CONTRACT NO - Texas Health and Human Services



CONTRACT NO. 2016-000000

PROGRAM ATTACHMENT NO. 000

CONTRACTOR:

SYSTEM AGENCY PROGRAM: Youth Prevention - Indicated (YPI)

SECTION I. STATEMENT OF WORK

A. PURPOSE

To provide Youth Prevention Indicated (YPI) services designed to prevent or interrupt the onset or progression of substance use for youth and young adults who are exhibiting early signs of substance use and other related problem behaviors associated with substance use.

Indicated prevention activities offer constructive methods designed to interrupt the onset or progression of substance use in the early stages by identifying individuals who are experiencing early signs of substance use and other related problem behaviors associated with substance use and targeting them with special curriculum and related prevention strategies. The individuals identified at this stage, though showing signs of early substance use, have not reached the point where a clinical diagnosis of substance abuse can be made.

Indicated prevention approaches are used for individuals who are experiencing early signs of substance use and other related problem behaviors associated with substance use. The individuals may or may not be abusing substances, but exhibit risk factors such as school failure, interpersonal social problems, delinquency, or other antisocial behaviors, or psychological problems, such as depression or suicidal behaviors that increase their chances of developing a drug abuse problem.

Youth are screened for risk factors to determine their appropriateness for participation in an indicated prevention program. The identified risk factors should be considered to determine the prevention strategies/activities that will best meet the needs of the youth participants in the indicated program.

B. GOAL

The goal of youth indicated prevention is to prevent or interrupt the use of alcohol, tobacco, and other drugs (ATOD) by youth who are showing early warning signs of substance use and/or exhibiting other at-risk problem behaviors in order to halt the progression and escalation of use and related problems.

C. TARGET POPULATION

1. The primary population includes youth 11-17 years of age (6th – 12th grades) and young adults 18-21 years of age that are still in high school and meet the program and curriculum criteria (collectively referred to as youth). Contractor shall refer to Section III. Program Service Area of this Program Attachment for specific age and grade ranges. These individuals may or may not be using substances, but may exhibit risk factors such as school failure, interpersonal social problems, delinquency, or other antisocial behaviors, or psychological problems, such as depression or suicidal behaviors that increase their chances of developing a substance abuse problem. The individuals identified at this stage, though showing signs of early substance use, have not reached the point where a clinical diagnosis of substance abuse can be made.

2. The secondary population includes the parents, grandparents, guardians, and siblings of the youth population.

D. SERVICE REQUIREMENTS

Contractor shall:

1. Provide YPI services in accordance with the rules in Title 25 of the Texas Administrative Code (TAC), Chapter 447.

2. Provide prevention services and activities where the target population is located as specified in Contractor’s response to the solicitation document, as approved by the System Agency.

3. Conduct prevention services and implement strategies that target the identified primary and secondary populations and include family-specific strategies, as appropriate.

4. Implement all required YPI activities in counties identified in Section III. Program Service Area of this Program Attachment.

5. Submit a written request for any changes to the target population age or grade range from Contractor’s original proposed and approved targets. Any requests for changes or expansion to the target age or grade range shall meet the curriculum requirements. Contractor shall also submit a written request for any change to the approved program service area (Section III.) in this Program Attachment. Contractor shall obtain written approval from the System Agency of such changes, prior to the delivery of prevention services.

6. Implement the Center for Substance Abuse Prevention (CSAP) prevention strategies, which are as follows:

a. Prevention Education aims to increase protective factors, foster resiliency, decrease risk factors, and positively affect critical life and social skills relative to substance abuse and/or Human Immunodeficiency Virus (HIV) risk of the participant and/or family members. This strategy is designed to promote and develop life skills, decision-making and problem-solving skills, as well as to provide accurate information about the harmful effects of ATOD use, abuse, and/or addiction. Sessions are characterized by information exchange and interaction between the educator/facilitator and the participants. Prevention education and skills training shall be designed and implemented to affect critical life and social skills and include decision-making, refusal skills, critical analysis, and systematic judgment abilities. The activities shall include extensive interaction between the facilitator and the participants. All activities shall be conducted according to a written, time-specific curriculum, which is based on proven, effective principles. All activities implemented within this strategy shall help participants gain knowledge and/or skills needed to access assistance or help with a problem.

Contractor shall conduct the activities as stated above and document each session for this strategy using the System Agency approved template as follows:

i. Date, time, and duration of activity;

ii. Location of activity;

iii. Name of curriculum;

iv. Prevention staff printed name, signature, and date;

v. Number of participants; and

vi. Session topic, purpose, and goal of activity.

Curriculum cycle documentation shall include the following:

i. Participant consent forms;

ii. Participant rights;

iii. Curriculum cycle attendance roster which includes participant demographic information and participant identifier;

iv. Participant pre-/post-tests using the System Agency approved templates for the specific curriculum;

v. Documentation for each curriculum session which shall include the information listed above in items (i-vi); and

vi. Documentation for required indicated prevention strategies and activities for each individual participant signed and dated by the prevention specialist conducting the activity.

b. Information Dissemination provides awareness and knowledge of ATOD use, abuse, and addictions; and/or HIV infection; their harmful effects on individuals, families and communities; and provides awareness of available curriculum and related prevention strategies and services to adults. Information can be in the form of brochures, pamphlets, resource directories, literature, and information about available resources. Information about available services and resources can be disseminated a number of ways to include, but not be limited to, (walk-in visitors, presentations, health fairs, etc.), or distributed through the mail or electronically via e-mail, social media, or other web-based applications. Electronic dissemination shall account for no more than ten (10) percent of the project goal. Information dissemination shall include activities to disseminate current information about the following topics as appropriate for the target populations: the nature and extent of alcohol, tobacco, and other drug use, abuse, and addiction; HIV infection, tuberculosis (TB), hepatitis, and sexually transmitted diseases (STDs); and information about available services and resources. The information shall be accessible and understandable to the target population in terms of content, mode, time, and location of delivery.

