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HomeMy WebLinkAboutResolutions - 2004.11.18 - 27616MISCELLANEOUS RESOLUTION 104317 November 18, 2004 BY: General Government Committee, William R. Patterson, Chairperson IN RE: DEPARTMENT OF HUMAN SERVICES/HEALTH DIVISION - SAMHSA TARGETED CAPACITY EXPANSION INNOVATIVE TREATMENT GRANT ACCEPTANCE To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the Oakland County Health Division/Office of Substance Abuse Services has applied for funding from the United States Department of Health and Human Services/ Substance Abuse and Mental Health Services Administration (SAMHSA) for programming which will address expand substance abuse treatment among the Hispanic population in Oakland County (primarily Pontiac); and WHEREAS grant funding has been approved in the amount of $500,000 per year for three years for the Targeted Capacity Expansion Innovative Treatment Grant program; and WHEREAS this program will target 55 adults and 25 adolescents and their families the first year with an additional 200 participants through the remaining two years of the grant; and WHEREAS $424,000 of these funds will be used to subcontract with Easter Seals-Michigan/E1 Centro "La Familia" to prevent and reduce the incidence of drug and alcohol abuse and dependency; and WHEREAS $1,500 will be used by the Office of Substance Abuse for training, $17,500 for administrative expenses, and $57,000 to facilitate detoxification and residential treatment related to this project; and WHEREAS there are no new positions associated with this program; and WHEREAS the grant agreement has been submitted and approved through the County Executive's Contract Review Process. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the Targeted Capacity Expansion Innovative Treatment Grant from the United States Department of Health and Human Services/ Substance Abuse and Mental Health Services Administration in the amount of $500,000 per year for three years. BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to execute the grant agreement and to approve minor changes and grant extensions, not to exceed fifteen (15) percent variance from the original award. BE IT FURTHER RESOLVED that the future level of service, including personnel, be contingent upon the level of funding for this program. Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing resolution. GENERAL GOVERNMENT COMMITTEE ) General Government Committee Vote: I, i, tr.- zAvri r- / Motion carried unanimously on a roll call vote. Tom Fackler From: Greg Givens [givensg©co.oakland.mi.us ] Sent: Wednesday, October 27, 2004 1:19 PM To: Doyle, Larry; Kosik, Sandy; Fockler, Tom Cc: Pearson, Linda; Smith, Laverne; Frederick, Candace; Worthington, Pam; Pardee, Mary; Hanger, Helen Subject: CONTRACT REVIEW — Health Division CONTRACT REVIEW - Health Division GRANT NAME: Targeted Capacity Expansion (TEC) - Culturally Sensitive Substance Abuse Treatment FUNDING AGENCY: US Department of Health and Human Services - SAMHSA DEPARTMENT CONTACT PERSON: Sandy Kosik / 85107 STATUS: Acceptance DATE: October 27, 2004 Pursuant to Misc. Resolution #01320, please be advised the captioned grant materials have completed internal contract review. Below are the comments returned by review departments. The captioned grant materials and grant acceptance package (which should include the Board of Commissioners' Liaison Committee Resolution, the grant agreement/contract, Finance Committee Fiscal Note, and this email containing grant review comments) may be requested to be placed on the appropriate Board of Commissioners' committee(s) for grant acceptance by Board resolution. Department of Management and Budget: Approved.- Laurie Van Pelt (10/8/2004) Department of Human Resources: Approved. - Ed Poisson (10/11/2004) Risk Management and Safety: Approved. - Gerald Mathews (10/14/2004) Corporation Counsel: I have reviewed the Grant Application and the Grant documents and approve the Grant for acceptance and signature. - John Ross (10/27/2004) 1 1,DATE ISSUED (Mo./Day/Yr.) 09/13/20041am:iota 93.243 3.5UPERSEDL5 AWARD NOTICE dated / / except that any additions or DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE 9. GRANTEE NAME AND ADDRESS a. Oakland County b. 1200 N. Telegraph Road d. Pontiac e.MIt48341 0 0 0 0 0 1,500 0 0 0 74,500 424,000 0 0 0 0 500,000 0 500,000 500,000 0 500,000 0 0 $500,000 YEAR YEAR 1 014 COSTS (DIRECT and INDIRECT) d. 0. 1. N/A PO: Lewis, Dorothy B (Jiut) Grants Management Officer, OPS, SAMHSA (240)276-1414 (Name-Typed/Print) Pendleton, Kimberly (240)276-1619 GMS:/Djokou, Emmanuel S MAN t GIBMF4.9ffPICIlets, (S/grLiehrre) af,t4 --100/0f4v restnctions previously imposed remain in effect unless specific* rescinded_ SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION kGRANTNO. 1 H79 TI16366-01 Fans* O. PROJECT PERIOD Mo./Day/Yr. Fon 09/30/2004 7. BUDGET PERIOD Mo./Dayffr. From 09/30/2004 5. ADMINISTRATIVE CODES TI—H79 / TCE MolDarAt nous* 09/29/2007 MonasTr. 11you10 09/29/2005 NK)TKNEOFERANTAWARD AUTHORIZATION (Legislation/Regulation) Section 509 of the Public Health As amended. Funded by CSAT 13. TITLE OF PROJECT (OR PROGRAM) (Limit to 58 spaces) Culturally sensitive substance abuse treatment W. DIRECTOR OF PROJECT (PROGRAM OIRC-CTOR/PRIAPPAL iNVESTIGATOR) (U4ST NAME FIRST AND ADDRESS) Kosik, Sandra Oakland County 1200 N. Telegraph, Road Pontiac, MI 48341 11. APPROVED BUDGET (Ersludes PHS Direct Assistan)ce 12. AWARD COMPUTATION FOR FINANCIAL ASSISTANCE PHS Grad Fists Or* II Total pled costs including grant fund) and all otter tarsi! parliapstkin (Select one and place NUMERAL in box.) a. Salaries and Wages b. Fringe Benefits C Total Personnel Costs cf. Consutant Costs e. Equipment Suppies g. Trayel h. Patient Care - Inpatient - Outpatient j. Alterations and RenovationS k. Other L Ccnsortium/Contractual Costs m. Trainee Related Expanses n. Trainee Stipends o. Trainee Tuition aid Fees p. Trainee Trawl q. TOTAL DIRECT COSTS r$ r. INDIRECT COSTS ewe 00 ltdsewmq s. TOTAL APPROVED BUDGET t WMFee 1$ u. FederWSNm v. Non-Federal Share & Amount of PHS Financial Assistance (from item Ito) b. Less 1.1nobligated Balance From Prior Budget Periods ,, . ..... . . . $ c. Less Cumulative Prior Award(s) This Budget Period... d. AMOLif IT OF FINANCIAL ASSISTANCE THISACT1ON gEcommage D From Suppowr (SUBJECT M DIE AVPIAILITT WEISMAN, SADSFACTORY PROGRESS OF THE MEM' TOTAL COSTS (DIRECT and INDIRECT) 500,000 500,000 N/A 14. APPROVED DIRECT ASSISTANCE BUDGET (IN UEU OF CASH)c a. Amount of PliS Direct Assistance b. Less Unobligated Balance From Prior Budget Periods c. Less Cumulative Prior Award(s) This Budget Period., d. AMOUNT OF DIRECT ASSISTANCE THIS ACTION 15. PROGRAM INCOME SUBJECT TO 45 CFR PAX 74, SUBPART F, OR 45 CFR 9225, SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING ALTERNATIVES: (Select One and Place LETTER in boa.) a. DEDUCTION b. ADDITIONAL COSTS c. MATCHING d, OTHER RESEARCH (Add/Deduct Oplion) e. OTHER (See REACARKS1 111. THIS MORD IS BASED ON M APFIJCATION SVISMITTIZI TO. MO AS APPROM BY, TNE PIO ON TIE IJKIVE MED PROJC-CT AND IS SMUT TO THE TERMS MD COMMONS INCORPORATED DRIER DIRECTLY OR BY REFERENCE N THE FOLLOWER a. The grant program legislation cited above. b. The grant program regulation cited above. c. The award notice including terms and conditions, if any, noted below under REMARKS. d. PHS Grants Policy Statement Including addenda in effect as of the beginning date of the budget period. 0.45 CFR Part 74 or 45 CFR Part 92 as applicable. In the event there are conflicting or othenvise inconsistent policies applicable to the grant, the above order of precedence shall prevail Acceptance of the grant terms and conditions M acknowledged by the grantee when funds are drawn or otherwise obtained from the grant payment system. a. 02 b. 03 C. REMARKS: (Other Terns and Conditions Attaated 121 Yes El No) This award reflects a correction to the indirect cost line item since there is no rate agreement to support the indirect charges. The "other" line item was increased to accommodate this change. Recommended future support (Line 13) reflects Total Cost (Direct + Indirect). See attached terms and conditions. 17. OBJ. CLASS. 7 41.45 1 113. CRS - EIN 1386004876A1 119. LIST NO: FYCAN °comer NO. ADMHSTRATIVE WOE MT. ACTION FIN. ASST. 04t1. ACTION DIR. ASST. 20.a. ' 2004C96T112 b. H9TI16366A d. d. $500,000 21.a b. G. a. a. Ma. b. 5. d. e. PHS-5152-3 (REV. 7192) 17194-- (Note: See reverse for payment information.) -2 Rockville MD 20857 September 20, 2004 Sinc9fely your DEPARTMENT OF HEALTH & HUMAN SERVICES Substance Abuse and Mental Health Services Administration RE: 1 T116366-01 Dear Grantee: You have been awarded support for your competing grant application by the Substance Abuse and Mental Health Services Administration (SAMHSA). A Notice of Grant Award (NGA) is enclosed with terms and conditions attached that require compliance. Drawing down funds from your account under the Payment Management System (PMS) constitutes acceptance of this NGA and the terms and conditions. Contact the Division of Federal Assistance Financing, DASP/DASF/OS/DHHS, P.O. Box 6021, Rockville, MD 20852 at 1-877-614-5533 for instructions on accessing funds. A copy of the PHS Grants Policy Statement (Rev. April 1, 1994) which is a compilation of the salient features of policies and various policy issues regarding administration of grant awards is available at www.nhs.gov/grantsnet/roadmap/index.html . Other compliance issues, referenced in order of precedence on the NGA (Item 16), may also be obtained through this website. You should obtain copies of the (1, -:uments for review and retention. The SAMHSA website at www.samhsa.gov (link on "grants" and the'"( ints Management at SAMHSA") provides answers to many grant relate questions including but not limited to the Division of Payment Mangement information, DHHS Division of Cost Allocation offices and Postaward Administration Requirements, etc. Most responses to reporting requirements, (unless specified by your project officer, i.e., timing and submission of progress report), terms and conditions and requests for post award amendments must be mailed to the attention of CSAT, CSAP or CMHS, Division of Grants Management, OPS, SAMHSA, 1 Choke Cherry Road, Room 7-1091, Rockville, MD 20857. If you need help or have concerns about the technical programmatic aspects of this project, please contact the Project Officer. Contact the Grants Management Specialist about the financial/business management aspects of this project which includes the interpretation of grant policy issues. The names of these individuals, including their phone numbers, are located in the "Remarks" section of the NGA. In communicating with your applicable Center, be sure to reference the grant number located in Item 4 of the NGA and Federal program title in Item 5. Correspondence must have the authorized official signature of the grantee institution. Failure to clearly reference the grant number and program title can impede our ability to respond to your requests. Kimberly Pendleton Division of Grants Management Office of Program Services, SAMHSA cc: Program Director 2. ( 3. ( GRANT PAYMENT INFORMATION NOTE APPROPRIATE PAYMENT SYSTEM CHECKED BELOW 1. ( X ) Payments under this award will be made available through the DHHS Payment Management System (PMS). PMS is administered by the Division of Federal Assistance Financing (DFAF), Office of the Deputy Assistant Secretary, Finance, which will forward instructions for obtaining payments. Inquiries regarding payment should be directed to: Division of Federal Assistance Financing DASP/DASF/OS/DHHS P.O. Box 8021 Rockville, MD 20852 Help Desk Support - Telephone Number 1-877-614-5533 Payments under this award will be made available through the Accounting and indirect Cost Section, Federal Assistance Accounting Branch of the National Institutes of Health. Inquiries regarding payment should be directed to: Accounting and Indirect Cost Section Federal Assistance Accounting Branch National Institutes of Health Building 31, Room B11304 9000 Rockville Pike Bethesda, MD Telephone Number (301) 496-5635 Payments under this award will be made available through the Grants Section, General Accounting Branch of the Health Resources and Services Administration. Inquiries regarding payment should be directed to: Grants Section, General Accounting Branch Health Resources and Services Administration Parklawn Building, Room 16-23 5600 Fishers Lane Rocicvffle, MD 20857 Telephone Number (301) 443-1463 4.( ) The HHS Inspector General maintains a toll-free hotline for receiving information concerning fraud, waste, or abuse under grants and cooperative agreements. Such reports are kept confidential and callers may decline to give their names if they choose to remain anonymous. The numbers are: Phone: 1-800-HHS-TIPS (1-800-447-8477) Fax 1-800-223-8164 Email: HHSTIPSQoig.hhs.gov TTY: 1-800-337-4950 The mailing address is: Office of Inspector General Department of Health and Human Services Attn: HOTLINE 330 Independence Ave.. SW Washington, DC 20201 PHS 5152-3 (Back) Rev. 7/92 TCE Innovative Treatment Grant # 1 H79 TI16366-01 SPECIAL CONDITION(S) OF AWARD: NONE SPECIAL TERM(S) OF AWARD: NONE STANDARD TERMS OF AWARD: 1. This grant is subject to the terms and conditions, included directly, or incorporated by reference on the Notice of Grant Award. Refer to the order of precedence in Block 16 on the Notice of Grant Award. 2. The grantee organization is legally and financially responsible for all aspects of this grant, including funds provided to sub-recipients. 3. Grants funds cannot be used to supplant current funding of existing activities. 4. The recommended future support as indicated on the Notice of Grant Awarded reflects TOTAL costs (direct plus indirect). Funding is subject to the availability of Federal funds, and that matching funds, (if applicable), is verifiable, progress of the grant is documented and acceptable. 5. By law, none of the funds awarded can be used to pay the salary of an individual at a rate in excess of the Executive Level I, which is $175,700 annually. 6. "Confidentiality of Alcohol and Drug Abuse Patient Records" regulations (42CFR 2) are applicable to any information about alcohol and other drug abuse patients obtained by a "program" (42 CFR 2.11), if the program is federally assisted in any manner (42 CFR 2.12b). Accordingly, all project patient records are confidential and may be disclosed and used only in accordance with (42 CFR 2). The grantee is responsible for assuring compliance with these regulations and principles, including responsibility for assuring the security and confidentiality of all electronically transmitted patient material. 7. Accounting Records and Disclosure - Awardees and sub-recipients must maintain records with adequately identify the source and application of funds provided for financially assisted activities. These records must contain information pertaining to grant or subgrant awards and authorizations, obligations, unobligated balances, assets, liabilities, outlays or expenditures, and income. The awardee, and all its sub-recipients, should expect that SAMBSA, or its designee, may conduct a financial compliance audit and on-site program review annually on grants with significant amuunis of Federal funding. 8. Per (45 CFR 92.34) and the PITS Grants Policy Statement, any copyrighted or copyrightable Page 2 - Grant # 1 1-179 T116366-01 works developed under this cooperative agreement/grant shall be subject to a royalty free, nonexclusive and irrevocable license to the government to reproduce, publish, or otherwise use them and to authorize others to do so for Federal Government purposes. Income earned from any copyrightable work developed under this grant must be used a program income. 9. A notice in response to the President's Welfare-to-Work Initiative was published in the Federal Register on May 16, 1997. This initiative is designed to facilitate and encourage grantees and their sub-recipients to hire welfare recipients and to provide additional needed training and/or mentoring as needed. The text of the notice is available electronically on the OMB home page at www.whitehouse.gov/wh/eop/omb. 10. The DIMS Appropriations Act requires that to the greatest extent practicable, all equipment and products purchased with funds made available under this award should be American made. 11. Program Income accrued under the award must be accounted for in accordance with (45CFR 74.24) or (45 CFR 92.25) as applicable. Program income must bereported on the Financial Status Report, Standard Form 269 (long form). Program income accrued under this award may be used in accordance with the additional costs alternative described in (45 CFR 74.24(b)(1)) or (45 CFR 92.25(g)(2)) as applicable. Program income must be used to further the grant objectives and shall only be used for allowable costs as set forth in the applicable OMB administrative requirements. 12. Actions that require prior approval must be submitted in writing to the Grants Management Officer (GM0), SAMHSA. The request must bear the signature of an authorized business official of the grantee organization as well as the project director. Approval of the request may only be granted by the GMO and will be in writing. No other written or oral approval should be accepted and will not be binding on SAMHSA. 13. Any replacement of, or substantial reduction in effort of the Program Director (PD) or other key staff of the grantee or any of the sub-recipients requires the written prior approval of the Grants Management Officer. The GMO must approve the selection of the PD or other key personnel, if the individual being nominated for the position had not been named in the approved application, or if a replacement is needed should the incumbent step down or be unable to execute the position's responsibilities. A resume for the individual(s) being nominated must be included with the request. Key staff (or key staff positions, if staff has not been selected) are listed below: Sandra L. Kosik, Project Director, In-kind EMS-EL, Evaluator, @ Unstated level of effort 14. None of the Federal funds provided under this award shall be used to carry out any program for distributing sterile needles or syringes for the hypodermic injection of any illegal drug. 15. Refer to the back of the Notice of Grant Awarded for information regarding grant payment information (1) and the Health and Human Services Inspector General's Hotline for information Page 3 - Grant # 1 H79 T116366-01 concerning fraud, waste or abuse. 16. As the grantee organization, you acknowledge acceptance of the grant terms and conditions by drawing or otherwise obtaining funds from the Payment Management System. In doing so, your organization must ensure that you exercise prudent stewardship over Federal funds and that all costs are allowable, allocable and reasonable. 17. No DHEIS funds may be paid as profit (fees) per (45 CFR Parts 74.81 and 92.22(2)). 18. RESTRICTIONS ON GRANTEE LOBBYING (Appropriations Act Section 503). (a) No part of any appropriation contained in this Act shall be used, other than for normal and recognized executive-legislative relationships, for publicity or propaganda purposes, for the preparation, distribution, or use of any kit, pamphlet, booklet, publication, radio, television, or video presentation designed to support or defeat legislation pending before the Congress, except in presentation to the Congress itself or any State legislature, except in presentation to the Congress or any State legislature itself. (b) No part of any appropriation contained in this Act shall be used to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence legislation or appropriations pending before the Congress or any State legislature. REPORTING REQUIREMENTS: 1. Financial Status Report, Standard Form 269 ( long form) is due within 90 days after expiration of the budget period, and 90 days after the expiration of the project period. Disbursements reported on the Financial Status Report must equal/or agree with the Final Payment Management System Report (PMS-272). 2. Submission of Programmatic Quarterly Reports is due no later than the dates as follows: 1st Quarterly Report - January 31, 2005 2nd Quarterly Report - April 30, 2005 3rd Quarterly Report - July 31, 2005 4th Quarterly Report - October 31, 2005 3. The grantee must comply with the GPRA requirements that include the collection and periodic reporting of performance data as specified in the RFA or by the Project Officer. This information is needed in order to comply with PL 102-62 which requires that SAMHSA report evaluation data to ensure the effectiveness and efficiency of its programs. 4. Submission of audit reports in accordance with the procedures established in OMB Circular A-133 is required by the Single Audit Act Amendmtnts of 1966 P.L. 104-156). An audit is required for all entities which expend $500,000 or more of Federal funds in each fiscal year and is due to the Clearinghouse within 30 days of receipt from the auditor or within nine (9) months of the *SST CONTACTS: Grants Management Specialist: Name :Emmanuel Djokon Federal Project Officer: Dorothy D. W1J Page 4 - Grant # 1 H79 1116366-01 fiscal year, whichever occurs first, to the following address: Federal Audit Clearinghouse Bureau of the Census 1201 E. 10th Street Jeffersonville, IN 47132 Failure to comply with this requirement may result in DHHS sanctions placed against your organization, i.e., classification as high risk, conversion to a reimbursement method of payment, suspension or termination of award. HUMAN SUBJECTS; Under governing regulations, Federal funds administered by the DIIHS shall not be expended for, and individuals shall not be enrolled in research involving human subjects without prior approval by the Substance Abuse and Mental Health Administration of the project's procedures for protection of human subjects. This restriction applies to all Multiple Project Assurance grantee institutions and performance sites without human subjects certification. For institutions with a Single Project Assurance, but no certification at time of award, no funds may be expended or individuals enrolled in research without prior approval by the Office for Human Research Protection (OHRP) of an assurance to comply with the requirements of (45 CFR 46) to protect human research subjects. INDIRECT COSTS: 1. Grantees that have established indirect cost rates are required to submit an indirect cost proposal to the appropriate office within 90 days from the start date of the project period. If the grantee requests indirect cost reimbursement but does not have an approved rate agreement at the time of award, the grantee shall be limited to a provisional rate equaling one-half of the indirect costs requested, up to a maximum of 10 percent of salaries and wages only. SAMHSA will not accept a research indirect cost rate. The grantee must use an other-sponsored program rate or lowest rate available. Please contact the appropriate office of the Division of Cost Allocation to begin the process for establishing an indirect cost rate. A list of the offices was included with your application package and through the SAMHSA website www.samhsa.gov then click on "grant opportunities" then search MIS Division of Cost Allocation Regional Offices. Address:. See Below Address : Systems Improvement Branch Page 5 - Grant # 1 H79 TT16366-01 1 Choke Cherry Road, Room 5-1002 Rockville, MD 20857 Phone :(240) 276-1414 Fax :(240) 276-1430 E-mail :edjokou@samhsa.gov Phone :(240) 276-1619 Fax :(240) 276-2970 E-mail :dlewis@samhsa.gov All responses to special terms and conditions of award and postaward requests must be mailed to the Division of Grants Management, OPS, SAMIISA below: For Regylar Delivery: Division of Grants Management OPS, SAMBSA 1 Choke Cherry Road,Room 7-1091 Rockville, MD 20857 For Overnight or Direct Delivery: Division of Grants Management, OPS, SAMHSA 1 Choke Cherry Road, Room 7-1091 Rockville, MD 20850 • APPLICATIO Version 7/02 FEOERALASSMTANCE 2. DATE SUBMITTED Applicant Identifier 9-21-na 1. TYPE OF SUBMISSION: 3. DATE RECEIVED BY STATE I Stale Application Identifier -- ApplicatIon Fre.application L. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier 0 Construction .0. Construction 1 zi2n-C o n s t r u ct fal _I'L_ _-_Cpristruct • 6 APPLICANT INFORMATION Legal Name: Organizational Unit: Oakland County Department:Hum an Services Organizational DUNS;• Division; Health Division 136200362 nffi,p, IX ca_linfn"r.oa Ahlica,..gervices Address: Name and telephone number of parson to be contacted on matters Street: involving this application (gIve area code Prefix; First Name:S Sandr a r a 1200 N. Tele g raph Rd. Ms , AMC City:Middle Name Pontiac L . County: Oakland Last Name. .Kosik l State: hip Code 48341 Suffix: MI . Gauntry: Email: USA kosiks@co.oakland.mi.us 8. EMPLOYER IDENTIFICATION NUMBER WM: Phone Number (give wee code) I Fax Number Wive area code) 248-858-5107 248-452-8672 L TYPE OF APPLICATION; 7. rreE OF APPLICANT: (See back of form for Application Types) IiKI Now ID Continuation TO Revision Count y Government If Revision, enter appropriate fetter(s) in box(es) (See back of form for description of letters.) C • Other (spedfy) 0 Other {specify) 9, NAME OF FEDERAL AGENCY: SAMHSA 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE HUMERI 11. DESCRIPTIVE TITLE OF APPLICANTS PROJECT: Egl -EEO Culturall y sensitive substance TITLE (Name cr( Pragrarn): abuse treatment TCE Grant ,. 