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State ofldaho DEPARTMENT OF HEALTH AND WELFARE Division of Family and Community Services DIRK KEMPTHORNE Governor KARL B. KURTZ Director ROSEANNE HARDIN Administrator March 6. 2000 Dan Weaver Police Chief ORIGINAL City of Moscow Police Department 118 E. 4th Moscow, Idaho 83843 Re: LEEP Grant KC 113200 Dear Chief W caver: Office Location: 450 West State Street, 5th Floor Boise, Idaho 83720-0036 (208) 334-5700 Fax: (208) 334-6699 or 334-6664 Mailing Address: PO Box 83720 5th Floor Boise, Idaho 83720-0036 Enclosed, find your copy of the finalized D.A.R.E. Grant \\hich ha: he,·n hy the Mayor of Mos•cow. Idaho and Roseanne !Jardin. FACS Administrator. When I can be of further assistance. please advise. Sincerely. John Kirsch Program Specialist ---PAGE BREAK--- STATE OF IDAHO STANDARD GRANT l I CONTRACT NO. KC113200 CONTRACTOR'S FEDERAL I.D. NO. 82-6000227 09 This Grant is entered into by the State of Idaho, Department of Health and Welfare, hereinafter referred to as the GRANT PROVIDER, and CITY OF MOSCOW POLICE DEPARTMENT, hereinafter referred to as the GRANT RECIPIENT. CFDA number is 84186A. This Grant is effective as of 01-01-2000 and expires 06-30-2000. WITNESSETH: The GRANT PROVIDER enters into this Grant pursuant to authority granted to it in Title 39, Chapter 1, Idaho Code. The GRANT RECIPIENT agrees to undertake performance of this Grant under the terms and conditions set forth herein. The GRANT RECIPIENT agrees to provide, and the GRANT PROVIDER to accept the services detailed in Appendix A and generally described as follows: DRUG ABUSE RESISTANCE EDUCATION LAW ENFORCEMENT EDUCATION PARTNERSHIP, SAFE AND DRUG FREE SCHOOLS FUNDS The following Attachments are hereby incorporated by reference and made a part of this Agreement: Standard Grant TOTAL CONTRACT AMOUNT CURRENT FY ENCUMBRANCE FUTURE FY ENCUMBRANCE SUB OBJECT 5170 PROGRAM COST ACCOUNT (PCA) 100% 25046 $2,278.00 $.00 $2.278.00 Appendix A - Serv. To Be Performed Appendix B - Additional Provisions Appendix C - Billing Procedures Appendix D - Project/Report Sched. FY 00 TC: 210 TC: 215 CONTRACT ORIGINATOR: JOHN KIRSCH , DATE CONTRACT APPROVED BY: ROSEANNE HARDIN, ADMINISTRATOR , DATE STANDARD GRANT Page 1 ---PAGE BREAK--- STANDARD GRANT I. GENERAL PROVISIONS: A. Alteration of the terms of this agreement may be made by a joint memorandum directing the change and signed by both the DEPARTMENT and the GRANTEE. B. The failure of the DEPARTMENT to require strict performance of any term or condition of this agreement, or to exercise any option herein, in any one or all instances shall not be construed to be a waiver or relinquishment of any such term or condition. The same shall be and remain in full force and effect, unless there is a prior written waiver by the DEPARTMENT. C. The GRANTEE agrees to maintain all fiscal records including, its books, audit papers, documents, and any other evidence of accounting procedures and practices, which sufficiently and properly reflect all direct and indirect costs of any nature expended in the performance of this grant. These records shall be available for and subject to inspection, review, or audit and copying by the DEPARTMENT and other personnel duly authorized by the DEPARTMENT or federal inspectors or auditors at all reasonable times, at either the GRANTEE'S principal place of business or upon premises tlesignated by the DEPARTMENT. D. The GRANTEE shall maintain all records and documents relevant to this grant for three years from the date of final payment. The DEPARTMENT and any persons duly authorized by the DEPARTMENT, shall have full access to and the right to inspect, review, and audit any of these materials during the retention period. If an audit, litigation or other action involving records is initiated before the three year period has expired, the records must be retained until all issues arising out of such action are resolved, or until an additional three year period has passed, whichever is later. E. The GRANTEE shall be monitored on a frequency to be determined by the DEPARTMENT and the program shall be periodically reviewed. The results of this program review may be used, with other information, to evaluate the GRANTEE'S provision of services funded by this grant. F. The GRANTEE shall indemnify, defend and save harmless the State of Idaho, and the DEPARTMENT, its officers, agents and employees, from and against all liability, claims, damages, losses, expenses, actions, and suits whatsoever, including injury or death of others or any employee of the GRANTEE caused by or arising out of the GRANTEE'S performance, act, or omission of any term of this Grant. Nothing in this provision shall extend the GRANTEE'S indemnification of the DEPARTMENT beyond the liability of the DEPARTMENT