Alcohol and other drugs (AOD) presentations for youth and adults are designed to create awareness and knowledge of alcohol and drug use, abuse and addiction; its harmful effects and consequences on individuals, families, and communities. This strategy also increases awareness about alcohol and other drug programs and services available to the general population. For the youth prevention universal, selective, and indicated programs, this strategy shall include, but is not limited to, presentations focused on the State’s three prevention priorities of alcohol (underage drinking), marijuana, and prescription drugs. The AOD presentations are conducted in-person at both schools and community sites. All presentations shall have an educational goal and objective and be conducted for a minimum of thirty (30) minutes with the same audience.

Minors and tobacco presentations for youth and adults are designed to create awareness and knowledge of tobacco use, abuse, and addiction; its harmful effects and consequences on individuals, families, and communities; and the Texas tobacco laws as they apply to minors. This strategy also increases awareness about quitting and tobacco cessation programs and services available to the general population. The minors and tobacco prevention presentations are conducted in-person at schools and community sites. All presentations shall have an educational goal and objective and be conducted for a minimum of thirty (30) minutes with the same audience. Contractor shall conduct the activities as stated above and document this strategy using the System Agency approved template as follows:

i. Date, time, and duration of activity;

ii. Location of activity;

iii. Prevention staff/volunteer printed name, signature, and date;

iv. Number of participants and/or number of individuals receiving written information/literature;

v. Educational goal and objective of presentation or purpose and goal of activity; and

vi. A brief description of the presentation/or activity.

c. Alternative Activities - AOD alternative activities and tobacco alternative activities are designed to encourage and foster bonding with peers, family, and community. This strategy provides adults the opportunity to take part in educational, cultural, recreational, and work-oriented substance-free and tobacco-free activities with youth involved in prevention curriculum and related prevention strategies. Alternative activities shall be designed and implemented to assist participants in the following areas: mastering new skills; developing/maintaining relationships with peers and family; bonding with peers, family, school, and community; building cultural understanding and honoring diversity; and identifying substance-free activities which offset attraction to alcohol, tobacco, and other drug use. Alternative activities shall be planned and conducted to complement the existing program design and proposed outcomes. All AOD and tobacco prevention alternative activities shall have an educational goal and objective and shall engage the same participant audience for a minimum of thirty (30) minutes.

Contractor shall conduct the activities as stated above and document this strategy using the System Agency approved template as follows:

i. Date, time, and duration of activity;

ii. Location of activity;

iii. Prevention staff/volunteer printed name, signature, and date;

iv. Number of participants;

v. Educational goal and objective of activity; and

vi. A brief description of activity.

d. Problem Identification and Referral is a strategy designed to ensure that the participant and/or family member is provided with information and resources to ensure access to the appropriate level and type of services needed by youth and/or their families. This includes the identification of youth participants who have used or are at risk of using illicit drugs and/or the inappropriate use of ATOD through an indicated prevention screening. The indicated prevention screening will help determine if their behavior can be changed through education or if the participant should be referred to a different level of service. This strategy shall not include any activity designed to determine if a person is in need of treatment. Problem Identification and Referral will most often result from the completion of an indicated prevention screening of risk factors or the indicated prevention counseling session with the prevention education participants. These are all interrelated core strategies, which shall be implemented to ensure an effective and comprehensive youth indicated prevention program. The required components for this strategy include screening for risk factors, referrals, and follow up to ensure participant success. The indicated prevention screening process shall be designed to determine the participant’s appropriateness to participate in the program based on identified risk factors that provide warning signs for ATOD use. The screening shall also identify STD/HIV risk factors as appropriate. Contractor shall maintain a current list of referral resources, including other services provided by Contractor. Contractor shall conduct and document follow-up on referrals to ensure that the participant has presented for services. Contractor shall conduct the activities as stated above and document this strategy using the System Agency approved template. (Refer to Indicated Prevention Screening (IPS), Indicated Prevention Counseling (IPC), Indicated Prevention Service Plan (IPSP), Referrals and Follow-ups, and Participant Exit Summary (PES) section of this Program Attachment.)

e. Community-Based Process aims to enhance the ability of the community to more effectively provide prevention, intervention, and treatment services for ATOD problems and HIV infection through community mobilization and empowerment. The program shall establish formal linkages with other service providers to build a continuum of substance abuse services in the community. The program shall document active participation in collaborations to support community resource development. Contractor shall establish or maintain a membership with a ATOD coalition in the Program Service Area and document active participation as required by the System Agency.

The program’s service coordination with another provider shall include a written agreement that is renewed annually (by signature or other documented contact) and includes:

i. Names of the entities entering into the agreement;

ii. Services or activities each entity will provide;

iii. Signatures of authorized representatives; and

iv. Dates of action and expiration.

f. Environmental and Social Policy aims to decrease the incidence and prevalence of ATOD and/or HIV infection in the general population by establishing and/or changing written and unwritten standards, codes, and attitudes within the community. This strategy may include activities that center on legal and regulatory initiatives and those that relate to service and action-oriented initiatives. Contractor shall accomplish this strategy through the work of a local ATOD coalition and minors and tobacco prevention presentations. Each program that provides activities within this strategy shall take steps to influence the incidence and prevalence of substance abuse through: legal and regulatory strategies or service and action-oriented activities. Activities shall involve members of the community and other key stakeholders who will be impacted by the outcome. Efforts shall be systematic and sustained. Contractor shall document active membership in a coalition to ensure participation towards environmental/social policy changes. Contractor shall conduct the activities as stated above and document this strategy as follows for environmental strategies focused on coalition involvement:

i. Date, time, and duration of activity;

ii. Key contact persons/providers involved;

iii. Purpose and goal of activity;

iv. Further action steps needed;

v. Action or change achieved; and

vi. Staff printed name, signature, and date.

