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HomeMy WebLinkAboutAgreement A-21-270 with Youth Leadership Institute.pdf1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 AGREEMENT This Agreement is made and entered into this ______ day of ___________ 2021, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as “COUNTY”, and YOUTH LEADERSHIP INSTITUTE, a California non-profit corporation, whose address is 209 9th Street, Suite 200, San Francisco, CA 94103-6800, hereinafter referred to as “CONTRACTOR” (collectively the “parties”). W I T N E S S E T H: WHEREAS, COUNTY, through its Department of Behavioral Health (DBH), recognizes the need for Fresno County youth and young adults to receive alcohol and drug abuse prevention services; and WHEREAS, COUNTY is authorized to contract with privately operated agencies for the provision of alcohol and drug abuse prevention services; and WHEREAS, CONTRACTOR has the staff, and is willing and able to provide prevention services required by the COUNTY, pursuant to the terms and conditions of this Agreement. NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties hereto agree as follows: 1.SERVICES A.CONTRACTOR shall perform all services and fulfill all responsibilities for the provision of alcohol, marijuana and prescription drug misuse prevention services for youth and young adults ages 10-20, and California Friday Night Live and Club Live program administration, as identified in Exhibits A-1 and A-2, Scope of Work, attached hereto and by this reference incorporated herein, COUNTY’s Request for Proposal (RFP) # 21-021 dated December 16, 2020, and Addendum I dated January 12, 2021, hereinafter collectively referred to as COUNTY Revised RFP #21-021, and CONTRACTOR’s response to said RFP #21-021, dated January 14, 2021, all incorporated herein by reference and made part of this Agreement. B.CONTRACTOR shall align evaluations, services, and practices with the vision, mission, and guiding principles of the DBH, as further described in Exhibit B, "Fresno County Department of Behavioral Health Guiding Principles of Care Delivery", attached hereto and by this reference incorporated herein and made part of this Agreement. 13th July Agreement No. 21-270 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 C. CONTRACTOR’s administrative level agency representative, who is duly authorized to act on behalf of the CONTRACTOR, must attend regularly scheduled monthly Behavioral Health Board Substance Use Disorder Sub-Committee meetings, CONTRACTOR meetings and quarterly Prevention Provider meetings, as deemed necessary by DBH Director or her designee. D. CONTRACTOR shall comply with all contract monitoring and compliance protocols, procedures, data collection methods, and reporting requirements conducted by the COUNTY. E. CONTRACTOR shall maintain, at CONTRACTOR’s cost, a computer system compatible with Primary Prevention Substance Use Disorder Services (PPSDS) for the provision of submitting information required under the terms and conditions of this Agreement. CONTRACTOR shall complete required PPSDS data entry for prevention service/activity by date of occurrence on an ongoing basis through each month. F. CONTRACTOR’s staff may be required to attend meetings and trainings on an as- needed basis, which may include but are not limited to prevention and fiscal trainings provided by the State of California. G. In the event of any inconsistency among these documents, the inconsistency shall be resolved by giving precedence in the following order of priority: 1) to this Agreement, including all Exhibits, 2) to the Revised RFP, and; 3) to the Response to the Revised RFP. A copy of COUNTY’s Revised RFP # 21-021, and CONTRACTOR’s response shall be retained and made available during the term of this Agreement by COUNTY’s Purchasing Division. 2. TERM The Agreement shall become effective upon execution and shall terminate on the 30th of June, 2024. This Agreement may be extended for two (2) additional consecutive twelve (12) month period upon written approval of both parties no later than thirty (30) days prior to the first day of the next twelve (12) month extension period. The DBH Director, or designee, is authorized to execute such written approval on behalf of COUNTY based on CONTRACTOR’s satisfactory performance. 3. TERMINATION A. Non Allocation of Funds - The terms of this Agreement, and the services to be provided thereunder, are contingent on the approval of funds by the appropriating government agency. 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Should sufficient funds not be allocated, the services provided may be modified, or this Agreement terminated at any time by giving CONTRACTOR thirty (30) days advance written notice. B. Breach of Contract - COUNTY may immediately suspend or terminate this Agreement in whole or in part, where in the determination of COUNTY there is: 1) An illegal or improper use of funds; 2) A failure to comply with any term of this Agreement; 3) A substantially incorrect or incomplete report submitted to COUNTY; 4) Improperly performed service. In no event shall any payment by COUNTY constitute a waiver by COUNTY of any breach of this Agreement or any default which may then exist on the part of CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to COUNTY with respect to the breach or default. COUNTY shall have the right to demand of CONTRACTOR the repayment to COUNTY of any funds disbursed to CONTRACTOR under this Agreement, which in the judgment of COUNTY were not expended in accordance with the terms of this Agreement. CONTRACTOR shall promptly refund any such funds upon demand or, at COUNTY’s option, such repayment shall be deducted from future payments owing to CONTRACTOR under this Agreement. C. Without Cause - Under circumstances other than those set forth above, this Agreement may be terminated by CONTRACTOR or COUNTY upon thirty (30) days advance written notice of an intention to terminate the Agreement. COUNTY’s DBH Director, or designee, is authorized to execute such written notice on behalf of COUNTY. 4. COMPENSATION A. For actual services provided as identified in the terms and conditions of this Agreement, including Exhibit A-1 and A-2, COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation in accordance with Exhibit C-1 and C-2, “Budget Summary,” attached hereto and by this reference incorporated herein. Payment shall be made upon certification or other proof satisfactory to COUNTY’s DBH that services have actually been performed by CONTRACTOR as specified in this Agreement. For the period effective upon execution through June 30, 2022, in no event shall 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 actual services performed be in excess of One Million, Two Hundred Nineteen Thousand, Three Hundred Fifty-Two and No/100 Dollars ($1,219,352.00). For the period July 1, 2022 through June 30, 2023, in no event shall actual services performed be in excess of One Million, Two Hundred Nineteen Thousand, Three Hundred Fifty-Two and No/100 Dollars ($1,219,352.00). For the period July 1, 2023 through June 30, 2024, in no event shall actual services performed be in excess of One Million, Two Hundred Nineteen Thousand, Three Hundred Fifty-Two and No/100 Dollars ($1,219,352.00). If this agreement is renewed for an additional one-year period pursuant to Section 2, TERM, for the period July 1, 2024 through June 30, 2025, in no event shall actual services performed be in excess of One Million, Two Hundred Nineteen Thousand, Three Hundred Fifty-Two and No/100 Dollars ($1,219,352.00). If this agreement is renewed for an additional one-year period pursuant to Section 2, TERM, for the period July 1, 2025 through June 30, 2026, in no event shall actual services performed be in excess of One Million, Two Hundred Nineteen Thousand, Three Hundred Fifty-Two and No/100 Dollars ($1,219,352.00). In no event shall services performed under this Agreement be in excess of Six Million, Ninety-Six Thousand, Seven Hundred Sixty and No/100 Dollars ($6,096,760.00). It is understood that all expenses incidental to CONTRACTOR’s performance of services under this Agreement shall be borne by CONTRACTOR. B. Except as provided below regarding State payment delays, payments shall be made by COUNTY to CONTRACTOR in arrears, for services provided during the preceding month, within forty-five (45) days after the date of receipt, verification, and approval of CONTRACTOR’s monthly itemized invoices and required reports further described in Section Twenty-Nine (29), REPORTS of this Agreement, by COUNTY’s DBH. C. If CONTRACTOR should fail to comply with any provision of this Agreement, COUNTY shall be relieved of its obligation for further compensation. All final invoices and/or any final budget modification requests shall be submitted by CONTRACTOR within sixty (60) days following the 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 final month of service for which payment is claimed. No action shall be taken by COUNTY on claims submitted beyond the sixty (60) day closeout period. Any compensation which is not expended by CONTRACTOR pursuant to the terms and conditions of this Agreement shall automatically revert to COUNTY. D. The contract maximum amount as identified in this Agreement and in Exhibits C-1 and C-2 may be reduced based upon State and Federal funding availability. In the event of such action, the COUNTY’s DBH Director or her designee shall notify the CONTRACTOR in writing of the reduction in the maximum amount within thirty (30) days of COUNTY’s notification. In the event that the State of California is unable to meet its financial obligations and payment to Counties for substance abuse services, COUNTY may delay or defer payment to CONTRACTOR until such a time as the State budget issues are resolved. The amount of deferred payment shall not exceed the amount of funding delayed by the State Controller to the COUNTY. The deferral by COUNTY shall not exceed the period of time the State Controller’s delay of payment plus forty-five (45) days. In addition, if the State of California does not allocate funding for services described in the terms and conditions of this Agreement, COUNTY shall not be obligated to reimburse CONTRACTOR for services performed. E. Public Information – CONTRACTOR shall disclose its funding source in all public information, however, this requirement of disclosure of funding source shall not be required in spot radio or television advertising. F. Lobbying Activity – CONTRACTOR shall not directly or indirectly use any of the funds provided under this Agreement for publicity, lobbying, or propaganda purposes designed to support or defeat legislation pending before the Congress of the United States or the Legislature of the State of California. G. Political Activity – CONTRACTOR shall not directly or indirectly use any of the funds under this Agreement for any political activity or to further the election or defeat of any candidate for public office. 5. INVOICING CONTRACTOR shall invoice COUNTY in arrears by the twentieth (20th) day of each month 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 for actual expenses incurred and services rendered in the previous month electronically to dbh-invoices@fresnocountyca.gov, with a carbon copy email to the assigned COUNTY’s DBH Staff Analyst. CONTRACTOR shall submit to the COUNTY by the twentieth (20th) of each month a detailed general ledger (GL), itemizing costs incurred in the previous month. Failure to submit GL reports and supporting documentation shall be deemed sufficient cause for COUNTY to withhold payments until there is compliance, as further described in Section Five (5) herein. Supporting documentation shall include but is not limited to receipts, invoices received, and documented administrative / overhead costs. No reimbursement for services shall be made until invoices, reports and outcomes are received, reviewed and approved by COUNTY’s DBH. Support documents will be made available upon request. At the discretion of COUNTY’s DBH Director or designee, if an invoice is incorrect or is otherwise not in proper form or substance, COUNTY’s DBH Director or designee shall have the right to withhold payment as to only that portion of the invoice that is incorrect or improper after five (5) days prior notice to CONTRACTOR. CONTRACTOR agrees to continue to provide services for a period of ninety (90) days after notification of an incorrect or improper invoice. If after the ninety (90) day period, the invoice(s) is still not corrected to COUNTY’s DBH satisfaction, COUNTY’s DBH Director or designee may elect to terminate this Agreement, pursuant to the termination provisions stated in Paragraph Three (3) of this Agreement. In addition, for invoices received ninety (90) days after the expiration of each term of this Agreement or termination of this Agreement, at the discretion of COUNTY’s DBH Director or designee, COUNTY’s DBH shall have the right to deny payment of any additional invoices received. CONTRACTOR must maintain such financial records for a period of three (3) years or until any dispute, audit or inspection is resolved, whichever is later. CONTRACTOR will be responsible for any disallowances related to inadequate documentation. 6. INDEPENDENT CONTRACTOR In performance of the work, duties, and obligations assumed by CONTRACTOR under this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of CONTRACTOR’s officers, agents, and employees will at all times be acting and performing as an independent contractor, and shall act in an independent capacity and not as an officer, agent, servant, 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 employee, joint venturer, partner, or associate of COUNTY. Furthermore, COUNTY shall have no right to control or supervise or direct the manner or method by which CONTRACTOR shall perform its work and function. However, COUNTY shall retain the right to administer this Agreement so as to verify that CONTRACTOR is performing its obligations in accordance with the terms and conditions thereof. CONTRACTOR and COUNTY shall comply with all applicable provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction over matters which are directly or indirectly the subject of this Agreement. Because of its status as an independent contractor, CONTRACTOR shall have absolutely no right to employment rights and benefits available to COUNTY employees. CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its employees all legally required employee benefits. In addition, CONTRACTOR shall be solely responsible and save COUNTY harmless from all matters relating to payment of CONTRACTOR's employees, including compliance with Social Security, withholding, and all other regulations governing such matters. It is acknowledged that during the term of this Agreement, CONTRACTOR may be providing services to others unrelated to COUNTY or to this Agreement. 7. SUBCONTRACTS CONTRACTOR shall be required to assume full responsibility for all services and activities covered by this Agreement, whether or not CONTRACTOR is providing services directly. Further, CONTRACTOR shall be the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from this Agreement. CONTRACTOR shall obtain written approval from COUNTY’s DBH Director, or designee, before subcontracting any of the services delivered under this Agreement, unless previously budgeted at time of award. COUNTY’s DBH Director, or designee, retains the right to approve or reject any request for subcontracting services. Any transferee, assignee, or subcontractor will be subject to all applicable provisions of this Agreement, and all applicable State and Federal regulations. CONTRACTOR shall be held primarily responsible by COUNTY for the performance of any transferee, assignee, or subcontractor unless otherwise expressly agreed to in writing by COUNTY’s DBH Director, or designee. The use of subcontractors by CONTRACTOR shall not entitle CONTRACTOR to any additional compensation that is 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 provided for under this Agreement. 8. MODIFICATION Any matters of this Agreement may be modified from time to time by the written consent of all the parties without, in any way, affecting the remainder. Changes to expense category (i.e., Salary & Benefits, Client Support, Facilities/Equipment, Operating Expenses, Administrative Expenses, Special Expenses, Fixed Assets, etc.) subtotals in the budgets, and changes to the volume of units of services/types of service units to be provided as set forth in Exhibit C-1 and C-2, that do not exceed 10% of the maximum compensation payable to the CONTRACTOR may be made with the written approval of COUNTY’s DBH Director, or designee. Said modifications shall not result in any change to the annual maximum compensation amount payable to CONTRACTOR, as stated in this Agreement. CONTRACTOR hereby agrees that changes to the compensation under this Agreement may be necessitated by a reduction in funding from State and/or Federal sources. The COUNTY’s DBH Director or her designee may modify the maximum compensation depending on State and Federal funding availability, as stated in Section Four (4), COMPENSATION in this Agreement. CONTRACTOR further understands that this Agreement is subject to any restrictions, limitations, or enactments of all legislative bodies which affect the provisions, term or funding of this Agreement in any manner. 9. NON-ASSIGNMENT Neither party shall assign, transfer or subcontract this Agreement nor their rights or duties under this Agreement without the prior written consent of the other party. 10. HOLD HARMLESS CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY’s request, defend COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs damages, liabilities, claims and losses occurring or resulting to any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, their 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 officers, agents or employees of covenants and duties under this Agreement. CONTRACTOR agrees to indemnify COUNTY for Federal and/or State of California audit exceptions resulting from noncompliance herein on the part of the CONTRACTOR. 11. INSURANCE Without limiting COUNTY's right to obtain indemnification from CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect the following insurance policies or a program of self-insurance, including but not limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA) throughout the term of this Agreement: A. Commercial General Liability Commercial General Liability Insurance with limits of not less than Two Million Dollars ($2,000,000) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including completed operations, product liability, contractual liability, Explosion-Collapse-Underground, fire legal liability or any other liability insurance deemed necessary because of the nature of this contract. B. Automobile Liability Comprehensive Automobile Liability Insurance with limits no less than One Million Dollars ($1,000,000) per accident for bodily injury and property damage. Coverage should include any automobile used in connection with this Agreement. C. Professional Liability If CONTRACTOR employs licensed professional staff (e.g. Ph.D., R.N., L.C.S.W., L.M.F.T., etc.) in providing services, Professional Liability Insurance with limits of not less than One Million Dollars ($1,000,000) per occurrence, Three Million Dollars ($3,000,000) annual aggregate. CONTRACTOR agrees that it shall maintain, at its sole expense, in full force and effect for a period of three (3) years following the termination of this Agreement, one or more policies of professional liability insurance with limits of coverage as specified herein. D. Worker’s Compensation A policy of Worker's Compensation Insurance as may be required by the California Labor Code. E. Molestation CONTRACTOR shall have either separate policy or an umbrella policy with 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 endorsements covering sexual abuse/molestation coverage or have a specific endorsement on their General Commercial liability policy covering sexual abuse/molestation. The policy limits for this policy shall be One Million Dollars ($1,000,000) per occurrence with a Two Million Dollars ($2,000,000) annual aggregate. The policy shall be on a per occurrence basis. F. Cyber Liability Cyber Liability Insurance, with limits not less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to duties and obligations undertaken by CONTRACTOR(S) in this agreement and shall include, but not be limited to, claims involving infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, alteration of electronic information, extortion and network security. The policy shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations. CONTRACTOR shall obtain endorsements to the Commercial General Liability insurance naming the County of Fresno, its officers, agents, and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned. Such coverage for additional insured shall apply as primary insurance and any other insurance, or self- insurance, maintained by COUNTY, its officers, agents and employees shall be excess only and not contributing with insurance provided under CONTRACTOR’s policies herein. This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written notice given to COUNTY. CONTRACTOR hereby waives its right to recover from COUNTY, its officers, agents, and employees any amounts paid by the policy of worker’s compensation insurance required by this Agreement. CONTRACTOR is solely responsible to obtain any endorsement to such policy that may be necessary to accomplish such waiver of subrogation, but CONTRACTOR’s waiver of subrogation under this paragraph is effective whether or not CONTRACTOR obtains such an endorsement. Within thirty (30) days from the date each CONTRACTOR signs this Agreement, said CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, 1925 E. Dakota Ave, Fresno, California, 93726, Attention: Public Behavioral Health Division, stating that such insurance coverages have been obtained and are in full force; that the County of Fresno, its officers, 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 agents and employees will not be responsible for any premiums on the policies; that for such worker’s compensation insurance the CONTRACTOR has waived its right to recover from the COUNTY, its officers, agents, and employees any amounts paid under the insurance policy and that waiver does not invalidate the insurance policy; that such Commercial General Liability insurance names the County of Fresno, its officers, agents and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned; that such coverage for additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees, shall be excess only and not contributing with insurance provided under CONTRACTOR policies herein; and that this insurance shall not be cancelled or changed without a minimum of thirty (30) days advance, written notice given to COUNTY. In the event CONTRACTOR fails to keep in effect at all times insurance coverage as herein provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this Agreement upon the occurrence of such event. All policies shall be with admitted insurers licensed to do business in the State of California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. 12. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT COUNTY and CONTRACTOR each consider and represent themselves as covered entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104- 191(HIPAA) and agree to use and disclose protected health information as required by law. COUNTY and CONTRACTOR acknowledge that the exchange of protected health information between them is only for treatment, payment, and health care operations. COUNTY and CONTRACTOR intend to protect the privacy and provide for the security of Protected Health Information (PHI) pursuant to the Agreement in compliance with HIPAA, the Health Information Technology for Economic and Clinical Health Act, Public Law 111-005 (HITECH), and regulations promulgated thereunder by the U.S. Department of Health and Human Services (HIPAA Regulations) and other applicable laws. As part of the HIPAA Regulations, the Privacy Rule and the Security Rule require 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CONTRACTOR to enter into a contract containing specific requirements prior to the disclosure of PHI, as set forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504(e) of the Code of Federal Regulations (CFR). 13. DATA SECURITY For the purpose of preventing the potential loss, misappropriation or inadvertent access, viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that enter into a contractual relationship with the COUNTY for the purpose of providing services under this Agreement must employ adequate data security measures to protect the confidential information provided to CONTRACTOR by the COUNTY, including but not limited to the following: A. CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices CONTRACTOR may not connect to COUNTY networks via personally-owned mobile, wireless or handheld devices, unless the following conditions are met: 1) CONTRACTOR has received authorization by COUNTY for telecommuting purposes; 2) Current virus protection software is in place; 3) Mobile device has the remote wipe feature enabled; and 4) A secure connection is used. B. CONTRACTOR-Owned Computers or Computer Peripherals CONTRACTOR may not bring CONTRACTOR-owned computers or computer peripherals into the COUNTY for use without prior authorization from the COUNTY’s Chief Information Officer, and/or his or her designee(s), including but not limited to mobile storage devices. If data is approved to be transferred, data must be stored on a secure server approved by the COUNTY and transferred by means of a Virtual Private Network (VPN) connection, or another type of secure connection. Said data must be encrypted. C. COUNTY-Owned Computer Equipment CONTRACTOR may not use COUNTY computers or computer peripherals on non- COUNTY premises without prior authorization from the COUNTY’s Chief Information Officer, and/or his or 13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 her designee(s). D. CONTRACTOR may not store COUNTY’s private, confidential or sensitive data on any hard-disk drive, portable storage device, or remote storage installation unless encrypted. E. CONTRACTOR shall be responsible to employ strict controls to ensure the integrity and security of COUNTY’s confidential information and to prevent unauthorized access, viewing, use or disclosure of data maintained in computer files, program documentation, data processing systems, data files and data processing equipment which stores or processes COUNTY data internally and externally. F. Confidential client information transmitted to one party by the other by means of electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128 BIT or higher. Additionally, a password or pass phrase must be utilized. G. CONTRACTOR is responsible to immediately notify COUNTY of any violations, breaches or potential breaches of security related to COUNTY’s confidential information, data maintained in computer files, program documentation, data processing systems, data files and data processing equipment which stores or processes COUNTY data internally or externally. H. COUNTY shall provide oversight to CONTRACTOR’s response to all incidents arising from a possible breach of security related to COUNTY’s confidential client information provided to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected individuals as required by law or as deemed necessary by COUNTY in its sole discretion. CONTRACTOR will be responsible for all costs incurred as a result of providing the required notification. 14. NON-DISCRIMINATION During the performance of this Agreement, CONTRACTOR and its subcontractors shall not deny the contract’s benefits to any person on the basis of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and veteran status, nor shall they discriminate unlawfully against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military or veteran status. CONTRACTOR shall insure that the evaluation and treatment of 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 employees and applicants for employment are free of such discrimination. CONTRACTOR and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code §12800 et seq.), the regulations promulgated thereunder (Cal. Code Regs., tit. 2, §11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of the Government Code (Gov. Code §11135-11139.5), and the regulations or standards adopted by the awarding state agency to implement such article. CONTRACTOR shall permit access by representatives of the Department of Fair Employment and Housing and the awarding state agency upon reasonable notice at any time during the normal business hours, but in no case less than twenty-four (24) hours notice, to such of its books, records, accounts, and all other sources of information and its facilities as said Department or Agency shall require to ascertain compliance with this clause. CONTRACTOR and its subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. (See Cal. Code Regs., tit. 2, §11105) CONTRACTOR shall include the Non-Discrimination and compliance provisions of this clause in all subcontracts to perform work under this Agreement. 15. COMPLAINTS CONTRACTOR shall log complaints and the disposition of all complaints from a client or client’s family. CONTRACTOR shall provide a summary of the complaint log entries concerning COUNTY-sponsored clients to COUNTY at monthly intervals by the fifteenth (15th) day of the following month, in a format that is mutually agreed upon. CONTRACTOR shall post signs informing consumer of their right to file a complaint or grievance. CONTRACTOR shall notify COUNTY of all incidents reportable to state licensing bodies that affect COUNTY consumers within twenty-four (24) hours of receipt of a complaint. Within fifteen (15) days after each incident or complaint affecting COUNTY-sponsored clients, CONTRACTOR shall provide COUNTY with information relevant to the complaint, investigative details of the complaint, the complaint and CONTRACTOR' disposition of, or corrective action taken to resolve the complaint. 16. NO THIRD PARTY BENEFICIARIES It is understood and agreed by and between the parties that the services provided by 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CONTRACTOR for COUNTY herein are solely for the benefit of the COUNTY, and that nothing in this Agreement is intended to confer on any person other than the parties hereto any right under or by reason of this Agreement. 17. COMPLIANCE WITH LAWS AND POLICIES CONTRACTOR shall comply with all applicable laws, ordinances and regulations in the performance of its obligations under this Agreement and guidelines applicable to CONTRACTORS’ performance under this Agreement or any local ordinances, regulations, or policies applicable. Such provisions include, but are not restricted to: A. CONTRACTOR shall submit accurate, complete and timely claims and cost reports, reporting only allowable costs. B. CONTRACTOR shall comply with statistical reporting and program evaluation systems as provided in State of California regulations and in this Agreement. C. CONTRACTOR shall comply with Substance Abuse Prevention and Treatment (SAPT) – Prevention Specific Requirements identified on Exhibit D, attached hereto and incorporated herein by reference. D. In the event any law, regulation, or policy referred to in this Agreement is amended during the term thereof, the parties hereto agree to comply with the amended provision as of the effective date of such amendment. Exhibits will be updated as needed and no formal amendment of this contract is required for new rules to apply. 18. COMPLIANCE CONTRACTOR shall comply with all requirements of the “Fresno County Behavioral Health Compliance Program Contractor Code of Conduct and Ethics” as set forth in Exhibit E. Within thirty (30) days of entering into this Agreement with the COUNTY, CONTRACTOR shall have all of CONTRACTOR employees, agents and subcontractors providing services under this Agreement certify in writing, that they have received, read, understood, and shall abide by the requirements set forth in Exhibit E. CONTRACTOR shall ensure that within thirty (30) days of hire, all new employees, agents and subcontractors providing services under this Agreement certify in writing that they have received, read, understood, and shall abide by the requirements set forth in Exhibit E. CONTRACTOR understands that 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 the promotion of and adherence to such requirements is an element in evaluating the performance of CONTRACTOR and its employees, agents and subcontractors. Within thirty (30) days of entering into this Agreement, and annually thereafter, all employees, agents and subcontractors providing services under this Agreement shall complete general compliance training and appropriate employees, agents and subcontractors shall complete documentation and billing or billing/reimbursement training. All new employees, agents and subcontractors shall attend the appropriate training within thirty (30) days of hire. Each individual who is required to attend training shall certify in writing that he or she has received the required training. The certification shall specify the type of training received and the date received. The certification shall be provided to the COUNTY’s Compliance Officer at 1925 E. Dakota Ave., Fresno, California 93726. CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty imposed upon COUNTY by the Federal Government as a result of CONTRACTOR violation of the terms of this Agreement. 19. CONFLICT OF INTEREST No officer, agent, or employee of COUNTY who exercises any function or responsibility for planning and carrying out the services provided under this Agreement shall have any direct or indirect personal financial interest in this Agreement. In addition, no employee of COUNTY shall be employed by CONTRACTOR to fulfill any contractual obligations with COUNTY. CONTRACTOR shall also comply with all Federal, State of California, and local conflict of interest laws, statutes, and regulations, which shall be applicable to all parties and beneficiaries under this Agreement and any officer, agent, or employee of COUNTY. 20. DISCLOSURE OF SELF-DEALING TRANSACTIONS This provision is only applicable if the CONTRACTOR is operating as a corporation (a for- profit or non-profit corporation) or if during the term of this Agreement, the CONTRACTOR changes its status to operate as a corporation. Members of the CONTRACTOR’s Board of Directors shall disclose any self-dealing transactions that they are a party to while CONTRACTOR is providing goods or performing services under this Agreement. A self-dealing transaction shall mean a transaction to which the CONTRACTOR is a party and in which one or more of its directors has a material financial interest. Members of the Board 17 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 of Directors shall disclose any self-dealing transactions that they are a party to by completing and signing a “Self-Dealing Transaction Disclosure Form”, attached hereto as Exhibit F and incorporated herein by reference and made part of this Agreement, and submitting it to the COUNTY prior to commencing with the self-dealing transaction or immediately thereafter. 21. TAX EQUITY AND FISCAL RESPONSIBILITY ACT To the extent necessary to prevent disallowance of reimbursement under Section 1861(v) (1) (I) of the Social Security Act, (42 U.S.C. § 1395x, subd. (v)(1)[I]), until the expiration of four (4) years after the furnishing of services under this Agreement, CONTRACTOR shall make available, upon written request of the Secretary of the United States Department of Health and Human Services, or upon request of the Comptroller General of the United States General Accounting Office, or any of their duly authorized representatives, a copy of this Agreement and such books, documents, and records as are necessary to certify the nature and extent of the costs of these services provided by CONTRACTOR under this Agreement. CONTRACTOR further agrees that in the event CONTRACTOR carries out any of its duties under this Agreement through a subcontract, with a value or cost of Ten Thousand and No/100 Dollars ($10,000.00) or more over a twelve (12) month period, with a related organization, such Agreement shall contain a clause to the effect that until the expiration of four (4) years after the furnishing of such services pursuant to such subcontract, the related organizations shall make available, upon written request of the Secretary of the United States Department of Health and Human Services, or upon request of the Comptroller General of the United States General Accounting Office, or any of their duly authorized representatives, a copy of such subcontract and such books, documents, and records of such organization as are necessary to verify the nature and extent of such costs. 