provided in the Idaho Tort Claims Act, Idaho Code 6-901 et !!.QQ , the aggregate of which is limited to $500,000 by Idaho Code 6-926. The DEPARTMENT shall indemnify, defend and save harmless the GRANTEE, its officers, agents and employees from and against all liability, claims, damages, losses, expenses, actions, and suits whatsoever, including injury or death of others or any employee of the DEPARTMENT caused by or arising out of the DEPARTMENT'S negligent performance, act or omission of any term of this Grant. Nothing in this prov1s1on shall extend the liability of the DEPARTMENT beyond that provided in the Idaho Tort Claims Act, Idaho Code 6-901 et l!.QQ · STANDARD GRANT Page 2 ---PAGE BREAK--- As an independent contractor, GRANTEE is responsible for all employee-related benefits, such as paid leaves and health insurance, and withholding and payment of F. I. C. F.U.T. and income taxes for federal and state purposes. The DEPARTMENT shall not be responsible for these employee-related benefits and tax items, and shall be indemnified and held harmless for any liability, cost or expense, including any interest, penalties and attorney's fees, that may be connected with the GRANTEE'S failure to provided or pay such items. G. It is expressly acknowledged and agreed that the GRANTEE shall observe the confidentiality of information provisions of the Idaho Code, and pertinent state and federal rules and regulations. The DEPARTMENT will furnish the GRANTEE with applicable statutes, rules and regulations upon receipt of written request for them. Further, the Grantee acknowledges that pursuant to Idaho Code Section 9-335 et , information or documents received from Grantee may be open to public inspection and copying unless exempt. H. The GRANTEE hereby agrees to provide all services funded through or affected by this grant without discrimination on the basis of race, color, national origin, sex, age, religion or physical/mental impairment, and to comply with all relevant state and federal laws regarding anti-discrimination. I. The GRANTEE certifies that none of the fund provided by this grant have been paid or will be paid by or on behalf of the GRANTEE to any person for influencing or attempting to influence an officer or employee of any governmental agency, a member, officer or employee of Congress or the State Legislature in connection with the awarding, continuation, renewal, amendment, or modification of any contract, grant, loan or cooperative agreement. If any funds, other than funds provided by this grant, have been paid or will be paid to any person for influencing or attempting to influence an office or employee of any governmental agency, a member, officer, or employee of Congress or the State Legislature in connection with this grant, the GRANTEE shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying, " in accordance with its instructions, and a copy of Standard Form LLL to the DEPARTMENT. The GRANTEE understands that a false statement of this certification may be grounds for rejection or termination of the grant, and that their signature upon this "Standard Grant" is a material representation of fact upon which reliance was placed when this grant was made or entered into. In addition, under Section 1352, Title 31, U. S. Code, a false statement shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such false statement. J. The Grantee must comply with the terms of the "Single Audit Act" of 1984. Funds provided under this Grant may be used to pay for compliance with this Act in proportion to other funding sources available to the GRANTEE. K. The DEPARTMENT or the GRANTEE may cancel this Grant at any time without cause upon thirty (30) calendar days' written notice specifying the date of termination. The Obligations and liabilities of the parties shall cease upon the date of termination, except that the obligations or liabilities incurred prior to the termination date shall be honored. II. SIGNATURE STANDARD GRANT Page 3 ---PAGE BREAK--- ORI L IN WITNESS WHEREOF, the parties have executed this agreement. GRANTEE Mailing Address: t1osr.vt-"' Prv;u""- STANDARD GRANT Page 4 ---PAGE BREAK--- APPENDIX SERVICES TO BE PERFORMED The City of Moscow Police Department (GRANTEE) is to perfom1 substance abuse prevention education services through the Drug Abuse Resistance Education (D.A.R.E.) Program to fifth graders enrolled in Moscow School District #281 and St. Mary's, a private school. The total number of students to be served with the Grant is 300 at a rate of $7.59 per student. Grant Terms and Conditions Appendices. IFYOO Page ---PAGE BREAK--- APPENDIX B ADDITIONAL PROVISIONS Mandatorv Criminal Historv Check All persons involved in providing services, under grant, with the GRANT PROVIDER, to persons under the age of eighteen shall submit to a