HomeMy WebLinkAbout071321 wsaHARNETT COUNTY BOARD OF COMMISSIONERS
Harnett County Resource Center and Library
455 McKinney Parkway
Lillington, North Carolina
Work Session
Tuesday
July 13, 2021 9:00 am
9:00 am Call to Order, Pledge of Allegiance and Invocation
9:05 am Presentation by Dawn Neighbors with NC Community Foundation
9:20 am Presentation by Veteran Harbor
9:30 am Discuss Memorandum of Agreement between the State of North Carolina and Local
Governments on Proceeds Relating to the Settlement of Opioid Litigation,
Christopher Appel
9:35 am Discuss the Bylaws of the Administrative Appeals Board for the School Bus Stop
Arm Violations, Christopher Appel
9:40 am Discuss a Resolution to Delegate Leasing Authority to the County Manager,
Christopher Appel
9:45 am Discuss a Farm Lease between the County of Harnett and Max Matthews, Jr. and
Harry Matthews. The property is located along Highway 421 S. in Harnett County,
PIN#0589-26-5102 & PIN#0589-23-2799 Tracts 1 & 2, Thomas Royer
9:50 am Recommendation on Tax Department Re-organization Plan, Bill Tyson
10:00 am Discussion of Sewer Allocation for North Harnett Wastewater Treatment Plant, Steve
Ward
10:20 am Discuss the North Harnett Wastewater Treatment Plant Capacity Upgrade Project
Ordinance, Steve Ward
10:25 am Discuss Engineering Consultant Agreement for MBD Consulting Engineers, PA,
Steve Ward
10:30 am Discuss Resolution from the Town of Dunn Requesting Extension of Development
Rights with the County of Harnett Request to Assign Exclusive Planning and
Development Regulations for Several Lots, Mark Locklear/Christopher Appel
10:40 am Discuss Proposed Amendments to the Harnett County Economic Development
Council Bylaws to add a Harnett County Schools Representative, Angie Stewart
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10:50 am Discuss Harnett County JCPC request for permission to submit county plan program
agreements for the NC Department of Public Safety, Juvenile Crime Prevention
Council programs for FY2021-2022:
- Harnett County Restitution
- 4-H Teen Court and At-Risk Youth Development
- ReEntry Healthy Choices
-PAL Academic Career Readiness and School Kids In Power (SKIP)
- Extended Learning
11:00 am Discuss Donation of Furniture, Brian Haney
11:10 am Discussion of County Facility Rentals, Brian Haney
11:20 am Recommendation on Septic Tank Hauler and Portable Toilet Wastewater Treatment
Plant Fees, George Wood
11:30 am Review of the Executive Search Firms’ Responses to the Request for Proposals for
the County Manager Recruitment Process, George Wood
11:40 am County Manager’s Report:
-July 19, 2021 Regular Meeting Agenda Review
-Review applications to serve on Boards and Committees
-Upcoming meetings and invitations
12:00 pm Closed Session
12:30 pm Adjourn
CONDUCT OF THE JULY 13, 2021 MEETING
OF THE HARNETT COUNTY BOARD OF COMMISSIONERS
Live audio of the meeting will also be streamed on the Harnett County Government’s YouTube
Channel at https://www.youtube.com/channel/UCU7mTF6HTD65x_98EhAMeMg/featured
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www.veteranharbor.com
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Contents
•Problem: Veteran homelessness
•Solution: Our mission & goal
•Partners & Sponsors: About our team
•Harnett County Project
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Problem
Troubled & homeless veterans in NC
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Homelessness
•Roughly a thousand veterans experience homelessness in NC
according to studies in recent years..
•Over 40%of Veterans in the Harnett County Veterans Treatment
Court are homeless.
•About 45% suffer from mental illness and slightly over 70% suffer
from substance-abuse problems.
•Much opiate addiction can be traced back to pain medications
from the military and the Veterans Administration.
The U.S. Department of Housing and Urban Development. The 2018 Annual Homeless Assessment Report (AHAR).
Retrieved (2019) from: https://files.hudexchange.info/resources/documents/2018-AHAR-Part-1.pdf
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This Problem Raises Unavoidable Questions…
Veteran homelessness is a blight and a war wound.
•How do we heal it?
•How do we help create a better future for troubled and hurting veterans?
•How do we grow into better ways of living alongside each other?
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Solution (nationwide)
The Veteran Harbor Mission:
To support veteran advocacy organizations by partnering with them to build specific structures with the intent to train or rehabilitate troubled veterans and their families.
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Solution (Harnett County)
Our goal locally:
To develop housing and a community center for veterans in the Harnett County area in order to stabilize and build a sustainable future
The Veterans Treatment Court will take control of the site upon completion of all construction.