22. SINGLE AUDIT CLAUSE A. If CONTRACTOR expends Seven Hundred Fifty Thousand Dollars and No/100 Dollars ($750,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR agrees to conduct an annual audit in accordance with the requirements of the Single Audit Standards as set forth in Office of Management and Budget (OMB) 2 CFR 200. CONTRACTOR shall submit said audit and management letter to COUNTY. The audit must include a statement of findings or a statement that there were no findings. If there were negative findings, CONTRACTOR must include a corrective action plan 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 signed by an authorized individual. CONTRACTOR agrees to take action to correct any material non- compliance or weakness found as a result of such audit. Such audit shall be delivered to COUNTY’s DBH Business Office for review within nine (9) months of the end of any fiscal year in which funds were expended and/or received for the program. Failure to perform the requisite audit functions as required by this Agreement may result in COUNTY performing the necessary audit tasks, or at COUNTY’s option, contracting with a public accountant to perform said audit, or, may result in the inability of COUNTY to enter into future agreements with CONTRACTOR. All audit costs related to this Agreement are the sole responsibility of CONTRACTOR. B. A single audit report is not applicable if CONTRACTOR’s Federal contracts do not exceed the Seven Hundred Fifty Thousand and No/100 Dollars ($750,000.00) requirement or CONTRACTOR’s only funding is through Drug-related Medi-Cal. If a single audit is not applicable, a program audit must be performed and a program audit report with management letter shall be submitted by CONTRACTOR to COUNTY as a minimum requirement to attest to CONTRACTOR’s solvency. Said audit report shall be delivered to COUNTY’s DBH Business Office for review, no later than nine (9) months after the close of the fiscal year in which the funds supplied through this Agreement are expended. Failure to comply with this Act may result in COUNTY performing the necessary audit tasks or contracting with a qualified accountant to perform said audit. All audit costs related to this Agreement are the sole responsibility of CONTRACTOR who agrees to take corrective action to eliminate any material noncompliance or weakness found as a result of such audit. Audit work performed by COUNTY under this Section shall be billed to the CONTRACTOR at COUNTY’s cost, as determined by COUNTY’s Auditor-Controller/Treasurer-Tax Collector. C. CONTRACTOR shall make available all records and accounts for inspection by COUNTY, the State of California, if applicable, the Comptroller General of the United States, the Federal Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a period of at least three (3) years following final payment under this Agreement or the closure of all other pending matters, whichever is later. 23. REFERENCES TO LAWS AND RULES In the event any law, regulation, or policy referred to in this Agreement is amended during 19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 the term thereof, the parties hereto agree to comply with the amended provision as of the effective date of such amendment. 24. CHILD ABUSE REPORTING CONTRACTOR shall utilize a procedure acceptable to COUNTY to ensure that all of CONTRACTORS’ employees, volunteers, consultants, subcontractors or agents performing services under this Agreement shall report all known or suspected child abuse or neglect to one or more of the agencies set forth in Penal Code Section 11165.9. This procedure shall include having all of CONTRACTORS’ employees, volunteers, consultants, subcontractors or agents performing services under this Agreement sign a statement that he or she knows of and will comply with the reporting requirements set forth in Penal Code Section 11166. The statement to be utilized by CONTRACTOR is set forth in Exhibit G, attached hereto and by this reference incorporated herein. 25. EVALUATION AND MONITORING COUNTY’s DBH Director or her designee shall monitor and evaluate the performance of CONTRACTOR under this Agreement to determine to the best possible degree the success or failure of the services provided under this Agreement. At the discretion of the COUNTY, a subcontractor may be obtained by the COUNTY to independently evaluate and monitor the performance of the CONTRACTOR. CONTRACTOR shall participate in the evaluation of the program for time periods as determined by COUNTY. CONTRACTOR shall participate in a program review at least yearly, or as needed, at the discretion of COUNTY. The CONTRACTOR agrees to supply all information requested by the COUNTY, County-subcontracted evaluator, State and/or Federal agency during program evaluation, monitoring, and/or review. COUNTY shall recapture from CONTRACTOR the value of any services or other expenditures determined to be ineligible based on the COUNTY or State monitoring results. At the discretion of the COUNTY recoupment can be made through a future invoice reduction or reimbursement by the CONTRACTOR. 26. CULTURAL COMPETENCY As related to Cultural and Linguistic Competence, CONTRACTOR shall comply with: A. Title 6 of the Civil Rights Act of 1964 (42 U.S.C. section 2000d, and 45 C.F.R. Part 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial assistance from discriminating against persons based on race, color, national origin, sex, disability or religion. This is interpreted to mean that a Limited English Proficient (LEP) individual is entitled to equal access and participation in federally funded programs through the provision of comprehensive and quality bilingual services. B. Policies and procedures for ensuring access and appropriate use of trained interpreters and material translation services for all LEP consumers, including, but not limited to, assessing the cultural and linguistic needs of its consumers, training of staff on the policies and procedures, and monitoring its language assistance program. The CONTRACTOR’s procedures must include ensuring compliance of any sub-contracted providers with these requirements. C. CONTRACTOR shall not use minors as interpreters. D. CONTRACTOR shall provide and pay for interpreting and translation services to persons participating in CONTRACTOR’s services who have limited or no English language proficiency, including services to persons who are deaf or blind. Interpreter and translation services shall be provided as necessary to allow such participants meaningful access to the programs, services and benefits provided by CONTRACTOR. Interpreter and translation services, including translation of CONTRACTOR’s “vital documents” (those documents that contain information that is critical for accessing CONTRACTOR’s services or are required by law) shall be provided to participants at no cost to the participant. CONTRACTOR shall ensure that any employees, agents, subcontractors, or partners who interpret or translate for a program participant, or who directly communicate with a program participant in a language other than English, demonstrate proficiency in the participant's language and can effectively communicate any specialized terms and concepts peculiar to CONTRACTOR’s services. E. CONTRACTORS shall submit to COUNTY for approval, within ninety (90) days from date of contract execution, CONTRACTORS’s plan to address all fifteen (15) National Standards for Culturally and Linguistically Appropriate Service (CLAS), as published by the Office of Minority Health and as set forth in Exhibit H, “National Standards on Culturally and Linguistically Appropriate Services”, attached hereto and incorporated herein by reference and made part of this Agreement. As the CLAS standards are updated, CONTRACTORS’s plan must be updated accordingly. COUNTY’s annual on-site 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 review of CONTRACTOR shall include collection of documentation to ensure all national standards are implemented. As requested by COUNTY, CONTRACTORS shall be responsible for conducting an annual CLAS self-assessment and providing the results of the self-assessment to the COUNTY. The annual CLAS self-assessment instruments shall be reviewed by the COUNTY and revised as necessary to meet the approval of the COUNTY. 27. RECORDS A. Record Establishment and Maintenance - CONTRACTOR shall establish and maintain records in accordance with State and Federal rules and regulations in addition to those requirements prescribed by COUNTY with respect to all matters covered by this Agreement. Except as otherwise authorized by COUNTY, CONTRACTOR shall retain all other records for a period of five (5) years after receiving the final payment under this Agreement or the earlier termination of this Agreement, or until State and/or Federal audit findings applicable to such services are resolved, whichever is later. B. Documentation - CONTRACTOR shall maintain adequate records in sufficient detail to make possible an evaluation of services, and contain all the data necessary in reporting to the State of California and/or Federal agency. All client records shall be maintained pursuant to applicable State of California and Federal requirements concerning confidentiality. C. Reports - CONTRACTOR shall submit to COUNTY monthly fiscal and all program reports as further described in Section Twenty-Nine (29), REPORTS and as indicated in Exhibit A-1 and A-2. Following the end of each fiscal year affected by this Agreement, CONTRACTOR shall submit a complete and accurate year-end cost report. CONTRACTOR shall also furnish to COUNTY such statements, records, reports, data, and information as COUNTY may request pertaining to matters covered by this Agreement. All reports submitted by CONTRACTOR to COUNTY must be typewritten. D. Suspension of Compensation - In the event that CONTRACTOR fails to provide reports specified in this Agreement, it shall be deemed sufficient cause for COUNTY to withhold payments until there is compliance. E. Disallowances – Payments by COUNTY shall be in arrears, for services provided during the preceding month, within forty-five (45) days after receipt, verification and approval of CONTRACTORS’ invoices by COUNTY’S DBH-SUD Services. If payment for services is denied or 22 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 disallowed by State; and subsequently resubmitted to COUNTY by CONTRACTOR, the disallowed portion will be withheld from the next reimbursement to the CONTRACTOR until COUNTY has received reimbursement from State for said services. F. Client Confidentiality – CONTRACTOR shall conform to and COUNTY shall monitor compliance with all State and Federal statutes and regulations regarding confidentiality, including but not limited to confidentiality of information requirements of 42 Code of Federal Regulations § 2.1 et seq., Welfare and Institutions Code §§ 5328, 10850 and 14100.2, Health and Safety Code §§ 11977 and 11812, Civil Code, Division 1, Part 2.6, and 22 California Code of Regulations § 51009. 28. DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST INFORMATION This provision is only applicable if CONTRACTOR is a disclosing entity, fiscal agent, or managed care entity as defined in Code of Federal Regulations (C.F.R), Title 42 § 455.101 455.104, and 455.106(a)(1),(2). In accordance with C.F.R., Title 42 §§ 455.101, 455.104, 455.105 and 455.106(a)(1),(2), the following information must be disclosed by CONTRACTOR by completing Exhibit I, “Disclosure of Ownership and Control Interest Statement”, attached hereto and by this reference incorporated herein and made part of this Agreement. CONTRACTOR shall submit this form to COUNTY’s DBH within thirty (30) days of the effective date of this Agreement. Additionally, CONTRACTOR shall report any changes to this information within thirty-five (35) days of occurrence by completing Exhibit I. CONTRACTOR is required to submit a set of fingerprints for any person with a five (5) percent or greater direct or indirect ownership interest in CONTRACTOR. COUNTY may terminate this Agreement where any person with a five (5) percent or greater direct or indirect ownership interest in the CONTRACTOR did not submit timely and accurate information and cooperate with any screening method required in CFR, Title 42, Section 455.416. Submissions shall be scanned portable document format (pdf) copies and are to be sent via email to DBHAdministration@fresnocountyca.gov, Attention: Contracts Administration. COUNTY may deny enrollment or terminate this Agreement where any person with a five (5) percent or greater direct or indirect ownership interest in CONTRACTOR has been convicted of a criminal offense related to that person’s involvement with the Medicare, Medicaid, or Title XXI program in the last ten (10) years. /// 23 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29. REPORTS A. PPSDS – CONTRACTOR and/or subcontractors receiving SABG Primary Prevention Set-Aside funding shall input planning, service/activity and evaluation data into the service. When submitting data, CONTRACTOR shall comply with the PPSDS Quality Standards. (https://www.dhcs.ca.gov/provgovpart/Documents/Substance%20Use%20Disorder- PPFD/PPSDS_Data_Quality_Standards.pdf). 1) CONTRACTOR shall report services/activities by the date of occurrence on an ongoing basis throughout each month. CONTRACTOR shall submit all data for each month no later than the 10th day of the following month. 2) In order to ensure that all persons responsible for prevention data entry have sufficient knowledge of the Prevention Data Quality Standards, all new users of the service, whether employed by the CONTRACTOR or its subcontractors, shall participate in prevention data collection and reporting training prior to inputting any data. 3) If CONTRACTOR is unable to submit PPSDS data due to system or service failure or other extraordinary circumstances of PPSD that affects its ability to submit timely PPSDS data, CONTRACTOR shall report the problem to the PPSDS Help Desk at (916) 552-8933 or PrimaryPvSUDData@dhcs.ca.gov and also notify the assigned DBH Staff Analyst via email and to SAS@fresnocountyca.gov. 4) If CONTRACTOR is unable to submit PPSDS data due to system or service failure or other extraordinary circumstance, a written notice shall be submitted to the assigned DHCS Prevention Analyst, the assigned DBH Staff Analyst via email and to SAS@fresnocountyca.gov prior to the data submission deadline and must identify the proposed new date. B. Measurement Tools – In addition to other program activities and outcomes reporting as may be required by this Agreement, CONTRACTOR shall implement program measurement tools and report program activities and outcomes as directed by the Program Evaluator and/or COUNTY staff. C. Cost Reports – On an annual basis for each fiscal year ending June 30th CONTRACTOR shall submit a complete and accurate detailed cost report(s). Cost reports must be 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 submitted to the COUNTY as a hard copy with a signed cover letter and an electronic copy by the due date. Submittal must also include any requested support documents such as general ledgers. All reports submitted by CONTRACTOR to COUNTY must be typewritten. COUNTY will issue instructions for completion and submittal of the annual cost report, including the relevant cost report template(s) and due dates within forty-five (45) days of each fiscal year end. All cost reports must be prepared in accordance with Generally Accepted Accounting Principles. Unallowable costs such as lobbying or political donations must be deducted from the cost report and all invoices. If the CONTRACTOR does not submit the cost report by the due date, including any extension period granted by the COUNTY, the COUNTY may withhold payment of pending invoices until the cost report(s) has been submitted and clears COUNTY desk audit for completeness and accuracy. During the term of this Agreement and thereafter, COUNTY and CONTRACTOR agrees to settle dollar amounts disallowed or settled in accordance with DHCS and COUNTY audit settlement findings related to the DMC and realignment reimbursements. DHCS audit process is approximately eighteen (18) to thirty-six (36) months following the close of the State fiscal year. COUNTY may choose to appeal DHCS settlement results and therefore reserves the right to defer payback settlement with CONTRACTOR until resolution of the appeal. In the event that CONTRACTOR fails to provide such reports or other information required hereunder, it shall be deemed sufficient cause for the COUNTY to withhold monthly payments until there is compliance. In addition, the CONTRACTOR shall provide written notification and explanation to the COUNTY within fifteen (15) days of any funds received from another source to conduct the same services covered by this Agreement. 30. PROPERTY OF COUNTY A. All purchases over Five Thousand and No/100 Dollars ($5,000.00) shall be identified as fixed assets and shall be maintained in COUNTY’s Asset Management System. Certain purchases under Five Thousand and No/100 Dollars ($5,000.00) including but not limited to computers, copiers, televisions, cameras and other sensitive items as determined by COUNTY’s DBH Director or designee made during the life of this Agreement shall be identified as assets that can be inventoried and maintained in COUNTY’s DBH Asset Inventory System. These assets shall be retained by COUNTY, as 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 COUNTY property, in the event this Agreement is terminated or upon expiration of this Agreement. CONTRACTOR agrees to participate in an annual inventory of all COUNTY fixed and inventoried assets and shall by physically present when fixed and inventoried assets are returned to COUNTY possession at the termination or expiration of this Agreement. CONTRACTOR is responsible for returning to COUNTY all COUNTY owned fixed and inventoried assets, or the monetary value of said assets if unable to produce the assets at the expiration or termination of this Agreement. CONTRACTOR further agrees to the following: 1) To maintain all items of equipment in good working order and condition, normal wear and tear is expected; 2) To label all items of equipment, to perform periodic inventories as required by COUNTY and to maintain an inventory list showing where and how the equipment is being used, in accordance with procedures developed by COUNTY. All such lists shall be submitted to COUNTY within ten (10) days of any request therefore; and 3) To report in writing to COUNTY immediately after discovery, the lost or theft of any items of equipment. For stolen items, the local law enforcement agency must be contacted and a copy of the police report submitted to COUNTY. B. The purchase of any equipment by CONTRACTOR with funds provided hereunder shall require the prior written approval of COUNTY’s DBH, shall fulfill the provisions of this Agreement as appropriate, and must be directly related to CONTRACTOR’s services or activity under the terms of this Agreement. COUNTY’s DBH may refuse reimbursement for any costs resulting from equipment purchased, which are incurred by CONTRACTOR, if prior written approval has not been obtained from COUNTY. C. The terms and conditions described in this Section are not applicable to the leasing of vehicles by CONTRACTOR with the funds provided under this Agreement. 31. PUBLIC PROHIBITION None of the funds, materials, property or services provided directly or indirectly under this Agreement shall be used for CONTRACTOR’s advertising, fundraising, or publicity (i.e., purchasing of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. Notwithstanding the 26 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 above, publicity of the services described in Section One (1) of this Agreement shall be allowed as necessary to raise public awareness about the availability of such specific services when approved in advance by COUNTY’s DBH Director, or his or her designee, and at a cost to be provided in Exhibit C for such items as written/printed materials, the use of media (i.e., radio, television, newspapers) and any other related expense(s). 32. ASSURANCES In entering into this Agreement, CONTRACTOR certifies that it is not currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs: that it has not been convicted of a criminal offense related to the provision of health care items or services; nor has it been reinstated to participation in the Federal Health Care Programs after a period of exclusion, suspension, debarment, or ineligibility. If COUNTY learns, subsequent to entering into a contract, that CONTRACTOR is ineligible on these grounds, COUNTY will remove CONTRACTOR from responsibility for, or involvement with, COUNTY’s business operations related to the Federal Health Care Programs and shall remove such CONTRACTOR from any position in which CONTRACTOR’s compensation, or the items or services rendered, ordered or prescribed by CONTRACTOR may be paid in whole or part, directly or indirectly, by Federal Health Care Programs or otherwise with Federal Funds at least until such time as CONTRACTOR is reinstated into participation in the Federal Health Care Programs. A. If COUNTY has notice that CONTRACTOR has been charged with a criminal offense related to any Federal Health Care Program, or is proposed for exclusion during the term of any contract, CONTRACTOR and COUNTY shall take all appropriate actions to ensure the accuracy of any claims submitted to any Federal Health Care Program. At its discretion given such circumstances, COUNTY may request that CONTRACTOR cease providing services until resolution of the charges or the proposed exclusion. B. CONTRACTOR agrees that all potential new employees of CONTRACTOR or subcontractors of CONTRACTOR who, in each case, are expected to perform professional services under this Agreement, will be queried as to whether: (1) they are now or ever have been excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) they have been convicted of a criminal offense related to the provision of health care items or services; and or 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 (3) they have been reinstated to participation in the Federal Health Care Programs after a period of exclusion, suspension, debarment, or ineligibility. 1) In the event the potential employee or subcontractor informs CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible, or has been convicted of a criminal offense relating to the provision of health care services, and CONTRACTOR hires or engages such potential employee or subcontractor, CONTRACTOR will ensure that said employee or subcontractor does no work, either directly or indirectly relating to services provided to COUNTY. 2) Notwithstanding the above, COUNTY at its discretion may terminate this Agreement in accordance with Section Two (2) of this Agreement, or require adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY. Such demand for adequate assurance shall be effective upon a timeframe to be determined by COUNTY to protect the interests of COUNTY consumers. C. CONTRACTOR shall verify (by asking the applicable employees and subcontractors) that all current employees and existing subcontractors who, in each case, are expected to perform professional services under this Agreement (1) are not currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) have not been convicted of a criminal offense related to the provision of health care items or services; and (3) have not been reinstated to participation in the Federal Health Care Program after a period of exclusion, suspension, debarment, or ineligibility. In the event any existing employee or subcontractor informs CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, or has been convicted of a criminal offense relating to the provision of health care services, CONTRACTOR will ensure that said employee or subcontractor does no work, either direct or indirect, relating to services provided to COUNTY. 1) CONTRACTOR agrees to notify COUNTY immediately during the term of this Agreement whenever CONTRACTOR learns that an employee or subcontractor who, in each case, is providing professional services under this Agreement is excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, or is convicted of a criminal offense relating 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 to the provision of health care services. 2) Notwithstanding the above, COUNTY at its discretion may terminate this Agreement in accordance with Section Three (3) of this Agreement, or require adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY. Such demand for adequate assurance shall be effective upon a timeframe to be determined by COUNTY to protect the interests of COUNTY clients. D. CONTRACTOR agrees to cooperate fully with any reasonable requests for information from COUNTY, which may be necessary to complete any internal or external audits relating to CONTRACTOR’s compliance with the provisions of this Section. E. CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty imposed upon COUNTY by the Federal Government as a result of CONTRACTOR’s violation of CONTRACTOR’s obligations as described in this Section. 33. DISCLOSURE – CRIMINAL HISTORY AND CIVIL ACTIONS CONTRACTOR is required to disclose if any of the following conditions apply to them, their owners, officers, corporate managers and partners (hereinafter collectively referred to as “CONTRACTOR”): A. Within the three (3) year period preceding the Agreement award, they have been convicted of, or had a civil judgment rendered against them for: 1) Fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; 2) Violation of a federal or state antitrust statute; 3) Embezzlement, theft, forgery, bribery, falsification, or destruction of records; or 4) False statements or receipt of stolen property. B. Within a three (3) year period preceding their Agreement award, they have had a public transaction (federal, state, or local) terminated for cause or default. 29 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Disclosure of the above information will not automatically eliminate CONTRACTOR from further business consideration. The information will be considered as part of the determination of whether to continue and/or renew the Agreement and any additional information or explanation that a CONTRACTOR elects to submit with the disclosed information will be considered. If it is later determined that the CONTRACTOR failed to disclose required information, any contract awarded to such CONTRACTOR may be immediately voided and terminated for material failure to comply with the terms and conditions of the award. CONTRACTOR must sign a “Certification Regarding Debarment, Suspension, and Other Responsibility Matters- Primary Covered Transactions” in the form set forth in Exhibit J, attached hereto and by this reference incorporated herein and made part of this Agreement. Additionally, CONTRACTOR must immediately advise the COUNTY in writing if, during the term of this Agreement: (1) CONTRACTOR becomes suspended, debarred, excluded or ineligible for participation in federal or state funded programs or from receiving Federal funds as listed in the excluded parties’ list system (http://www.epls.gov); or (2) any of the above listed conditions become applicable to CONTRACTOR. CONTRACTOR shall indemnify, defend and hold the COUNTY harmless for any loss or damage resulting from a conviction, debarment, exclusion, ineligibility or other matter listed in the signed Certification Regarding Debarment, Suspension, and Other Responsibility Matters. 34. AUDITS AND INSPECTIONS CONTRACTOR shall at any time during business hours, and as often as COUNTY may deem necessary, make available to COUNTY for examination all of its records and data with respect to the matters covered by this Agreement. CONTRACTOR shall, upon request by COUNTY, permit COUNTY to audit and inspect all such records and data necessary to ensure CONTRACTOR's compliance with the terms of this Agreement. If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00), CONTRACTOR shall be subject to the examination and audit of the State of California Auditor General for a period of three (3) years after final payment under contract (California Government Code section 8546.7). Notwithstanding the provisions stated in Section Three (3), TERMINATION of this 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Agreement, it is acknowledged by the parties hereto that this Agreement shall continue in full force and effect until all audit procedures and requirements as stated in this Agreement have been completed to the review and satisfaction of COUNTY. CONTRACTOR shall bear all costs in connection with or resulting from any audit and/or inspections including, but not limited to, actual costs incurred and the payment of any expenditures disallowed by either COUNTY, State, or Federal governmental entities, including any assessed interest and penalties. 35. NOTICES The persons having authority to give and receive notices under this Agreement and their addresses include the following: COUNTY CONTRACTOR Director, County of Fresno Chief Executive Officer Department of Behavioral Health Youth Leadership Institute 1925 E. Dakota Ave 209 9th Street, Suite 200 Fresno, CA 93726 San Francisco, CA 94103 All notices between the COUNTY and CONTRACTOR provided for or permitted under this Agreement must be in writing and delivered either by personal service, by first-class United States mail, by an overnight commercial courier service, or by telephonic facsimile transmission. A notice delivered by personal service is effective upon service to the recipient. A notice delivered by first-class United States mail is effective three (3) COUNTY business days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice delivered by an overnight commercial courier service is effective one (1) COUNTY business day after deposit with the overnight commercial courier service, delivery fees prepaid, with delivery instructions given for next day delivery, addressed to the recipient. A notice delivered by telephonic facsimile is effective when transmission to the recipient is completed (but, if such transmission is completed outside of COUNTY business hours, then such delivery shall be deemed to be effective at the next beginning of a COUNTY business day), provided that the sender maintains a machine record of the completed transmission. For all claims arising out of or related to this Agreement, nothing in this Section establishes, waives, or modifies any claims presentation requirements or procedures provided by law, including but not limited to the Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with Section 810). 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 36. CHANGE OF LEADERSHIP / MANAGEMENT Any and all notices between COUNTY and CONTRACTOR provided for or permitted under this Agreement or by law, shall be in writing and shall be deemed duly served when personally delivered to one of the parties, or in lieu of such personal service, when deposited in the United States Mail, postage prepaid, addressed to such party. In the event of any change in the status of CONTRACTORS’ leadership or management, CONTRACTOR shall provide written notice to COUNTY within thirty (30) days from the date of change. Such notification shall include any new leader or manager’s name, address and qualifications. “Leadership or management” shall include any employee, member, or owner of CONTRACTOR who either a) directs individuals providing services pursuant to this Agreement, b) exercises control over the manner in which services are provided, or c) has authority over CONTRACTORS’ finances. 37. RESTRICTION ON DISTRIBUTION OF STERILE NEEDLES CONTRACTOR shall adhere to the requirement that no funds shall be used to carry out any program of distributing sterile needles or syringes for the hypodermic injection of any illegal drug unless the DHCS chooses to implement a demonstration syringe services program for intravenous drug users. 38. CONFIDENTIALITY OATH CONTRACTOR shall ensure that all of its employees sign a written confidentiality oath, attached hereto as Exhibit K, before the begin employment with CONTRACTOR and shall renew said documents annually thereafter. CONTRACTOR shall retain each employee’s written confidentiality oath for COUNTH and DHCS inspection for a period of six (6) years following the termination of this agreement. 39. FRIDAY NIGHT LIVE Contractors and subcontractors receiving SABG Friday Night Live (FNL) funding must: A. Engage in programming that meets the FNL Youth Development Standards of Practice, Operating Principles and Core Components outlined at http://fridaynightlive.org/aboutus/cfnlpoverview/. B. Use the prevention data collection and reporting service for all FNL reporting 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 including profiles and chapter activity. C. Follow the FNL Data Entry Instructions for the Primary Prevention Substance Use Disorder Data Service (PPSDS) and reporting service as provided by DHCS. D. Meet the Member in Good Standing (MIGS) requirements, as determined by DHCS in conjunction with the California Friday Night Live Collaborative and the California Friday Night Live Partnership. Contractors that do not meet the MIGS requirements shall obtain technical assistance and training services from the California Friday Night Live Partnership and develop a technical assistance plan detailing how the Contractor intends to ensure satisfaction of the MIGS requirements for the next review. 40. GOVERNING LAW Venue for any action arising out of or related to the Agreement shall only be in Fresno County, California. The rights and obligations of the parties and all interpretation and performance of this Agreement shall be governed in all respects by the laws of the State of California. 41. SEVERABILITY If any non-material term, provision, covenant, or condition of this Agreement is held by a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the provisions shall remain in full force and effect, and shall in no way be affected, impaired or invalidated. 42. ELECTRONIC SIGNATURE The parties agree that this Agreement may be executed by electronic signature as provided in this section. An “electronic signature” means any symbol or process intended by an individual signing this Agreement to represent their signature, including but not limited to (1) a digital signature; (2) a faxed version of an original handwritten signature; or (3) an electronically scanned and transmitted (for example by PDF document) of a handwritten signature. Each electronic signature affixed or attached to this Agreement (1) is deemed equivalent to a valid original handwritten signature of the person signing this Agreement for all purposes, including but not limited to evidentiary proof in any administrative or judicial proceeding, and (2) has the same force and effect as the valid original handwritten signature of that person. The provisions of this section satisfy the requirements of Civil Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 2, Title 2.5, beginning with 33 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 section 1633.1). Each party using a digital signature represents that it has undertaken and satisfied the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) through (5), and agrees that each other party may rely upon that representation. This Agreement is not conditioned upon the parties conducting the transactions under it by electronic means and either party may sign this Agreement with an original handwritten signature. 43. ENTIRE AGREEMENT This Agreement, including all Exhibits, RFP No. 21-021, Addendum I, and CONTRACTOR’s responses thereto, constitute the entire Agreement between the CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous negotiations, proposals, commitments, writings, advertisements, publications, and understandings of any nature whatsoever unless expressly included in this Agreement. /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// 1 IN WITNESS WHEREOF , the parties hereto have executed this Agreement as of the day and year 2 first hereinabove written . 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 (Authorized Signature) Patricia Barahona Print Name & Title CEO Youth Leadership Institute 209 9th Street, Suite 200 , SF, CA 94103 Mailing Address Steve Brandau, Chairman of the Board of Supervisors of the County of Fresno ATTEST: Bernice E. Seidel Clerk of the Board of Supervisors County of Fresno, State of California -~-~-· _S_. _S.___,~.