads/promotions Other (vacancies) 39 Equipment Purchases : Capital Expense 0 .00 0.001 137153 .00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 0 . 00 0 .00 21500.00 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 5/16/2005 LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages) 1 . List Priority Needs area addressed . Error! Not a valid link. 2. Briefly describe program activities including location of services. The LST program is a three year prevention program designed to be conducted in school classrooms . Based on Theoretical framework, the LST program was developed to impact drug-related knowledge, attitudes and norms ; teach skills for resisting social influences to use drugs and promote the development of general personal self-management skills and social skills . Consistent with this, the LST program can be best conceptualized as consisting of management skills . The second component focuses on teaching general social skills. The third component includes information and skills that are specifically related to the problem drug abuse. The first two components are designed to enhance overall personal competence and decrease both the motivations to use drugs and vulnerability to drug related social influences . The problem specific component is designed to provide students with materials relating directly to drug abuse (drug resistance skills, anti-drug attitudes, and anti-drug norms) . Services are provided in Indian River County Middle Schools . The LST program is a primary prevention program that targets individuals who have not yet developed drug abuse problems. The goal of the program is to prevent the use of gateway substance use among adolescents by making an impact on risk and protective factors associated with tobacco , alcohol, and marijuana use, particularly occasional and experimental use. Simultaneously a systematic community awareness campaign is conducted. It is designed to impact community norms and educate the community regarding the incidence of substance abuse. On the FYSA Survey (2004), Indian River County scored higher than the State and other like Counties in the following risk factors areas : • Poor Family Supervision • Poor Family Discipline • Family History of Antisocial Behavior • Parental Attitude Favorable to ATOD use • Parental Attitude Favorable to Antisocial • Friends Use of Drugs Behavior • Peer Rewards for Antisocial Behavior • Youth Attitude Favorable to ATOD use • Youth Attitude Favorable to Antisocial • Perceived Risks of Drug Use Behavior • Early Initiation of Drug Use • Sensation Seeking According to Center for Substance Abuse prevention (CSAP), Selected Findings In Prevention, A Decade of Results from the Center For Substance Abuse Prevention, 1997, the findings indicate that the proposed strategies above are effective with this target population. They demonstrated repeated documentation that adolescent risk perceptions were favorably impacted by reducing favorable parental, peer and community attitudes towards ATOD . We must take these facts and information and as with all knowledge, empower ourselves and educate our youth and community. The LST program is a research based, proven effective curriculum in the reduction of adolescent drug usage and has. been endorsed by the Center for Disease Control (CDC) . The LST program was selected by the Center for the Study and Prevention of Violence (CSPV), University of Colorado at Boulder as a Blueprint 2000 program and OJJDP selected the LST program for replication nation-wide and is 1 of only 11 programs that is considered "exemplary" by all program evaluators. LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC 3 . 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. The LST program is based on Theoretical framework. The LST program was developed to impact • drug-related knowledge • attitudes and norms • teach skills for resisting social influences to use drugs • promote the development of general personal self-management skills and social skills . Since all of these skills are directly related and positively impact Drug Use Trends ; Attitudes towards Drug Use and Risk and Protective Factors, the continuation of the LST program and it' s protective skill building framework should continue to contribute to the : • Decline in Drug Use Trends • Increase in perceived risk or harm of substances • Decrease risk factors such as Favorable attitudes to ATOD use • Delay the age of onset for early initiation of drug use 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform with the information in the Position Listing on the Budget Narrative Worksheet). The LST program is currently staffed by three Council employees . The LST Coordinator assumes primary responsibility for the LST program. One hundred percent (33 hours per week) of this position is currently allocated to the program . One additional LST instructor (30 hours per week) is also assigned to this program and currently dedicated 100% of the position. The need now exists the need to increase staffing to three full time instructors help continue to implement the program to the incoming 6`h, 7th and 8th grades in the fall of 2004 . During year 3 , all 8a` graders will continue with LST booster instruction, while we concurrently implement the 1s' and 2nd year classes to the 6th & 7th grades . Each year an estimated total of 3 ,900 students will receive • , 17 sessions in the 6th grade With on going LST booster sessions, instruction will continue with • 10 sessions in the 7`h grade • 5 sessions in the 80' grade The LST Coordinator has had 6 years of experience in the substance abuse prevention field. The other two LST instructors require a BA. All LST instructors are nationally certified to teach the LST curriculum. 