HomeMy WebLinkAboutProfessional Services Agreement with Bethany Gadzinski for MADC Recognize Program Evaluation ServicesPROFESSIONAL SERVICES AGREEMENT
FOR MADC RECOGNIZE PROGRAM EVALUATION SERVICES
IN AN AMOUNT NOT TO EXCEED $15,000
THIS AGREEMENT FOR PROFESSIONAL SERVICES is made this 3k -A day of 4wq
2011 ("Effective Date"), and entered into by and between the City of Meridian, a municipal corporation
organized under the laws of the State of Idaho, hereinafter referred to as "City," 33 East Broadway
Avenue, Meridian, Idaho, and Bethany Gadzinski, an individual, hereinafter referred to as "Contractor,"
whose address is 2633 West Piazza Drive, Meridian, Idaho.
WHEREAS, in 2009, City received a Drug -Free Communities Grant from federal agencies
including, but not limited to, the Office of National Drug Control Policy ("ONDCP") and the Substance
Abuse and Mental Health Services Administration ("SAMHSA"), which grant monies were used to
institute the MADC Recognize Program, which seeks to reduce substance abuse among youth by
addressing the factors in our community that increase the risk of substance abuse and promoting the
factors that minimize the risk of substance abuse;
WHEREAS, on January 20, 2011, City received an additional grant from CRP, Incorporated for
evaluating the effectiveness of the Recognize Program, as set forth in the Subcontract Agreement between
City and CRP, Incorporated, attached hereto as Exhibit A;
WHEREAS, Contractor is specially trained, experienced, and competent to provide, and has
agreed to provide, such services;
NOW, THEREFORE, in consideration of the mutual promises, covenants, terms and conditions
hereinafter contained, the parties agree as follows:
I. TERMS AND CONDITIONS
A. Scope of Services.
1. Contractor shall perform and furnish to City, upon execution of this Agreement, all services,
and comply in all respects, as it relates to evaluation of the Recognize Program, as specified in
the Subcontract Agreement between City and CRP, Incorporated, attached hereto as Exhibit A
and the grant application attached hereto as Exhibit B, both of which are incorporated herein by
this reference.
2. Contractor shall provide services and work under this Agreement consistent with the
requirements and standards established by applicable federal, state and city laws, ordinances,
regulations and resolutions. Contractor represents and warrants that she will perform her work
in accordance with generally accepted industry standards and practices for the profession or
professions that are used in performance of this Agreement and that are in effect at the time of
performance of this Agreement.
3. Services and work provided by Contractor under this Agreement shall be performed in a timely
manner in accordance with the document entitled "Timeline for accomplishing tasks and
milestones," a copy of which is attached hereto in Exhibit B (p. 15) and incorporated herein by
this reference.
PROFESSIONAL SERVICES AGREEMENT — EVALUATION OF MADC RECOGNIZE PROGRAM PAGE 1 of 5
B. Consideration.
1. Payment shall be in the form of a firm fixed fee. City shall pay Contractor five thousand
dollars ($5,000.00) upon the completion and delivery of each of the three (3) Units specified in
the Budget set forth in Exhibits A (p. 10) and B (p. 16) hereto. The amount paid by City to
Contractor under this Agreement shall not exceed fifteen thousand dollars ($15,000.00).
2. To receive payment, Contractor shall provide an invoice to the Meridian Police Department
certifying the delivery of the specified Unit in conformance with Exhibits A and B hereto.
Following verification of such delivery and conformance by the Meridian Police Department,
City shall pay Contractor within thirty (30) days of receipt of such invoice. Contractor shall
submit the final invoice to City no later than thirty (30) days after the expiration or termination
of the Agreement.
3. Except as expressly provided in this Agreement and Exhibits hereto, Contractor shall not be
entitled to receive from City any additional consideration, compensation, salary, wages, or
other type of remuneration for services rendered under this Agreement., including, but not
limited to: meals, lodging, or transportation. Further, without limitation, Contractor shall not
be entitled by virtue of this Agreement to consideration in the form of overtime, health
insurance benefits, retirement benefits, paid holidays or other paid leaves of absence of any
type or kind whatsoever.
C. Time of performance.
1. This Agreement shall become effective as of the Effective Date upon execution by both
parties, and shall expire on January 31, 2012, unless earlier terminated or mutually extended by
separate written agreement.
2. The parties hereto acknowledge and agree that time is strictly of the essence with respect to
each and every term, condition and provision hereof, and that the failure to timely perform any
of the obligations hereunder shall constitute a breach of, and a default under, this Agreement
by the party so failing to perform.
D. Independent contractor. In all matters pertaining to this agreement, Contractor shall be acting as
an independent contractor, and neither Contractor nor any officer, employee or agent of Contractor
shall be deemed an employee of City. Except as expressly provided in Exhibits A and B,
Contractor has no authority or responsibility to exercise any rights or power vested in City. The
selection and designation of the personnel of City in the performance of this agreement shall be
made by City.
E. Indemnification and insurance:
1. Contractor shall indemnify and save and hold harmless City from and for any and all losses,
claims, actions, judgments for damages, and/or injury to persons or property and losses and
expenses and other costs including litigation costs and attorneys' fees, arising out of, resulting
from, or in connection with the performance of this Agreement by Contractor and/or
Contractor's officers, employs, agents, representatives and/or subcontractors and resulting in
and/or attributable to personal injury, death, and/or damage and/or destruction to tangible or
PROFESSIONAL SERVICES AGREEMENT - EVALUATION OF MADC RECOGNIZE PROGRAM PAGE 2 Of 5
intangible property and not caused by or arising out of the tortious conduct of City or its
employees.
2. Contractor shall not be required by this Agreement to obtain Worker's Compensation
Insurance because she is acting as a sole practitioner; however, should Contractor, in the
course of work related to this Agreement, employ any person, Contractor shall notify City and
shall obtain Worker's Compensation Insurance in the statutory limits as required by law.
F. Notices. Any and all notices, invoices, and/or reports required to be provided by either of the
parties hereto, unless otherwise stated in this Agreement, shall be in writing and be deemed
communicated when mailed by United States Mail, certified, return receipt requested, addressed as
follows:
Lt. John Overton
Meridian Police Department
1401 E. Watertower Street
Meridian, Idaho 83642
Bethany Gadzinski
2633 West Piazza Drive
Meridian, Idaho 83642
Either party may change its address for the purpose of this section by giving written notice of such
change to the other in the manner herein provided.
G. Attorney fees. Should any litigation be commenced between the parties hereto concerning this
Agreement, the prevailing party shall be entitled, in addition to any other relief as may be granted,
to court costs and reasonable attorneys' fees as determined by a Court of competent jurisdiction.
This provision shall be deemed to be a separate contract between the parties and shall survive any
default, termination or forfeiture of this Agreement.
H. Assignment. It is expressly agreed and understood by the parties hereto, that Contractor shall not
have the right to assign, transfer, hypothecate or sell any of her rights under this Agreement except
upon the prior express written consent of City.
I. Discrimination prohibited. In performing the services required hereunder, Contractor shall not
unlawfully discriminate in violation of any federal, state or local law, rule or regulation against any
person on the basis of race, color, religion, sex, national origin or ancestry, age or disability.
J. Reports and information. At such times and in such forms as City may require, there shall be
furnished to City such statements, records, reports, data and information as City may request
pertaining to matters covered by this Agreement.
K. Audits and inspections. At any time during normal business hours and as often as City may
deem necessary, there shall be made available to City for examination all of Contractor's records
with respect to all matters covered by this Agreement. Contractor shall permit City to audit,
examine, and make excerpts or transcripts from such records, and to make audits of all contracts,
invoices, materials, payrolls, records of personnel, conditions of employment and other data
relating to all matters covered by this Agreement.
L. Publication, reproduction and use of material. No material produced in whole or in part under
this Agreement shall be subject to copyright in the United States or in any other country. City
shall have unrestricted authority to publish, disclose and otherwise use, in whole or in part, any
reports, data or other materials prepared under this Agreement.
PROFESSIONAL SERVICES AGREEMENT — EVALUATION OF MADC RECOGNIZE PROGRAM PAGE 3 of 5
M. Compliance with laws. In performing the scope of services required hereunder, Contractor shall
comply with all applicable laws, ordinances, and codes of federal, state, and local governments.
N. Termination:
1. Grounds for termination of this Agreement shall include, but shall not be limited to:
a. Any act or omission by Contractor and/or her officers, employees, or agents, by which
Contractor fails to fulfill in a timely and proper manner her obligations under this
Agreement, violates any of the covenants, agreements, and/or stipulations of this
Agreement, falsifies any record or document required to be prepared under this agreement,
engages in fraud, dishonesty, or any other act of misconduct in the performance of this
contract.
b. A determination by the Meridian City Council that termination of this Agreement is in the
best interest of City.
c. An act or omission by either party which breaches any term of this Agreement.
d. An act of nature, loss of grant funding, or other unforeseeable event which precludes or
makes impossible the performance of the terms of this Agreement by either party.
e. A change in circumstances that renders the performance by either party a detriment to the
public health, safety, or welfare.
2. Either party may terminate this Agreement by providing fourteen (14) days advance written
notice of intention to terminate. Such written notice shall include a description of the breach
or circumstances providing grounds for termination. A seven (7) day cure period shall
commence upon mailing of the notice of intention to terminate. If, upon the expiration of such
cure period, cure of the breach or circumstances providing grounds for termination has not
occurred, this Agreement may be terminated upon provision of written notice of termination.
3. In the event of any termination of this Agreement for any reason and/or by either party, all
finished or unfinished documents, data, and reports prepared by Contractor under this
Agreement shall, at the option of City, become its property, and Contractor shall be entitled to
receive just and equitable compensation for any work satisfactorily completed hereunder.
4. Notwithstanding the above or any other provision of this Agreement, Contractor shall not be
relieved of liability to City for damages sustained by City by virtue of any breach of this
Agreement by Contractor, and City may withhold any payments to Contractor for the purposes
of set-off until such time as the exact amount of damages due City from Contractor is
determined. This provision shall survive the termination of this agreement and shall not
relieve Contractor of her liability to City for damages.
O. Construction and severability. If any part of this Agreement is held to be invalid or
unenforceable, such holding will not affect the validity or enforceability of any other part of this
Agreement so long as the remainder of the Agreement is reasonably capable of completion.
PROFESSIONAL SERVICES AGREEMENT — EVALUATION OF MADC RECOGNIZE PROGRAM PAGE 4 of 5
P. Advice of attorney. Each party warrants and represents that in executing this Agreement, it has
received independent legal advice from its respective attorney and/or has received the opportunity
to seek such advice.
Q. Non -waiver. Failure of either party to promptly enforce the strict performance of any term of this
Agreement shall not constitute a waiver or relinquishment of any party's right to thereafter enforce
such term, and any right or remedy hereunder may be asserted at any time after the governing body
of either party becomes entitled to the benefit thereof, notwithstanding delay in enforcement.
R. Entire agreement. This Agreement contains the entire agreement of the parties and supersedes
any and all other agreements or understandings, oral of written, whether previous to the execution
hereof or contemporaneous herewith.
S. Applicable law. This Agreement shall be governed by and construed and enforced in accordance
with the laws of the State of Idaho.
T. Approval required. This Agreement shall not become effective or binding until approved by the
governing body of City.
CONTRACTOR:
j{jj'f' �yM
. � r .rsHneY SNP 9�
B Y •
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Bethany ad ' nski1-010
IM ...
STATE OF IDAHO I HEREBY CERTIFY that on this day of , 2011, before the
ss: undersigned, a Notary Public in the State of Idaho, personally appeared BETHANY
County of ) GADZINSKI, known or proved to me to be the person who executed the said instrument,
and acknowledged to me that she executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official
seal, the day and year in this certificate first above written.
Notary Public f Idaho
Residing at ,Idaho
My Commission Expires:
CITY OF MERIDIAN:
BY.