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, efc): Oakland Count y 13, PROPOSED PROJECT ta.. CONGRESSIONAL DISTRICTS OF: Start Date: Ending Date; a. Applicant b. Project 1 0 - 1-04 9-30-0:7 9 • , 15. ESTIMATED FUNDING: 1 1e. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE 1 1st ear 'ORDER 12372 PROCk5s7 a Federal . ..,. ,_ in THIS PREAPPLICATIONJAPPLICATION WAS MADE i 500, 0 0 0 ' Yea. l'-' AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 : b. Applicant PROCESS FOR REVIEW ON • c. State . DATE: d. Local b. No. in PROGRAM IS NOT COVERED BY E. 0. 12372 a. Other n OR PROGRAM HAS NOT BEEN SELECTED BY STATE I, Program Income $ .u. •'" FOR RgVIEW .17, IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? .TOTAL $ 500 , 00 0 - ID Yes If "Yee attach an explanation. 42 No 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS ApPLICATION/PREAPPLICATI N ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING 800Y OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE I ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. A.,....9titbs epteisontative . Prefix First Name rdliddla Name , Mr David —, lost Name , _...4"..„, _ .. ••—, Suffix “..,,...,...,t ,„, ... ,..• N. -\ .I t y'r-. -laper-p ,..6 om'in i i o n earisaPhas 7 rhrnbtrgte. anon) . ." • : Ki A r-1 .1 , 1 revious Edified US:3W? - Previous Edified US:3W? - Authorized for Local Reproduction / ?a. Date Signed 5-*, 27 Standard Form 424 (Rev.9-2003) Prescribed by OMB Circular A-182 • . , ABSTRACT The Oakland County Health Division/Office of Substance Abuse Services (OSAS) is applying for a federal targeted capacity expansion grant through the Office of Substance Abuse and Mental Health Services Administration (SAMHSA) to expand substance abuse treatment among the Hispanic population. OSAS will contract with Easter Seals-Michigan and providers of residential services to implement this project to provide culturally competent services to the community in Oakland County. The target population for this program will be members of the Hispanic community of Oakland County, which includes individuals, families and adolescents impacted by substance abuse. The proposed program will directly service a total of 55 adults and 25 adolescents and their families during its initial year of implementation, and an additional 200 participants throughout the remaining two years of the grant. The purpose of the proposed project is to reduce the impact of alcohol and other drugs (ATOD) use on Hispanic adults, adolescents and families. We are proposing to implement two evidenced- based treatment modalities: the Brief Strategic Family Therapy (BSFT) and Cognitive- Behavioral Therapy (CBT) through a sub-contract with Easter Seals-Michigan/E1 Centro "La Familia" and other residential treatment providers. The BSFT is an effective, problem-focused and practical approach to the "treatment" of conduct problems, early drug use and accompanying family interactions; all of which are recognized risk factors for substance abuse. It successfully reduces problem behaviors with 6 to 17-year-old children and adolescents and strengthens their families. CBT assumes that individuals with substance abuse problems have poor coping skills, choose not to use the skills they have or are inhibited from using effective coping skills. CBT is effective because it helps clients recognize the situations in which they are likely to use substances, find ways of avoiding those situations and cope more effectively with the variety of feelings and behaviors related to their substance abuse. These models will be offered via individual and group therapy sessions, adolescent and family groups and support groups. Increasing awareness of the problem, improving families' access to bilingual and culturally- sensitive substance abuse services and improving retention and completion of services through extensive outreach will help produce meaningful results. 2 III. TABLE OF CONTENTS I. Face Page 1 II. Abstract 2 III. Table of Contents .3 IV. Budget .4 V. Project Narrative and Supportive Documentation .6 A. Statement of Need . 6 B. Proposed Evidenced-Based Service/Practice ... 11 B.1. Objectives 12 B.2. Evidenced-based services 13 B.3. Justification of selected practices 14 B.4. Addressing the needs of the target population .14 B. 5. Logic model of proposed project 15 - C. Proposed Implementation Approach 16 C.1. Contracting for Culturally Competent Services .16 C.2. Key staff and timeline 17 C.3. Recruiting target population .19 C.4. Input provided by members of target population 19 C.5. Program relationship to existing services and community Partners .20 C.6. Ensuring planning and implementation timeliness 20 C.7. Potential barriers ... 20 C.8. Sustaining resources 20 D. Staff and Organizational Experience .22 D.1. Experience in providing culturally competent services • .22 D.2. Key project staff 24 D.3. Staffing characteristics of key and non-project staff 25 D.4. Resources available for project .25 E. Evaluation and Data 26 F. Literature Citations 31 G. Budget Justification .32 H. Biographical sketches and job descriptions 34 I. Confidentiality SAMHSA participant protection .43 VI. Appendices 46 Appendix 1. Letters of commitment/support 47 Appendix 2. Data collection Instruments/Interview Protocols 54 Appendix 3. Sample of Consent Forms 64 Appendix 4. Letter to Single state agency .70 Appendix 5. County Strategic plan- support letter 72 VII. Assurances— non-construction programs 74 VIII. Certifications 77 , IX. Disclosure of Lobbying Activities ... 81 . 521 X. Cheult.libt 3 V. PROJECT NARRATIVE Section A: Statement of Need Drug abuse and addiction encompass a public health problem that affects many people and has wide-ranging social cost, including health consequences, financial hardship, and criminal behavior. Most of the society tends to typify people who take drugs as morally weak or as having illegal tendencies. A lack of cultural understanding makes them believe that drug abusers and addicts should be able to stop taking drugs if they are willing to modify their behavior. These beliefs have incorrectly stereotyped those with drug-related problems, their families, their communities, and their health care providers (National Drug Control Strategy, 2002). Recent studies have shown increase in the prevalence of severe drug problems and their consequences - notably from the epidemic of intensive/heavy cocaine use and from the increased spread of the HIV epidemic, both of which were in their early stages in mid 80's (Cultural Issues in Substance Abuse Treatment, 2001). Current statistics are alarming, for example the 2000 Drug Abuse Warning Network (DAWN) major findings included a 601,776 estimated drug- related emergency department (ED) episodes where alcohol-in-combination with other drugs was the most frequently mentioned drug at time of ED admission (204,524). From 1999 to 2000, total drug related ED visits increased 20% for clients age 12 to 17and 13% for clients age 18 to 25, but remained stable for older age groups (Gilvarry, 2000). The proposed project will serve Oakland County, a large county of 1.2 million residents on the northern border of Detroit, Michigan. The 30 cities, 10 villages and 21 townships within the county's border vary widely in ethnic makeup and socioeconomic status and range from rural to suburban to urban. Prevalence data provided by the state substance abuse agency estimates that 11.6% of the Oakland County population is in need of substance abuse treatment. The Oakland County Health Division/Office of Substance Abuse Services (OSAS) is one of sixteen state regional coordinating agencies (CA's) whose functions include need determination, comprehensive planning, subcontracting for prevention and treatment services, administration and management, data collection, utilization review and program monitoring for fiscal accountability and clinical quality within their region. CA's administer Federal Substance abuse Block Grants and state federal funds received through the services in their region. The OSAS FY 03/04 funded network includes 19 prevention programs and 35 uvatment programs. During FY 02/03, although less than 5,000 individuals (Medicaid and uninsured) received treatment services through our funding, only 218 individuals (4.4%) identified themselves as Hispanic. In Oakland County, there is one outpatient substance abuse treatment program that has one bilingual staff and there is another program that has several bilingual staff providing substance abuse treatment services. We are obviously not reaching the Hispanic population. Children and adolescents from families at risk for substance abuse and violence experience r significant health and developmental problems. Hispanic families are less likely to receive services that are linguistically and culturally appruptiate. • 6 A.1. Target Population The target population for this program will be members of the Hispanic community of Oakland County which includes individuals, families and adolescents impacted by substance abuse. The proposed program will directly service a total of 50 individuals and 25 adolescents and their families during its initial year of implementation and an additional 200 participants throughout the remaining two years of the grant. The socioeconomic variables that affect general health and well being also reliably predict the likelihood of accessing health services. Appropriate health services, particularly preventive care, is least likely for those without health insurance, persons living at or below the poverty level or living in a low-income household. The poorly educated, the young, and those without a primary care provider also lack appropriate health care services. All of these conditions prevail in Hispanic communities. Hispanics are highly traditional in their health practices and are commonly distrustful of physicians and modem medical practices and technology. For example, 33% of Latinos versus 24% of the total U.S. population believe that home remedies are more effective at treating illness than prescribed medications. While this may stem from their traditional health beliefs, it is amplified by dissatisfaction with services and the approach of various American health care providers. Traditional concepts of illness and healing are often at odds with the American diagnostic and clinical practices. Many Hispanics believe that illness can be caused by psychological states such as embarrassment, envy, anger, fear, fright, excessive worry, turmoil in the family, improper behavior or violation of moral or ethical codes. Environmental or natural conditions such as bad air, germs, dust, excess cold or heat, bad food, or poverty; and supernatural causes such as malevolent spirits, bad luck, or the witchcraft of living enemies (who are believed to cause harm out of vengeance or envy) are also believed to cause illness by the Hispanic population. Moreover, Hispanic patients may view mental health problems as a sign of weakness and these problems may carry stigma. Consequently, physical symptoms may be a more appropriate conduit for support. Hispanics have a high incidence of mental health problems, particularly depression, anxiety and substance abuse. A major contributing factor involves the stressors of cultural transition caused by immigration, acculturation and biculturalism. These stressors are often manifested in feelings of irritability, anxiety, helplessness and despair. Hispanics may mourn the loss of family, friends, language and culturally determined values and attitudes. These reactions are not signs of individual pathology, but rather normal responses to the often-disruptive process of change. Several stressors are related to social adjustment to the dominant culture that affects several generations of Hispanics. Three stressors are: • Acculturative stress that is most typically felt by immigrants who are faced with the turmoil of leaving their homeland and adapting to a new society • Ethnic minorities who feel disempowered because of inadequate financial resources and limited social class standing often experience socioeconomic stress • Minority stress refers to the tensions that minorities encounter resulting from racism 7 qt' Ethnocentrism and lack of cultural training among health care providers and, thus, the inability or failure to provide culturally sensitive medical advice and services reduces the effectiveness of treatment, patient education and disease prevention within the Hispanic community. Awareness of such cultural beliefs and practices often explains poor patient compliance with recommended treatment, making it crucial for health care providers to identify if and how their recommendations may be culturally incompatible with the patient's idea of what treatments are effective. Health care providers who take the time to explain the reasoning behind certain treatments and who discuss and respect the perspectives of immigrant patients will experience improved clinical outcomes.' Hispanic culture is based on strong familial ties and interdependency among members of a family. It is not uncommon for a home to include extended family members, all of whom are seen as an integral part of the close family experience and as a result, decision-making regarding health care is often done as a family. It is therefore important for health care providers to consult with family members and to encourage them to express their opinions during the initial consultation and throughout patient's care. Analysis of data from a nationally representative sample of Hispanic youth (age 12-17) and their parents investigated the impact of a number of variables on youths' drug-using behavior. The significance of youth, household and parental characteristics were tested using measures of youth drug use as dependent variables in regression models. Parents' attitudes and use of licit and illicit drugs were found to play an important role in their children's drug use behavior. The results also provide some support for the hypothesis that Hispanic children whose parents are more acculturated into American society are at higher risk of using drugs. Youths of Mexican origin, youths living outside large metropolitan areas and females were found to be more likely to use drugs. The results provide supportive evidence that drug prevention education programs must be family-oriented to be effective with Hispanic youths. (Protective and Risk Factors Associated -- With Drug Use Among Hispanic Youth, Gfroerer, J.; De La Rosa, M. Journal of Addictive Diseases 12(2): 87-107, 1993). Data from SAMSHA has revealed the racial/ethnic disparities in the US substance abuse - epidemic. For example, data from the 1999 Household Survey of Drug Abuse demonstrate that alcohol abuse is higher among racial/ethnic minority groups and alcohol appears to be the major drug of choice among Hispanics, with more than half (58.5%) reporting that they had used alcohol in the past year. Rates of heavy alcohol use (five or more drinks per occasion on five or more days in the past 30 days) are higher among Mexican-Americans (6.9%) than among non- Hispanic whites (5.3%) or non-Hispanic blacks (4.7%). 1 Furthermore, data indicate that rates of alcohol use increase‘with acculturation among all U.S. Hispanic groups. This trend is particularly evident among Hispanic women. Hispanic males are more likely to have used alcohol in the past year (68.3%) than Hispanic females (48.4%). However, current data demonstrates that among Hispanic youth, 18.8% of Hispanic males report alcohol use in the past month compared to 19.1% of Hispanic females. A Primer of Cultural Proficiency: Towards Quality Health Services for Hispanics, National Alliance tor Hispanic health, 2001 8 The co-occurrence of addictive disorders among persons with mental disorders is gaining increasing attention from mental health professionals. Among adults aged 18 years ahd older in the general population with a lifetime history of any mental disorder, 29% have a history of an addictive disorder; those with an alcohol disorder, 37% have had a mental disorder; and among those with other drug disorders, 53% have had a mental disorder. Of those with serious and persistent mental illness, 27% have both mental and addictive disorders. Adding further complications are the serious barriers to the receipt of services for these families, including language and a need for transportation. Focus groups conducted during the last three months of 2003 indicated that lack of available transportation and mothers' lack of driving abilities were major barriers to accessing services and using community resources. This also holds true in many situations when a family with language barriers needs to access other health or human services in the community. When interfacing with Hispanics, appreciation of not only the Spanish language, but also the variety of dialects and accents, idioms and colloquial meanings among different Spanish-speaking sub-groups is crucial to becoming culturally proficient. In addition, direct translation of English into other languages without a cultural awareness of the meaning, idioms, slang usage and various contexts in which those languages are used, can lead to confusion and miscommunication. Other factors, including environment, economics, genetics, previous and current health status, and psychosocial factors exert considerable influence on well-being. Migration and separation from family may cause stress in Hispanic patients who are used to making decisions in collaboration with other family members. The values of young immigrant workers or couples new in the United States may clash with those of other family members. Similarly, teenagers who quickly acculturate to the United States and the manners of their peers may demand to be treated as individuals and show signs of typical adolescent conflict with their parents and other relatives who maintain traditional values and customs. Out of a sense of respeto ('respect") many Hispanic patients tend to avoid disagreeing or expressing doubts to their health care provider in relation to the treatment they are receiving. They may even be reluctant to ask questions or admit they are confused about their medical instructions or treatment. Associated with this is a cultural taboo against directly expressing negative feelings. This taboo may manifest itself in a patient's withholding information, not following treatment orders or terminating medical care. Although some overlap exists among these stressors, they are conceptually distinct forces and often require specific coping strategies. Each stressor influences the quality of life and mental health of nonwhites regardless of immigration status. A.1.a. National Statistics Recently, the Census Bureau reported that the Hispanic population grew to 38.8 million, a 10%, increase, between 2000 and 2002. This growth is four times that of the overall population, making Hispanics the largest minority group in the country for the first time. Currently, one in six children in the United States is Hispanic, and by 2020 the number is expected to be almost one in four. The poverty rate among Hispanics is among the highest of any minority group. In 1999 the poverty rate reached 22.8%, equaling the all-time low reached twenty years earlier. An additional 1.5 million (20.2%) lived in households classified as "low income." iniensifyilig £h piobieni, 9 Hispanic families are larger than the national average. In the Hispanic community, 30.6% of families have five or more people, while only 11.8% of white families are of equal size. These numbers take on greater significance in light of the fact they earn lower wages than other minority groups. Few, if any, of the low-wage service sector jobs open to poorly educated Hispanics with limited English proficiency offer health insurance as part of their compensation package. 35.7% of Hispanics are under 18 years of age and a median age of 25.9 years; 23.5% of the nation's total population is under 18, and the national median age is 35.3 years. In 1999, Hispanic women of all descents made up 11.2% of the U.S. female population (DHHS, 2000). Hispanic women, particularly Mexicans, have the highest fertility rates of all ethnic/racial groups in the United States. Fourteen percent of live births to all women in the U.S. in 1990 were to Hispanic women, and of those, 65% were to Mexicans, and 14% were to Central and South American women. Hispanic adolescents are reported to be more likely to become pregnant than black or white teenagers, have more repeated births and have the highest non-marital birth rate of all racial and ethnic groups (Juarbe, 1995; Taylor, et. al., 1999). In 2000, Hispanic females aged 12 to 17 were at higher risk for suicide than other youths. Only 32% of Hispanic female youths at risk for suicide during the past year received mental health treatment during this same time period (SAMHSA's National Household Survey on Drug Abuse). According to 2000 Census data, 43% of Hispanics twenty-five years and older, had not obtained at least a high school education. One third of Hispanic students drop out of school which is the largest dropout rate of any minority, and the number of students with limited English proficiency skills that dropout is even higher, with one half dropping out before completing high school (National Alliance for Hispanic Health, 2001). A.1.b. Oakland County demographics The 2000 Census revealed that the total population of Michigan increased by 6.9%. In that same period, the Hispanic population in Michigan expanded by 61%: within Oakland County, this growth was 48%. The city of Pontiac is home to the largest concentration of Hispanics in Oakland County; Pontiac's 8,463 Hispanics constitute 29% of Oakland County's Hispanic population. Hispanic children and families in Oakland County share the many critical issues affecting Hispanics nationwide. Young Hispanic women are more likely than their peers to become pregnant during their teens. Although teen pregnancies decreased in both Oakland County and Pontiac (6% and 32% respectively) between 1990 and 1999, the rate of teen pregnancies among Hispanics increased by 37% in Pontiac, and 34% in Oakland County. 10 Two surveys were conducted by El Centro staff at a Hispanic Health Fair held in June 2002 at the Mexican Mutualista Club and at the Mexican Festival in August 2002. The results indicate the areas where people feel they need the most assistance are: Counseling (51%), Parenting Education (45%), Substance Abuse (44%), Legal assistance and Head Start in Spanish (38%), Spanish pre-school (31%), English as a Second language (28%) and Prenatal classes (28%). These percentages are based on a total population surveyed of 182 Hispanic individuals attending the events. The issues they saw most frequently in their families were anxiety, depression and substance abuse. Community strengths for the Spanish-speaking population were also identified and include the existence of mental health and substance abuse treatment services, a mentoring program, bilingual education, two parenting classes, and English as a second language instruction. A.2. Documentation of Need Surveys of Oakland County middle and high school students consistently show higher percentages of drug and alcohol use than national averages reported in the National Institute of Drug Addiction-sponsored annual Monitoring the Future Study of U.S. 8th, 10th and 12th graders. Statistics gathered by OSAS indicate increasing treatment needs by county adolescents. In 2002, a Community Health Assessment Survey conducted by Healthy People, Healthy Oakland confirmed alarming misuse of alcohol in the county and indicated that abuse of alcohol and other drugs were the number one health concern of county residents. It became apparent that the abuse of alcohol and other drugs was a major public health problem that needed to be addressed. Therefore, substance abuse prevention and treatment objectives are now part of the Health Division's four 2003-2005 Strategic Goals. This proposed project will assist in meeting two of the objectives under the second goal, which is to "Improve health through lifestyle change" by: 1) increasing the number of minors who choose to lead an alcohol, tobacco and drug-free lifestyle and 2) decreasing abuse of alcohol, tobacco and other drugs by adults. Section B: Proposed Evidenced -Based Service/Practice The purpose of the proposed project is to reduce the impact of alcohol and other drugs (ATOD) use on Hispanic adults, adolescents and families living in Oakland County, Michigan. Our model will increase awareness of the problem, improve families' access to bilingual and culturally- sensitive substance abuse services and improve retention and completion of services through extensive outreach, strategies proven to produce meaningful results. In an attempt to increase access to services, conduct outreach to traditionally isolated groups and engage individuals and families in culturally and linguistically competent substance abuse services, we are planning to sub-contract with Easter Seals-Michigan (ESM) and residential providers to help meet the needs of this growing population. By implementing this project, we expect to achieve the following objectives: 11 B.1. Objectives Adolescents will: 1. Demonstrate fewer incidences of alcohol, marijuana or other drug use Adults will: 2. Report fewer driving under the influence (DUI) violations 3. Demonstrate reduced ATOD consumption with the goal of complete abstinence 4. Demonstrate greater use of community resources Families will: 5. Demonstrate increased awareness of the impact of drug abuse on their children's health and development 6. Demonstrate increased skills in effective parenting, including successful management of children's behavior and improved family problem-solving skills. B.2. Evidenced-based services The project will focus on two specific populations: Hispanic substance abusing adolescents and their families and Hispanic adults with a diagnosis of abuse or dependence. The Brief Strategic Family Therapy (BSFT) will be used with the adolescent population (ages 13 to 17) and a full continuum of care will be provided to the adult population with Cognitive-Behavioral Therapy (CBT) being the primary model of therapeutic intervention. B.2.a. Brief Strategic Family Therapy (BSFT) The BSFT is an effective, problem-focused, and practical approach to the treatment of adolescent conduct problems, early drug use and accompanying family interactions, all of which are recognized risk factors for substance abuse. It successfully reduces problem behaviors in 6 to 17- year-old children and adolescents and strengthens their families. BSFT provides families with tools to decrease individual and family risk factors through focused interventions that improve problematic family relations and skill building strategies. It targets conduct problems, antisocial behaviors, early substance use and problematic family relations. The program fosters parental leadership, appropriate parental involvement, mutual support among parenting figures, family communication, problem solving, clear rules and consequences, nurturing and shared responsibility for family problems. In addition, the program provides specialized outreach strategies to bring families into therapy. BSFT sessions take place once a week for a total of 8-12 weeks. Sessions may occur more frequently around crises times, as they present opportunities for change. Sessions run from 1 to 1 V2 hours. BSFT can be implemented in a variety of settings, including social service agencies, family clinics and mental health clinics. 