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Partners & Sponsors
About our team
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Who we are
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www.veteranharbor.com•Veteran Harbor, Inc
•A 501 (c)(3) nonprofit founded in order to develop temporary
rehabilitative housing for homeless and troubled veterans.
•We work in partnership with veterans’ charities such as COMBAT
VTC, Inc. in order to supply on their land the housing and
community facilities they need to help get downtrodden veterans
back on their feet.
•Brian Stanfill, President & Executive Director
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Key Partner for Harnett County
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www.combatvtc.org•COMBAT VTC, Inc
•A 501 (c)(3) nonprofit that supports the Harnett County Veterans
Treatment Court. Provides some transportation to and from court
and treatment.
•Provides small monetary assistance case-by-case, some food and
clothing, and a Mentor Support Group.
•Helps meet emergency temporary housing needs (hotel
accommodation) for homeless veterans in the treatment court
program (approx. 40%).
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Supporters and Sponsors
•B.A. Stanfill Construction, LLC
•DBI Enterprises, Inc.
•SSG Dustin M. Wright Foundation
•Independence Realty Group
•Fayetteville Marksmen hockey team
•Defender Ammunition Co.
•DeepRichDirt Publishing LLC
•DSM Home Improvements, LLC
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Progress
Harnett County project in planning
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Site: Harnett project
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Site: Old Benhaven School
https://gis.harnett.org/gisviewer/
Size: 4800SqFt
40’L x 120’W
Capacity potential
3 x 2 person bedrooms
Full Kitchen w/ dining
4x full bath
2x office space
1 x Staff Bedroom
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Layout
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Funding Target (Harnett)
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$ 450,000
•This includes all projected expenses from beginning
to end of all construction.
•Structural renovation: $175,000
•Interior build-out: $175,000
•Finishings and exterior infrastructure: $100,000
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Veteran Harbor
“Building solid ground for veterans”
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For questions, email us at:
admin@veteranharbor.com
To donate, make checks payable to:
Veteran Harbor, Inc.
PO Box 64219
Fayetteville, NC 28306
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Sustainment of Veteran Harbor
-PROJECT DIRECTOR
-ATTORNEY
-CERTIFIED PUBLIC ACCOUNTANT
-OTHER
BUILD PHASE: Veteran Harbor, Inc.
OPERATIONAL PHASE: COMBAT VTC, Inc.
-COMMUNITY DIRECTOR
-STEERING BOARD
-VOLUNTEER COORDINATOR
-GROUNDS/ BUILDING MANAGER
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(Operations and sustainment)
(Programs of Veterans
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•Board consists of Combat Veterans as well as Retired
District Attorney and Retired Clerk of Court for Harnett
County.
▪Provide assistance with housing, food, transportation,
treatment and many other services to our veterans in
need.
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There is a massive need for temporary housing for
veterans in Harnett County.
Currently we rely on many outside resources to
provide housing for our Veterans. Most of these
come at an expense of over $1,000 per month which
is currently being paid by private donors to Combat
VTC.
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Projected Use
•Provide NA and AA meetings at the facility.
•Provide access to job searching through partnership with NC
Works
•Provide random Drug and Alcohol testing
•Provide access to online schooling
•Provide a meeting place for court Mentors as well as our Clinical
staff.
•Encourage and assist the Veteran to get back on their feet and
become productive citizens once again.
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Operational
•Veterans will be required to perform daily cleaning and
upkeep of the facility.
•Veterans who receive VA disability or other forms of
income will pay a monthly fee based on their income to
cover costs of operating the facility.
•This is not permanent housing. The goal is to provide a
safe place to aid in recovery and stabilization to get the
veteran back on their feet and out on their own.
•Veterans will have to remain drug and alcohol free!
•Random inspections will take place of the facility.
•Mentors will assist the veterans and prepare them to
transition back into society.
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We request of Harnett County:
Please donate the above-mentioned
property to COMBAT VTC so this county
can set a regional precedent with a new
“Veteran Harbor of Harnett County”
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•Questions
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RESOLUTION BY THE HARNETT COUNTY BOARD OF COMMISSIONERS TO
DELEGATE LEASING AUTHORITY TO THE COUNTY MANAGER
WHEREAS, the County of Harnett owns various parcels of property that are not needed for use by
the County; and
WHEREAS, North Carolina General Statutes § 153A-176 and § 160A-272 authorizes a board of
commissioners to delegate to the county manager the authority to determine that specific parcels are
temporarily surplus to the county’s needs and to lease such parcels for periods of up to one year; and
WHEREAS, the Harnett County Board of Commissioners desires to delegate such authority to the
Harnett County Manager.