___n,, ___ By: _ __..Cl\~~=--· __,.,"6~=L._(). __ _ <$uthorized Signature) Deputb Joninna Simpson Print Name Chief Financial Officer Title: Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer FOR ACCOUNTING USE ONLY : Fund : Subclass : ORG : Account: 0001 10000 56302081 7295/0 34 Exhibit A-1 Page 1 of 62 SUMMARY OF SERVICES ORGANIZATION: Youth Leadership Institute AREA OF FOCUS: Alcohol Prevention PROGRAM NAME: Reducing Alcohol Access to Youth (RAAY) CONTACT(S): Patricia Barahona, Chief Executive Officer Cynthia Rocha, Central Valley Director of Programs A. SUMMARY OF SERVICE To meet the goal of decreasing youth access to alcohol—ultimately reducing the instance on underage drinking in Fresno County—Youth Leadership Institute (YLI) will partner with youth to achieve the following two identified objectives using proven processes: 1) Decrease the percentage of youth who report alcohol is easy to access by 2% and 2) Increase the percentage of youth who disapprove of underage drinking by 3%. Our intent is to reach both these objectives by 2026, as measured by the Fresno County Student Insight Survey. The Reducing Alcohol Access to Youth (RAAY) project will utilize various Center for Substance Abuse Prevention (CSAP) strategies to decrease underage alcohol access and increase perceptions of harm and disapproval. The CSAP strategies utilized in the RAAY Project include: ● Information Dissemination Strategies – Community and School Outreach Events, Multi-media Development & Dissemination, Printed Material Development & Dissemination, Social Media Development & Maintenance, and Presentations ● Educational Strategies – Classroom and School Educational Services, Community Educational Services, and Peer Leader Programs ● Alternative Strategies – Community Service Activities, Social/Recreational Event & Activities, Youth and Adult Leadership Activities ● Community-Based Processes – Assessing Community Needs, Coalition/Workgroup Activities, Intra/Inter-Agency Coordination/Collaboration, Training and Technical assistance, and Evaluation Services. YLI will be integrating the RAAY Project into the already established Friday Night Live (FNL), Club Live, and Friday Night Live Kids cohorts (Chapters) across the county, which includes eight high schools, two middle schools and one elementary school. Utilizing a youth development framework, YLI will build the leadership capacity and partner with 11 Friday Night Live sites, as well as the FNL countywide youth council known as the Youth Advocacy Leadership League (YALL), to lead underage drinking prevention Exhibit A-1 Page 2 of 62 campaigns/initiatives utilizing the CSAP strategies identified above. YLI Staff and youth together, will coordinate efforts to support the education of peers, parents and caregivers and identify the specific CSAP strategy or strategies to address alcohol accessibility, perceptions of harm and disapproval that are relevant to their own schools, neighborhoods and communities. To address the issue of adults as social sources of alcohol for youth, YLI staff and youth will be using the survey findings to develop educational presentations on youth access to alcohol for parents, caregivers, and community stakeholders. Youth participants will also develop outreach materials and identify communication channels to conduct additional parent and caregiver outreach. Youth-Adult Partnership and capacity building training opportunities will also be offered to parent groups and adult allies who indicate interest in partnering in the implementation of the RAAY Project. To monitor impact and refine the project process to reflect lessons learned, an Adult Ally Advisory Council of project stakeholders, experts, and youth will be established to oversee and support the implementation of each RAAY Project. Similarly, the Youth Development Coalition will share youth development best practices on meaningfully engaging youth and adult allies in the community to support the continual participation and retention of youth involved in the project over the course of the RAAY project year. B. TARGET POPULATION Youth and Young Adults Ages 10 - 20 C. LOCATION OF SERVICES Alcohol Prevention Services will be delivered in the general community and at various schools. Locations include but are not limited to: School/Location City Edison High School Fresno Gaston Middle School Fresno Kerman High School Kerman Kerman Middle School Kerman Orange Cove High School Orange Cove Reedley Middle College High School Reedley Roosevelt High School Fresno San Joaquin Elementary (7th-8th grade) San Joaquin Selma High School Selma Sunnyside High School Fresno Tranquility High School Tranquility Fresno City College Fresno Fresno State University Fresno Fresno Pacific University Fresno Exhibit A-1 Page 3 of 62 D. EVIDENCE BASED TOOLS / LOCAL INNOVATIVE PRACTICE ● SPORT (Alcohol/Drug) Prevention Plus Wellness Program/Curriculum (SPORT PPW) ● InShape (Alcohol/Drug) Prevention Plus Wellness Program/Curriculum (InShape PPW) ● Friday Night Live Curriculum, Roadmap, Tool Kits ● Communities Mobilizing for Change on Alcohol (CMCA) E. ACTIVITIES GOALS / PERFORMANCE OUTCOME MEASURES / REPORTS (See Implementation Tables Below) Exhibit A-1 Page 4 of 62 Coalition/Advisory Council (UNDERAGE DRINKING) Goal(s): Decrease youth access to alcohol. Objective(s): By 2026, the percentage of youth who believe alcohol is easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who believe alcohol is easy to access will decrease by 1% as measured by the Fresno County Student Insight survey. IOM Category(ies): Universal Population(s): Youth, Adults, Other Professionals Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Form an advisory council to support the development and implementation of countywide alcohol prevention services. ● Invite and recruit via email selected representatives from Fresno County DPH, school site administration, alcohol and drug prevention professionals, community youth organizations, scholars from local universities, parents, and youth to serve as advisory members ● During the first quarterly meeting facilitate the advisory council’s overview of the RAAY Project and ensure the group is aware of goals and outcomes. ● Successfully retain an advisory council of at least 15 adult stakeholders and partners, by maintaining email communications and providing updates on project implementation through YLI social media and website Jul 2021 - June 2022 Jul 2021 - June 2022 Annually Prevention Provider CBP - Coalition/ Workgroup Activities Sign-in Sheets Agendas/Meeting Notes PPSDS Reporting Exhibit A-1 Page 5 of 62 Convene advisory council quarterly to discuss implementation of prevention campaigns. ● Calendar Quarterly meetings and send email reminders and agendas to meetings in advance to advisory members ● Include implementation progress, campaign development and challenges as standing agenda items Quarterly Quarterly Prevention Provider CBP - Coalition/ Workgroup Activities Agendas/Meeting Notes PPSDS Reporting Provide training to advisory council members on Youth Adult Partnerships. ● At the second quarter meeting, schedule a Youth and Adult Partnership Training as part of Communities Mobilizing for Change on Alcohol (CMCA), a Substance Abuse and Mental Health Services Administration (SAMHSA) designated evidence-based program model to be facilitated by YLI staff ● YLI staff to conduct the training in Quarter two or Quarter three Quarterly Quarterly Prevention Provider CBP - Training and Technical Assistance Agendas/Meeting Notes Training Materials Agendas/Meeting Notes PPSDS Reporting Form a coalition to share youth development best practices and engage youth in community, school-based wellness, and county prevention efforts. ● Invite and recruit via email selected representatives from community youth organizations. The Youth Development Coalition will be made up of various local youth-serving organizations; including but not exclusive to: non-profits, grassroots organizations, faith-based organizations, and youth-serving programs ● During the first two quarterly meetings staff will provide an overview of the Prevention & Early Intervention work to ensure the group is aware of goals and outcomes. ● Successfully retain at least 15 representatives of partnering youth organizations annually. Some potential partners may include: The kNOw Youth Media, Fresno City College, California Jul 2021 - June 2022 Oct 2021 - June 2022 Annually Prevention Provider CBP - Coalition/Wo rkgroup Activities Sign-in sheets Agendas/Meeting Notes PPSDS Reporting Exhibit A-1 Page 6 of 62 Youth Connection, The Children’s Movement, Fresno Boys and Men of Color, Bitwise Industries, Boys and Girls Club, Economic Opportunities Commission, GenUp and City of Fresno Youth Commission, Mobilizing Youth to Nix Tobacco, and Barrios Unidos Convene coalition quarterly to discuss implementation of prevention campaigns. ● YLI staff will share prevention campaigns with the coalition and share ways that the coalition may support campaign efforts ● Staff will facilitate discussions and decision making of the coalition’s purpose/vision and goals Quarterly Quarterly Prevention Provider CBP - Coalition/ Workgroup Activities Agendas/Meeting Notes PPSDS Reporting Provide training to Youth Development Coalition members on Youth Adult Partnerships. ● At the second quarter meeting, schedule a Youth and Adult Partnership Training as part of Communities Mobilizing for Change on Alcohol (CMCA), a Substance Abuse and Mental Health Services Administration (SAMHSA) designated evidence-based program model to be facilitated by YLI staff ● YLI staff to conduct the training in Quarter three or Quarter four Quarterly Quarterly Prevention Provider CBP - Training and Technical Assistance Training Materials Agendas/Meeting Notes PPSDS Reporting Administer annual Advisory Council/Coalition Surveys. ● At the fourth quarter meeting administer the Adult Ally retrospective survey to measure relationship building, involvement and knowledge built, Youth and Adult partnerships, and AOD Environmental Prevention Annually (May/June) Prevention Provider, Evaluator CBP - Evaluation Services & Outcomes Adult Ally Retrospective Survey results Exhibit A-1 Page 7 of 62 School-Based Youth Education Programs (UNDERAGE DRINKING) Goal(s): Decrease youth access to alcohol. Objective(s): By 2026, the percentage of youth who believe alcohol is easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who believe alcohol is easy to access will decrease by 1% as measured by the Fresno County Student Insight survey. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Outreach to and establish buy-in (written MOU) from schools that agree to host youth leadership and education programs. ● Develop a Memo of Understanding (MOU) template that outlines what YLI will provide, and what each site will provide to establish the RAAY youth leadership programs and SPORT Prevention Plus Wellness education programs ● Formalize a Memo of Understanding (MOU) with each school site to ensure that Administrators and Advisors understand their commitments clearly at the following sites: ● Edison High School ● Gaston Middle School ● Kerman High School ● Kerman Middle School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● San Joaquin Elementary (K-8) ● Selma High School ● Sunnyside High School ● Tranquility High School Jul 2021 - June 2022 Jul 2021 - June 2022 Prevention Provider CBP - Intra/Inter- Agency Coordination/ Collaboration Signed written agreement/ Memorandum of Understandings with schools Exhibit A-1 Page 8 of 62 Develop marketing materials that appeal to potential student participants and distribute throughout Fresno County schools. ● Develop compelling marketing materials that appeal to potential student participants to join the RAAY youth leadership program ● Develop compelling marketing materials that appeal to potential student participants to join the SPORT Prevention Plus Wellness (SPORT PPW) Education Program ● Receive feedback from advisory council, school administration and advisors ● YLI Staff will distribute materials widely throughout Fresno County in partnership with the school administration, teachers, Health Center staff, community-based organization, and other partnering adult allies Jul 2021 - June 2022 Jul 2021 - June 2022 Jul 2021 - June 2022 Ongoing Prevention Provider CBP Intra/inter Agency Coordination and Collaboration & ID - Printed Materials PPSDS Reporting Final Drafts of Marketing Materials Developed Partner with local youth organizations and school staff to identify and recruit a diverse group of youth participants. ● YLI Staff will reach out to partners and community event organizers to secure participation in tabling opportunities such as school club rush events, health fairs and community events Ongoing Prevention Provider CBP Intra/inter Agency Coordination and Collaboration & ID - Community/ School Outreach Events PPSDS Reporting Recruit 300 youth from schools with high rates of alcohol use to participate in education programs that include curriculum about positive coping and decision-making skills. ● YLI staff will outreach at the following schools to recruit cohorts of 10-15 youth (110 youth annually) to participate in the RAAY youth leadership programs: ● Edison High School ● Gaston Middle School Annually Prevention Provider CBP Intra/inter Agency Coordination and Collaboration Sign-in sheets PPSDS Reporting Exhibit A-1 Page 9 of 62 ● Kerman High School ● Kerman Middle School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● San Joaquin Elementary (K-8) ● Selma High School ● Sunnyside High School ● Tranquility High School ● YLI Staff will outreach at the following schools to recruit 200 youth to participate in the evidence-based SPORT Prevention Plus Wellness (SPORT PPW) Education Program ● Edison High School ● Gaston Middle School ● Kerman High School ● Kerman Middle School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● San Joaquin Elementary (K-8) ● Selma High School ● Sunnyside High School ● Tranquility High School Annually Implement training curriculum to prepare youth for authentic participation in prevention campaigns. ● YLI Staff will train the RAAY youth leadership program participants at each site on the Friday Night Live (FNL) Roadmap curriculum (the FNL Roadmap is based on the evidence-based Youth Development Standards of Practice), the evidence- based Community Mobilizing for Change on Alcohol (CMCA), facilitation, public speaking, and presentation skill development. Additionally, this cohort will receive training on the evidence-based Annually Prevention Provider ED- Classroom School Education Services Sign-in Sheets Youth Development Survey PPSDS reporting SPORT PPW Program pretest and post test Exhibit A-1 Page 10 of 62 SPORT Prevention Plus Wellness (SPORT PPW) Curriculum and the Youth SPORT PPW Peer Facilitator Curriculum. ● YLI Staff will train the RAAY youth leadership program cohorts on additional skills and tools needed to prepare youth for authentic participation in this project. ● The youth leadership program cohorts from each site will facilitate a training for their peers on the SPORT Prevention Plus Wellness (SPORT PPW) Curriculum Annually Annually Administer the FCSIS with youth at target schools (or use CHKS data). ● YLI Staff will connect and receive approval from school administrators to conduct the FCSIS at the following sites: ● Edison High School ● Gaston Middle School ● Kerman High School ● Kerman Middle School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● San Joaquin Elementary (K-8) ● Selma High School ● Sunnyside High School ● Tranquility High School Annually Prevention Provider, Evaluator CBP- Assessing Community Needs/Assets FCSIS Survey Outcomes Administer Youth Participant Survey. ● YLI Staff will administer and collect the YD (Youth Development) Survey to RAAY youth leadership program participants at the following sites: ● Edison High School ● Gaston Middle School ● Kerman High School ● Kerman Middle School Annually Prevention Provider, Evaluator CBP- Assessing Community Needs/Assets YD Survey Outcomes SPORT PPW Pre & Post Test Outcomes Exhibit A-1 Page 11 of 62 ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● San Joaquin Elementary (K-8) ● Selma High School ● Sunnyside High School ● Tranquility High School ● YLI Staff will administer the SPORT PPW Pre and Post Test to Program Participants at the following sites: ● Edison High School ● Gaston Middle School ● Kerman High School ● Kerman Middle School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● San Joaquin Elementary (K-8) ● Selma High School ● Sunnyside High School ● Tranquility High school Annually Exhibit A-1 Page 12 of 62 Prosocial Youth Activities (UNDERAGE DRINKING) Goal(s): Decrease youth access to alcohol. Objective(s): By 2026, the percentage of youth who believe alcohol is easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who believe alcohol is easy to access will decrease by 1% as measured by the Fresno County Student Insight survey. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Identify and formalize partnerships to provide workshops and educational training at countywide youth events. ● YLI Staff will reach out to partners and community event organizers to schedule opportunities to provide workshops and educational training on partnering with youth to prevent underage drinking ● YLI Staff will reach out to partners, community-based organizations, and experts in their field to provide workshops and educational trainings at YLI hosted events like Teen Summit, Fall Fest, Winter Celebration and Spring Jam Annually Annually Prevention Provider CBP - Intra/Inter- Agency Coordination/ Collaboration Sign-in sheets PPSDS Reporting Event Agenda’s Exhibit A-1 Page 13 of 62 Develop and distribute marketing materials that appeal to potential student participants throughout Fresno County schools. ● Develop compelling marketing materials and social media messages that appeal to college-aged youth leaders to join YLI’s intern program, charged with co-hosting and facilitating YLI hosted events like Teen Summit, Fall Fest, Winter Celebration and Spring Jam ● Staff will develop a Job Description and Application Process for the internship ● Develop compelling marketing materials and social media messages that appeal to potential student/youth to participate in YLI hosted events like Teen Summit, Fall Fest, Winter Celebration and Spring Jam ● Receive feedback from advisory council, school administration and advisors ● YLI Staff will distribute materials widely throughout Fresno County in partnership with the school administration, teachers, Health Center staff, colleges, community- based organization, and other partnering adult allies ● YLI Staff will share developed messages on multiple social media platforms Annually Annually Annually Annually Annually Annually Prevention Provider CBP - Intra/Inter- Agency Coordination/ Collaboration & ID - Printed Materials PPSDS Reporting Final Drafts of Marketing Materials Developed Social Media Post Analytics Recruit at least 200 youth to participate in countywide youth events for leadership, empowerment building, and prosocial activities. ● YLI Staff will partner with Fresno City College, Clovis Community College, Reedley College, West Hills College, Fresno State, and Fresno Pacific to receive designation as a qualifying internship organization Annually Prevention Provider CBP - Intra/Inter- Agency Coordination/ Collaboration & ALT - Social / Recreational Events/ Activities Sign-in sheets PPSDS Reporting Event Agenda’s Exhibit A-1 Page 14 of 62 ● YLI Staff will reach out to Fresno City College, Clovis Community College, Reedley College, West Hills College, Fresno State, Fresno Pacific to secure participation in tabling opportunities at college events to recruit interns ● YLI Staff will reach out to College Professors in their networks to secure opportunities for class recruitment presentations ● YLI Staff will recruit 12 interns/college- aged youth leaders ages 18-20 (3-4 annually) to support the planning and coordination of YLI prosocial youth leadership empowerment events. ● YLI staff will develop and lead an internship orientation and onboarding training for interns to complete on the first day ● YLI Staff will recruit 16 youth leaders from the 11 RAAY youth leadership Program sites and other YLI Programs to serve on a countywide youth council known as the Youth Advocacy Leadership League (YALL) charged with supporting the planning and coordination of YLI prosocial youth leadership empowerment events, co-hosting and facilitating workshops, and educating their peers about alcohol prevention ● YLI staff will develop and lead an YALL orientation and onboarding training for YALL leaders to complete at the first meeting Annually Annually Annually Annually Annually Annually Exhibit A-1 Page 15 of 62 ● YALL and interns will plan and coordinate and implement Prosocial youth leadership empowerment events like the Teen Summit, Fall Fest, Winter Celebration and Spring Jam ● YLI Staff will reach out to partners and community event organizers to schedule outreach opportunities for tabling at school club rush events, health fairs and community events for the purpose of recruiting 200 youth to participate at YLI hosted educational and prosocial leadership events like Teen Summit, Fall Fest, Winter Celebration and Spring Jam ● YLI Staff will use Eventbrite platform and/or Google Forms to track and confirm registration and attendance at events Annually Annually Annually (3 per year) Train youth to co-facilitate educational workshops at the events. ● During the Summer or Fall, YLI staff will coordinate a three-day train-the-trainer retreat/academy to ensure YALL and interns have a clear understanding of the FNL Roadmap and are able to facilitate the trainings and workshops. The trainings include: youth and adult partnerships, facilitation, learning about the issue - alcohol prevention, public speaking, media literacy and community engagement ● YALL participants will be trained by YLI staff on the SPORT PPW curriculum ● Interns will be trained on the InShape Prevention Plus Wellness (InShape PPW) curriculum Annually Annually Annually Prevention Provider Education - Community Education Services & ALT - Youth and Adult Leadership Activities Sign-in sheets PPSDS Reporting Event Agenda’s Training Materials Exhibit A-1 Page 16 of 62 ● Convene twice a month with YLI staff to plan, coordinate and implement youth events for leadership, empowerment building, and prosocial activities ● YALL leader and interns will work with staff to develop facilitator agendas and prepare training materials for peer educational workshops ● YALL and Interns will co-facilitate workshops with YLI Staff at YLI prosocial leadership empowerment events like, Fall Fest, Winter Celebration, Spring Jam, and the Teen Summit Twice monthly Annually Annually (3 per year) Engage youth to produce and disseminate a product that highlights storytelling and SUD prevention through the lens of impacted youth. ● YLI staff will train and build capacity of YALL participants and Interns on storytelling and utilizing it for advocacy ● YLI staff, YALL and interns will create and develop a Youth Fresno County ATOD Prevention Mini Magazine referred to a ZINE ● YLII staff will distribute the ZINE at Schools and Community outreach events and online as a downloadable PDF Annually Annually (1 per year) Annually Prevention Provider ID - Printed Materials Sign-in sheets Final Draft of Zine Administer Youth Participant Survey. ● YLI Staff will administer and collect the YD (Youth Development) Survey to YALL participants ● YLI staff will administer the intern exit survey for college interns ● YLI Staff will administer and collect Youth Participant Surveys at the conclusion of every prosocial leadership empowerment event Annually Annually Annually Prevention Provider CBP - Evaluation Services Event Survey Results Exhibit A-1 Page 17 of 62 Parent and Community Education (UNDERAGE DRINKING) Goal(s): Decrease youth access to alcohol. Objective(s): By 2026, the percentage of youth who believe alcohol is easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who believe alcohol is easy to access will decrease by 1% as measured by the Fresno County Student Insight survey. IOM Category(ies): Universal Population(s): Parents, Other Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop and update educational materials to inform parents about underage drinking issues and their responsibility as parents/adults. ● YLI staff will provide a Canva and data analysis training for RAAY youth leaders. ● Using the FCSIS data YLI staff and RAAY youth leaders will develop educational materials and media to present to parents, caregivers, community members, and stakeholders. The purpose of materials is to increase awareness and dialogue regarding underage drinking, youth access to alcohol, and the risk and consequences associated with underage alcohol use. ● Receive feedback from advisory council and advisors Annually Prevention Provider CBP - Intra/Inter- Agency Coordination/ Collaboration & ID - MultiMedia Sign-In Sheets PPSDS Reporting Identify and attend parent group meetings to distribute educational materials. ● YLI staff will reach out to community organizations and/or parent groups to offer educational presentations to parents, caregivers and adults as well as distribute created educational materials Ongoing Prevention Provider ID - Presentations & CBP - Intra/Inter Agency Collaboration PPSDS Reporting Sign-In Sheets Exhibit A-1 Page 18 of 62 Implement 48 educational presentations and/or town halls for parents about positive parental involvement, the harms/risks of underage drinking and legal consequences of providing alcohol to minors. ● YLI Staff, YALL and RAAY youth leaders will plan and implement community Town Halls using the SAMHSA Town Hall toolkit to inform and educate on the consequences of providing alcohol to minors. ● YLI Staff, YALL and RAAY youth leaders will co-facilitate educational workshops for parents, caregivers, and stakeholders on youth access to alcohol. Parent messages and marketing materials will be created and disseminated using at least one channel of communication. The Not On My Watch developed by the Friday Night Live (FNL) Partnership will be used to engage and reinforce parental responsibility and control of youth access to alcohol Annually (16 per year) Prevention Provider ED - Community Education Services PPSDS Reporting Sign-In Sheets Presentation Materials Developed Exhibit A-1 Page 19 of 62 Countywide Media Campaign (UNDERAGE DRINKING) Goal(s): Decrease youth access to alcohol. Objective(s): By 2026, the percentage of youth who believe alcohol is easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who believe alcohol is easy to access will decrease by 1% as measured by the Fresno County Student Insight survey. IOM Category(ies): Universal Population(s): Youth, Young Adults, Parents, Other Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop 4 countywide youth-led media campaigns to educate youth and adults on consequences of providing alcohol to youth and underage drinking. ● YLI staff will provide a Public Service Announcement (PSA) development training for YALL leaders. This will include Radio PSA, Billboard PSA, and other media PSA development. ● Using the FCSIS data YALL staff and YALL will develop a youth-led media PSA campaign to educate youth and adults on consequences of providing alcohol to youth and underage drinking based on data generated by the Fresno County Student Insights Survey. ● Receive feedback from Advisory Council and Youth Development Coalition Annually (1 per year) Prevention Provider CBP - Intra/Inter Agency Collaboration & ID - MultiMedia PPSDS Reporting Final Drafts of Marketing Materials Developed Radio and Billboard PSA Analytics Exhibit A-1 Page 20 of 62 Implement countywide youth-led media campaigns that will provide education on healthy behaviors, positive parental involvement, and educate decision makers on the harm/risks of underage drinking. ● YLI staff and YALL will partner with media groups (iHeart Media, Pandora, Spotify) to secure radio ad placement for the Radio PSA’s developed ● YLI Staff and YALL will partner with Outfront Media to secure billboard placement of created PSA messaging Annually (1 per year) Prevention Provider ID - MultiMedia PPSDS Reporting Final Drafts of Marketing Materials Developed Radio and Billboard PSA Analytics Develop educational materials and media to present to parents, community members, and stakeholders. ● YLI staff will provide a Canva, and media development training for YALL leaders. ● Using the FCSIS data YALL staff and YALL will develop educational materials, social media messages, and media to present to parents, community members, and stakeholders on the issue of underage drinking based on data generated by the Fresno County Student Insights Survey. ● Receive feedback from Advisory Council and Youth Development Coalition Annually Prevention Provider CBP - Intra/Inter Agency Collaboration & ID - MultiMedia/ Printed Materials PPSDS Reporting Identify and attend community events and resources fairs to distribute educational materials and messages. ● YLI Staff will reach out to partners and community event organizers to secure participation in 10 tabling opportunities such as school events, resources fairs, health fairs and community events ● YLI staff will target parents and caregivers of students who attend each of the 11 school sites. Up to 40,000 households will be targeted by the youth-led media campaign. Annually Prevention Provider ID - Community/Sch ool Outreach Events PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-1 Page 21 of 62 Youth-Led Social Norms Campaign (UNDERAGE DRINKING) Goal(s): Decrease youth access to alcohol. Objective(s): By 2026, the percentage of youth who disapprove of underage drinking will have increased by 3% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who disapprove of underage drinking will have increased by 2% as measured by the Fresno County Student Insight Survey. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop youth-led social norms campaigns to educate youth and adults on consequences of providing alcohol to youth and underage drinking. ● YLI staff will train RAAY youth leadership participants on conducting and analyzing data research through the Youth- Led Action Research training, and share results of the FCSIS ● Utilizing data, RAAY youth leadership participants, in partnership with YLI staff, will generate positive social norms youth messages and deliver these messages using various communication channels ● Receive feedback from advisory council, school administration, advisors, and youth Annually (1 per year) Prevention Provider CBP - Intra/Inter Agency Collaboration & ID - MultiMedia/ Printed Materials YD Survey PPSDS Reporting Final Drafts of Marketing Materials Developed Radio and Billboard PSA Analytics Implement youth-led social norms campaigns to reach peers about the actual vs perceptions about alcohol use among youth. ● YLI staff and RAAY youth leaders will generate messages about actual alcohol- use norms versus perceptions and disseminated to youth using at least one communication channel Annually (1 per year) Prevention Provider ID - Printed Materials YD Survey PPSDS Reporting Final Drafts of Marketing Exhibit A-1 Page 22 of 62 ● YLI staff will partner with other youth serving organizations and/or community youth hubs to secure permission to distribute printed social norms materials at their sites of services ● YLI staff will also share social norms messaging virtually via YLI social media platforms Materials Developed Radio and Billboard PSA Analytics Train youth on conducting and analyzing data, as well as toolkits to develop a Positive Social Norms Campaign. ● YLI staff will train RAAY youth leadership participants on evidence-based toolkits from the FNL Roadmap that will aid youth in building the skills necessary to develop a Positive Social Norms Campaigns will focus on increasing the disapproval of underage drinking among youth Annually Prevention Provider ED- Classroom/ School Education Services PPSDS Reporting Presentation Materials Developed Sign-In Sheets Use data to generate youth messaging and deliver messages using school-based communication channels. ● YLI staff will partner with school administration to secure permission to distribute printed social norms materials at the 11 school sites ● YLI staff will also request permission from school administrators to share and tag (#) social norms messaging on the school social media pages Annually Prevention Provider CBP -CBP - Intra/Inter Agency Collaboration & ID - Social Media Development and Maintenance PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-1 Page 23 of 62 SCOPE OF WORK ORGANIZATION: Youth Leadership Institute AREA OF FOCUS: Marijuana Prevention PROGRAM NAME: Reducing Marijuana Access to Youth (RMAY) CONTACT(S): Patricia Barahona, Chief Executive Officer Cynthia Rocha, Central Valley Director of Programs A. SUMMARY OF SERVICE To meet the goal of decreasing youth marijuana use, Youth Leadership Institute (YLI) will partner with youth to achieve the following five identified objectives using proven processes: 1) Decrease the percentage of youth who report marijuana is easy to access by 2%. 2) Increase the percentage of youth who believe marijuana is harmful by 2%. 3) Increase the percentage of youth who believe people close to them disapprove of using marijuana by 2%. 4) Increase the percentage of youth who participate in alternative marijuana prevention activities by 10%. 5) Ensure 80% of youth report that mentoring has helped them feel good about themselves and has increased their social competence. Our intent is to reach these objectives by 2026, as measured by the Fresno County Student Insight Survey and the California Healthy Kids Survey. The Reducing Marijuana Access to Youth (RMAY) project will utilize various Center for Substance Abuse Prevention (CSAP) strategies to decrease marijuana access and increase perceptions of harm and disapproval. The CSAP strategies utilized in the RMAY Project include: ● Information Dissemination Strategies – Community and School Outreach Events, Curriculum Development, Multi-media Development & Dissemination, Printed Material Development & Dissemination, Social Media Development & Maintenance, and Presentations ● Educational Strategies – Classroom and School Educational Services, Community Educational Services, and Mentoring ● Alternative Strategies – Community Service Activities, Social/Recreational Event & Activities, Youth and Adult Leadership Activities ● Community-Based Processes – Assessing Community Needs, Coalition/Workgroup Activities, Evaluation Services, Training and Technical assistance, Program Development & Improvement, and Intra/Inter-Agency Coordination/Collaboration. Exhibit A-1 Page 24 of 62 YLI will be integrating the RMAY Project into the already established and newly established Friday Night Live (FNL), Club Live, and Friday Night Live Kids cohorts (Chapters) across the county, which includes seven high schools and four middle schools. Utilizing a youth development framework, YLI will build the leadership capacity and partner with all eleven Friday Night Live sites, to lead marijuana prevention campaigns utilizing the CSAP strategies identified above. YLI Staff and youth together, will coordinate efforts to support the education of peers, parents and caregivers and identify the specific CSAP strategy or strategies to address marijuana accessibility, perceptions of harm and disapproval that are relevant to their own schools, neighborhoods, and communities. YLI staff and youth will be using the Fresno County Student Insight Survey findings to develop educational presentations on youth access, knowledge, and beliefs around harm of marijuana for parents, caregivers, and community stakeholders. Youth participants will also develop outreach materials and identify communication channels to conduct additional parent and caregiver outreach. Youth-Adult Partnership and capacity building training opportunities will also be offered to parent groups and adult allies who indicate interest in partnering in the implementation of the RMAY Project. To monitor impact and refine the project process to reflect lessons learned, an Adult Ally Advisory Council of project stakeholders, experts, and youth will be established to oversee and support the implementation of each RMAY Campaign. Annually YLI will also invest in staff development to build capacity on youth development best practices on meaningfully engaging youth and adult allies in the community to support the continual participation. B. TARGET POPULATION Youth and Young Adults Ages 10 - 20 C. LOCATION OF SERVICES Marijuana Prevention Services will be delivered in the general community and at various schools. Locations include but are not limited to: School/Location City Central East High School Fresno Central West High School Fresno McLane High School Fresno Fresno High School Fresno Sanger High School Sanger Washington Academy Middle School Sanger Mendota High School Mendota Mendota Junior High School Mendota Rio Del Rey High School Fresno San Joaquin Elementary School (4th-6th grades) San Joaquin Exhibit A-1 Page 25 of 62 Fresno City College Fresno Fresno State University Fresno Fresno Pacific University Fresno D. EVIDENCE BASED TOOLS / LOCAL INNOVATIVE PRACTICE ● SPORT (Alcohol/Drug) Prevention Plus Wellness Program/Curriculum (SPORT PPW) ● Marijuana Prevention Plus Wellness Program/Curriculum (Marijuana PPW) ● Friday Night Live Curriculum, Roadmap, Tool Kits E. ACTIVITIES GOALS / PERFORMANCE OUTCOME MEASURES / REPORTS (See Implementation Tables Below) Exhibit A-1 Page 26 of 62 Coalition/Advisory Council (MARIJUANA) Goal(s): Decrease youth access to marijuana. Objective(s): By 2026, the percentage of youth who report marijuana is easy to access will decrease by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who report marijuana is easy to access will have decreased by 1% as measured by the Fresno County Student Insight Survey. IOM Category(ies): Universal Population(s): Youth, Adults, Other Professionals Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Form an advisory council to support the development and implementation of countywide marijuana prevention services. ● Invite and recruit via email selected representatives from Fresno County DPH, school site administration, marijuana and drug prevention professionals, community youth organizations, scholars from local universities, parents, and youth to serve as advisory council members During the first quarterly meeting facilitate the advisory council’s overview of the RMAY Project and ensure the group is aware of goals and outcomes. Successfully retain of an advisory council of at least 15 adult stakeholders and partners, by maintaining email communications and providing updates on project implementation through YLI social media and website Jul 2021 - June 2022 Prevention Provider CBP - Coalitions/ Workgroup Activities Sign-in Sheets Agendas/Meeting Notes PPSDS Reporting Convene Advisory Council quarterly to discuss implementation of prevention campaigns. ● Calendar Quarterly meetings and send email reminders and agendas to meetings in advance to advisory members Quarterly Prevention Provider CBP - Coalitions/ Workgroup Activities Agendas/Meeting Notes PPSDS Reporting Exhibit A-1 Page 27 of 62 ● Include implementation progress, campaign development and challenges as standing agenda items Provide training to Advisory Council members on Youth Adult Partnerships. ● At the second quarter meeting, schedule a Youth and Adult Partnership Training as part of Communities Mobilizing for Change on Alcohol (CMCA), a curriculum review of the SPORT Prevention Plus Wellness evidence- based program, and the supplemental Marijuana Prevention Plus Wellness (Marijuana PPW) curriculum to be facilitated by YLI staff ● YLI staff to conduct the training and curriculum review in Quarter two or Quarter three Quarterly Prevention Provider CBP - Training and Technical Assistance Agendas/Meeting Notes Training Materials Agendas/Meeting Notes PPSDS Reporting Form a coalition to share youth development best practices and engage youth in community, school-based wellness, and county prevention efforts. ● Invite and recruit via email selected representatives from community youth organizations. The Youth Development Coalition will be made up of various local youth-serving organizations; including but not exclusive to: non-profits, grassroots organizations, faith-based organizations, and youth-serving programs ● During the first two quarterly meetings staff will provide an overview of the Prevention & Early Intervention work to ensure the group is aware of goals and outcomes. Jul 2021 - June 2022 Jul 2021 - June 2022 Prevention Provider CBP - Coalition/Wo rkgroup Activities Sign-in sheets Agendas/Meeting Notes PPSDS Reporting Exhibit A-1 Page 28 of 62 ● Successfully retain at least 15 representatives of partnering youth organizations annually. Some