Tammy def erd, Mayor
Attest:
Mia
Ja cee H an, City Clerk
PROFESSIONAL SERVICES AGREEMENT — EVALUATION OF MADC RECOGNIZE PROGRAM PAGE 5 of 5
EXHIBIT A
GRANT AGREEMENT - CRP AND CITY
Contract. # 2.77'08-4215
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Trackiu g ; #84= 4.3
Service to Science.':'-::,:
SUBCONTRACT AGREEMENT
Between
CRP, INCORPORATED
City of Meridian, Meridian Police Department
(MADC Recognize)
This Subcontractor Agreement (the "Agreement") is made and entered into this 31" day of
January, 2011 between CRP, Incorporated (CRP) of Silver Spring, MD, hereinafter called
"Contractor" and City of Meridian, Meridian Police Department, of Meridian., ID, hereinafter
called "Subcontractor."
WHEREAS, CRP has entered into a contract with the Substance Abuse and Mental Health
Services ,Administration, Center for Substance Abuse Prevention's Center for the ,A.pplication.
of Prevention 'technologies (SAMHSA/CSAP/CAPT), start-up mate of February 7, 201.1., _
hereinafter called the "Contract", for a funding period of February 7, 2011 to February 2, 2012,
and
WHEREAS CRP with guidance from the SAMHSA/CSAI'/CAPT has competitively selected City
of McMian, Meridian Police Department to perform certain tasks and services required under
the Contract, and
WHEREAS CRI? has approved City of Meridian, Meridian Police Department as a
subcontractor;
NOW THEREFORE, it is mutually agreed as follows:
1. Provisions of the Subcontract. All provisions of the Subcontract are attached to and made
a part of this Subcontract Agreement.
SAMHSA/CSAP/CAPT
U.S. Department of Health and Human Services
�. Contract No. 277-08-0218
1
shall. perform for CRP, in a good and businesslike
2. Scope of Fork. Subcontractor
manner, and subject to the provisions hereof, the tasks and services (hereinafter called the
" Subcontractor's technical proposal and as described in Exhibit
Mork} as outlined in the
va uation Capacity.-BuildingEnhancement}. Review of reports, products,
�. Proposed � 1
and other deliverables called for b this Subcontract shah. be by the Contractor's Corporate
Monitor, Carolyn l B. Rudd Ed.D. the Contractor's CAPT Service to Science Mini-
subcontract
innsubcontract Administrator Carmelita Crady, Ph.D., and the Contract's CAPT Service to
Science Chief, Dins Dash, M.P.H., M.A.
1. Subcontractor personnel listed in Exhibit B (Key' Personnel) are attached
3. `Personne
hereto and made a part hereof, are considered to be essential to the proper performance of
the Work. Prior to diverting e thspecified individuals from Work, or upon knowing of
p
their unavailability to perform the Work for any reason, Subcontractor shall propose a
substitution and shall obtain approval from CRP.
4. Terrn agrees
. The Subcontractor a to promptly begin work on or after February 7, 2011.
Performance of all Work required hereunder shall be completed on or before the
Subcontract ex date of Feb2, 2012. leo time extensions will be granted to
expiration February
the Subcontractor. CRI' must receive a signed W-9 form from the City of Meridian,
Meridian Police Department to ensure that payment is processed.
5. CRP's Responsibilities* CRP agrees to perform, or be responsible for, the following:
a. Monitor the progress of Subcontractor in achieving the proposed evaluation
enhancement(s). CRP will monitor all activities to assure that Fork is being
implemented, performed, and managed satisfactorily and that time schedules are
beingmet. Monitoring procedures will. include review of progress reports, and
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telephone contact with Subcontractor staff and/or consultants, if necessary. _-
Midterm reports and subsequent final reports will form the basis of a summary
accomplishments report of lishm.ents CRP will prepare and submit to SAMHSA/
p p
CSAP/CAPT.
b. Process the award of ($29,777), a fixed-price subcontract to the Subcontractor, in
consultation with appropriate ro riate SAMHSA,/CSAP/CA PT contracting staff. CRP Will
issue the initial 90% of the award payment ($26,799.30) within 30 days following
.
receipt of his signed Agreement from our organization. While this fee has been
designated b SA.MHSA/CSA.P/C,A.PT to be paid in advance, Subcontractor shall
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be liable for this fee until such time that CRP has determined that the scope of
work specified hereunder had been completed. In the event that Subcontractor
fails to complete the work as specified in the aforementioned "scope," CRP in
consultation Frith SAMHSA//CSAP/CAPT contract . personnel shall thea
determine the extent to which the "scope" has been fulfilled and adjust the liability
accordingly. . The 10% balance of the award will be paid within 14 days of receipts
of your final report.
C* Coordinate an initial, telephone consultation with the Subcontractor and the
CAPT. .
2
d. Assist the Subcontractor in resolving any problems during the project period.
6. SubcontractorResponsibilities. Subcontractor agrees to perform, or be responsible for
the following:
a. Prepare a mi.d-term progress report and a final report as outlined in Section Seven
p p
(7) of this Agreement.
b. Participate in an initial telephone consultation with the CAPT.
c. Participate, if necessary, in ad hoc telephone conference calls with the appropriate
CAPT and CRP staff and respond to periodic inquiries as needed.
d. Devote the best efforts, attention, knowledge, and skills of its assigned staff and
consultants to the performance of this Agreement.
e. Perform all Work and obligations under the total costs applicable to this
Subcontract according to the final budget. Subcontractor's budget component of
the funded proposal is provided as. Exhibit C to this Agreement.
7. p
Mid. -term Report and Final Report. The following instructions are for developing and
submitting � P required reports. The reports should tell an ongoing story of progress made in
movie program in the direction of being more evidence -based, and not a duplication
moving p �
of previous reports.
The Subcontractor will provide CRS' with a mid-term and final report by the due dates
indicated below. These reports will be reviewed and approved by CRP, Inc. and the
CAPT. Each report shall be typewritten in Microsoft lord, single-spaced, and. shah. not
p
exceed fifteen(15) single-space pages in length. The following table shows the performance
period and the corresponding due dates for the raid -term (1) progress and final reports to
be submitted in 2011/2012.
Progress Rod loci Reoart�ue Date
. ,_....
(2011-2012)
Mid-term February - June 2011 July 15, 2011
Final February - February 2012 March 3 0, 2012
The Subcontractor shall. organize and prepare the mid-term and final report using the
format sent electronically by CRI' and included in the mini -subcontract package.
The Subcontractor shall submit a midterm, report and the finial report electronically to
Carmelita Grady �c ady r cvxx�comn), CAPT Service to Science Mini�-subcontract
Administrator with a copy to Kim Dash (kdash@edc-org), CAPT Service . to Science
Chief� and to Brown at (sbrown@cmcom-coin�. Submission should be in
Stace 'Y
Microsoft Office format (2000 or higher). The Subcontractor shall submit hard copies only
in those instances when electronic transmission of attachments is not possible. If
3
necessary, the Subcontractor shall mail two (2) copies of the midterm report and final .
report to:
Carmelita Grady, Ph.D.
CAPT Service to Science Mini -subcontract Administrator
CRP, Incorporated
1110 Bonifant Street, Suite 400
Silver Spring, MD 20910
Telephone: (240) 247-.2142
Facsimile: (240) 247-2143
9. Confidentiality. In the performance of this Subcontract, Subcontractor shall not release
to parties other than the Contractor any information collected, reports prepared, or
products and' tools developed as part of the performance of this Subcontract without the
prior written consent of CRP.
10. Relationship. It is understood that Work is undertaken hereunder by Subcontractor as an
independent contractor and not as an employee, agent, consultant, or representative of
CRP.
�.. Professional Recognition. For publishing data/information, delivering presentations,
issuing reports, or other such activities, the Subcontractor agrees to give appropriate-
recognition
ppropriaterecognition of the Work for CRP, Inc. for the SAMHSA/CS,,A P/CAI'T and any technical
assistance facilitated.
12. Etitire .Agreement. This instrument and attachments contain the entire Agreement and
understanding of the parties hereto. It may not be changed orally, but only by agreement
in writing signed by the party against whom enforcement or any waiver, change,
modification, extension, or discharge is sought. There is no other contemporaneous _
understanding or Agreement, oral or written, between the parties on said subject matter.
IN WITNESS WHEREOF, the parties through duly authorized officials do execute this
Subcontract effective as of the day and year indicated on the first page.
CR', Incorporated City of Meridian, Meridian Police
Department
N7 4
BY: BY: �/
SigJae''*V
B(/ Y:
Carolyn B. Rudd, Ed.D.. Pres. CECT
Name and Title
i1/31/2011
ii iiIWY .i.Yl. . ■ VY.• 1 I Y I YIYY YY li 1 .IM.��
Date
•-. tiio�y k,i�,�.�a��
co
John Overton/Community Services Liaison
Name and Title
1/31/2011
Date
EIN# _
4
Form W09 Request for Taxpayer Give form to the
(Rev. November zoos Identification Number and Certification requester. Do not
Departmertt of the Treasury send to the IRS.
IntmW Revenue Service
cq Name (as shown on your income tax return)
COO
of Meridian
M Business name, if different from above
Q
� C
Individual/ corporation Exempt from backup
Le
Check appropriate box: Sole proprietor ❑Corporation ❑Partnership other p.. ... . .. . ....... . . withholding
G Address (number, street, and apt. or suite no.) Requester's name and address (optional)
33 E Broadway Avenue
City, state, and ZIP code
CLMeridian, Idaho 83942
List account number(s) here (optional)
co
Tax a er Identification Number #N
Enter your 11N in the appropriate box. The TIN provided trust match the name given on Une 1 to avoid Social sscurity number
backup withholding. For individuals, this Is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see blow to get a TIN on page 3. or
Note. If the account Is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number
number to enter. 8_1__2+6 0 10 12 12 15
[MMI Certification
Under penalties of penury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or l am waiting for a number to be Issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) l have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. I am a U.S. person (Including a V.S. resident alien).
Certification Instructions. You must cross out item 2 above If you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. (See the instructions on page 4.)
Sign Signature of ��
Here U.& person 10- 2z t � � h21001 Date 100 -
Purpose
Purpose of Form
A person who Is required to file an information return with the
IRS, must obtain your correct taxpayer identification number
(TIN) to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
(including a resident alien), to provide your correct TIN to the
person requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a
U.S. exempt payee.
In 3 above, if applicable, you are also certifying that as a
U.S. person, your allocable share of anypartnership income
from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively
connected Income.
Note. If a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
For federal tax purposes, you- are considered a person if you
• An individual who is a citizen or resident of the United
States,
e A partnership, corporation, company, or association
created or organized In the United States or under the laws
of the United States, or
• Any estate (other than a foreign estate) or trust. See
Regulations sections 301.7701-6(a) and 7(a) for additional
information.
Special rules for partnerships. Partnerships that conduct a
trade or business In the United States are generally required
to pay a withholding tax on any foreign partners' share of
income from such business. Further, in certain cases where a
Form W-9 has not been received, a partnership Is required to
presume that a partner is a foreign person, and pay the
withholding tax. Therefore, if you are a U.S. person that Is a
partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to
establish your U.S. status and avoid withholding on your
share of partnership income,
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and i4volding
withholding on its allocable share of net income from the
partnership conducting a trade or business in the United
States Is In the following cases:
• The U.S. owner of a disregarded entity and not the entity,
are.
Cat. No. 10231X Form W-9 (Rev. 11-2005)
1po�
Form W-9 (Rev. 11-2005)
• The U.S. grantor or other owner of a grantor trust and not
the trust, and
e The U.S. trust (other than a grantor trust) and not the
beneficiaries of the trust.
Foreign person. If you are a foreign person, do not use
Form W-9. Instead, use the appropriate Form W-8 (see
Publication 515, Withholding of Tax on Nonresident Aliens
and Foreign Entitles).
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the
terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of Income. However, most tax treaties contain a
provision known as a "saving clause." Exceptions specified
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipient
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who Is relying on an
exception contained in the saving clause of a tax treaty to
claim an exemption from U.S. tax on certain types of income,
you must attach a statement to Form W-9 that specifies the
following five items:
1. The treaty country. Generally, this must be the same
treaty under which you claimed exemption from tax as a
nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) In the tax treaty that
contains the saving clause and its exceptions.
4. The type and amount of Income that qualifies for the
exemption from tax.
5. Sufficient facts to justify the exemption from tax under
the terms of the treaty article.