NOW, THEREFORE, BE IT RESOLVED THAT:
1. The Harnett County Manager is authorized to determine that specific parcels of County-
owned property are surplus to the County’s current needs and to enter into leases of such
parcels for periods of up to one year, upon such terms and conditions as the County Manager
shall determine.
2. The Harnett County Manager shall provide an annual report to the Board of Commissioners
detailing any leases of County-owned property entered into pursuant to this Resolution.
Duly Adopted this the 19th day of July, 2021.
__________________________________________
W. Brooks Matthews, Chairman
Attest:
______________________________________________
Melissa Capps, Clerk to the Board
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Board Meeting
Agenda Item
MEETING DATE: July 13, 2021
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: North Carolina Department of Public Safety Program Agreements JCPC
Annual Funding 2021-2022
REQUESTED BY: Kimberly Whitted, Harnett County JCPC Chairperson
REQUEST:
Requesting permission to submit county plan program agreements for the NC Department of
Public Safety, Juvenile Crime Prevention Council programs for FY2021-2022:
Harnett County Restitution
4-H Teen Court and At-Risk Youth Development
ReEntry Healthy Choices
PAL Academic Career Readiness and School Kids In Power (SKIP)
Extended Learning
FINANCE OFFICER’S RECOMMENDATION:
COUNTY MANAGER’S RECOMMENDATION:
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Juvenile Crime Prevention Council County Plan
Harnett County
FY 2021-2022
Table of Contents
I. Executive Summary
II. Harnett County Funding Plan
III. Harnett County Juvenile Crime Prevention Council Organization
IV. Harnett County Risk and Needs Assessment Summary
V. Harnett County Juvenile Crime Prevention Council Request for
Proposals
VI. Funding Decisions Summary
VII. Funded Programs Descriptions
Attachments:
Program Agreements
JCPC Certification
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Executive Summary
The Harnett County Juvenile Crime Prevention Council (JCPC), in fulfillment of the duties and
responsibilities as set forth in the General Statutes of the State of North Carolina, has reviewed
and updated the County Plan.
The JCPC has identified the issues and factors which have an influence and impact upon
delinquent youth, at-risk youth, and their families in Harnett County. Further, the JCPC has
identified the strategies and services most likely to reduce/prevent delinquent behavior.
JCPC Action Plan Progress:
We have consistent attendance at meetings and committed members. We have gained several
new members during the 2020-2021 year.
Priorities for Funding:
The risk and needs assessment and resource assessment has determined that the following
services are needed to reduce/prevent delinquency in Harnett County:
1. Restitution/Community Service
2. Teen Court/Restorative Justice
3. Vocational/Independent Living Skills
4. Individual/Family/Mentoring Services
5. Sex Offender Treatment
6. Respite/Crisis Services
7. Clinical Assessments
8. Tutoring/Academic Enhancement
Monitoring and Evaluation:
Each program funded in the past year by the JCPC has been monitored. The monitoring results
and program outcomes evaluations were considered in making funding allocation decisions. The
JCPC continues to conduct implementation monitoring of its action plan and its funded programs
on a quarterly basis. (See attached monitoring reports.)
Funding Recommendations:
Having published a Request for Proposals for these needed services for a minimum of thirty (30)
days, the JCPC has screened the submitted proposal and has determined which proposals best
meet the advertised needed services.
As required by statute, the JCPC recommends allocation of the North Carolina Department of
Juvenile Justice and Delinquency Prevention (NC DJJDP) funds to the following programs in the
amounts specified below for the upcoming fiscal year. (See JCPC funding description summary
and funded program descriptions.):
1. 4-H Teen Court - $40,000
2. Extended Learning - $7,991
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3. Harnett County Juvenile Restitution - $81,000
4. Healthy Choices - $35,000
5. PAL Academic Career Readiness and School Kids In Power (SKIP) - $99,054
The JCPC further recommends that the amount of $15,500 be allocated from the NC DJJDP
funds for the administrative costs of the Council, which will include hiring a part time JCPC
Coordinator.
After a program application was withdrawn, the Council has unallocated funds totaling $41,500
that will be made available to other programs to apply for funding by submitting an RFP. The
RFP will be opened in August and will be advertised for thirty (30) days.
Respectfully Submitted,
Kimberly Whitted
Chairperson, Harnett County Juvenile Crime Prevention Council
Date: June 11, 2021
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Harnett County Funding Plan
06/11/2021
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Harnett County Juvenile Crime Prevention Council Organization
Name Organization Title
Chairperson Kimberly Whitted Campbell University Director, Technology
Infrastructure &
Operations
Vice-Chairperson Avis Watkins-Smith Harnett County
Health Department
Social Worker
Secretary Matthew Willis Harnett County
Register of Deeds
Register of Deeds
Number of Members: 22
List meeting dates during the current fiscal year and identify the number of JCPC members in
attendance for each.