5. How will the target population be made aware of the program ? The LST program has been offered to all middle schools in Indian River County. In order to qualify as an OJJDP site all middle schools had to agree to allow the Substance Abuse Council to implement the LST program in a classroom period. The remaining private schools were also invited to receive services from the Substance Abuse Council . They were made aware of the program by letter with a follow-up face to face meeting. 6. How will the program be accessible to target population (i.e. , location, transportation, hours of operation) ? As previously stated, LST program is implemented during the school day in all Indian River County Middle Schools . Instructors render themselves to the individual school sites . 48 Substance Abuse Council of Indian River County 41 Books/Educational Materials 500. 001 500.00 87 , 000 .00 • Books/videos • Materials ($ x staff) 42 Food & Nutrition 0. 001 0.001 41213 . 85 • 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 500 . 001 500 .001 91000 . 00 Independent Audit Review 45 Specific Assistance to Individuals 0. 001 0 .001 2 ,000.00 • Medical assistance • Meals/Food • Rent Assistance • Other 46 Other/Miscellaneous 0 .001 0 .001 51 , 350.00 • Background check/drug test • Other 47 Other/Contract 0. 001 0 . 001 65, 000 .00 Sub-contract for program services 4 TOTAL EXPENSES $62 , 500 . 87 $62 , 500 . 87 $851 , 360 .00 0.00 5116/2005 j �j SubsG Abuse Cowl of Mian Rw Cowry UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME : Substance Abuse Council of Indian River County FY 03/04 FY 04105 FY 05106 % INCREASE FYE 9130/4 FYE9/30/05 FYE9/30/06 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. Ccol. BNcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 0.00 0.00 #DIV/01 2 Children's Services Council-Martin 0.00 0.00 0.00 #DIV/0! 3 Advisory Committee-Indian River 160 000.00 175,000.00 199 536.00 14. 02% 4 United Way-St Lucie County 0.00 0.00 0.00 #DIV/0 ! 5 United Way-Martin County 0.00 0.00 0.00 #DIV/0! 6 United Way-Indian River County 79z000.00 40,500.00 41 ,000.00 1 .23% 7 Department of Children & Families 75 000.00 30 000.00 30 000.00 0.00% 8 County Funds 12850.00 0.00 0. 00 #DIV/0 ! 9 Contributions-Cash 55y000.00 75 ,000.00 759000.00 0 .00% 10 Program Fees 419000.00 40M0.00 55 000.00 37.50% 11 Fund Raising Events-Net 61s745.00 50 000.00 35 000.00 -30.00% 12 Sales to Public-Net 9,036.00 81000.00 10,000.00 25 .00% 13 Membership Dues 5,680.00 6, 500.00 61500.00 0.00% 14 Investment Income 391 .00 800.00 500.00 -37.50% 15 Miscellaneous 17786.00 0.00 0.00 #DIV/O! 16 Legacies & Bequests 0.00 0.00 0.00 #DIV/01 17 Funds from Other Sources 298 986.00 320 200.00 397 000.00 23.99% 18 Reserve Funds Used for Operating 41 ,583.00 0.00 0.00 #DIV/01 19In-Kind Donations (Not incwaewmtaaq 0.00 0.00 0.00 #DIV/01 20 TOTAL $31 ,057.00 746;000.00 849 536.00 13 .88% EXPENDITURES 21 Salaries 395 180.00 345 684.00 331 ,536.00 -4.09% 22 FICA 30 231 .00 26 445.00 25 362.50 -4.09% 23 Retirement 6p21 1 .00 5 773.00 5629.80 -2.48% 24 Life/Health 32 400.00 36 000.00 33,600.00 -6.67% 25 Workers Compensation 31222.00 49459.00 41276.81 -4.09% 26 Florida Unemployment 0.00 0.00 0.00 0.00% 27 Travel-Daily 26 050.00 21 106.00 21 400.00 1 .39% 28 Travel/Conferences/Training 159275.00 22 400.00 34 600.03 54.46% 29 Office Supplies 51 227.00 269600.00 26 600.00 0. 00% 30 Telephone 12 454.00 89460.00 81460.00 0.00% 31 Postage/Shipping 31914.00 4 220.00 41250.00 0.71 % 32 Utilities 3v490,00 49000.00 4T500 .00 12.50% 33 Occupancy (Building & Grounds 26p933.00 33p600.00 399000.00 16.07% 34 Printing & Publications 8 219.00 45 849.00 469200.00 0.77% 35 Subscriion/Dues/Membershi 19808.00 1 000.00 11000.001 0.00% 36 Insurance 14 201 .00 18 500.00 14 328.00 -22.55% 37 E ui ment:Rental & Maintenance 71512.00 69000.00 71400.00 23. 33% 38 Advertising 12,889.00 14 419.00 9 000.00 -37 . 58% 39 Equipment Purchases:Ca ital Expense 0.00 39000.00 13 153.00 338.43% 40 Professional Fees (Legal, Consulting) 19989.00 2 000.00 21500.00 25.00% 41 Books/Educational Materials 62 307.00 50 940.00 87 000.00 70.79% 42 Food & Nutrition 37000.00 4195.00 41213.85 0.45% 43 Administrative Costs 0.00 0.00 0.00 0.00% 44 Audit Expense %000.00 %000.00 9,000.00 0.00% 45 Specific Assistance to Individuals 593.00 10000.00 29000.00 100.00% 46 Other/Miscellaneous 449872.00 6,350.00 51 350.00 708.66% 47 Other/Contractlde reciation 56,180.00 45 000.00 659000.00 44.44% 48 TOTAL 831 057.00 746 000.00 8517360 .00 14. 12% 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 -1 , 824.00 #DIV/0! SmGrow LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC D. MEASURABLE OUTCOMES (Description of Intent) Use the Measurable Outcomes form. This description pgge does not need to be included in the proposat In order to show the impact that your program is having on the target population and the community, the funders are requiring measurable outcomes . Please review the examples and summaries below to insure your understanding of what is expected . OUTCOMES : Describes what you want to achieve with the target population. Indicates the results of the services you provide, not the services you provide . Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. ACTIVITIES : Describes the tasks that will be accomplished in the program to achieve the results stated in the outcomes . Activities utilize action words such as complete, establish, create, provide , operate , and develop. The activities should reflect the services described in the PROGRAM DESCRIPTION (C2) . Use the following elements to develop your outcomes. All elements must be included: • Direction of change • Timeframe • Area of change • As measured by • Target population • Baseline: The number that you will be measuring • Degree of chane against Example 1 (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 2003 School Board attendance records (as measured by). Baseline : 2003 School Board attendance records for enrolled boys and girls . Example 1 (Activity) , To provide anger management classes to enrolled boys and girls 2 times a week for 12 weeks . Example 2 (Outcome) : 75 % (degree of change) of youth (target population) who have participated in the academic enrichment activities (as measured by) for 6 months or more (time frame), will improve (direction of change) their scores in one or more subject area (area of change) . 