Example. Article 20 of the U.S.-China Income tax treaty
allows an exemption from tax for scholarship Income
received by a Chinese student temporarily present in the
United States. Under U.S. law, this student will become a
resident alien for tax purposes if his or her stay in the United
States exceeds 5 calendar years. However, paragraph 2 of
the first Protocol to the U.S.-China treaty (dated April 30,
1984) allows the provisions of Article 20 to continue to apply
even after the Chinese student becomes a resident alien of
the United States. A Chinese student who qualifies for this
exception (under paragraph 2 of the first protocol) and is
relying on this exception to claim an exemption from tax on
his or her scholarship or fellowship income would attach to
Form W-9 a statement that includes the information
described above to support that exemption.
If you are a nonresident alien or a foreign entity not subject
to backup withholding, give the requester the appropriate
completed Form W-8.
What is backup withholding? Persons making certain
payments to you must under certain conditions withhold and
pay to the IRS 28% of such payments (after December 31,
2002). This is called "backup withholding." Payments that
may be subject to backup withholding include Interest,
dividends, broker and barter exchange transactions, rents,
royalties, nonemployee pay, and certain payments from
fishing boat operators. Real estate transactions are not
subject to backup withholding.
You will not be subject to backup withholding on payments
you receive if you give the requester your correct TIN, make
the proper certifications, and report all your taxable Interest
and dividends on your tax return.
Payments you receive will be subject to backup
withholding if:
1. You do not furnish your TIN .to the requester,
2. You do not certify your TIN when required (see the Part
If Instructions on page 4 for details),
Page 2
3. The IRS tells the requester that you furnished an
Incorrect TIN,
4. The IRS tells you that you are subject to backup
withholding because you did not report all your interest and
dividends on your tax return (for reportable interest and
dividends only), or
5. You do not certify to the requester that you are not
subject to backup withholding under 4 above (for reportable
interest and dividend accounts opened after 1983 only).
Certain payees and payments are exempt from backup
withholding. See the Instructions below and the separate
Instructions for the Requester of Form W-9.
Also see Specht rules regarding partnerships on page 1.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN
to a requester, you are subject to a penalty of $50 for each
such failure unless your failure is due to reasonable cause
and not to willful neglect.
Civil penalty for false information with respect to
withholding. If you make a false statement with no
reasonable basis that results in no backup withholding, you
are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully
falsifying certifications or affirmations may subject you to
criminal penalties including fines and/or Imprisonment.
Misuse of TiNs. If the requester discloses or uses TINs in
violation of federal law, the requester may be subject to civil
and criminal penalties.
Specific Instructions
Name
If you are an individual, you must generally enter the name
shown on your Income tax return. However, if you have
changed your last name, for instance, due to marriage
without informing the Social Security Administration of the
name change, enter your first name, the last name shown on
your social security card, and your new last name.
If the account is In joint names, list first, and then circle,
the name of the person or entity whose number you entered
in Part i of the form.
Sole proprietor. Enter your individual name as shown on
your income tax return on the "Name" line. You may enter
your business, trade, or "doing business as (DBA)" name on
the "Business name" line.
Limited liability company (LLC). If you are a single -member
LLC (including a foreign LLC with a domestic owner) that is
disregarded as an entity separate from Its owner under
Treasury regulations section 301.7701-3, enter the owner's
name on the "Name" line. Enter the LLC's name on the
'sBusiness nacre" line. Check the appropriate box for your
filing status (sale proprietor, corporation, etc.), then check
the box for "Other" and enter "LLC" in the space provided.
Other entities. Enter your business name as shown on
required federal tax documents on the `Name" line. This
name should match the name shown on the charter or other
legal document creating the entity. You may enter any
business, trade, or DBA name on the "Business name" line.
Note. You are requested to check the appropriate box for
your status (individual/sole proprietor, corporation, etc.).
Exempt From Backup Withholding
If you are exempt, enter your name as described above and
check the appropriate box for your status, then check the
"Exempt from backup withholding" box In the line following
the business name, sign and date the form.
Form W-9 (Rev. 11-2005) Page 3
Generally, individuals (including sole proprietors) are not
exempt from backup withholding. Corporations are exempt
from backup withholding for certain payments, such as
interest and dividends.
Note. If you are exempt from backup withholding, you
should still complete this form to avoid possible erroneous
backup withholding.
Exempt payees. Backup withholding Is not required on any
payments made to the following payees:
1. An organization exempt from tax under section 501(a),
any IRA, or a custodial account under section 403(b)(7) If the
account satisfies the requirements of section 401 (f)(2),
2. The united States or any of its agencies or
instrumentalities,
3. A state, the District of Columbia, a possession of the
United States, or any of their political subdivisions or
instrumentalities,
4. A foreign government or any of its political subdivisions,
agencies, or instrumentalities, or
5. An international organization or any of its agencies or
instrumentalities.
Other payees that may be exempt from backup
withholding include:
6. A corporation,
7. A foreign central bank of issue,
8. A dealer in securities or commodities required to register
in the United States, the District of Columbia, or a
possession of the United States,
9. A futures commission merchant registered with the
Commodity Futures Trading Commission,
10. A real estate investment trust,
11. An entity registered at all times during the tax year
under the Investment Company Act of 19401
12. A common trust fund operated by a bank under
section 584(a),
13. A financial institution,
14. A middleman known in the investment community as a
nominee or custodian, or
15. A trust exempt from tax under section 664 or
described in section 4947.
The chart below shows types of payments that may be
exempt from backup withholding. The chart applies to the
exempt recipients listed above, 1 through 15.
IF the payment Is for ...
THEN the payment is exempt
for.. .
Interest and dividend payments
All exempt recipients except
for 9
Broker transactions
Exempt recipients 1 through 13.
Also, a porson registered under
the Investment Advisers Act of
1940 who regularly acts as a
broker
Barter exchange transactions
Exempt recipients 1 through 5
and patronage dividends
Payments over $600 required
Generally, exempt recipients
to be reported and direct
'I through 7
sales over $5,000 t
iSee Form 1099-MISC, Miscellaneous Income, and Its instructions.
However, the following payments made to a corporation {including gross
proceeds paid to an attorney under section 6045(f), even If the attorney is a
corporation) and reportable on Form 1099-MISC are not exempt from
backup withholding: medical and health care payments, attorneys' fees; and
payments for services paid by a federal executive agency.
Part 1. Taxpayer Identification
Number (TIN)
Enter your TIN in the appropriate box. If you are a resident
alien and you do not have and are not eNentification
lble to et an SSN,
our TIN Iour IRS individual taxpayer number
ITIN . Enter It In the social security mber box. If you do
t have an ITIN see Now toget TIN below.
no
If you are a sole proprietor and you have an EIN, you may
enter either your SSN or EIN. However, the IRS prefers that
you use your SSN.
If you are a single -owner LLC that Is disregarded as an
entity separate from its owner (see Limited liabliq company
(LLC) on page 2), enter your SSN (or EIN, if you have one). If
the LLC Is a corporation, partnership, etc., enter the entity's
EIN.
Note. See the chart on page 4 for further clarification of
name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one
Immediately. To apply for an SSN, get Form SS -5,
Application for a Social Security Card, from your local Social
Security Administration office or get this form online at
www.socialsecuritygov. You may also get this form by
calling 1-800-772-1213. Use Form W-7, Application for IRS
Individual Taxpayer Identification Number, to apply for an
ITIN, or Form SS -4, Application for Employer Identification
Number, to apply for an EIN. You can apply for an EIN online
by accessing the IRS website at www.rrs.gov/businesses and
clicking on Employer ID Numbers under Related Topics. You
can get Forms W-7 and SS -4 from the IRS by visiting
www.irs.gov or by calling 1 -800 -TAX -FORM
(1-800-829-3676).
If you are asked to complete Form W-9 but do not have a
TIN, write "Applied For" In the space for the TIN, sign and
date the form, and give it to the requester. For interest and
dividend payments, and certain payments made with respect
to readily tradable instruments, generally you will have 60
days to get a TIN and give It to the requester before you are
subject to backup withholding on payments. The 60 -day rule
does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you
provide your TIN to the requester.
Note. Writing "Applied For" means that you have already
applied for a TIN or that you intend to apply for one soon.
Caution: A disregarded domestic entity that has a foreign
owner must use the appropriate Form W-8.
Form W-9 (Rev. 11.2005)
Part 11, Certification
To establish to the withholding agent that you are a U.S.
person, or resident alien, sign Form W-9. You may be
requested to sign by the withholding agent even If items 1, 4,
and 5 below indicate otherwise.
For a joint account, only the person whose TIN is shown in
Part I should sign (when required). Exempt recipients, see
Exempt From Backup Withholding on page 2.
Signature requirements. Complete the certification as
Indicated in 1 through 5 below.
1. Interest dividend, and barter exchange. accounts
opened before 1984 and broker accounts considered
active during 1983. You must give your correct TIN, but you
do not have to sign the certification.
2. Interest, dividend, broker, and barter exchange
accounts opened after 1983 and broker accounts
considered inactive during 1983. You must sign the
certification or backup withholding will apply. If you are
subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2
in the certification before signing the form.
3. Real estate transactions, You must sign the
certification. You may cross out item 2 of the certification.
4. Other payments. You must give your correct TIN, but
you do not have to sign the certification unless you have
been notified that you have previously given an Incorrect TIN.
"Other payments" Include payments made in the course of
the requester's trade or business for rents, royalties, goods
(other than bills for merchandise), medical and health care
,,. services (including payments to corporations), payments to a
nonemployee for services, payments to certain fishing boat
crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or
abandonment of secured property, cancellation of debt,
qualified tuition program payments (under section 529),
IRA, Coverdell ESA, Archer IVISA or HSA contributions or
distributions, and pension distributions. You must give
your correct TIN, but you do not have to sign the
certification.
Privacy Act Nonce
Paye 4
What Nerve and Number To Give the
Requester
For this ty a of account Give nente and SSN oh
1. Individual The individual
2. Two or more Individuals (joint The actual owner of the account
account) or, If combined funds, the first
Individual on the account '
3. Custodian account of a minor The minor Z
(Uniform Gift to Minors Act)
4. a. The usual revocable The grantor -trustee '
savings trust (grantor is
also trustee)
b. So-called trust account The actual owner '
that is not a legal or valid
trust under state law
5. Sole proprietorship or The owner 3
single -owner LLC
For this type of account: Give nerve and EiN of:
6. Sole proprietorship or The owner 3
single -owner LLC
7. A valid trust, estate, or Legal entity d
pension trust
8. Corporate or LLC electing The corporation
corporate status on Form
8832
9. Association, club, religious, The organization
charitable, educational, or
other tax-exempt organization
10. Partnership or multi -member The partnership
LLC
11. A broker or registered The broker or nominee
nominee
12. Account with the Department The public entity
of Agriculture In the name of
a public entity (such as a
state or local government,
school district, or prison) that
receives agricultural program
payments
'List first and circle the name of the person whose number you furnish. If
only one person on a joint account has an SSN, that person's number must
be furnished.
2circie the minor's name and furnish the minor's SSN.
3
You must show your Individual name and you may also enter your business
or "OSA" name on the second name line. You may use either your SSN or
EIN Of you have one). If you are a sole proprietor, IRS encourages you to
use your SSN.
' List first and circle the name of the legal trust, estate, or pension trust. (Do
not furnish the TIN of the personal representative or trustee unless the legal
entity itself Is not designated In the account title.) Also see Special tides
regarding partnerships on page 1.
Note, If no name Is circled when more than one name is
listed, the number will be considered to be that of the first
name listed.
Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file Information returns
with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or
abandonment of secured property, cancellation of debt, or contributions you made to an IRA, or Archer AIISA or HSA. The IRS
uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this
Information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S.
possessions to carry out their tax laws. We may also disclose this Information to other countries under a tax treaty, to federal
and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat
terrorism.
You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable
Interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply.