Meeting Date Number of Members in
Attendance
Quorum Present? Yes/No
10/19/2020 10 No
10/28/2020 14 Yes
11/13/2020 15 Yes
12/14/2020 8 No
01/25/2021 16 Yes
02/15/2021 15 Yes
03/15/2021 13 Yes
04/19/2021 14 Yes
05/17/2021 14 Yes
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Harnett County Risk and Needs Assessment Summary
I. Risk Assessment Summary
II. Needs Assessment Summary
III. Summary of the Existing Community Resources
IV. Summary of Gaps and Barriers in the Continuum of Services
V. Proposed Priority Services for Funding
Risk Assessment Summary
The Risk and Needs Assessment Committee reviewed data gleaned from the Juvenile Risk
Assessment instrument administered by Juvenile Court Counselors after juveniles are referred
with a complaint alleging that a delinquent act has occurred and prior to adjudication of the
juvenile. The Juvenile Risk Assessment is an instrument used to predict the likelihood of the
juvenile being involved in future delinquent behavior. For some youth, some of the individual
item ratings may be heavily dependent upon information reported by the juvenile or the
parent(s). For these items (represented by percentages which have a star next to them), there is a
likelihood of under-reporting the incidence of a particular behavior and the actual incidence may
be higher than suggested by these figures. In those cases, the figure should be interpreted as a
measure of the minimum level of occurrence.
Needs Assessment Summary
The Risk and Needs Assessment Committee also reviewed data gleaned from the Juvenile Needs
Assessment instrument administered by Juvenile Court Counselors prior to court disposition of a
juvenile. The Juvenile Needs Assessment is an instrument used to examine a youth’s needs in
the various domains of his life: The Individual Domain, The School Domain, The Peer Domain,
and the Community Domain. This instrument was designed to detect service intervention needs
as an aid in service planning. As with the Juvenile Risk Assessment, some of the individual item
ratings may be heavily dependent upon information reported by the juvenile or the parent(s). For
these items (represented by percentages which have a star next to them), there is a likelihood of
under-reporting the incidence of a particular behavior and the actual incidence may be higher
than suggested by these figures. In those cases, the figure should be interpreted as a measure of
the minimum level of occurrence.
Summary of the Existing Community Resources
The Harnett County JCPC funded the following programs in FY2020-2021:
4-H Teen Court
Extended Learning
Harnett County Juvenile Restitution
Healthy Choices
PAL Academic Career Readiness and School Kids In Power (SKIP)
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Lifeguard Instruction and Development Services (LiDs) (Returned $25,000 to JCPC due
to inability to provide services caused by the COVID-19 pandemic)
Take Two at the Academy (Returned $40,000 to JCPC due to inability to provide
services caused by the COVID-19 pandemic)
Summary of Gaps and Barriers in the Continuum of Services
Barriers to JCPC Programs
During the past year, the largest barrier to the funded programs was the COVID-19 pandemic.
Facilities were closed and the ability to provide services were limited to the public health
precautions enacted to prevent the spread of the virus. Two of the funded programs were forced
to return funds due to the inability to serve youth in their facilities. The number of youth served
this year was drastically reduced compared to previous years. Referrals to the programs from the
school and court systems affected the youth entering most of the programs. Most program
providers were able to adjust accordingly as the guidelines allowed.
In addition to the public health issues that affected everyone, transportation to the programs
remains as a barrier. There have been a number of requests to assist providing vans for use to
transport the youth to facilities where services are provided.
Gaps and Barriers of other Community Programs
In general, most programs are located in central Harnett County, leaving other areas of the
county without access to JCPC-funded services. A future goal for the JCPC is to identify other
services and programs that are located in the areas of the county that have been underserved.
Proposed Priority Services for Funding
The committee compared the services needed to address the elevated Juvenile Risk Factors and
Juvenile Needs with services currently available in the community. Services which are currently
available in the community and sufficient to meet the needs of court involved youth or those
youth most at risk for court involvement are not considered as a priority for JCPC funding.
The Committee proposes that the following services in ranked order be approved as the
funding priorities for FY 2021-2022:
1. Restitution/Community Service
2. Teen Court/Restorative Justice
3. Vocational/Independent Living Skills
4. Individual/Family/Mentoring Services
5. Sex Offender Treatment
6. Respite/Crisis Services
7. Clinical Assessments
8. Tutoring/Academic Enhancement
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Funding Decisions Summary
Funded Program Descriptions
See the attached program agreements.