25 % of participants in academic enrichment activities will maintain the initial level of performance assessed at entry. Baseline : Pre-test scores from the academic enrichment test. Example 2 (Activity) . 1 ) Provide pre and post-test exercises on the Advanced Learning System software ; 2) Participants will go through the one lesson per week and be graded for 10 weeks . IMPORTANT NOTE : Keep in mind when developing your PROGRAM OUTCOMES , that if funded, this will be what you are held 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 that are going to influence the outcome and impact the unacceptable condition in your Program Need Statement. LifeSkills Training Program Substance Abuse Council of Indian River County Indian River County CSAC D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements or the Measurable Outcomes Add the tasks to accomplish the Outcome(s) 1 . To decrease by 5 % the "first use" numbers of 1 . To provide 3 ,900 youth weekly LST group sessions drug and alcohol use among middle school (6`I', to youth according to the following schedule : 7t`, 8t' grade) students over a period of one year . 17 sessions in the 6t' grade as reported by the 2006 FYSAS survey. . 10 sessions in the 7th (Baseline 2004 FYSAS Survey) . 5 sessions in the 8th grades. 2 . To provide a total of seven-teen ( 17) weekly ongoing 2 . To reduce by 2% the incidences of sixth grad education sessions to sixth grade students on the various adolescents reporting the use of tobacco, alcohol substance abuse and resiliency skills building topics and marijuana following the first year of LST Program as reported by the 2006 FYSAS survey (Baseline 2004 FYSAS Survey) 3 . To reduce by 2% the incidences of seventh 3 . We will provide a total of ten ( 10) weekly ongoing grade adolescents reporting the use of tobacco, booster education sessions to seventh grade students on alcohol, and marijuana following the second the various substance abuse and resiliency skills building year of LST program as reported by the 2006 topics FYSAS survey (Baseline 2004 FYSAS Survey) 4 . To reduce by 1 % the incidences of eight 4. We will provide a total of five (5) weekly ongoing grade adolescents reporting the use of booster education sessions to seventh grade students on tobacco, alcohol, and marijuana following the various substance abuse and resiliency skills building the third year of LST program as reported topics by the 2006 FYSAS survey (Baseline 2004 FYSAS Survey) 5 . To increase audience knowledge by 25 % 5 . Provide factual, current and up-to-date information following educational presentation forums concerning drugs and their harmful effects . concerning drugs and their harmful effects Pre/ post testing will be conducted and rated to as reported by self-disclosure on pre-testing. indicate a change in knowledge . (Baseline : Individual and group administered Pre-tests of forum participants .) TO SubzWm ft� C=wjofWem R� Camty UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME : Substance Abuse Council of Indian River County /Life Skills Training FY 03104 FY 04/05 FY 05/06 % INCREASE FYE9/30/04 FYE9/30/05 FYE9/30/06 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. C<ol- Bilcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 0.00 0 .00 #DIV/0 ! 2 Children's Services Council-Martin 0.00 0.00 0.00 #DIV/01 3 Advisory Committee-Indian River 50 000.00 6000000 62 500.00 4. 1706 United Way-St Lucie County 0.00 0.00 0.00 #DIV/01 5 United Way-Martin County 0.00 0.00 0.00 #DIV/0! 6 United Way-Indian River County 0.00 0.00 0.00 9DIV/0! 7 Department of Children & Families 0.00 0.00 0.00 #DIV/01 B County Funds 0.00 0.00 0.00 #DIV/0! 9 Contributions-Cash 0.00 0.00 0.00 #DIV/01 10 Program Fees 0.00 0.00 0.00 #DIV/01 11 Fund Raising Events-Net 0.00 0.00 0.00 #DIV/0! 12 Sales to Public-Net 0.00 0.00 0.00 #DIV/0 ! 13 Membership Dues 0.00 0.00 0.00 #DIV/0 ! 14 Investment Income 0.00 0.00 0.00 #DIV/0! 15 Miscellaneous 0.00 0.00 0.00 #DIV/01 16 Legacies & Bequests 0.00 0.00 0.00 #DIV/01 17 Funds from Other Sources 0.00 0.00 0.00 #DIV/01 is Reserve Funds Used for Operating 0.00 0.00 0.00 #DIV/01 19 in-Kind Donations lNwhcwaeantow) 0.00 0.00 0.00 #DIV/01 20 TOTAL 50 000.00 60000.00 62 500.00 4. 17% EXPENDITURES 21 Salaries 29 458.00 3709500 49 756.00 34. 13% 22 FICA Z253.00 Z837.001 3,806.33 34. 17% 23 Retirement 947.00 1 112.00 149268 34.23% 24 Life/Heafth 4123.00 59300.001 21100.00 -60.38% 25 Workers Compensation 637.00 478.00 641 .85 34.28% 26 Florida Unemployment 0.00 0.00 0.00 #DIV/0! 27 Travel-Daily 900.00 900.00 500.00 -44.44% 26 Travel/Conferences/Training 0.00 0.00 0.00 #DIV/0! 29 Office Supplies 600.00 600.00 250.00 -58 .33% 30 Telephone 1 113.00 19113.00 0.00 -100.00% 31 Postage/Shipping 608.00 608.00 100.00 -83.55% 32 Utilities 264.00 620.00 0.00 -100.00% 33 Occu nc (Building & Grounds 31600,00 3600.00 29854. 00 -20.72% 34 Printing & Publications 0.00 0.00 0.00 #DIV/0! 35 Subscription/Dues/Memberships 250.00 0.00 0.00 #DIV/0! 36 Insurance 750.00 0.00 0.00 #DIV/01 37 E ui ment:Rental & Maintenance 578.00 500.00 0.00 -100.00% 38 Advertising 0.00 0.00 0.00 #DIVIO! 39 Equipment Purchases:Ca ital Expense 0.00 0.00 0.00 #DIV/01 40 Professional Fees (Legal, Consukin 0.00 0.00 0.00 #DIV/0! 41 Books/Educational Materials 19419.001 49487.00 500.00 -88.86% 42 Food & Nutrition 0.00 0.00 0.00 #DIV/01 43 Administrative Costs 0.00 0.00 0.00 MV/01 44 Audit Expense 750.00 750.00 500.00 -33.33% 45 Specific Assistance to Individuals 0.00 0.00 0.00 #DIV/0! 46 Other/Miscellaneous 11750.00 0.00 0.00 #DIV/0! 47 Other/Contract 0.00 0.00 0.00 #DIV/0! 48 TOTAL 50 000.00 60 000.00 62 500. 87 4. 17% 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 -0.87 #DIV/0! 