City of Meridian, Meridian Police Department
ATTACHMENTS
Exhibit A - Proposed Evaluation Capacity -Building
Enhancements)
Exhibit B - Key Personnel
Exhibit Coo Budget
s
City of Meridian, Meridian Police Department
� � nt
Exhibit A
Proposed Evaluation Capacity-Building
Enhancement(s)
Statement of Work
L Describe the program's prelim* evaluation plan
. ry n
The..
pro
,ect evaluation plans for Recognize is verys` .
many Prevention F� ams nod nnphstxc and ane that is used by
c nationally. Pre and post tests are given, via survey monkey, to ba
children/adolescents who have completed the web base � �' �
then analysed b the coalitionslag anti to the teaches. This data is
y , contracted evaluator and results are distribute
��IADC. In additions anecdotal and qualitative d to members of
� ve data us gathered though structured interviews
with school personnel and con3munity leaders. All of .
aro combined and become the quanttxt4five data and qualitative data
.. part of year end evaluation s ..As MARC is a
Communities grantee, data is also given to S�dSA an g Free
COT. and via their reporting system --
2. Identify and describe gaps in the prei ary* evaluation pian.There are tremendous gaps in the c=ent evaluation
plan that include the foilov�ln
* At present, there is no �va�r to d�:ter�ne if��co Recognize, . g
positive outcomes we are se , as a program, is driving the
Specific to this program
g m. Meridian as we have not isolated the outcomes data.
• No followh-up data is gathered to deternidne lou term e
participants and stakeho3 densg effects of the program on
.
.� No randomized or quasi-experi�.�c:m evaluattian has be
A data collection system
� conducted an tixc proms
Whas not been developed to anal all data a
program tv include �e c+vnxb�n o f g scrod for his-
� �. l , g qualitative and quantitative data,
plan for Journal article reporting bras not been develo ed
• Systematic empirical research has not been conducted. p
on the program that wouldrovide
evidence of stat isd.ca Uy significant effectiveness p
No plan for developing a manual for thisry am has b .
way to define "fidefi '� p been developed thus there is no
ty
3. Identify the evaluation s exxhancement (
wig address � ) to be implemented and explain howthxslthese
gaps and imitations of the preliminary evaluation plan.
The .Recognize evaluation project includes two key ca
ca acx ofecogne will be sur �' mpanents. First the external evaluation
strengthened � the areas of fortnat6ng data. for xc�fessional.
analysis, wxitiug a eles for peer reviewed `owls anapplicationp
recd J d developing an for NREPP
recognition. Second, a. contract �r�d�i�:nt with the coalitions- •
additional extern ro axxx evai outside evaluator w�1.1 provide for ,�,,,. cation a ertisc
Tile internal ca
�.Xggfty development component �� commit --"6-
rp
ffie
coalitiaxx Project Director exclusivelyp t � hours per weed of the tinge of
to .�ccog�ize Program
evaluation capacity will be conxu p gram evaluation activities. This focused
tted to collecting any missing data, formatting this data '
Excel spreadsheets for statistical analysis, obtainingsec' g into
with the external evaluator, spec evaluation t�raiWng, ccs. -authoring,
P�gr�n evaluation articles to be submitted for publ,icatic� and co -
The
with. the external evaluator, a proposal for NREp - • �
P l' recognition.
'fixe exle-mal Drogram one
evalua#;io coin xxt incl • • •
coalition eialuator to w include purchase of additional time from the
City of Meridian,, Meridian Police Department
,,.-.�
�► Design a quwiMexpexental Ovalua#Yom,
th the variable being the web used curicui
and coaches messaging, 'mss is feasible asPecogn'urn
the zeprogram be an without the
web based Gur,�.cul�,n and coaches tr ..g
training. within this evaluation the le ac .Reco Sze
Program Will be offered to a comparable g
� p � group.
Develop andimplement data collection
systems and ulsxnxeuts
AjWyze the data
+� Preli i=7 preparation of a journal a dole re
pop program dings
Provide technical assistance for developing � $ all NREpp application
4. Explain the purpose of thero osed
P � enhancement(s)
The purpose of the proposed enhancement -s to deteraarne the folio
Recognize proms; wuzg in regards to the
• Do the outcomes we see last ager the corn 1 •
P mon o� the curriGulx based components?
i
* Is t that onents
the combination of the corn '
p gives us the outcomes?
0 Is this program replicable other sett s .
such as midd 1 a schools?
in the Past fiwo Ycars the MADC as a coalition has seen the foliowiu results.
Outcome
Increase age of first use by 1%
2006 data
2008 Data
Change
'
7°lo before0
25 /� before
12 percentage points
Decrease f uenc of use b 1% in $� graders
ae13
o
�� Io no use
age 13
�fot collected
,�ecreas �
e fie uen of ase b 1 to in 10� raders
Decrease fre uen of use o
1 /o in 12 raders
55% no use
�.
7f to no use
1percent-a-ge points-'
Increase dlsa roval of usingsubstances b 1 a
�g°�� no use
63°l0 no use
ercenta a Dints
Increase the belief that substance use carnes�2ercep§ga
51l�
ruts
unacceptable s
n ks or is harmful b1°fo
5 /�
13 percentage points
� 9 �
Decrease reported use by friends b 'lo
50
Increaseo°I°
the belief that parents disapprove of
40%151%
7 Percentage in
substance useby 2°I4
.ts
11 percentage points
We theories we have achieved these result
m i s,
i -M p� through the development and
implementation einentat��n o�the Recognize program, The Purpose •
scientific p� of the proposed enhancement �s to
ally prove or disprove thus belief, If we c .
� a Iic � prove this theox�, we w�li move �vr�rard
pP ataon to NREPP,
S. Explain haw the techRical asstance'
prov�ded though the Service to Scienee initiative
helped inform your decisions about the s ative
proposed evaluation eu�aneement
(}
Key MADC sato include,
* Elisha Figueroa, Coalition. Project Director
r
Brenda Murdoch, Coalition Coordinator
cnator
• Lt. John Overton, Community services Division, Meridian Police Department
! Bete Gadzinski, Coaiftton External Evaluator
.00�,
orked %ith Eric Ohison, MSW, Service to '
. �cienae Coorcbaacator, Center dor e Application
Substance Abuse Technologies, University of
of m an. onsite da '
� long g tec hiucal
N
City of Meridiatip Meridian Police Department
p ment
assistance session to determine needed'
valuation enhancements. Extensive discussion.
workshop and follow-up em�s were card at �s
conducted to determine ' e the caaiit�on's readiness to
undertake the rigorous evaluation and s ec'
. P �e steps necessary for an NREpp submission
Recognize pro�ranx. �'hrou this technical� .#
n afthe
assistance, t�,e d�G3s10 coalition
and the mayor of IVler�chan t was made by coa ition std'
a pursue an application far funding through the Service to '
Initiative Building Evaluation C act Science
. . , q ty for FViden -Based Intervontlons Request
'fh�s decision was not made lightly � for Proposals.
g tly but was made due to the information
received Ervin a technical an and encourage we
assistance provided through the �ervlce to �cieuc • � .
iniffative.
Aft. t�hlson was inst�,rneutal � re � .
• p pig us, by sending P examples and through continual
dialogue via email, for completingthis a ng ntinual
application,
6. Identify potential barriers to thero
p paced enhaxcement�s� and describe ho t, '
addressed♦
i be
enever an entity undertakes a compreheasive and in- .
the an depth evaluation of a program, such as
e is proposing. that includes multi
pie COnZponents grid a quasi"ex eflmeaW
evaluation, there can be barriers. `hese b 'e p
arri rs include;
* Failure of one or more of �e cciataa onents
s p to fly engage ui the evaluation process
Conflicting results that create tensions
between the program cans onents
• As this is a one year project _ P
p 1 g out of tme to complete �
the p j'ect
Each of the components of this rQ arra •
40 • p � have committed either verbal or in • .
the evaluation project which .leads us �a Y writing to support
believe that we can address the firstbut
constant can�munica#lon and feedba let point with
ck to each of components. All co
that the evaluation may or may not show n�xponents understand
�' that this proms is key to the outcarn
as a coalition. If the results are not Positive., es we have seen
p five, each canxponent is willin to work o '
increase the viability of the program. � g u their piece to
p gr As far � barrier three, we behave that
updates on the evaluation, at through monthly
� �C meetings, we wd1 keep on frac
Finah , we believe p k to xsh m one year.
y' based on past perforinance we can overcome any potential barriers.
City of Meridian, Meridian Police Department
' p ent
Exhibit B
Key Personnel
The following persons are named as Key Personnel:
P •
NAME
Elisha Figueroa
Bethany Gadzins,
Lt* John Overton
TITLIE
Coalition Project Director
Coalition Evaluator
Liaison
E
/00"�.
10
City of Meridian, Meridian Police Department
Exhibit C
Budget
"City's proposal is conditioned on the agreement of the parties on mutuaR � acceptable t�31'n5,
Cfl1�.C�,tioi2S, idel1(A
ne5 anC�reements� ss
.
EXPENSES
Mini subcontract - Eviduation Enhancement
Totals
January 1 = 2011 • December 31, 2D1 1
Name
FTE
Annual
Sala
Total
Pry tarn Administrator
5°1ap00.00
$ 2 200
Total Salaries,
Fringe
Percentage
Total $ala
$ 21200.00
I s% of Position
Total
'15°la
2120D.OU
330.00
Fringe
Total staff costs
$ 330.00 .
Evaluation Consultants
� 2 53Q.00
Bethany oadzinski, Coalition
Evaluator
Rafe
Unit
Development of suye tools
$ 51006
�
$ 5 �0D
Implement evaluation $ 51000
Analysis, key findin s, final document
t
�
$ 5 00Q
re aration
$ 51000
�
$ 5,000
Total Consultants
...... Evaluation Partici ants
5 000
1. Item
Incentive for evaluation
#
Cyst Partici ants
# groups
participants
$ 200
2
x,000
Total ParUalpant Costs
o aratin
$ 5,Q00
Item
WPM
Cost Months
Amt
Phone (local, long distance,
jnteemet)
$ 150 12
$ 11800
c9pies
$ 30 12
$ 880
Software license SPSS
$ 300
$ 300
Supplies
$ 50 12
$ 600
PostaRe
$ 40 'i 2
$ 430
Total operating
Total Direct Costs
$ 3t640
� 2�,OT4
Indirect Cost - 10%
Total Expense.
$ .2L707
7
$ 29}777
/00"�.
10
ra
City of Meridian, Meridian Police Department
Budget Nartive:
ra
Coalition Project Director � 5% of her time
Fringe
5 hours per weep .. � �`��
p of the time of the Coalition Prosect Director exclusively
to Reco W.
iz ro am evaluation p gr activities. This focused evaluation
capacity wdl be co tied to collecting an missing data formatting .
�' g r�a�attuzg this
data into Excel spreadsheets for statistical analysis, obtai ' .
.. � � � spec��c
evaluation training, co-authoring, with the external evaluator,
program
Evaluation Consultant
The coalition floes not have the expertise to conduct a rigorous `
g us evalua�on
of the Recognize prOgram so we will add to the current ear u `
.s al atIon contract
of the coahtions external evaluator who dQes have the expertise to conduct
this program evaluation,
xp
• Design a quasi -experimental evaluation with the variable being the
web based curriculum and coaches messy ' `this is feasible asible as � 57000
61
the Recognize program began without the web based c .c
. urr! ulu�n
and coaches training. Within this evaluation the le ac
g y Recognize
program wdl be offered to a comparable gmu .
p
+ Develop and *IMP lement data collection systems and instruments
+ Analyze the data
• Preliminary preparation of a #oumal article re ort- o a QQo
&dk p m9program gram f
gs
+ Provide technical assistance for developing N l'P application S 000
p g an
Evaluation Participant incentives
Each participant who participates in the six and twelve month post
program evaluation, from both the pro,*ect and control ou r c ' $ 6,000
$15 "� certificate � p e eve a
gi a incentive. 'ire believe, based on research that this
incentive wall help to increase pardeipation in the evaluation.