For coalition meetings, a copy of the coalition’s meeting agenda and minutes shall be attached to the documentation form.

g. Contractor’s comprehensive indicated prevention services shall include the following prevention strategies and activities:

i. Prevention Education (Prevention Education CSAP Prevention strategy): The approved selected curriculum shall be provided to eligible individuals who participate in the YPI program according to the curriculum design. Family-focused curricula shall include the youth participants and their parent or guardian. The prevention education documentation shall include the following:

a) Group Cycle Attendance Roster;

b) Participant Consent Form;

c) Participant Rights;

d) Documentation for each curriculum session;

e) Participants’ Pre-/Post-Tests using the System Agency approved templates for the specific curriculum; and

f) Required documentation signed by the prevention specialist for the required indicated prevention strategies and activities for each individual participant.

ii. Indicated Prevention Screening (IPS) (Problem Identification and Referral CSAP Prevention strategy): An IPS shall be conducted with all YPI youth participants. The IPS shall gather information to identify the youth participant’s risk and protective factors in five domains:

a) Individual;

b) Family;

c) School;

d) Peer relationships; and

e) Community.

If the participant and/or family member needs a more intensive level of services, Contractor shall facilitate their access to needed services. The indicated prevention screening shall include the following:

a) Information about the individual that includes:

1) Age, gender, culture and ethnicity;

2) Individual assets;

3) ATOD use; and

4) Legal issues.

b) Information about the family, as permitted by law that includes:

1) Structure;

2) Functioning; and

3) Family history of ATOD use.

c) School information that includes:

1) Literacy level;

2) Academic performance; and

3) Behavioral functioning issues.

d) Information about peer relationships that includes:

1) ATOD use;

2) Gang or club involvement;

3) Legal issues; and

4) Social functioning.

e) Information about the community that includes:

1) Economic status;

2) General environment;

3) Criminal activity; and

4) Availability of ATOD.

iii. Indicated Prevention Counseling (IPC) (Problem Identification and Referral CSAP Prevention strategy): IPC shall be provided to a minimum of eighty percent (80%) of the YPI youth participants enrolled in prevention education whose IPS reflects risk factors that identify specific needs for which the youth participant will receive referrals. IPC may also be provided if during any curriculum session it is determined that the YPI youth participant has specific needs for services for which referrals will be made. The indicated prevention counseling shall be conducted face-to-face in a confidential setting. The Indicated Prevention Counseling Session shall be documented as follows:

a) Date of indicated prevention counseling session;

b) Participant identifier;

c) Name and signature of prevention staff conducting the session (including date);

d) A summary of each of the indicated prevention counseling sessions conducted;

e) Progress on identified goals and referrals made as indicated on the indicated prevention service plan; and

f) Date of next indicated prevention counseling session, if necessary.

iv. Indicated Prevention Service Plan (IPSP) (Problem Identification and Referral CSAP Prevention strategy): An IPSP shall be developed with and for each youth participant who receives IPC. The IPSP shall be designed to address the identified needs of the participant. The IPSP documentation shall include:

a) Date of indicated prevention service plan;

b) Participant identifier;

c) Behavioral goals;

d) Timelines for completing the goals;

e) Referrals and recommended services;

f) Date of scheduled follow-up;

g) Signature of the participant and the prevention staff; and

h) Date prevention staff documents the activity conducted.

v. Referrals and Follow-Ups (Problem Identification and Referral CSAP Prevention strategy): Referrals for services shall be provided to a minimum of twenty percent (20%) of the YPI youth participants receiving IPC. Follow-ups shall be conducted with the youth participant to ensure that the YPI youth participant obtained access or presented for services according to the IPSP, or to determine if the YPI youth participant is in need of additional referrals for services. Contractor shall conduct a follow-up to determine if the participant was successful in obtaining access to services or if there is need for additional referrals and resources. Referrals shall be documented in the Indicated Prevention Service Plan and the Indicated Prevention Counseling session documentation. A referral form for documentation shall include:

a) Date of referral;

b) Participant identifier;

c) Name of prevention staff making the referral;

d) Purpose of referral;

e) Referral contact information: name of organization or agency participant was referred to, phone number, and/or email address for the referral source;

f) Expected follow-up date;

g) Follow-up date;

h) Indication whether participant was successfully referred (Participant shall present for services in order for the referral to be considered successful);

i) Indication whether referral was unsuccessful and state the reason participant was not successful in accessing services;

j) Signature of the participant and the prevention staff; and

k) Date prevention staff documents the activity conducted.

vi. Participant Exit Summary (PES) (Problem Identification and Referral CSAP Prevention strategy): A PES shall be completed with each YPI youth participant receiving IPC. The PES documentation shall include the following:

a) Date of exit summary;

b) Participant identifier;

c) Name of prevention staff conducting exit summary;

d) Summary of participant’s success in achieving goals in the indicated prevention service plan, such as behavioral and/or academic achievements or improvements, success in obtaining access to and/or completing recommended services obtained through referrals, etc.;

e) Participant status at closure;

f) Signature of the participant and the prevention staff; and

g) Date prevention staff documents the activity conducted.