5MWWs �s} Type the Organization and Program Name UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME . Substance Abuse Council / Life Skills Training Program FUNDER : IRC CSAC A B C FY 05/06 FY 05106 % OF TOTAL FUNDER TOTAL VS . PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col . A) EXPENDITURES 21 Salaries 49 ,756 . 00 49 , 756 .00 100 . 00% 22 FICA 31806 . 33 31806 . 33 100 . 00 % 23 Retirement 1 ,492 .68 11492 .68 100 . 00 % 24 Life/Health 2 , 100 . 00 2 , 100 .00 100 .00 % 25 Workers Compensation 641 .85 641 .85 100.00 % 26 Florida Unemployment 0 .00 0 .00 #DIV/0 ! 27 TravelmDaily 500 .00 500 .00 100 . 00% 28 Travel/Conferences/Training 0 .00 0 .00 #DIV/01 29 Office Supplies 250 . 00 250 .00 100 .00% 3o Telephone 0 . 00 0 .00 #DIV/01 31 Postage/Shipping 100 .00 100 .00 100 .00% 32 Utilities 0.00 0 .00 #DIV/0 ! 33 Occupancy ( Building & Grounds 2 ,854.00 2,854.00 100 .00 % 34 Printing & Publications 0 .00 0 .00 #DIV/0 ! 35 Subscription/Dues/Memberships 0 .00 0 .00 #DIV/0 ! 36 Insurance 0 .00 0 .00 #DIV/0 ! 37 Equipment: Rental & Maintenance 0 . 00 0 .00 #DIV/0 ! 38 Advertising 0 .00 0 .00 #DIV/01 39 Equipment Purchases : Capital Expense 0 .00 0 .00 #DIV/01 4o Professional Fees (Legal , Consulting) 0 . 00 0 .00 #DIV/0 ! 41 Books/Educational Materials 500 .00 500.00 100 . 00% 42 Food & Nutrition 0.00 0 .00 #DIV/01 43 Administrative Costs 0 . 00 0 .00 #DIV/0 ! 44 Audit Expense 500 . 00 500 . 00 100 . 00% 45 Specific Assistance to Individuals 0 . 00 0 .00 #DIV/O ! 46 Other/Miscellaneous 0 .00 0 .00 #DIV/0 ! 47 Other/Contract 0 .00 0 . 00 #DIV/O ! 0 . 00 48 TOTAL 62 ,500 . 871 $62 , 500 . 87100 .00 % 5/16/2005 Substance Abuse Council of Indian River County SALARIESIV 1 Gross 11 Portion /it Funder % of Gross Annual POSITION LISTING Annual Salary of Salary on Proposed Program Speck Budget Salary (Agency) Position Title / Total Hrs/wk Requested(CIA) Example: Executive Director / 40 hrs 70,000.00 10,000.00 51000.00 7. 14% Executive Director -40 hrs/ wk 65,000.00 0.00 0 .00 0 . 00% Prevention Program Coordinator-40 hrs / wk 42 , 000.00 0.00 0.00 0 . 00 % PREVENT Program. Coordinator-40 hrs / wk 29, 000 .00 0.00 0.00 0 . 00 % Lifeskills Educator ( 1 ) - 33 hrs / wk/$ 16 271456.00 27 ,456.00 27,456.00 94 . 68 % Lifeskills Educator (2) -33 hrs / wk/$ 13 22,300.00 22 ,300.00 22,300.00 0 . 00% Diversion Specialist -40 hrs / wk 28,000.00 0.00 0.00 0 . 00% Diversion Assistant ( 1 ) 20 hrs/wk /$ 12 12,480.00 0.00 0.00 0 . 00 % Information Specialist- 35 hrs / wk/ $ 13 231660.00 0.00 0.00 0 . 00 % Case Manager - 25 hrs / wk $ 16 . 00 20,800. 00 0.00 0.00 0 . 00% Under Age Prog Coord 20hrs/ wk $ 15 15 ,600.00 0.00 0.00 0 . 00 % Lab Techician 30 hrs/ wk/ $ 13 20,280.00 0.00 0-00 0 . 00 % Diversion Assistant 20 2) hrs/wk /$ 12 12,480. 00 0.00 0.00 0 . 00% Diversion Assistant 20(3) hrs/wk /$ 12 122480. 00 0.00 0.00 0 . 00% 0.00 0.00 0 . 00 % 0.00 0.00 #VALUE ! 0.00 0.00 #VALUE ! 0.00 0.00 #VALUE ! #VALUE ! #VALUE ! #VALUE ! Remaining positions throughout the agency Total Salaries $331 , 536 .001 $49 , 756 .00 1 $49 , 756 .00 15 . 010/6 FRINGE BENEFITS DETAIL (Funder Specific Budget I Funder It 111 IV V IA Vll Column C only, from line 21 to 26) Specific FICA 7.65% Pension Worker's Unemp/oyme Total Fringes Funder S cffic Bu Health Ins. Compens. nt Compens. Speck Position Title / Total Hrs/wk Example: Case Manager/ 40 hrs 5,000.00 382.50 200.001 500.00 300.00 200.00 11582.50 Executive Director -40 hrs/ wk 0. 00 0. 00 0.00 0. 00 0. 00 0 . 00 Prevention Program Coordinator-40 his / wk 0 . 00 0 . 00 0.00 0.00 0 .00 0.00 0.00 PREVENT Program Coordinator-40 hrs / wk 0 . 00 0:00 0 . 00 Lifeskills Educator (1 ) - 33 hrs / wk/$ 16 27 ,456. 00 21100. 38 823 .68 0.00 354. 18 37278. 25 Lifeskills Educator (2) -33 hrs / wk/$ 13 22 , 300 .00 11705 . 95 669.00 21100.00 287.67 4 , 762 . 62 Diversion Specialist -40 hrs / wk 0 . 00 0. 00 1 0 . 00 Diversion Assistant ( 1 ) 20 hrs/wk /$ 12 0 . 00 0. 00 0 . 00 Information Specialist- 30 hrs / wk/ $ 13 0. 00 0 . 00 0. 00 0.00 0. 00 0 . 00 Case Manager - 25 hrs / wk $16. 00 0 . 00 0. 00 0 . 00 Under Age Prog Coord 20hrs/ wk $ 15 0. 00 0. 00 0 . 00 Lab Techician 30 hrs/ wk/ $13 0 .00 0 . 00 0 . 00 Diversion Assistant 20 (2) hrs/wk /$12 0. 00 0 . 00 0 . 00 Diversion Assistant 20(3) hrs/wk /$12 0 . 00 0 . 00 0 . 00 Case Manager - 25 hrs / wk $ 16 . 00 0. 00 0. 00 0 . 00 0. 00 0 . 00 0 . 00 0 . 00 0. 00 0 . 00 0 . 00 0 . 000 . 0 0. 00 0 . 00 0 . 00 0 . 00 0 . 000 1 1 0 . 00 0 . 001 0 . 001 0 . 00 Total Funder Request Fringe Benefits 1 $49 ,756 . 001 $3, 806 . 33 $ 11492.68 $2J00 . 001 $641 . 851 $0 . 00 $8 , 040. 87 B C EXPENDITURES A Proposed Total Program Budget Funder Specific Total Agency Budget Budget 5/16/2005 tan Substance Abuse CouncA of Indian River County 27 Travel-Daily 500 .001 500 . 001 21 ,400 . 00 WV # of Staff x average # of miles/wk x 50 wks x SWAT 310 miles a month $ = Estimated Daily Travel/Mileage Reimb. LST 385 miles a month 28 Travel/Conferences/Training 0 . 001 0 . 001 34 , 600 .03 • National Conference (cost per staff) FADDA registration $250 • Training/Seminar (cost per staff) Hotel $ 150 per night x 3 nights = $450 $21 Per diem per day x 3 days = $63 • Other Trainings (cost of travel, lodging , 250 miles x .29 = $72.50 registration , food) Tolls $ 15 PRIDE $9000 29 Office Supplies 250 .001 250 .001 261600 .00 . Office supplies (monthly average x 12 Other Programs $500 a month x 12 months = $6000 months = estimated cost of office supplies $50 x 12 months for UW = based on present history. Other Programs $500 a month x 12 months = $6000 30 Telephone 0 .001 o .001 81460 .00 # Phone lines x average cost per month x Long distance charges $ 120 per month x 12 months= 1440 12 months = local phone cost Cell phones 4 phones x $60 per line per month =240x 12 months= 2880 . Average long distance calls x 12 months = Pagers $8 per month x 12 employees =96 x 12 = 1152 Estimated cost of long distance Internet connection $ 25 per month x 12 months= $300 31 Postage/Shipping 100. 001 loo . 