12 The first step in BSFT is to establish a therapeutic alliance with each family member and with the family as a whole. This requires that the therapist accepts and respects each member of the family, as well as the totality of the family unit. The second step in BSFT is to encourage and permit the family to behave as it would usually behave if the therapist were not present. This is done by encouraging family members to speak to each other about the concerns that bring them to therapy. In this way, the therapist can see how they relate to each other in their usual way and identify any maladaptive patterns of family interactions that are linked to the youth's problem behaviors. For example, family members may not speak with clarity or their communications may contain confusing messages. The third step in BSFT is to bring about change in maladaptive family interactions and make them more supportive, while helping the family to perform their child-rearing functions more successfully. In this step, the therapist is problem-focused, direction-oriented and practical. Change strategies used include changing the meaning of interactions through cognitive restructuring; interventions that are called reframes. Reframes are intended to transform the negative affect of frustrating family interactions into more positive affect that improves communication. Other change interventions include directing or redirecting communication, shifting family alliances (e.g., change an alliance between parent and child against another parent to an alliance between the two parents around behavior management of a drug using son) and helping the family to stay focused on the problem until they have resolved it successfully. The Substance Abuse and Mental Health Services Administration and the U.S. Department of Health and Human Services recognize BSFT as a model program. In addition, BSFT has received a Presidential Award from the Society for Prevention Research and a Research Award by the Center for Substance Abuse Prevention. B.2.b. Cognitive Behavioral Therapy (CBI') The primary model of therapy for adults that will be used at El Centro is Cognitive Behavioral Therapy (CBT). CBT assumes that adults with, substance abuse problems have poor coping skills, choose not to use those skills they have, or are inhibited from using those skills. CBT is generally effective because it helps clients recognize the situations in which they are likely to use substances, find ways of avoiding those situations and cope more effectively with the variety of feelings and behaviors related to their substance abuse. To achieve these therapeutic goals, CBT incorporates three elements: 1) Functional analysis - this analysis attempts to identify the antecedents and consequences of substance use behaviors, which most commonly serve as triggers and maintaining factors; 2) Coping skills training — one of the most important aspects of CBT is the development of coping skills; 3) Relapse prevention - this element focuses on the cognitions or thought processes associated with high-relapse situations, as well as learning more positive coping skills. B.3. Justification of selected practices with the target population BSFT was developed at the Spanish Family Guidance Center in the Center for Family Studies, Uni-vcrsity of Miami, and }Inc been conducted at these centers since 1975. The Center for Family Studies is the nation's most prominent center for development and testing of minority family 13 therapy interventions for prevention and treatment of adolescent substance abuse and related behavior problems. It is also the nation's leading trainer of research-proven, family therapy for Hispanic families. BSFT was tested and proven in Hispanic families and adapted and tested with African-American families. BSFT helps children and adolescents, 6 to 17 years old, who exhibit early substance use, truancy, rebelliousness and association with problem peers. BSFT also benefits families that are affected by poor behavior management, parental discord, blaming interactions and other problematic behaviors. The rationale for using this program is threefold. First, it has been developed and successfully replicated with different cultural and ethnic groups, including the Hispanic community. Second, BSFT has proven to be effective in increasing family participation in therapy and has produced results such as program retention of over 75% of youth, 42% improvement in conduct problems and 75% reduction in marijuana use. Third, materials are not only culturally relevant but they are written in Spanish, which is the primary language of the target population. Cognitive-behavioral therapy (CBT) was chosen because of its emphasis on the development of coping skills and identification of the chain of events that contributes to the onset of use and the maintaining the drug using behaviors. Group therapy was chosen as the service delivery model because it is one of the most common modalities for treatment of substance abuse disorders. Group therapy gives clients the opportunity to see the progression of abuse and dependency on themselves and others, and also • provides an opportunity to experience personal success and the success of others in an ambience of support. In addition, having a group for adolescents and spouses will provide them with a forum to talk about their needs and provide support to each other. B.4. Addressing the needs of target population . Many of the clients targeted for participation in this project come from families composed of at least two children and several adults living in the home. Some families are recent immigrants, while others have lived in the United States for several years. The average education level is third grade and most are either monolingual in Spanish or have limited English proficiency. BSFT has been tested and proven in Hispanic families whose characteristics are similar to the proposed population, so adaptations to the original model are not necessary. Therefore, fidelity and adherence to the original format is enhanced. In addition to our stated objectives, we anticipate that the benefits will extend beyond the period of project funding. We expect to achieve our objectives of involving the family (spouses and children) in the recovery of the adult substance abuser participating in our outpatient group therapy sessions for persons struggling with substance abuse. Furthermore, by developing and strengthening our partnerships with local media organizations, we will be able to educate the community and increase awareness of substance abuse in a language that the target audience will understand. 14 PROCESS OUTCOMES B.5. Logic Model of proposed program The following table provides a description of the activities that we are proposing and the outcomes we are expecting to achieve. RESOURCES ACTIVITIES OUTPUTS OUTCOMES GOALS _ Bilingual staff Didactic and psycho Weekly groups Reduction in Abstinence educational groups held substance abuse Reduction in drug- Mental Health related offenses Bilingual including DUI arrests Programs Individual therapy Sessions Abstinence sessions offered goals achieved Abstinence Substance Abuse Increased Community Bilingual knowledge of resources accessed programs community resources Bilingual BSFT sessions Weekly 1 V2 hrs Reduction in Reduction in drug families of BSFT adolescent drug use and arrests sessions for experimentation families Improved Improved family parenting skills problem-solving skills Media Media educational Spanish written Increase in Informed Hispanic partners campaign on SA materials knowledge population disseminated about SA Community via flyers and among stakeholders PSA Hispanics Oakland Develop stronger New Increased Improved County Office partnerships with partnerships coordination coordination and of Substance Hispanic agencies with Hispanic greater access to Abuse leaders services for Spanish- Services speaking families 4. 15 Section C: Proposed Implementation Approach The Oakland County Office of Substance Abuse Services (OSAS), in collaboration with ESM-El Centro "La Familia" will provide substance abuse services to approximately 55 adults meeting the abuse and/or dependence criteria and 25 adolescents and their families during the first year of implementation and an additional 200 participants throughout the remaining two years of the grant. C.1. Contracting for Culturally Competent Services Through a sub-contract with OCHD/OSAS, ESM-El Centro, one of many ESM service sites with a specialty serving Hispanic people, will provide all of the outpatient substance abuse prevention and treatment services, case management and outreach, childcare and transportation and the project supervision. The evaluation component will be provided through a sub-contract that ESM will have with SPECS Associates, an experienced, research and evaluation agency and by ESM- El Centro staff, which will do data collection and data input. The OSAS's Chief of Substance Abuse Services will serve as Project Director and will provide the monitoring and oversight of program services and fiscal accountability. OSAS will additionally, through its subcontracts with residential providers, pay claims and monitor services through its regular site visit audit process including ESM-El Centro. C.1.a. CBT Adult Population A full continuum of care will be made available to those seeking services, with level of care being determined based on the client's individual needs. The point of entry will be ESM-El Centro, where a thorough biopsychosocial assessment and the Addiction Severity Index (ASI) will be conducted to determine the severity of illness. The Addiction Society of Addiction Medicine (ASAM) Patient Placement Criteria will be used to determine the most appropriate level of care placement. If the client is in need of detoxification and/or residential treatment, the client will be authorized via the OSAS Prior Authorization and Central Evaluation Unit (PACE) and referred to a culturally sensitive residential treatment provider, where there is an identified bilingual therapist on staff Coordination will occur between the case manager at ESM-El Centro, the admissions team at the residential treatment program and PACE in order to facilitate the referral. Upon completion of detoxification and/or residential treatment, the primary therapist will coordinate with ESM-El Centro to set up continuing care services and transportation. Outpatient treatment services will then be continued at ESM-El Centro. Based on the recommendations of the therapist and the team at ESM-El Centro, the outpatient clients will be referred to a variety of groups and/or individual therapy. Group therapy will be provided daily and will include a variety of topics including: anger management, relapse prevention, women's issues, etc. Clients will also be involved in individual therapy, at a minimum one time per week and family therapy will be provided when needed. If a client is new to the treatment/recovery procss and has no history of treatment, he/she will be referred to the eight-week didactic/treatment readiness course that will provide basic education addiction and 16 recovery and will assist in determining the client's willingness and motivation for treatment and change. AA, NA and other community based 12-step support groups will also be recommended. The table below illustrates the groups being offered during the week. TIME MON TUE WED I THUR FRI SAT Treatment 10:00 to I Co- readiness 11:30 am dependence group group Sessions throughout the day at BSFT BSFT BSFT BSFT BSFT clients sessions sessions sessions sessions sessions convenience — 4:00 to Adolescent 5:00 pm support ' group Psycho- Psycho- Group Group 5:30 to 7:00 educational Educational therapy therapy pm group group C.1.b. BSFT Adolescent and Families Adolescents and families will be assessed using BSFT model instruments and will participate in 12 BSFT sessions either at their home or in the El Centro office. Assistance with transportation and childcare will be provided when needed and adolescents will be invited to participate in an adolescent support group one month after completion of the 12 BSFT sessions. They may continue receiving case management services and/or a higher level of care placement if necessary. C.2. Key Staff and Timeline The following table describes the timeline for this project including activities performed, milestones and responsible staff: 4. 17 Time Line Activity Milestone Responsible Staff Month I Post Positions Actual posting and Interviews Project Supervisor Interview applicants Orient them to SA program _ Month 1 Develop referral procedures Referral procedures described and Project Director for residential services understood by partners Month I Develop Policies and Policies and procedure manual Project Supervisor, DDx* procedures and seek input clients, other staff, stakeholders Month 1 Begin to provide substance Actual individual sessions, # of Project Coordinator abuse CBT treatment to adult screenings and assessments, Project staff clients and group therapy treatment plans developed, case sessions (this is -possible management, group therapy - because we are already getting referrals and serve limited # of clients who participate in DDx group sessions only) Month I Develop and complete Actual completion and approved Project Coordinator program brochures for clients by Easter Seals for . DDx clients, parents marketing./printing Month 2 Complete referral processes Completed presentations to at least Project Coordinator for agencies/organizations 2 mayor stakeholder groups Month 2 Enroll staff & coordinator in Gain the basic skills needed to Project Coordinator the BSFT Training successfully conduct the BSFT Center for Family Studies workshop. Training program trainers Month 2 Tape Public Service Completion of taping of Project Coordinator Announcements announcements and scheduling actual airing. Month 3 Disseminate project brochures Actual dissemination of flyers and Project staff and attend formal events (i.e. brochures, meeting with courts, courts, FIA, police stations, probation officers, FIA directors, schools, clinics, Latino giving presentations in church organizations, etc.) and prior to mass, etc. informal events (i.e. churches, community events, barbershops, public buildings, public bulleting boards, etc.) to advertise the new program in the Latino community. Month 4 Hold the first BSFT session Creating the context for these Project Coordinator and 1 for first 15 families sessions and scheduling sessions project team on a weekly basis. Month 6 Conduct evaluations and GPRA's completed Case Managers GPRA's surveys for adults (six months after baseline) Month 7 Conduct evaluations and GPRA's completed Case Managers GPRA's surveys for BSFT evaluation tools completed Project staff adolescents (three months after baseline) . Month 12 Conduct annual evaluations GPRA's completed Project staff ‘DDx= Dual diagnosis clients 18 C.3. Recruiting Target Population We will target the Spanish-speaking population through a comprehensive outreach campaign. A unique component of this project is our extensive outreach capability. We will leverage strong media partnerships to produce and place radio and television public service announcements targeted directly to the Spanish-speaking audience, on Hispanic channels/programs. We will coordinate articles/press releases to Spanish print media. Finally, we will draw on the strength of mainstream media relationships to promote general awareness of this program, and the issues it addresses. We will produce professional broadcast-quality radio and television public service announcements (PSA) to ensure we eliminate language as a barrier in reaching prospective BSFT participants. To achieve this, we will produce at least a one 30-second PSA in Spanish for radio distribution. Each PSA will be tagged with contact information for the Easter Seals— Michigan center in that market. Media releases will also be disseminated among the Hispanic/Latino press and other non-Hispanic media. Individuals will be identified at the presentations provided at different sites and by our partners at various agencies including the members of the Oakland County Hispanic Coalition (please see Appendix 1 for letter of support) and other Hispanic agencies. Current relationships with the circuit courts, probation officers, Police Department, FIA, Oakland County Community Mental Health Authority, public schools, churches, consulates, Latino organizations, hospitals and clinics, HAVEN domestic violence program, Common Ground Sanctuary, etc., in conjunction with the media blitz and outreach efforts, will assure there will be an adequate number of participants for each service offered. Clients who are court ordered to participate in substance abuse services will naturally be expected to continue their participation in treatment. Those clients participating in support group services do on a strictly voluntary basis. However, in• order to foster their participation, transportation and childcare will be provided to those in need. C.4. Input Provided by Members of Target Population ESM has an organization wide policy of involving consumers in program development, implementation and evaluation. In preparing this project, input was sought from members of the target population on an informal and formal basis. In addition, input has been solicited from organizations including the Oakland Hispanic Coalition, Family Independence Agency, public schools, the Health department and Healthy Start. Moreover, in order to assure program integrity, a feedback process - will be developed to assure consumer satisfaction (i.e. consumer satisfaction questionnaires, focus groups discussions) and program effectiveness (i.e. using BSFT clinical instruments to measure change in the impact and exposure to substance abuse, d. measuring change in substance use/abuse, etc). 19 Members of the dual diagnosis substance abuse groups at ESM-El Centro were surveyed regarding this project (See Appendix 1 for letter of support). They provided input on the preparation of this proposal and they will continue to provide feedback in the implementation and evaluation of the program. Program evaluators will conduct focus groups at different intervals in order to evaluate satisfaction with services and obtain suggestions for improvements. C.5. Program Relationship to Existing Services and Community Partners One of the primary objectives of this program is not only to provide needed services, but also to augment and maximize the current services being provided at ESM-El Centro. Services being proposed will be embedded within the existing service delivery system in order to allow ESM-El Centro to provide proportionate services to Latino consumers. Rather than either denying a consumer for services because they do no meet current criteria or accepting a consumer for services that might offer more than what is required, this program will grant clinicians and families a greater continuum of services and choices. For example, monolingual parents will be able to participate in substance abuse services without having to have a dual diagnosis of a serious mental illness and substance abuse diagnosis. Likewise, this program will allow families, friends and children to participate in didactic and psycho-educational support groups to help them cope with the impact of alcoholism and drug abuse. If an individual, child, or family engaged in the proposed services were to manifest a need for additional services, they would be referred to a more intensive program i.e. domestic violence, individual, family and/or child therapy, Healthy Start, occupational therapy or physical therapy. ESM-El Centro staff has conducted several meetings with community organizations to complete needs assessments and service plans. They also addressed the need for coordinated efforts and services, resources for facilities and funding and they formed a consensus about priority needs in the local community. Organizations such as the Family Independence Agency, City of Pontiac, Child Abuse and Neglect Council, Mexican Consulate and La, Clinica de la Mama have participated in this effort and expressed their commitment and support in helping families . achieve their goals (See Appendix 1 for letters of commitment). C.6. Ensuring Planning and Implementation Timeliness We are ensuring that services will be implemented within month .'one of grant award by identifying key staff among current ESM-El Centro staff, developing a list of potential candidates by advertising the possibility of additional funding and by seeking input on community need and current dual-diagnosis group participants feedback. C.7. Potential Barriers Although there are significant strengths and resources readily available in Oakland County, the lack of qualified bilingual staff and limited number of agencies that provide treatment services in the language of the target population, makes it necessary to partner with ESM to expand their existing bilingual mental health and family support services, and their status within the target population, to include the substance abuse treatment. 20 Despite ESM's commitment to provide quality, cutting-edge services to the Latino community and excellent working relationship with CMHA, FIA, schools, hospitals and clinics, Hispanic Coalition, churches, and consulates, the following potential barriers to successfully conduct this project have been identified. 1. Staffing: There are limited staff that are qualified, trained and experienced, who are also Hispanic, bilingual and bicultural in the state of Michigan. Competition for these therapists is fierce. As the Latino population continues to grow, it is likely that there will be a proportionate increase in the need for culturally appropriate services statewide. As a result, we are devoting time and resources to develop additional relationships with local and state universities. 2. Transportation and childcare: Many of the clients do not have reliable transportation or their driver's license has been suspended and therefore cannot attend individual and group sessions. In addition, many of them have several children and childcare is a barrier for participation. 