7. Provide prevention education using the System Agency approved evidence-based curriculum identified for the target population as specified in Contractor’s response to the solicitation document, as approved by the System Agency. Contractor shall maintain fidelity of the curriculum design. (Prevention Education CSAP Prevention strategy)

8. Implement the System Agency-approved curriculum with individuals who do not meet Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for addiction, but who are showing early danger signs, such as falling grades and consumption of alcohol, and other gateway drugs. The group size for the indicated prevention education services shall be 10-12 youth participants. Contractors shall work with the school personnel to select the participants that meet the selective prevention program criteria. The approved selected curriculum shall be provided to eligible individuals who participate in the YPI program according to the curriculum design. Family-focused curricula shall include the youth participants and their parent or guardian. Contractor shall comply with the recommended group sizes for the YPI program provided in the Curriculum Implementation Plan (CIP) instructions. The indicated prevention program is not an open-ended program and participants shall not be enrolled after the second curriculum session. (Prevention Education CSAP Prevention strategy)

9. Have received written approval from the System Agency and Curriculum Developer prior to implementing the curriculum with any adaptation or modification to the System Agency approved implementation structure based on the curriculum design. Contractor shall submit a written request with justification for System Agency review and consideration of the curriculum modification or adaptation. Upon review, the System Agency shall provide written approval or disapproval to the Contractor. (Prevention Education CSAP Prevention strategy)

10. Ensure that the program design, content, communications and materials are culturally, linguistically, and developmentally appropriate to the target population, as evidenced by:

a. Pamphlets and other written materials that are gender- and age-specific and appropriate for educational and health literacy levels of the target population;

b. Literature and signage in languages of the target populations;

c. Use of interpreters, as appropriate;

d. Lobby and office environment welcoming to the target populations; and

e. Training curricula and personnel records that document adherence to staff competency requirements.

11. Complete a CIP for each school semester (Fall and Spring) that details the prevention education activities that will be conducted during the term of this Program Attachment for System Agency review. Contractor shall submit Fall Semester CIP by September 30, and Spring Semester CIP by January 31 to the System Agency for review and to receive technical assistance, if necessary. Contractor shall update the CIP as changes occur to ensure that the CIP matches the Curriculum Outcome Measures Report.

12. Conduct AOD presentations for youth and adults in school and/or community settings. The AOD presentations shall have an educational goal and objective specific to the presentation topic to prevent or reduce AOD among youth and adults. The presentation topics shall be inclusive of the states’ three prevention priorities, alcohol (underage drinking), marijuana, and prescription drugs. The AOD presentations shall include educational information regarding drugs and their health consequences. Facilitators shall engage participants for a minimum of thirty (30) minutes (with the same audience) when conducting an AOD prevention presentation. (Information Dissemination CSAP Prevention strategy)

13. Conduct tobacco-specific presentations for youth and adults in school and/or community settings. The tobacco presentations shall have an educational goal and objective specific to the presentation topic to prevent or reduce tobacco use among youth and adults. The presentations shall include educational information including, but not limited to the following: the health consequences of tobacco use, information on tobacco cessation, and information on the state tobacco laws as they apply to minors. Facilitators shall engage participants for a minimum of thirty (30) minutes (with the same audience) when conducting a tobacco prevention presentation. (Information Dissemination CSAP Prevention strategy)

14. Ensure that all AOD alternative activities (Alternative Activities CSAP Prevention strategy) are facilitated by prevention program staff and include an educational goal and objective to prevent or reduce substance use/abuse. The AOD alternative activities shall be substance-free, age-appropriate, and teach and/or reinforce skills that promote a healthy and substance-free lifestyle. The AOD alternative activities shall serve as an alternative to activities that may otherwise lead to the use of alcohol and other drugs. AOD alternative activities shall not include trips to theme parks, camping, fishing, overnight activities or similar outings unrelated to AOD prevention education with the exception of those listed below. Facilitators shall engage participants for a minimum of thirty (30) minutes (with the same participant audience) when conducting an AOD alternative activity.

The following examples of System Agency approved substance-free alternative activities that can be tailored to focus on AOD prevention for this Program Attachment service requirement. Each example listed below shall include an AOD specific interactive learning activity:

a. Activities or games that focus on teaching or reinforcing skills learned or taught through the curriculum;

b. Activities or games that teach leadership skills, and promote team-building and peer-bonding;

c. Cultural awareness activities designed to increase knowledge of heritage and/or other cultures;

d. Community service projects;

e. Arts and crafts activities;

f. AOD poster contests;

g. Sport activities that promote team-building and peer-bonding such as basketball, soccer, baseball, etc.; and

h. Red Ribbon and related activities.

Equipment rental is an allowable cost for large AOD alternative activities/events conducted for 50 or more individuals and shall not exceed $150 per event.

Additional guidance for AOD alternative activities may be obtained from System Agency program staff.

15. Ensure that all tobacco prevention alternative activities (Alternative Activities CSAP Prevention strategy) are facilitated by prevention program staff and include an educational goal and objective to prevent the use of tobacco products. The tobacco prevention alternative activities shall create awareness of the health consequences of tobacco use and include tobacco prevention strategies. The tobacco prevention alternative activities shall be substance-free, age-appropriate, and promote a healthy lifestyle. Tobacco alternative activities shall not include trips to theme parks, camping, fishing, overnight activities or similar outings unrelated to tobacco prevention. Facilitators shall engage participants for a minimum of thirty (30) minutes (with the same participant audience) when conducting a tobacco prevention alternative activity.

The following examples of System Agency approved tobacco prevention alternative activities that can be tailored to focus on tobacco prevention for this Program Attachment service requirement. Each example listed below shall include a tobacco specific interactive learning activity:

a. Activities or games that focus on teaching or reinforcing skills learned or taught through the curriculum;

b. Activities or games that promote team-building and promote peer-bonding;

c. Community service projects;

d. Sport activities that promote team-building and peer-bonding such as basketball, soccer, baseball, etc.;

e. The Store Alert Project;

f. Tobacco-Free Kids Day;

g. World Tobacco-Free Day; and

h. Great American Smokeout (GASO).