001 41250 .00 • Quarterly Mailing of Newsletter Bulk Mail $ 200 per month x 12 months= 2400 • Special events , etc. Bulk mail permit $300 • Bulk mailings - appeals Post office Box Rental $200 32 Utilities 0 .001 0 .001 4 , 500 .00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) - Garbage ($ x 12 months) Utilities $375 per month x 12 months+ $4500 33 Occupancy (Building & Grounds) 21854 . 00 21854 .00 39 ,000 .00 • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes Rent $13058 a month x 12 months 36,696 34 Printing & Publications 0.001 0.001 46 , 200.00 Quarterly Newsletter ($ x 4) Letterheads , Envelopes, etc. Fundraising materials Other 35 Subscription/Dues/Memberships 0.001 0.001 11000 .00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines , etc. 36 Insurance 0.001 0. 001 14 , 328 .00 • Directors/Officers Liab . • Commercial/General Insurance • Bond Ins . • Auto Insurance 37 Equipment: Rental & Maintenance 0.001 0.001 71400 .00 • Copier lease ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) • Computer Maintenance ( $ x 12 months) • Other 38 Advertising 0 . 00 0 .001 91000.00 • Newspaper ads • Fundraising ads/promotions Other (vacancies) 39 Equipment Purchases : Capital Expense 0 .00 0.001 137153 .00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 0 . 00 0 .00 21500.00 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 5/16/2005 EXHIBIT B ( From policy adopted by Indian River County Board of county Commissioners on February 19 , 2002 ) " D . Nonprofit Agency Responsibilities After Award Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only . All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately . Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1St may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year and (September 30th) must be submitted on a timely basis . Each year, the Office of Management and 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 expense by type . These summaries should be broken down into salaries , benefit , 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. " EXHIBIT - B - EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices . Any notice , request, demand , consent , approval , or other communication required or permitted by this Contract shall be given , or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the addresses of the parties shown below: County : Joyce Johnston -Carlson , Director Indian River County Human Services 184025 th Street Vero Beach , Florida 32960-3365 Recipient : CEBH - Center for Emotional & Behavioral Health 119037 th Street Vero Beach , Florida 32960 Attention : Mariamma Pyngolil , RN , Program 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 provision and term 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 context indicates otherwise , words importing the singular number include the plural number, and vise 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. EXHIBIT - C - Substance Abuse Council of Indian River County 41 Books/Educational Materials 500. 001 500.00 87 , 000 .00 • Books/videos • Materials ($ x staff) 42 Food & Nutrition 0. 001 0.001 41213 . 85 • 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 500 . 001 500 .001 91000 . 00 Independent Audit Review 45 Specific Assistance to Individuals 0. 001 0 .001 2 ,000.00 • Medical assistance • Meals/Food • Rent Assistance • Other 46 Other/Miscellaneous 0 .001 0 .001 51 , 350.00 • Background check/drug test • Other 47 Other/Contract 0. 001 0 . 001 65, 000 .00 Sub-contract for program services 4 TOTAL EXPENSES $62 , 500 . 87 $62 , 500 . 87 $851 , 360 .00 0.00 5116/2005 j �j SubsG Abuse Cowl of Mian Rw Cowry UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME : Substance Abuse Council of Indian River County FY 03/04 FY 04105 FY 05106 % INCREASE FYE 9130/4 FYE9/30/05 FYE9/30/06 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. Ccol. BNcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 0.00 0.00 #DIV/01 2 Children's Services Council-Martin 0.00 0.00 0.00 #DIV/0! 3 Advisory Committee-Indian River 160 000.00 175,000.00 199 536.00 14. 02% 4 United Way-St Lucie County 0.00 0.00 0.00 #DIV/0 ! 5 United Way-Martin County 0.00 0.00 0.00 #DIV/0! 6 United Way-Indian River County 79z000.00 40,500.00 41 ,000.00 1 .23% 7 Department of Children & Families 75 000.00 30 000.00 30 000.00 0.00% 8 County Funds 12850.00 0.00 0. 00 #DIV/0 ! 9 Contributions-Cash 55y000.00 75 ,000.00 759000.00 0 .00% 10 Program Fees 419000.00 40M0.00 55 000.00 37.50% 11 Fund Raising Events-Net 61s745.00 50 000.00 35 000.00 -30.00% 12 Sales to Public-Net 9,036.00 81000.00 10,000.00 25 .00% 13 Membership Dues 5,680.00 6, 500.00 61500.00 0.00% 14 Investment Income 391 .00 800.00 500.00 -37.50% 15 Miscellaneous 17786.00 0.00 0.00 #DIV/O! 16 Legacies & Bequests 0.00 0.00 0.00 #DIV/01 17 Funds from Other Sources 298 986.00 320 200.00 397 000.00 23.99% 18 Reserve Funds Used for Operating 41 ,583.00 0.00 0.00 #DIV/01 19In-Kind Donations (Not incwaewmtaaq 0.00 0.00 0.00 #DIV/01 20 TOTAL $31 ,057.00 746;000.00 849 536.00 13 .88% EXPENDITURES 21 Salaries 395 180.00 345 684.00 331 ,536.00 -4.09% 22 FICA 30 231 .00 26 445.00 25 362.50 -4.09% 23 Retirement 6p21 1 .00 5 773.00 5629.80 -2.48% 24 Life/Health 32 400.00 36 000.00 33,600.00 -6.67% 25 Workers Compensation 31222.00 49459.00 41276.81 -4.09% 26 Florida Unemployment 0.00 0.00 0.00 0.00% 27 Travel-Daily 26 050.00 21 106.00 21 400.00 1 .39% 28 Travel/Conferences/Training 159275.00 22 400.00 34 600.03 54.46% 29 Office Supplies 51 227.00 269600.00 26 600.00 0. 00% 30 Telephone 12 454.00 89460.00 81460.00 0.00% 31 Postage/Shipping 31914.00 4 220.00 41250.00 0.71 % 32 Utilities 3v490,00 49000.00 4T500 .00 12.50% 33 Occupancy (Building & Grounds 26p933.00 33p600.00 399000.00 16.07% 34 Printing & Publications 8 219.00 45 849.00 469200.00 0.77% 35 Subscriion/Dues/Membershi 19808.00 1 000.00 11000.001 0.00% 36 Insurance 14 201 .00 18 500.00 14 328.00 -22.55% 37 E ui ment:Rental & Maintenance 71512.00 69000.00 71400.00 23. 