3. Financial need: Many clients work long hours in construction, retail and food industry jobs and have a minimum of two children at home which makes it difficult for them to think about spending limited time to receive extensive treatment or to complete surveys requested by program staff. We are eliminating the staffing bather by moving two of our current staff into two of the key positions. One of them has extensive experience working with families as well as excellent organizational skills and the other is working on obtaining her Certified Addictions Counselor certification. Identifying potential candidates early in the process and developing a pool of candidates is also part of the staffing plan. The reputation that ESM-EL Centro has in the community has created interest from potential candidates. Providing transportation and childcare supports will help reduce inconsistent participation and barriers to engaging in treatment. Other bathers such as stigma and lack of awareness about substance abuse issues are addressed by providing education to the community. By providing monetary incentives to clients ($10 per Government Performance and Results Act (GPRA) survey answered at two follow up intervals), we expect to meet requirements for data collection and follow up. C.8. Sustaining Resources Once the project is established, ESM will charge the participants with driving violations a small fee for group sessions, which is common practice as required by courts. The current rate for therapy sessions, following substance abuse driving violations, ranges from $25 to $50 based on ability to pay. Clients do not usually pay for individual sessions unless they have insurance. No client will be refused services based on lack of insurance or inability to pay the minimum fee. ESM will develop relationships with large companies such as General Motors, Chrysler and United Automobile Workers that employ a large number of Hispanic people. We plan to use these preliminary relationships as a way to receive review by insurance panels for substance • abuse treatment reimbursement. In addition, ESM may develop an EAP program specifically for bilingual substance abuse services as a way to subsidize treatment for low-income clients. 21 Section D: Staff and Organizational Experience D.1. Experience in providing culturally competent services D.1.a. Oakland County Health Division/OSAS In 1972 the Oakland County Board of Commissioners designated the Oakland County Health Division/ Office of Substance Abuse Services (OSAS) to be the Substance Abuse Coordinating Agency (CA) for the Oakland Region. Since that time OSAS has served as a resource for and provided technical assistance on chemical dependency treatment and prevention. OSAS has many funded agencies, through a competitive bid process, that provide prevention and treatment services within the county, and has provided the fiscal and programmatic oversight to ensure quality and accountability for the public dollars supporting these services. In FY 02/03 OSAS funded a full continuum of care including sub-acute detoxification, short and long term residential, intensive outpatient (coed, women only, co-occurring disorders, and adolescent) and outpatient treatment services for over 5,000 individuals. The Oakland County Health Division has made culturally sensitive programming a priority for all health department services and maintains a list of health department employees who speak other languages who may be called upon as interpreters for individuals seeking various clinic services. We also provide telephone interpreters through a private national interpreter service. OSAS currently funds a Hispanic prevention and outreach program through Catholic Social Services, an Arab Chaldean prevention, parenting and outreach program through the Arab- American and Chaldean Council and a prevention program for African American male adolescents. We also fund several treatment providers with programming specifically directed to the African American population as well as an outpatient program for the deaf provided by a deaf therapist. Through our telephone and in person interpreter services We have provided interpreters for a Russian-speaking client in residential treatment and interpreters for Arabic, Vietnamese and Korean speaking clients in outpatient treatment OSAS works very closely with other key agencies in Oakland County in an effort to coordinate services and maximize the dollars available to provide substance abuse prevention . and treatment services. OSAS staff also participates on the planning teams for seven drug courts in Oakland County and manages the dollars each drug court has allocated for treatment. In conjunction with Oakland County Community Mental Health Authority, OSAS jointly funds three programs for individuals with co-occurring disorders. In collaboration with the Oakland County Community Corrections Agency, OSAS jointly funds two programs, one for adults and one for adolescents. D.1.b. ESM-El Centro "La Familia" Easter Seals-Michigan (ESM), a non-profit 501 (c) (3) organization, is uniquely qualified to provide the proposed services. For more than 80 years, ESM has helped individuals with disabilit.;,-s and grerini needs and their families to live with equality, dignity and independence. ESM's focus is on providing innovative services that are not otherwise available to help 22 individuals with physical, cognitive, developmental and psychosocial challenges live full, meaningful and satisfying lives. From an evolution as the first national voluntary agency to speak and act on behalf of children with disabilities in the 1920s, to leading the creation and implementation of the Americans with Disabilities Act in the 1990s, Easter Seals—Michigan continues to play an integral community-based role, helping thousands of people experience a better quality of life each year. For more than 20 consecutive years, The National Health Council has recognized Easter Seals, Inc. nationally as the not-for profit health agency allocating the highest percentage of donated dollars to direct client services. While Easter Seals' national average is 94%, with only 6% of contributions accounting for administrative overhead, during the 2002-2003 fiscal year in Michigan. a full 96.6 cents of every dollar was earmarked for direct service in the community it was donated. ESM is CARF (Certification Agency for Rehabilitation Facilities) accredited, and is recognized as one of Metropolitan Detroit's "101 Best and Brightest Companies to Work For" (2001, 2002, 2003), as determined by the Michigan Business and Professional Association. Throughout the last 80 years, this organization has developed and enacted programs that address some of the most difficult problems facing children and families in Michigan. In 2000, ESM obtained a 16 million dollar contract from the Oakland County Community Mental Health Authority to provide mental health services to individuals with a severe and persistent mental illness. Three years after this contractual relationship started, the mental health budget increased to 26 million dollars due to the quality of services provided, feedback provided by the clients they surveyed and community need. ESM has offices at several locations throughout Michigan including the Hispanic program, El Centro "La Familia" where this substance abuse project will be implemented. El Centro is located in the heart of Pontiac, Michigan in an area central to the primary Hispanic population within Oakland County. SMART buses one block from the building on the east (Huron and Saginaw) and at other nearby locations provide transportation. The mission at ESM- El Centro is to provide high quality culturally congruent and culturally sensitive mental health services to the Latino community of Oakland County. Since 1997, El Centro has been licensed to provide outpatient substance abuse services and in 1999 received a license to provide screening and referral and prevention services. With the rapid accession of the Hispanic/Latino population in Oakland County, and with the uncompromised support and commitment from the Easter Seals Board of Directors and the agency's CEO, ESM-El Centro has become the largest Hispanic agency of its kind in Michigan. It now provides a continuum of services including the following: Outpatient Mental Health (available for individuals, families, and children, school-based and home-based) Short-term crisis intervention services Healthy Start Program (home-based services to provide support and enhance parenting skills for families with children 0-5 years of age). 23 Pregnancy Workshops (based on a partnership with March of Dimes to ensure a healthy pregnancy) Nurturing Group Sessions (a 23-week program for parents with young children (0 to 5) focusing on parenting skills, living skills and personal growth) Dual-Diagnosis Substance Abuse Services (a comprehensive outpatient service for clients with severe and persistent mental illness and substance abuse). Case Management for clients with a mental health diagnosis Psychiatric evaluation and follow-up Support Services (Women's support group) Prevention Educational Groups (offer classes addressing health issues) Domestic Abuse Intervention (providing intervention services to batterers, support to victims- Las Rosas support group and outreach/education to the community). El Centro is one of four recipients in Michigan who, in 1998 received national recognition as an exemplary program for children's mental health by the National Latino Children's Institute. Di. Key Project Staff Sandy Kosik RN, MPH, an employee of OSAS, will serve as the Project Director and will provide the monitoring and oversight of the entire project services and fiscal accountability. She will be responsible for required SAMHSA reports, overseeing that claims are processed accurately and that the total budget is being used as planned. Sonia Acosta, PhD, ESM-El Centro Director, will serve as the Project Supervisor for this project. She will be responsible for insuring that budget and activities are being performed and will monitor contract compliance with OSAS. She is bilingual and of Hispanic origin and has helped El Centro grow from a staff of 4.5 staff to 20 staff currently. Maria Munoz, MSW will serve as the Project Coordinator and will work with this project .100% of her time. Maria has a Master's Degree in social work, is bilingual and of Hispanic origin. She has over five years of experience working with families and children. KarMa Jeifez, PhD will be hired to work with the adolescents and their families using the BSFT model. She has a doctoral degree in Psychology, is bilingual and of Hispanic origin. She will work 20 hours a week and 100% of her time will be dedicated to working with this population group. Maria Huanes, MSW will provide services for clients of this project 100% of her time. She has a Master's Degree in social work, is bilingual and of Hispanic origin. She will provide individual CBT treatment and implement several group therapy and didactic groups. She will also be available to assist with BSFT therapists. Sandra Gonzalez and Melquiades Gomez will be the case managers to be hired to work with this project team. They are both bilingual and of Hispanic origin. These full time bachelor's level 4. case managers will provide intensive case management and outreach services and assist in the 24 implementation of the curriculum and the GPRA outcome data collection.. They will also oversee the activities of the parent assistants. Parent assistants will provide transportation and childcare for project participants. They will work between 5 and 20 hours per week and will report directly to the case managers. Melanie Hwalek, PhD will be conducting the evaluation for this project. She is the President of the evaluation and consulting firm, SPEC Associates. She has extensive experience working with federal grants and has brought her knowledge of outcome measurement to the project team. D.3. Staffing characteristics of key and non -project staff ESM-El Centro is composed of 20 bilingual/bicultural staff. Clerical staff, program staff, team leaders, supervisors, and the director of the agency are all bilingual and bicultural. This constitutes a 100% representation of the racial and/or ethnic characteristics of the target population. Likewise, many of the staff come from countries such as Mexico, Puerto Rico, Argentina, Dominic Republic, Colombia, etc. and - like the target population- are at different levels of acculturation. Languages spoken at El Centro include English, Spanish, Portuguese, Rumanian, Arabic and French. D.4. Resources available for project ESM-El Centro has housed all of its programs in a 6,000 square foot facility. As ESM-El Centro has increased its continuum of services and staffing, a need to move to a larger facility had been identified. In 2003, due to its excellent relationship with the Latino community, local and state government, hospitals, clinics, schools, and community organizations, El Centro was approached by Clinica de La Mama (Georgia-based health clinic) and offered the opportunity to move its current services to a new facility. Currently, the plan is for Clinica de la Mama to partner up with ESM, the City of Pontiac, Family Independence Agency, and other local Latino-based organizations, and metropolitan hospitals/county clinics, in an effort to eliminate health disparities among Hispanic people. Clinica de la Mama will provide the much-needed pediatric, obstetrics and gynecological services, and a culturally competent education and early detection program to eliminate the health disparities among Latino communities in Oakland County. Their primary focus will be to promote health awareness to the underserved Latino community by providing an ethnic-specific education, a culturally appropriate setting for early detection screening and prevention care; a bilingual resource information guide, and patient navigation for follow-up services in rural and urban areas. This new facility, expected to be completed by spring 2005 will provide ESM-El Centro 20,000 square feet of space to house all of the staff and current programs. This facility will be built within a mile of its current location, maintaining its central location. By forming a partnership with Clinica de la Mama, City of Pontiac and Community Mental Health, consumers will be able to access multiple services in one location. 25 Design and construction of this new facility will be in accordance with the Americans with Disabilities Act Accessibility Guidelines issued by the Architectural and Transportation Barriers Compliance Board and incorporated in the final Department of Justice title III regulation. Section E: Evaluation and Data ESM-El Centro and OSAS will work closely with the external evaluator, SPEC Associates, to implement the process and outcome evaluations in a culturally competent manner. The evaluation will be designed to comply with all data collection requirements of SAMHSA and will provide regular feedback to the project in order to assure the fidelity of the treatment programs and to improve services over time. The evaluation process will use mixed methods to obtain information about the quality of services received. It will include quarterly analysis and reporting of service data collected through ESM-El Centro's management information system (MesH). It will also include semi- annual focus group meetings with project staff and, in years two and three, focus group interviews with a sample of teens, their parents and adults who accessed treatment services through this program. The outcome evaluation will involve regular collection of GPRA data as specified in the SAMHSA NOFA as well as collection of additional data on parent coping and management skills from families involved in the BSFT intervention and a telephone survey of agencies serving the Spanish-speaking community in Oakland County. The evaluation will assess both process and outcome, will use validated or standardized outcome measures and will report available results to ESM-El Centro and OSAS on a quarterly basis. To assure cultural sensitivity, the evaluation will employ Spanish speaking staff and/or consultants for in-person data collection from clients. E.1. Ability to collect and report on GPRA The evaluation of ESM-El Centro's Culturally Sensitive Substance Abuse Treatment Program will fully comply with the GPRA requirements. All of the items on the CSAT GPRA Client Outcome Measures for Discretionary Programs will be used for interviewing clients at baseline, 3 months (adolescents only), 6 months and 12 months post-baseline, as specified in the NOFA. ESM-El Centro will implement an intensive tracking system to assure that clients complete the GPRA interviews according to schedule and data is entered within 7 days of being collected. Prior to data collection, Institutional Review Board (IRB) approval will be obtained for all instruments, consent forms and study procedures, assuring the protection of human subjects. Independent Review Consulting, Inc. will be the IRB used in this project. This organization is very responsive to study timelines and can review, suggest revisions and approve study materials within a several-day timeframe. SPEC .A.Enpintes will he the local evaluator on this project. SPEC Associates has completed evaluations of similar programs in Detroit, including the 1993 evaluation of the Pre- reatment 26 and Aftercare Program at Latino Family Services. SPEC Associates is currently evaluating the CSAT grant to Community Health Awareness Group in Detroit to implement its Point of Change (POC) program. In the POC evaluation, SPEC has been complying with all SAMHSA and CSAT regulations regarding the collection of GPRA data. SPEC has a history of working with IRC, Inc. in procuring IRB approvals. E.2. Additional Measures to be Used Three additional quantitative measures will be used to collect evaluation data: 1. MesH Data on Clients and Services: This is the management information system that El Centro uses to collect information about the characteristics of clients and the services they received. Data from MesH will be downloaded quarterly and provided to_SPEC Associates for regular feedback to El Centro. The data will also be analyzed annually and presented in a summary evaluation report. 2. Parent Coping and Management Skills: The tools used by the University of Miami to measure and report on these outcomes of BSFT will be integrated into the data collected from parents of adolescents served through this program. 3. Telephone Survey Instrument for Oakland County Hispanic Coalition Agencies: By the end of year one, a telephone survey questionnaire will be developed to measure the outcomes of increased coordination and improved access to services for Spanish-speaking families. The questionnaire will ask about agencies' knowledge of ESM-El Centro's services, recollection of media campaign advertisements, referral of clients between their organization and ESM- El Centro and opinions about how this project has improved access to services among Spanish-speaking families. In addition to these quantitative measures, as mentioned above, focus group interview data will be gathered from ESM-El Centro staff (semi-annually each year) and from adolescents, parents and adults receiving treatment (annually in years two and three) to assess satisfaction with services. E.3. Data Collection, Management, Analysis, Interpretation and Reporting The local evaluation will be guided by the logic model listed in this grant application. The logic model was developed jointly by ESM-El Centro, OSAS and the evaluator. The following outcomes from the logic model will be measured in the evaluation: 1. Fewer incidences of alcohol, marijuana or other drug use among adolescents (using GPRA data) 2. Fewer incidences of alcohol, marijuana or other drug use among Hispanic adults (using GPRA data) 3. Fewer arrests for drug-related offenses (using GPRA data) 4. Greater use of community resources among Hispanic individuals (telephone survey data from Hispanic Agency Coalition) 27 5. Increased awareness of the impact of drug abuse on their children's health and development (focus groups with BSFT parents) 6. Increased successful management of children's behavior and improved family problem-solving skills (BSFT instruments) 7. Increased coordination and greater access to services for Spanish-speaking families (telephone survey data from Hispanic Agency Coalition) As stated earlier, the local evaluation will build upon ESM-El Centro's existing system for collecting data on client service use and outcomes. ESM-El Centro has a sophisticated management information system (called MesH) that collects information about clients, from entry into the program through discharge. The evaluation will integrate data from MesH with GPRA outcome data to be collected on adolescents and Hispanic adults and entered into CSAT's web-based GPRA database. The evaluation will also include the collection of qualitative data as mentioned in section E.2 above. E.3.a. Data collection Utilization, implementation, quality assurance (i.e. process) and outcome data will be collected for this evaluation. To obtain utilization data, ESM-El Centro will provide data from MesH to the evaluator. The data will provide information about: (1) the number of clients and families served by BSFT and CBT each month, (2) the demographic characteristics of clients served (e.g., age, gender, marital status), (3) length of stay in treatment, (4) number of treatment sessions attended and (5) reason for discharge (e.g. treatment goals completed vs. unsuccessful discharge). Data from MesH will be used to describe who provided what services to whom in what context and at what cost. ESM-El Centro staff will be responsible for collecting the utilization data. All ESM-El Centro clinical staff is bilingual and can collect this information in Spanish as needed. SPEC will retrieve utilization data from El Centro on a quarterly basis. Information about fidelity of the interventions (QA) will be collected through three sources: 1. Documentation from ESM-El Centro that clinical staff has attained acceptable levels of skills in CBT and/or BSFT. CBT trainers will provide certificates for each staff member who successfully completes training. BSFT trainers will also certify, at the end of the three training sessions, that staff has attained a sufficient skill level to implement this treatment modality. 2. Documentation of additional training and consultation with treatment modality experts. BSFT training services include review of videotapes of clients in treatment sessions and feedback to ESM-El Centro on compliance of staffs clinical activities with standards of the treatment modality. Both CBT and BSFT are available to consult with ESM-El Centro if questions arise in the implementation of these treatment modalities. CBT will provide refresher training annually. The evaluation will collect from ESM-El Centro records, the extent to 28 which CBT and BSFT trainers have been consulted regarding issues of fidelity and staff participation in refresher training. 3. Documentation of treatment fidelity and quality from clients. In years two and three, the evaluator will conduct focus group interviews with a sample of adolescents, parents and Hispanic adults who successfully completed their respective treatment (BSFT or CBT). During the focus group, the facilitator will ask questions to assess the extent to which the treatment modality was followed as described in BSFT and CBT documentation. Information will also be obtained about clients' perceptions of the quality of these services. All focus group interviews will be conducted in Spanish. Outcome data will be collected to answer questions such as: What was the effect of treatment on participants? What program/contextual factors were associated with outcomes? What individual factors were associated with outcomes? How durable were the effects? Quantitative outcome data will come from GPRA and the parent coping and child management skills instruments. Data will be collected at the CSAT prescribed times of baseline, 3 months (adolescents only); 6 months and 12 months post-baseline (please see Appendix 2 for samples of data collection tools). The evaluator will work closely with ESM-El Centro staff in the formatting of the dara collection tools, training staff on their use, and advising staff on methods to find hard-to-locate clients for the surveys. Tracking methods could include any one or more of the following: (a) a contact sheet completed at intake, (b) laminated call-back phone card, (c) database, telephone and/or in- person search for clients who are consistently absent from El Centro treatment services, (d) mailing of birthday cards and (e) $10 incentives for completion of each interview. E.3.13. Data management, analysis and interpretation To protect client confidentiality, a unique, anonymous identifier system will be established using information already contained in MESH (e.g. first two initials of first and last names, date of birth, and gender). This identifier will be used to enter GPRA data into CSAT's website database and will be used on all data collection instruments provided to the evaluator for data entry. Client consent to participate in the evaluation will be obtained prior to conducting the GPRA baseline. IRB approval will be obtained prior to data collection. During the first three months of the evaluation, SPEC, ESM-El Centro and OSAS will discuss the best formats for reporting utilization and outcome data. These formats will be used in the analysis and quarterly and annually reporting of results. Semi-annually, at management meetings, process and outcome results available to date will be discussed with OSAS and El ir Centro. Outcome data available to date will also be discussed with staff and clients during the focus group interviews, to obtain their interpretations of the results. 