potential partners may include: The kNOw Youth Media, Fresno City College, California Youth Connection, The Children’s Movement, Fresno Boys and Men of Color, Bitwise Industries, Boys and Girls Club, Economic Opportunities Commission, GenUp and City of Fresno Youth Commission, Mobilizing Youth to Nix Tobacco, and Barrios Unidos Annually Convene coalition quarterly to discuss implementation of prevention campaigns. ● YLI staff will share prevention campaigns with the coalition and share ways that the coalition may support campaign efforts ● Staff will facilitate discussions and decision making of the coalition’s purpose/vision and goals Quarterly Quarterly Prevention Provider CBP - Coalition/Wo rkgroup Activities Agendas/Meeting Notes PPSDS Reporting Administer annual Advisory Council Surveys. ● At the fourth quarter meeting administer the Adult Ally retrospective survey to measure relationship building, Youth and Adult partnerships opportunities, and knowledge built on Marijuana Prevention efforts led by YLI Annually (May/June) Prevention Provider, Evaluator CBP - Evaluation Services Adult Ally Retrospective Survey results Exhibit A-1 Page 29 of 62 School-Based Youth Education Programs (MARIJUANA) Goal(s): Decrease youth access to marijuana. Objective(s): By 2026, the percentage of youth who report marijuana is easy to access will decrease by 2% as measured by the Fresno County Student Insight Survey. By 2026, the percentage of youth who believe marijuana is harmful will increase by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who report marijuana is easy to access will have decreased by 1% as measured by the Fresno County Student Insight Survey. By 2025, the percentage of youth who have knowledge of the health impacts of marijuana use will increase by 2% as measured by the Fresno County Student Insight Survey IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Outreach to and establish buy-in (written MOU) from schools that agree to host youth education programs. ● Develop a Memo of Understanding (MOU) template that outlines what YLI will provide, and what each site will provide to establish the RMAY youth leadership programs and SPORT Prevention Plus Wellness education programs ● Formalize a Memo of Understanding (MOU) with each school site to ensure that Administrators and Advisors understand their commitments clearly ● McLane High School ● Fresno High School ● Sanger High School ● Mendota High School ● Rio Del Rey High School ● Mendota Jr. High School ● Central Unified School District High Schools and Middle Schools ● Washington Academy Middle School Jul 2021 - June 2022 Prevention Provider CBP - Intra/Inter Agency Coordination/ Collaboration Signed written agreement/ Memorandum of Understandings with schools Exhibit A-1 Page 30 of 62 Develop marketing materials that appeal to potential student participants and distribute throughout Fresno County schools. ● Develop compelling marketing materials that appeal to potential student participants to join the RMAY youth leadership program ● Develop compelling marketing materials that appeal to potential student participants to join the SPORT Prevention Plus Wellness (SPORT PPW) Education Program ● Receive feedback from advisory council, school administration, and advisors Jul 2021 - June 2022 Prevention Provider CBP - Intra/Inter Agency Coordination/ Collaboration & ID - Printed Materials PPSDS Reporting Final Drafts of Marketing Materials Developed Partner with local youth organizations and school staff to identify and recruit a diverse group of youth participants. ● YLI Staff will reach out to partners and community event organizers to secure participation in tabling opportunities such as school club rush events, health fairs and community events Ongoing Prevention Provider CBP - Intra/Inter Agency Coordination/ Collaboration PPSDS Reporting Exhibit A-1 Page 31 of 62 Recruit 600 youth from schools with high rates of marijuana use to participate in education programs. ● YLI staff will outreach at the following schools to recruit cohorts of 10-15 youth (100 youth annually) to participate in the RMAY youth leadership programs: ● McLane High School ● Fresno High School ● Sanger High School ● Mendota High School ● Rio Del Rey High School ● Mendota Jr. High School ● Central Unified School District High Schools and Middle Schools ● Washington Academy Middle School ● YLI Staff will outreach at the following schools to recruit 500 youth to participate in the evidence- based SPORT Prevention Plus Wellness (SPORT PPW) Education Program ● McLane High School ● Fresno High School ● Sanger High School ● Mendota High School ● Rio Del Rey High School ● Mendota Jr. High School ● Central Unified School District High Schools and Middle Schools ● Washington Academy Middle School Annually Prevention Provider CBP - Intra/Inter Agency Coordination/ Collaboration & ED - Classroom/ School Educational Services Sign-In Sheets Develop and implement supplemental training curriculum to prepare youth for authentic participation in prevention campaigns. ● YLI Staff will attend Marijuana/ Substance Abuse Prevention Trainings, Webinars and Conferences to build capacity in engaging youth in marijuana prevention efforts Annually Prevention Provider ED - Classroom/School Educational Services Sign-In Sheets PPSDS Reporting Exhibit A-1 Page 32 of 62 ● YLI Staff will secure training and certification to implement the Marijuana Prevention Plus Wellness (Marijuana PPW) as an add-on the evidence-based SPORT PPW and InShape PPW program curriculums ● Staff will train youth on supplemental curriculum during scheduled RMAY youth leadership Program Meetings that will help them plan and carry out youth- led prosocial leadership and empowerment activities Provide a minimum of 90 one- time youth developed and led presentations for youth about legal consequences of providing marijuana to minors. ● YLI Staff will train the RMAY youth leadership program participants at each site on the Friday Night Live (FNL) Roadmap curriculum (the FNL Roadmap is based on the evidence- based Youth Development Standards of Practice), facilitation, public speaking, and presentation development skill building. Additionally, each cohort will receive training on the evidence-based SPORT PPW Curriculum, Marijuana PPW and the Youth SPORT PPW Peer Facilitator Curriculum. ● The RMAY youth leadership program cohorts from each site will facilitate a training for their peers on the Marijuana Prevention Plus Wellness (Marijuana PPW) Curriculum ● YLI Staff will partner with the RMAY Youth Leadership Program cohorts to develop and deliver 30 Annually (30 per year) Prevention Provider ALT -Youth and Adult Leadership Activities & ED - Classroom/School Education Services Sign-In Sheets PPSDS Reporting Exhibit A-1 Page 33 of 62 educational presentations annually for youth about the legal consequences on providing marijuana to minors ● RMAY youth leaders will plan and carry out prosocial leadership and empowerment activities at their school site Administer the FCSIS with youth at target schools (or use CHKS data) to collect evaluation data. ● YLI Staff will connect and receive approval from school administrators to conduct the FCSIS at the following sites: ● McLane High School ● Fresno High School ● Sanger High School ● Mendota High School ● Rio Del Rey High School ● Mendota Jr. High School ● Central Unified School District High Schools and Middle Schools ● Washington Academy Middle School Annually (Apr/May ) Prevention Provider, Evaluator CPB - Assessing Community Needs FCSIS Survey Results Administer Youth Participant Survey. ● YLI Staff will administer and collect the YD (Youth Development) Survey to RMAY youth leadership program participants at the following sites: ● McLane High School ● Fresno High School ● Sanger High School ● Mendota High School ● Rio Del Rey High School ● Mendota Jr. High School ● Central Unified School District High Schools and Middle Schools ● Washington Academy Middle School Annually Prevention Provider, Evaluator CBP - Evaluation services YD Survey Outcomes SPORT PPW Pre & Post Test Outcomes Pro-social activity evaluation surveys Exhibit A-1 Page 34 of 62 ● YLI Staff will administer the SPORT PPW Pre and Post Test to Program Participants at the following sites: ● McLane High School ● Fresno High School ● Sanger High School ● Mendota High School ● Rio Del Rey High School ● Mendota Jr. High School ● Central Unified School District High Schools and Middle Schools ● Washington Academy Middle School ● RMAY Youth Leaders will administer the Marijuana PPW Pre and Post Test to Presentation Participants and prosocial activity participation evaluations Exhibit A-1 Page 35 of 62 Youth Mentoring Program (MARIJUANA) Goal(s): Decrease youth access to marijuana. Objective(s): By 2025, 80% of youth will have reported that the mentoring they received helped them to feel good about themselves and increased their social competence as measured by a mentoring program survey. By 2026, 10% more youth will have participated in alternative activities as measured by marijuana prevention activity log Intermediate Outcome(s): By 2024, 50% of youth will report an increased negative attitude toward marijuana use as measured by a mentoring program survey. By 2024, the number of youth who participated in alternative activities will increase by 5% as measured by marijuana prevention activity log. IOM Category(ies): Selective Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop a mentoring program framework and curriculum that outlines goals and intended outcomes, as well as the frequency, format, assignment guidelines for meetings between mentors and mentees. ● YLI Staff will receive training from CFNLP on the Friday Night Live (FNL) Mentoring Model ● YLI Staff will develop a Mentoring program framework and curriculum that outlines goals and intended outcomes, as well as the frequency, format, assignment guidelines for meetings between mentors and mentees utilizing the FNL Mentoring Model and the SPORT PPW and Marijuana PPW Curriculum ● YLI Staff will develop compelling marketing materials and social media messages that appeal to college-aged youth leaders to serve as Mentors in YLI’s Mentorship program ● Staff will develop a Mentor Description and Application Process for the Program Jul 2021 - June 2022 Prevention Provider CBP - Program Development and Improvement PPSDS Reporting Finalized Mentoring Program Framework & Curriculum Train mentors and establish a pilot mentoring program that can serve at least 8 youth. ● YLI Staff will recruit 8 Mentors ages 18-20 to support the planning, coordination, and implementation of YLI Mentoring Program Jul 2021 - June 2022 Prevention Provider ED - Mentoring PPSDS Reporting Sign-in Sheets Training agendas Exhibit A-1 Page 36 of 62 ● YLI staff will develop and lead a Mentor orientation and onboarding training for Mentors to complete on the first day ● YLI staff will coordinate a two-day Mentor retreat/academy to ensure Mentors have a clear understanding of the FNL Mentorship model and have comfortability in relationship building and coaching. Training will also include: youth and adult partnerships, facilitation, learning about the issue - marijuana prevention, public speaking, media literacy and community engagement ● Staff will additionally train mentors on Interns will be trained on the InShape Prevention Plus Wellness (InShape PPW) curriculum and the Marijuana PPW Program Recruit at least 8 youth for the mentoring program who are deemed at risk for marijuana use or showing early phase marijuana use. ● YLI Staff will develop compelling marketing materials that appeal to potential Youth Mentees and distribute materials widely throughout Fresno County in partnership with high school and middle school administration, teachers, Health Center staff, community-based organization, and other partnering adult allies. ● YLI Staff will reach out to school site counselors and youth serving organizations to provide referrals and recommendations on potential youth mentee participants for the program. Annually (Jul 2022 - June 2025) Prevention Provider PIDR - Student Assistance programs & ED - Mentoring PPSDS Reporting Finalized Marketing Materials developed Exhibit A-1 Page 37 of 62 Implement the mentoring program framework. ● YLI Staff will facilitate and implement the Mentoring program utilizing the FNL Mentoring Model and the SPORT PPW and Marijuana PPW Curriculum with eight mentors and eight mentees annually Annually - Jul 2022 - June 2025 Prevention Provider ED - Mentoring PPSDS Reporting Sign-in Sheets Meeting Agendas Administer Mentoring Program Survey. ● YLI Staff will administer and collect the YD (Youth Development) FNL Mentoring Survey to Mentoring program participants Annually - May/June Prevention Provider, Evaluator CBP - Evaluation Services YD FNL Mentoring Survey results Exhibit A-1 Page 38 of 62 Parent and Community Education (MARIJUANA) Goal(s): Decrease youth access to marijuana. Objective(s): By 2026, the percentage of youth who report marijuana is easy to access will decrease by 2% as measured by the Fresno County Student Insight Survey. By 2026, the percentage of youth who believe people close to them (e.g., friends, parents) disapprove of using marijuana will increase by 2% as measured by the Fresno County Student Insight Survey. By 2026, the percentage of youth who believe marijuana is harmful will have increased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who report marijuana is easy to access will have decreased by 1% as measured by the Fresno County Student Insight Survey. By 2025, 70% parents/guardians will increase their knowledge about providing a positive parental environment and the harmful consequences of youth marijuana use as measured by a post-program survey. By 2025, the percentage of youth who have knowledge of the health impacts of marijuana use will increase by 2% as measured by the Fresno County Student Insight Survey IOM Category(ies): Universal Population(s): Parents, Other Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop and update educational materials to inform parents about marijuana issues and their responsibility as parents/adults. ● YLI staff will provide a Canva and data analysis training for RMAY Youth leaders. ● Using the FCSIS data YLI staff and RMAY youth leaders will develop educational materials, power points and media to present to parents, caregivers, community members, and stakeholders. The purpose of materials is to inform parents about marijuana issues and their responsibility as parents/adults. ● Receive feedback from advisory council and advisors Annually Prevention Provider CBP - Intra/Inter Agency Coordination & ID - MultiMedia Sign-In Sheets PPSDS Reporting Identify and attend parent group meetings to distribute educational materials. ● YLI staff will reach out to community organizations and/or parent groups to offer educational presentations to parents, caregivers and adults as well as distribute created educational materials Ongoing Prevention Provider ID - Presentations & CBP - Intra/Inter Agency Coordination/ Collaboration PPSDS Reporting Sign-In Sheets Exhibit A-1 Page 39 of 62 Provide 48 educational presentations for parents/adults about the health impacts of marijuana use and legal consequences of providing marijuana to minors. ● YLI Staff, YALL and RMAY youth leaders will plan and implement community Town Halls using the SAMHSA Town Hall toolkit to inform and educate on the consequences of providing marijuana to minors. ● YLI Staff, YALL and RMAY youth leaders will co-facilitate educational workshops for parents, caregivers, and stakeholders about the health impacts of marijuana use and legal consequences of providing marijuana to minors. Parent messages and marketing materials will be created and disseminated using at least one channel of communication. 16 per year (Jul 2021 - June 2024) Prevention Provider ED - Community Educational Services PPSDS Reporting Sign-In Sheets Presentation Materials Developed Administer Parent Survey. ● YLI Staff will develop, administer, and collect a Parent Survey to Parent/caregiver and other adult participants Ongoing (after each presentatio n) Prevention Provider, Evaluator CBP - Evaluations Services Parent/Caregiver & Adult Stakeholder Survey outcomes Exhibit A-1 Page 40 of 62 Countywide Media Campaign (MARIJUANA) Goal(s): Decrease youth access to marijuana. Objective(s): By 2026, the percentage of youth who report marijuana is easy to access will decrease by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who report marijuana is easy to access will have decreased by 1% as measured by the Fresno County Student Insight Survey. IOM Category(ies): Universal Population(s): Youth, Young Adults, Parents, Other Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop educational materials and media to present to parents, community members, and stakeholders. ● YLI staff will provide a Public Service Announcement (PSA) development training for RMAY youth leaders. This will include Radio PSA, Billboard PSA, and other media PSA development. ● Using the FCSIS data YLI staff and RMAY youth leaders will develop a youth-led media PSA campaign to educate youth and adults on the legal consequences of providing marijuana to minors and youth marijuana use rates based on data generated by the Fresno County Student Insights Survey. ● Receive feedback from advisory council Annually Prevention Provider CBP - Intra/Inter Agency Coordination/ Collaboration & ID - MultiMedia PPSDS Reporting Final Drafts of Marketing Materials Developed Radio and Billboard PSA Analytics Identify and attend community events and resources fairs to distribute educational materials and messages. ● YLI Staff will reach out to partners and community event organizers to secure participation in 10 tabling opportunities such as school events, resources fairs, health fairs and community events ● YLI staff will target youth, parents and caregivers of students who attend each of the school sites. Up to 40,000 households will be targeted by the youth-led media campaign. Annually Prevention Provider ID - Community/ School Outreach Events PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-1 Page 41 of 62 Implement 3 countywide youth- led media campaigns to educate youth and adults on consequences of providing marijuana to youth and marijuana use. ● YLI staff will provide a Public Service Announcement (PSA) development training for RMAY youth leaders. This will include Radio PSA, Billboard PSA, and other media PSA development. ● YLI staff and YALL will partner with media groups (iHeart Media, Pandora, Spotify) to secure radio ad placement for the Radio PSA’s developed ● YLI Staff and YALL will partner with Outfront Media to secure billboard placement of created PSA messaging Annually (1 per year) Prevention Provider ID - MultiMedia PPSDS Reporting Final Drafts of Marketing Materials Developed Radio and Billboard PSA Analytics Produce a youth podcast series that highlights storytelling through the lens of youth in Fresno County. ● YLI staff and YLI Communications Team will train and build capacity of YALL and RMAY youth leadership participants on storytelling for advocacy, Multimedia productions, podcast planning, recording and implementation ● YLI staff, YALL and RMAY youth leaders will develop and create scripts for the Youth Fresno County ATOD Podcast Series that focus on youth stories and insight on substance abuse, and prevention efforts ● YLI staff, YLI Communications Team, YALL and RMAY youth leaders will record, edit, and finalize Youth Fresno County ATOD Podcast Series episode for dissemination Annually Prevention Provider ID - MultiMedia PPSDS Reporting Podcast Analytics Exhibit A-1 Page 42 of 62 Distribute podcast online via social media and website. ● YLI staff will distribute the podcast on social media, the YLI website and promote it at Schools and Community outreach events. ● YLI will ask partners and school to share on their Social Media sites Annually Prevention Provider CBP - Intra/Inter Agency Coordination & ID - MultiMedia PPSDS Reporting Podcast Analytics Exhibit A-1 Page 43 of 62 Youth-Led Social Norms Campaign (MARIJUANA) Goal(s): Decrease youth access to marijuana. Objective(s): By 2026, the percentage of youth who believe marijuana is harmful will increase by 2% as measured by the Fresno County Student Insight Survey. By 2026, the percentage of youth who believe people close to them (e.g., friends, parents) disapprove of using marijuana will increase by 2% as measured by the Fresno County Student Insight Survey. By 2026, 10% more youth will have participated in alternative activities as measured by marijuana prevention activity log Intermediate Outcome(s): By 2025, the percentage of youth who have knowledge of the health impacts of marijuana use will increase by 2% as measured by the Fresno County Student Insight Survey. By 2024, the number of youth who participated in alternative activities will increase by 5% as measured by marijuana prevention activity log. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop youth-led social norms campaigns to educate youth and adults on consequences of providing marijuana to youth and marijuana. ● YLI staff will train RMAY youth leadership participants on conducting and analyzing data research through the Youth-Led Action Research training, and share results of the FCSIS ● Utilizing data, RMAY youth leadership participants, in partnership with YLI staff, will generate positive social norms youth messages and deliver these messages using various communication channels ● Receive feedback from advisory council, school Administrators, advisors, and youth Annually (1 per year) Prevention Provider CBP - CBP - Intra/Inter Agency Coordination & ID - MultiMedia/ Printed Materials YD Survey PPSDS Reporting Final Drafts of Marketing Materials Developed Implement youth-led social norms campaigns to reach peers about the actual vs perceptions about marijuana use among youth. ● YLI staff and RMAY youth leaders will generate messages about actual marijuana-use norms versus perceptions and disseminated to youth using at least one communication channel Annually (1 per year) Prevention Provider ID - Printed Materials YD Survey PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-1 Page 44 of 62 ● YLI staff will partner with other youth serving organizations and/or community youth hubs to secure permission to distribute printed social norms materials at their sites of services ● YLI staff will also share social norms messaging virtually via YLI social media platforms Radio and Billboard PSA Analytics Train youth on conducting and analyzing data, as well as toolkits to develop a Positive Social Norms Campaign. ● YLI staff will train RMAY youth leadership participants on evidence-based toolkits from the FNL Roadmap that will aid youth in building the skills necessary to develop a Positive Social Norms Campaigns will focus on increasing the disapproval of underage marijuana use among youth Annually Prevention Provider ED- Classroom/ School Education Services PPSDS Reporting Presentation Materials Developed Sign-In Sheets Use data to generate youth messaging and deliver messages using school-based communication channels. ● YLI staff will partner with school administration to secure permission to distribute printed social norms materials at the 11 school sites ● YLI staff will also request permission from school administrators to share and tag (#) social norms messaging on the school social media pages Annually Prevention Provider ID - Social Media Development and Maintenance PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-1 Page 45 of 62 SUMMARY OF SERVICES ORGANIZATION: Youth Leadership Institute AREA OF FOCUS: Prescription Drug Prevention PROGRAM NAME: Reducing Prescription Drug Access to Youth (RPDAY) CONTACT(S): Patricia Barahona, Chief Executive Officer Cynthia Rocha, Central Valley Director of Programs A. SUMMARY OF SERVICE To meet the goal of decreasing youth prescription drug misuse, Youth Leadership Institute (YLI) will partner with the Fresno County Superintendent of Schools (FCSS) and youth to achieve the following two identified objectives using proven processes: 1) Decrease the percentage of youth who report Prescription drugs are easy to access by 2%. 2) Decrease the percentage of youth misusing prescription drugs (in the past 30 days) by 2%. Our intent is to reach both these objectives by 2026, as measured by the Fresno County Student Insight Survey. The Reducing Prescription Drug Access to Youth (RPDAY) project will utilize various Center for Substance Abuse Prevention (CSAP) strategies to decrease prescription/over- the-counter drug access and misuse. The CSAP strategies utilized in the RPDAY Project include: ● Information Dissemination Strategies – Community and School Outreach Events, Multi-media Development & Dissemination, Printed Material Development & Dissemination, Social Media Development & Maintenance, and Presentations ● Educational Strategies – Classroom and School Educational Services, and Community Educational Services ● Alternative Strategies – Community Service Activities, Social/Recreational Event & Activities, Youth and Adult Leadership Activities ● Community-Based Processes – Assessing Community Needs, Coalition/Workgroup Activities, and Intra/Inter-Agency Coordination/Collaboration, Training and Technical assistance and Evaluation Services. ● Environmental Strategies – Community and Neighborhood Mobilization Exhibit A-1 Page 46 of 62 YLI will be integrating the RPDAY Project into the already established after-school Fresno’s Recreation Enrichment & Scholastic Health (FRESH) Programs, led by the Fresno County Superintendent of Schools (FCSS) across the county. The program will be conducted at five middle schools and one elementary school. Utilizing a youth development framework, YLI will build the capacity of FCSS staff and FRESH Program staff at John Sutter Middle School in Fowler, Coalinga Middle School, Huron Middle School, Firebaugh Middle School, Conejo Middle School in Laton, and Riverdale Elementary School to implement the YLI/Friday Night Live Youth Development model. FCSS Staff and youth at these sites will utilize skills developed and training provided by YLI staff to lead prescription drug abuse prevention campaigns utilizing the Information Dissemination, Education and Alternative CSAP strategies identified above. YLI Staff, FCSS staff and youth together, will coordinate efforts to support the education of peers, parents and caregivers and identify the specific projects to address prescription drug accessibility, perceptions of harm and disapproval that are relevant to their own schools, neighborhoods and communities. To address the issue of adults as sources of prescription drugs for youth, YLI staff, FCSS staff, and youth will be using the survey findings to develop educational presentations on youth access to prescription drugs for parents, caregivers, and community stakeholders. Youth participants will also develop outreach materials and identify communication channels to conduct additional parent and caregiver outreach. Youth-Adult Partnership and capacity building training opportunities will also be offered to parent groups and adult allies who indicate interest in partnering in the implementation of the RPDAY Project. To monitor impact and refine the project process to reflect lessons learned, an Adult Ally Advisory Council of project stakeholders, experts, and youth will be established to oversee and support the implementation of each RPDAY Project. Annually YLI will also invest in FRESH program staff development, at each identified site, to build capacity on youth development best practices on meaningfully engaging youth and adult allies in the community to support the continual participation and retention of youth involved in the project over the course of the RPDAY project year. B. TARGET POPULATION Youth and Young Adults Ages 10 - 20 Exhibit A-1 Page 47 of 62 C. LOCATION OF SERVICES Prescription Drugs Prevention Services will be delivered in the general community and at various schools. Locations include but are not limited to: School/Location City Conejo Middle School Laton John Sutter Middle School Fowler Coalinga Middle School Coalinga Huron Middle School Huron Firebaugh Middle School Firebaugh Riverdale Elementary School Riverdale D. EVIDENCE BASED TOOLS / LOCAL INNOVATIVE PRACTICE ● SPORT (Alcohol/Drug) Prevention Plus Wellness Program/Curriculum (SPORT PPW) ● Opioid Prevention Plus Wellness/Curriculum (Opioid PPW) ● Friday Night Live Curriculum, Roadmap, Tool Kits E. ACTIVITIES GOALS / PERFORMANCE OUTCOME MEASURES / REPORTS (See Implementation Tables Below) Exhibit A-1 Page 48 of 62 Coalition/Advisory Council (Rx DRUGS) Goal(s): Decrease youth access to prescription drugs Objective(s): By 2026, the percentage of youth who believe prescription drugs are easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025 establish two additional prescription drug drop boxes in Fresno County. By 2025, the pounds of Rx drugs collected through the drop box program will increase as compared to the baseline pounds of Rx drugs collected through the drop box program in 2020. IOM Category(ies): Selective Population(s): Youth, Adults, Other Professionals Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Form an advisory council to support the development and implementation of countywide Rx prevention services and procurement of resources to support the Rx drop box program. ● Invite and recruit via email selected representatives from Fresno County DPH, school site administration, alcohol and drug prevention professionals, community youth organizations, scholars from local universities, parents, and youth to serve as advisory members ● Invite Members from the Fresno County Opioid Coalition to participate in the Rx Advisory Council and designate staff to represent YLI Rx advisory on the Opioid Coalition ● During the first quarterly meeting facilitate the advisory council’s overview of the RPDAY Project and ensure the group is aware of goals and outcomes. ● Successfully retain an Rx advisory council of at least 15 adult stakeholders and partners, by maintaining email communications and providing updates on project implementation through YLI social media and website Jul 2021 - June 2022 Jul 2021 - June 2022 Jul 2021 - June 2022 Annually Prevention Provider CBP - Coalitions/ Workgroup Activities Sign-in Sheets Agendas/Meeting Notes PPSDS Reporting Exhibit A-1 Page 49 of 62 Convene advisory council quarterly to discuss implementation of prevention campaigns. ● Calendar Quarterly meetings and send email reminders and agendas to meetings in advance to advisory council members ● Include implementation progress, campaign development and challenges as standing agenda items Quarterly Quarterly Prevention Provider CBP - Coalitions/ Workgroup Activities Agendas/Meeting Notes PPSDS Reporting Provide training to advisory council members on Youth Adult Partnerships. ● At the second quarter meeting, schedule a Youth and Adult Partnership Training as part of Communities Mobilizing for Change on Alcohol (CMCA), a curriculum review of the SPORT Prevention Plus Wellness evidence-based program, and the supplemental Opioid Prevention Plus Wellness (Opioid PPW) curriculum to be facilitated by YLI staff ● YLI staff to conduct the training in Quarter two or Quarter three Quarterly Quarterly Prevention Provider CBP - Training and Technical Assistance Agendas/Meeting Notes Training Materials Agendas/Meeting Notes PPSDS Reporting Administer Advisory Council Survey ● At the fourth quarter meeting administer the Adult Ally retrospective survey to measure relationship building, involvement and knowledge built, Youth and Adult partnerships, and Prescription Drug Prevention Efforts led by YLI Annually (May/June) Prevention Provider, Evaluator CBP - Evaluation Services Adult Ally Retrospective Survey results Exhibit A-1 Page 50 of 62 School-Based Youth Education Programs (Rx DRUGS) Goal(s): Decrease youth access to prescription drugs Objective(s): By 2026, the percentage of youth misusing prescription drugs in the past 30 days will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth misusing prescription drugs in the past 30 days will have decreased by 1% as measured by the Fresno County Student Insight Survey. By 2025, 70% of youth will have increased their knowledge about positive coping and decision-making skills as measured by a post-test with a retrospective pre-test. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Outreach to and establish buy-in (written MOU) from schools that agree to host youth education programs. ● Develop a Memo of Understanding (MOU) template that outlines what FCSS provide, and what each site will provide to establish the RPDAY youth leadership programs and SPORT Prevention Plus Wellness education programs ● Formalize a Memo of Understanding (MOU) with each school site to ensure that Administrators and Advisors understand their commitments clearly at the following sites: ● Conejo Middle School in Laton ● John Sutter Middle School in Fowler ● Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Riverdale Elementary School Jul 2021 - June 2022 Prevention provider subcontractor - FCSS CBP - Intra/Inter Agency Coordination/ Collaboration Signed written agreement/ Memorandum of Understandings with schools Develop marketing materials that appeal to potential student participants and distribute throughout Fresno County schools. ● Develop compelling marketing materials that appeal to potential student participants to join the RPDAY youth leadership program Jul 2021 - June 2022 Prevention provider subcontractor - FCSS CBP - Intra/Inter Agency Coordination/ Collaboration & ID - Printed Materials PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-1 Page 51 of 62 ● FCSS/FRESH staff will distribute materials widely throughout Fresno County in partnership with the school administration, teachers, Health Center staff, community-based organization, and other partnering adult allies ● Received feedback from advisory council, school administrators and advisors Partner with local youth organizations and school staff to identify and recruit a diverse group of youth participants. ● FCSS/FRESH staff will reach out to partners and community event organizers to secure participation in tabling opportunities such as school club rush/lunch events, health fairs and community events Ongoing Prevention provider subcontractor - FCSS CBP - Intra/Inter Agency Coordination/ Collaboration PPSDS Reporting Recruit at least 300 youth to participate in education programs that include curriculum about positive coping and decision-making skills. ● FCSS/FRESH staff will outreach at the following schools to recruit cohorts of 10- 15 youth (90 youth annually) to participate in the RPDAY youth leadership programs: ● Conejo Middle School in Laton ● John Sutter Middle School in Fowler ● Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Riverdale Elementary School ● FCSS/FRESH staff will outreach at the following schools to recruit 210 youth to participate in the evidence-based SPORT Prevention Plus Wellness (SPORT PPW) Education Program ● Conejo Middle School in Laton ● John Sutter Middle School in Fowler ● Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Riverdale Elementary School Jul 2021 – June 2024 Prevention provider subcontractor - FCSS CBP - Intra/Inter Agency Coordination/ Collaboration & ED - Classroom/ School Educational Services Sign-In Sheets PPSDS Reporting Exhibit A-1 Page 52 of 62 Implement supplemental training curriculum to prepare youth for authentic participation in prevention campaigns. ● FCSS/FRESH staff and YLI Staff will attend Opioid/ Substance Abuse Prevention Trainings, Webinars and Conferences to build capacity in engaging youth in Rx prevention efforts ● YLI Staff will secure training and certification to implement the Opioid Prevention Plus Wellness (Opioid PPW) as an add-on the evidence-based SPORT PPW and InShape PPW program curriculums ● YLI Staff will train FCSS/FRESH on supplemental curriculum ● FCSS/FRESH staff and YLI Staff will train the RPDAY youth leadership program participants at each site on the Friday Night Live (FNL) Roadmap curriculum (the FNL Roadmap is based on the evidence-based Youth Development Standards of Practice), facilitation, public speaking, and presentation skill development. Additionally, this cohort will receive training on the evidence-based SPORT Prevention Plus Wellness (SPORT PPW) Curriculum, Opioid Prevention Plus Wellness (Opioid PPW) and the Youth SPORT PPW Peer Facilitator Curriculum. ● FCSS/FRESH staff will train the RPDAY youth leadership program cohorts on additional skills and tools needed to prepare youth for authentic participation in this project. Annually Annually Annually Annually Annually Prevention provider and subcontractor - FCSS ED - Classroom/School Educational Services Sign-in Sheets Youth Development Survey PPSDS reporting SPORT PPW Program pretest and post test Exhibit A-1 Page 53 of 62 Administer the FCSIS with youth at target schools (or use CHKS data). ● FCSS/FRESH Staff will connect and receive approval from school administrators to conduct the FCSIS at the following sites: ● Conejo Middle School in Laton ● John Sutter Middle School in Fowler ● Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Riverdale Elementary School Annually Prevention provider subcontractor - FCSS CBP - Assessing Community Needs FCSIS Survey Outcomes Administer Youth Participant Survey. ● FCSS/FRESH staff will administer and collect the YD (Youth Development) Survey to RPDAY youth leadership program participants at the following sites: ● Conejo Middle School in Laton ● John Sutter Middle School in Fowler ● Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Riverdale Elementary School ● FCSS/FRESH staff will administer the SPORT PPW Pre and Post Test to Program Participants at the following sites: ● Conejo Middle School in Laton ● John Sutter Middle School in Fowler ● Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Riverdale Elementary School Annually Prevention provider subcontractor - FCSS, Evaluator CBP - Evaluation services YD Survey Outcomes SPORT PPW Pre & Post Test Outcomes Exhibit A-1 Page 54 of 62 Prosocial Activities for Youth (Rx DRUGS) Goal(s): Decrease youth access to prescription drugs Objective(s): By 2026, the percentage of youth misusing prescription drugs in the past 30 days will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth misusing prescription drugs in the past 30 days will have decreased by 1% as measured by the Fresno County Student Insight Survey. By 2025, 70% of youth will have increased their knowledge about positive coping and decision-marking skills as measured by a post-test with a retrospective pre-test. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Identify and formalize partnerships to provide workshops and educational training at events. ● YLI staff and FCSS/FRESH will reach out to partners and community event organizers to schedule opportunities to provide workshops and educational training on partnering with youth to address prescription drug abuse ● FCSS/FRESH will reach out to partners, community based organizations, and experts in their field to provide workshops, educational trainings and participate in at FCSS/FRESH hosted events like sports and physical activity field days, walk/jog-a- thons, and other cultural and wellness events Annually Prevention Provider and subcontractor - FCSS CBP - Intra/Inter- Agency Coordination/ Collaboration Sign-in sheets PPSDS Reporting Event Agenda’s Develop marketing materials that appeal to potential student participants and distribute throughout Fresno County schools. ● FCSS/FRESH staff will develop compelling marketing materials and social media messages that appeal to potential student/youth to participate in events like sports and physical activity field days, walk/jog-a-thons, and other cultural and wellness events Annually Prevention Provider subcontractor - FCSS CBP - Intra/Inter Agency Coordination/ Collaboration & ID - Printed Materials PPSDS Reporting Final Drafts of Marketing Materials Developed Social Media Post Analytics Exhibit A-1 Page 55 of 62 ● FCSS/FRESH staff will distribute materials widely throughout Fresno County in partnership with the school administration, teachers, Health Center staff, colleges, community-based organization, and other partnering adult allies ● FCSS/FRESH staff will share developed messages on multiple social media platforms ● Receive feedback from YLI Staff, advisory coalition, school administration and advisors Attempt to engage 300 youth to participate in countywide youth events for leadership, empowerment building, and prosocial activities. ● FCSS/FRESH staff will reach out to partners and community event organizers to schedule outreach opportunities for tabling at school club rush/lunch events, health fairs and community events for the purpose of recruiting 300 youth to participate at YLI hosted educational and prosocial leadership events like sports and physical activity field days, walk/jog-a-thons, and other cultural and wellness events ● FCSS/FRESH will use sign-in sheets to track and confirm attendance at events Annually (3 per year) Prevention Provider subcontractor - FCSS ALT - Social/ Recreational Events/ Activities Sign-in sheets PPSDS Reporting Event Agenda’s Train youth to co-facilitate educational workshops at the events. ● During RPDAY cohort meetings FCSS/FRESH staff will train youth leaders on youth-led action planning and event planning and implementation. ● FCSS/FRESH staff and RPDAY youth leaders will convene planning meetings to plan, coordinate and implement youth events for leadership, empowerment building, and prosocial activities ● RDAY youth leaders will co-facilitate educational workshops and activities with FCSS/FRESH Staff at the prosocial leadership empowerment events they plan Annually Ongoing Ongoing Prevention Provider subcontractor - FCSS ED - School Based education Services & ALT - Youth and Adult Leadership Activities Sign-in sheets PPSDS Reporting Event Agenda’s Training/Activity Materials Exhibit A-1 Page 56 of 62 Administer Youth Participant Survey. ● YLI Staff will administer and collect Youth Participant Surveys at the conclusion of every prosocial leadership empowerment event Annually Prevention Provider, Evaluator CBP - Evaluation Services Event Survey Results Exhibit A-1 Page 57 of 62 Parent and Community Education (Rx DRUGS) Goal(s): Decrease youth access to prescription drugs Objective(s): By 2026, the percentage of youth who believe prescription drugs are easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth who report that medications are locked up in their home will increase by 10% as compared to baseline percentage in 2020 as measured by the Fresno County Student Insight Survey. IOM Category(ies): Universal Population(s): Parents, Other Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop and regularly update educational materials to inform parents about Rx issues and their responsibility as parents/adults. ● YLI staff and FCSS/FRESH staff will provide Canva and data analysis training for RPDAY leaders. ● Using the FCSIS data FCSS/FRESH staff and RPDAY youth leaders will develop educational materials and media to present to parents, caregivers, community members, and stakeholders. The purpose of materials is to inform parents about Rx issues and their responsibility as parents/adults. Annually Prevention Provider and subcontractor - FCSS CBP - Intra/Inter Agency Coordinatio n/ Collaboratio n & ID - MultiMedia Sign-In Sheets PPSDS Reporting Identify and attend parent group meetings to distribute educational materials. ● FCSS/FRESH staff will reach out to community organizations and/or parent groups to offer educational presentations to parents, caregivers and adults as well as distribute created educational materials ● Receive feedback from YLI Staff, advisory coalition, school administration and advisors Ongoing Prevention Provider subcontractor - FCSS ID - presentation s & CBP - Intra/Inter Agency PPSDS Reporting Sign-In Sheets Implement 48 educational presentations and/or town halls for parents/adults about youth Rx use issues and the proper disposal and storage of Rx drugs. ● FCSS/FRESH staff and RPDAY youth leaders will plan and implement community Town Halls using the SAMHSA Town Hall toolkit to inform and educate parents/adults about youth Rx use issues and the proper disposal and storage of Rx drugs. ● FCSS/FRESH staff and RPDAY youth leaders will co-facilitate educational workshops for parents, caregivers, and stakeholders on youth Rx use issues and the proper disposal and storage of Rx drugs. Parent messages and marketing materials will be created and disseminated using at least one channel of communication. Annually (16 per year) Prevention Provider subcontractor - FCSS ED - Community Educational Services PPSDS Reporting Sign-In Sheets Presentation Materials Developed Exhibit A-1 Page 58 of 62 Countywide Education Campaign (Rx Drugs) Goal(s): Decrease youth access to prescription drugs Objective(s): By 2026, the percentage of youth who believe prescription drugs are easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the pounds of Rx drugs collected through the drop box program will increase as compared to the baseline pounds of Rx drugs collected through the drop box program in 2020. By 2025, the percentage of youth who report that medications are locked up in their home will increase by 10% as compared to baseline percentage in 2020 as measured by the Fresno County Student Insight Survey. IOM Category(ies): Universal Population(s): Youth, Young Adults, Parents, Other Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop educational materials and media on Rx drop boxes in Fresno County and the consequences of Rx drug use and providing Rx drugs to others. ● YLI and FCSS/FRESH staff will provide a Public Service Announcement (PSA) development training and Canva training for RPDAY leaders. This will include Radio PSA, Billboard PSA, and other media PSA development. ● Using existing information on drop boxes in Fresno County, FCSS/FRESH staff and RPDAY youth leaders will develop a youth-led media PSA campaign on Rx drop boxes in Fresno County and the consequences of Rx drug use and providing Rx drugs to others ● FCSS/FRESH staff and RPDAY youth leaders will develop educational materials, social media messages, and media to present to parents, community members, and stakeholders on Rx drop boxes in Fresno County and the consequences of Rx drug use and providing Rx drugs to other ● Receive feedback from YLI Staff and advisory coalition Annually Annually Annually Prevention Provider and subcontractor - FCSS CBP - Intra/Inter Agency Collaboratio n & ID - MultiMedia/ Printed Materials Sign-in Sheets Agendas PPSDS Reporting Finalized Educational Materials Exhibit A-1 Page 59 of 62 Identify and attend community events and resources fairs to distribute educational materials and messages. ● YLI and FCSS/FRESH Staff will reach out to partners and community event organizers to secure participation in 10 tabling opportunities such as school events, resources fairs, health fairs and community events ● YLI and FCSS/FRESH staff will target parents and caregivers of students who attend each of the six school sites. Up to 40,000 households Annually Annually Prevention Provider and subcontractor - FCSS ID- Community/ School Outreach Events PPSDS Reporting Implement youth-led media campaigns to educate youth and adults on Rx drug use by youth and the proper storage and disposal of Rx. ● YLI and FCSS/FRESH staff will partner with media groups (iHeart Media, Pandora, Spotify) to secure radio ad placement for the Radio PSA’s developed ● YLI and FCSS/FRESH staff will partner with Outfront Media to secure billboard placement of created PSA messaging Annually (1per year) Prevention Provider and subcontractor - FCSS ID - MultiMedia PPSDS Reporting Media Analytics Exhibit A-1 Page 60 of 62 Youth-Led Social Norms Campaign (Rx Drugs) Goal(s): Decrease youth access to prescription drugs Objective(s): By 2026, the percentage of youth misusing prescription drugs in the past 30 days will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the percentage of youth misusing prescription drugs in the past 30 days will have decreased by 1% as measured by the Fresno County Student Insight Survey. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Develop youth-led social norms campaigns to educate youth and adults on consequences of providing Rx to youth and Rx use. ● FCSS/FRESH staff will train RPDAY youth leadership participants on conducting and analyzing data research through the Youth-Led Action Research training, and share results of the FCSIS ● Utilizing data, RPDAY youth leadership participants, in partnership with FCSS/FRESH, will generate positive social norms youth messages and deliver these messages using various communication channels ● Receive feedback from YLI Staff, school administration, advisor, youth, and advisory coalition Annually (1 per year) Prevention provider subcontractor - FCSS CBP - Intra/Inter Agency Collaboration & ID - MultiMedia/ Printed Materials YD Survey PPSDS Reporting Final Drafts of Marketing Materials Developed Implement youth-led social norms campaigns to reach peers about the actual vs perceptions about Rx use among youth. ● FCSS/FRESH staff and RPDAY youth leaders will generate messages about actual vs perceptions about Rx use among youth and disseminate to youth using at least one communication channel ● FCSS/FRESH staff will partner with other youth serving organizations and/or community youth hubs to secure permission to distribute printed social norms materials at their sites of services ● FCSS/FRESH staff will also share social norms messaging virtually via social media platforms Annually (1 per year) Prevention provider subcontractor - FCSS ID - Printed Materials YD Survey PPSDS Reporting Final Drafts of Marketing Materials Developed Radio and Billboard PSA Analytics Exhibit A-1 Page 61 of 62 Train youth on conducting and analyzing data, as well as toolkits to develop a Positive Social Norms Campaign. ● FCSS/FRESH staff will train RPDAY youth leadership participants on evidence-based toolkits from the FNL Roadmap that will aid youth in building the skills necessary to develop a Positive Social Norms Campaigns will focus on increasing the disapproval of underage drinking among youth Annually Prevention provider subcontractor - FCSS ED- Classroom/ School Education Services PPSDS Reporting Presentation Materials Developed Sign-In Sheets Use data to generate youth messaging and deliver messages using school-based communication channels. ● FCSS/FRESH staff will partner with school administration to secure permission to distribute printed social norms materials at the 6 school sites Annually Prevention provider subcontractor - FCSS ID - Social Media Development and Maintenance PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-1 Page 62 of 62 Rx Drop Box Program (Rx DRUGS) Goal(s): Decrease youth access to prescription drugs Objective(s): By 2026, the percentage of youth who believe prescription drugs are easy to access will have decreased by 2% as measured by the Fresno County Student Insight Survey. Intermediate Outcome(s): By 2025, the pounds of Rx drugs collected through the drop box program will increase as compared to the baseline pounds of Rx drugs collected through the drop box program in 2020. IOM Category(ies): Universal Population(s): Youth, Young Adults, Parents, Other Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Engage advisory council to procure resources to support the Rx drop box program. ● During Quarterly meetings YLI staff will inform Rx Advisory Council about drop box program and ask for their support to connect with local jurisdiction law enforcement about the establishing a drop box program in their community Ongoing Prevention Provider CBP - Coalition/ Workgroup activities PPSDS Reporting Agendas Establish 2 additional prescription drug drop boxes in Fresno County. ● YLI staff will outreach to local law enforcement agencies, pharmacies, and local decision makers about attending an informational session on establishing a drop box program ● YLI staff will connect with those interested and connect them with resources to obtain the physical drop box ● YLI staff will provide TA and Technical assistance to the launch the program July 2021- June 2025 Prevention Provider ENV - Community and Neighborhood Mobilization PPSDS Reporting Agendas Sign-in sheets Collect data on pounds of Rx drugs collected through the drop box program. ● YLI Staff will collaborate with DEA, law enforcement agencies, pharmacies, and local decision makers to promote Take Back Day ● YLI staff will reach out to agencies, pharmacies, and DEA to collect data of pounds of Rx drugs collected through the drop box program Quarterly Prevention Provider ENV - Community and Neighborhood Mobilization & CBP - Assessing Community Needs PPSDS Reporting Rx Drop Box collection Data Exhibit A-2 Page 1 of 10 SCOPE OF WORK ORGANIZATION: Youth Leadership Institute AREA OF FOCUS: Friday Night Live/Club Live/Friday Night Live Kids CONTACT(S): Patricia Barahona, Chief Executive Officer Cynthia Rocha, Central Valley Director of Programs A. SUMMARY OF SERVICE Youth Leadership Institute (YLI) will partner with youth to achieve the following two identified objectives using proven processes: (1) Sustain and expand partnerships for positive and healthy youth development that engage high school age youth as active leaders and resources in their communities and (2) Sustain and expand partnerships for positive and healthy youth development that engage elementary and middle school-age youth as active leaders and resources in their communities. Fresno County Friday Night Live draws on the California Friday Night Partnership theory of change that states programs and chapters that integrate five youth development standards of practice (community engagement, leadership and advocacy, relationship building, safety, and skill development) will create settings rich in youth development support and opportunities. This theory is supported by a wealth of youth development research going back more than twenty years. YLI organizes its tools, training, and mini-grants program to support allies and programs in creating these environments and making these opportunities available. A second and equally important theory is that environmental strategies are effective in reducing youth exposure, access to and desire to use alcohol. This strategy is grounded in significant research and supported by at least three Substance Abuse and Mental Health Services Administration (SAMHSA) model programs that demonstrate measurable positive change from environmental prevention approaches. Youth-led interventions that use environmental strategies are more likely to have longer term and systemic impacts than those youth-led projects that focus on raising awareness of the harms of using substances (Deborah A. Fisher, Ph.D, Environmental Prevention Strategies: An Introduction and Overview, 1998). YLI will use the FNL Roadmap curriculum, which provides facilitators at all levels with a step- by-step guide that leads them through the entire process of supporting a youth-led prevention program and campaign. The Roadmap is based on the evidence-based Youth Development Standards of Practice to help create a standard process across Friday Night Live chapters so that all programs are able to support the common goal of partnering youth with adults to build healthier communities. All FNL chapters will follow a “roadmap” for youth‐led community prevention initiatives that includes: Exhibit A-2 Page 2 of 10 • Capacity Building – Recruiting youth, creating a vision, gathering an understanding of the environment, and learning about youth‐led change, including training for both youth and the adults working with them. • Assessment – Building action research skills, conducting research and using data for action. • Planning – Using findings from the assessment to choose a solution and make a plan. • Implementation – Implementing the identified solutions. • Evaluation and Reflection – Reflecting on process. Rather than directly supporting young leaders only as a school-site program, YLI will help maintain and expand a network of chapters composed of youth and adult allies focusing on prevention and health promotion using environmental prevention approaches. Chapters of high school or older youth are known as Friday Night Live Chapters. Those of middle school age youth are known as Club Live Chapters. The FNL Kids program is designed for elementary school-aged youth in fourth through sixth grade. YLI’s program design will support and engage young leaders in school settings to undertake projects that prevent alcohol and other drug use and promote community health. In partnership with school site administrators, partner community based organizations, and other stakeholders, YLI staff will build youth knowledge of the issue, and build the capacity of program participants to collect data about youth access points to alcohol pertaining to underage drinking. Evidence- based strategies and example model campaigns from the Friday Night Live Roadmap will be shared with youth to support campaign selection and implementation. B. TARGET POPULATION Youth and Young Adults Ages 10 - 18 C. LOCATION OF SERVICES Alcohol Prevention Services will be delivered in the general community and at various schools. Locations include but are not limited to: School/Location City Chapter Edison High School Fresno FNL Gaston Middle School Fresno Club Live Kerman High School Kerman FNL Kerman Middle School Kerman Club Live Orange Cove High School Orange Cove FNL Reedley Middle College High School Reedley FNL Roosevelt High School Fresno FNL San Joaquin Elementary (7th-8th grade) San Joaquin Club Live Exhibit A-2 Page 3 of 10 Selma High School Selma FNL Sunnyside High School Fresno FNL Tranquility High School Tranquility FNL Central East High School Fresno FNL Central West High School Fresno FNL McLane High School Fresno FNL Fresno High School Fresno FNL Sanger High School Sanger FNL Washington Academy Middle School Sanger Club Live Mendota High School Mendota FNL Mendota Junior High School Mendota Club Live Rio Del Rey High School Fresno FNL San Joaquin Elementary School (4th-6th grades) San Joaquin FNL Kids Conejo Middle School Laton Club Live John Sutter Middle School Fowler Club Live Coalinga Middle School Coalinga Club Live Huron Middle School Huron Club Live Firebaugh Middle School Firebaugh Club Live Riverdale Elementary School Riverdale FNL Kids Fenix Apartments - Lowell Fresno FNL Kids Hacienda Heights Apartment Kerman FNL Kids D. EVIDENCE BASED TOOLS / INNOVATIVE PRACTICE Friday Night Live Curriculum, Roadmap, Tool Kits E. ACTIVITIES GOALS / PERFORMANCE OUTCOME MEASURES / REPORTS (See Implementation Tables Below) Exhibit A-2 Page 4 of 10 Friday Night Live (FNL)/Club Live (CL) Goal(s): Decrease youth access to alcohol, marijuana, and prescription drugs. Objective(s): 1. Sustain and expand partnerships for positive and healthy youth development that engage high school age youth as active leaders and resources in their communities. 2. Sustain and expand partnerships for positive and healthy youth development that engage elementary and middle school age youth as active leaders and resources in their communities. Intermediate Outcome(s): 80% of participating youth will report positive changes in leadership skills, confidence in their ability to participate in campaign development, and understanding of environmental approaches to prevention in the Youth Development Survey. At least 75% of adult allies who receive training services will report increased skills, knowledge, and confidence in supporting youth leadership in prevention activities in the Adult Ally Survey. IOM Category(ies): Universal Population(s): Youth, Young Adults Major Tasks Primary Activities Timeline Responsible Party Strategy Monitoring/ Evaluation Approach Outreach to and establish buy- in (written MOU) from schools that agree to host youth education programs. ● Develop a Memo of Understanding (MOU) template that outlines what YLI will provide, and what each site will provide to establish the Friday Night Live (FNL)/ Club Live (CL)/ FNL Kids programs ● Formalize a Memo of Understanding (MOU) with each school site to ensure that Administrators and Advisors understand their commitments clearly at the following potential FNL sites: ● Edison High School ● Kerman High School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● Selma High School ● Sunnyside High School ● Tranquility High School ● McLane High School ● Mendota High School ● Fresno High School Jul 2021 - June 2022 Prevention Provider CBP - Intra/Inter Agency Collab. & ALT - Youth & Adult Leadership Activities Signed written agreement/ Memorandum of Understandings with schools Exhibit A-2 Page 5 of 10 ● Rio del Rey High School ● Sanger High School ● Central Unified ● Formalize a Memo of Understanding (MOU) with each school site to ensure that Administrators and Advisors understand their commitments clearly at the following potential Club Live sites: ● Gaston Middle School ● Kerman Middle School ● Gaston Middle School ● Mendota Jr High School ● John Sutter Middle School in Fowler Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Conejo Middle School in Laton ● San Joaquin Elementary ● Riverdale Elementary ● Formalize a Memo of Understanding (MOU) with each school site to ensure that Administrators and Advisors understand their commitments clearly at the following FNL Kids sites: ● Fenix-Lowell Housing ● Hacienda Heights Housing Develop marketing materials that appeal to potential student participants and distribute throughout Fresno County schools. ● Develop compelling marketing materials that appeal to potential student participants to join the FNL, CL and FNL Kids programs ● YLI Staff will distribute materials widely throughout identified Fresno County school sites in partnership with the school administration, teachers, Health Center staff, community-based organization, and other partnering adult allies ● Receive feedback from school administration and advisors Jul 2021 - June 2022 Prevention Provider CBP - Intra/Inter Agency Collab. & ALT - Youth & Adult Leadership Activities PPSDS Reporting Final Drafts of Marketing Materials Developed Exhibit A-2 Page 6 of 10 Partner with local youth organizations and school staff to identify and recruit a diverse group of youth participants. ● YLI Staff will reach out to partners and community event organizers to secure participation in tabling opportunities such as school club rush/lunch events, health fairs and community events Ongoing Prevention Provider CBP - Intra/Inter Agency Collab. & ALT - Youth & Adult Leadership Activities PPSDS Reporting Implement 14 community based or school based FNL/CL chapters comprised of at least 15 youth leaders and an adult ally to take action around prevention issues. ● YLI staff will outreach at the following schools to recruit Chapters of 15 youth (210) youth annually) to participate in the FNL youth leadership programs: ● Edison High School ● Kerman High School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● Selma High School ● Sunnyside High School ● Tranquility High School ● McLane High School ● Mendota High School ● Fresno High School ● Rio del Rey High School ● Sanger High School ● Central Unified ● YLI staff will outreach at the following schools to recruit Chapters of 15 youth (150) youth annually) to participate in the Club Live Program ● Gaston Middle School ● Kerman Middle School ● Gaston Middle School ● Mendota Jr High School ● John Sutter Middle School in Fowler Coalinga Middle School ● Huron Middle School Annually Prevention Provider ED - School- based Edu. & ALT - Youth & Adult Leadership Activities Sign-In Sheets PPSDS Reporting Exhibit A-2 Page 7 of 10 ● Firebaugh Middle School ● Conejo Middle School in Laton ● San Joaquin Elementary ● Riverdale Elementary ● YLI staff will outreach at the following schools to recruit Chapters of 15 youth to participate in the FNL Kids Program ● Fenix-Lowell Housing ● Hacienda Heights Housing Train youth and adult advisors utilizing the FNL Roadmap curriculum. ● YLI staff will train the FNL and CL Chapters and Advisors at each site on the Friday Night Live (FNL) Roadmap curriculum (the FNL Roadmap is based on the evidence-based Youth Development Standards of Practice). ● YLI staff and Advisors will train FNL Kids program participants on the FNL Kids curriculum. Annually Prevention Provider ED- Community Edu. & ALT - Youth & Adult Leadership Activities Sign-in Sheets Youth Development Survey PPSDS reporting Adult Ally Retrospective Survey Implement supplemental training curriculum to prepare youth for authentic participation in prevention campaigns. ● YLI Staff will train the FNL and CL Chapters on additional skills and tools needed to prepare youth for authentic participation in the program including: True Colors, Public Speaking, Social Justice 101, and Storytelling for Advocacy Annually Prevention Provider ED- School Based Edu. & ALT - Youth & Adult Leadership Activities Sign-in Sheets Youth Development Survey PPSDS reporting Provide concrete assistance and guidance to chapter youth and their adult allies by offering a set of tools and resources for adult allies and youth. ● YLI Staff will facilitate an advisor training on Youth and Adult Partnerships and Youth Advocacy and provided one-on-one support ● YLI staff will organize and offer a comprehensive set of tools and resources for Chapter adult allies and youth that cover a broad range of prevention and civic engagement topics and skill development areas. These materials will be available on the Friday Night Live website and accessible to Fresno FNL chapters. In addition, YLI staff will periodically distribute relevant tools or resources to chapter allies through email or a list-serve Ongoing Prevention Provider ED- Community Edu. & ALT - Youth & Adult Leadership Activities Youth Development Survey Adult Ally Retrospective Survey results Exhibit A-2 Page 8 of 10 ● YLI staff will directly support youth chapter engagement and successful project implementation. Chapters will be able to select from a menu of training that staff will directly provide for them to implement with their adult ally Facilitate connections and relationships between chapter youth through social media, social events, and trainings. ● FNL and CL chapters will be extended an invitation to attend and participate in the hosted Prosocial youth leadership empowerment events like the Teen Summit, Fall Fest, Winter Celebration and Spring Jam ● YLI staff will provide opportunities for FNL and CL Chapters to host joint chapter meetings and collaborate on projects and activities. Ongoing Prevention Provider CBP - Intra/Inter Agency Collab. & ALT - Youth & Adult Leadership Activities Sign-in sheets PPSDS Reporting Agendas YD Survey Administer the FCSIS with youth at target schools (or use CHKS data). ● YLI Staff will connect and receive approval from school administrators to conduct the FCSIS at the following FNL sites: ● Edison High School ● Kerman High School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● Selma High School ● Sunnyside High School ● Tranquility High School ● McLane High School ● Mendota High School ● Fresno High School ● Rio del Rey High School ● Sanger High School ● Central Unified ● YLI Staff will connect and receive approval from school administrators to conduct the FCSIS at the following Club Live sites: ● Gaston Middle School ● Kerman Middle School ● Gaston Middle School ● Mendota Jr High School Annually Prevention Provider, Evaluator CBP- Assessing Community Needs/Assets FCSIS Survey Outcomes Exhibit A-2 Page 9 of 10 ● John Sutter Middle School in Fowler Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Conejo Middle School in Laton ● San Joaquin Elementary ● Riverdale Elementary Administer Youth Participant Survey. ● YLI Staff will administer and collect the YD (Youth Development) Survey to youth leadership program participants at the following FNL sites: ● Edison High School ● Kerman High School ● Orange Cove High School ● Reedley Middle College High School ● Roosevelt High School ● Selma High School ● Sunnyside High School ● Tranquility High School ● McLane High School ● Mendota High School ● Fresno High School ● Rio del Rey High School ● Sanger High School ● Central Unified ● YLI Staff will administer and collect the YD (Youth Development) Survey to youth leadership program participants at the following Club Live sites: ● Gaston Middle School ● Kerman Middle School ● Gaston Middle School ● Mendota Jr High School ● John Sutter Middle School in Fowler Coalinga Middle School ● Huron Middle School ● Firebaugh Middle School ● Conejo Middle School in Laton ● San Joaquin Elementary ● Riverdale Elementary Annually - May/June Prevention Provider, Evaluator CBP- Evaluation Services & ALT - Youth & Adult Leadership Activities YD Survey Outcomes Exhibit A-2 Page 10 of 10 Administer Adult Ally Survey At conclusion of the every fiscal year, YLI staff will administer the Adult Ally retrospective survey to measure relationship building, involvement and knowledge built, Youth and Adult partnerships, and AOD Environmental Prevention Annually - May/June Prevention Provider, Evaluator CBP - Evaluation Services & Outcomes Adult Ally Retrospective Survey results Guiding Principles of Care Delivery 1 rev 2017 Dec DBH VISION: Health and well-being for our community. DBH MISSION: The Department of Behavioral Health is dedicated to supporting the wellness of individuals, families and communities in Fresno County who are affected by, or are at risk of, mental illness and/or substance use disorders through cultivation of strengths toward promoting recovery in the least restrictive environment. DBH GOALS: Quadruple Aim •Deliver quality care •Maximize resources while focusing on efficiency •Provide an excellent care experience •Promote workforce well-being GUIDING PRINCIPLES OF CARE DELIVERY: The DBH 11 principles of care delivery define and guide a system that strives for excellence in the provision of behavioral health services where the values of wellness, resiliency, and recovery are central to the development of programs, services, and workforce. The principles provide the clinical framework that influences decision-making on all aspects of care delivery including program design and implementation, service delivery, training of the workforce, allocation of resources, and measurement of outcomes. 1.Principle One - Timely Access & Integrated Services o Individuals and families are connected with services in a manner that is streamlined, effective, and seamless o Collaborative care coordination occurs across agencies, plans for care are integrated, and whole person care considers all life domains such as health, education, employment, housing, and spirituality o Barriers to access and treatment are identified and addressed o Excellent customer service ensures individuals and families are transitioned from one point of care to another without disruption of care Exhibit B - Page 1 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 2 rev 2017 Dec 2.Principle Two - Strengths-based o Positive change occurs within the context of genuine trusting relationships o Individuals, families, and communities are resourceful and resilient in the way they solve problems o Hope and optimism is created through identification of, and focus on, the unique abilities of individuals and families 3.Principle Three - Person-driven and Family-driven o Self-determination and self-direction are the foundations for recovery o Individuals and families optimize their autonomy and independence by leading the process, including the identification of strengths, needs, and preferences o Providers contribute clinical expertise, provide options, and support individuals and families in informed decision making, developing goals and objectives, and identifying pathways to recovery o Individuals and families partner with their provider in determining the services and supports that would be most effective and helpful and they exercise choice in the services and supports they receive 4.Principle Four - Inclusive of Natural Supports o The person served identifies and defines family and other natural supports to be included in care o Individuals and families speak for themselves o Natural support systems are vital to successful recovery and the maintaining of ongoing wellness; these supports include personal associations and relationships typically developed in the community that enhance a person’s quality of life o Providers assist individuals and families in developing and utilizing natural supports. 