33% 38 Advertising 12,889.00 14 419.00 9 000.00 -37 . 58% 39 Equipment Purchases:Ca ital Expense 0.00 39000.00 13 153.00 338.43% 40 Professional Fees (Legal, Consulting) 19989.00 2 000.00 21500.00 25.00% 41 Books/Educational Materials 62 307.00 50 940.00 87 000.00 70.79% 42 Food & Nutrition 37000.00 4195.00 41213.85 0.45% 43 Administrative Costs 0.00 0.00 0.00 0.00% 44 Audit Expense %000.00 %000.00 9,000.00 0.00% 45 Specific Assistance to Individuals 593.00 10000.00 29000.00 100.00% 46 Other/Miscellaneous 449872.00 6,350.00 51 350.00 708.66% 47 Other/Contractlde reciation 56,180.00 45 000.00 659000.00 44.44% 48 TOTAL 831 057.00 746 000.00 8517360 .00 14. 12% 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 -1 , 824.00 #DIV/0! SmGrow see . ... 46f, eexJO 1. ,1, . 44 mi. ir. '1 ' / /d5b34�b4 NO , 1304 Q AC.98D. CERTIFICATE of LIABILITY INSURANCE t?F 3 11 1 05 PRODUCER 2NDI THIS CER71FtCAT6 IS ISSUED AS A MATTER OF IIdFCNtMA1'!gN ONLY AND CONFER$ NO RIGHTS UPON THE CERTIFICATE IDID NOT II68 "OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6525 VarriaoA Blvd „ Suite 200 ALTER TWE COVERAGE AFFORDED OY THE POLICIES BELOW. Charlotte VC 28211 PhOne : 800 - 72 !1 4145 - Paxr704 - 365 - ? 114 INSURIMAFFCROINGCOv6RACZ MAIC # otstalteo WSURE:RA : Admiral Invarance Co . �^-- �.I�w.wi '.w._ .. M .hwnr .�. . s . . - . r . nr.... v. . -.r.��.Mlw♦.� -�IFFl.wA....r.... _ .r INSWRERB; aswetew iwtwwa ,v JAN. Co . Indian River Memorial Hospital Greg Drer aA I INSURER C' � OOV 36t Street INSUREAM aro beach FL 33960 rNSUReN p ; COVERAGES THE POLICMS OP INSUHAWA LIMD RC-a0W HAV: BEEN ISSUR0 TO THE IN$URRD NA6A0 A" FrOp THj POwCY r+ERIOD IAOIOATRO. NOTIArHlT&NOrNQ ANY RE000fWNT, TERM OR GON mom 0r ANY CONTRACT OROTMEROOO MIENT WITM ItW40TTO wmc" P-IW CQRTIFd;ATr3 MAY M ;$SUED OR MAY PERTAIN. TNF INSUR4106 AFiORMO yY THE POLiCISS OESCFaM HEREIN Ii $VWECT TO ALL YHE TpRTAS . 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AUTOONLY' Aster i DtC6CSA 04MLLA L"ttrry I CACH OOCLMLNCL A CCcuR X❑ CLAIMSMAD@ cRL - au - 14033 - 1002 - 04 11 / 01 / 05 j 11 / 01 /06 AaoR52ATE ifZ0 , 000 , 000 Exceed _ _ DEDUCTISLE j AAave SIR ! RETENTION 3 I 9 SaeJ S i 5Id i W310441115 00100GATIONANO TpPtYtMAR3 fiR E)RPLOY6RS LUIMLITI' UFFy PROPRIETORNAATNEftXX6CvTI1A E.L�ACCIDETJT S FIC61VM8MTE)ER EXCLUDED* Y.L. DISMA Q . EA OftOYEE t myym drscowl ural $P"P& PROVISIONS Wow E.L. DISEASE - POLICY LN"T I a OTITftlt f DE.SCRIP'►IONOI� 6►ERAT�ONt + �oCa*ION. rv>:MiCt ' I K L IONSADDeDsvwtDoasra�BNTf5PEC1ALPA0V{SEO1Vi Certificate Holder is added as Additional rngUred With reapeee to their interest in contract wiv% the Namd lasured . CERTIFICATE ?FOLDER CANCELLATION ZNp2riATt M" OP TPIR AVOW MCMI POt4CIOS e! CAMM146 D WNFORE TN! dKF1%A OATR TNFRROF, 7Ha 1#BLIND INSURER MLL YeNoW►VOR TQ MAI. 3 O PAY; rlmrm NOYICC TO TKA VARTTFIC,ATE HOL06111 NAM&D TO TKF LEFTS 0VT FAILVRC TO 00 JO /MAML Indian River County IWOMNOOBLIGATION ORLIAWLiTrOFANY NINOUPONTNTW40*lR, I1'RAr,.RNTS0* 1640 26th Street REPRE 5tTATM Vero Basch 8L 32960 AUT rogarRc• TA vE V ACORD 2312001108) 0 ACORD CORPORA ON 1969 _ - -- - . • , , � a I r c.JQ.. 004 IJi7 . 3134 GV3 AC. N CERTIFICATE OF LIABILITY INSURANCE OP �Ar� IM��Yryl PRODUCER I li 05 TKSCE#tTIFICATI! dSISSUOASAMAM140FWFOPMATION Ploa<ie4e Boa itsl Assocrnrn Svc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE )i HOLDER, THIS CERTIFICATE DOES NOT AMEN D• EXTIINDOR 1675 Terrell brill Rd . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELow, Y*Oriattn GA 30067 Fhoue ; 800 - 676 - 7501 Fax : 770 { SS0 . 0A8a ►N8tlRERSAFFQRDiNGCOVERAGE NAIGa iNsuRed — W, _. _ _ - INSURERA: trARLt3bN1 CA�,Wq Ca.p�Mr _� India& River Memorial Hospital INsua-R e; ere biu ;fL INSURER C. 100 3 6 GA 97CY L►p ��'� ~` vera eoacu AL 3 1 INSURER D co "RAGES wsuRFR E, TWE POLICIES OF ;Np I1A LISTED BELOW r tAv[ t3EEn ISSV60 TO THE INSURED NAMED AAOVE FOR THE POLICY PEPRM INDICAM, NOTWq)13rANOINC ANY Ri4VtR£MENT, TERN OR CONDrYPON OF ANY CONTkACr OFI O KIPI OOC"..NT 'IIITM RE$PCCTTO WMICN TwIS CERTIrrAT@ MAY Be rBjMOOR MAY 9CRTAIN, TW r 04564MNCC Ar FOROLO by THE PCL C ICS OCbCR+.GEO K1RVN IS SUBJECT TC Aid rHE TMft4, C�tOyU91ON8 ANOCONOITIDNS OF 1UCW POLICIES ACROMOAri LIMITS SMQWN .%AT 1' AVE WN "OuCEO BY PAID CLAMSe IMM URAnICB POLICY WUIM/R 1 19 L09M Of MALLIANUTY A4v OCCURRENCEr MEMO! D ~ • _ L COMMERCM WNCRAL 4Kft ITvE7�oCureRLe1 CutAa 404; OCCUR VMM FJt• (AAV OU PMQRi 9 _ . ... _.._ - ... 3GRSONAL lE ADV INJURY f - �21NIPAL AGWQAYE f — OEN't AQ[+slfsOATC LIMIT APPLIES PCA. i PROWL730COAIPbP Am POLICY Wy .. » . . ..,.ww., .• r Loc wmkvovu L"Lm COMBINED tWGLE LIMIT ANY AUTO � ifis Er w6 aei,lex) f ALL *WNEO AUTOS -- SCNEO"(;0 AUTOS I BODILY INJURY f (Per 000RY IN.[IRY NCN PWNtcD ALITOS + q+r adwtpMPIMCIAMAGE = � (Per wdwq i Wiwi LwWwry AUTO ONLY . FA ACCDFNt 6 -_ ANY AUTOOTPIER THANEA A , f AUTOONLY; ACfS I i R%CEaotuRe IFLIALIAWYY I rACwOCCURRBNC! f OCCVR CLAlbannnOr: RL34REGA7t? f OEOUCTEL! R£TEN710p1 f I 1 c i WOWN$ COMPEN5ATION AND EMPLOVERIr LIABILITY x _,R,Y„NMIRu .R A ANrPROPalElnRRaAa�RwrFcunvE w - 12d5884387e 01 / 01 / 05 01 / 02/ 06 GL, FacitACctOGNr s ¢ l , 000 , 000 OFFICEWMENIBERFJtCLUDEDI •—•---- _...... .. - _ V a, deaerlllR unear E1, 006AX � FA EMPLOYE f $ Z . 000 000 rl auPAovsaNew.YI E,L OIAEA5E - POUCVLIMir c t 000 . 000 OIMLR j � I V=RWr10N OF OPRRATIORS / LOCATId t V#F4Im.,e5 ' 9XCLU&M Z-00 Pv CMDORSEAAEN1 I SPECIAL PROVISIONS 1'roo6 Of Coverage £wr Indian River Uem01181 lospital . I { C&RTIFlCATE HOLDER CANCELLATION INDIANC 6401A-93ANY OF TME APO D!1400 ed6 POMCIHS Be CANCELLVO NeWORE TME MXPRATWN BATE TMEREOF, ,The ISSUP4 IWXVRER WILL J04"AVOR TO A9AI6 30 p/iTi MRIrTEH NOTICE TO THE CCR►1FtCA16 HOLDER NAMCb TO TtR! LHPT, Y11r FAILURE TO 0074 SlIALL Into IEA River county IMPOSE NO ORLICAMON OR WA810Y0! AAWV KIND UPON TNO NSUR6R, ITS AO8m OR 1010 25th Street RUPRE TATURS, . . Vero Sanc7a FL 32960AU4W P1% PW4PTATV1 AGORA 25 f200TJOQj 0ACORD CORPORATION 1088 SubzWm ft� C=wjofWem R� Camty UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME : Substance Abuse Council of Indian River County /Life Skills Training FY 03104 FY 04/05 FY 05/06 % INCREASE FYE9/30/04 FYE9/30/05 FYE9/30/06 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. C<ol- Bilcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 0.00 0 .00 #DIV/0 ! 