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
North Carolina Department of Public Safety
JCPC Program - Program Application
SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION
FUNDING PERIOD:FY 21-22 DPS/JCPC FUNDING # (cont only)543-XXXX
COUNTY:Harnett AREA:Central Area
Multi-County:No Multi-Components No
NAME OF PROGRAM:4-H Teen Court and At-Risk Youth Development
SPONSORING AGENCY:Harnett County Government
SPONSORING AGENCY
PHYSICAL ADDRESS:
200 Alexander Drive
Lillington NC 27546
SPONSORING AGENCY
MAILING ADDRESS:
POB 940
Lillington NC 27546
TYPE:Public FEDERAL ID #56-6000306
COMPONENT ID #NAME OF PROGRAM COMPONENT PROGRAM TYPE TOTAL COST OF
EACH COMPONENT
32104 4-H Teen Court and At-Risk Youth Development Teen Court $ 47,692
Total cost of components:$ 47,692
Program Manager Name & Address (same person on signature page)
Name:Jackie Helton Title:County Extension 4-H Agent
Mailing
Address:
126 Alexander Drive
City:Lillington Zip:27546Suite 300
Phone:(910) 814-6027 Fax:(910) 893-7539 E-mail:jhelton@harnett.org
Contact Person (if different from program manager)
Name:Alia Langdon Title:Program Coordinator
Mailing
Address:
126 Alexander Drive
City:Lillington Zip:27546Suite 300
Phone:(910) 814-6022 Fax:(910) 893-7539 E-mail:alangdon@harnett.org
Program Fiscal Officer (cannot be program manager)
Name:Kimberly Honeycutt Title:County Finance Officer
Mailing
Address:
PO Box 760
City:Lillington Zip:27546
Phone:(910) 893-7557 Fax:(910) 893-3445 E-mail:khoneycutt@harnett.org
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION I B PROGRAM COMPONENT DESCRIPTION
COMPONENT ID #COMPONENT INFORMATION
32104 NAME OF COMPONENT: 4-H Teen Court and At-Risk Youth Development
BRIEF DESCRIPTION: Program provides as a community resource for the diversion of cases
in which juveniles ages 6-17 years old have allegedly committed certain offenses for hearing by
a jury of their peers The Teen Court Jury may assign the juvenile to counseling, restitution,
curfews, community service, or other rehabilitative measures.
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 01/09/2012
Department of Public Safety
SECTION II COMPONENT STATISTICAL INFORMATION
Multi-Components No
Component Service Statistics PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name:4-H Teen Court and At-Risk Youth Development Component ID #
32104
What is this component's maximum client capacity at any given time?20
Frequency of client contact per month:4 Anticipated Average Length of
Stay:120 Days
Total Component Cost:$47,692 ÷ by Estimated # to be served during funding period:30
Estimated Average Cost Per Youth:$1,590
Applies to
continuation
programs only.
Actual number of youth admitted FY 19-20:22
1 Number of admissions Juvenile Justice Referred 4.55% of total admissions
21 Number of admissions Law Enforcement Referred 95.45% of total admissions
0 Number of admissions District Court Referred 0% of total admissions
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:4-H Teen Court and At-Risk Youth Development
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
Based on current JCPC Risk and Needs Assessment data, Harnett County youth are at the following levels for school
based offenses and complaints received. Non Court Involved/ Court Involved R1-23.5/ 1.7%, R2-35.3/ 6.7%, R3-36.3/
48.3%, R4-4.9/ 33.3%, R5-0/ 10%. County data is consistent with State data which reflects that the majority of youth
for the two year period, average 86.5%, are age 12 or older when their first delinquent offense was reported in an
alleged complaint.
To combat this problem, the 4-H Teen Court and At-Risk Youth Development Program will provide youth with
opportunities to not only be held accountable for their actions, but to continue association with pro-social peers while
completing and also upon completion of mandated sanctions via year round 4-H life skill development opportunities.
4-H Teen Court provides an alternative sentencing method for misdemeanor offenders and imposes sanctions that not
only allow youth to be accountable for their actions, but also engages them in purposeful life skill building programming
that will result in positive behavior change and increased interaction with pro-social peers within the traditional 4-H
program. This will potentially reduce the case load of the traditional court system and allow for more prompt
reinforcement for the youth involved. All 4-H program components are open to Teen Court youth during and after
completion of required sanctions. Continued participation will be encouraged after sanctions have been completed.
In addition to increasing opportunities for interaction with pro-social peers, program involvement allows youth to form
trusting relationships with positive adults in the form of both paid and volunteer staff. 4-H program involvement allows
families to build a network of adults and positive teens to encourage and uplift youth.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
Youth, ages 6 to 17 years old whose referring behavior constitutes a violation of the law or misdemeanor and are
deemed appropriate referrals for a Teen Court program.