Operating
In order to successMy complete this project there are '
. p J � standard operating
costs to include
Phone $ 3t240
Copies
Supplies
Postage
In addition, the coalition clues not have the needed software'
for this
prosect. The evaluator does have the software so coordination of $ 300
information collection will be enhanced b the coalition
software
y also have �P��
Indirect -- Standard City indirect of 10% 2 707
TOTAL $29J77
11
Center for the Application
of Prevention Technologies
captus-samhsa.gov
January 20, 2011
Bethany Gadzinski
City of. Meridan, Meridian Police Department
MADC
1401 E. Watertower Avenue
Meridian, ID 83642
RE: Proposal No. 0171 MADC
Dear Ms. Gadzinski:
CONGRATULATIONS1 The Proposal you submitted in response to the Substance Abuse and
Mental Health Services Administration (SAMHSA Center for Substance Abuse Prevention
(CSAP), Service to Science InNative"s 2010-11 Request for Proposals on BuildinEvaluation
g
Capacity for Evidence -based Interventions has been selected to receive a mini -subcontract.
On behalf of SAMHSA/CSAP, the Center for the Application of Prevention Technologies (CAPT)
oversees and manages the competitive selection and award of mini -subcontracts, as well as
provides technical assistance, on building evaluation capacity •to Service to Science participants.
The CAPT selected your proposal for award under the aforementioned request for proposals
released to State -nominated programs participating in a Regional Service to Science Academy
between January and May 2010. The CAPT used a very rigorous review process to make this
selection.
Your organization will receive a subcontract award in the amount of $29,777 to sup po
-building efforts. The per od of pe o ance of this
implementation of your evaluation capacity i performance rm rt the
one-year subcontract award is approximately January, 2011 •to January, 2012. Prior to award,
mini -subcontract recipients are required to attend a phone meeting with the •CAPT to review
requirements of the award. The CAPT Service to Science Mini-subcontractAdministrator,
Carmelita Grady, will contact you shortly with information about that meeting.
An exciting and valuable component of the award is that you will •receive additional customized
technical assistance (TA) from the CAPT West Regional Team to support the accomplishment
of your goals, address any concerns reviewers identified inyour proposal (see the synthesis of
reviewer comments attached), and meet the requiremen
will bis of the award. A copy of your proposal
e shared with the CAPT West Regional Team; and the Service to Science Lead on that
Team will contact you within the next several weeks to discuss TA next steps.
CAPT National Office
Education Development Center, Inc.
55 Chapel Street
Newton, MA 02458-1060
Phone: 888-EDC-CAPT, ext. 3383
Fax: 617-244-3436
A Life In the Community for Everyone
Subatanco Abuto onct Mcnijil ma;gth Scrv;ces AdmjnjSjrAtj0.,j
VA 00POdOtat Of Health and Hwun SmIfts
Again, congratulations and we look forward to working k g With you this year.
Sincerely,
Carmellta Grady, PhD
Service to Science Mlnl-subcontract
Administrator
Center forthe Application of Prevention
Technologies
co ra dv pmeorp.cor n
Klm Dash, MPH, MA
Chief, Service to Science Initiative
Center for the Application of Prevention
Technologies
Wash edc. g
Enclosure: Synthesis of Reviewers' Comments
co: Bethany D. Cadzinski, Substance Use DIsarder Bureau Chief
Divigton of Behavioral Health, Idaho Dep$rtment of Health and Welfare
Terry Pappin, program Specialist
ldeha Department of Health and Welfare
Carol McHale, SAMHSA/CSAP CAPT Service to Science
Project Officer
Alyssa O'Hair, CAPT Western Regional Team DoordInator
Eric Qhlson, CAPT W stern Regional Team Service to Sciences
Lead
Service to science
Building Evaluation Capacity for Evidence-Based v n ions
REVIEWER SUMMARIES
2010-2011
MADC
MADC's Recognize is a comprehensiveprogram that reaches youth from many angles to
improve risk and protective factors and eventually lower substance use rates. The program has
been part of a Drug Free Communitiesgrantee for several years, and, as such, has been
conducting evaluation with Positive outcomes. The strength of this proposal is in its readiness
to move to the next level of evaluation and its strong community •backing. They do a very good
job detailing the gaps in the current evaluationplan. Unfortunately, they don't do as good a job
of detailing how they will overcome those gaps. The major concern is whether the applicant
will be able to implement the enhancement given that the. evaluation consultant doesn't have
experience as an evaluation researcher but seems more comfortable in the role of program
manager. Moreover, the applicant did not provide a really strong enhancement design or a
really good description of how the program would use available technical assistance to fill this
gap in expertise.
EXHIBIT B
GRANT PROPOSAL
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
Abstract
The cornerstone of MADC's prevention programming, and the program to be evaluated. through
the Service to Science initiative, is Recognize. The MADC's Recognize program has earned
praise and honors from the Association of Idaho Cities, the Northwest Alcohol Conference, as
well as substance abuse professionals throughout the country. The coalition has been advised by
those professionals, as well as the CAPT, that to achieve long-term sustainability of the coalition,
we should apply for this Service to Science contract. This award would fund a scientifically
rigorous evaluation of the Recognize program. If this longitudinal study shows a correlation
between recognize and the reduction of substance abuse, we woWd seer to publish our findings
and request the program be listed as an evidence -based program on the National Registry of
Effective Programs and Policies. This listing would allow the MA DC to sell Recognize to other
communities, thereby ensuring the long-term sustainability of the coalition and substance abuse
prevention in the City of Meridian.
Page 2
Meridian Anti -Drug Coalition
Bethany Gadzinski – Principle Evaluator
Table of Contents
Cover . er Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /.
Abstract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 2
Section 1 — Program Description . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . 4
Section 2 — Description & Justification of Evaluation Capacity -Building Enhancement .. 8
Section 3 -- Organizations Readiness to Implement. 6 6 0 6 . . . . . . . . . . . . . . . . . . . . . . . . . 11
Section 4 — Staff Capabilities and Project Management ...... 14
Section 5— Budget.........................................................
16
Appendices:
AppendixA — Logic Model ........................................... IS
Appendix B — List and summary of evaluation report ....................... I �
Appendix C — Resumes and letters of Commitment ............... 9 . 4 0 8 . . , , 22
Page 3
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
Proposal Narrative and Budget Outline
Section 1. Program description
The Meridian Mayor's Anti -Drug Coalition (MARC) was created in 2004, bringing
together key community stakeholders to define and deliver solutions to address grooving
concerns of substance abuse as well as its negative effects on area businesses, schools, places of
worship, neighborhoods, and the community as a whole. MADC utilizes a holistic approach that
sustains and. enhances the quality of life by providing an environment where area families and
children will thrive. MADC, through the strength and passion of its members, has made positive
strides, bringing effective programs to the community through our members and volunteers.
The cornerstone of MADC's prevention programming, and the program to be evaluated
through the Service to Science initiative, is Recognize. The MA.DC's Recognize prograrn has
earned praise and honors from the Association of Idaho Cities, the Northwest Alcohol
Conference, as well as substance abuse professionals throughout the country. The coalition has
been advised by those professionals, as well as the CAPT, that to achieve long -terra
sustainability of the coalition, we should apply for this Service to Science contract. This award
would fund a scientifically rigorous evaluation of the Recognize program. If this longitudinal
study shoves a correlation between Recognize and the reduction of substance abuse, we would
seek to publish our findings and request the program be listed as an evidence -based program on
the National Registry of Effective Programs and Policies. This listing would allow the MADC to
sell Recognize to other communities, thereby ensuring the long-term sustainability of the
coalition and substance abuse prevention in the City of Meridian.
I. The general substance abuse problem to be addressed and its contributing factors and
consequences, with supporting evidence from research anchor practice
The Recognize program is a holistic prevention and. leadership development program that
addresses both specific substances of abuse (alcohol, Marijuana and tobacco) and the protective
factors that lead to non-use to include individual/peer factors, family factors, and community T -
factors. Recognize is a collaboration between the Meridian Joint School District, local Meridian
Businesses, Meridian's PAL youth sports league, Law Enforcement, Community Leaders, and
L.E.A.D.E.R.S.H.I.P. Ise. The Recognize program specifically targets high school. students in the
Meridian School District and elementary students who play sports with the PAL youth sports
league.
Research on adolescent substance use has focused on the .relationship between
characteristics of individuals and the environments where they live. David Hawkins, Richard
Catalano and Janet Miller reviewed the research literature to identify what they called risk and
protective factors. This work was later described in a 1992 book entitled "Communities that
Care: Action for Drug Abuse Prevention. These factors are divided into four separate categories:
Individual/Peer, Family, School and Community. As identified in our logic model in Appendix
A., Recognize is designed to address several key risk and protective factors to include:
• Increasing student disapproval of substance use by others individual/peer factor
The influence of the peer group on children and adolescent's decision making, including
the decision to use substances, is one of the most powerful forces parents and teachers
have to contend with. School and community programs that provide safe havens and pro -
social activities, such as Recognize, can increase exposure to positive peer groups and
adult role models and can lessen the influence of the negative peer group.
• Increasing students perception of substance abuse risks — xndividual/peer factor
Page 4
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
Youth who believe that substance use carries unacceptable risks or is harmful are less
likely to use alcohol hol and other substances. Substance abuse prevention programs that
health decision making and convey accurate risk information, such as Recognize,
teach y g
can Increase youth understandingof the risks of substance use and should result in lower
use rates
o
Increasing the belief thatparents disapprove of substance use — family factor
The impact of parental attitudes about teen substance use and the conuuunication of that
disapprovalg is one of the strongest protective factors that research has identified.
Preventionro rams intended to raise community awareness and social norming
p �
such. as Recognize, can snake parents aware of the importance of their roles as
programs, �
substance abuse prevention educators
• Increasing Community Attachment -- community factor
ProgramsY that increase community attachment, such. as .recognize, have been correlated
to lowering substance use by adolescents/children
2. Summarize the essential prevention programactivities
Below is a schematic of the Recognize program components followed by a more in-depth
description of each component
L.E.A..D. .R.. S .PI.I.P. Is
web based curriculum
�ommitment by `\
Community Leaders
To publicly recognize
adolescents/children for
positive behavior �
Local businesses recognize
participants with free
items
Coaches delivery of messages
through I.1.E.A.D.E.R.S.H.I.P. Ist
coaches training
Adolescent/child participant-
Commitment
articipant
Commitment in writing
by participant to stay
drug/alcohol free
Component 1 — L.E.A.D. .R.S.H.I.P. 1sT web -based curriculum
Commitment by
parent to work with
child on web based
curriculum
'Commitment b�
School district
to implement
program with Nigh
School Student
Athletes ,
Commitment in writing by •
participant to serve as a
leader & mentor among their
peers & assist in inducting
the next generation of
.-,student leaders /
L.E.A.D.E.&SM.I.P. V is a curriculum that is designed to be used in a variety of settings to
educate and empower individuals to become "self directed leaders." This innovative structure
allows for positive peer pressure to occur, used as a character education program that allows
those who are enrolled to develop leadership skills. with a state of the art technology platform,
Page 5
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
• t providing leadership development, drug and alcohol education, and
this innovative approach o P g P
healthy alternatives is used to impact and empower youth. Using evidence based model to
p p •
to his program can b e implemented in three easy phases. Duration of this
capture pre and post data t p g p
component is 12 weeps with daily to weekly exposure
Component 2 — Coaches messaging and training
xP1"t rovides a anion program to the web based student curriculum
L.E.A,.D.E.R.S.... P com P
that focuses on engagingand training athletic directors and coaches on messaging the same
components that are beinght within the web based curriculum.. This messaging reinforces
g
t and provides positive modeling of the concepts. Duration of this component is 12
the concepts p p g
weeps with daily to weekly exposure
Component 3 — Parents working and reinforcing messaging from web -based curriculum
p g '
As with their child's coach, the web based curriculm-n is intended to be reinforced through parent
interaction with the child. as the are moving through the 12 geek course. Duration of this
component is 12 weeks with daily to weekly exposure
Component 4 — Commitment by Community Leaders
nit Leadership, from the Mayor on down, have committed to making Recognize
Community p, y
dynamic and sustainable program. Recognize participants are routinely spotlighted at
Y
community meetings s and events. Duration of this component is ongoing with continual
exposure
Component 5 — Commitment by the School District
The Meridian School District has committed, from the Superi
mntendent to the school principles to
the teachers and coaches, to implement the Recognize program. This commitment includes
p
public recognition for students who are involved in the program at such events as varsity football
pub g -
games and all school assemblies. Duration of this component is ongoing with continual . --
exposure
Component 6 — Local. Business recognition
Participating students receive a dog tag with MADC's emblem, their name, and the message
`not -even -once'. Partici sting businesses display a door sticker and plaque in support of
p
Recognize and offer services or goods to those students who present their dog tags. For example,
g g
Blimp ie(Sub Sandwich) offers a discount to youth displaying their not -even -one dog -tag.
p t
Businesses prompt their employees to ask the question `Are you drug free?' before the
wa -a-
discountl five is given; of course the answer must be 'yes'. By creating a conduit for youth
g y
to become engaged in the community, this program will foster a dialogue among area youth and
local businesses. It also reinforces kids that make good choices in committing to be drug-free.