Equipment rental is an allowable cost for large tobacco alternative activities/events conducted for 50 or more individuals and shall not exceed $150 per event.

Additional guidance for tobacco prevention alternative activities may be obtained from System Agency program staff.

16. Establish and maintain working linkages (Community-Based Process CSAP Prevention strategy) with the schools and community sites where prevention services will be delivered. Contractor shall document these linkages by securing Community Agreements (CAs)/Memoranda of Understanding (MOUs) prior to service delivery. Contractor shall maintain copies of the signed CAs/MOUs on file for System Agency review upon request.

a. All CAs/MOUs shall address the agreed terms between the school and Contractor for service delivery.

b. All CAs/MOUs shall be signed by both parties, contain begin and end dates, and be renewed annually based on service delivery.

17. Establish and maintain working linkages (Community-Based Process CSAP Prevention strategy) through CAs/MOUs with a resource network of community and social service agencies serving or having an interest in the target population. These CAs/MOUs are designed to ensure accessible services for program participants and/or their families. The CAs/MOUs shall encourage networking, service coordination, and referrals to help address gaps in services in their respective regions, communities, and service areas and address the needs of the program participants and/or families. Contracts that are newly funded as of the current fiscal year, shall have CAs/MOUs in place within 60 days of the start date of this Program Attachment. All other contracts, being renewed and continued as of the current fiscal year, shall adhere to the specified quarterly goals, as outlined in Section II: Performance Measures of this Program Attachment. All CAs/MOUs shall be reported into Clinical Management for Behavioral Health Services (CMBHS) system as they are established/renewed each month, in support of their quarterly goal. Contractor shall maintain copies of the signed CAs/MOUs on file for System Agency review upon request.

a. All CAs/MOUs shall address the non-duplication of services.

b. All CAs/MOUs shall address the agreed terms between the entities entering into the agreement which shall include referrals to ensure accessible prevention and support services.

c. All CAs/MOUs shall be signed by both parties, contain begin and end dates, and be renewed annually.

d. At a minimum, Contractor shall have CAs/MOUs with the following entities in Contractor’s service area:

i. All System Agency-funded substance abuse, prevention, intervention and treatment providers;

ii. Education Service Centers (ESCs);

iii. Local Mental Health Authorities (LMHAs); and

iv. Other community social service agencies that may provide support services for the program participants and/or their families.

18. Participate in a System Agency-funded coalition. If a System Agency-funded coalition is not located within Contractor’s services area then Contractor may participate in a non-System Agency-funded coalition.

19. Participate in the statewide Prevention Media Campaign to enhance already reported performance measures by doing the following:

a. Coordinate and collaborate with System Agency prevention program staff and System Agency-funded providers through the Texas Prevention Media Campaign to promote a consistent statewide message for media campaigns focused on the state’s three prevention priorities of alcohol (underage drinking), marijuana, and prescription drugs.

b. Contractor shall support the System Agency-funded Prevention Media Campaign through participation in the statewide media campaign and the annual Red Ribbon Rally media outreach activities.

c. Participate in meetings and conference calls regarding collaboration and participation in the System Agency-funded Prevention Media Campaign.

20. Contractors in regions 8, 9, 10, and 11 shall document the number of participants receiving services who are residents of a Colonia (unincorporated community within 62 miles of the international border), which shall be reported in the monthly performance measures reports submitted in CMBHS. Contractors in these regions shall train staff and develop and maintain a current written policy to ensure that information gathered from participants is conducted in a respectful, non-threatening, and culturally competent manner.

21. Establish and maintain a current inventory and tracking system that reflects the assignment and return of all program curriculum materials issued to and collected from prevention staff (Curriculum Inventory). The Curriculum Inventory shall be updated any time staff changes occur that affect the Curriculum Inventory. Contractor shall complete the Curriculum Inventory and maintain a copy on file for System Agency review upon request.

22. Contractor is required to develop and maintain a current written program plan that will serve as guide for the implementation of the required prevention strategies for the key performance measures, excluding prevention education. Contractor shall maintain a current program plan on file, available for System Agency review upon request. The program plan shall include the following:

a. The planned or projected activities that will be conducted to meet the required key performance measures through the term of this Program Attachment;

b. The date of the projected activity;

c. The projected number of youth and/or adults that will be served; and

d. A strategy to address activities that do not occur as planned or projected.

23. Provide prevention services in a safe, clean, well-lit, and well-maintained environment. The site where activities will be held (including buildings, electrical, lighting, plumbing, sanitation, ventilation and mechanical systems, appliances, equipment, and furniture) shall be structurally sound, functional, and in good repair. The site’s building and grounds shall be clean and free of garbage and debris.

24. Develop and maintain current written policies and procedures for employees, contracted labor, and volunteers who work directly or indirectly with participants. The written policies and procedures shall address participant safety and ensure that all activities with participants are conducted in a respectful, non-threatening, non-judgmental and confidential manner. Contractor shall maintain current policies and procedures on file and make them available for review by the System Agency upon request.

25. Post the prevention Participant Rights during the delivery of educational sessions. Postings shall be displayed in English and in a second language(s) appropriate to the populations served. Postings shall be explained in an appropriate manner to a participant who has an impairment of vision, hearing, or cognition. The Participant Rights shall include the following:

a. Protection against abuse, neglect, and exploitation. Participants shall have the right to be free from abuse, neglect and exploitation;

b. Dignity and Respect. Participants shall have the right to be treated with dignity and respect;

c. Complaints. Participants shall have the right to make a complaint to the Contractor or System Agency at any time;

d. Non-discrimination. The Contractor shall not unlawfully discriminate against a participant based on race, color, national origin, religion, sex, age, or disability; and

e. Program Information. Participants shall have the right to know about the prevention program, including its length.