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
Goal 1: To provide an alternative sentencing method for misdemeanor youth offenders ages 6-17 in order to reduce
the case load of the traditional juvenile justice system.
Goal 2: To provide real world accountability for youth offenders using educational methods that result in positive
behavior change reflected by increased civic/community engagement.
Goal 3: To provide real world accountability for youth offenders using educational methods that result in positive
behavior change reflected by an increased knowledge of career skills.
Goal 4: To assist youth and families in developing a network of positive adults and teens to create increased
opportunities for prosocial interactions.
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:4-H Teen Court and At-Risk Youth Development
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
75% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
completion.
75% Clients will have no new complaints with an offense date after the admission date.
75% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
90% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
95% Clients will demonstrate improvement in developing and/or maintaining social and interpersonal interactions
during program participation.
75% Clients will have no new adjudications for a complaint with an offense date after the admission date.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
The 4-H Teen Court and At-risk Youth Development Program will provide programming that will address the need for a
Teen Court program as identified by the latest Juvenile Crime Prevention Council needs assessment.
Assessment data reflects that Harnett County youth are at low risk of reoffending. Teen Court will target youth that
commit first-time misdemeanor offenses ages 6 to 17. Life skill development sanctions will be mandated that hold the
youth accountable for their actions and that promote increased knowledge and awareness of community enhancement
and civic engagement. Youth will be empowered by involvement in real world projects to raise feelings of self-worth
and competence.
Sanctions will include but are not limited to:
NC 4-H Hungry to Help: NC is 2nd in childhood food insecurity only behind Louisiana. Youth will engage in gardening
and food collection programs to assist in reducing childhood food insecurity. Projects will include sweet potato
gleaning, and food drives. Partners include NC 4-H, the Central Food Bank of NC, the NC Cooperative Extension,
Harnett County Schools and the Harnett County Food Pantry.
4-H Life Skill Development Programming: 4-H Teen Leadership/Presentation Program (Public Speaking Skills), 4-H
Livestock Judging (Critical Thinking, Organizational and Problem Solving Skills), 4-H Shooting Sports Program (Safety,
Self-Discipline and Value of Environmental and Natural Resources)
Current assessment data also indicates that Harnett County youth are more likely to associate with undisciplined or
delinquent youth. While participating in Teen Court sanctions, youth will interact with traditional 4-H program youth
creating opportunities for increased association with pro-social peers and adult volunteers and staff. Upon completion
of sanctions, youth will be encouraged to continue 4-H participation to maintain opportunities for pro-social interaction.
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:4-H Teen Court and At-Risk Youth Development
1. Location: List physical address(es) and describe where program services are delivered.
Program Staff
Harnett County Agriculture Center
126 Alexander Drive, Suite 300
Lillington, NC 27546
Teen Court Proceedings
Harnett County Courthouse
301 W. Cornelius Harnett Blvd.
Lillington, NC 27546
The program will be housed within the NC Cooperative Extension, Harnett County Center office via the 4-H Youth
Development program. Program staff will be located in Suite 300 of the Agriculture Center. Conference room facilities
will be available for parent/guardian meetings and the Training room will be utilized for Leadership Training and
sanctions. Teen Court proceedings will take place at the Harnett County Court House or at the Harnett County
Agriculture Center as needed due to extenuating circumstances.
2. Operation: Describe the daily/weekly schedule of program operation.
Teen Court sessions will be held twice monthly on a regularly scheduled basis during the evening hours. Schedule will
be subject to inclement weather closings and will be on schedule with Harnett County Schools. Schedule is also
subject to change when Teen Court Staff is at a training.
Example: 1st and 3rd Tuesday night of each month at 6:00 pm
Referred youth will be accepted year round.
Once accepted, the 4-H Teen Court Coordinator will communicate with parents and youth until program termination to
ensure understanding of Teen Court proceedings and sanction expectations. Communication may be via Teen Court
sessions, involvement in sanctions, email with a response, phone calls or face to face meetings.
Opportunities for sanction completion will be offered on a bi-weekly basis. Sanctions will be conducted year round with
schedules being set by the 4-H Teen Court Coordinator. Sanctions with specific deadlines mandated by the NC 4-H
program will be planned accordingly with County level programming provided to support youth success such as
presentation practice sessions. Outdoor/gardening activities will be conducted as weather is appropriate. Indoor
oriented sanctions will be conducted year round.
Youth will be enrolled for a maximum of 120 days. Extended involvement will be agreed upon as deemed necessary
by the referring parties and parents. Involvement beyond 120 days will be outlined in a written agreement such as the
4-H Enrollment Form or Teen Court Parent Agreement.