29 E.3.c. Reporting and Dissemination Evaluation results will be provided quarterly to ESM-El Centro and OSAS. Annually, an evaluation report will be prepared by the evaluator summarizing evaluation activities and findings to date. With permission from ESM-El Centro and OSAS, evaluation results may also be submitted for presentation at the American Evaluation Association and/or the Michigan Association for Evaluation. EA. Reliability and Validity of Evaluation Methods and Instruments All outcome data to be collected from clients will use existing measures. The GPRA data will be proscribed from CSAT and will be collected using standard interviewing techniques. Prior to GPRA data collection, the evaluator will provide training to staff on proper interviewing techniques. The Spanish version of the GPRA instrument will be used with Spanish-speaking clients. Parent coping and child management skills will be measured using the instrument developed from the University of Miami to measure the outcomes of BSFT. The construct validity of the telephone survey questionnaire for Hispanic Coalition agencies will be assured through the instrument's development. ESM-E1 Centro and OSAS will help to design the questionnaire, and will review drafts prior to use. Consensus among El Centro, OSAS and SPEC Associates will be reached on the wording of all questions to assure that the results will measure the outcomes of access and coordination in a manner meaningful for decision-making. In a similar fashion, all focus group questions developed for this evaluation will be jointly created by SPEC, El Centro and some of its clients and OSAS. They will be translated into Spanish by qualified bilingual staff. The client focus groups will be lead by a bilingual facilitator, who will prepare the focus group report in English. E.5. Use of Evaluation to Ensure Fidelity of the Practice The focus group interviews with staff will use the philosophical framework of Appreciative Inquiry. Appreciative Inquiry "is a relatively new asset-based approach...(It) is a process that inquires into, identifies, and further develops the best of what is in organizations (programs) in order to create a better future."2 Appreciative Inquiry focuses on the strengths, capacities and successes of programs in attaining program goals and desired outcomes. Challenges to program success are identified and examined with a view on how program strengths can be applied in resolving those challenges. 2 Coghlan, A. T., Preskill, H. and Catsambas, T. T. (2003). An Overview of Appreciative Inquiry 4. in Evaluation. Using Appreciative Inquiry in Evaluation. New Directions in Evaluation, no. 100, Winter. 30 Using this Appreciative Inquiry framework, the first focus group with staff will occur early in the program year. It will be used to define the staffs vision of success for the interventions and to ascribe characteristics of fidelity to the interventions. Follow-up focus group interviews with staff will build upon the information obtained in prior groups to answer questions such as: How closely did implementation match the plan? What types of deviation from the plan occurred? What led to the deviations? What effect did the deviations have on the planned intervention and evaluation? As mentioned above, every quarter the evaluator will produce a data report according to the specifications of El Centro and OSAS. Semi-annually, the evaluator will meet with El Centro and OSAS to review evaluation data obtained to date, and discuss the meaning of the results for insuring the fidelity of the practice. E.6. Unit Cost of the Project We estimate that the cost per unit of service will be $5,000, based on 80 individuals being served during the first year, and 200 individuals for years two and three. Section F: Literature Citations A Primer of Cultural Proficiency: Towards Quality Health Services for Hispanics, National Alliance for Hispanic health, 2001. Coghlan, A. T., Preskill, H. and Catsambas, T. T. (2003). An Overview of Appreciative Inquiry in Evaluation. Using Appreciative Inquiry in Evaluation. New Directions in Evaluation, no. 100, Winter. Cultural Issues in Substance Abuse Treatment. Center for Substance Abuse Treatment (SAMSHA). DHHS Publication No. (SMA) 01-3612, 2001. Gilvarry E. Substance Abuse in Young People. J. Child Psychiatry. 2000;41(1):55-80. National Drug Control Strategy. The White House, Washington, DC. February 2002. Protective and Risk Factors Associated With Drug Use Among Hispanic Youth, Gfroerer, J.; De La Rosa, M. Journal of Addictive Diseases 12(2):87-107, 1993. 31 Section G. Budget Justification OCHD/OSAS will contract with ESM-El Centro to provide outpatient, case management and support services for a total of $429,180, and with detoxification, short-term and long-term residential providers for a total of S50,000 a year. G.1. OSAS G.1.a. Personnel Sandy Kosik will serve as the Project Director and will be responsible for required SAMHSA reports, overseeing that claims are processed accurately and that the total budget is being used as planned. There will be no personnel charges to the grant. G.1.e. Travel The Project Director will attend two 3-day SAMHSA meetings in Washington D.C. at an estimated cost of $3320 for airfare, lodging and meals. Contractual The major sub-contract will be with EMS-El Centro to provide outpatient services, including individual, family and group therapies, as well as intensive case management and outreach. The total amount of this contract will be $429,180 (see 0.2 below for budget details). OSAS will use existing sub-contracts with several detoxification and residential treatment providers. Unit rates for each level of care differ depending on the facility but range as follows: Detoxification - $160-$250 per day, Short-term 'Residential - $98-275 per day, Long-term Residential - $45-$60 per day. G.2. Easter Seals — El Centro G.2.a. Personnel Sonia Acosta, PhD will serve as the Project Supervisor and will be responsible for insuring that the budget is followed, overall activities are being performed and monitoring compliance with OSAS contract. Project Coordinator will help coordinate project activities. The responsibilities will include: supervising the project team, coordinating activities and reporting to the project supervisor. This position will work 100% of her time in this project for 12 months at an annual salary of $52,000. CBT Mental Health Clinician this master's level therapist will implement CBT and provide group therapy. This staff will work 100% of her time in this project at an annual salary of 448.000 per year. 32 Part-time Mental Health Clinician will assist with BSFT implementation at a salary of $30 an hour for 20 hours a week for a total of $30,000 per year. This staff will work 10 hours a week for the first 4 months until she develops a caseload. Salary costs for the first year will be $21,000. Case Managers (2) will be two full time bachelor's level bilingual case managers who will provide intensive case management, outreach services and will conduct face-to-face interviews in order to collect the GPRA data at a salary of $35,000 annually. Peer Assistants (2-3) will provide childcare and transportation for individual and group sessions for the participants of these proposed services as well as recipients of other El Centro services. They will work 40 hours a week at a salary of $9 an hour for a total budget of $18,720 per year. Data/clerical staff will be hired to enter data collected for GRPA. She will work 10 hours a week at $13 an hour, for a total annual cost of $6,760 for the first year. ESM subtotal budget for personnel is estimated at $221,720. Salaries are competitive and take into account their bilingual skills and years of experience. Salary of data staff is part of the evaluation costs. G.2.b. Fringes Fringes are estimated at 30% for full time personnel ($51,000) and 15% for part-time staff ($6,972). Full time benefits include medical insurance (including vision and dental), unemployment and life insurance, workers compensation and retirement plan; costs for part-time personnel include workers compensation and unemployment. ESM subtotal costs for fringe benefits are estimated at $57,972. G.2.c. Travel SAMHSA Annual Mandatory Grantee Meetings. The Project Supervisor, Project Coordinator and the Evaluator will attend two 3 -day SAMHSA meetings in Washington, D.C. at an estimated cost of $3,600 for airfare, $5,400 for lodging and $1,560 for meals for all staff for a total of $10,560. BSFT Training Project team members and supporting staff will participate in three 3-day BSFT workshops during the first year of the project and ongoing consultations at a cost of $ 23,500 plus travel ($3,285) for up to 15 participants. Mileage and Transportation Costs El Centro will lease a 12-passenger van to provide transportation for participants at a cost of 4$6,500 annually, plus gasoline and van maintenance expenses of $1,600 and $1,300 respectively. Additionally, two staff will use their personal vehicles to provide home services and outreach at 33 a cost of $1,125 for mileage estimated at 1,500 miles for both staff for 10 months during the first year. ESM subtotal for travel is $47,870, of which $10,560 is part of evaluation costs. G.2.d. Equipment - None G.2.e. Supplies ESM will need to buy a camcorder, tapes, batteries and a 3-year warranty recommended if used on a daily basis for an estimated $1,126. The will purchase a VCR to view the videos for a cost of $500 as well as 5 computers at about $1,300 each for a total of $6,500 and office supplies, including paper, flip boards, office furniture (desks and bookcases) and postage for an additional $ 6,132. In order to encourage completion of GPRA. required data, ESM will provide a $10 gift certificate to clients for surveys completed after baseline (after 3 months and six months) for a total of $1,600. ESM subtotal costs for supplies are estimated at $ 10,618. G.2.f. Contractual ESM will sub-contract with SPEC Associates for conducting the evaluation of the project for a total of $50,000 a year for 3 years. They will manage evaluation procedures, conduct focus groups, train staff on GPRA administration and perform all other data processing analysis and evaluation reports. ESM subtotal for contractual is $50-,000 a year. G.2.h. Other ESM will require project staff to purchase a cell phone and they will get a monthly cell phone allowance of $50 to cover their service. ESM will also purchase a cell phone that will be rotated among parent assistants while performing their transportation duties. This will have a cost of $3,000 a year. ESM will place information about the project and recruitment criteria for participation in a local Hispanic newspaper, the Latino Press, which will be willing to publish some information about certain events free of charge. This newspaper has a weekly circulation of over 20,000 readers. Costs for media are estimated at $2,000. Office space for 5 staff will have a cost of $ 600 a month per office at an annual cost of $7,200 X 5 offices= $36,000. ESM subtotal costs for other expenses are $41,000 a year. H. Biographical Sketches and Job descriptions Biographical sketches of key personnel are provided below. 34 Maria Munoz Sobczak 28631 Cumberland Street Farmington Hills, Michigan 48334 H (248) 615-4153 W (248) 858-5320 Mmunoz@essmichigan.org EDUCATION 1996 Wayne State University, Detroit, Michigan Master of Social Work, Summa Cum Laude WSU Graduate-Professional Scholarships 1993 University of Michigan, Ann Arbor, Michigan Bachelor of Arts, Psychology, Magna Cum Laude American Psychological Association Minority Fellowship TEACHING EXPERIENCE 9/00-3/01 Community Service Prngtams, Irvine, California Taught court-ordered classes on Parents, Youth and the Law through the County of Orange Probation Department for parents of first-time offending youth. RESEARCH EXPERIENCE 5/99-3/00 University of Michigan, Ann Arbor, Michigan Interviewer for principal investigator, Carol Mowbray, Ph.D.'s, study on mentally ill mothers, including work with the Hispanic population. CLINICAL EXPERIENCE 7/01-current Easter Seals, El Centro "La Familia," Pontiac, Michigan Home-based individual and family therapy for the Hispanic population with an interdisciplinary bilingual and bicultural mental health team. Participation in outreach efforts and community events. Member' of the Advisory Council for Hispanic Affairs. Chair of the Advisory Council's Subcommittee on Finances. Facilitation of United Way research group on Hispanic parents. Member of United Way Diversity Committee. Coordinator of Community Mental Health newsletter. Supervision of MSW intern. 12/99-6/01 County of Orange, Anaheim, California Outpatient and in-home individual and family therapy for juvenile offenders at a collaborative, school-based site. Facilitation of groups on pro-social skills and anger management. Mental health presentations for collaborative agencies. Coordinator of the collaborative newsletter. 35 10/99-8/00 Alpha Center, Placentia, California Non-profit, private practice individual and family therapy using psychoanalytic model. 9/95-10/99 Southwest Counseling 8w=giaLScrvices. Detroit Michigan Outpatient individual and family therapy for the Hispanic population, including the chronically mentally ill. Facilitation of groups for ADHD boys and Hispanic women. Research projects through the Kellogg Foundation on grandparents raising their grandchildren. Development projects including public speaking, publication of newspaper articles, a radio commercial and a radio program. Chair of the Staff Development Committee. • 36 SONIA ACOSTA, Ph.D. 1455 Oakwood Sylvan Lake, MI 48320 (248) 858-5317(0) sacosta@essmichigan.org EDUCATION: • Doctor of Philosophy in Psychology, December 1990. Western Michigan University, Kalamazoo. • Specialty in Alcohol and Drug Abuse, August 1993. Western Michigan University, Kalamazoo. • Master of Arts in Psychology, April 1986. Western Michigan University. Emphasis in Applied Behavior Analysis. • Bachelor of Arts in Psychology, June 1983. Universidad Del Noreste, Tampico, Mexico. Emphasis in Clinical Psychology. LICENSURE AND CERTIFICATION: • Michigan Psychologist Full License # 6301006874 • Certificate in Alcohol and Drug Abuse August 20, 1993 PROFESSIONAL WORK EXPERIENCE: Program Manager: El Centro "La Familia" (Easter Seals), Pontiac, Michigan. October 2000 to date. Managing all administrative and programmatic functions of the agency, enforcing agency policies and procedures, authorizing expenditures and managing the budget. Other functions include managing grants, preparing documentation for CARF, Medicaid and other accrediting bodies, program development and review of clinical documentation for completeness. Program Supervisor: El Centro "La Familia" (Oaldand County Community Mental Health Authority), Pontiac, Michigan. April 1992 to 2000. Working with a Hispanic population with different mental health needs in an outpatient setting. Providing family, individual and group therapy, assessments, treatment planning, program development and supervising mental health clinicians. Staff Psychologist: Kalamazoo Regional Psychiatric Hospital, Michigan. September 1987 to April 1992. Working with an adult and geriatric population with diverse psychiatric diagnoses. Providing individual and group therapy, testing and evaluation, designing and implementing behavior management programs, supervising graduate students and providing training to staff. Coordinator of Self-Management Center: Western Michigan University, Department of Psychology, Kalamazoo. Fall 1986. Counseled students on academic probation on time- management and study skills. • Coordinator of Special Education Center: Universidad Del Noreste, Tampico, Mexico. Fall 1983 winter 110r. Responsible for 15 cl,i1A-en with slow learning, speech disorders motor 37 coordination disabilities. Supervised instructors and provided parent training on behavior modification principles. Part-time Professor: Universidad Del Noreste, Dept. of Psychology, Tampico, Mexico. Winter 1983 - winter 1984. Taught psychological assessment course (MMPI, WAIS-R) INTERNSHIPS: Farmington Area Advisory Council, Inc., Farmington Hills, Michigan. August 92 to August 93. Worked with adults with substance abuse problems providing individual and group therapy. Kalamazoo Regional Psychiatric Hospital, Michigan. Spring and summer 1986 and 1987. Worked with adult population with diverse cognitive, behavioral and personality problems. • PUBLICATIONS: 1992 Training for Impact: Improving the Quality of Staffs Performance. Performance Improvement Quarterly, vol. 5, No. 2, 2-11. 1990 Auditory Hallucinations and Delusional Thinking: A Review and Critique of Outcome Studies. Behavioral Residential Treatment, vol. 5, No. 3, 189-206. COMMUNITY OUTREACH AND CONSULTATION: 2001 - Participant at several SAMSHA grant review panels 1995-2000 — Member of the Board of Directors at St. Joseph Mercy Community Health Care System as well as the Quality and Mission Effectiveness subcommittee 1996-1998 - Co-chair of the Community and Social Values subcommittee of the Healthy People Healthy Oakland project Since 1998 — Member of the prevention subcommittee of the March of Dimes organization 1998-2000 - Member of the Children's Advisory Committee of the Michigan Association of Community mental Health Boards Since 1998 Member of the Healthy Start Advisory Board at St. Joseph Mercy Hospital Since 1998 - Member of the Hispanic Roundtable on Domestic Violence Since 1998 — Member of the prevention subcommittee of the Child Abuse and Neglect Council Since 1999 - Member of the Family Strides Leadership Council of the United Way PROFESSIONAL ORGANIZATIONS: Since 1999 - Member of the National Council of La Raza Since 1998 - Member of the Family Support Coalition Since 1992- Member of the National Alliance of Hispanic Health 1987- 1999 - Member of the American Psychological Association AWARDS: Special tribute from the Commission on Spanish Speaking Affairs in Lansing, Michigan Department of Mental Health stipend Western Michigan University Doctoral Associateship and Teaching Assistantship Rotary International Foundation scholarship. 4. 38 Karina Andrea Jeifez 29436 Laurel Drive, Farmington Hills, MI 48331 (248)-553-7287 EDUCATION: September, University of Detroit Mercy, Michigan 1997- Doctor of Philosophy in Clinical Psychology, April 2004. April 2004 Master of Arts in Clinical Psychology, December 1999. Limited License Psychologist, October 2002. October University of Haifa, Israel 1992- Bachelor of Arts in Psychology and English, 1996 October 1996 CLINICAL TRAINING EXPERIENCE: September 2001- Children's Hospital of Michigan, Detroit, Michigan August 2002 Pediatric Psychology Intern Training Directors: Arthur Robin, Ph.D., & Michele Ondersma, Ph.D. Participation in multi-disciplinary medical specialty clinics including: Developmental Assessment/ Infant Chronic Illness, and Asthma/Allergy/ Immunology. Involvement in inpatient consultation-liaison services. Play, family, individual/pediatric psychology outpatient psychotherapy cases with presenting problems including poor medical adherence, parent-child conflict, oppositional behavior, mood disorders, and ADFID. Extensive assessment training in Neuropsycho logy, ADHD, and Autism. October 2000- Children' Hospital of Michigan, Detroit, Michigan August 2001 Clinical Assistant, Performed psychological, developmental and neuropsychological assessments of children and adolescents with HIV and others, including administration, scoring and writing evaluation reports. September 2000- El Centro "La Familia" ,Pontiac, Michigan January 2001 Diagnostic Practicum Student Performed psychological assessments of bilingual and Spanish speaking children in an Easter Seals center for the Latino community, including administration, scoring and writing evaluation reports. Population included developmental delays, ADHD, Learning Disabilities, disruptive behavior, and anxiety disorders. September 1999- Children's Hospital of Michigan, Detroit, Michigan August 2000 Therapy & Diagnostic Practicum Student Assisted psychologist in Multi-Disciplinary Clinic in providing outpatient services to children with }UV, and their families, including assessment, intervention, & treatment planning. Provided psychological evaluations & therapy for children with or without HIV in an inner-city teaching hospital. May 1999- Hawthorn Center, Northville, Michigan August 1999 Therapy & Diagnostic Practicum Student Therapist and co-therapist to child and adolescent inpatients, in individual and group modalities, and conducted psychological evaluations in a long-term state psychiatric facility for children and adolescents. Population: depression, psychosis, eating disorders, disruptive behavior disorders and borderline personality disorder. Currryision: Toy Wolfe-Fnsor, Ph.D., & James Bow, Ph.D. University of Detroit Mercy Psychology Clinic, Detroit, Michigan September 1998- Therapy & Diagnostic Practicum Student 39 August 2001 Provided therapy to children and adult outpatients in an inner city university psychology clinic. Therapy provided in both English and Spanish. Common diagnoses: adjustment disorders, depression, personality disorders, disruptive behavior disorders. Supervision: Gale Swan, Ph.D., Cheryl Munday, Ph.D., & Sara Bahar, Ph.D. September 1998- Performed diagnostic assessments, including interview and test based evaluation of August 1999 children, adolescents and adults with a wide variety of behavioral and emotional problems. Population included ADHD„ Learning Disabilities, disruptive behavior, and anxiety disorders. Supervision: Cheryl Munday, Ph.D. TEACHING EXPERIENCE: September 1999- August 2000 University of Detroit Mercy, Detroit, Michigan A. Teachin2 Assistant Met individually with graduate students enrolled in a school psychology in-house assessment practicum and in a clinical psychology child assessment course. Duties: reviewing assessment protocols, and providing individual and group supervision. DISSERTATION: Family System, Demographic and Illness Knowledge Factors as Predictors of Health-Related Quality of Life in Children with HIV. Dissertation Chair: Margaret Stack, Ph.D. RESEARCH EXPERIENCE: September 1999- Children Hospital of Michigan, Detroit, Michigan August 2000 B. Research Assistant Participated in conducting research studying the use of Multi-Systemic Therapy in Urban Adolescents with Poor Metabolic Control. Duties: Interviewed families, collected psychosocial data, downloaded glucose meters, and assisted in setting up database for statistical analysis. Supervision: Deborah Ellis, Ph.D., & Sylvie Naar- King, Ph.D. February 1999- University of Detroit Mercy April 1999 Detroit, Michigan Research Assistant Assisted Jean Gust, Ph.D. in research on the Effects of Childhood Sexual Abuse on Adult Psychological Adjustment. Duties: organization of questionnaires, and assisting in setting up database for statistical analysis. Supervision: Judy McCown, Ph.D. October 1995- October 1996 Participated in scoring Emotional Availability scales of mother-infant dyads. Conducted research on Emotional Availability of Mother-Infant Dyads as mediated by Maternal Role Satisfaction. Supervision: Avi Sagi, Ph.D. CULTURAL DIVERSITY: Native speaker of both Spanish and Hebrew, has been conducting psychotherapy and testing in Spanish, and capable of doing so in Hebrew. PROFESSIONAL AFFILIATIONS: IYYo t t:r pi-escnt • FAAllA ,l /VGA" .13 ,‘,,,Ii•-nIrtrrioa 1 A qcnriatinn rtrprIliste student affiliate La, 1999 to present Society of Pediatric Psychology — Student affiliate 40 SANDRA M. GONZALES 5614 Central Detroit, Michigan 48210 (313) 895-0933 /sandritalou(@vahoo.com EDUCATION Columbia University Antioch University Michigan State University University of Washington Specialist Ed.M. 2002 M.A. 1996 B .S . 1992 Certificate 1997 Education Psychology Psychology Ethnic Minority Mental Health EMPLOYMENT 8/00-8/03 Coordinator, Big Brother/Big Sister, Community Impact-Columbia University. Responsible for recruitment, development, coordination, supervision and training of all components of Columbia University's Big Brother/Big Sister Program as well as seven other student- based youth programs. Directed training initiatives that bridged responsible, civic-mined volunteerism with community ethics and participant-driven partnerships. Developed, coordinated and facilitated campus and community based meetings, activities, and workshops, including the organization's annual weekend retreat. Advised student activities and student executive board reinforcing university and departmental protocol, sound judgment, accountability and teamwork. Acted as staff Social Worker , investigating and mediating studentkommunity concerns and challenges. Facilitated site visits to partner agencies, measuring compliance, effectiveness and satisfaction with service provision be student volunteers. All programs collaboratively functioned with non-profit agencies and public schools within the Harlem community. 