26. Post in a prominent location legible prohibitions against firearms, weapons, alcohol, and illegal drugs, illegal activities, and violence at program sites that do not have the existing prohibitions posted.

27. Contractor’s administrative site shall post the hours and days of operation at all building entrances. Standard days of operation shall reflect a forty (40)-hour workweek, Monday through Friday.

28. Post exit diagrams conspicuously throughout program sites (except in one-story buildings where all exits are clearly designated as such).

29. Ensure that the Prevention Program Director and one to two (1-2) Prevention Specialists attend the System Agency Annual Behavioral Health Institute (BHI).

30. Ensure that the Prevention Program Director and one to two (1-2) Prevention Specialists attend the System Agency Annual Prevention Provider Meeting to increase their knowledge and skills.

31. Ensure that activities include informational prevention strategies that include the state’s three prevention priorities: alcohol (underage drinking), marijuana, and prescription drugs; and

32. Submit any additional documents and information as requested by System Agency program staff for the purpose of determining and assessing program technical assistance needs.

E. Criminal Background Verification Requirements

Contractor shall:

1. Not employ or allow a subcontractor to use any individual who is on probation or parole to deliver prevention services to youth and/or their families;

2. Prior to employment, conduct criminal background checks and pre-employment drug testing of Contractor’s potential employees and/or subcontractors who will deliver prevention services and/or have direct contact with youth and/or their families;

3. Conduct annual criminal background checks for Contractor’s current staff and/or subcontractors who will deliver prevention services and/or have direct contact with youth and/or their families;

4. Conduct criminal background checks of interns or volunteers who will deliver prevention services and/or have direct contact with youth and/or their families;

5. Ensure that any individual who is on probation, parole and/or is the subject of an ongoing investigation by law enforcement is prohibited from working directly with youth and/or their families;

6. Develop and maintain current written policies and procedures addressing the requirements for criminal background checks as a condition for employment of potential employees, subcontractors, interns, and/or volunteers who work directly with youth and/or their families;

7. Develop and maintain policies and procedures that require individuals (staff, subcontractors, interns, and volunteers) to notify the Contractor of an arrest, conviction, investigation, or any other legal involvement;

8. Maintain documentation of each notification of arrest, conviction, investigation, or any other legal involvement on file and make available to the System Agency for review upon request; and

9. Maintain documentation of each criminal background check and pre-employment drug testing on file and make available to the System Agency for review upon request.

F. STAFFING REQUIREMENTS

1. Within 30 days of the start date of this Program Attachment, the Contractor shall hire the number of prevention program staff specified in Contractor’s response to the solicitation document, as approved by the System Agency, to implement evidence-based substance abuse prevention curricula and conduct the related substance abuse prevention strategies and activities.

2. Within 30 days of the start date of this Program Attachment, the Contractor shall hire a Prevention Program Director to provide oversight and coordination of the YPI program.

3. Notify the System Agency within ten (10) business days of any changes to the YPI program staff. This includes the Program Director and Prevention Specialists.

4. Submit one (1) Substance Abuse Prevention Program Organization Staffing (SAPPOS) Form which includes a list of all the direct prevention staff for the Contractor’s System Agency-funded prevention programs by September 15.

G. STAFF COMPETENCIES

1. Ensure that the requirements in Section G. Staff Competencies apply to all employees, subcontractors, interns, and volunteers that will work directly with youth and/or their families that will implement the evidence-based curriculum and/or conduct any required prevention strategies or activities.

1. Ensure that the Prevention Program Director is a Certified Prevention Specialist (CPS) or an Associate Prevention Specialist (APS) working towards CPS certification. Contractor shall submit a copy of the Program Director’s CPS or APS Designation certificate to the System Agency by September 15.

a. The Prevention Program Director who does not possess a CPS certification shall obtain a CPS certification within 12 months of employment in this position. Contactor shall submit a copy of the Program Director’s CPS certificate within 30 calendar days of his/or her attainment of the CPS certification. Contractor shall maintain a copy of the employee’s CPS certification in the personnel file and make it available for review by the System Agency upon request.

b. Contractor shall ensure that all non-certified prevention staff employed with the organization achieves their APS designation within 20 months of employment for this program. Contractor shall maintain a copy of the employee’s APS designation in the personnel file and make it available for review by the System Agency upon request.

2. Ensure that the Prevention Program Director and all prevention staff complete the following required trainings as specified below:

a. Cardio-Pulmonary Resuscitation (CPR) and First Aid Certifications. Contractor shall ensure that all prevention staff complete and maintain current CPR and first aid certifications within 60 days from the start date of this Program Attachment or 60 days from the date of hire for a prevention position, whichever is later.

b. 15-hour Prevention Training. This required training shall be completed through the System Agency-funded Prevention Training Services (PTS) contractor. Prevention staff shall complete the 15-hour Prevention Training within 6 months from the start date of the Program Attachment or 6 months from the date of hire for any prevention position, whichever is later (or be able to provide documentation that the training has been completed at any time). (This is a one-time requirement that must be completed by the Prevention Program Director and all prevention staff.) The fifteen (15) hours shall include a minimum of three (3) hours in each of the following areas:

i. Cultural competency;

ii. Risk and protective factors/building resiliency;

iii. Child development and/or adolescent development, as appropriate;

iv. Strategies for strengthening families; and

v. Prevention across the life span.

c. Substance Abuse Prevention Skills Training (SAPST). This required training shall be completed through the System Agency-funded PTS contractor. (This is a one-time requirement that must be completed by the Prevention Program Director and all prevention staff. Staff that have a certificate of completion for the previously required Substance Abuse Prevention Specialist Training (SAPST) are not required to attend the new SAPST training.)