2 Children's Services Council-Martin 0.00 0.00 0.00 #DIV/01 3 Advisory Committee-Indian River 50 000.00 6000000 62 500.00 4. 1706 United Way-St Lucie County 0.00 0.00 0.00 #DIV/01 5 United Way-Martin County 0.00 0.00 0.00 #DIV/0! 6 United Way-Indian River County 0.00 0.00 0.00 9DIV/0! 7 Department of Children & Families 0.00 0.00 0.00 #DIV/01 B County Funds 0.00 0.00 0.00 #DIV/0! 9 Contributions-Cash 0.00 0.00 0.00 #DIV/01 10 Program Fees 0.00 0.00 0.00 #DIV/01 11 Fund Raising Events-Net 0.00 0.00 0.00 #DIV/0! 12 Sales to Public-Net 0.00 0.00 0.00 #DIV/0 ! 13 Membership Dues 0.00 0.00 0.00 #DIV/0 ! 14 Investment Income 0.00 0.00 0.00 #DIV/0! 15 Miscellaneous 0.00 0.00 0.00 #DIV/01 16 Legacies & Bequests 0.00 0.00 0.00 #DIV/01 17 Funds from Other Sources 0.00 0.00 0.00 #DIV/01 is Reserve Funds Used for Operating 0.00 0.00 0.00 #DIV/01 19 in-Kind Donations lNwhcwaeantow) 0.00 0.00 0.00 #DIV/01 20 TOTAL 50 000.00 60000.00 62 500.00 4. 17% EXPENDITURES 21 Salaries 29 458.00 3709500 49 756.00 34. 13% 22 FICA Z253.00 Z837.001 3,806.33 34. 17% 23 Retirement 947.00 1 112.00 149268 34.23% 24 Life/Heafth 4123.00 59300.001 21100.00 -60.38% 25 Workers Compensation 637.00 478.00 641 .85 34.28% 26 Florida Unemployment 0.00 0.00 0.00 #DIV/0! 27 Travel-Daily 900.00 900.00 500.00 -44.44% 26 Travel/Conferences/Training 0.00 0.00 0.00 #DIV/0! 29 Office Supplies 600.00 600.00 250.00 -58 .33% 30 Telephone 1 113.00 19113.00 0.00 -100.00% 31 Postage/Shipping 608.00 608.00 100.00 -83.55% 32 Utilities 264.00 620.00 0.00 -100.00% 33 Occu nc (Building & Grounds 31600,00 3600.00 29854. 00 -20.72% 34 Printing & Publications 0.00 0.00 0.00 #DIV/0! 35 Subscription/Dues/Memberships 250.00 0.00 0.00 #DIV/0! 36 Insurance 750.00 0.00 0.00 #DIV/01 37 E ui ment:Rental & Maintenance 578.00 500.00 0.00 -100.00% 38 Advertising 0.00 0.00 0.00 #DIVIO! 39 Equipment Purchases:Ca ital Expense 0.00 0.00 0.00 #DIV/01 40 Professional Fees (Legal, Consukin 0.00 0.00 0.00 #DIV/0! 41 Books/Educational Materials 19419.001 49487.00 500.00 -88.86% 42 Food & Nutrition 0.00 0.00 0.00 #DIV/01 43 Administrative Costs 0.00 0.00 0.00 MV/01 44 Audit Expense 750.00 750.00 500.00 -33.33% 45 Specific Assistance to Individuals 0.00 0.00 0.00 #DIV/0! 46 Other/Miscellaneous 11750.00 0.00 0.00 #DIV/0! 47 Other/Contract 0.00 0.00 0.00 #DIV/0! 48 TOTAL 50 000.00 60 000.00 62 500. 87 4. 17% 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.00 -0.87 #DIV/0! 5MWWs �s} Type the Organization and Program Name UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME . Substance Abuse Council / Life Skills Training Program FUNDER : IRC CSAC A B C FY 05/06 FY 05106 % OF TOTAL FUNDER TOTAL VS . PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col . A) EXPENDITURES 21 Salaries 49 ,756 . 00 49 , 756 .00 100 . 00% 22 FICA 31806 . 33 31806 . 33 100 . 00 % 23 Retirement 1 ,492 .68 11492 .68 100 . 00 % 24 Life/Health 2 , 100 . 00 2 , 100 .00 100 .00 % 25 Workers Compensation 641 .85 641 .85 100.00 % 26 Florida Unemployment 0 .00 0 .00 #DIV/0 ! 27 TravelmDaily 500 .00 500 .00 100 . 00% 28 Travel/Conferences/Training 0 .00 0 .00 #DIV/01 29 Office Supplies 250 . 00 250 .00 100 .00% 3o Telephone 0 . 00 0 .00 #DIV/01 31 Postage/Shipping 100 .00 100 .00 100 .00% 32 Utilities 0.00 0 .00 #DIV/0 ! 33 Occupancy ( Building & Grounds 2 ,854.00 2,854.00 100 .00 % 34 Printing & Publications 0 .00 0 .00 #DIV/0 ! 35 Subscription/Dues/Memberships 0 .00 0 .00 #DIV/0 ! 36 Insurance 0 .00 0 .00 #DIV/0 ! 37 Equipment: Rental & Maintenance 0 . 00 0 .00 #DIV/0 ! 38 Advertising 0 .00 0 .00 #DIV/01 39 Equipment Purchases : Capital Expense 0 .00 0 .00 #DIV/01 4o Professional Fees (Legal , Consulting) 0 . 00 0 .00 #DIV/0 ! 41 Books/Educational Materials 500 .00 500.00 100 . 00% 42 Food & Nutrition 0.00 0 .00 #DIV/01 43 Administrative Costs 0 . 00 0 .00 #DIV/0 ! 44 Audit Expense 500 . 00 500 . 00 100 . 00% 45 Specific Assistance to Individuals 0 . 00 0 .00 #DIV/O ! 46 Other/Miscellaneous 0 .00 0 .00 #DIV/0 ! 47 Other/Contract 0 .00 0 . 00 #DIV/O ! 0 . 00 48 TOTAL 62 ,500 . 871 $62 , 500 . 87100 .00 % 5/16/2005 EXHIBIT B ( From policy adopted by Indian River County Board of county Commissioners on February 19 , 2002 ) " D . Nonprofit Agency Responsibilities After Award Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only . All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately . Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1St may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year and (September 30th) must be submitted on a timely basis . Each year, the Office of Management and 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 expense by type . These summaries should be broken down into salaries , benefit , 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. " EXHIBIT - B - EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices . Any notice , request, demand , consent , approval , or other communication required or permitted by this Contract shall be given , or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the addresses of the parties shown below: County : Joyce Johnston -Carlson , Director Indian River County Human Services 184025 th Street Vero Beach , Florida 32960-3365 Recipient : CEBH - Center for Emotional & Behavioral Health 119037 th Street Vero Beach , Florida 32960 Attention : Mariamma Pyngolil , RN , Program 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 provision and term 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 context indicates otherwise , words importing the singular number include the plural number, and vise 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. EXHIBIT - C - see . ... 