5.Principle Five - Clinical Significance and Evidence Based Practices (EBP) o Services are effective, resulting in a noticeable change in daily life that is measurable. o Clinical practice is informed by best available research evidence, best clinical expertise, and client values and preferences o Other clinically significant interventions such as innovative, promising, and emerging practices are embraced Exhibit B - Page 2 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 3 rev 2017 Dec 6.Principle Six - Culturally Responsive o Values, traditions, and beliefs specific to an individual’s or family’s culture(s) are valued and referenced in the path of wellness, resilience, and recovery o Services are culturally grounded, congruent, and personalized to reflect the unique cultural experience of each individual and family o Providers exhibit the highest level of cultural humility and sensitivity to the self- identified culture(s) of the person or family served in striving to achieve the greatest competency in care delivery 7.Principle Seven - Trauma-informed and Trauma-responsive o The widespread impacts of all types of trauma are recognized and the various potential paths for recovery from trauma are understood o Signs and symptoms of trauma in individuals, families, staff, and others are recognized and persons receive trauma-informed responses o Physical, psychological and emotional safety for individuals, families, and providers is emphasized 8.Principle Eight - Co-occurring Capable o Services are reflective of whole-person care; providers understand the influence of bio-psycho-social factors and the interactions between physical health, mental health, and substance use disorders o Treatment of substance use disorders and mental health disorders are integrated; a provider or team may deliver treatment for mental health and substance use disorders at the same time 9.Principle Nine - Stages of Change, Motivation, and Harm Reduction o Interventions are motivation-based and adapted to the client’s stage of change o Progression though stages of change are supported through positive working relationships and alliances that are motivating o Providers support individuals and families to develop strategies aimed at reducing negative outcomes of substance misuse though a harm reduction approach o Each individual defines their own recovery and recovers at their own pace when provided with sufficient time and support Exhibit B - Page 3 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 4 rev 2017 Dec 10.Principle Ten - Continuous Quality Improvement and Outcomes-Driven o Individual and program outcomes are collected and evaluated for quality and efficacy o Strategies are implemented to achieve a system of continuous quality improvement and improved performance outcomes o Providers participate in ongoing professional development activities needed for proficiency in practice and implementation of treatment models 11.Principle Eleven - Health and Wellness Promotion, Illness and Harm Prevention, and Stigma Reduction o The rights of all people are respected o Behavioral health is recognized as integral to individual and community well-being o Promotion of health and wellness is interwoven throughout all aspects of DBH services o Specific strategies to prevent illness and harm are implemented at the individual, family, program, and community levels o Stigma is actively reduced by promoting awareness, accountability, and positive change in attitudes, beliefs, practices, and policies within all systems o The vision of health and well-being for our community is continually addressed through collaborations between providers, individuals, families, and community members Exhibit B - Page 4 of 4 Fresno County Department of Behavioral Health Exhbit C-1 Page 1 of 30 Employee Salaries Acct #Position FTE Admin Direct Total 1102 Director of Central Valley Programs 0.30 - $22,950 $22,950 1103 Communications Manager 0.02 - $1,428 $1,428 1104 Trainer 0.05 - $3,120 $3,120 1106 Program Manager 0.70 - $44,848 $44,848 1107 Program Manager 1.00 - $61,605 $61,605 1108 Program Coordinator 1.00 - $44,540 $44,540 1109 Program Coordinator 1.00 - $44,540 $44,540 1110 Program Coordinator 1.00 - $42,827 $42,827 1111 Program Coordinator 1.00 - $42,827 $42,827 1112 Program Coordinator 1.00 - $42,827 $42,827 1113 Program Coordinator 0.50 - $22,270 $22,270 1114 Program Coordinator 0.80 - $34,262 $34,262 1115 Program Coordinator 0.50 - $21,414 $21,414 Personnel Salaries Subtotal 8.87 -$ $429,458 $429,458 Employee Benefits Acct #Admin Direct Total 1201 -$ $2,200 $2,200 1202 - $1,540 $1,540 1203 - $60,124 $60,124 -$ $63,864 $63,864 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $32,854 $32,854 1303 - $4,774 $4,774 -$ $37,628 $37,628 -$ $530,950 $530,950 2000: CLIENT SUPPORT Acct #Amount 2009 $506 2011 $15,000 $15,506DIRECT CLIENT CARE TOTAL Program Supplies - Medical (First Aid kit for each site of service) Other (Client Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2021-22) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhbit C-1 Page 2 of 30 3000: OPERATING EXPENSES Acct #Amount 3001 $10,560 3002 $8,500 3003 $36,020 3004 $4,080 3005 $7,920 3006 $14,784 $81,864 4000: FACILITIES & EQUIPMENT Acct #Amount 4002 $26,000 4003 $1,000 $27,000 5000: SPECIAL EXPENSES Acct #Amount 5003 $315,000 5004 $1,000 $316,000 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $206,311 $206,311 7000: FIXED ASSETS Acct #Amount 7001 $11,721 $11,721 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $1,189,352 $1,189,352 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL Line Item Description FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES $1,189,352 PROGRAM FUNDING SOURCES SPECIAL EXPENSES TOTAL: Line Item Description Administrative Overhead FACILITIES/EQUIPMENT TOTAL: Line Item Description Contractual/Consulting Services (Fresno County Superintendent of Schools) Translation Services TOTAL PROGRAM FUNDING SOURCES:$1,189,352 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL Staff Development & Training Staff Mileage Computer Equipment & Software OPERATING EXPENSES TOTAL: Line Item Description Rent/Lease Building Rent/Lease Equipment Line Item Description Telecommunications Printing/Postage Office, Household & Program Supplies (program curriculum $20000 + office supplies $252 Advertising Exhbit C-1 Page 3 of 30 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 530,950 Employee Salaries 429,458 1102 Director of Central Valley Programs 22,950 Supervision of Managers, direct budget management, direct oversight of program development, Contract contact, Partnership development lead (FCSS & School), and direct coalition strategy lead. FTE (0.30)x ($76,500) = $22,950 1103 Communications Manager 1,428 Direct media support to local campaigns. This included youth media trainings, social media content development and social media posting. FTE (0.02 )x ($71,400) = $1,428 1104 Trainer 3,120 Direct training and capacity building support for Communities Mobilizing for Change on Alcohol (CMCA) evidence based model. YLI is the exclusive SAMHSA CMCA Trainer, so this trainer is a staff person. FTE (0.05)x ($62,400) = $3,120 1106 Program Manager 44,848 Supervision of Program Coordinators, liaison to school and community partners, lead on youth leader programs (YALL & College), and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Edison HS and Gaston MS. FTE (0.70)x ($64,069) = $44,848 1107 Program Manager 61,605 Supervision of Program Coordinators, liaison to school and community partners, lead on the media strategy implementation, and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Fresno HS and McLane. FTE (1.0) x ($61,605) = $61,605 1108 Program Coordinator 44,540 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Kerman HS, KMS, Hosing Sites. FTE (1.0) x ($44,540) = $44,540 1109 Program Coordinator 44,540 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Selma HS, Reedley MCHS, and Orange Cove HS. FTE (1.0) x ($44,540) = $44,540 1110 Program Coordinator 42,827 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at at San Joaquin Elem., Tranquility HS, and Rio Del Rey HS. FTE (1.0) x ($42,827) = $42,827 SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2021-22) Budget Narrative Exhbit C-1 Page 4 of 30 1111 Program Coordinator 42,827 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Roosevelt HS and Sunnyside HS. FTE (1.0) x ($42,827) = $42,827 1112 Program Coordinator 42,827 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Mendota HS and Mendota JR HS,. FTE (1.0) x ($42,827) = $42,827 1113 Program Coordinator 22,270 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified High Schools. FTE (.50) x ($44,540) = $22,270 1114 Program Coordinator 34,262 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified Middle Schools. FTE (.80) x ($42,827) = $34,262 1115 Program Coordinator 21,414 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Sanger and WAMS. FTE (.50) x ($42,827) = $21,414 Employee Benefits 63,864 1201 Retirement 2,200 403(b) Retirement contribution at 5.5% of salaries based on FY2021 allocations. 1202 Worker's Compensation 1,540 Worker's Compensation contribution at 5.5% of WC expense based on FY2021 allocations 1203 Health Insurance 60,124 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $429,458 = $60,124 Payroll Taxes & Expenses:37,628 1301 OASDI - 1302 FICA/MEDICARE 32,854 FICA/Medicare contribution at .0765% of salaries. .0765 x $429,881 = $32,886 1303 SUI 4,774 SUI is 6.2% x # of staff x $7K. 6.2% x $7,000 x 11 staff = $4774 2000: CLIENT SUPPORT 15,506 2009 Program Supplies - Medical (First Aid kit for each site of service) 506 1st Aid kit for each of the 31 sites. Estimate - 31 sites x $16.33/kit = $506 2011 Other (Client Stipends)15,000 Advisor and Youth Stipends for time travel and expenses associated with the Development of Outreach Materials, Youth Publication (aka Zine) and Podcast. Estimate - 30 stipends x $500 each = $15000 Exhbit C-1 Page 5 of 30 3000: OPERATING EXPENSES 81,864 3001 Telecommunications 10,560 Telecommunications reimbursement of cell phone and internet. Staff may include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs. $80 per staff x 11 staff x 12 months = $10,560 3002 Printing/Postage 8,500 Educational material printing which may include but are not limited to informational/educational brochures, flyers, posters, and educational worksheets. Estimated at approximately $400 per month x 12 months = $4,800 Estimated cost to printed youth magazine publication (aka Zine) - $3,700 3003 Office, Household & Program Supplies (program curriculum $20000 + office supplies $2520 +13500 prosocial events) 36,020 Office, Household, and Program supplies which include but are not limited to binders, folders, staplers, hole-punchers, paper, pens, hand sanitizer, and cleaning supplies. Estimated at $210 per month x 12 months = $2520. Curriculum and Educational supporting materials cost for SPORT PPW ($5,000), InShape PPW ($5,000), Marijuana PPW ($5,000), and Opioid PPW ($5,000) Program materials equals = $20,000. Materials purchased for prosocial leadership events and activities may include but are not limited to workshop materials, pens, pencils, workbooks, folders, t- shirts, listening devices, tablets, cameras, post-its pads, makers, theme decor, speakers, expert presenters. Estimated for each event/activity planned by youth = $4500 x 3/yearly = $13,500 3004 Advertising 4,080 Facebook and Instagram social media post boosts three times a quarter. Estimated cost = ($150/each boost x12), two AudioGO (or similar provider) PSA Online Radio Ad purchase ($500/10 day run), and three billboard purchases (estimated at $350/each ). 3005 Staff Development & Training 7,920 Staff development $720 x 11 staff. Staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs. 3006 Staff Mileage 14,784 This is approximately 200 miles per month x 11 staff traveling to/from school and partner sites x .56 mileage rate. The 11 staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs 200 miles x 11 staff x 12 months x $.56 = $14,784 4000: FACILITIES & EQUIPMENT 27,000 4002 Rent/Lease Building 26,000 Estimated annual rent is $52K. Based on FTE located in Fresno office, 50% of rent is allocated to this contract. 4003 Rent/Lease Equipment 1,000 Monthly cost of rented and leased equipment (Including printer and storage) = 83.33 per month x 12 months = $1000 Exhbit C-1 Page 6 of 30 5000: SPECIAL EXPENSES 316,000 5003 Contractual/Consulting Services (Fresno County Superintendent of Schools) 315,000 Subcontract with Fresno County Superintendent (FCSS) of Schools Safe and Health Kids Department for the Implementation of Prescription Drug Abuse Prevention Programs. Programs will integrated into the Fresno’s Recreation, Enrichment and Scholastic Help (FRESH) after-school programs and will be led and delivered by FCSS staff with the support of FRESH Program Staff. Cost associated with the contract include staffing, programs curriculum, supplies and materials, and well as mileage, staff develop and training. 5004 Translation Services 1,000 Cost of Translations services for Trainings, Outreach Materials, and Zine. Estimated $1000 annually. 6000: ADMINISTRATIVE EXPENSES 206,311 6001 Administrative Overhead 206,311 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($206,311) 7000: FIXED ASSETS 11,721 7001 Computer Equipment & Software 11,721 Estimated cost for MacBook Laptop, software and accessories for 6 new staff ($1,786 x 6 staff = $10,716 ), two projectors (cost per projector $200 x 2 = $400), two Zoom Professional account (cost per account $200 x 2 = $400), one Canva subscription ($120/yr), and one Toonly subscription . TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,189,352 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,189,352 - Exhbit C-1 Page 7 of 30 Employee Salaries Acct #Position FTE Admin Direct Total 1102 Director of Central Valley Programs 0.30 - $23,409 $23,409 1103 Communications Manager 0.02 - $1,457 $1,457 1104 Trainer 0.05 - $3,182 $3,182 1106 Program Manager 0.70 - $45,745 $45,745 1107 Program Manager 1.00 - $62,837 $62,837 1108 Program Coordinator 1.00 - $45,431 $45,431 1109 Program Coordinator 1.00 - $45,431 $45,431 1110 Program Coordinator 1.00 - $43,684 $43,684 1111 Program Coordinator 1.00 - $43,684 $43,684 1112 Program Coordinator 1.00 - $43,684 $43,684 1113 Program Coordinator 0.50 - $22,715 $22,715 1114 Program Coordinator 0.80 - $34,947 $34,947 1115 Program Coordinator 0.50 - $21,842 $21,842 Personnel Salaries Subtotal 8.87 -$ $438,047 $438,047 Employee Benefits Acct #Admin Direct Total 1201 -$ $2,234 $2,234 1202 - $1,577 $1,577 1203 - $61,327 $61,327 -$ $65,138 $65,138 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $33,511 $33,511 1303 - $4,774 $4,774 1304 - $0 $0 -$ $38,285 $38,285 -$ $541,470 $541,470 2000: CLIENT SUPPORT Acct #Amount 2009 $506 2011 $15,000 $15,506DIRECT CLIENT CARE TOTAL Program Supplies - Medical Other (Client Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Other (Specify) SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2022-23) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhbit C-1 Page 8 of 30 3000: OPERATING EXPENSES Acct #Amount 3001 $10,560 3002 $8,500 3003 $16,020 3004 $3,850 3005 $7,920 3006 $14,784 $61,634 4000: FACILITIES & EQUIPMENT Acct #Amount 4002 $26,780 4003 $1,000 4004 $7,560 $35,340 5000: SPECIAL EXPENSES Acct #Amount 5003 $315,000 5004 $1,000 5005 $9,920 $325,920 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $205,993 $205,993 7000: FIXED ASSETS Acct #Amount 7001 $3,489 $3,489 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $1,189,352 $1,189,352 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL Line Item Description FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES $1,189,352 PROGRAM FUNDING SOURCES SPECIAL EXPENSES TOTAL: Line Item Description Administrative Overhead FACILITIES/EQUIPMENT TOTAL: Line Item Description Contractual/Consulting Services (Fresno County Superintendent of Schools) Translation Services Other (Youth Conference Costs & Travel) TOTAL PROGRAM FUNDING SOURCES:$1,189,352 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL Staff Development & Training Staff Mileage Computer Equipment & Software OPERATING EXPENSES TOTAL: Line Item Description Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles (Van Rentals for 3 prosocial events and One 3-day conference) Line Item Description Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Exhbit C-1 Page 9 of 30 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 541,470 Employee Salaries 438,047 1102 Director of Central Valley Programs 23,409 Supervision of Managers, direct budget management, direct oversight of program development, Contract contact, Partnership development lead (FCSS & School), and direct coalition strategy lead. FTE (0.30)x ($78,030) = $23,409 1103 Communications Manager 1,457 Direct media support to local campaigns. This included youth media trainings, social media content development and social media posting. FTE (0.02 )x ($72,828) = $1,457 1104 Trainer 3,182 Direct training and capacity building support for Communities Mobilizing for Change on Alcohol (CMCA) evidence based model. YLI is the exclusive SAMHSA CMCA Trainer, so this trainer is a staff person. FTE (0.05)x ($63,648) = $3,182 1106 Program Manager 45,745 Supervision of Program Coordinators, liaison to school and community partners, lead on youth leader programs (YALL & College), and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Edison HS and Gaston MS. FTE (0.70)x ($65,350) = $45,745 1107 Program Manager 62,837 Supervision of Program Coordinators, liaison to school and community partners, lead on the media strategy implementation, and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Fresno HS and McLane. FTE (1.0) x ($62,837) = $62,837 1108 Program Coordinator 45,431 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Kerman HS, KMS, Hosing Sites. FTE (1.0) x ($45,431) = $45,431 1109 Program Coordinator 45,431 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Selma HS, Reedley MCHS, and Orange Cove HS. FTE (1.0) x ($45,431) = $45,431 1110 Program Coordinator 43,684 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at at San Joaquin Elem., Tranquility HS, and Rio Del Rey HS. FTE (1.0) x ($43,684) = $43,684 SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2022-23) Budget Narrative Exhbit C-1 Page 10 of 30 1111 Program Coordinator 43,684 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Roosevelt HS and Sunnyside HS. FTE (1.0) x ($43,684) = $43,684 1112 Program Coordinator 43,684 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Mendota HS and Mendota JR HS,. FTE (1.0) x ($43,684) = $43,684 1113 Program Coordinator 22,715 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified High Schools. FTE (.50) x ($45,431) = $22,715 1114 Program Coordinator 34,947 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified Middle Schools. FTE (.80) x ($43,684) = $34,947 1115 Program Coordinator 21,842 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Sanger and WAMS. FTE (.50) x ($43,684) = $21,842 Employee Benefits 65,138 1201 Retirement 2,234 403(b) Retirement contribution at 5.5% of salaries based on FY2021 allocations. 1202 Worker's Compensation 1,577 Worker's Compensation contribution at 5.5% of WC expense based on FY2021 allocations 1203 Health Insurance 61,327 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $438,047 = $61,327 Payroll Taxes & Expenses:38,285 1301 OASDI - 1302 FICA/MEDICARE 33,511 FICA/Medicare contribution at .0765% of salaries. .0765 x $439,423 = $33,616 1303 SUI 4,774 SUI is 6.2% x # of staff x $7K. 6.2% x $7,000 x 11 staff = $4774 2000: CLIENT SUPPORT 15,506 2009 Program Supplies - Medical 506 1st Aid kit for each of the 31 sites. Estimate - 31 sites x $16.33/kit = $506 2011 Other (Client Stipends)15,000 Advisor and Youth Stipends for time travel and expenses associated with the Development of Outreach Materials, Youth Publication (aka Zine) and Podcast. Estimate - 30 stipends x $500 each = $15000 Exhbit C-1 Page 11 of 30 3000: OPERATING EXPENSES 61,634 3001 Telecommunications 10,560 Telecommunications reimbursement of cell phone and internet. Staff may include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs. $80 per staff x 11 staff x 12 months = $10,560 3002 Printing/Postage 8,500 Educational material printing which may include but are not limited to informational/educational brochures, flyers, posters, and educational worksheets. Estimated at approximately $400 per month x 12 months = $4,800 Estimated cost to printed youth magazine publication (aka Zine) - $3,700 3003 Office, Household & Program Supplies 16,020 Office, Household, and Program supplies which include but are not limited to binders, folders, staplers, hole-punchers, paper, pens, hand sanitizer, and cleaning supplies. Estimated at $210 per month x 12 months = $2520. Materials purchased for prosocial leadership events and activities may include but are not limited to workshop materials, pens, pencils, workbooks, folders, t- shirts, listening devices, tablets, cameras, post-its pads, makers, theme decor, speakers, expert presenters. Estimated for each event/activity planned by youth = $4500 x 3/yearly = $13,500 3004 Advertising 3,850 Facebook and Instagram social media post boosts three times a quarter. Estimated cost = ($150/each boost x12), two AudioGO (or similar provider) PSA Online Radio Ad purchase ($500/10 day run), and three billboard purchases (estimated at $350/each ). 3005 Staff Development & Training 7,920 Staff development $720 x 11 staff. Staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs. 3006 Staff Mileage 14,784 This is approximately 200 miles per month x 11 staff traveling to/from school and partner sites x .56 mileage rate. The 11 staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs 200 miles x 11 staff x 12 months x $.56 = $14,784 4000: FACILITIES & EQUIPMENT 35,340 4002 Rent/Lease Building 26,780 Estimated annual rent is $53,560 (3% increase for 2 year lease). Based on FTE located in Fresno office, 50% of rent is allocated to this contract. 4003 Rent/Lease Equipment 1,000 Monthly cost of rented and leased equipment (Including printer and storage) = 83.33 per month x 12 months = $1000 4004 Rent/Lease Vehicles (Van Rentals for 3 prosocial events and One 3-day conference) 7,560 Van Rentals for the three annual prosocial events and One 3-day conference. (Estimated cost) 1 Day Prosocial Events: Vans cost $420 each x 3 Vans x 3 events = $3780. 3 Day Youth Conference $420(Van) x3 vans x 3 days = $3780. Exhbit C-1 Page 12 of 30 5000: SPECIAL EXPENSES 325,920 5003 Contractual/Consulting Services (Fresno County Superintendent of Schools) 315,000 Subcontract with Fresno County Superintendent (FCSS) of Schools Safe and Health Kids Department for the Implementation of Prescription Drug Abuse Prevention Programs. Programs will integrated into the Fresno’s Recreation, Enrichment and Scholastic Help (FRESH) after-school programs and will be led and delivered by FCSS staff with the support of FRESH Program Staff. Cost associated with the contract include staffing, programs curriculum, supplies and materials, and well as mileage, staff develop and training. 5004 Translation Services 1,000 Cost of Translations services for Trainings, Outreach Materials, and Zine. Estimated $1000 annually. 5005 Other (Youth Conference Costs & Travel)9,920 16 people = Lodging ca rate $182/night (2 nights) x 8 rooms= $2,912. Conference costs $240 /per person x 16 people = $3,840 , Meals per diem $66/day x 3day x16 people = $3,168. 6000: ADMINISTRATIVE EXPENSES 205,993 6001 Administrative Overhead 205,993 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($205,993) 7000: FIXED ASSETS 3,489 7001 Computer Equipment & Software 3,489 Estimated cost may be utilized, but is not limited to, potential replacement Macbook Laptop, software and accessories for one current staff ($1,786), virus protection and recyclying fee of old laptops ($1183), two professional Zoom accounts ($200 per account x 2 = $400), and one Canva subscription ($120/yr). TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,189,352 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,189,352 - Exhbit C-1 Page 13 of 30 Employee Salaries Acct #Position FTE Admin Direct Total 1102 Director of Central Valley Programs 0.30 $23,877 $23,877 1103 Communications Manager 0.02 $1,486 $1,486 1104 Trainer 0.05 $3,246 $3,246 1106 Program Manager 0.70 - $46,660 $46,660 1107 Program Manager 1.00 - $64,094 $64,094 1108 Program Coordinator 1.00 - $46,339 $46,339 1109 Program Coordinator 1.00 - $46,339 $46,339 1110 Program Coordinator 1.00 - $44,557 $44,557 1111 Program Coordinator 1.00 - $44,557 $44,557 1112 Program Coordinator 1.00 - $44,557 $44,557 1113 Program Coordinator 0.50 - $23,170 $23,170 1114 Program Coordinator 0.80 - $35,646 $35,646 1115 Program Coordinator 0.50 - $22,279 $22,279 Personnel Salaries Subtotal 8.87 -$ $446,807 $446,807 Employee Benefits Acct #Admin Direct Total 1201 -$ $2,279 $2,279 1202 - $1,609 $1,609 1203 - $62,553 $62,553 -$ $66,441 $66,441 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $34,181 $34,181 1303 - $4,774 $4,774 -$ $38,955 $38,955 -$ $552,203 $552,203 2000: CLIENT SUPPORT Acct #Amount 2009 $506 2011 $15,000 $15,506DIRECT CLIENT CARE TOTAL Program Supplies - Medical Other (Client Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2023-24) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhbit C-1 Page 14 of 30 3000: OPERATING EXPENSES Acct #Amount 3001 $10,560 3002 $8,500 3003 $16,020 3004 $3,850 3005 $5,500 3006 $15,048 $59,478 4000: FACILITIES & EQUIPMENT Acct #Amount 4002 $26,780 4003 $1,000 4004 $5,040 $32,820 5000: SPECIAL EXPENSES Acct #Amount 5003 $315,000 5004 $1,000 5005 $4,960 $320,960 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $205,994 $205,994 7000: FIXED ASSETS Acct #Amount 7001 $2,391 $2,391 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $1,189,352 $1,189,352 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL Line Item Description FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES $1,189,352 PROGRAM FUNDING SOURCES SPECIAL EXPENSES TOTAL: Line Item Description Administrative Overhead FACILITIES/EQUIPMENT TOTAL: Line Item Description Contractual/Consulting Services (Fresno County Superintendent of Schools) Translation Services Other (Youth Leadership Conference Costs & Travel) TOTAL PROGRAM FUNDING SOURCES:$1,189,352 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL Staff Development & Training Staff Mileage Computer Equipment & Software OPERATING EXPENSES TOTAL: Line Item Description Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles Line Item Description Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Exhbit C-1 Page 15 of 30 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 552,203 Employee Salaries 446,807 1102 Director of Central Valley Programs 23,877 Supervision of Managers, direct budget management, direct oversight of program development, Contract contact, Partnership development lead (FCSS & School), and direct coalition strategy lead. FTE (0.30)x ($79,590) = $23,887 1103 Communications Manager 1,486 Direct media support to local campaigns. This included youth media trainings, social media content development and social media posting. FTE (0.02 )x ($74,284) = $1,486 1104 Trainer 3,246 Direct training and capacity building support for Communities Mobilizing for Change on Alcohol (CMCA) evidence based model. YLI is the exclusive SAMHSA CMCA Trainer, so this trainer is a staff person. FTE (0.05)x ($64,921) = $3,246 1106 Program Manager 46,660 Supervision of Program Coordinators, liaison to school and community partners, lead on youth leader programs (YALL & College), and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Edison HS and Gaston MS. FTE (0.70)x ($66,657) = $46,660 1107 Program Manager 64,094 Supervision of Program Coordinators, liaison to school and community partners, lead on the media strategy implementation, and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Fresno HS and McLane. FTE (1.0) x ($64,094) = $64,094 1108 Program Coordinator 46,339 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Kerman HS, KMS, Hosing Sites. FTE (1.0) x ($46,339) = $46,339 1109 Program Coordinator 46,339 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Selma HS, Reedley MCHS, and Orange Cove HS. FTE (1.0) x ($46,339) = $46,339 1110 Program Coordinator 44,557 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at at San Joaquin Elem., Tranquility HS, and Rio Del Rey HS. FTE (1.0) x ($44,557) = $44,557 SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2023-24) Budget Narrative Exhbit C-1 Page 16 of 30 1111 Program Coordinator 44,557 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Roosevelt HS and Sunnyside HS. FTE (1.0) x ($44,557) = $44,557 1112 Program Coordinator 44,557 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Mendota HS and Mendota JR HS,. FTE (1.0) x ($44,557) = $44,557 1113 Program Coordinator 23,170 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified High Schools. FTE (.50) x ($46,340) = $23,170 1114 Program Coordinator 35,646 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified Middle Schools. FTE (.80) x ($44,558) = $34,262 1115 Program Coordinator 22,279 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Sanger and WAMS. FTE (.50) x ($44,558) = $22,279 Employee Benefits 66,441 1201 Retirement 2,279 403(b) Retirement contribution at 5.5% of salaries based on FY2021 allocations. 1202 Worker's Compensation 1,609 Worker's Compensation contribution at 5.5% of WC expense based on FY2021 allocations 1203 Health Insurance 62,553 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $446,808 = $62,553 Payroll Taxes & Expenses:38,955 1301 OASDI - 1302 FICA/MEDICARE 34,181 FICA/Medicare contribution at .0765% of salaries. .0765 x $446,808 = $34,181 1303 SUI 4,774 SUI is 6.2% x # of staff x $7K. 6.2% x $7,000 x 11 staff = $4,774 2000: CLIENT SUPPORT 15,506 2009 Program Supplies - Medical 506 1st Aid kit for each of the 31 sites. Estimate - 31 sites x $16.33/kit = $506 2011 Other (Client Stipends)15,000 Advisor and Youth Stipends for time travel and expenses associated with the Development of Outreach Materials, Youth Publication (aka Zine) and Podcast. Estimate - 30 stipends x $500 each = $15000 Exhbit C-1 Page 17 of 30 3000: OPERATING EXPENSES 59,478 3001 Telecommunications 10,560 Telecommunications reimbursement of cell phone and internet. Staff may include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs. $80 per staff x 11 staff x 12 months = $10,560 3002 Printing/Postage 8,500 Educational material printing which may include but are not limited to informational/educational brochures, flyers, posters, and educational worksheets. Estimated at approximately $400 per month x 12 months = $4,800 Estimated cost to printed youth magazine publication (aka Zine) - $3,700 3003 Office, Household & Program Supplies 16,020 Office, Household, and Program supplies which include but are not limited to binders, folders, staplers, hole-punchers, paper, pens, hand sanitizer, and cleaning supplies. Estimated at $210 per month x 12 months = $2520. Materials purchased for prosocial leadership events and activities may include but are not limited to workshop materials, pens, pencils, workbooks, folders, t- shirts, listening devices, tablets, cameras, post-its pads, makers, theme decor, speakers, expert presenters. Estimated for each event/activity planned by youth = $4500 x 3/yearly = $13,500 3004 Advertising 3,850 Facebook and Instagram social media post boosts three times a quarter. Estimated cost = ($150/each boost x12), two AudioGO (or similar provider) PSA Online Radio Ad purchase ($500/10 day run), and three billboard purchases (estimated at $350/each ). 3005 Staff Development & Training 5,500 Staff development $500 x 11 staff. (staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs). 3006 Staff Mileage 15,048 This is approximately 200 miles per month x 11 staff traveling to/from school and partner sites x .57 mileage rate. The 11 staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs 200 miles x 11 staff x 12 months x $.57 = $15,048 4000: FACILITIES & EQUIPMENT 32,820 4002 Rent/Lease Building 26,780 Estimated annual rent is $53,560. Based on FTE located in Fresno office, 50% of rent is allocated to this contract. 4003 Rent/Lease Equipment 1,000 Monthly cost of rented and leased equipment (Including printer and storage) = 83.33 per month x 12 months = $1000 4004 Rent/Lease Vehicles 5,040 Youth transportation to and from the three annual Prosocial Events and One 3- day youth leadership conference : Vans cost $420 each x 3 Vans x 3 events = $3780. 3 Day Youth Conference $420(Van) x 3 days = $1260. Exhbit C-1 Page 18 of 30 5000: SPECIAL EXPENSES 320,960 5003 Contractual/Consulting Services (Fresno County Superintendent of Schools) 315,000 Subcontract with Fresno County Superintendent (FCSS) of Schools Safe and Health Kids Department for the Implementation of Prescription Drug Abuse Prevention Programs. Programs will integrated into the Fresno’s Recreation, Enrichment and Scholastic Help (FRESH) after-school programs and will be led and delivered by FCSS staff with the support of FRESH Program Staff. Cost associated with the contract include staffing, programs curriculum, supplies and materials, and well as mileage, staff develop and training. 5004 Translation Services 1,000 Cost of Translations services for Trainings, Outreach Materials, and Zine. Estimated $1000 annually. 5005 Other (Youth Leadership Conference Costs & Travel) 4,960 8 people = Lodging ca rate $182/night (2 nights) x 4 rooms= $1456. Conference costs $240 /per person x 8people = $1920 , Meals per diem $66/day x 3day x 8people = $1584. 6000: ADMINISTRATIVE EXPENSES 205,994 6001 Administrative Overhead 205,994 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($205,994) 7000: FIXED ASSETS 2,391 7001 Computer Equipment & Software 2,391 Estimated cost may be utilized, but is not limited to, potential replacement Macbook Laptop, software and accessories for one current staff ($1,786), two professional Zoom accounts ($200 per account x 2 = $400), one Canva subscription ($120/yr), and one Toonly subscription ($85/yr). TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,189,352 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,189,352 - Exhbit C-1 Page 19 of 30 Employee Salaries Acct #Position FTE Admin Direct Total 1102 Director of Central Valley Programs 0.30 $24,354 $24,354 1103 Communications Manager 0.02 $1,515 $1,515 1106 Program Manager 0.70 - $47,594 $47,594 1107 Program Manager 1.00 - $65,376 $65,376 1108 Program Coordinator 1.00 - $47,266 $47,266 1109 Program Coordinator 1.00 - $47,266 $47,266 1110 Program Coordinator 1.00 - $45,448 $45,448 1111 Program Coordinator 1.00 - $45,448 $45,448 1112 Program Coordinator 1.00 - $45,448 $45,448 1113 Program Coordinator 0.50 - $23,634 $23,634 1114 Program Coordinator 0.80 - $36,359 $36,359 1115 Program Coordinator 0.50 - $22,725 $22,725 Personnel Salaries Subtotal 8.82 -$ $452,433 $452,433 Employee Benefits Acct #Admin Direct Total 1201 -$ $2,307 $2,307 1202 - $1,629 $1,629 1203 - $63,341 $63,341 -$ $67,277 $67,277 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $34,611 $34,611 1303 - $4,774 $4,774 -$ $39,385 $39,385 -$ $559,095 $559,095 2000: CLIENT SUPPORT Acct #Amount 2009 $506 2011 $15,000 $15,506 3000: OPERATING EXPENSES Acct #Amount 3001 $10,560 3002 $8,500 3003 $24,020 3004 $3,850 3005 $6,345 3006 $15,180 $68,455 Staff Development & Training Staff Mileage OPERATING EXPENSES TOTAL: DIRECT CLIENT CARE TOTAL Line Item Description Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Program Supplies - Medical Other (Client Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2024-25) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhbit C-1 Page 20 of 30 4000: FACILITIES & EQUIPMENT Acct #Amount 4002 $27,583 4003 $1,000 4004 $3,780 $32,363 5000: SPECIAL EXPENSES Acct #Amount 5003 $300,000 5004 $1,000 5005 $4,522 $305,522 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $205,994 $205,994 7000: FIXED ASSETS Acct #Amount 7001 $2,417 $2,417 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $1,189,352 $1,189,352 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL Line Item Description FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES $1,189,352 PROGRAM FUNDING SOURCES SPECIAL EXPENSES TOTAL: Line Item Description Administrative Overhead FACILITIES/EQUIPMENT TOTAL: Line Item Description Contractual/Consulting Services (Fresno County Superintendanet of Schools) Translation Services Other (Youth Leadership Conference Costs & Travel) TOTAL PROGRAM FUNDING SOURCES:$1,189,352 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL Computer Equipment & Software Line Item Description Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles Exhbit C-1 Page 21 of 30 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 559,095 Employee Salaries 452,433 1102 Director of Central Valley Programs 24,354 Supervision of Managers, direct budget management, direct oversight of program development, Contract contact, Partnership development lead (FCSS & School), and direct coalition strategy lead. FTE (0.30)x ($81,181) = $24,354 1103 Communications Manager 1,515 Direct media support to local campaigns. This included youth media trainings, social media content development and social media posting. FTE (0.02 )x ($75,769) = $1,428 1106 Program Manager 47,594 Supervision of Program Coordinators, liaison to school and community partners, lead on youth leader programs (YALL & College), and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Edison HS and Gaston MS. FTE (0.70)x ($67,991) = $47,594 1107 Program Manager 65,376 Supervision of Program Coordinators, liaison to school and community partners, lead on the media strategy implementation, and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Fresno HS and McLane. FTE (1.0) x ($65,376) = $65,376 1108 Program Coordinator 47,266 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Kerman HS, KMS, Hosing Sites. FTE (1.0) x ($47,266) = $47,266 1109 Program Coordinator 47,266 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Selma HS, Reedley MCHS, and Orange Cove HS. FTE (1.0) x ($47,266) = $47,266 1110 Program Coordinator 45,448 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at at San Joaquin Elem., Tranquility HS, and Rio Del Rey HS. FTE (1.0) x ($45,448) = $45,448 1111 Program Coordinator 45,448 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Roosevelt HS and Sunnyside HS. FTE (1.0) x ($45,448) = $45,448 SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2024-25) Budget Narrative Exhbit C-1 Page 22 of 30 1112 Program Coordinator 45,448 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Mendota HS and Mendota JR HS,. FTE (1.0) x ($45,448) = $45,448 1113 Program Coordinator 23,634 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified High Schools. FTE (.50) x ($47,267) = $23,634 1114 Program Coordinator 36,359 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified Middle Schools. FTE (.80) x ($45,449) = $36,359 1115 Program Coordinator 22,725 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Sanger and WAMS. FTE (.50) x ($45,449) = $22,725 Employee Benefits 67,277 1201 Retirement 2,307 403(b) Retirement contribution at 5.5% of salaries based on FY2021 allocations. 1202 Worker's Compensation 1,629 Worker's Compensation contribution at 5.5% of WC expense based on FY2021 allocations 1203 Health Insurance 63,341 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $452,433 = $63,341 Payroll Taxes & Expenses:39,385 1301 OASDI - 1302 FICA/MEDICARE 34,611 FICA/Medicare contribution at .0765% of salaries. .0765 x $452,433 = $34,147 1303 SUI 4,774 SUI is 6.2% x # of staff x $7K. 6.2% x $7,000 x 11 staff = $4774 2000: CLIENT SUPPORT 15,506 2009 Program Supplies - Medical 506 1st Aid kit for each of the 31 sites. Estimate - 31 sites x $16.33/kit = $506 2011 Other (Client Stipends)15,000 Advisor and Youth Stipends for time travel and expenses associated with the Development of Outreach Materials, Youth Publication (aka Zine) and Podcast. Estimate - 30 stipends x $500 each = $15000 Exhbit C-1 Page 23 of 30 3000: OPERATING EXPENSES 68,455 3001 Telecommunications 10,560 Telecommunications reimbursement of cell phone and internet. Staff may include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs. $80 per staff x 11 staff x 12 months = $10,560 3002 Printing/Postage 8,500 Educational material printing which may include but are not limited to informational/educational brochures, flyers, posters, and educational worksheets. Estimated at approximately $400 per month x 12 months = $4,800 Estimated cost to printed youth magazine publication (aka Zine) - $3,700 3003 Office, Household & Program Supplies 24,020 Office, Household, and Program supplies which include but are not limited to binders, folders, staplers, hole-punchers, paper, pens, hand sanitizer, and cleaning supplies. Estimated at $210 per month x 12 months = $2520. Curriculum and Educational supporting materials cost for SPORT PPW ($5,000), InShape PPW ($5,000), Marijuana PPW ($5,000), and Opioid PPW ($5,000) Program materials equals = $20,000. Materials purchased for prosocial leadership events and activities may include but are not limited to workshop materials, pens, pencils, workbooks, folders, t- shirts, listening devices, tablets, cameras, post-its pads, makers, theme decor, speakers, expert presenters. Estimated for each event/activity planned by youth = $4500 x 3/yearly = $13,500 3004 Advertising 3,850 Facebook and Instagram social media post boosts three times a quarter. Estimated cost = ($150/each boost x12), two AudioGO (or similar provider) PSA Online Radio Ad purchase ($500/10 day run), and three billboard purchases (estimated at $350/each ). 