7/96-6/99 Director, Social Services & Health Education, SEA MAR Community Health Center. Responsible for all aspects of social service and health education programming for monolingual Spanish-speaking communities with emphasis on migrant farm-workers. Developed and directed installation of Quality Improvement measures in compliance with the Joint Commission for Accreditation of Health Care Organizations (JCAH0). Developed and expanded standardized methods of tracking employees and employee productivity/accountability community wide and agency task forces focusing on community building, support networks, diversity and cross-cultural dialogue. Investigated and mediated intra and intra-departmental and community complaints to resolution. Programs under direct supervision included: Women Infants and Children (WIC), Nutrition, Dietetic Internship Program, University Partnerships and Internship Rotations Maternity Support Services (MSS), Clinical Social Work, Health Education, Breast and Cervical Healtli*igrant Outreach and Front Desk Reception/Switchboard. 7/95-7/96 Manager, Social Services& Health Education, SER MAR Community Health Center. Expanded a program of 7 employees into a department of 16 employees. Established departmental structure and organization increasing productivity and profit by 99% for King County programs. Secured funding and implemented programs for health education and social work services targeting low-income, Latino communities. Strengthened staff moral and cohesiveness via use of team building exercises and leadership training. Received recognition for outstanding contributions and dedicated services for 1995. 7/94-7/95 Social Worker, SEA MAR Community Health Center, 41 Provided Maternal Support Services (MSS) and Maternal Case Management home visits to "high risk" Latino women and their families. Conducted psychosocial assessments, established client care plans in compliance with state regulations and facilitated case consultation with a multidisciplinary team of doctors, nurses, nutritionists and psychologists. Provided community resources, crisis intervention, education and information/referrals for caseload of more than 100 clients. 2/93-6/94 Social Worker, Community Health and Social Services. Conducted individual and group counseling, prenatal support and education, HIV pre and post- test counseling, crisis intervention, psychosocial assessments and home visit services. 10/92-2/93 Counselor, Case Maria Family Services. Conducted intake, screening and assessment of runaway youth ages 10 to 17. Facilitated social adjustment thought individual, family and group counseling. Advocated for youth both in court and education settings. Provided case management and shelter assistance. COMMUNITY SERVICE Detroit Detroit Public Schools Volunteer Hispanic Outreach Volunteer, Catholic Community Services St. Anne de Detroit Food Bank Volunteer New York Latino Peer Mentor Program, Columbia University GED Volunteer Teacher Student Ambassador, Teacher College, Columbia University Coalition of Latino Scholars, Teacher College — Founding member and Co-chair PRESENTATIONS "Bridging the Gap; Latinos in Health Care" — Cross Cultural Health Care Program "Community Volunteerism; Community Ethics" — Columbia Urban Experience Columbia University "Nuts and Bolts of Coordination" — Community Impact, Columbia University "Child Protection Services for Mandated Reporters" — Community Impact, Columbia University MISCELLANEOUS Bilingual/Bicultural English/Spanish Proficient 41, 42 I. Confidentiality SAMSHA Participant Protection (SPP) 1. Protection of clients and staff from noteutial risks There are no foreseeable physical, or medical risks or potential adverse effects as a result of the project itself or any data collection activity. However, in the partake of any endeavor, including treatment/therapy, there are a number of issues or concerns that one must be cognizant of. In particular, potential psychological, social and legal issues that needs to be addressed. For example, in the Hispanic/Latino community, participation in substance abuse or mental health services often carries a stigma (e.g. "loco", a lack of character, etc.) and as a result, participation in many of these programs is avoided or denied. Additionally, family loyalty and fidelity, which is a paramount value, often keeps families and family members from openly addressing and discussing issues or concerns. Family members who fail to adhere to these values often report feeling they have betrayed or dishonored the family. Similarly, there are a number of legal issues that require further consideration. The fact that a number of clients participating in this program are court ordered implies that staff will be required to maintain contact with the courts and will exchange a minimum amount of information to keep the courts abreast of client's attendance and progress. Some of this information exchange may result in potential adverse effects, e.g. client's failing to attend the program as depicted by the court may be sanctioned. Lastly,. there is one additional, collateral risk that has been identified. This potential risk has to do with the fact that in order to continue on-going professional development/supervision with the staff at BSFT, there will be a need to exchange videotape of six sessions between the state of Michigan and Florida. The loss of one of these videotapes would risk confidentiality. • ESM-El Centro strives to assure that the dignity and rights of persons served are preserved and protected according to state and federal laws, and in compliance with many policies and procedures that govern how staff and providers deliver services. ESM-El Centro protects the privacy of persons served in the Network as required by state and federal laws. These include the Health Insurance Accountability and Portability Act of 1996, also known as HIPAA (with Privacy Rules as defined in 45 CFR Parts 160 and 164). Pertinent to this law, ESM-El Centro is required to publish and provide to persons served a Notice of Information Practices. ESM protects and safeguards private information in a variety of administrative and operational ways, including strong policies driven by applicable laws with appropriate non-compliance sanctions, physical and electronic safeguards to records and data, extensive training of the employees and providers, control of internal uses based on "need-to-know," and requirements for specific signed consent for disclosure of information to third parties. Stizma:, In order to minimize the stigma as a result of participation in this and other programs, ESM has made it a point to provide multiple services to the Hispanic/Latino community. Some of these services include support groups, community support services, English as a second language classes, healthy start, parenting classes, etc. Thus clients participating in services might not feel they are being stigmatized by engaging in 'mental health' services. Confidentiality: ESM-El Centro is required to protect, mentally and physically, the members of the group. Confidentiality is one of the protections. Educating group members concerning the ir need to maintain confidentiality is essential to the ultimate success of each individual's therapy. While the group therapy leader is bound by all the therapeutic ethical and legal rules of 43 confidentiality. The group members have an ethical responsibility but not necessarily a legal one. (Source: Psychotherapy Finances - June, 2002. ... See also: PORTABLE LAWYER, Bernstein & Hartsell, John Wiley & Sons, Group Therapy, Confidentiality pp. 63-67). As a result, the following guidelines will be implemented while the clinician is creating the context for group therapy: • At the onset or formation of the group spell out clearly the need for confidentiality and repeat this guideline or rule at the beginning of every session. • Have every participant sign a confidentiality form before the first session. • Emphasize often, the seriousness of the confidentiality process. • Indicate that a consequence of any violation of confidentiality is immediate expulsion from the group. Enforce this rule. Mailing of Videotapes for supervision: To minimize the loss of a videotape ESM-El Centro has been recommended by the staff at BSFT to utilize a "tractable" mail delivery system e.g. FedEx, Priority Mail, etc. Staff at BSFT reported they have never had any videotapes lost throughout the time they have been providing supervision of videotapes. Additionally, information other than the first names of family members will not be included in the videotapes. 1. Fair selection of Participants The clients for this program include all Hispanic/Latino clients identified with substance abuse problems and/or their families (families at risk) living in Oakland County, Michigan. The clients participating in this program are expected to be in the lower income range of the socioeconomic status, consistent with the local demographics of the client population served by this agency. The participants will include adolescents 13-17 and adults. Services will be advertised via local ads in local Latino publications (Latino Press, Siesta, etc.), collaboration with Hispanic Coalition groups, Public Service Announcements, community presentations, and through outreach efforts (e.g. making courts aware of program, strengthening relationships with probation officers, school officials/staff, etc.) Additionally, many of these clients will be referred to this agency via court orders, and schools. Recruited clients will be informed of program purposes and procedures, given opportunities to ask questions and have these answered, and provided written informed consents for participation. 2. Absence of Coercion Clients referred by the courts will be court ordered to participate in services. Others participation in the program will be voluntary. Clients participating in the evaluation will do so on a voluntary basis. Intervention services will be administered to all clients. However, participating • in interviews will be paid $10.00 for completing each of the two follow up interviews. If they contact the agency to change or confirm information about where they can be found, Or to schedule a follow-up interview, they will receive an additional $5.00 after the conclusion of the interview (please see Sample Informed Consent Form). 3. Data Collection Data will be collected from all wining participants themselves. It will consist of questionnailes depicting items to be assessed to measure program effectiveness. Identification numbers will 44 identify data obtained from participants. Actual names will not be utilized in this process so that confidentiality may be assured. We will use the GPRA survey in Spanish and the Revised Behavioral Problem Checklist and other tools provided by the University of Miami Center for Family Studies. 4. Privacy and Confidentiality ESM-El Centro strives to assure that the dignity and rights of persons served are preserved and protected according to state and federal laws, and in compliance with many policies and procedures that govern how staff and providers deliver services. ESM-El Centro protects the privacy of persons served in the Network as required by state and federal laws. These include the Health Insurance Accountability and Portability Act of 1996, also known as HIPAA (with Privacy Rules as defined in 45 CFR Parts 160 and 164). Pertinent to this law, ESM-El Centro is required to publish and provide to persons served a Notice of Information Practices. ESM-El Centro protects and safeguards private information in a variety of administrative and operational ways, including strong policies driven by• applicable laws with appropriate non-compliance sanctions, physical and electronic safeguards to records and data, extensive training of the employees and providers, control of internal uses based on "need-to-know," and requirements for specific signed consent for disclosure of information to third parties. ESM is also subject to other laws that in most cases have stricter confidentiality rules specifically applicable to records of mental health and substance abuse service recipients. These include the Michigan Mental Health Code (Act 258 of P.A.1974 As Amended), and Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2). All data will be kept in a safe place with information stored in a password protected system and locked rooms. Privacy information will meet the HIPPA privacy rule (effective April 14, 2003), protecting clients for unnecessary disclosure information. 5. Adequate Consent Procedures Clients will receive a number of consents. These will include a Consent to Treatment, Release of Information (where applicable based on HIPPA regulations and 42 CFR Part 2), and an Inform Consent Form allowing the agency to evaluate the effectiveness and efficacy of the program. All consents will be given to clients on their native language and/or will be read and explained to those unable to read or adequately process this information. Children will have this information explained to them by therapist and their parents will consent to their participation. Participation of all non-court ordered clients would be voluntary, allowing clients to terminate services when they declare they feel satisfied with concluding services, without any consequences/ repercussions. Clients referred by the courts will be expected to adhere to court orders and program staff will adhere to court expectations regarding the communication of client participation. If these clients failed to participate according to court orders, there could be potential adverse consequences. ESM-El Centro will exchange a minimum amount of information to keep the courts abreast of client's attendance and progress to protect clients from additional risks. 6. Risk/Benefit Discussion e Benefits proposed by this program far outweigh any risk. As depicted in this proposal, the goal is to service 55 individuals and 25 adolescents and their families during its initial year of 45 implementation, as well as 200 participants throughout the remaining two years of the grant. In particular, this grant is geared to provide services to the Hispanic population suffering of acculturative, socioeconomic, situational, and developmental stressors. More over, by providing a culturally sensitive/culturally congruent treatment model, Hispanic clients should be able to access services and remain engaged in necessary services. Clinical instruments to measure program effectiveness will contribute toward the evaluation and treatment of these client demographics and may serve toward the expansion of services in other areas. APPENDICES Appendix 1. Letters of commitment/support Appendix 2. Data Collection Instruments/ Interview Protocols Appendix 3. Sample of Consent Forms Appendix 4. Letter to Single State Agency Appendix 5. County Strategic Plan- support letter Appendix 7. Assurances — non Construction Programs Appendix 8. Certifications Appendix 9. Disclosure of Lobbying Activities Appendix 10. Checklist 46 Appendix 1. Letters of commitment/support ! ; i • ; j I .! . • • / • • • • 47 JENNIFER M. GRANHOLM GQ-vERNGR 0.1e. :117ch,"4,— Lia T — iO11 11.171 WA' ;17335:2121 •Irs • STATE OF MICHIGAN OFFICE OF DRUG CONTROL POLICY Department of Community Health Yvoane Black:nom:1 Dirr.ctor JANET OLSZEWSKI DIRECTOR Department or Community Heath May 19, 2004 Sandra Kosik, Coordinator Oakland County Health Division Office of Substance Abuse 250 Elizabeth Lake Road, Suite 1550 • „ Dear Ms. Kosik: I am writing on behalf of the Michigan Department of Community Health/Office. of Drug Control Policy (IvIDCH/ODCP) to support the Oakland County Health Division's Office of Substance Abuse proposal to the Substance Abuse and Mental Health Services Administration (SAMHSA) tithed Grant to Exoand Substance Abuse Treatment Capacity in Tarzeted Areas of Need (TI 04-0031 We are pleased that your agency is seeking to improve your existing program design to serve the substance 'in Tispric population in Oakland County, Michigan_ This initiative meets with the MDCHIODCP planning strategies around the importance of substance abuse tr:T.,..-rtn-cratti.u. u.ildeived populations. Many thanks for your efforts OD. behalf of the Hispanic population seeking substance abuse t-reannent in Oakland County, Michigan. Pontiac, MI 48341-1050 Y Blackatind, Director 18/dm . . cc: Deborah Y. Hollis . 4. ricoHsA OAKLAND COALITION OF HISPANIC SERVICES AGENCIES IPO Box 430641 !:Pontiac, MI 43343-9998. May 15, 2004 • !! .i'Office of Substance Abuse Services 1250 Elizabeth Lake Road •!Pontiac, M148342 Dear Ms Kosik: .4 am pleased to support your proposal for a Substance Abuse Capacity Expansion Grant that will enhances services in Pontiac and assist the Hispanic 'population. By lending support to the Office of Substance Abuse, we are supporting the greater issue of collaboration among all of the agencies in !Oakland County; such collaboration will enhance the provision of mental health treatment and education of prevention, case management. At OCOHSA, we are comrnittd -to ensuring access to critical services for the :Hispanic community. Easter Seals El Centro "La Familia" has proven to be a .valued resource for high quality, culturally sensitive, in both mental health and :substance abuse treatments. Both our constituent organizations and their ; 'clients have benefited from their Substance Abuse Programs and have been satisfied with their interactions with center providers and staff. The value to our ethnic population of unified communication, cooperation and interaction between social assistance agencies and services is important, and serves to strengthen those communities. We support your submission of the :Substance Abuse and Mental Health Administration Services application, and .look forward to building solid foundations of support in our future endeavors. S'nce‘ Debra Ehrmann President system expectations. I, i .. . --) - • illy I • l 1 , . ' t ' ' , 1 •-' A Tr' / r ....1 SINCERELY, May 12, 2004 TO WHOM IT MAY CONCERN ; FROM: MEMBERS' OF SUBSTANCE ABUSE. EDUCATION AND DUAL-DIAGNOSISTREATME\TT GROUP-"ELCENTRO SUBSTANCE { ABUSE GROUP" Easter Seals-El Centro La Familia 35 W. Huron St. Pontiac Mi 48342 WE SUPPORT THE EFFORT EL C•NTRO LA FANnuA mAKEs and particularly we support THE APPLICATION That the Office of Substance Abuse (OSAS) is submitting to SAMHSA in an effort to expand this substance abuse education program to help the Latinos having drinking problems in the Oakland County Communities. This program of substance abuse education at El Centro La Familia helps us understand problems related to alcohol contrary to what our culture has taught us. This is a very needed program for the Latino people in the community of Pontiac and the other communities surrounding Pontiac. Most of us got in trouble with the law for drunk driving and other drinking • problems and ended up coming to El Centro La Familia to be helped. • To be in this group has been a very helpful experience, it is a school where we learn all the things related to drugs and alcohol that affect the family the mind, the body and our social lives and our jobs. We have also found a place where we feel comfortable and accepted like in family. We understanding that recovering from alcoholism is a long journey and we intend to continue coming to this program beyond compliance with the legal i',, -, \ i . c) aC‘ /-Ci ,s Ailk) 5 A . \\-) , L., n. . /1 (. , &VC , c's it j Ck- 1 i r I l - 0 //L i 0 ,r,,,,_,:s i ..--,, ! .. 50 -51 • / ,,ii I le.-...„...., .., I/ ..,,..:=Lz,) ,,'4,-. i., /..,/ "7 - .., , . ,...,.. / / ; • Grupo # ./ / NOriabre /7/ //2,,/:-:; • I COME,NTARIOS ,- ; - 4; • . ., ,,,...„),,.....o.- "/ ..,--• / y i , — ..... .., ,, :La -="; • /2 4 -1/ 1 /7 • /74 _d`77/4, 477,7? - , „577 .;‘ 1/ I 0 / • _ z52, /1 7J- .n• -7ce.7 ; ir 7 L 6 .14")C11,;;Irt. - c(J/-47 /"/ /--.7 y.,••=, ti ' /`• 7"7" /-14.9 (1,2_ .1, /7 e7 . . .., cy. /2 kli/ cc. -6/ a ---1// d 1,1 '---, /W(0 6_1 T2-----,-2 4-ii (1/ 7.7 1--) (// - , - - / . i-- ': _, — r ' — S . 2-C-/ -4.-f. /-1-.... /24.--<;e j %It Sr I MICHAEL C. t;.1ARTINEZ DISTRICT JUDGE 70 NORTH SAGINAW STREET PONTIAC, MICHIGAN 49342 (248) 758-3859 (248) 451-2697 (FAX) ?49ttrit 50TH DISTRICT COURT May 10, 2004 Office of Substance Abuse Services 250 Elizabeth Lake Road Pontiac, MI 48342 Dear Ms. Kosik: It is my pleasure to extend my support for your proposal for a Substance Abuse Capacity Expansion Grant that will help enhance services provided to the Hispanic population of Oakland County. Our district court refers many clients to the Office of Substance Abuse Services including Easter Seals-El Centro "La Familia" because We know that they employ qualified bilingual staff to provide services in a culturally sensitive way. We support El Centro's mission to provide mental health and substance abuse treatment and prevention, case management and other family support services. As I'm sure you are aware, Pontiac has a documented and undocumented Hispanic - population of approximately 16-18%. This grant is needed if we are to provide effective services to decrease the number of individuals that abuse alcohol and other drugs and if we are to have an impact on the number of individuals that drive while intoxicated in our community. The support that the Substance Abuse and Mental Health Services Administration could provide would further facilitate the development and implementation of our shared goals in this endeavor. Hon. Michael C. Martinez 50th 50 District Court .5 3-- CYNTHIA THOMAS WALKER DISTRICT JUDGE • 70 NORTH SAGINAW STREET PONTIAC, MICHIGAN 43342 (246).758-3882 (248) 451:2697 (FAX) rizrze if ECT--i DISTRICT COURT May 24, 2004 Office of Substance Abuse Services 250 Elizabeth Lake Road POntiac, MI 48342 Dear Ms. K.osik: I.!arn' writing in support of your proposal to enhance services to the Hispanic population of (Yakland County througlaz Substance Abuse Capacity Expansion Grant. As a judge of the 50 th District Court in Pontiac, I have witnessed a disproportionate number of SPanish-speaking defendants involved in alcohol abuse. Our community would certainly benefit from effective services to reduce alcohol and drug abuse in this seinent of our population. We currently refer our defendants to agencies who provide qualified bilingual staff and substance abuse treatment and prevention services. The Substance Abuse and Mental Health Services Administration could provide much needed Stipport to develop and implement our shared goals related to this issue. Sincerely, , • .iCynthia Thomas Walker .iDistrict Judge 53 Appendix 2. Data Collection Instruments/ Interview Protocols 1 54 Form Approved OMB No. 0930-0208 Expiration Date 12/31/2005 CSAT GPRA. Client Outcome Measures for Discretionary Programs Public reporting burden for this collection of information is estimated to average 20 minutes per response if all items are asked of a client/participant; to the extent that providers already obtain much of this linformation as part of their ongoing client/participant intake or follow-up, less time will be required. :Send comments regarding this burden estimate or any other aspect of this collection of information to ,SAMHSA Reports Clearance Officer, Room 16-105, 5600 Fishers Lane, Rockville, MD 20357. An .;agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The control number for this project is 0930- 0208. Client ID Contract/Grant ID Grant Year Year 1111111 1 1 1 1 1 J 1 /1 Interview Date Interview Type 1/11111 11121=83111 REEEIZZERINE 115113:051 A. RECORD MANAGEMENT 1. Intake 2. 6 month follow-up 3. 12 month follow-up 4. 3-month follow-up Service Type For intake interview: What service type will the that applies.) 1. Case Management 2. Day Treatment 3. Inpatient 4. Outpatient 5. Outreach 6. Intensive Outpatient 7. Methadone 8. Residential 9, Other 10. Other 11. Other client receive in your program? (Check all 7/4,1. r"....! DRUG AND ALCOHOL USE During the past 30 days how many days have you used the following: a. Any alcohol bl. Alcohol to intoxication (5+ drinks in one sitting) b2. Alcohol to intoxication (4 or fewer drinks and felt high) c. Illegal drugs During the past 30 days, how many days have you used any of the following: a. Cocaine/Crack b. Marijuana/Hashish (Pot, Joints, Blunts, Chronic, Weed, Mary Jane) Number of Days LI 1 1_1_1 Number of Days 1 L1 1 • II 56 1 1_1_1 1 1 _I 1 1 1 1_1 l_f Wack, c. Heroin (Smack, H, Sunk, Skag), or other opiates: I. Heroin (Smack, H, Junk, Skag) 2. Morphine 3. Diluadid 4. Demerol 5. Percoc'et 6. Darvon 7. Codeine 3. Tylenol 2,3,4 d. Non-prescription methadone e. Hallucinogens/psychedelics, PCP (Angel Dust, Ozone, Rocket Fuel) MDMA (Ecstasy, XTC, X, Adam), LSD (Acid, Boomers, Yellow Sunshine), Mushrooms or Mescaline f. Methamphetainine or other amphetamines (Meth, Uppers, Speed, Ice, Chalk, Crystal, Glass, Fire, Crank) . 1.. Benzodiazepines: Diazepam (Valium); Alpeazo lam (Xanax); Triazolam (Halcion); and Estasolarn (Prosom and Rohypnol- also known as rootles, roche, and cope) 2. Barbiturates: Mephobarbital (IvIebacut); and pentobarbital sodium (Nembutal) 3. Non-prescription GHB (known as Grievous Bodily Harm; Liquid Ecstasy; and Georgia Home Boy) 4. Ketamine (known as Special K or Vitamin K) 5. Other tranquilizers, downers, sedatives or hypnotics 1_1_1 h. Inhalants (poppers, snappers, rush, whippets) i. Other illegal drugs (specify) In the past 30 days have you injected drugs? 