Duration of this component is ongoing with continual exposure.
Component 7 — Commitment by participant to stay drug --free
Students sign a public commitment to remain drug free, which is displayed in each of the schools
and a copy of their pledge given to their parents. Duration of this component is ongoing with
continual exposure.
Component S — Commitment by participant to serve as a leader and mentor
Being inducted into the program is not as simple as signing the pledge, as we are truly trying to cultivate student leaders. Participants are required to go through the L.B.A.D.B.R.S.H.I.P. 1 ST
Page 6
Meridian anti -Drug Coalition
Bethany Gadzinski -- Principle Evaluator
eq
web based curriculum ICulurr�. and are �. • uired to serve as a leader and mentor among their peers and
assist in inducting the next
• generation of student leaders (one grade below). Duration of this
component is ongoing with continual exposure.
3. Identify expected ected substance abuse (and other relevant) outcomes of the program
p
activities and explain why the program will affect those outcomes.
Expected short intermediate and long term outcomes from this program include:
• Short term:
o Increase age of first use by 1 %
o Increase
the belief that substance use carries unacceptable risks or is harmful by I%
o Increase Disapproval of others using substance by 1%
o Decrease reported use by friends by 1%
• Intermediate
o Increase age of first use by 2%
o Increase the belief that substance use carries unacceptable risks or is harmful by 3%
o Increase Disapproval of others using substance by 2%
o Decrease reported use by friends by 3%
• Long -terra
o Increase age of first use by 410
o Increase the belief that substance use carries unacceptable risks or is harmful by 5%
o Increase Disapproval of others using substance by 6%
o Decrease reported use by friends by 8%
Over the past two years we have seen the short terra outcomes come to fruition. This makes us
that the intermediate and long-term outcomes are possible. However, without the
believe t g
rigorous follow-upevaluation to be developed and implemented with funds from this contract,
we will not be able to definitively determine if this program specifically impacted the M -
intermediate and long-term outcomes.
4 Explain how the program is innovative; that is, new, original, creative and feasible or
.� p p g
useful
Although there are man programs that contain pieces of the Recognize program, we have not
g y p g that
found a program that contains all the elements of the Recognize program. Dur hypothesis is t
o p g
' nation of the program components is what is getting us the outcomes we are currently
the canlb� p g p
seeing. w g g
We believe tlu-ou h a rigorous fallow -up evaluation of this particular program we will be
able to definitively determine the following:
• Do the outcomes we see last after the completion of the curriculum based components?
• Is it the combination of the components that gives us the outcomes?
• Is thisp rograrn replicable in other settings — such as middle schools?
If our hypothesis is correct, the answer to each of the questions above will be yes. Through
discussions with other communities at CADCA and PAL events, other communities are
interested in adopting this innovative program if we can prove this specific program has a casual
rn p g p g
relationship to the positive outcomes we are seeing in Meridian.
Page 7
Meridian Anti -Drug Coalition
Bethany Gadxinski — Principle Evaluator
B. Section 2: Description and Justificationn i of Evaluation Capacity -Building Enhancement
X. describe the program's preliminary evaluation plan
evaluation plan for Recognize is very simplistic and one that is used by
The current project p �'
ro rams nationally. Pre and post tests are given, via survey monkey, to both
many prevention p g y
childienladoles
cents who have completed the web based training and to the coaches. This data is
y
then analyzed
b the coalitions contracted evaluator and results are distributed. to members of
In addition anecdotal and qualitative data is gathered through structured interviews
MA��C.
hoof personnel and community leaders. All of the quantitative data and qualitative data
with sc p �' .
combined and become art of the year end evaluation summary. As MARC is a Drug Free
are p y
Communitiesg rantee, data is also given to SA HSA. and. ONDCP via their reporting system —
COMET.
2. Identify and describe gaps in the preliminary evaluation plan.
There are tremendousg aps in the current evaluation plan that include the following
• At resent there is no way to determine if Recognize, as a program, is driving the
present, y
positive outcomes ,we are seeing in Meridian as we have not isolated the outcomes data
specific to this program
• No follow-up data is gathered to determine long term effects of the program on
participants and stakeholders,
• No randomized or quasi -experimental evaluation has been conducted on the program.
• A data collection system has not been developed to analyze all data gathered for this
program to include the combining of qualitative and quantitative data.
• A, plan for journal article reporting has not been developed
•
Systematic empirical research has not been conducted on the program that would provide
evidence of statistically significant effectiveness _ -
• Nolan for developing a manual for this program. has been developed thus there is no
p P
way to define "fidelity"
3. Identify the evaluation enhancement(s) to be implemented and explain how this/these
will address gaps and limitations of the preliminary evaluation pian.
The Recognize evaluation project includes two key components. First the internal evaluation
g
cavacitv of Recognize will be strengthened in the areas of formatting data for professional
analysis, writing articles for peer reviewed journals, and developing an application for NREPP
recognition. Second, a contract amendment with the coalitions outside evaluator will provide for
additional external program evaluation expertise.
The internal caDacitv development component will commit S hours per week of the time of the
coalition Project Director exclusively to Recognize program evaluation. activities. This focused
evaluation capacity will be committed to collecting any missing data, formatting this data into
Excel i
spreadsheets for statistical analysis, obtaining specific evaluation training, co-authoring,
p
with the extenial evaluator, program evaluation articles to be submitted for publication, and co-
authoring, with the external evaluator, a proposal for N]PP recognition.
The external ro rain evaluation corn orient will include purchase of additional time from the
coalition evaluator to
Page 8
Meridian Anti -Drug Coalition
Bethany Gadzinski -- Principle Evaluator
• •-
a Design quasi -experimental erimental evaluation with the variable being the web based curriculum
� P
and coaches messaging. This is feasible as the Recognize program began without the
web based curriculum and coaches training. Within this evaluation the legacy Recognize
program will be offered to a comparable group ■
• Develop and implement data collection systems and instruments
• Analyze the data
• Preliminary preparation of a journal article reporting program endings
• Provide technical assistance for developing an NREPP application
4. Explain the purpose of the proposed enhancement(s)
Thep � u ose of the proposed enhancement is to determine the following in regards to the
Recognize program;
9 Do the outcomes we see last after the completion of the curriculum based components?
• Is it the combination of the components that gives us the outcomes?
® is this program replicable in other settings — such as middle schools?
In the ast two ears the 11 A.DC as a coalition has seen the followin results:
Outcome
2006 Data
II
2008 Data
Change
Increase age of first use by 1%
37% before
age 13
25% before
age 13
12 percentage points
Decrease frequency of use by I% in 8th raders
63% no use
Not collected
Decrease frequency of use by 1% in 10tH raders
56% no use
71 % no use
15 percenta. a Dints
Decrease frequency of use b 1 % in 12th raders
60% no use
63% no use
3 percentaLe. points
Increase disap al of using substances by 1 %
63%
66%
3 percentage points
Increase the belief that substance use carries
unacce table risks or is harmful by 1%
51%
64%
13 percentage points
Decrease re pried use b friends by 1%
60%
53%
7 percentage points
Increase the belief that parents disapprove of
substance use by 201/0
40%
51%
11 percentage points
We theorize we have achieved these results, in part, through the development and
implementation of the Recognize program. The purpose of the proposed enhancement is to
scientifically prove or disprove this belief. If we can prove this theory, we will move forward
with application to NREPP.
5. Explain how the technical assistance provided through the Service to Science initiative
helped inform your decisions about the proposed evaluation enhancement(s).
Key MADC staff to include:
o Elisha Figueroa, Coalition Project Director
• Brenda Murdoch, Coalition Coordinator
• Lt. John Overton, Community Services Division, Meridian Police Department
• Bethany Gadzinski, Coalition. External Evaluator
worked with Eric Ohlson, MSW, Service to Science Coordinator, Center for the Application. of
Substance Abuse Teelmologies, University of Nevada, Reno in an onsite day long technical
Page 9
Meridian Anti -Drug Coalition
Bethany Cadxinski -- Principle Evaluator
assistance session to determine needed evaluation enhancements. Extensive discussion at this
workshop and follow-up emails were conducted to detennine the coalition's readiness to
undertake the rigorous evaluation and specific steps necessary for an NREPP submission of the
Recognize program. Through this technical assistance, the decision was made by coalition staff
and the Mayor of Meridian to pursue an application for funding through the Service to Science
Initiative Building Evaluation Capacity for Evidence -Eased Interventions Request for Proposals.
This decision was not made lightly but was made due to the information and encouragement we
received from the technical assistance provided through the Service to Science initiative.
Mr. Ohlson was instrumental in preparing us, by sending RFP examples and through continual
dialogue via email, for completing this application.
6. Identify potential barriers to the proposed enhancement(s) and describe how they will be
addressed,
Whenever an entity undertakes a comprehensive and in-depth evaluation of a program., such as
the one MA DC is proposing, that includes multiple components and. a quasi -experimental
evaluation, there can be barriers. These barriers include:
Failure of one or more of the components to fully engage in the evaluation process
Conflicting results that create tensions between the program components
As this is a one year project - running out of time to complete the project
Each of the components of this program have committed either verbally or in writing to support
the evaluation project which leads us to believe that we can address the first bullet point with
constant communication and feedback to each of the components. All components understand
that the evaluation may or may not show that this program is key to the outcomes we have seen
as a coalition. If the results are not positive, each component is willing to work on their piece to
increase the viability of the program. As far as barrier three, we believe that through monthly
updates on the evaluation, at MARC meetings, we will keep on track to finish in one year.
Finally, we believe that based on past performance we can overcome any potential barriers.
Page 10
Meridian Anti -Drug Coalition
Bethany Gadxinski — Principle Evaluator
C. Section 3: Organizaction's.Readiness to Implement Proposed Evaluation Capacity
Enhancement
1. MA.DC's current evaluation capabilities
MA.DC currently contracts with an outside evaluator to conduct ongoing coalition and
coalition sponsored programs evaluation.. As a Drug Free Communities grantee, evaluation is a
key and integral component of the coalition. To describe current capabilities, the following is
the most recent evaluation com onent u date:
Evaluation Activity Name: "Re co nine" Coaches Survey
Status:
Coaches Survey for the Recognize program. This instrument is a seven question
Complete
survey to gather information From coaches on the effectiveness of the Recognize
program. Survey results showed the 78.7% of coaches strongly agreed that targeting
athletes with substance abuse prevention information is important and 59.6% felt
using coaches to instruct athletes regarding the effects of substance abuse definitely
affective.
Evaluation Activity Name: Meridian police Department Alcohol Server Training.Status:
Alcohol Server Training post class survey. This is an eight question survey given after
Complete
the Meridian Police Department Alcohol Server Training Nine surveys were
completed during this reporting period. Results showed that participants generally or
strongly agreed with each of the following eight questions, with all ranking question 6
as strongly agree:
1) The training I received covered the declared objectives
2) The training I received is appropriate for nay current duties, or duties expected in
the near future
3) This course has increased my knowledge regarding lags surrounding alcohol sales
4) The information was presented in an appropriate level of detail for my use
5) Handouts were easily understandable
d} As a result of this training I am less likely to sell to a minor
7) Overall, course objectives, organization and content were of high quality
8) Mould you recolnrnend this training to others?
Evaluation Activity Name: Smart Moves, program conducted at the Meridian
Status
Boys and Girls club
Post-test program evaluation utilizing the Thorsteinson assessment tool. This tool
Complete
asks questions around attitudes, behavioral expectations/intentions, behavioral
willingness, and risk of harm. Participants are asked to rate 4 attitude questions from
good to un -enjoyable, 8 behavioral expectations/intentions questions from definitely
not to definitely will, 8 behavioral willingness questions from not at all to very
willing, 6 risk of harm questions from no risks to great risk. Survey results showed an
increase in positive attitudes and behavioral expectations/intentions around non-use, a
willingness to say no to peer pressure to sue and an understanding of the risk and harm
g Y p
of using substances.