3005 Staff Development & Training 6,345 Staff development $500 x 11 staff totalling $5,500. (staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs). In additional we will hold a capacity-building staff retreat which consists of facility cost of $220, and a meal budget of $440 (2 meals, Breakfast and Lunch), and $143 in training curriculum supplies and materials, totalling $803. 3006 Staff Mileage 15,180 This is approximately 200 miles per month x 11 staff traveling to/from school and partner sites x .575 mileage rate. The 11 staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs 200 miles x 11 staff x 12 months x $.575 = $15,180 4000: FACILITIES & EQUIPMENT 32,363 4002 Rent/Lease Building 27,583 Estimated annual rent is $55,167 (3% increase for 2 year lease). Based on FTE located in Fresno office, 50% of rent is allocated to this contract. 4003 Rent/Lease Equipment 1,000 Monthly cost of rented and leased equipment (Including printer and storage) = 83.33 per month x 12 months = $1000 4004 Rent/Lease Vehicles 3,780 Youth transportation to and from the three annual Prosocial Events and One 3- day youth leadership conference : Vans cost $420 each x 3 Vans x 3 events = $3780. Exhbit C-1 Page 24 of 30 5000: SPECIAL EXPENSES 305,522 5003 Contractual/Consulting Services (Fresno County Superintendanet of Schools) 300,000 Subcontract with Fresno County Superintendent (FCSS) of Schools Safe and Health Kids Department for the Implementation of Prescription Drug Abuse Prevention Programs. Programs will integrated into the Fresno’s Recreation, Enrichment and Scholastic Help (FRESH) after-school programs and will be led and delivered by FCSS staff with the support of FRESH Program Staff. Cost associated with the contract include staffing, programs curriculum, supplies and materials, and well as mileage, staff develop and training. 5004 Translation Services 1,000 Cost of Translations services for Trainings, Outreach Materials, and Zine. Estimated $1000 annually. 5005 Other (Youth Leadership Conference Costs & Travel) 4,522 7 people (1 Program Coordinator & 6 youth) = Lodging Ca rate $182/night (2 nights) x 4 rooms= $1456. Conference costs $240 /per person x 7people = $1,680 , Meals per diem $66/day x 3day x 7people = $1386. 6000: ADMINISTRATIVE EXPENSES 205,994 6001 Administrative Overhead 205,994 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($205,994) 7000: FIXED ASSETS 2,417 7001 Computer Equipment & Software 2,417 Estimated cost may be utilized, but is not limited to, potential replacement Macbook Laptop, software and accessories for one current staff (cost of each Macbook, software, accessories and recyclying fee eof old laptop equals $1,803). Two Zoom Professional account ($200/account x 2 = $400), Canva subscription ($120/ry), and Toonly subscripton ($94). TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,189,352 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,189,352 - Exhbit C-1 Page 25 of 30 Employee Salaries Acct #Position FTE Admin Direct Total 1102 Director of Central Valley Programs 0.25 $24,842 $24,842 1103 Communications Manager 0.02 $1,546 $1,546 1106 Program Manager 0.70 - $48,545 $48,545 1107 Program Manager 1.00 - $66,683 $66,683 1108 Program Coordinator 1.00 - $48,212 $48,212 1109 Program Coordinator 1.00 - $48,212 $48,212 1110 Program Coordinator 1.00 - $46,357 $46,357 1111 Program Coordinator 1.00 - $46,357 $46,357 1112 Program Coordinator 1.00 - $46,357 $46,357 1113 Program Coordinator 0.50 - $24,106 $24,106 1114 Program Coordinator 0.80 - $37,086 $37,086 1115 Program Coordinator 0.50 - $23,179 $23,179 Personnel Salaries Subtotal 8.77 -$ $461,482 $461,482 Employee Benefits Acct #Admin Direct Total 1201 -$ $2,354 $2,354 1202 - $1,661 $1,661 1203 - $64,607 $64,607 -$ $68,622 $68,622 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $35,303 $35,303 1303 - $4,774 $4,774 -$ $40,077 $40,077 -$ $570,181 $570,181 2000: CLIENT SUPPORT Acct #Amount 2009 $506 2011 $15,000 $15,506 3000: OPERATING EXPENSES Acct #Amount 3001 $10,560 3002 $8,500 3003 $16,020 3004 $4,399 3005 $6,391 3006 $15,312 $61,182 Staff Development & Training Staff Mileage OPERATING EXPENSES TOTAL: DIRECT CLIENT CARE TOTAL Line Item Description Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Program Supplies - Medical Other (Client Stpiends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2025-26) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhbit C-1 Page 26 of 30 4000: FACILITIES & EQUIPMENT Acct #Amount 4002 $27,583 4003 $1,000 4004 $6,300 $34,883 5000: SPECIAL EXPENSES Acct #Amount 5003 $300,000 5004 $1,000 $301,000 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $205,995 $205,995 7000: FIXED ASSETS Acct #Amount 7001 $605 $605 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $1,189,352 $1,189,352 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL Line Item Description FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES $1,189,352 PROGRAM FUNDING SOURCES SPECIAL EXPENSES TOTAL: Line Item Description Administrative Overhead FACILITIES/EQUIPMENT TOTAL: Line Item Description Contractual/Consulting Services (Fresno County Superintendanet of Schools) Translation Services TOTAL PROGRAM FUNDING SOURCES:$1,189,352 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL Computer Equipment & Software Line Item Description Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles Exhbit C-1 Page 27 of 30 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 570,181 Employee Salaries 461,482 1102 Director of Central Valley Programs 24,842 Supervision of Managers, direct budget management, direct oversight of program development, Contract contact, Partnership development lead (FCSS & School), and direct coalition strategy lead. FTE (0.3)x ($82,805) = $24,842 1103 Communications Manager 1,546 Direct media support to local campaigns. This included youth media trainings, social media content development and social media posting. FTE (0.02 )x ($77,284) = $1,545 1106 Program Manager 48,545 Supervision of Program Coordinators, liaison to school and community partners, lead on youth leader programs (YALL & College), and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Edison HS and Gaston MS. FTE (0.70)x ($69,349) = $48,545 1107 Program Manager 66,683 Supervision of Program Coordinators, liaison to school and community partners, lead on the media strategy implementation, and direct lead on the education curriculum delivery strategy implementation, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Fresno HS and McLane. FTE (1.0) x ($66,684) = $66,684 1108 Program Coordinator 48,212 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Kerman HS, KMS, Hosing Sites. FTE (1.0) x ($48,212) = $48,212 1109 Program Coordinator 48,212 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Selma HS, Reedley MCHS, and Orange Cove HS. FTE (1.0) x ($48,212) = $48,212 1110 Program Coordinator 46,357 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at at San Joaquin Elem., Tranquility HS, and Rio Del Rey HS. FTE (1.0) x ($46,357) = $46,357 1111 Program Coordinator 46,357 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Roosevelt HS and Sunnyside HS. FTE (1.0) x ($46,357) = $46,357 SUD Primary Prevention Youth Leadership Institute Fiscal Year (FY 2025-26) Budget Narrative Exhbit C-1 Page 28 of 30 1112 Program Coordinator 46,357 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Mendota HS and Mendota JR HS,. FTE (1.0) x ($46,357) = $46,357 1113 Program Coordinator 24,106 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified High Schools. FTE (.50) x ($48,212) = $24,106 1114 Program Coordinator 37,086 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Central Unified Middle Schools. FTE (.80) x ($46,358) = $34,947 1115 Program Coordinator 23,179 Direct educational curriculum delivery, youth prosocial and leadership activity development, parent education delivery, community education/awareness outreach, and social norms campaign development and implementation at Sanger and WAMS. FTE (.50) x ($46,358) = $23,179 Employee Benefits 68,622 1201 Retirement 2,354 403(b) Retirement contribution at 5.5% of salaries based on FY2021 allocations. 1202 Worker's Compensation 1,661 Worker's Compensation contribution at 5.5% of WC expense based on FY2021 allocations 1203 Health Insurance 64,607 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $461,482 = $64,607 Payroll Taxes & Expenses:40,077 1301 OASDI - 1302 FICA/MEDICARE 35,303 FICA/Medicare contribution at .0765% of salaries. .0765 x $461,482 = $35,303 1303 SUI 4,774 SUI is 6.2% x # of staff x $7K. 6.2% x $7,000 x 11 staff = $4774 2000: CLIENT SUPPORT 15,506 2009 Program Supplies - Medical 506 1st Aid kit for each of the 31 sites. Estimate - 31 sites x $16.33/kit = $506 2011 Other (Client Stpiends)15,000 Advisor and Youth Stipends for time travel and expenses associated with the Development of Outreach Materials, Youth Publication (aka Zine) and Podcast. Estimate - 30 stipends x $500 each = $15000 Exhbit C-1 Page 29 of 30 3000: OPERATING EXPENSES 61,182 3001 Telecommunications 10,560 Telecommunications reimbursement of cell phone and internet. Staff may include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs. $80 per staff x 11 staff x 12 months = $10,560 3002 Printing/Postage 8,500 Educational material printing which may include but are not limited to informational/educational brochures, flyers, posters, and educational worksheets. Estimated at approximately $400 per month x 12 months = $4,800 Estimated cost to printed youth magazine publication (aka Zine) - $3,700 3003 Office, Household & Program Supplies 16,020 Office, Household, and Program supplies which include but are not limited to binders, folders, staplers, hole-punchers, paper, pens, hand sanitizer, and cleaning supplies. Estimated at $210 per month x 12 months = $2520. Materials purchased for prosocial leadership events and activities may include but are not limited to workshop materials, pens, pencils, workbooks, folders, t- shirts, listening devices, tablets, cameras, post-its pads, makers, theme decor, speakers, expert presenters. Estimated for each event/activity planned by youth = $4500 x 3/yearly = $13,500 3004 Advertising 4,399 Facebook and Instagram social media post boosts three times a quarter ($150/each boost x12), three AudioGO (or similar provider) PSA Online Radio Ad purchase ($516.33/11 day run), and three billboard purchases (estimated at $350/each ). 3005 Staff Development & Training 6,391 Staff development $500 x 11 staff. (staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs). Capacity- building staff retreat which consists of facility cost of $220, and a meal budget of $440 (2 meals, Breakfast and Lunch), and $143 in training curriculum supplies and materials, and transportation costs of $88 (parking and mileage) totalling $891. 3006 Staff Mileage 15,312 This is approximately 200 miles per month x 11 staff traveling to/from school and partner sites x .58 mileage rate. The 11 staff include 8 Program Coordinators, 2 Program Managers, and 1 Director of Central Valley Programs 200 miles x 11 staff x 12 months x $.58 = $15,312 4000: FACILITIES & EQUIPMENT 34,883 4001 Building Maintenance - 4002 Rent/Lease Building 27,583 Estimated annual rent is $55,167 (3% increase for 2 year lease). Based on FTE located in Fresno office, 50% of rent is allocated to this contract. 4003 Rent/Lease Equipment 1,000 Monthly cost of rented and leased equipment (Including printer and storage) = 83.33 per month x 12 months = $1000 4004 Rent/Lease Vehicles 6,300 Youth transportation to and from the three annual Prosocial Events and One 3- day youth leadership conference. (Estimated Cost) Vans cost $420 each x 3 Vans x 3 events = $3780. 3 Day Youth Conference $420(Van) x 2vans x 3 days = $2520. Exhbit C-1 Page 30 of 30 5000: SPECIAL EXPENSES 301,000 5003 Contractual/Consulting Services (Fresno County Superintendanet of Schools) 300,000 Subcontract with Fresno County Superintendent (FCSS) of Schools Safe and Health Kids Department for the Implementation of Prescription Drug Abuse Prevention Programs. Programs will integrated into the Fresno’s Recreation, Enrichment and Scholastic Help (FRESH) after-school programs and will be led and delivered by FCSS staff with the support of FRESH Program Staff. Cost associated with the contract include staffing, programs curriculum, supplies and materials, and well as mileage, staff develop and training. 5004 Translation Services 1,000 Cost of Translations services for Trainings, Outreach Materials, and Zine. Estimated $1000 annually. 6000: ADMINISTRATIVE EXPENSES 205,995 6001 Administrative Overhead 205,995 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($205,995) 7000: FIXED ASSETS 605 7001 Computer Equipment & Software 605 Zoom Professional account (professional zoom account), Canva subscription, and Toonly subscripton TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,189,352 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,189,352 - Exhibit C-2 Page 1 of 10 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.05 -$ $3,203 $3,203 Personnel Salaries Subtotal 0.05 -$ $3,203 $3,203 Employee Benefits Acct #Admin Direct Total 1201 -$ $80 $80 1202 - $56 $56 1203 - $448 $448 -$ $584 $584 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $245 $245 1303 - $199 $199 -$ $444 $444 -$ $4,232 $4,232 2000: CLIENT SUPPORT Acct #Amount 2004 $6,548 2011 $14,000 $20,548 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $5,220 $5,220 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $30,000 $30,000 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL TOTAL PROGRAM EXPENSES $30,000 PROGRAM FUNDING SOURCES Line Item Description Administrative Overhead TOTAL PROGRAM FUNDING SOURCES:$30,000 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL DIRECT CLIENT CARE TOTAL Other (Advisor/Mentor Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Clothing, Food, & Hygiene Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Friday Night Live Youth Leadership Institute Fiscal Year (FY 2021-22) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhibit C-2 Page 2 of 10 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 4,232 Employee Salaries 3,203 1101 Program Manager 3,203 Supervision of Program Coordinators, direct implementation of programming at Edison HS and Gaston MS, liaison to school and community partners. FTE (0.05) x ($64,069) = $3,203. Employee Benefits 584 1201 Retirement 80 403(b) Retirement contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of retirement cost. Which comes out to 2.5% in relation to the salary. 2.5% x $3,203 = $80 1202 Worker's Compensation 56 Worker's Compensation contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of workers compensation cost. Which comes out to 1.75% in relation to the salary. 1.75% x $3,203 = $56 1203 Health Insurance 448 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $3,203 = $448 Payroll Taxes & Expenses:444 1301 OASDI - 1302 FICA/MEDICARE 245 FICA/Medicare contribution at .0765 * salaries .0765% * $3,203 = $245 1303 SUI 199 SUI is 6.2% of salaries (.062% x $3,203 = $199) 2000: CLIENT SUPPORT 20,548 2004 Clothing, Food, & Hygiene 6,548 Youth Food and Hospitality for 28 Chapters provided during FNL program Meetings and trainings $545.66/month x 12months= $6,548 2011 Other (Advisor/Mentor Stipends)14,000 Friday Night Live (FNL) and Club Live (CL) Advisors/Mentors stipend for time travel and expenses associated with the development and implementaion of FNL/CL progams 28 Stipends x $500.00 each = $14,000 6000: ADMINISTRATIVE EXPENSES 5,220 6001 Administrative Overhead 5,220 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($5,220) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:30,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:30,000 - Friday Night Live Youth Leadership Institute Fiscal Year (FY 2021-22) Budget Narrative Exhibit C-2 Page 3 of 10 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.05 -$ $3,268 $3,268 Personnel Salaries Subtotal 0.05 -$ $3,268 $3,268 Employee Benefits Acct #Admin Direct Total 1201 -$ $82 $82 1202 - $57 $57 1203 - $457 $457 -$ $596 $596 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $250 $250 1303 - $203 $203 -$ $453 $453 -$ $4,316 $4,316 2000: CLIENT SUPPORT Acct #Amount 2004 $6,463 2011 $14,000 $20,463 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $5,220 $5,220 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $30,000 $30,000 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL TOTAL PROGRAM EXPENSES $30,000 PROGRAM FUNDING SOURCES Line Item Description Administrative Overhead TOTAL PROGRAM FUNDING SOURCES:$30,000 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL DIRECT CLIENT CARE TOTAL Other (Advisor/Mentor Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Clothing, Food, & Hygiene Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Friday Night Live Youth Leadership Institute Fiscal Year (FY 2022-23) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhibit C-2 Page 4 of 10 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 4,316 Employee Salaries 3,268 1101 Program Manager 3,268 Supervision of Program Coordinators, direct implementation of programming at Edison HS and Gaston MS, liasion to school and community partners. FTE (0.05)x ($65,350) = $3,268 Employee Benefits 596 1201 Retirement 82 403(b) Retirement contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of retirement cost. Which comes out to 2.5% in relation to the salary. 2.5% x $3,268 = $82 1202 Worker's Compensation 57 Worker's Compensation contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of workers compensation cost. Which comes out to 1.75% in relation to the salary. 1.75% x $3,268 = $57 1203 Health Insurance 457 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. .14% x $3,268 = $457 Payroll Taxes & Expenses:453 1301 OASDI - 1302 FICA/MEDICARE 250 FICA/Medicare contribution at .0765 * salaries .0765% x $3,268 = $250 1303 SUI 203 SUI is 6.2% of salaries .062% x $3,268 = $203 2000: CLIENT SUPPORT 20,463 2004 Clothing, Food, & Hygiene 6,463 Youth Food and Hospitality for 28 Chapters provided during FNL program Meetings and trainings $538.58/monthy x 12months = $6,463 2011 Other (Advisor/Mentor Stipends)14,000 Friday Night Live (FNL) and Club Live (CL) Advisors/Mentors stipend for time travel and expenses associated with the development and implementaion of FNL/CL progams 6000: ADMINISTRATIVE EXPENSES 5,220 6001 Administrative Overhead 5,220 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($5,220) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:30,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:30,000 - Friday Night Live Youth Leadership Institute Fiscal Year (FY 2022-23) Budget Narrative Exhibit C-2 Page 5 of 10 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.05 -$ $3,333 $3,333 Personnel Salaries Subtotal 0.05 -$ $3,333 $3,333 Employee Benefits Acct #Admin Direct Total 1201 -$ $83 $83 1202 - $58 $58 1203 - $467 $467 -$ $608 $608 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $255 $255 1303 - $207 $207 -$ $462 $462 -$ $4,403 $4,403 2000: CLIENT SUPPORT Acct #Amount 2004 $6,377 2011 $14,000 $20,377 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $5,220 $5,220 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $30,000 $30,000 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL TOTAL PROGRAM EXPENSES $30,000 PROGRAM FUNDING SOURCES Line Item Description Administrative Overhead TOTAL PROGRAM FUNDING SOURCES:$30,000 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL DIRECT CLIENT CARE TOTAL Other (Advisor/Mentor Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Clothing, Food, & Hygiene Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Friday Night Live Youth Leadership Institute Fiscal Year (FY 2023-24) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhibit C-2 Page 6 of 10 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 4,403 Employee Salaries 3,333 1101 Program Manager 3,333 Supervision of Program Coordinators, direct implementation of programming at Edison HS and Gaston MS, liasion to school and community partners. FTE (0.05)x ($66,657) = $3,333 Employee Benefits 608 1201 Retirement 83 403(b) Retirement contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of retirement cost. Which comes out to 2.5% in relation to the salary. 2.5% x $3,333 = $83 1202 Worker's Compensation 58 Worker's Compensation contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of workers compensation cost. Which comes out to 1.75% in relation to the salary. 1.75% x $3,333 = $58 1203 Health Insurance 467 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $3,333 = $467 Payroll Taxes & Expenses:462 1301 OASDI - 1302 FICA/MEDICARE 255 FICA/Medicare contribution at .0765 * salaries .0765% x $3,333 = $255 1303 SUI 207 SUI is 6.2% of salaries .062% x $3,333 = $207 2000: CLIENT SUPPORT 20,377 2004 Clothing, Food, & Hygiene 6,377 Youth Food and Hospitality for 28 Chapters provided during FNL program Meetings and trainings. $531.42/monthy x 12months = $6,377 2011 Other (Advisor/Mentor Stipends)14,000 Friday Night Live (FNL) and Club Live (CL) Advisors/Mentors stipend for time travel and expenses associated with the development and implementaion of FNL/CL progams 28 Stipends x $500.00 each = $14,000 6000: ADMINISTRATIVE EXPENSES 5,220 6001 Administrative Overhead 5,220 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($5,220) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:30,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:30,000 - Friday Night Live Youth Leadership Institute Fiscal Year (FY 2023-24) Budget Narrative Exhibit C-2 Page 7 of 10 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.05 -$ $3,400 $3,400 Personnel Salaries Subtotal 0.05 -$ $3,400 $3,400 Employee Benefits Acct #Admin Direct Total 1201 -$ $85 $85 1202 - $59 $59 1203 - $476 $476 -$ $620 $620 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $260 $260 1303 - $211 $211 -$ $471 $471 -$ $4,491 $4,491 2000: CLIENT SUPPORT Acct #Amount 2004 $6,289 2011 $14,000 $20,289 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $5,220 $5,220 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $30,000 $30,000 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL TOTAL PROGRAM EXPENSES $30,000 PROGRAM FUNDING SOURCES Line Item Description Administrative Overhead TOTAL PROGRAM FUNDING SOURCES:$30,000 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL DIRECT CLIENT CARE TOTAL Other (Advisor/Mentor Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Clothing, Food, & Hygiene Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Friday Night Live Youth Leadership Institute Fiscal Year (FY 2024-25) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhibit C-2 Page 8 of 10 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 4,491 Employee Salaries 3,400 1101 Program Manager 3,400 Supervision of Program Coordinators, direct implementation of programming at Edison HS and Gaston MS, liasion to school and community partners. FTE (0.05)x ($67,990) = $3,400 Employee Benefits 620 1201 Retirement 85 403(b) Retirement contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of retirement cost. Which comes out to 2.5% in relation to the salary. 2.5% x $3,400 = $85 1202 Worker's Compensation 59 Worker's Compensation contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of workers compensation cost. Which comes out to 1.75% in relation to the salary. 1.75% x $3,400 = $59 1203 Health Insurance 476 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $3,400 = $476 Payroll Taxes & Expenses:471 1301 OASDI - 1302 FICA/MEDICARE 260 FICA/Medicare contribution at .0765 * salaries .0765% x $3,400 = $260 1303 SUI 211 SUI is 6.2% of salaries .062% x $3,400 = $211 2000: CLIENT SUPPORT 20,289 2004 Clothing, Food, & Hygiene 6,289 Youth Food and Hospitality for 28 Chapters provided during FNL program Meetings and trainings. $524.08/monthy x 12months = $6,289 2011 Other (Advisor/Mentor Stipends)14,000 Friday Night Live (FNL) and Club Live (CL) Advisors/Mentors stipend for time travel and expenses associated with the development and implementaion of FNL/CL progams 28 Stipends x $500.00 each = $14,000 6000: ADMINISTRATIVE EXPENSES 5,220 6001 Administrative Overhead 5,220 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($5,220) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:30,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:30,000 - Friday Night Live Youth Leadership Institute Fiscal Year (FY 2024-25) Budget Narrative Exhibit C-2 Page 9 of 10 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.05 -$ $3,467 $3,467 Personnel Salaries Subtotal 0.05 -$ $3,467 $3,467 Employee Benefits Acct #Admin Direct Total 1201 -$ $87 $87 1202 - $61 $61 1203 - $485 $485 -$ $633 $633 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ $0 $0 1302 - $265 $265 1303 - $215 $215 -$ $480 $480 -$ $4,581 $4,581 2000: CLIENT SUPPORT Acct #Amount 2004 $6,199 2011 $14,000 $20,199 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 $5,220 $5,220 Acct #Amount 8101 Drug Medi-Cal $0 8102 SABG $30,000 $30,000 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description ADMINISTRATIVE EXPENSES TOTAL TOTAL PROGRAM EXPENSES $30,000 PROGRAM FUNDING SOURCES Line Item Description Administrative Overhead TOTAL PROGRAM FUNDING SOURCES:$30,000 NET PROGRAM COST: $0 SUBSTANCE USE DISORDER FUNDS TOTAL DIRECT CLIENT CARE TOTAL Other (Advisor/Mentor Stipends) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Clothing, Food, & Hygiene Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Friday Night Live Youth Leadership Institute Fiscal Year (FY 2025-26) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Retirement Worker's Compensation Health Insurance Exhibit C-2 Page 10 of 10 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 4,581 Employee Salaries 3,467 1101 Program Manager 3,467 Supervision of Program Coordinators, direct implementation of programming at Edison HS and Gaston MS, liasion to school and community partners. FTE (0.05)x ($69,349) = $3,467 Employee Benefits 633 1201 Retirement 87 403(b) Retirement contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of retirement cost. Which comes out to 2.5% in relation to the salary. 2.5% x $3,467 = $87 1202 Worker's Compensation 61 Worker's Compensation contribution is calculated as a proration compared to other YLI contracts. For FY2021 our FNL contract has averaged about 0.20% of workers compensation cost. Which comes out to 1.75% in relation to the salary. 1.75% x $3,467 = $61 1203 Health Insurance 485 Medical, Dental, Vision, Life, Fertility Benefits at 14% of salaries. 14% x $3,467 = $485 Payroll Taxes & Expenses:480 1301 OASDI - 1302 FICA/MEDICARE 265 FICA/Medicare contribution at .0765 * salaries .0765% x $3,467 = $265 1303 SUI 215 SUI is 6.2% of salaries .062% x $3,467 = $215 2000: CLIENT SUPPORT 20,199 2004 Clothing, Food, & Hygiene 6,199 Youth Food and Hospitality for 28 Chapters provided during FNL program Meetings and trainings. $516.58/monthy x 12months = $6,199 2011 Other (Advisor/Mentor Stipends)14,000 Friday Night Live (FNL) and Club Live (CL) Advisors/Mentors stipend for time travel and expenses associated with the development and implementaion of FNL/CL progams 28 Stipends x $500.00 each = $14,000 6000: ADMINISTRATIVE EXPENSES 5,220 6001 Administrative Overhead 5,220 Indirect costs are those costs of general management that are agency-wide. General management costs consist of expenditures for administrative activities necessary for the general operation of YLI. ($5,220) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:30,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:30,000 - Friday Night Live Youth Leadership Institute Fiscal Year (FY 2025-26) Budget Narrative SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) SPECIFIC REQUIREMENTS Fresno County, through the Department of Behavioral Health, makes substance use disorder treatment services available throughout the county to Medi-Cal eligible beneficiaries through funds provided under an Intergovernmental Agreement with the California Department of Health Care Services. The County, and all contracted providers, must comply with the terms of the Intergovernmental Agreement, and any amendments thereto, including but not limited to the following: 1.RESTRICTIONS ON USE OF SABG FUNDS TO PAY FOR SERVICES REIMBURSABLE BY MEDI-CAL CONTRACTOR shall ensure that billing SABG funds only occurs for services that are not reimbursable by Medi-Cal. If CONTRACTOR utilizes SABG funds to pay for a service included in the DMC-ODS, CONTRACTOR shall maintain documentation sufficient to demonstrate that Medi-Cal reimbursement was not available. This documentation shall be provided to COUNTY at the time of billing and retained in the beneficiary file for review. 2.STATE ALCOHOL AND DRUG REQUIREMENTS A.INDEMNIFICATION The CONTRACTOR agrees to indemnify, defend and save harmless the State, its officers, agents and employees from any and all claims and losses accruing or resulting to any and all contractors, subcontractors, materialmen, laborers and any other person, firm or corporation furnishing or supplying work, services, materials or supplies in connection with the performance of this Agreement and from any and all claims and losses accruing or resulting to any person, firm or corporation who may be injured or damaged by the CONTRACTOR in the performance of this Agreement. B.INDEPENDENT CONTRACTOR The CONTRACTOR and the agents and employees of CONTRACTOR, in the performance of this Agreement, shall act in an independent capacity and not as officers or employees or agents of State of California. C.CONTROL REQUIREMENTS This Agreement is subject to all applicable Federal and State laws, regulations and standards. CONTRACTOR(S) shall establish written procedures consistent with State-County Contract requirements. The provisions of this Agreement are not intended to abrogate any provisions of law or regulation existing or enacted during the term of this Agreement. D.CONFIDENTIALITY Exhibit D - Page 1 of 13 CONTRACTOR shall conform to and COUNTY shall monitor compliance with all State of California and Federal statutes and regulations regarding confidentiality, including but not limited to confidentiality of information requirements at Part 2, Title 42, Code of Federal Regulations; California Welfare and Institutions Code, sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 of the California Health and Safety Code; Title 22, California Code of Regulations, section 51009; and Division 1, Part 2.6, Chapters 1-7 of the California Civil Code. E.REVENUE COLLECTION POLICY CONTRACTOR shall conform to all policies and procedures regarding revenue collection issued by the State under the provisions of the Health and Safety Code, Division 10.5. F.EXPENDITURE OF STATE GENERAL AND FEDERAL FUNDS CONTRACTOR agrees that all funds paid out by the State shall be used exclusively for providing alcohol and/or drug program services, administrative costs, and allowable overhead. G.ACCESS TO SERVICES CONTRACTOR shall provide accessible and appropriate services in accordance with Federal and State statutes and regulations to all eligible persons. H.REPORTS CONTRACTOR agrees to participate in surveys related to the performance of this Agreement and expenditure of funds and agrees to provide any such information in a mutually agreed upon format. I.AUDITS All State and Federal funds furnished to the CONTRACTOR(S) pursuant to this Agreement along with related patient fees, third party payments, or other related revenues and funds commingled with the foregoing funds are subject to audit by the State. The State may audit all alcohol and drug program revenue and expenditures contained in this Agreement for the purpose of establishing the basis for the subsequent year's negotiation. J.RECORDS MAINTENANCE 1)CONTRACTOR shall maintain books, records, documents, and other evidence necessary to monitor and audit this Agreement. 2)CONTRACTOR shall maintain adequate program and fiscal records relating to individuals served under the terms of this Agreement, as required, to meet the needs of the State in monitoring quality, quantity, fiscal accountability, and accessibility of services. Information on each individual shall include, but not be limited Exhibit D - Page 2 of 13 to, admission records, patient and participant interviews and progress notes, and records of service provided by various service locations, in sufficient detail to make possible an evaluation of services provided and compliance with this Agreement. 3.FEDERAL CERTIFICATIONS CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION LOWER TIER COVERED TRANSACTIONS A.DBH and CONTRACTOR recognize that Federal assistance funds will be used under the terms of this Agreement. For purposes of this section, DBH will be referred to as the "prospective recipient". B.This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). 1)The prospective recipient of Federal assistance funds certifies by entering this Agreement, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 2)The prospective recipient of funds agrees by entering into this Agreement, that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Federal department or agency with which this transaction originated. 3)Where the prospective recipient of Federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 4)The CONTRACTOR shall provide immediate written notice to DBH if at any time CONTRACTOR learns that its certification in this clause of this Agreement was erroneous when submitted or has become erroneous by reason of changed circumstances. 5)The prospective recipient further agrees that by entering into this Agreement, it will include a clause identical to this clause of this Agreement, and titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions", in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 6)The certification in this clause of this Agreement is a material representation of fact upon which reliance was placed by COUNTY when this transaction was entered into. Exhibit D - Page 3 of 13 C.CONTRACTOR shall not employ or subcontract with any party listed in the government wide exclusions in the System for Award Management (SAM) in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp. p. 189) and 12689 (3 CFR part 1989., p. 235), “Debarment and Suspension.” SAM exclusions contain the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. If CONTRACTOR employs or subcontracts an excluded party, DHCS has the right to withhold payments, disallow costs, or issue a CAP, as appropriate, pursuant to HSC Code 11817.8(h). 4.SMOKING PROHIBITION REQUIREMENTS CONTRACTOR shall comply with Public Law 103-227, also known as the Pro-Children Act of 1994 (20 USC Section 6081, et seq.), and with California Labor Code Section 6404.5, the California Smoke-Free Workplace Law. 5.CONFIDENTIALITY OATH CONTRACTOR shall ensure that all of its employees sign a written confidentiality oath, attached hereto as Attachment A, before they begin employment with CONTRACTOR and shall renew said document annually thereafter. CONTRACTOR shall retain each employee’s written confidentiality oath for COUNTY and DHCS inspection for a period of six (6) years following the termination of this agreement. 6.CULTURALLY COMPETENT SERVICES CONTRACTOR shall ensure equal access to quality care by diverse populations by adopting the federal Office of Minority Health Culturally and Linguistically Appropriate Service (CLAS) national standards and complying with 42 CFR 438.206(c)(2). CONTRACTOR shall promote the delivery of services in a culturally competent manner to all beneficiaries, including those with limited English proficiency and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity. 7.ADA CONSIDERATIONS CONTRACTOR shall ensure that physical access, reasonable accommodations, and accessible equipment for Medicaid beneficiaries with physical or mental disabilities are provided to all beneficiaries. 8.ADDITIONAL CONTRACT RESTRICTIONS This Contract is subject to any additional restrictions, limitations, or conditions enacted by the Congress, or any statute enacted by the Congress, as well as federal or Exhibit D - Page 4 of 13 state governments which may affect the provisions, terms, or funding of this Contract in any manner. 9.HATCH ACT CONTRACTOR shall comply with the provisions of the Hatch Act (Title 5 USC, Sections 1501-1508), which limit the political activities of employees whose principal employment activities are funded in whole or in part with federal funds. 10.UNLAWFUL USE OF DRUGS AND ALCOHOL OR UNLAWFUL USE MESSAGES CONTRACTOR shall ensure that information produced with Federal funds pertaining to drug and alcohol related programs contains a clearly written statement that there shall be no unlawful use of drugs or alcohol associated with the program. Additionally, CONTRACTOR shall ensure that no aspect of the program includes any message in materials, curricula, teachings, or promotion of the responsible use, if the use is unlawful, of drugs or alcohol pursuant to Health and Safety Code (HSC) 11999- 11999.3. CONTRACTOR must sign the Unlawful Use of Drugs and Alcohol Certification, attached hereto as Attachment B, incorporated herein by reference and made part of this Agreement agreeing to uphold the obligations of HSC 11999 – 11999.3. This agreement may be unilaterally terminated, without penalty, if CONTRACTOR or a subcontractor that is a private entity is determined to have violated a prohibition of the Unlawful Use of Drugs and Alcohol message or has an employee who is determined by the DBH Director or her designee to have violated a prohibition of the Unlawful Use of Drugs and Alcohol message. 11.LIMITATION ON USE OF FUNDS FOR PROMOTION OF LEGALIZATION OF CONTROLLED SUBSTANCES CONTRACTOR shall ensure that none of the funds made available through this Agreement with COUNTY may be used for any activity that promotes the legalization of any drug or other substance included in Schedule I of Section 202 of the Controlled Substances Act (21 USC 812). 