0 Yes 0 No If no, go to Section C. In the past 30 days, how often did you use a syringe/needle, cooker, cotton or water that someone else used? O Always O More then half the time O Half the time O Less then half the time O Never - )7 131E=SEI CENSIZEIE ESIEEZZEBilli PM= GIME IMESEESIMI GEZIEDIEMESIEZM2 FAMILY AND LIVING CONDITIONS In the past 30 days, where have you been living most of the time? O Shelter (safe havens, TLC, low demand facilities, reception centers, other temporary day or evening facility) O Street/outdoors (sidewalk, doorway, park, public or abandoned building) O Institution (hospital, nursing home, jail/prison) . O Housed: O Own/rent apartment, room, or house O Someone else's apartment, room or house O Halfway house O Residential treatment O Other housed (specify) 2. During the past 30 days, how stressful have things been for you because of your use of alcohol or other drugs? 0 Not at al! O Somewhat o Considerably O Extremely 0 Not applicable 3. During the past 30 days, has your use of alcohol or other drugs caused you to reduce or give up important activities? O Not at all . • Somewhat O Considerably O Extremely o Not applicable During the past 30 days., has your use of alcohol or other drugs caused you to have emotional problems? O Not at all O Somewhat O Considerably O Extremely o Not Applicable Mainerezzsamo===aliMIZEIS EDUCATION, EMPLOYMENT, AND INCOME 53 EIBEEINIMIEEME UM= .00 .00 .00 .00 ,00 .00 1: Are you currently enrolled in school or a job-training program? (IF ENROLLED: Is that full time or part time?) o Not enrolled o Enrolled, full time o Enrolled, part time o Other (specify) 2.: What is the highest level of education you have finished, whether or not you received a degree? (01=1st grade, 12=12th grade, 13=college freshman, 16=college completion) level in years 2a:. If less than 12 years of education, do you have a GED (General Equivalency Diploma)? Yes 0 No 3 you currently employed? (Clarify by focusing on status during most of the previous .y.eek, determining whether client worked at all or had a regular job but was off work) " 0 Employed full time (35-F hours per week, or would have been ) ., I: 0 Employed part time ,i 0 Unemployed, looking for work • . 0 Unemployed, disabled . 0 Unemployed, volunteer work ., , 0 Unemployed, retired ,i 0 Unemployed, not looking for work 0 Other (specify) 4. Approximately, how much money did YOU receive (pre-tax individual income) in the past 30 days from... INCOME a. Wages b. Public assistance c. Retirement d. Disability e. Non-legal income f. Other (specify) ___ imm==3021=a131:10 CRIME AND CRIMINAL JUSTICE STATUS In the past 30 days, how many times have you been arrested? If no arrests, go to item E3 In the past 30 days, how many times have you been arrested for drug-related I I I times offenses? 3. In the past 30 days, how many nights have you spent in jail/prison? I I I nights • , I I I times .114, a. Inpatient Treatment for: If yes, altogether No Yes ± for how many nights (DK=98) If yes, altogether How many (DK=98) I MENTAL AND PHYSICAL HEALTH PROBLEMS AND TREATMENT How would you rate your overall health right now? O Excellent O Very good O Good O Fair O Poor During the past 30 days, did you receive: i. Physical complaint . 0 0 ii. Mental or emotional difficulties 0 0 iii. Alcohol or substance abuse 0 0 b. Outpatient Treatment for: If yes, altogether No Yes ± how many times (DK=98) i. Physical complaint 0 0 ii. Mental or emotional difficulties 0 0 iii. Alcohol or substance abuse 0 0 c. Emergency Room Treatment for: If yes, altogether No Yes ± for how many times (D1(--98) 111* i. Physical complaint 0 0 ii. Mental or emotional difficulties 0 0 iii. Alcohol or substance abuse 0 0 During the past 30 days, did you engage in sexual activity? ONot permitted to ask 0 Yes a. Sexual contacts (vaginal, oral, or anal) did you have? b. Unprotected sexual contacts did you have? c. Unprotected sexual contacts were with an individual who is or was: 0 No 60 I I 1. NW oositive or has AIDS 2. An injection drug user 3. High on some substance _I arat=1 In the past 30 days (not due to your use of alcohol or drugs) how many days have you: a. Experienced serious depression b. Experienced serous anxiety or tension c. Experienced hallucinations d. Experienced trouble understanding, concentrating, or remembering e. Experienced trouble controlling, violent behavior f. Attempted suicide g. Been prescribed medication for psychological/emotional problem I_L___1 1 I I I I I I 1 1 1 I I 4a. r If you reported one or more days in question 4, how much have you been bothered by these psychological or emotional problems in the past 30 days? (If you did not report any days to the items in question 4, skip to the next question.) • O Not at all O Slightly 0 Moderately O Considerable O Extremely DEMOGRAPHICS (ASKED ONLY AT BASELINE) Gender O Male O Female O Transgender O Other (specify) Are you Hispanic or Latino? 0 Yes 0 No If yes, what ethnic group do you consider yourself? (CSAT ONLY) O Central American 0 Cuban O Dominican 0 Mexican O Puerto.Rican O South American L., 4-0,1 , k.n j 6I =.1 :21M22= M11119221M What is your race? (Select one or more) O Black or African American 0 Alaska Native O Asian 0 White O American Indian 0 Other (specify) O Native Hawaiian or other Pacific Islander What is your date of birth? 1 I Month / Day / Year MINIZEIMEZ222= FOLLOW-UP STATUS (REPORTED BY PROGRAM STAFF ABOUT CLIENT ONLY AT FOLLOW-UP) What is the follow-up status of the client? o 01 = Deceased at time of due date o ii = Completed within specified window o 21 = Located, but refused, unspecified O 22 = Located, but unable to gain institutional access o 23 = Located, but otherwise unable to gain access O 24 = Located, but withdrawn from project o 31 = Unable to locate, moved , • 32 = Unable to locate, other 4- DISCHARGE STATUS (REPORTED BY PROGRAM STAFF ABOUT CLIENT ONLY AT FOLLOW-UP) On what date was the client discharged? / I II I I I Month / Day / Year What is the client's discharge status? O 01 = Completion/Graduate O 02 = Termination If the client was terminated, what was the reason for termination? (Select one response.) O 01 = Left on own against staff advice with satisfactory progress o 02 = Left on own against staff advice without satisfactory progress O 03 = Involuntarily discharged due to nonparticipation o 04 = Involuntarily discharged due to violation of rules o 05 = Referred to another program or other services with satisfactory progress O 06 = Referred to another program or other services with unsatisfactory progress o 07 = Incarcerated due to offense committed while in treatment with satisfactory progress 0 08 = Incarcerated due to offense committed while in treatment with • unsatisfactory progress . 09 -7 Inc=:...trat-i due to od =vamp or el-IRr sgPd from before enterin g treatment with 62 1211:1110 satisfactory progress 0 10 = Incarcerated due to old warrant or charged from before entering treatment with unsatisfactory progress 0 ii Transferred to another facility for health reasons 0 •• 12 = Death 0 13 = Other During the course of treatment in your project, what types of services did the client receive? (Check all that apply and tell how many weeks the client spent in each service.) 1. Case Management 2. Day Treatment 3. Inpatient 4. Outpatient 5. Outreach 6. Intensive Outpatient 7. Methadone 3. Residential 9. Other weeks 10. Other weeks 11. Other weeks weeks weeks weeks weeks weeks weeks weeks weeks 63 . • Appendix 3. Sample of Consent Forms • , r, t r . , 1,1 ,r1 i t 64 • Sample Informed Consent Form Introduction/Purpose YOU are invited to participate in an evaluation study of Easter Seals Michigan (ESM)-Ei Centro's SUbS tance Abuse Treatment Program. The purpose of the evaluation study is to collect information that is required by the agency of the federal government that is funding ESM-El Centro's services. The federal agency is the Center for Substance Abuse Treatment in the U.S. Department of Health and Human Services. The study will end in October of 2007, but we are asking you to participate for only one year.. Procedures If you agree to participate in the evaluation study you are giving permission for the ESM-El Centro staff to share your program participation records with the evaluation team and you are agreeing to be interviewed three times during the next twelve months. If you agree to participate, we will do the first interview today. The first interview will take about 45 minutes. The second interview will be completed in about six months, and we will complete the final interview in about one year. All interviews will be conducted at ESIVI-E1 Centro offices, by one or more Members of the staff. Each of the follow-up interviews will take about 30 Minutes. During the interviews, you will be asked questions about your health, alcohol and other drug use, sexual activities, criminal activities (if any), income, and employment. Also, during the first two interviews, we will ask you for information to help us contact you to schedule the next interviews. Yhu have the right to refuse co participate in the evaluation study. If you refuse to participate, it Will not keep you from receiving services from El Centro. If you agree to participate, you can still refuse to answer some of the questions during the interviews. You also have the right to stop an interview at any point. If you agree to the interviews, you are agreeing to give thoughtful, honest responses to the questions that you answer. Confidentiality a of your answers to the interview questions will be confidential, to the extent provided by the law. None of the answers you provide during the interview will be told to anyone outside of the Staff and evaluation team. Your name will not be on the interview form. Only your program case number will be on the form. Your name will not appear in any reports of the study results. Benefits No direct benefits will result from your participation in the study. compensation You will receive no money for completing this first interview, but you will be paid $10.00 for Completing each of the two follow-up interviews. If you contact us to change or confirm information about where to find you, or to schedule a follow-up interview, you will receive an Additional $5.00 after you finish the interview. 65 Risks We know of no risks associated with participation in this evaluation study. Rights as a Research Subject Ifyou have any questions, now or in the future, about your participation in the study or how the inforMation you provide will be used, you may call Melanie Hwalek at 313-964-0500 at extension 202. If you have any questions about your rights as a study participant, you may contact Dr. Sonia Acosta at El Centro. Dr. Acosta can be reached at 248-858-5317. cdnsent to Participate in the Research Study I have read, or had read to me, the above information about the study. The meaning of this information has been explained and I understand my rights. All of my questions have been answered. I have received a copy of this consent form. I volunteer to participate in the eYaluation study of the El Centro program. Respondent's name printed Respondent's signature Date Guardian's name printed Guardian's signature Date Interviewer's signature Date 66 CONSENT TO VIDEOTAPE I understand that one of my counseling sessions will be videotaped for the purposes of staff development and training. I also understand that I have the right to stop videotaping at any time; or choose not to be videotaped at all, and that.there will be no consequences for my family and me. I also understand that these videotapes will be destroyed one month after receiving feedback from evaluators. I understand that videotapes will be labeled using a code that maintains my family's confidentiality, and that only professional staff or trainees will have access to these videotapes. Understanding this, I give my permission to have our family sessions videotaped. Signature Date Signature of parent/Guardian Of client is a minor) Date date Note: This consent is valid until guardian's signature. or within a year from client or 67 Pledge of Confidentiality (for other ESM staff and evaluators assigned to this SAMHSA project) The presentation that you are attending will include videotapes of actual therapy seSsions. The clients in these tapes have signed a release for the use of their tapes for the training of professionals. Please remember that you are bound by the ethical principles of all mental health professions and training programs to safeguard the priVacy of therapy clients. Please do not discuss identifying clinical information with any persons not attending this presentation. If you recognize any client in a presentation, please let the presenter know immediately. have read the above paragraph and a&ee to abide by the stated principles of confidentiality. Date: Signature: Affiliation: 68 v • Address: State: Easter Seals — Michigan, Inc, General Information, Your Rights & Consent to Services Date: Name: ES Client ID: CMHA Case #: Phone: General Information and Your Rights Yes •.;: No 0 I have been advised of my rights, under law, as a client of Easter Seals services including an explanation of my rights. O , 0 I have received and reviewed the Easter Seals Internal Dispute Resolution Process including the name drily case manager/clinician's supervisor. O 0 [have received and reviewed the "Your Rights" booklet included in the Orientation Packet mailed/given to me and other information including program brochure, Person-Centered Planning handout, and confidentiality guidelines. O 0 I have been advised of the services available and the qualifications of those who provide the services to me, including • psychiatrists, psychologists, social workers, other mental health professionals and volunteers. • • 0 I have been advised that my records may be destroyed after seven (7) years following termination of services or for minors seven (7) years after attaining the age of eighteen (18). O 0 am interested in Rights Training. (The office of Recipient Rights provides education, monitoring, and complaint resolution to OCCMHA customers. The Rights training provides the basic understanding of the Rights you have as a - customer and other options outside the Rights Office for complaint resolution. You get an opportunity to learn about advocacy groups an.d network with others.) Client Guardian ES RepreSentative 17, Consent to Services O I authorize the mental health worker assigned to me to provide treatment and/or recommendations, as the worker considers necessary and Proper. I realize that treatment does require a mutually agreed-upon Person Centered Plan of Service. This plan, developed with my Participation, shall define a vision for my future or that of my child and my/our goals, roles, and responsibilities. O 1 understand through implementation of this Person Centered Plan, my/our worker will assist me/us in understanding all procedures used; any possible risks, the purposes of treatment, any discomfort, the reasonable expected benefits, and any alternatives to treatment, which may be helpful. I/we agree to participate this Person Centered Plan voluntarily, and 1/we understand that my/our consent to treatment may be withdrawn by me/us at anytime O My records will be kept confidential, and am-ee that my records and progress will be presented during staff conferences for I supervisory purposes. O If I an a parent of a minor, that I am expected to participate in my child's treatment. ln Signature Guardian [ ES Representative: 4. I Date Date Date Date Date Date 05/17/04 - al General Info, Your Rights & Consent to Treatment Appendix 4. Letter to Single State Agency F COLI•:NTY MICHIGAN 0 4PAR7)vIENT OP HUMAN 5?.FIVICIES Kay 18, 2004 L. BROOKS PATTERSON, OAKLAND COUNTY EXECUTIVE HEALTH DIVISION George J. war, M.A., Manager Richard Pfaff SOutheast Michigan Council of Government 35 Griswold, Suite 300 Detroit, Michigan 48226 Pear Mr. Pfaff: E.3.closed please find a copy of the grant application entitled " Culturally Competent Substance Abuse Treatment" that we are submitting to the Substance Abuse and Mental Health Services Administration Office through their CSA.T Targeted Capacity Expansion Grant Program. '1 Oakland County Health Division/Office of Substance Abuse Services is one of sixteen state regional cbordinating agencies (CA's) whose functions include needs determination, comprehensive planning, subcontracting for prevention and treatment services, administration and management,- data collection, utilization review, and program monitoring for fiscal accountability and clinical quality within their In an attempt to address the gap between services provided to the growing Hispanic population of the Ounty, we are collaborating with Easter Seals Michigan- El Centro. "La Familia" and residential providers to provide substance abuse services to adults and adolescents meeting the abuse and/or dependence criteria. !I Easter Seals of Michigan is an affiliate of Easter Seals a nationwide network of agencies, program and services. All people who are 'touched by the organization recognize Easter Seals throughout the country for their quality of services. Easter Seals, Et Centro "La Familia" is the Hispanic program whose mission iS to provide ethnic-sensitive mental health, substance abuse and family support services in a bilingual and bicultural mode. e believe that if this project is funded, it will benefit a great number of Hispanic families who would Otherwise fail to access quality substance abuse and mental health services. OAKLAND COUNTY HEALTH DIVISION Department of Human Services / f Sandra L. Kosik, RN, MPH Chief of Substance Abuse Services 248-858-0001 CI, e,nclosusre 11 BLDG 36 EAST 1200 N TELEGRAPH RD DEPT 432 250 ELIZABETH LX RD - 97725 GREENFIELD RD 1010 E WEST MAPLE RD PONTIAC MI 4834-1050 • SOUTHFIELD MI 48078-3625 • WALLED LAKE MI 48890-35138 PONTIAC MI 48341-0432 Appendix 5. County Strategic Plan- support letter 72 7,71=4,1."11 COUNTY MICHIGAN DEPARTMENT CH HUMAN SERVICES L. BROOKS PATTE.R.SON, OAKLAND COUNTY EXECUTIVE HEALTH DIVISION George J. Miller, M.A., Manager Mav 19' 2004 T,47hoin It May Concern: This letter conies in support of the "Culturally Sensitive Substance Abuse Services" grant prO'posal that is being submitted by the Oakian.d County Health Division/Office of Substance Abuse Services (0S.AS). The Health Division has always given priority to programming that addresses the needs of minorities and other special populations and this proposal specifically addresses the substance abuse needs of the Hispa.nie population in Oakland. .:! ReSearch and statistics show that Oakland County students have a higher incidence of drug and alebhol use than the national average and a report by Healthy People, Health Oakland identified driig and. alcohol misuse as a major health concern among -. Oakland County residents. As a result, the: Oakland County Health Division's 2003-2005 Strategic Plan has incorporated substance ab.Use prevention and treatment objectives into their comprehensive plan. Goal number two of the three-year plan is to "Improve health through lifestyle change." Two of the objectives: "Increase minors choosing an alcohol, tobacco and drug free lifestyle" and "Decrease abuse of al' 5 y clohol tobacco and other drugs b— will be addressed by this innovative program. The evidenced-based practices of Brief Strategic Family Therapy and Cognitive Behavioral Therapy are well-researched and proven methods for effective intervention with Hispanics and substance abusers. In collaboration with Easter Seals. of Michigan — El Centro and OSAS's network of residential treatment providers, the services identified in this proposal will bring substance abuse prevention and intervention to the growing, population of Hispanics in Oakland - 1.1 County. :.! !! Thank you for your consideration of this worthwhile project. nicerely, 6; OAKLAND COUNTY HEALTH DIVISION 'Department of Human Services 'eortJ. Niller, M.A. Man ,er/I-Xealth Officer jI BLDG 36 'CAST 1200 N TELEGRAPH AD DEPT 432 P,ONTIAC MI 48341-0432 (248) 858-1280 1 2:::(:1-_-L.IL5.dE I H LK HU 27725 GREENFIELD RD 1U1U VVIaS I MAI-L • PONTIAC MI 48341-1050 • SOUTHFIELD MI 48076-3625 • INALLED LAKE MI 48390-3588 (246) 424-7000 (243) 926-3300 Appendix 7. Assurances — non Construction Programs if ! 1 74 CMS Approval ?4o. o34s..n0.0 • ASSURANCES - NON-CONSTRUCTION PROGRAMS Ptib mcarting burden for this coilecicinof informztition is estimat,ed to averzce, 15 minutes per response, including time for re.vieY.Vinc instructions, searching existing data sources, Gathering and maintaining the data riaeded, and cornpietir and; reviewing the collectic,ri of ihfc,rmation.'Send comments resalting tfle burden estimate or any other aspect of this collection of infoimation, including sugcestior,s for recluoinG this burden, to the Offick7, cf l'_itanagernent Budbet, PaperWock Peductic,r, I Pro.ieirt (042.-0040), Wastiingron, DC 20503. J., PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, sE4i) IT TO TH.E ADDRESS PROViDED BY THE sPoNS0RING AGENCY, Note.;.; Certain of these assurances may not be applicable to your project or program. 'lf you have questions, please cont-act the awarding agency. Fui'ter, certain FeCerai awarding agencies may require applicants to certify to additional assurznces. such is the case, you will be notified. As the duly authorized representative of the applicant certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient ':o pay the hon-Federal share of project costs) to ensure Proper planning, manacement and completion of th,e, project described in this applice,ion, 2. Will oNe the awarding agency, the C'r..,-mptroller General of the United' States, end if appropriate-, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in ac:cordance with generally accepted accounting standard or agency directives. 3. Willestablish safeguards to prohibit employees from Using their positions for 2 purpose that constitutes or presents the appearance of pers,onei or oigenizational conflict of interest, or personal gain. 4. IiIi initiate and complete the work within the abplicable time frame after receipt of :approval of the awarding agency, 5. Iiil comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. al14728-4763) relating to prescribed standards for merit syatema for .orograms funded under one of the nineteen statutes or regulations specified in Appendix A of OPM's Standard for a Merit System of Personnel Administration (-5 C.F.F.s. 900, Subpart F--) 6, Will comply with all Federal statutes relating to hondiscrimination. These include but era not limited .13: (a) Title Vl of the Civil Rights Act of 1964 (PL. 6.8-352) which prohibits discrimination on the basis Ci.tf race, color or national origin; (b) Title IX of the tducation Amendments of 1972, as amended (20 (;§1681-16a3, and 1833- 1656), which prohibits discrimination on the basis of sax; ( Section 504 of' the Rehabilitation Ac: of 1973, as :amended (29 U..b.C. •;hich p;ohiblts !.discriminaticn on the basis of handicaps; (0) the .Age Discrimination Act of 1975, as amended (42 , §§6101-6104 which prohibits discrimination on thc is of (e) the .Drug Abuse Office and Treatrnent.Act of 1972 (P,L. 92-255),, as amended, relating to nondiscrimination on the basis Of drug abuse; (f) the • Comprehensive Alcohol Abuse and Alcoholism Pre,./ention, Treatment and Rehabilitation Act of 1970 (iP,L, 91-616), as amended, relating to nondiscrimination on the. basis of alcohol abuse or alcoholism; (9) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§29O dd-3 and 290 as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title yvi of the civil Rights Act of 1968 (42 U.S .C. §§3601 et seq.), as amended, relating to non- discrimination in the sate, rental or financing of housing; (i) any other nondiscrimination provisions In the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has alrady compiled, with the requirements of Title li end III of the Uniform Relboation Assistance and Real ,Property Acqui- sition Policies Act of 1970 (Pl. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted .programs. These requirements apply to all Interests in real property acquiRid for project purposes regardless of Federal participation in purchases, S. Will comply with the provisions of the Hatch Act (5 §41501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded In whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the F.'Leils-ae.con Act (40 U.S.C. §§276a to 276e-7), the Copeland Act (40 U,S,C, §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333), regarding )nor standards for federally assisted construction subegreements. i2 (P.m% Prancabcd by VAB arcuisr A- n02 VVnIL ccmply, if applicable, with flood insUrance purchase requirements of Section 102(a) of tile. Flood Disaster Protection Act t.',f 1975 (PL. 93-72'54) which requires recipients in a s-pacial OO hazard area to penricipate in the program and to . purchase. Reed insurance if the toicai cast of insurable construction and acquisition is 1'10,000 or M'cra, 11. comply with environmental standards which may be prescribed pt:rsuant to the followinc: (a) institution of environmental quality control meaisures under the National Environmental Policy Act :of 1939 (PI. 91-190) and Executive Order (Ea) 11514; (t) netificaticn of violating facilities pursuant to 11738; (c) p.rotection of wetland purs.uant to E.0 11990: (d) evaluation of flood hazrcis in flocdpla;ns • in accordance with EC., 11938; (e) assurance of project consistency with the approved State management crocram deVeloped under the Costal Zone Manacement Ad ;of 1972 (13 U,S.C.. §145i et see,); (1) conformity of Federal actions to State (Clear Air) impiementation Plans under Section 176(o) of the Clear Air Act of 155E. as amended (42 §§7401 at seq.): (9) protection of undercround scUices of drinking water under the Safe Drinking Water Act of 1974, as amairide.d, (Pl. 53-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (Pl. 93-205). • 12_ WU:comply with the Wild and Scenic Rivers Act of 1968 (13 U.S.C. W1271 et seq.) related to procectine ccs.mponents or potential components of the rational wild and scenic rivers system. :1 13. 