46f, eexJO 1. ,1, . 44 mi. ir. '1 ' / /d5b34�b4 NO , 1304 Q AC.98D. CERTIFICATE of LIABILITY INSURANCE t?F 3 11 1 05 PRODUCER 2NDI THIS CER71FtCAT6 IS ISSUED AS A MATTER OF IIdFCNtMA1'!gN ONLY AND CONFER$ NO RIGHTS UPON THE CERTIFICATE IDID NOT II68 "OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6525 VarriaoA Blvd „ Suite 200 ALTER TWE COVERAGE AFFORDED OY THE POLICIES BELOW. Charlotte VC 28211 PhOne : 800 - 72 !1 4145 - Paxr704 - 365 - ? 114 INSURIMAFFCROINGCOv6RACZ MAIC # otstalteo WSURE:RA : Admiral Invarance Co . �^-- �.I�w.wi '.w._ .. M .hwnr .�. . s . . - . r . nr.... v. . -.r.��.Mlw♦.� -�IFFl.wA....r.... _ .r INSWRERB; aswetew iwtwwa ,v JAN. Co . Indian River Memorial Hospital Greg Drer aA I INSURER C' � OOV 36t Street INSUREAM aro beach FL 33960 rNSUReN p ; COVERAGES THE POLICMS OP INSUHAWA LIMD RC-a0W HAV: BEEN ISSUR0 TO THE IN$URRD NA6A0 A" FrOp THj POwCY r+ERIOD IAOIOATRO. NOTIArHlT&NOrNQ ANY RE000fWNT, TERM OR GON mom 0r ANY CONTRACT OROTMEROOO MIENT WITM ItW40TTO wmc" P-IW CQRTIFd;ATr3 MAY M ;$SUED OR MAY PERTAIN. TNF INSUR4106 AFiORMO yY THE POLiCISS OESCFaM HEREIN Ii $VWECT TO ALL YHE TpRTAS . EXCLUSONS ANO CONDITIONS OF SUCH P0LIC M ASOMATE LIM'TS SMOWN MAY NAVE KieN REDUCED DV RAID CLAIMS, VRmC 1 006IC1' NUUBRN PA D A s O LBMT7; sRMRALLIARVYY I F.ACH000URRENCE Q5 , 000 . 000 X 1 X COMMERCIAL 08NEAAl LiAMLIY" CAPTIVE ISZRwell itjpl / 05 11 01/ 06 j-aR�yl�i s X CLAWS %"us �_ � O.CUR �t+ED ISKp IMY mepertm) 7 Q00 000 c12KRALAGOMOAM i 695 P 000 , 000 WAK AOOR£OATE LVAT PER APPLIES I 1 aRODUCTi • COt0LA7P AGG 3 5 O OO , 0 Q Q POLICY ° i . . .. . i AUrCM21LE L AMLrrY )( ANY AUTO COMDINIM MME LIMO' ! a Q 0 0 Q O (E� nuiwu) ^ ALL OWNED ALrrOS 14» tv INJURY f B X SC1FMLEOAMS i MZA90833367 11 / 01 / 05 21/ 01 / 06 IParpen°n► n X: PUTEDALIT03 TQx,]►$ o633367 11 / 01105 li / OV06 i001LYuuuRY 6 8 N MowmmAvros KZ 80833367 11 / 01. 105 11 / 01 /06 wP , . _n ,. . �. P�Ilv4PEMdApTyeMjAntgOE GARACELYMnLTv AUToouLY - F.AACCIOENT ! -� ANYA'JTo OTNERTHAN ! AUTOONLY' Aster i DtC6CSA 04MLLA L"ttrry I CACH OOCLMLNCL A CCcuR X❑ CLAIMSMAD@ cRL - au - 14033 - 1002 - 04 11 / 01 / 05 j 11 / 01 /06 AaoR52ATE ifZ0 , 000 , 000 Exceed _ _ DEDUCTISLE j AAave SIR ! RETENTION 3 I 9 SaeJ S i 5Id i W310441115 00100GATIONANO TpPtYtMAR3 fiR E)RPLOY6RS LUIMLITI' UFFy PROPRIETORNAATNEftXX6CvTI1A E.L�ACCIDETJT S FIC61VM8MTE)ER EXCLUDED* Y.L. DISMA Q . EA OftOYEE t myym drscowl ural $P"P& PROVISIONS Wow E.L. DISEASE - POLICY LN"T I a OTITftlt f DE.SCRIP'►IONOI� 6►ERAT�ONt + �oCa*ION. rv>:MiCt ' I K L IONSADDeDsvwtDoasra�BNTf5PEC1ALPA0V{SEO1Vi Certificate Holder is added as Additional rngUred With reapeee to their interest in contract wiv% the Namd lasured . CERTIFICATE ?FOLDER CANCELLATION ZNp2riATt M" OP TPIR AVOW MCMI POt4CIOS e! CAMM146 D WNFORE TN! dKF1%A OATR TNFRROF, 7Ha 1#BLIND INSURER MLL YeNoW►VOR TQ MAI. 3 O PAY; rlmrm NOYICC TO TKA VARTTFIC,ATE HOL06111 NAM&D TO TKF LEFTS 0VT FAILVRC TO 00 JO /MAML Indian River County IWOMNOOBLIGATION ORLIAWLiTrOFANY NINOUPONTNTW40*lR, I1'RAr,.RNTS0* 1640 26th Street REPRE 5tTATM Vero Basch 8L 32960 AUT rogarRc• TA vE V ACORD 2312001108) 0 ACORD CORPORA ON 1969 _ - -- - . • , , � a I r c.JQ.. 004 IJi7 . 3134 GV3 AC. N CERTIFICATE OF LIABILITY INSURANCE OP �Ar� IM��Yryl PRODUCER I li 05 TKSCE#tTIFICATI! dSISSUOASAMAM140FWFOPMATION Ploa<ie4e Boa itsl Assocrnrn Svc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE )i HOLDER, THIS CERTIFICATE DOES NOT AMEN D• EXTIINDOR 1675 Terrell brill Rd . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELow, Y*Oriattn GA 30067 Fhoue ; 800 - 676 - 7501 Fax : 770 { SS0 . 0A8a ►N8tlRERSAFFQRDiNGCOVERAGE NAIGa iNsuRed — W, _. _ _ - INSURERA: trARLt3bN1 CA�,Wq Ca.p�Mr _� India& River Memorial Hospital INsua-R e; ere biu ;fL INSURER C. 100 3 6 GA 97CY L►p ��'� ~` vera eoacu AL 3 1 INSURER D co "RAGES wsuRFR E, TWE POLICIES OF ;Np I1A LISTED BELOW r tAv[ t3EEn ISSV60 TO THE INSURED NAMED AAOVE FOR THE POLICY PEPRM INDICAM, NOTWq)13rANOINC ANY Ri4VtR£MENT, TERN OR CONDrYPON OF ANY CONTkACr OFI O KIPI OOC"..NT 'IIITM RE$PCCTTO WMICN TwIS CERTIrrAT@ MAY Be rBjMOOR MAY 9CRTAIN, TW r 04564MNCC Ar FOROLO by THE PCL C ICS OCbCR+.GEO K1RVN IS SUBJECT TC Aid rHE TMft4, C�tOyU91ON8 ANOCONOITIDNS OF 1UCW POLICIES ACROMOAri LIMITS SMQWN .%AT 1' AVE WN "OuCEO BY PAID CLAMSe IMM URAnICB POLICY WUIM/R 1 19 L09M Of MALLIANUTY A4v OCCURRENCEr MEMO! D ~ • _ L COMMERCM WNCRAL 4Kft ITvE7�oCureRLe1 CutAa 404; OCCUR VMM FJt• (AAV OU PMQRi 9 _ . ... _.._ - ... 3GRSONAL lE ADV INJURY f - �21NIPAL AGWQAYE f — OEN't AQ[+slfsOATC LIMIT APPLIES PCA. i PROWL730COAIPbP Am POLICY Wy .. » . . ..,.ww., .• r Loc wmkvovu L"Lm COMBINED tWGLE LIMIT ANY AUTO � ifis Er w6 aei,lex) f ALL *WNEO AUTOS -- SCNEO"(;0 AUTOS I BODILY INJURY f (Per 000RY IN.[IRY NCN PWNtcD ALITOS + q+r adwtpMPIMCIAMAGE = � (Per wdwq i Wiwi LwWwry AUTO ONLY . FA ACCDFNt 6 -_ ANY AUTOOTPIER THANEA A , f AUTOONLY; ACfS I i R%CEaotuRe IFLIALIAWYY I rACwOCCURRBNC! f OCCVR CLAlbannnOr: RL34REGA7t? f OEOUCTEL! R£TEN710p1 f I 1 c i WOWN$ COMPEN5ATION AND EMPLOVERIr LIABILITY x _,R,Y„NMIRu .R A ANrPROPalElnRRaAa�RwrFcunvE w - 12d5884387e 01 / 01 / 05 01 / 02/ 06 GL, FacitACctOGNr s ¢ l , 000 , 000 OFFICEWMENIBERFJtCLUDEDI •—•---- _...... .. - _ V a, deaerlllR unear E1, 006AX � FA EMPLOYE f $ Z . 000 000 rl auPAovsaNew.YI E,L OIAEA5E - POUCVLIMir c t 000 . 000 OIMLR j � I V=RWr10N OF OPRRATIORS / LOCATId t V#F4Im.,e5 ' 9XCLU&M Z-00 Pv CMDORSEAAEN1 I SPECIAL PROVISIONS 1'roo6 Of Coverage £wr Indian River Uem01181 lospital . I { C&RTIFlCATE HOLDER CANCELLATION INDIANC 6401A-93ANY OF TME APO D!1400 ed6 POMCIHS Be CANCELLVO NeWORE TME MXPRATWN BATE TMEREOF, ,The ISSUP4 IWXVRER WILL J04"AVOR TO A9AI6 30 p/iTi MRIrTEH NOTICE TO THE CCR►1FtCA16 HOLDER NAMCb TO TtR! LHPT, Y11r FAILURE TO 0074 SlIALL Into IEA River county IMPOSE NO ORLICAMON OR WA810Y0! AAWV KIND UPON TNO NSUR6R, ITS AO8m OR 1010 25th Street RUPRE TATURS, . . Vero Sanc7a FL 32960AU4W P1% PW4PTATV1 AGORA 25 f200TJOQj 0ACORD CORPORATION 1088