The work schedule of the 4-H Teen Court and At-risk Youth Development Program Coordinator will consist of 40 work
hours each week. The primary work schedule will be 8:00-5:00 with adjustments being made to allow for Teen Court
sessions, training or sanctions that are required to occur after hours or on weekends in order not to exceed 40 hours
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:4-H Teen Court and At-Risk Youth Development
per week.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
1 F/T 4-H Teen Court Program Manager (4-H Program Assistant)
Qualifications: Must possess a minimum of an Bachelors degree in a Human Services or a related field or a four year
degree in any other field with at least 2 years experience as a direct service professional in a juvenile serving agency.
Responsibilities: Include case oversight and supervision of all Teen Court proceedings including court sessions and
sanctions organized by 4-H. The position is also responsible for evaluation of sanctions conducted by partnering
agencies/organizations. In addition, the position will recruit, supervise and train all professional and community based
program volunteers. The position will network with all partnering agencies needed to conduct Teen Court and to
accept referrals. Partnerships will be fostered to ensure sustainability of program efforts. The position will be the main
point of contact for the Teen Court program and maintain expected levels of partner and parent/youth communication.
Responsibilities also include development of evaluation tools used to evaluate program success in addition to
completing required funding and program impact reports.
Teen Court Professional Volunteers (Attorneys, Judges and District Attorneys)
Qualifications: Professional career in the specific volunteer role with Teen Court.
Responsibilities: Adult Volunteers will be utilized to serve as career coaches for teens involved in Teen Court
proceedings to include defense and prosecuting attorneys, clerk, bailiff and jury members.
Adult Volunteers
Qualifications: Must complete the NC 4-H Volunteer Screening application process that includes a background check.
Responsibilities: Ensure efficient proceeding of Teen Court cases. Community volunteers will assist with
implementation of sanctions.
Teen Volunteers
Qualifications: An interest in working with Teen Court and successfully completed the training for the role taken with
the program.
Responsibilities: Youth volunteers ages 13-17 will be recruited to serve as attorneys, jurors, the bailiff and clerk during
all Teen Court proceedings. Teen volunteers will also be recruited to assist with sanction planning and
implementation.
NOTE: All volunteers, both adult and youth, are required to attend Teen Court trainings that address the needs of their
assigned responsibility. All will receive written volunteer job descriptions and are required to sign a standard of
behavior and confidentiality statement.
4. Service Type SPEP: Describe implementation to include:
This program is a STRUCTURE ONLY.
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:4-H Teen Court and At-Risk Youth Development
4-H Teen Court referrals will be accepted from Law Enforcement Officials and Juvenile Justice.
Referral Process: Email notification that there is a referral coming. Upon receiving a written referral by fax or in person,
the Teen Court Coordinator will assess the suitability of referred youth. Within 30 days of receiving the referral, the
Coordinator will make contact with the accepted referred youth's parent/guardian.
Screening Process: Questionable referrals will be reviewed by the Program Director and a determination will be made
concerning acceptance. All other referrals will be approved by the Coordinator.
Admission Process: Once a referral is received and accepted, the Teen Court Coordinator will contact the family to
schedule an intake appointment followed by contact with the referring agency within 14 business days orally or in
writing to confirm intake. A participation agreement will be signed by the referring agency, youth and parent/guardian
during the intake appointment. Juveniles must be admitted into the program within 30 days of receiving the referral.
Client tracking data will be entered within 7 days of the admission decision.
Reasons why a referral may not be accepted: If a youth has reached their 18 birthday and/or is charged with any of the
following: Teen Court coordinator feels that the level of service needed is beyond the program's capacity. Driving while
impaired, Class A1 misdemeanors, An assault in which a weapon was used, or a controlled substance offense under
Article 5 of Chapter 90 of the NC General Statues, excluding simple possession of a schedule VI drug or alcohol
offense and Sexual offenses.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
The Teen Court Program Manager makes terminations decisions.
Termination Process: A written termination form will be completed which will include sanctions (activities) completed,
results, recommendations, last date of program contact and reason for termination. Upon termination, copies of the
termination form must be provided to the referring agency and the parent/guardian of the youth involved within 7
business days. Data will be entered into client tracking within 7 days of the termination decision.
Successful Completion: Indicates a high level of juvenile participation in program activities and achievement of
behavior improvement goals.
Satisfactory Completion: Indicates an acceptable level of juvenile participation and behavior improvement even though
the juvenile did not complete all program activities and did not meet all behavior goals.(Must obtain approval from
Program Director and notify referring agency)
Unsuccessful Completion: Failure to meet specific goals and requirements or make sufficient progress in the program.