i. The Prevention Program Director shall provide documentation of their completion of the SAPST training upon the date of hire for the Prevention Program Director position. Contractor shall maintain a copy of the employee’s SAPST certificate in the employee’s personnel file and make it available for review by the System Agency upon request.

ii. Contractor shall ensure that all other prevention staff employed with the organization complete the SAPST training within 18 months of employment for this program.

d. Evidence-Based Curriculum Training. This required training shall be completed through the System Agency-funded PTS contractor.

i. Prevention Program Director for the YPI program shall complete the evidence-based curriculum training for the specified curriculum in the Contractor’s response to the solicitation document, as approved by the System Agency. The evidence-based curriculum training shall be completed within 60 days from the start date of this Program Attachment or 60 days from the employee’s date of hire for the Prevention Program Director position, whichever is later.

ii. Prevention program staff shall complete the training for the implementation of the evidence-based curriculum specified in the Contractor’s response to the solicitation document, as approved by the System Agency. The evidence-based curriculum training shall be completed within 60 days from the start date of the Program Attachment or 60 days from the date of hire for the Prevention program position, whichever is later. The Prevention program staff shall complete the evidence-based curriculum training prior to service delivery.

e. 15-Hour Prevention Continuing Education. A minimum of 15 hours of prevention continuing education specifically related to prevention or job-related duties shall be completed annually. This required training may be obtained through the System Agency-funded PTS contractor, Behavioral Health Institute (BHI), or other entities approved as continuing education providers by the Texas Certification Board of Addiction Professionals (TCBAP). Information for certification may be found on the TCBAP website at . This training shall be completed by August 31. The 15 hours of continuing education is not required to be completed during the same contract year as the 15-hour Prevention Training listed above.

4. Maintain documentation of credentials and training certificates for Program Director and all prevention staff and subcontractors in personnel files and make available to the System Agency for review upon request.

5. Any interns or volunteers that assist prevention staff with AOD or tobacco presentations, or AOD or tobacco alternative activities at least twelve (12) times per year will be required to complete the following staff competencies:

a. Cardiopulmonary Resuscitation (CPR) and First Aid Certifications;

b. 15-Hour Prevention Training;

c. Contractor training which shall include an overview of the prevention program services.

6. Ensure that interns or volunteers conducting alternative activities or presentations shall have a prevention staff member present.

7. Maintain on file documentation for each individual’s (including interns and volunteers) trainings and make available to the System Agency for review upon request.

H. GUIDANCE ON INCENTIVES AND ALTERNATIVE ACTIVITIES

1. Purchase of food or snacks for participants is allowed for after-school youth and family-focused curricula programs and afterschool alternative activities to be able to actively engage participants and be effective in these activities. For other youth program alternative activities, snacks may be provided to participants only in events lasting at least one half-day, and snacks or light meals may be provided to participants only in full-day activities and events. The cost of snacks, food, or light meals shall be reasonable.

2. Agency shirts or T-shirts (with Contractor’s name and/or logo) for staff conducting program activities are not necessary for performing the duties of this Program Attachment and are not an allowable cost. Reasonable cost to purchase T-shirts for participants, volunteers, and staff with a ‘No use’ ATOD message that provides education and awareness on the harmful effects of ATOD is allowable.

3. Gift cards are an allowable cost only for family-focused curricula programs for families to purchase food as required by the curriculum. Gift cards may be given only to families that cannot afford to purchase the groceries to prepare the meal for the family-focused activity. Contractors shall track the gift cards to ensure they are used for food only. Gift cards shall not be used for alcohol, tobacco, and/or other drug products. Contractors shall maintain receipts and detailed accurate records to ensure appropriate documentation for audits. Gift cards are not allowed as an incentive.

4. Incentives used to engage participants in youth prevention activities purchased with System Agency funds shall be of reasonable cost and shall be imprinted with a drug-free message. Incentive items may include an imprint with the name of the youth prevention program, phone number and/or website, but may not include the organization’s name.

I. SUBMISSION SCHEDULE AND REPORTING REQUIREMENTS

1. Submit all documents identified below by the dates specified by the System Agency. Contractor shall submit documents to the designated System Agency Substance Abuse mailbox (SA mailbox) unless otherwise noted.

2. Contractor’s duty to submit documents shall survive the termination or expiration of this Program Attachment.

3. Submit one Substance Abuse Prevention Program Organization Staffing by September 15.

4. Submit copy of Program Director’s CPS certificate to the System Agency by September 15.

5. Submit a CMBHS Security Attestation Form and List of Authorized Users bi-annually by September 15 and March 15.

6. Complete a separate CIP for the Fall and Spring Semesters. Contractor shall submit the completed CIP to the System Agency as follows: Fall Semester CIP is due by September 30, and the Spring Semester CIP is due by January 31.

7. Submit Performance Measures in the CMBHS system by the 15th day of the month following the month being reported.

8. Document the System Agency defined curriculum outcome measures and the schools and community sites where services were delivered. Contractor shall report each individual curriculum cycle in the CMBHS system within fifteen (15) days after the curriculum cycle is completed.

9. Comply with the System Agency’s definition and minimum performance outcome measure requirements as follows:

a. Completion rate is the number of youth who complete the curriculum cycle being reported (the number of youth that attend the required number of curriculum sessions) divided by the number of youth who were enrolled per group cycle. Contractor shall achieve an eighty percent (80%) completion rate per curriculum cycle.

b. Success rate is the number of youth who successfully completed the curriculum cycle (the number of youth that attended the required number of curriculum sessions and completed the pre and post surveys and maintained or improved their pre/post scores) divided by the number of youth that completed the curriculum cycle. Contractor shall achieve a ninety percent (90%) success rate per curriculum cycle.

c. Overall success rate is the number of youth who successfully completed the curriculum cycle divided by the number of youth enrolled per curriculum cycle. Contractor shall achieve a seventy percent (70%) overall success rate per curriculum cycle.