Evaluation A.ctivi Larne: Recognize
Status
This is a pre/post survey given to PAL baseball players who participated in the
Ongoing
Summer 2010 season. Twenty-two children participated in the activity and responded
to both the pre and post assessment. Results showed that 21 of the 22 participants
improved their knowledge and l stayed the same.
Page 11
Meridian Anti -Drug Coalition
Bethany Gadzinski -- Principle Evaluator
Evaluation Activity Name: Cultural and Linguistic Competence Policy
Status
Assessment
This survey is an adaptation of the Cultural and Linguistic Competence Policy
Ongoing
Assessment created by Georgetown University for community health centers. This
survey is taken each year by the coalition board. Questions revolve around Five key
competency areas to include:
• Knowledge of diverse communities
• Organizational philosophy
• Coalition involvement in diverse communities
• Resources and linkages
• Engagement of diverse communities
The results of the survey showed key communities we .have not been able to engage.
A plan was created to attempt to engage these communities in the MADC.
Evaluation Activi Name: Sixstainabili self assessment
Status:
Sustainability Self -Assessment Tool developed by The Finance Project. This
Ongoing
assessment was completed by the coalition Board. This survey is completed each
year. This survey looks at eight elements of sustainability — vision, results orientation,
strategic financing orientation, board -based community support, key champions,
adaptability to changing conditions, strong internal systems, and sustainability plan.
Surveys from year one of the DFC grant were compared to the surveys taken
912312010. The surveys showed a marred positive increase from "have begun to
implement" to "have made solid progress In implementing the task."
Evaluation .Activity Name: 'Teens and Substance Abuse: what Every Parent and
Status:
Educator Must Know — Sessions 1
This survey was a post workshop survey utilizing a 4 point lickert scale from
Complete
outstanding (1) to below average (4). The session this evaluation covered was a
workshop entitled "Understanding the Social and Emotional Development of Teens."
The five questions asked with the corresponding average scores are:
1) Relevancy of Topic --1.6 8
2) Provided new information/ideas --1.84
3) Speaker presentation skills —1.90
4) Quality/relevance of visual aids — 1.87
5) Opportunity for questions —1.8 0
Evaluation Activity Name: Teens and Substance ,Abuse: what Every Parent and
Status:
Educator Must Know — Session 2
This survey was a post workshop survey utilizing a 4 point lickert scale from
Complete
outstanding (1) to below average (4). The session this evaluation covered was a
workshop entitled "Brain Development in Teens -Mental Health Issues and
Addiction." The Five questions asked with the corresponding average scores are:
1) Relevancy of Topic — 1.36
2) Provided new informationlideas —1.57
3) Speaker presentation skills —1.75
4) Quality/relevance of visual aids —1.64 .
5) Op ortunity for questions — 1.61
Evaluation Activity Name: Teens and Substance Abuse: What Every Parent and
Status:
Educator Must Know* — Session 3
Page 12
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
This survey was a post workshop survey utilizing a 4 point lickert scale from
Complete
outstanding (I) to below average (4). The session this evaluation covered was a
workshop entitled "Tobacco, Alcohol, Marijuana and Current Drug Trends." The five
questions asked with the corresponding average scores are:
1) Relevancy of Topic —1.06
2) Provided new information/ideas —1.09
3) Speaker presentation skills —1..13
4) Quality/relevance of visual aids —1.06
S) 02portunity for questions -1.40
Evaluation Activity Name: Drug Free Idaho Workplace Parenting Course
Status:
Pre/post evaluation for the DrugFree Idaho Workplace Parenting Course. The
Complete
assessment used a five point lickert scale with one being positive and five being very
negative. The assessment looked at four different areas of the course. The areas and
the overall pre and post test scores are:
1) Parental involvement and engagement in children's activities: 2.5 pre and 3.0 post
2) Rules and Family Structure: 2.8 pre and 3.4 post
3) Communication and Emotional Expression: 3.3 pre and 3.9 post
4) Beliefs about substance abuse: 3.1 re and 3.5 post
Evaluation Activity Name: Coalition self assessment
Status:
This assessment is given every six months and looks at 23 specific questions around
Ongoing
the quality of the MADC. Questions are rated on a 10 point lickert scale with 1 being
"strongly disagree" and 10 being "Strongly agree." This reporting period covered the
fourth survey cycle. Results of the survey showed continued growth in all areas of
coalition development.
2. Identify evaluation needs, gaps, and/or limitations
The largest need we have in regards to our evaluation is the lack of funding to conduct extensive
evaluations that meet the requirements to become NREPP approved. we believe vire have the
right people in place and the ability to create the right tools if we had the funding. without this
funding, we are limited to our current evaluation which will not meet the standards for NREPP
consideration.
3. Describe organizational resources to he allocated to the proposed enhancement
MADC staff and members have agreed to commit the time necessary to support the evaluation of
our .recognize program. It is clearly understood by all members that NREPP designation of the
Recognize program is a key component of the coalition's sustainability plan. Please see the
letter of commitment by MADC Project Director
L.E.A.D.E.R.S.H.I.P 1" is committed to participating in the evaluation and providing any
information necessary for the evaluation.
Our external evaluator has quoted a flat rate for her services and is committed to setting aside as
many hours as needed to complete the deliverables of this contract. Please see her letter of
commitment,
Page 13
Meridian Anti -Drug Coalition
Bethany Gadzinski -- Principle Evaluator
4. Explain how you will use technical assistance from the CAPT to supplement or
complement your capacities
The project as described is a complex and multi component evaluation. Due to this, MARC and
its external evaluator will be in constant contact with our CAPT to assure we are on target and
that each step is in compliance with. our ultimate goal of receiving NREPP designation. All
technical assistance provided through the CAPT will be utilized.
D. Section 4: Staff Capabilities and Project Management,
1. Key internal and external project staff, including evaluation staff or independent
evaluators, as well as other staff to be assigned to implement the proposed enhancement
and the relevant expertise, qualifications, and skins of staff assigned to this project
The key internal prog_ra . evaluation staff for this project is Coalition Project Director Elisha
Figueroa. Elisha has been the Coalition Project Director for the past two years. Elisha led the
coalitions strategic planning for the current year and was instrumental in moving the Recognize
program. forward. Elisha is an MSW who has experience in program planning and evaluation.
Elisha will dedicate S hours per week of her time exclusively to Recognize program evaluation
activities. This focused evaluation capacity will be committed to collecting any missing data,
formatting this data into Excel spreadsheets for statistical analysis, obtaining specific evaluation
training, co-authoring, with the external evaluator, program evaluation articles to be submitted
for publication, and co-authoring, with the external evaluator, a proposal for NREPP recognition.
The key external vrogram evaluation staff is Coalition Evaluator Bethany Gadzinski. Because
the Coalition understood early on that we do not have all the experience and capability needed to
p P Y
lead and update a comprehensive coalition and program specific evaluation, vire have contracted
with. Ms. Gadzinski to lead our evaluation efforts. As the formes- Idaho Single State Authority
Director for Substance Abuse Prevention and. Treatment, Ms. Gadzinsld has access to a
multitude of State, Regional and local data bases. Ms. Gadzinski has been collecting, analyzing
and reporting local and State project evaluation data, to include quazi-experimental evaluations,
for the past 12 years.
In addition to Ms. Figueroa and Ms. Gadzins1d, Lt. John Overton will serve as the liaison
between the project and City leadership. Lt. Overton has held the position of Liaison between
the Coalitional and the City since the coalition's inception in 2004. Lt. Overton has been
instrumental in moving forward both the coalition and the programs it sponsors.
3. Describe the management and administration of the proposed project enhancement.
The responsibility for the implementation and timely completion of evaluation enhancement
tasks specified for this project will be co -managed by Ms. Figueroa and Ms. Gadzinski. The
design of this project includes monthly work sessions at the Meridian Police Department that
have been incorporated to develop a highly productive and ongoing partnership between the
Evaluation Project, the Coalition and Ms. Gadzinski. we firmly believe that this commitment to
ongoing face-to-face co -management meetings will provide the structure and focus necessary for
accomplishment of project goals and activities. A portion of each meeting will be dedicated to
reviewing the sequential project goals and activities, identifying tasks to be accomplished within
the next month, clarifying the respective roles and responsibilities for completing each project
activity, and reviewing work that has been completed since the preceding meeting.
g
Page 14
Meridian Anti -Drug Coalition
Bethany Gadzinski -w Principle Evaluator
4. Timeline for accomplishing
tasks and milestones
What
who
when -r Jan 2011 — Dec. 2001
Jan
Feb
March
Aril May June July AM
Set Oct
Nov
]dee
Receipt of
NIADC
x
contract
Contract
MADC and
X
Negotiation
CAPT
Add
NADC and
X
contract
B. ,
deliverable
Gadzinski
to
evaluators
contract
Weekly
E Figueroa
x
x
x
x X x x x
x x
x
X
meetings
B.
with
Gadzinski
Evaluator
and Project
Director
Commence
Begin work
B.
x
x
on survey
Gadzinski
tools
Develop
B.
x
X x
and
Gadzinski
implement
data
collection
systems
and
instruments
Begin
B.
X x x
x x
Evaluation
Gadzinski
E. Figueroa
Analyze
B.
x
x
Data
Gadzinski
Prepare
B.
x
x
report
Gadzinski
Preliminary
B,
X
X
preparation
Gadzinski
of a journal.
article
reporting
program
findings
Begin
B.
x
Developme
Gadzinski
nt of
E. Figueroa
REPP
application
Page 15
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
E. Section 5: Budget.
"City's proposal is conditioned on the agreement of the parties on mutually acceptable terms,
conditions, guidelines and requirements."
EXPENSES
Mini subcontract - Evaluation Enhancement
Totals
January 1, 2411 - december 31, 2011
Name
FTE
Annual
said
Total
1 Program Administrator
5°l0
44,000.00
$ 23200
Total Salaries
$
2,200.00
Fringe
Percenta a
Total salar
15% of Position
15%
21200.00
330.00
Total
Fringe
$
330.04
Total staff costs
$
2,530.00
Evaluation Consultants
Bethany Gadzinski, Coalition
Evaluator Date Unit
of survey tools $ 51000 1
$ 53000
_Development
Implement evaluation $ 51000 1
$ 5 000
Analysis, key findings, final document
$ 51000 1
1 $ 51000
_preparation
Total Consultants
$
15,400
Evaluation Participants
Item
Incentive for evaluation
participants
Total Participant costs
Operating
Item
Phone (local, long distance,
interne()
Copies
Software license SPSS
Supplies
Postage
$
$
$
$
$
$
Cast
15
Cost
150
30
300
50
40
#
Participants
200
Months
12
12
12
12
#groups
2
Amt
1
$
$
$
$
$
$
61000
11800
360
300
600
480
$
61000
Total Operating
$
31540
Total Direct Costs
$
27,070
Indirect Cost -10%
Total Expenses
$
$
23707
291777
Page 16
Meridian Anti -Drug Coalition
Bethany Gadzinski w Principle Evaluator
Budget Narrative:
Coalition Project Director — 5% of her time $ 21200
Fringe $ 330
5 hours per week of the time of the coalition Project Director exclusively
to Recognize program evaluation activities. This focused evaluation
capacity will be committed to collecting any missing data, formatting this
data into Excel spreadsheets for statistical analysis, obtaining specific
evaluation training, ca -authoring, with the external evaluator, program
Evaluation Consultant
The coalition does not have the expertise to conduct a rigorous evaluation
of the Recognize program so we will add to the current evaluation contract
of the coalitions external evaluator who sloes have the expertise to conduct
this program evaluation.
• Design a quasi -experimental evaluation with the variable being the
web based curriculum and coaches messaging. This is feasible as $ 59000
the Recognize program began without the web based curriculum
and coaches training. Within this evaluation the legacy Recognize
program will be offered to a comparable group.