criminal history check in accordance with the provisions ofldaho Department of Health and Welfare Rules and Regulations. Title 6, Chapter 4, "Rules and Regulations Governing Mandatory Criminal History Checks". lt shall be the responsibility of the GRA.NT RECIPIENT to see that all procedures and requirements for the criminal history checks are completed, and cover the costs involved. Grant Terms and Conditions Appendices. IFYOO Page 2 ---PAGE BREAK--- APPENDIX C BILLING PROCEDURES A. Procedure for Reimbursement: The GRANTEE shall receive payments upon submission of a Substance Abuse Prevention Program Grant Payment Request Form (shown in Attachment to the Department. This form shall be submitted no more often than once per month. The linal_payment will be withheld until the GRANTEE submits a Substance Abuse Prevention Provider Report Form (shown in Attachment B) to the Department. Payment will not be made until the form is reviewed and deemed to be complete. B. Total billing for services for the Grant period (December 15, !999 to June 30, 2000) shall not exceed $2,278.00. The following amounts will be spent tor the following expense categories. Travel: Materials: Supplies: 278.00 Salary: B. Send, do not fax, the Substance Abuse Prevention Proljram Grant Payment Request Form. Attachment A. and direct all payment inquiries to the grant monitor named below: Terry Pappin. Program Specialist Department of Health and Welfare Division of Family and Community Services Bureau of Mental Health and substance Abuse P.O.Box 83720, 5th Floor Boise Idaho 83720-0036 Phone: Fax: [PHONE REDACTED] [PHONE REDACTED] Grant Terms and Conditions Appendices, IFYOO Page 3 ---PAGE BREAK--- APPENDIX D PROJECT/REPORT SCHEDULE The GRANT RECIPIENT shall submit the SUBSTANCE ABUSE PREVENTION PROVIDER REPORT FORM. Attachment B. by July 15, 2000 in order that future grant requests not be jeopardized. Grant Terms and Conditions Appendices. IFYOO Page 4 ---PAGE BREAK--- Attachment A DEPARTMENT OF HEALTH AND WELFARE DIVISION OF FAMILY AND COMMUNIJ'Y SERVICES Bureau of Mental Health and Substance Abuse SUBSTANCE ABUSE PREVENTION PROGRAM GRANT PAYMENT REQUEST FORM INVOICE NO.: GRANT RECIPIENT: City of Moscow Police Department ADDRESS: 118 E. 4'h CITY/STATE/ZIP: Moscow, Idaho 83843 PERIOD: January I, 2000 to June 30, 2000 CONTRACT NO.: KC113200 PERSON COMPLETING FORM: PHONE: (208) 885-5253 REIMBURSEMENT REQUEST FORl\11: Total Grant s 2,278.00 Previous Expenditures: $ _ _ Present Grant Balance: $ Expenditures this Request (List categories/items): l. _ $ 2. $ ' J. $ 4. $ _ _ Total Funds Needed This Request: $ New Grant Balance: $ I certify the above expenditures and grant balance are true and correct to the best of my knowledge. Authorized Signature Date Legible Version of Signature ---PAGE BREAK--- Attachment B DEPARTMENT OF HEALTH AND WELFARE-- Division of Family and Community Services Bureau of Mental Health and Substance Abuse SUBSTANCE ABUSE PREVENTION PROVIDER REPORT FORiv1 Provider: City of Moscow Police Department Contract No.: KC113200 Program Title: Drug Abuse Resistance Education (D.A.R.E.) Person Completing Report: Phone No.: (208) 885-2254 Contract Period: (Start Date) l-l-00 (End Date) 6-30-00 Period Covered by Report: (From) (To) STATISTICAL INFOR!WA TION Numbers Served In Each Category: Ages 0-4 Ages 10-12 • Ages 16-18 Ages 5-8 Ages !3-15 Adults I Total Number Served During Report Period For the reporting period, how many of the service recipients were: School-aged youth attending public or private schools School-aged youth, not in school (e.g homeless, dropouts, incarcerated) Parents or guardians Law enforcement ofticials (including district attorneys) Teachers and other school personnel Other community members Check the type of services the program provides: Dissemination and media activities Training for parents, teachers, law entorcement officials, and other community members Comprehensive services and programs Program coordination with law enforcement or other community and state ---PAGE BREAK--- agencies or organizations Activities to protect students traveling to and from school After-school or before-school programs Check the type of services the program provides (continued): Activities to prevent violence related to prejudice and intolerance or the study of intolerance in history Anti-gang activities Surveys of drug and violence prevalence and safety Community service projects Program evaluation Drug prevention instruction Violence prevention instruction • Curriculum acquisition or development Youth/student support services assistance programs, counseling. mentoring, identification and referral) Alternative education programs Parent education/involvement Services to out-of-school youth Services to youth in school Special. one-time events Conflict resolution/peer