'Nig assist the awarding acency in a5surino ccmpliance witlt Section 106 of the National 'Historic Prieservaori. Act of 1965, as st -nende6 (19 E470), ED 11893 (identification and protection of historic properties), and the .4rohaecicc)c.a anoi 'Historic Pre.seriation Act of 1974 (16 U.S.C. 499a-1 et sail.). 14. Will comply with Pi. 93-348 regaftitng the orc.tection of human sub:ler:As involved in research, :7::evelment,. and -reated activities suppor ted by this award of assistance, 5. Will comply with the .....,Gboratori Animal Welfare.- Act of 1933 89-544, as amended, 7 §„z:-.72131 et seq.) pertaining to the care, hanciline, ahe treatment of warm blooded animals held far research, teaching, or other activities .suppened by this award of assistance. 19. Will cam* with the Lead-eased Paint Poisoning PraVention Act (42 U.S.C. 6§4801 et seq.) which prohibits the Use of lead based paint in con- struction or rehabilitation of residence structures. 17. Will cause to Ce performed the required financial ai,nd compliance audits in accordance with the Single Audit Act of 1984. 18. Will comply with ail applicable requirements of all other Federz-li laws, executive orders, re- guletions and policies governing this program_ i sIGNATibRF/CFNC.LITHORIZ=0 CERTIFYING OFFICIAL ,,..---) ..,, 7- i _/' • / ,_.... hill 1 / ) /1,--"1-----77./ .. - • -• f/(1 / "T/ / / / L ,/,',//, 1 , 7/ ..- //I , -iy A ,/ \\ /1/2.--rf/, ..., - -/ . 7/ r--- , 1 Appuc'XNr-5r„-,r4lz*TioN 0k1-and County ; il TITLE Vice—Chairman, Oakland County Board of Commissibriers DATE SLIEMITT:;-:0 Lir (Rev. 7,97) 5?ct: Appendix 8. Certifications I I I S I .1! or 77 0,-)) (c) (ci) (a) Co) (c) (d) (C) ( ) (4) 6TS-5161.-1 (1(10) Pap 17 0 Y.P, A pprowd No. 7'.720-01 CERTIFICATIONS CERTIFICATION REGARDING DA.RNINT .AND SITS:PENSION The undersi.zaked (atithorized official signing fo-r the 1.1 appticant organization) certifes to the best of his or her knowledge and belief, that the applicant, defin.ed as the primary participant in, acci;ordan.ce with 45 CFR P'ai.'t 76, and its principals: (.i) are not presently debarred, suspended., proposed , for de-a---ierr < r,-r 7011t"1I excluded fr,c.m. covered transactions by say Feder-al Dcparttnent or agency; have hot within a 3-year period preceding this proposal been convicted of or had a civil judz,rnent rendered zrzainst them for commission of fraud or a criminal offense in, carinectiori with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public rt.:ix:sac:60n; violation of Federai or State antitrust statutes ."..)r z.0 rnmisaioo. of ernhczziernent, theft, ;forzery, bribery, falsification or. destraction of records, making false statel-nents, or re.ceivi7n.g stolen property: are nOr prescridy indicted . or otherwise criminally or civilly oli.n...rged by a goveranacttal entity (Federal, State, or local) ',Iijth corn- mission of any of the offenses enumerated in paragraph (h) of this certification; and Cave not within a 3-year period preeedint: this application/proposal had one or more public transactions (Federal, State, or, local) terminated for cause or dE.:fa-ult. heuld the applicant nor be able o provide this eertification. an explanation as to why should be placect after the asSurances page in the application • package. Alie applicant agrees by submitting this proposal that will include, without.rriodification, the clause titled 'Certification Re,.,-farding Debarment, Suspension, In !eligibility, and Voluntary ,Ex.elusion.--Lower Tier all lower tier eavien-..,-ci iransac.tio.ns (i.e., transaetions with sub- grantees :andicx contractors) and in all solicitations for lower tier covered transactions in accordance with 45 CFR Part '16. 2. CERTIFICATION REGARDING DRUG-FRE.E V:IORKP L A CE .REQUIREM ENTS The undersimcd (authorized official signing for die applicant organization) certifies that the applicant or will continue to provide a drug-free work- place inacc.ordence with .45. CFR Part 76 by: Publishizg a statement notifying employee; that the unlawful manufacture, distribution, dis- pensing, possession or use of a controlled substance is prohibited in the grantee's work- place and specifying the actions that will be taken against employees for violation of such prohibition; Establishing an ongoing drug-free awareness program to iriform employees about- ()) The dangers of drug abuse in the workplace; t'2) The grantee's .poiley of maintaining a drug-free workplace: Any available druz counseling, rehabil- itation, and employec assistance programs; .and The penalties that may be imposed upon employ E..-es for drug abuse violations oecurrinz in the workplace; Makinp. It a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a) above; Notifying the employee in the statement re- quired by paruraph (a), above, that, as a condition of employment under the grant, the employee will— (1) Abide by the terms of the statement; and (2) Notify -the employer in -,vriting of his or her conviction-for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; Notifying the agency in writing within ten calendar day S after receiving notice under paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working,. unless the Federal agency has designated a central P3zc. point for the receipt of such notices. Notice snail include the identification number(s) of acn affected grant; (f) Taking one of the following actions, within 30 calendar days of receiving notice under Paragraph (d) (2), with respect to any - employee, I ' Wno is so convitatecl-- , (..1) Taking appropriate pCrsonn.el action against ! such an employs; up to ar,d including . . et miinat:iels, consistent with the recuirernents of the • R.ehabilitation cF 1973. as amended; or (2) Requiring such employee to p,articipace • sadsfactorily in a drug buse assistance cr •t rehabilitation program approved for such .1 urnoce- by a Federal, State, or local health, P :.1 taw enforcement, or other appropriate ;1 agency; Making .a good faith effort to continue to •• maintain a drug-free woricplace through .irinple- •entaticr) of paragraphs (a), (b), (c), (d), (e), id (f. .1 • • For purposes of ,parazaph (e) regarding agency notification of criminal drag convictions, the DI-11-1S has .1 designated the following central point for receipt of „ such notices: Office of Grants and Aceuisition Management Office of Grants Management Office of the Assistant Secretary for Management and Budget Departrrient of Health and Human Services 200 Independence Avenue, S.W., Roorrt 5.17-D it• Washington, D.C. 20201 S. CERTIFICATION REGARDING LOBBYING Tit1ej31, United States Code, Section. 1352, entitled "Lirriltaticn or, use of appropriated funds to in- fluence certain Federal contracting and finarteial transactions, zenerally prohibits recipients of Fcelcial grants and cooperative agreements rram using Federal (appropriated) futds fer lobbYl•5:zi the •....N,e0.1tive or Legislative Branches of the Federal Goqrrament in connection with a SPECIFIC grant or cookra,tiye agreement. Section 1352 also requires that ieach person who requests or receives a Federal g.'ran,f or cooperative agreement must disclose lobbi)ing undertaken .• with Don-Federal (non- appr'epriated) funds. These requirements apply to grants and cooperative agreements EXC:EEDING $109,000 in total costs (45 CFI?, Pala 93). Thc:iundersigned ,authorized o.wLia sigair2;, for thr. applicant organization) cartiLes, to the best of his or her ktoWledgc and belief, that:: ,t (1) No appropriaicd •fuAids .h.ave been paid jot will be paid, by or on behalf of the under- iniSr-S161-1(7/0() Signed, to any person for tnfluencitiR or attempting infucnca an ,officer or employee of any agency, a k,,terrOcez- of Con:fres:6, an officer or ernpleyee of Co.nisress; or an e;:nolcyce of a Member of Congress in eel-meet:ion with the awarding of airy Federal cc:lin-act, the ma.lciaT of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, zontirraatien, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative az.reernent, (2) If any .f,,Lads other than Federally appropriated funds . have been paid or will be paid to any person for influcrieln.2 or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, gtdrit, loan, OT cooperative agreement, the undersigned shall complete and submit Standard "Disclosure of Lobbying Acnvities, in accordance with its instructions, (If needed, Standard Form-ILL, "Disclosure of Lobbying Activities," its instructions, and continuation sheet are included at the end of this application form.) (3) The undersigned shall, require that the language of this certificaticsi b e included in the award doc- uments for all subawards at all tiers (including 1,113contractS, ,subgrants; and contracts under grants, (cans and cooperative agreements) and that - all subrecip.icnts shall certify and disclose accordingly. This certification is a „material representation o.f fact upon which reliance was placed when this transaction was made or entered into. Subrnission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, U.S. Code. Any person who fails to. file the required certification shall be subject to a civil pCrIalty Cf not less than 510,000 and not mere than 5100,000 for each such failure, 4. CERTIFICATION REGARDING PROGRAM FRAUD CIVIL REMEDIES ACT (PFCRA) The undersigned (authorized official signing fox the aPplicant organization) certifies that the statements herein are true, complete, awl accurate to the best of his or her knowledge, and that he or she is aware that any false, fictitious., or fraudulent statements Of rn.7y subject _him or her to criminal, civil, or administrative penalties. The undersigned agrees that the applicant organization will comply with the Public.' Health Set-vice terms and conditions of award if a gfmt is awarded as a result of this aon I •-,41 f.$) 4, 11 i; '7:774're AIORz."4 f ; STIFYIPIG ) / , (7/0q.! 5_ CERTI.FICA,TTON REGARDING ENVTRONIVITINTAL TOBACCO SMOKE:, Law 103-227,. also known as 'she Pro-Cliiidran At of 1994. (.<.!tot,), requires that ki not be prrnit ter: ir 1-c•—t''',"" of or, leased or contracted c-or by ari -entity and used rOUtincly or re:a-alai-1y for the pnovision of nealti-„ cisy cd.re, early childhood development services, eid'JCation. lib.rary set-vices to eljidrea tir.d.er the .1 age of the services are f.'unded by Federal pltiograros ether directly or through State or local overtiments, by Federal grant, coarract, loan s or loan gUarancee. Thc law also applies to chiidren's services that arz provided in indoor facilities that arc O6Ttstructed, opts:aced, ort L CJwith such E..ckieral funds. The Jaw does not apply to ebildren's vices provided in private residence, portions of facilities used for inpatient cruc a a n CO:n.0: treatment, striicc providers whose sole source b.f applicable Tr'e.deral funds is Mcdieilre or -Medicaid, or facilities WIC coupons are redeemed. 11' 1 - 1 P:t: 19 Failure :o comply with the PrOVi5i0Z6 of the law may result in the i..position of a civil monetary ocrialty of Up to .51,000 for each violation and/or the imposition of an administrative compliance order an the rcspcmsible 'entity. signing the ceri:Eication, tbc undersigned certifies that the applicant.organiz.ation will comply wit.1 rae 7,,,,,ii-otrienrits of the ,k,‘_ct and will .riot allow smoking any 1,-,,ortion of any indoor facility used for the provision of services for children as defined by the Act. The 'applicant organization agrees that it will require that th4.-. language of this certification be included in ar,y sdbawards which contain. provisions fOr children's services and that all subrecipicnts shall certify accordino.ly. The Public Health. Services stron.gly encourages all grant recipients to provide a smoke-free workplace and pro:mote the non-use of tobacco products. T.his is oeonsiatent with the rtis mission to protect and advance the physical an mental health of the American people. Ii APFLICANT ORGA417-1CN•N :Oakland County TIME "DPW1 Ni 0 ys-'71 TT L.zi ce _chairtnan, 1 Oakland County Boa.td: of CommiAsionersi OATS SUOMITTED Appendix 9. Disclosure of Lobbying Activities 11 11 81 p Approved by 0M8 0348-0046 ?C r 1 07," BYIN G ACTIVITIES Complete this form to disclose lobbyinc, ectivities pursuant to 3 1 U.S.C. '352 (See reverse for public burden disciosure,) . 1. HType of Federal Action: ' 2. Status of Federal Action ; I 3. Report Type: i--- . i — a. contract i n a. bid/oiler/lication . 1 ri a, initial filing app I' b. grant b. initial award a. material change I c. cooperative agreement C. post-award For Material Change Only: d. loan Year ' • Quarter e. loan cuarantee f, loan insurance date of last report 4.: Name and Address of Reporting Entity: 5. if Reporting Entity in Na. 4 is Subawardee, Enter Name and I Address of Prime: Prime 0... Subawardee Tier , if KnOwn: !., Congressional District, if known: I Congressional District, if known: 6. Federal DepartmentlAgency: .7. Federal Program Name/Description: i CFDA Number, dependable: 8 :ii Federal Action Number, if known: 9. Award Amount, if known: 1 $. 10..a. Name and Address of Lobbying Entity b. individuals Performing Services (including address if different i (if individual, last name, first name, MI): from No. 10a.) (lest name, first name, MO: I 11',I Information requested through this form is authorized by :1 title 31 U.S.C. section 1352. This disclosure of lobbying Signature: • I activities is a material representation of fact upon which • . n , reliance was placed by the tier above when this transaction •1 i was made or entered into. This disclosure is required Print Name: .4 pursuant to 31 U.S.C. 1352. This information will be reported , .:I to the Congress semi-annually and will be available for i.1 public inspection. Any person who fail to file the required Title: ,1 disclosure shall be subject to a civil penalty of not less than $10,000 and not more than 5100,000 for each such failure. Telephone No.: Date: - „.. ..1..:, - ,..71-7-'"?...f.1., .,.M..-- • -,. 1.--,2"" - - -,:. .--:-•, ,:..i. Authorized for Local Reproduction . .... ,..- Appendix 10. Checklist ;1 H 83 i.609) L':i nt: 2s Ef ctearance Officer, :000 Clifton Ficau, MS 0.2.1, Atlanta, GA 303:33, ATTN: PP.A 092C .04 2e.). pr; sand the. completed 101)11 to this NOTES TO APPLICANT: This farm must be cerapieleti anu submitted oith the oricMal oh ;four application. Be sure to complete both Sides of this k;i0.1. Check he appropriate. boxes .and provide the informatiof': :et:ate:a:ed. This form shouid be attached as the last oane of the signed Qriginni of the application. 'me ;agc a ,eserve0 tor P1.15 staff use ordy, 'title Chief organizatioiOakl and County Orgablvition tz) Address 248 -492 -8672 Fax Mutat; er °MO AI:pew/Al No. 0900.0423j April 30, 2000 (71-1:E.C1c1,:ST Public Burden Statement: Pubfic reporting ;;;.t:r(ito G; oollOctinninformation is estimated to average 4 - response. inctuding the Hine for reviewing instr.ictions, searching existipg data sources, gathering and maintaining the data needed, antf,completing and reviewing the ,—ueolion ofinformothl. Al agey may not conduct or sponsor, and a person is :lot !'entlired to reppond to a oolleclon of information Wioss it displays a currently valid 0M13 cantroi number. Send comments reoan!ing this .burden estimate or aziy all aspect of this colleQ;ion ol inforination. Including suggestions lor reducing this 0tircion to CDC, ..' _ Nonoompelini,i . Compotinid 71 e. Typel at Application: 1%7 NEW ;:.I.:1 Condnuaticn. • ;!.., LI: Continuation LLI :auppleinental PA l-T,V, A: The followin g checklist is provided to assure that proper sigt tatures, assurances, and certifications have been - subiliitted. NOT lFi . induded Applicithle : lli, Proper Signature and Date for Item 16 on SF 424 (FACE PAGE) 2. Proper Signature and Date on P1-5-5161:1 l'Certiffcalions 4 par j. Proper Signature and Date an approprfate 'Assurances" page, i.e.. SF-42413 (Non-Construction Programs) or SF-4240 (Construction Programs) 4. If your o(ganization currently has on hie with DHFIS lhe following assurances, please identify which have been flied by indicating the data of Such fling on the line proviCed. (AII four have been consolidated into a single form, HIAS 1:01111 200) Ir-1. Civil f'tights Assurance 115 OFR 30). . . Assurance Concerning the lianuicapoeu 0.) ,,,i 1-1 , 0 il Assurance Concerning Sex DiScrimination (45 CFR ai) ... '.1 .Assurance Concerning Age Discrimination (45 CFR 90 & 45 CFR 91) 5. Human Subjects Certification, when applicable (45 CFR 46) PAR-1;8: This part is provided to assure tlmt pertinent information h as !melt e ddressad and inctuded in the application. NOT i: " YES Applicable l'd Hoe a Public Health System Impact Statement for the proposed program/Ion:Disci 1 been completed and distributed as required'? , 2.1 Has the appropriate box been checked for item g •l1.3 on the SF-424 (FACE PAGE) regarding intergovernmental review under E.O. 12372 ? (45 CFA Part 1,00) 1...:.1 3;1 Has the entire proposed project period been identified in item 3 13 of the FACE PAGE 0 14 4,1 Have biogr,aohical sketch(eS) with fob description(s) been attached, when ii required? 21 rr-7 5: Has the "Budget information" page, SF-424A (Non-Construction Programs) or : SF-424C (Construction Programs), been compieted and included? itoj 5. Has .the 12 month detailed budget been provided?' . . • . 7.i, Has the budget for the entire pi :coot:ad project penod with suificiert detail ocon (ra' provided? 1111 . 8.1! For a Supplemental application, does the detailed budget address only the additional 1 1 funds requested? Lij 1.4 - 9 -il For Cc:Mr:0(41g Continuation and Supplemental appiications, has a progress rei3ort 1 Pr. r ; I been included? • .. PART to the spaces provided below, please provide the requested information. !'flusIness Official lo s nedlled if ail award :s Is be made, Program Cireclor/Project OireclariPtincleal InvesliVelbr designall%1 to direct • Ihe xoposed I)rI*er Sr prurjram. Sandra L. Kosik Natea Sandra L. Kosik 1 . 0-nummdress kosiks@co oakland.mi .us „1,,1iiimwe iteledirone nIumbar 248 -858 -5 07 Teloollone iguniber one:1„n-ilz,,,T;ON'S [2-0IGIT 0145 CIII (Ii aireerly ivssfrined) SOCIAL 531:00FIlrf Nousan 't .1 I tt I I I bEGAFFFAlamiLla l'atte (7:00) 1 !I U c.,s; PART:p: kvprivste, ncr;protit orrja;;;zation !oust tncl.itil evidence of its nonprofit stows tho apptication. Any of the following is acceota 14,1e. evidence, Cluiek the appropriate 1..:OXorcuJllplola "PmvicJsiy i7ittit:1" sin 011 whichever is aoplicabtra. A reference to-the or,3;anizstion's iislinq in the Internf Revenue Se.rvice's (IRS) most reoet it list of lax-exempt ordanizations desorrheolii section 501-(,„;)(3.1 of the IRS Code, A ccpy of a cuffetety valid interne! Revenue Service Tax exetrption t;ertificaie. A statement frOm a State taxing body, Stale Attorney General, or other appropriate Slate official certifying that the applicant orcianizailun has a nonprofit status and that none of the net earnings accrue to any private shareholders or infiividuals. (d) A certified Copy of the organization's certifi<;ate of incorpordtion or sirnt;Ir• dr:,,cLu tient 1i(dearly establishes the nonprofit status of the or9anization. Any of the :r.lbove proof for a State or national parent organization, ant.t .ittsiot:it-itit- signed by It-te pcirent olguniztaiion thai ttipplicent orc.,..412i.4.31ion ic a local 1014)R/tit It an- applicant has evidence Of airrelll YOnpiCiii status on file with an agency P PHS, it will nut be necessary to file similar papers again, but the piece of timing most be indicated. (z) fl (b) (c) Previously Filed with: (Auetwy) art Mate) • I INVENTION:3 If this ei:In application for continued s upport, include; the report of inventions conceived or reduced to practice rerlotred by the terms arid ccnclitiorts or the grant; or (2)a list of inventions already reported, or (3) a negative Oertiftc:AtIon. E-7,(i_--CUTIVE ORDER 12372 Effective; September 30, i9133, Executive Order 12372 ((ntergq,ernincatal Review of Federal Programs) directed OMB to abolish i'OM.I3 Circular A-95 and establish a new process Thr consultin4 with State and local elected officials on proposed Federal tinanciatlassistance. The Department' Of Health :lad Human Services itsipientOtcd the .Exectitive Order through regulations at 45 CFR kart ,.„ , WO pier-governmental Review of Department of anU Human Scrvice41Programs aud Activities). The objectives of the Ettcsetivc Order aiii to '1) Inemve Shit- tle,ibiiity to design a consultatien - process nd select the programs it wishes to review, (2) increase the abilitybf State and local elected officials co influence Federal decisioa and (3) compel Federal officials to be responsive 10 State =cents; or explain the reasons. The regPlations at 45 CFR.J'art ICU 'xere ;Jobilsbed ill the (fe'.(11 Re.iste14 ' On Juno 24, 1910, along with a notiee ide.atit'fing the e, I Department's prograins that arc sttbject to the provisions of Executive Order 12372. formulation reltarclitig PUS programs subject to Executive Order 32372 is t(so available from the appropriate awarding office, States participating in Iltisproarmitu establish State Single Points of Contact: (SPOC,$) to coocclitan and' manage the review and comment on. proposed Fetierat financial assistance. Applicants should contact the Caveritor's oaice for information regarding the SPOC, programs selected fur t•treic.-N, lud the eutualltation (review) process desi,gned by Their State. • Applicants are to eerLiP; (m die face page of the S3-424 (attache) whether the recitiest- is. for a program covered under Executive . Order 12372 and, where appropriate, Whether the Slate has 'occit given au epportunity to comment, FISCAL NOTE (MISC. 104317) November 18, 2004 BY: FINANCE COMMITTEE, CHUCK MOSS, CHAIRPERSON IN RE: DEPARTMENT OF HUMAN SERVICES/HEALTH DIVISION - SAMSHA TARGETED CAPACITY EXPANSION INNOVATIVE TREATMENT GRANT ACCEPTANCE TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced resolution and finds: 1. The Department of Human Services/Health Division has been awarded by the United States Department of Health and Human Services/Substance Abuse and Mental Health Services Administration (SAMSHA) $500,000 per year for three years for programming which will address substance abuse treatment among the Hispanic population in Oakland County (primarily Pontiac). 2. Funding in the amount of $424,000, will be used to subcontract with Easter Seals El Centro to provide services to prevent and treat the incidence of drug and alcohol abuse and dependency, $1,500 for travel for the Contract Manager, $17,500 for contract administration, and the remaining $57,000 will be used by the Office of Substance Abuse to pay for detoxification, residential treatment related to this project. 3. There are no new positions associated with this program. 4. The grant period is September 30, 2004 through September 29, 2007. 5. The Fiscal Year 2005 budget should be amended to match the Fiscal Year 2005 award as delineated below. Fund 275 FY2005 FY2006 Revenue 1-154902-72500-0113 Federal $500,000 $500,000 Expenditures 2-254902-72500-2572 Contracted Svs. 2-254902-72500-3756 Travel 2-254902-72500-3196 Miscellaneous 2-254902-72500-2568 Contract Adm. Fund 221 Revenues 1-16-201100-72500-0267 Admin. Fees 3-90-430000-98101-1701 O.T. In Fund 101 Expenditures 3-90-310000-98221-8001 O.T. Out 2-90-290000-25000-2564 Contingency 424,000 424,000 1,500 1,500 57,000 57,000 17,500 17,500 $500,000 $500,000 $ 17,500 17,500 (17,500) (17,500) -0- $ -0- $(17,500) (17,500) 17,500 17,500 -0- $ -0- FINANCE COMMITTEE FINANCE COMMITTEE Motion carried unanimously on a roll call vote. G. William Caddell, County Clerk - Resolution #04317 November 18, 2004 Moved by Wilson supported by Hatchett the resolutions on the Consent Agenda be adopted (with accompanying reports being accepted). AYES: Coleman, Crawford, Douglas. Gregory, Hatchett, Jamian, Knollenberg, KowaII, Law, Long, McMillin, Middleton, Moffitt, Moss, Palmer, Patterson, Potter, Rogers, Scott, Suarez, Webster, Wilson, Zack. NAYS: None. (0) A sufficient majority having voted therefore, the resolutions on the Consent Agenda were adopted (with accompanying reports being accepted). STATE OF MICHIGAN) COUNTY OF OAKLAND) I, G. William Caddell, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on November 18th, 2004 with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac, Michigan this 18th day of November, 2004.