10. Contractors in Regions 8, 9, 10, and 11 shall report the number of participants receiving services who are residents of a Colonia in the monthly performance measures reports submitted in CMBHS.

11. Submit Financial Status Reports (FSRs) in CMBHS by the last business day of the month following the end of each quarter of this Program Attachment term. The final FSR is due within 45 days after the Program Attachment end date.

12. Submit closeout documents in an annual report due 45 days after the Program Attachment end date.

|Report Name |Due Date |

|Substance Abuse Prevention Program Organization Staffing Form |September 15 |

|Program Director’s CPS Certificate |September 15 |

|CMBHS Security Attestation Form and List of Authorized Users |September 15 & March 15 |

|Curriculum Implementation Plan (Fall) |September 30 |

|Curriculum Implementation Plan (Spring) |January 31 |

|Performance Measures |15th of the month following the month being reported |

|Curriculum Outcome Measures Reports |Due within 15 days after the curriculum cycle is completed |

|Financial Status Reports (FSR) |Last business day of the month following the end of each quarter |

| |of the Program Attachment term. |

| |* Final Financial Status Report (FSR) due October 15. |

|Closeout documents – Annual Report |October 15 |

SECTION II. PERFORMANCE MEASURES

A. Contractor's performance will be measured in part on the achievement of the following key performance measures.

B. Contractor shall report these performance measures monthly through CMBHS under the Measures component.

C. Each report is due by the 15th of the following month for the month being reported.

KEY PERFORMANCE MEASURE(S):

|Measure: |Sep-Nov |Dec-Feb |Mar-May |Jun-Aug |Annual Goal |

|Number of adult involved in tobacco alternative activities | | | | | |

|Number of adults attending alcohol and other drugs (AOD) presentations | | | | | |

|Number of adults attending minors and tobacco presentations | | | | | |

|Number of adults involved in alcohol and other drugs (AOD) alternative | | | | | |

|activities (Do Not Include Tobacco Specific Activities) | | | | | |

|Number of adults receiving alcohol, tobacco and other drugs (ATOD) | | | | | |

|information | | | | | |

|Number of alcohol and other drugs (AOD) presentations | | | | | |

|Number of prevention presentation that include minors and tobacco info | | | | | |

|Number of written Community Agreements (CAs) or Memorandum of | | | | | |

|Understanding (MOUs) | | | | | |

|Number of youth attending alcohol and other drugs (AOD) presentations | | | | | |

|Number of youth attending minors and tobacco presentations | | | | | |

|Number of youth involved in alcohol and other drugs (AOD) alternative | | | | | |

|activities (Do Not Include Tobacco Specific Activities) | | | | | |

|Number of youth involved in tobacco alternative activities | | | | | |

|Number of youth receiving alcohol, tobacco and other drugs (ATOD) | | | | | |

|information | | | | | |

|Number of youth receiving indicated prevention counseling | | | | | |

|Number of youth receiving prevention education/skills training | | | | | |

|(approved evidence-based curriculum) | | | | | |

SECTION III. PROGRAM SERVICE AREA

A. Contractor shall provide the specified services in each of the counties listed in the table below.

B. The curriculum name includes the age ranges for the purpose of identifying the appropriate outcome code based on the Contractor’s proposed curriculum for prevention education.

C. The specific age and grade ranges are those proposed in the Contractor’s proposal for prevention education and shall be the only target age and grade ranges that are served under this Program Attachment. Any changes to the specific age and grade ranges will require the Contractor to submit a written request for approval by the System Agency prior to the delivery of services.

|Counties |Curriculum |Outcome Measure |Age Ranges |

| | | | |

| | | | |

| | | | |

SECTION IV. PROGRAM STRATEGIES

The following strategies are approved and shall be maintained through this Program Attachment:

|Program |Percentage of Effort |

|Information Dissemination |5.00% |

|Prev Educ/Skills Training |65.00% |

|Alternative Activities |10.00% |

|Environmental/Social Policy |5.00% |

|Community Based Processes |5.00% |

|Problem ID and Referral |10.00% |

SECTION V. SOLICITATION DOCUMENT

The Department of State Health Services (DSHS) Behavioral Health Prevention Services Request for Proposals issued on November 5, 2012, RFP# SA-PREV-539.1.

SECTION VI. RENEWALS

None

SECTION VII. PAYMENT METHOD

Cost Reimbursement

Funding is further detailed in the attached Categorical Budget and, if applicable, Equipment List.

SECTION VIII. BILLING INSTRUCTIONS

A. Contractor shall submit all invoices to the System Agency through CMBHS monthly.

B. Contractor shall be paid on a monthly basis and in accordance with services performed under this Program Attachment.

C. All invoices must reference Purchase Order Number.

D. Contractor may access the Transactions List report in CMBHS to identify the amount of federal funds allocated to this award for each transaction.

E. The Catalog of Federal Domestic Assistance (CFDA) number for the Substance Abuse Prevention and Treatment (SAPT) Block Grant is 93.959. The CFDA number is identified in the CMBHS Transactions List report.

SECTION IX. FUNDING

A. Contractor shall contribute an amount equal to at least five percent (5%) of the total System Agency share of the Program Attachment expenditures in matching cash or in-kind contributions from sources eligible to be used for matching purposes.

B. Any unexpended balance associated with any other Program Attachment on the Contract may not be applied to this Program Attachment.

Funding Source: 93.959; State

DUNS Number: XXXXXXX

System Agency Share: $0.00

Match: $0.00

Total: $0.00

SECTION X. SPECIAL PROVISIONS

All requirements identified in the Fiscal Year FY2018 Program Attachment that extend past the term of that Program Attachment shall be due no later than October 15, 2018.

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