mediation Security personnel and equipment PROCESS INFORJ'\1ATION Program Meeting Participant Number Goals') Yes No Program :Vleeting Timeline Goals'' Yes No Changes in Program Staff' Yes No Program Encountered Problems'' Yes No ---PAGE BREAK--- GLOSSARY 01' TERMS After-school program: Any program. conducted after regular school hours. that encourages drug/violence free lifestyles. Programs may be recreational, instructionaL culturaL or artistic in nature. Alternative education program: Any program for students who are not enrolled in the regular school environment. such as students who are at risk of dropping out. students who have been expelled from their regular classes. students who are undergoing outpatient treatment for drug use, etc. Before-school program: Any program, conducted before regular school hours, that encourages drug/violence free lifestyles. Programs may be recreational, instructional, cultural, and/or artistic in nature. Community service projects: Activities conducted by students for the benefit of the larger community that encourage students to lead drug/violence free lifestyles or increase students' sense of community. Comprehensive services/programs: Activities or services which include a variety of topics and strategies such as violence prevention. substance abuse prevention, and student support services. Conflict resolution program: Any program offering peer mediation, or conflict and anger management instruction to students. Curriculum acquisition or development: Purchase of or local development of drug/violence prevention instructional materials for preschool through grade 12 students. It includes acquisition or development of books, workbooks. videotapes, software, and other learning resources. Drug prevention instruction: Instruction aimed at drug prevention that is presented in the classroom a unit in a health or physical education class that teaches about tobacco. alcohol, and other drugs: drug prevention instruction that is infused into the general curriculum; or stand-alone program or curriculum such as Here's Looking at You 2000. DARE, Quest. or BABES). Parent education/involvement: Direct participation of parents or guardians in drug or violence prevention programs. Types of involvement include receipt of drug and violence prevention-related programming (education or training); assisting with drug and violence prevention-related instruction or activities in the schools as instructors, aides, mentors, etc.). Prevention services/activities: AI! alcohol and other drug and violence prevention education services. including drug prevention instruction, violence prevention instruction. prevention-related student support services (e.g student assistance programs), and conflict resolution programs. Security equipment: Any equipment for use in maintaining a drug/violence-free school environment. for example metal detectors, or beepers. cellular phones. and intercoms for security/school personnel. Security personnel: Specia!ly-trained personnel who ensure safety and security of a school building and its occupants. Services for out-of-w:lwol youth: Drug/violence prevention projects. activities. or services for school-aged youth not currently enrolled in schooL such as drop-outs, and youth in detention centers. Special, one-time events: Drug/violence prevention-related activities that occur once during a school year (e.g Red Ribbon Week, Project Graduation, special assemblies.) Stwlent support services: Programs. activities. and events that aim to prevent alcohol and other drug use. Examples include support groups. help lines. counseling services, and mentoring. Teaclter/stafftraining: Professional development. training, or technical assistance for teachers. certified personnel, or other staff that addresses drug or violence prevention, curriculum implementation, student support. comprehensive health education. early intervention. or rehabilitation referrals. Violence prevention instruction: Instruction that is presented in the classroom as part of a class or separate curriculum for the purposes of preventing violence. ---PAGE BREAK--- PROCESS IN FORMA • tON CONTINUED: (Please identify technical assistance needs. Use additional sheets for explanation. if necessary) Explain not meeting participant number and/or time line goals. Explain staff changes and/or problems encountered. IMPACT EVALUATION PROGRESS INF0Rl'\1ATION: (Please identify technical assistance needs. Use additionaJ sheets if necessary) Describe the criteria used to demonstrate benefits to program participants. Attach a copy of the instrument(s) or detail the method used to measure benefits. Describe the progress made towards achieving demonstrable benefits to participants during this reporting period and attach a copy of impact measurement results.