12.NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS FOR RELIGIOUS CONTRACTORS CONTRACTOR shall establish such processes and procedures as necessary to comply with the provisions of Title 42, USC, Section 300x-65 and Title 42, CFR, Part 54 to prohibit discrimination against nongovernmental organizations and certain individuals on the basis of religion in the distribution of government funds to provide substance abuse services and to allow the organizations to accept the funds to provide the services to the individuals without impairing the religious character of the organizations or the religious freedom of the individuals. Exhibit D - Page 5 of 13 13.COUNSELOR CERTIFICATION CONTRACTOR shall ensure that any counselor or registrant providing intake, assessment of need for services, treatment or recovery planning, individual or group counseling to participants, patients, or residents in a DHCS licensed or certified program is required to be certified as defined in Title 9, Division 4, Chapter 8. 14.INTRAVENOUS DRUG USE (IVDU) TREATMENT CONTRACTOR shall ensure that beneficiaries in need of IVDU treatment shall be encouraged to undergo AOD treatment adhering to provisions in 42 USC 300x- 23 and 45 CFR 96.126(e). DHCS shall monitor programs for compliance with this requirement. 15.TUBERCULOSIS TREATMENT CONTRACTOR shall ensure the following related to Tuberculosis (TB): A.Routinely make available TB services to each individual receiving treatment for AOD use and/or abuse. B.Reduce barriers to patients’ accepting TB treatment. C.Develop strategies to improve follow-up monitoring, particularly after patients leave treatment, by disseminating information through educational bulletins and technical assistance. 16.TRAFFICKING IN PERSONS PROVISIONS – PRIVATE ENTITY CONTRACTOR shall conform to all Federal statutes and regulations prohibiting trafficking in persons, as well as trafficking-related activities, including, but not limited to the trafficking of persons provisions in Section 106(g) of the Trafficking Victims Protection Act of 2000 (TVPA) as amended by Section 1702. CONTRACTOR, CONTRACTOR’s employees, subrecipients, and subrecipients’ employees may not: A.Engage in severe forms of trafficking in persons during the period of time that the award is in effect; B.Procure a commercial sex act during the period of time that the award is in effect; or C.Use forced labor in the performance of the award or subawards under the award. This agreement may be unilaterally terminated, without penalty, if CONTRACTOR or a subrecipient that is a private entity is determined to have violated a prohibition of the TVPA or has an employee who is determined by the DBH Director or her designee to have violated a prohibition of the TVPA through conduct that is either associated with performance under the award or imputed to the CONTRACTOR or their subrecipient using the standards and due process for imputing the conduct of Exhibit D - Page 6 of 13 an individual to an organization that are provided in 2 C.F.R. Part 180, “OMB Guidelines to Agencies on Government-wide Debarment and Suspension (Nonprocurement). CONTRACTOR must inform the DBH Director or her designee immediately of any information received from any source alleging a violation of a prohibition of the TVPA. CONTRACTOR must sign a certification annually acknowledging the Trafficking Victims Protection Act of 2000 requirements (TVPA Certification), attached hereto as Attachment C, incorporated herein by reference and made part of this Agreement and must require all employees to complete annual TVPA training. 17.BYRD ANTI-LOBBYING AMENDMENT CONTRACTOR certifies that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 USC 1352. CONTRACTOR shall also disclose to DHCS any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. 18.NONDISCRIMINATION IN EMPLOYMENT AND SERVICES CONTRACTOR certifies that under the laws of the United States and the State of California, incorporated into the State-County Intergovernmental Agreement, CONTRACTOR shall not unlawfully discriminate against any person. 19.FEDERAL LAW REQUIREMENTS CONTRACTORS shall comply with the following Federal law requirements: A.Title VI of the Civil Rights Act of 1964, Section 2000d, as amended, prohibiting discrimination based on race, color, or national origin in federally funded programs. B.Title VIII of the Civil Rights Act of 1968 (42 USC 3601 et seq.) prohibiting discrimination on the basis of race, color, religion, sex, handicap, familial status or national origin in the sale or rental of housing. C.Age Discrimination Act of 1975 (45 CFR Part 90), as amended (42 USC Sections 6101 – 6107), which prohibits discrimination on the basis of age. D.Age Discrimination in Employment Act (29 CFR Part 1625). Exhibit D - Page 7 of 13 E.Title I of the Americans with Disabilities Act (29 CFR Part 1630) prohibiting discrimination against the disabled in employment. F.Americans with Disabilities Act (28 CFR Part 35) prohibiting discrimination against the disabled by public entities. G.Title III of the Americans with Disabilities Act (28 CFR Part 36) regarding access. H.Rehabilitation Act of 1973, as amended (29 USC Sectio n 794), prohibiting discrimination on the basis of individuals with disabilities. I.Executive Order 11246 (42 USC 2000(e) et seq. and 41 CFR Part 60) regarding nondiscrimination in employment under federal contracts and construction contracts greater than $10,000 funded by federal financial assistance. J.Executive Order 13166 (67 FR 41455) to improve access to federal services for those with limited English proficiency. K.The Drug Abuse Office and Treatment Act of 1972, as amended, relating to nondiscrimination on the basis of drug abuse. L.The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism. 20.STATE LAW REQUIREMENTS CONTRACTOR shall comply with the following State law requirements: A.Fair Employment and Housing Act (Government Code Section 12900 et seq.) and the applicable regulations promulgated thereunder (California Administrative Code, Title 2, Section 7285.0 et seq.). B.Title 2, Division 3, Article 9.5 of the Government Code, commencing with Section 11135. C.Title 9, Division 4, Chapter 8, commencing with Section 10800. D.No state or Federal funds shall be used by COUNTY, or CONTRACTOR, for sectarian worship, instruction, and/or proselytization. No state funds shall be used by CONTRACTOR, or CONTRACTOR, to provide direct, immediate, or substantial support to any religious activity. E.Noncompliance with the requirements of nondiscrimination in services shall constitute grounds for state to withhold payments Exhibit D - Page 8 of 13 under this Agreement or terminate all, or any type, of funding provided hereunder. 21.INFORMATION ACCESS FOR INDIVIDUALS WITH LIMITED ENGLISH PROFICIENCY CONTRACTOR shall comply with all applicable provisions of the Dymally- Alatorre Bilingual Services Act (Government Code sections 7290 -7299.8) regarding access to materials that explain services available to the public as well as providing language interpretation services. CONTRACTOR shall comply with the applicable provisions of Section 1557 of the Affordable Care Act (45 CFR Part 92), including, but not limited to, 45 CFR 92.201, when providing access to: A.Materials explaining services available to the public, B.Language assistance, C.Language interpreter and translation services, and D.Video remote language interpreting services. 22.INTERIM SERVICES CONTRACTOR must adhere to the State-County Contract requirement to provide Interim Services in the event that an individual must wait to be placed in treatment. Interim Substance Abuse Services means services that are provided until an individual is admitted to a substance abuse treatment program. The purposes of the services are to reduce the adverse health effects of such abuse, promote the health of the individual, and reduce the risk of transmission of disease. At a minimum, interim services include counseling and education about HIV and tuberculosis (TB), about the risks of needle-sharing, the risks of transmission to sexual partners and infants, and about steps that can be taken to ensure the HIV and TB transmission does not occur, as well as referral for HIV or TB treatment services if necessary. For pregnant women, interim services also include counseling on the effects of alcohol and drug use on the fetus, as well as referral for prenatal care. Records must indicate evidence that Interim Services have been provided and documentation will be reviewed for compliance. 23.CHARITABLE CHOICE CONTRACTOR may not discriminate in its program delivery against a client or potential client on the basis of religion or religious belief, a refusal to hold a religious belief, or a refusal to actively participate in a religious practice. Any specifically religious activity or service made available to individuals by the CONTRACTOR must be voluntary as well as separate in time and location from County funded activities and services. CONTRACTOR shall inform County as to whether it is faith-based. If CONTRACTOR Exhibit D - Page 9 of 13 identifies as faith-based it must submit to DBH Contracts Division - SUD Services a copy of its policy on referring individuals to alternate treatment CONTRACTOR, and include a copy of this policy in its client admission forms. The policy must inform individuals that they may be referred to an alternative provider if they object to the religious nature of the program, and include a notice to SUD Services. Adherence to this policy will be monitored during annual site reviews, and a review of client files. If CONTRACTOR identifies as faith-based, by July 1 of each year CONTRACTOR will be required to report to SUD Services the number of individuals who requested referrals to alternate providers based on religious objection. In addition, CONTRACTOR shall comply with the provisions of Title 42, USC, Section 300x-65 and Title 42, CFR, Part 54. 24.MINIMUM QUALITY DRUG TREATMENT STANDARDS CONTRACTOR shall comply with the Minimum Quality Drug Treatment Standards for SABG for all Substance Use Disorder (SUD) treatment programs. The Minimum Quality Drug Treatment Standards are attached hereto and by this reference incorporated herein as Attachment D. 25.RISK ASSESSMENT CONTRACTOR shall comply with the sub-recipient pre-award risk assessment requirements contained in 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards. COUNTY, as the SABG first-tier sub- recipient, shall review the merit and risk associated with all potential grant second-tier sub- recipients (CONTRACTOR) annually prior to making an award. COUNTY shall perform and document annual subrecipient pre-award risk assessments for each CONTRACTOR and retain documentation for audit purposes. 26.CONTROL REQUIREMENTS Performance under this Agreement is subject to all applicable Federal and State laws, regulations and standards. In accepting the State drug and alcohol combined program allocation pursuant to California Health and Safety Code section 11757, CONTRACTOR shall establish written accounting procedures consistent with applicable Federal and State laws, regulations and standards, and shall be held accountable for audit exceptions taken by the State or COUNTY for failur e to comply with these requirements. These requirements include, but may not be limited to, those set forth in this Agreement, and: A.HSC, Division 10.5, Part 2 commencing with Section 11760. B.Title 9, California Code of Regulations (CCR) (herein referred to as Title 9), Division 4, commencing with Section 9000. C.Government Code, Title 2, Division 4, Part 2, Chapter 2, Article 1.7. D.Government Code, Article 7, Federally Mandated Audits of Block Grant Funds Allocated to Local Agencies, Chapter 1, Part 1, Divisio n 2, Title 5, commencing at Section 53130. E.Title 42 United State Code (USC), Sections 300x-21 through 300x- 31, 300x-34, 300x-53, 300x-57, and 330x-64 through 66. Exhibit D - Page 10 of 13 F.Title 2, CFR 200 -The Uniform Administration Requirements, Cost Principles and Audit Requirements for Federal Awards. G.Title 45, Code of Federal Regulations (CFR), Sections 96.30 through 96.33 and Sections 96.120 through 96.137. H.Title 42, CFR, Sections 8.1 through 8.6. I.Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2, Subparts A - E). J.Title 21, CFR, Sections 1301.01 through 1301.93, Department of Justice, Controlled Substances. K.State Administrative Manual (SAM), Chapter 7200 (General Outline of Procedures). 27.DRUG FREE WORKPLACE CONTRACTOR shall comply with the requirements of the Drug-Free Work Place Act of 1990 (California Government Code section 8350). 28.YOUTH TREATMENT GUIDELINES CONTRACTOR shall follow the “Youth Treatment Guidelines,” available at the DHCS web address at: http://www.dhcs.ca.gov/individuals/Pages/youthSUDservices.aspx and by this reference incorporated herein, in developing and implementing youth treatment programs funded under this Agreement until such time new Youth Treatment Guidelines are established and adopted. No formal amendment of this contract is required for new guidelines to apply. 29.HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996 If any of the work performed under this Agreement is subject to the HIPAA, CONTRACTOR shall perform the work in compliance with all applicable provisions of HIPAA. As identified in Exhibit F of the State County Intergovernmental Agreement, DHCS, COUNTY and CONTRACTOR shall cooperate to assure mutual agreement as to those transactions between them, to which this Provision applies. Refer to Exhibit F for additional information. A.Trading Partner Requirements 1)No Changes: CONTRACTOR hereby agrees that for the personal health information (PHI), it shall not change any definition, data condition or use of a data element or segment as proscribed in the federal Health and Human Services Transaction Standard Regulation [45 CFR Part 162915(a)]. 2)No Additions: CONTRACTOR hereby agrees that for PHI, it shall not add any data elements or segments to the maximum data set as proscribed in the HHS Transaction Standard Regulation [45CFR Part 162.915 (b)]. Exhibit D - Page 11 of 13 3)No Unauthorized Uses: CONTRACTOR hereby agrees that for PHI, it shall not use any code or data elements that are marked ‘not used” in the in the HHS Transactions Implementation specification or are not in the HHS Transaction Standard’s implementation specification [45CFR Part 162.915 (c)]. 4)No Changes to Meaning or Intent: CONTRACTOR hereby agrees that for PHI, it shall not change the meaning or intent of the HHS Transaction Standard’s implementation specification [45CFR Part 162.915 (d)]. B.Concurrence for Test Modifications to HHS Transaction Standards CONTRACTOR agrees and understands that there exists the possibility that DHCS or others may request an extension from the uses of a standard in the HHS Transaction Standards. If this occurs, CONTRACTOR agrees that it shall participate in such test modifications. C.Adequate Testing CONTRACTOR is responsible to adequately test all business rules appropriate to their types and specialties. If the CONTRACTOR is acting as a clearinghouse for enrolled providers, CONTRACTOR has obligations to adequately test all business rules appropriate to each and every provider type and specialty for which they provide clearinghouse services. D.Deficiencies The CONTRACTOR agrees to cure transactions errors or deficiencies identified by DHCS, and transactions errors or deficiencies identified by an enr olled CONTRACTOR if the COUNTY is acting as a clearinghouse for that CONTRACTOR. If the CONTRACTOR is a clearinghouse, the CONTRACTOR agrees to properly communicate deficiencies and other pertinent information regarding electronic transactions to enrolled CONTRACTORS for which they provide clearinghouse services. E.Code Set Retention Both Parties understand and agree to keep open code sets being processed or used in this Agreement for a least the current billing period or any appeal period, whichever is longer. F.Data Transmission Log Both Parties shall establish and maintain a Data Transmission Log, which shall record any and all data transmissions taking place between the Parties during the term of this Agreement. Each Party shall take necessary and reasonable steps to ensure that such Data Transmission Logs constitute a current, accurate, complete and unaltered record of any and all Data Transmissions between the Parties, and shall be retained by each Party for no less than twenty-four (24) months following the date of the Data Transmission. The Data Transmission Log may be maintained on computer Exhibit D - Page 12 of 13 media or other suitable means provided that, if necessary to do so, the information contained in the Data Transmission Log may be retrieved in a timely manner and presented in readable form. Exhibit D - Page 13 of 13 Exhibit E Page 1 of 3 FRESNO COUNTY MENTAL HEALTH COMPLIANCE PROGRAM CONTRACTOR CODE OF CONDUCT AND ETHICS Fresno County is firmly committed to full compliance with all applicable laws, regulations, rules and guidelines that apply to the provision and payment of mental health services. Mental health contractors and the manner in which they conduct themselves are a vital part of this commitment. Fresno County has established this Contractor Code of Conduct and Ethics with which contractor and its employees and subcontractors shall comply. CONTRACTOR(S) shall require its employees and subcontractors to attend a compliance training that will be provided by Fresno County. After completion of this training, CONTRACTOR(S), CONTRACTOR(S)’ employees and subcontractors must sign the Contractor Acknowledgment and Agreement form and return this form to the Compliance Officer or designee. Contractor and its employees and subcontractor shall: 1.Comply with all applicable laws, regulations, rules or guidelines when providing and billing for mental health services. 2.Conduct themselves honestly, fairly, courteously and with a high degree of integrity in their professional dealing related to their contract with the COUNTY and avoid any conduct that could reasonably be expected to reflect adversely upon the integrity of the COUNTY. 3.Treat COUNTY employees, consumers, and other mental health contractors fairly and with respect. 4.NOT engage in any activity in violation of the COUNTY’s Compliance Program, nor engage in any other conduct which violates any applicable law, regulation, rule or guideline 5.Take precautions to ensure that claims are prepared and submitted accurately, timely and are consistent with all applicable laws, regulations, rules or guidelines. 6.Ensure that no false, fraudulent, inaccurate or fictitious claims for payment or reimbursement of any kind are submitted. Exhibit E Page 2 of 3 7.Bill only for eligible services actually rendered and fully documented. Use billing codes that accurately describe the services provided. 8.Act promptly to investigate and correct problems if errors in claims or billing are discovered. 9.Promptly report to the Compliance Officer any suspected violation(s) of this Code of Conduct and Ethics by COUNTY employees or other mental health contractors, or report any activity that they believe may violate the standards of the Compliance Program, or any other applicable law, regulation, rule or guideline. Fresno County prohibits retaliation against any person making a report. Any person engaging in any form of retaliation will be subject to disciplinary or other appropriate action by the COUNTY. CONTRACTOR(S) may report anonymously. 10.Consult with the Compliance Officer if you have any questions or are uncertain of any Compliance Program standard or any other applicable law, regulation, rule or guideline. 11.Immediately notify the Compliance Officer if they become or may become an Ineligible person and therefore excluded from participation in the Federal Health Care Programs. Exhibit E Page 3 of 3 Fresno County Mental Health Compliance Program Contractor Acknowledgment and Agreement I hereby acknowledge that I have received, read and understand the Contractor Code of Conduct and Ethics. I herby acknowledge that I have received training and information on the Fresno County Mental Health Compliance Program and understand the contents thereof. I further agree to abide by the Contractor Code of Conduct and Ethics, and all Compliance Program requirements as they apply to my responsibilities as a mental health contractor for Fresno County. I understand and accept my responsibilities under this Agreement. I further understand that any violation of the Contractor Code of Conduct and Ethics or the Compliance Program is a violation of County policy and may also be a violation of applicable laws, regulations, rules or guidelines. I further understand that violation of the Contractor Code of Conduct and Ethics or the Compliance Program may result in termination of my agreement with Fresno County. I further understand that Fresno County will report me to the appropriate Federal or State agency. For Individual Providers Name (print): _____________________________________ Discipline: Psychiatrist Psychologist LCSW LMFT Signature: _______________________________ Date: ___/____/___ For Group or Organizational Providers Group/Org. Name (print): ______________________________________ Employee Name (print): _______________________________________ Discipline: Psychiatrist Psychologist LCSW LMFT Other:_________________________________________________ Job Title (if different from Discipline): ___________________________ Signature: _______________________________ Date: ___/____/___ Exhibit F - Page 1 of 2 SELF-DE ALING TRANSAC TION DISCLOSURE FORM In order to conduct business with the County of Fresno (hereinafter referred to as “COUNTY”), members of a CONTRACTOR(S)’ board of directors (hereinafter referred to as “County Contractor”), must disclose any self-dealing transactions that they are a party to while providing goods, performing services, or both for the COUNTY. A self-dealing transaction is defined below: “A self-dealing transaction means a transaction to which the corporation is a party and in which one or more of its directors has a material financial interest” The definition above will be utilized for purposes of completing this disclosure form. INSTRUCTIONS (1)Enter board member’s name, job title (if applicable), and date this disclosure is being made. (2)Enter the board member’s company/agency name and address. (3)Describe in detail the nature of the self-dealing transaction that is being disclosed to the COUNTY. At a minimum, include a description of the following: a.The name of the agency/company with which the corporation has the transaction; and b.The nature of the material financial interest in the corporation’s transaction that the board member has. (4)Describe in detail why the self-dealing transaction is appropriate based on applicable provisions of the Corporations Code. (5)Form must be signed by the board member that is involved in the self-dealing transaction described in Sections (3) and (4). Exhibit F - Page 2 of 2 (1) Company Board Member Information: Name: Date: Job Title: (2) Company/Agency Name and Address: (3) Disclosure (Please describe the nature of the self-dealing transaction you are a party to): (4)Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233 (a): (5) Authorized Signature Signature: Date: Exhibit G – Page 1 of 1 NOTICE OF CHILD ABUSE REPORTING LAW The undersigned hereby acknowledges that Penal Code section 11166 and the contractual obligations between County of Fresno (COUNTY) and YOUTH LEADERSHIP INSTITUTE (CONTRACTOR), require that the undersigned report all known or suspected child abuse or neglect to one or more of the agencies set forth in Penal Code (P.C.) section (§) 11165.9. For purposes of the undersigned’s child abuse reporting requirements, “child abuse or neglect” includes physical injury inflicted by other than accidental means upon a child by another person, sexual abuse as defined in P.C. §11165.1, neglect as defined in P.C. §11165.2, willful cruelty or unjustifiable punishment as defined in P.C. §11165.3, and unlawful corporal punishment or injury as defined in P.C. §11165.4. A child abuse report shall be made whenever the undersigned, in his or her professional capacity or within the scope of his or her employment, has knowledge of or observes a child whom the undersigned knows or reasonably suspects has been the victim of child abuse or neglect. (P.C §11166.) The child abuse report shall be made to any police department or sheriff’s department (not including a school district police or security department), or to any county welfare department, including Fresno County Department of Children and Family Services’ 24 Hour CARELINE. (See PC §11165.9.) For purposes of child abuse reporting, a “reasonable suspicion” means that it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect. The pregnancy of a child does not, in and of itself, constitute a basis for reasonable suspicion of sexual abuse. (P.C. §11166(a)(1).) Substantial penalties may be imposed for failure to comply with these child abuse reporting requirements. Further information and a copy of the law may be obtained from the County of Fresno Department head or designee. I have read and understand the above statement and agree to comply with the child abuse reporting requirements. __________________________________ ________________________ SIGNATURE DATE National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and health care organizations to: Principal Standard: 1.Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs. Governance, Leadership, and Workforce: 2.Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy, practices, and allocated resources. 3.Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area. 4.Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis. Communication and Language Assistance: 5.Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services. 6.Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing. 7.Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided. 8.Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area. Engagement, Continuous Improvement, and Accountability: 9.Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations. 10.Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities. 11.Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery. 12.Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area. 13.Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness. 14.Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflicts or complaints. 15.Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and the general public. Think Cultural Health https://www.thinkculturalhealth.hhs.gov/ contact@thinkculturalhealth.hhs.gov Exhibit H - Page 1 of 2 The Case for the National CLAS Standards Health equity is the attainment of the highest level of health for all people.1 Currently, individuals across the United States from various cultural backgrounds are unable to attain their highest level of health for several reasons, including the social determinants of health, or those conditions in which individuals are born, grow, live, work, and age,2 such as socioeconomic status, education level, and the availability of health services.3 Though health inequities are directly related to the existence of historical and current discrimination and social injustice, one of the most modifiable factors is the lack of culturally and linguistically appropriate services, broadly defined as care and services that are respectful of and responsive to the cultural and linguistic needs of all individuals. Health inequities result in disparities that directly affect the quality of life for all individuals. Health disparities adversely affect neighborhoods, communities, and the broader society, thus making the issue not only an individual concern but also a public health concern. In the United States, it has been estimated that the combined cost of health disparities and subsequent deaths due to inadequate and/or inequitable care is $1.24 trillion.4 Culturally and linguistically appropriate services are increasingly recognized as effective in improving the quality of care and services.5,6 By providing a structure to implement culturally and linguistically appropriate services, the National CLAS Standards will improve an organization’s ability to address health care disparities. The National CLAS Standards align with the HHS Action Plan to Reduce Racial and Ethnic Health Disparities7 and the National Stakeholder Strategy for Achieving Health Equity,8 which aim to promote health equity through providing clear plans and strategies to guide collaborative efforts that address racial and ethnic health disparities across the country. Similar to these initiatives, the National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. Adoption of these Standards will help advance better health and health care in the United States. Of all the forms of inequality, injustice in health care is the most shocking and inhumane. — Dr. Martin Luther King, Jr. Bibliography 1. U.S. Department of Health and Human Services, Office of Minority Health (2011). National Partnership for Action to End Health Disparities. Retrieved from http://minorityhealth.hhs.gov/npa 2. World Health Organization. (2012). Social determinants of health. Retrieved from http://www.who.int/social_determinants/en/ 3. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Healthy people 2020: Social determinants of health. Retrieved from http://www. healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39 4. LaVeist, T. A., Gaskin, D. J., & Richard, P. (2009). The economic burden of health inequalities in the United States. Retrieved from the Joint Center for Political and Economic Studies website: http://www. jointcenter.org/sites/default/files/upload/research/files/The%20Economic%2 0Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf 5. Beach, M. C., Cooper, L. A., Robinson, K. A., Price, E. G., Gary, T. L., Jenckes, M. W., Powe, N.R. (2004). Strategies for improving minority healthcare quality. (AHRQ Publication No. 04-E008-02). Retrieved from the Agency of Healthcare Research and Quality website: http://www.ahrq.gov/downloads/pub/evidence/pdf/minqual/minqual.pdf 6. Goode, T. D., Dunne, M. C., & Bronheim, S. M. (2006). The evidence base for cultural and linguistic competency in health care. (Commonwealth Fund Publication No. 962). Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/usr_doc/Goode_evidencebasecultlinguisticcomp_962.pdf 7. U.S. Department of Health and Human Services. (2011). HHS action plan to reduce racial and ethnic health disparities: A nation free of disparities in health and health care. Retrieved from http:// minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf 8. National Partnership for Action to End Health Disparities. (2011). National stakeholder strategy for achieving health equity. Retrieved from U.S. Department of Health and Human Services, Office of Minority Health website: http://www.minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286 Think Cultural Health https://www.thinkculturalhealth.hhs.gov/ contact@thinkculturalhealth.hhs.gov Exhibit H - Page 2 of 2 Exhibit I – Page 1 of 2 DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT I.Identifying Information Name of entity D/B/A Address (number, street) City State ZIP code CLIA number Taxpayer ID number (EIN) Telephone number ( ) II.Answer the following questions by checking “Yes” or “No.” If any of the questions are answered “Yes,” list names and addresses of individuals or corporations under “Remarks” on page 2. Identify each item number to be continued. A.Are there any individuals or organizations having a direct or indirect ownership or control interest of five percent or more in the institution, organizations, or agency that have been convicted of a criminal offense related to the involvement of such persons or organizations in any of the programs established YES NO by Titles XVIII, XIX, or XX? ......................................................................................................................... ❒ ❒ B.Are there any directors, officers, agents, or managing employees of the institution, agency, or organization who have ever been convicted of a criminal offense related to their involvement in such programs established by Titles XVIII, XIX, or XX? ...................................................................................... ❒ ❒ C.Are there any individuals currently employed by the institution, agency, or organization in a managerial, accounting, auditing, or similar capacity who were employed by the institution’s, organization’s, or agency’s fiscal intermediary or carrier within the previous 12 months? (Title XVIII providers only) ........... ❒ ❒ III.A. List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names and addresses under “Remarks” on page 2. If more than one individual is reported and any of these persons are related to each other, this must be reported under “Remarks.” NAME ADDRESS EIN B.Type of entity: ❒ Sole proprietorship ❒Partnership ❒Corporation❒Unincorporated Associations ❒Other (specify) C.If the disclosing entity is a corporation, list names, addresses of the directors, and EINs for corporations under “Remarks.” D.Are any owners of the disclosing entity also owners of other Medicare/Medicaid facilities? (Example: sole proprietor, partnership, or members of Board of Directors) If yes, list names, addresses of individuals, and provider numbers. .......................................................................................................... ❒❒ NAME ADDRESS PROVIDER NUMBER Exhibit I – Page 2 of 2 YES NO IV. A. Has there been a change in ownership or control within the last year? ....................................................... ❒ ❒ If yes, give date. B. Do you anticipate any change of ownership or control within the year?....................................................... ❒ ❒ If yes, when? C. Do you anticipate filing for bankruptcy within the year?................................................................................ ❒ ❒ If yes, when? V.Is the facility operated by a management company or leased in whole or part by another organization?.......... ❒ ❒ If yes, give date of change in operations. VI.Has there been a change in Administrator, Director of Nursing, or Medical Director within the last year?......... ❒ ❒ VII. A. Is this facility chain affiliated? ...................................................................................................................... ❒ ❒ (If yes, list name, address of corporation, and EIN.) Name EIN Address (number, name) City State ZIP code B.If the answer to question VII.A. is NO, was the facility ever affiliated with a chain? (If yes, list name, address of corporation, and EIN.) Name EIN Address (number, name) City State ZIP code Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the information requested may result in denial of a request to participate or where the entity already participates, a termination of its agreement or contract with the agency, as appropriate. Name of authorized representative (typed) Title Signature Date Remarks Exhibit J - Page 1 of 2 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS INSTRUCTIONS FOR CERTIFICATION 1.By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2.The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3.The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4.The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5.The terms covered transaction, debarred, suspended, ineligible, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. CERTIFICATION (1)The prospective primary participant certifies to the best of its knowledge and belief, that it, its owners, officers, corporate managers and partners: (a)Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b)Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; Exhibit J - Page 2 of 2 (c)Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2)Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Signature: Date: (Printed Name & Title) (Name of Agency or Company) PRIVACY AND SECURITY AGREEMENT REGARDING AUTHORIZED ACCESS TO CONFIDENTIAL PROTECTED HEALTH INFORMATION FOR FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH (DBH) EMPLOYEES AND/OR NON-DBH SUD SERVICES WORKFORCE MEMBERS OATH OF CONFIDENTIALITY As a condition of obtaining access to any Protected Health Information (PHI) that is necessary to carry out my function with DBH, I ___________________________, agree to not divulge any PHI to unauthorized persons. Furthermore, I maintain that I will not publish or otherwise make public any information regarding persons who receive Substance Use Disorder Services such that the persons who receive or have received such services are identifiable. Access to such data shall be limited to Fresno County DBH personnel, subcontractors, and subcontractors’ personnel who require this information in the performance of their duties and have signed an Oath of Confidentiality with DBH. By signing this oath, I agree to uphold the security and confidentiality requirements outlined by the Medi- Cal Privacy and Security Agreement signed by DBH, surveillance and safeguarding announcements issued by DHCS, and other applicable terms and stipulations provided by the HIPAA doctrine as well as other relevant state and federal regulations. I hereby certify my understanding of the need to: 1.Exercise due care to preserve data integrity and confidentiality. 2.Treat passwords and user accounts as confidential information. 3.Take reasonable precautions to ensure the protection of PHI from unauthorized access. 4.Notify DHCS when there is a possible security violation including unauthorized access to PHI by completing a “Privacy Incident Report” at: http://www.dhcs.ca.gov/formsandpubs/laws/priv/Pages/DHCSBusinessAssociatesOnly.aspx and return the completed form to: privacyofficer@dhcs.ca.gov. I recognize that unauthorized release of confidential information may make me subject to civil and criminal sanctions pursuant to the provisions of the Welfare and Institutions Code Section 14100.2, Welfare and Institutions Code Section 5328 et seq. and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). I further acknowledge that the unauthorized release of confidential information as described in this document may result in disciplinary action up to and including termination of any office of employment or contract. Agency Name: Signature: ____________________________________ Date: ____________________________________ Exhibit K - Page 1 of 1