• Develop and implement data collection systems and instruments
• Aimlyze the data
e Preliminary preparation of a journal article reporting program $ 51000
Endings
• Provide technical assistance for developing an NREPP application lication $ 5,000
p
Evaluation Participant Incentives
Each participant who participates in the six and twelve month post
$x,000
program evaluation, from both the project and control groupwill receive a
$15 gift certificate incentive. we believe, based on research that this
incentive will help to increase participation in the evaluation.
Operating
In order to successfully complete this project, there are standard operating
costs to include
Phone
Copies
Supplies
Postage
In addition, the coalition does not have the needed software for this
project. The evaluator does have the software so coordination of
information collection will be enhanced by the coalition also have SPSS
software
Indirect — Standard City indirect of 1.0%
TOTAL
Page 17
$ 3,240
$ 300
$ 2,707
$29,777
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Meridian Anti -Drug Coalition
Bethany Gadxinski —Principle Evaluator
Appendix B, a list and summary of evaluation reports
Evaluation Activity Name** "Recognize" Coaches Surve
Coaches Survey for the Recognize program. This instruine '
g nt is a seven question survey to gather
information from coaches on the effectiveness of the Recognize •
g ze p.iogram. Survey results showed
the 78.7% of coaches strongly agreed that targeting athletes .
. g g with substance abuse prevention
information is important and 59.6% felt using coaches to instruct athletes regarding the effects of
substance abuse definitely affective.
Evaluation Activity Name: Meridianpolice_ Department Ai •
Alcohol Server TraYnYn
Alcohol Server Training post class survey. This is an eight question Y g on survey given after the
Meridian Police Department Alcohol Server TrainingNine e surveys were completed during this
reporting period. Results showed that participants generally orwith each of the
following eight questions, with all rankingquestion 6 as strongly q agree.
9) The training I received covered the declared objectives
I 0
} The t �
raining I received is appropriate for in current duties - `
future
Y , of duties expected in the near
11 ) This course has increased my knowledge regarding laws surrounding alcohol sales
12) The information was presented in an appropriate level of detail •
for nay use
13) Handouts were easily understandable
14) As a result of this training I am less likely to sell to a minor
15) Overall, course objectives, organization and content were of high g quality
16) would you recommend this training to others?
Evaluation Activity Name: Smart Moves,ro ram conducted at the .
p g e l�er�dian boys and
Girls club
Post --test program evaluation utilizing the Thorsteinson assessment tool. This .
his tool asks questions
around attitudes, behavioral expectations/intentions, behavioral willingness,
and risk of harm.
Participants are asked to rate 4 attitude questions from ood to un -enjoyable, g $behavioral _
expectationslintentions questions from definitely not to definitely will 8 behavioral -
• y , willingness
questions from not at all to very willing, 6 risk of harm. questions from no risks to •.
q great risk.
Survey results showed an increase in positive attitudes and behavioral expectations/intentions
around non-use, a willingness to say no to peer pressure to sue and an understanding •'
. p Landing of Lire r..�.slc
and harm of using substances.
Evaluation Activity Maine: Recognize
This is a pre/post survey given to PAS, baseball players who participated in the Summer
2010
season. Twenty-two children participated in the activity res to both the
y and responded p pre and past
assessment. Results showed that 21 of the 22 participants improved their knowledge and p g 1 stayed
the same.
Evaluation Activi Name: Cultural and Linguistic Competence Polio
Assessment
This survey is an adaptation of the Cultural and Linguistic Competence Poli
cy Assessment created
by Georgetown University for community health centers. This survey i
.. Y y s taken each year by the
coalition board. Questions revolve around five keycompetency areas to in
p y crude .
• Knowledge of diverse communities
• Organizational philosophy
• Coalition involvement in diverse communities
• Resources and linkages
• Engagement of diverse communities
Page 19
Meridian Anti -Drug Coalition
Bethany Gadzinski -M Principle Evaluator
The results of the survey showed keycommunities we have not been
able to engage. A plan ,was
created to attern t to engage these communities in the MARC.
Evaluation Activity Name: Sustainabiii self assessment
Sustainability Self -Assessment Tool developed by The Finance Project.
This assessment was
completed by the coalition Board. This survey is completed each year. This survey looks at eight
elements of sustainability W-- vision, results orientation strategic financing .
• .. . g .. g or�entatron, board -based
community support, key champions, adaptability to changing conditions strong internals systems,
and sustainability plan. Surveys from year one of the IUPC ant
y gr were compared to the surveys
taken 9/23/2010. The surveys showed a markedositive increase from "have e begun to
implement" to "have made solid progress in inp lementin the task."
Evaluation Activity Name: Teens and Substance Abuse: what Eve Parent ent and Educator
Must Know -- Session 1
This survey was a post workshop survey utilizing a 4 point lickert scale from outstanding
(1)to
below average (4). The session this evaluation covered was a workshop entitled "Understanding
. p erstanding
the Social and Emotional Development of Teens." The five questions asked with the
corresponding average scores are:
6} Relevancy of Topic —1.68
7} Provided new information/ideas — 1.84
8} Speaker presentation skills — 1.90
9} Quality/relevance of visual aids -1.87
10} Opportunity for questions —1.80
Evaluation Activity Name: Teens and Substance Abuse: what Eve Parent and Educator
Must Know -- Session 2
mus Every
This survey was a post workshop survey utilizing a 4 point lickert scale from. outstanding (1) to
below average (4). The session this evaluation covered was a workshop entitled "Brain
Development in Teens -Mental Health Issues and Addiction." The fiveq uestions asked with the
corresponding average scores are:
6} Relevancy of Topic —1.3 6
7} Provided neve information/ideas — 1.57
8} Speaker presentation. skills —1.75
9) Quality/relevance of visual aids — 1.64
10} Opportunity for questions —1.61
Evaluation Activity Name: Teems and Substance Abuse: what E very Parent and Educator
Must Know --- Session 3
This survey was a post workshop survey utilizing a 4 point lickert scale from outstanding 1 to
below average (4). The session this evaluation covered was a workshop entitled "Tobacco
Alcohol, Marijuana and Current ]drug Trends." The five questions asked with the corresponding
average scores are:
P
6) Relevancy of Topic — 1.06
7} Provided new information/ideas - -1.09
8} Speaker presentation shills — 1.13
9} Quality/relevance of visual aids — 1.06
101 Opportunity for questions —1.40
evaluation Activity Name: Drug Free Idaho Workplace Parenting Course
Pre/post evaluation. for the DrugPree Idaho workplace Parenting Course. The assessment used a
five point lickert scale with one being positive and five being very negative. The assessment
Page 20
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
looped at four different areas of the course. The areas and the overall pre and post test scores are:
5) Parental involvement and engagement in children's activities: 2.5 re and 3.0 post
. p
6) Rules and Family Structure: 2.8 pre and 3.4 post
7) Communication and Emotional Expression: 3.3 pre and 3.9 post
8) Beliefs about substance abuse: 3.1 pre and 3.5...post
Evaluation Activ Ifty Name: Coalition self assessment
This assessment is given every six months and loops at 23 specific questions around theualit of
� y
the II ADC. Questions are rated on a 10 point lickert scale with I being "strongly disagree" and
10 being "Strongly agree." This reporting period covered the fourth survey cycle. Results of the
survey showed continued growth in all areas of coalition develo-pment.
Page 21
Meridian Anti -Drug Coalition
Bethany Gadzinski — Principle Evaluator
Appendix C, resumes, with letters of commitment, for all keyproject staff
proJ
Elisha Figueroa — Project Director
Meridian Anti -Drug Coalition
Education:
Arizona State University
BSw, Social work
1993-1995
/Northwest Nazarene University
MSW, Social work/Administrative Management
2006-2008
Elisha has held the position of MADC Project Director for the past two ears. Her
. ... p y
responsibilities include:
Essential Duties and Responsibilities:
• Coordinate and facilitate the development and implementation of substance abuse
prevention / education programs within the City of Meridian;
To act as a representative of the City of Meridian and the Police Department in developing
p p g
partnerships with other Treasure valley drug prevention / educationro rams and entities.
p g
These would include but not be limited to PAYADA, Drug Free Idaho the Meridian
School District, and The Boys and Girls Club;
• Aggressively pursue all available grant opportunities;
• Develop educational brochures and handouts dealing with dru prevention and education
g
on a local community level; - �-
• Facilitates and/or conducts training in the areas of substance abuse prevention / education
as requested by local businesses, citizens and community groups;
• Market substance abuse prevention education programs and strategies within the
community;
• work with the media as required.
Her Core Skills include:
* Computer Skills w Microsoft Office Suite (word, Excel, Outlook, Publisher)
• Laws/Law Enforcement Procedures
• Crime Prevention and Community Policing (Understanding ofdynamics involved and
problem solving)
• Excellent verbal and written communication skills
• Program Evaluation
• Strategic Planning
• Substance abuse education
• Substance abuse program implementation
• Media relations
Page 22
Meridian Anti -Drug Coalition
Bethany Gadzinski -- Principle Evaluator
Bethany Gadzinski w- Coalition Evaluator
Page 23
City of Meridian, Meridian Police Department
Exhibit C
Budget
"City's proposal is conditioned on the agreement of the parties on mutually acceptable terms,
conditions, guidelines and Ee wLrements."
PEEXP�NSES
Mini subcontract - Evaluation Enhancement
Totals
January 1, 2011 - December 3'1, 2011
Annual
Name
FTE
salaq
Total
1 Pro ram Administrator
5%
44,OOO.00
$
2120D
Total Salaries
$ 21200.00
Prin ge Percentage
Total sola
1 °I of Position
16%
2,2OO.00
330.00
Total
Fringe
$
330.00
Tatar staffcosts
$ x,630.00
Evaluation Consultants
Bethany Gadxinski, Coalition
Evaluator
Fate
Unit
Development of survey tools
$ 5 000
1
$
000
Implement evaluation
$ 51000
$
51000
Analysis, key findings, final document
preparation
$ 51000
1
$
51000
Total consultants
$
151000
Evaluation Participants
Item
cost
ParticE ants
# groups
Incentive for evaluation
participants $
15
200
2
$
61000
Total Participant Costs
$
99,000
Op grating
Item
Cost
Months
Anent
Phone (local, long distance,
internet) $
150
12
$
1,800
Copies $
30
12
$
360
Software license SPSS $
300
1
$
300
Supplies $
50
12
$
600
Postage $
40
12
1
$
430
Total Operating
$
3p540
Total Direct costs
$
27,070
Indirect Cost N 1 D%
$
2,707
Total Expense
$
299,777
10
City of Meridian, Meridian Police Department
Budget Narrative;
Coalition Project Director -- 5% of her time 29200
Fringe
S hours per week of the time of the coalition Project Director exclusively
to Recognize program evaluation activities. This focused evaluation
capacity will be committed to collecting any .missing data, fornattm*g this
data into Excel spreadsheets for statistical analysis, obtainna.g specific
evaluation trannng, co-authoring, with the extern evaluator, program
Evaluation Consultant
The coalition does not have the expertise to conduct a rigorous evaluation
of the Recognize program so we will add to the current evaluation contract
of the coalitions external evaluator who does have the expertise to conduct
this program evaluation.
Design a quasi -experimental evaluation with the variable being the
web based cumoulum and coaches messaging. This is feasible as S 5P0
the Recognize program began without the web based cumculum
and coaches training, within this evaluation the legacy Recognize
program will be offered to a comparable group.
+ Develop and implement data collection systems and instruments
,Analyze the data
preliminary preparation of a journal article reporting program S 59000
findmgs
Provide technical assistance for developing an. N EPP application S 59000
Evaluation Participant Incentives
Each participant who participates in the six and twelve month post
p
program evaluation, from both the project and control group will receive a � �,�'��
$15 gift certificate incentive. we believe, used on research that this
incentive will help to increase participation in the evaluation..
Operating
In order to successfully complete this project, there are standard operating
costs to include
Phone
Copies
Supplies
Postage
In addition, the coalition does not have the needed software for this
project. The evaluator does have the software so coordination of
information collection will be enhanced by the coalition also have SASS
soft -ware
Indirect — Standard City indirect of 10%
TOTAL
$ 3,240
$ 300
$ 2,707
$29,777
11