(Must obtain approval from Program Director and notify referring agency),
Non-Compliance: Unexcused absences or refusing to participate in treatment activities. Must obtain approval from
Program Director and notify referring agency.
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:4-H Teen Court and At-Risk Youth Development
How is the referring agency involved with the termination process?
The referring agency will be notified through written, oral, or email correspondence prior to termination in order to
provide an opportunity to communicate with Teen Court program staff pertaining to expected youth progress.
Feedback will be reflected on the termination form and filed for each juvenile.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
The Teen Court Coordinator will communicate at least monthly with Court Counselors and other referring agencies in
reference to client progress. Communication will take place via face to face meetings, phone, email or in writing.
Client progress forms will be used to document monthly progress and filed.
The Teen Court Coordinator will also provide the program report at monthly JCPC meetings.
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
utilized in this component and how will parents/guardians be involved?
The 4-H Teen Court and At-risk Youth Development Program will engage youth in purposeful life skill enriching
activities that will create opportunities for real world learning, youth empowerment and building of community capacity.
As a result, youth will develop mastery of skills and gain an increased sense of self-worth. In addition, youth will
increase time spent with pro-social peers and adults building a sense of acceptance.
Research shows that if youth needs go unmet or are met in negative ways youth will:
seek to belong through promiscuous behaviors,
attempt to feel mastery by cheating or practicing other delinquent skills,
try to establish independence by acting as a bully or by displaying defiant behavior,
or feel unable to establish their own positive self identity.
The 4-H Teen Court and At-risk Youth Development Program will strive to involve youth in meaningful experiences that
meet the needs of positive youth development in order to encourage youth who:
experience belonging, and develop a trusting and friendly demeanor,
seek productive opportunities to experience mastery of a skill and become problem solvers displaying self-motivation,
and that when presented with opportunities to become independent, display self-confidence and self-discipline as
youth leaders showing care and generosity to others.
Parents/guardians will be involved in the Teen Court process by intake meetings, Teen Court proceedings, and weekly
communication with program staff during Teen Court program involvement including sanctions. Parent surveys will be
conducted during the termination process to gauge parental observations pertaining to youth progress and program
impact. Parents will be encouraged to contact program staff with any concerns or celebrations regarding youth
progress.
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:4-H Teen Court and At-Risk Youth Development
Teen Court is based on North Carolina's comprehensive strategy for juvenile deliquency and resarch based best
practice of graduated sanctions and is an alternative sentencing mothod for first-time misdemeanor youth offenders,
therefore minimizing the case load of traditional juvenile court.
Teen Court utilizes a matrix to organize sanctions according to risk level and severity of the offense. Sanctions
imposed take into consideration the characteristics of the client in addition to the intended outcome of the sanction
being imposed. Dosage or amount of time engaged in the identified sanction is directly related to the characteristics of
the juevenile client and the desired behavior change to be displayed. Supplementary or opportunities for follow up are
also taken into consideration when imposing Teen Court sanctions. These are all identified as characteristics of
effective programs and are identified in the Teen Court standard operating procedures.
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SECTION V Terms of Agreement
This section of the JCPC Program Application will ONLY be completed if approved for funding and will be
included in the required JCPC Program Agreement document for completion.
This Agreement is entered into by and between Department of Public Safety, (hereinafter referred to as the DPS), and
County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to
as the JCPC) and (hereinafter referred to as the Sponsoring Agency).
The DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows:
Term of Agreement
This Agreement shall become effective _______ and shall terminate ________.
Payment to Sponsoring Agency
All parties agree that services will be delivered as described in the approved Program Agreement and that funds will be
disbursed in an amount not to exceed the amount $___________ for the term of this agreement, unless amended by
an approved Program Agreement Revision.
Availability of Funds:
All parties to this Agreement agree and understand that the payment of the sums specified in this Program Agreement
budget, or most recently approved Program Agreement Revision, is dependent and contingent upon and subject to the
appropriation, allocation, and availability of funds for this purpose to DPS.
Responsibilities of the Parties
DPS shall:
1.Disburse funds monthly to County Governments, for payment to the Sponsoring Agency, from the fund
appropriation by the General Assembly;
2.Reserve the right to suspend payment to the County for any non-compliance by the Sponsoring Agency with any
reporting requirements set forth in DPS JCPC Policy and Procedures;
3.Notify in writing the County and Sponsoring Agency immediately if payments are suspended and again once
payments resume;
4.Pay only for work as described in the Program Agreement, or most recently approved Program Agreement
Revision, provided by the Sponsoring Agency and approved subcontractors;
5.Provide technical assistance, orientation and training to the Sponsoring Agency, the County and the JCPC;
6.Monitor Sponsoring Agency’s funded program(s) in accordance with DPS JCPC Policy 3. Operations: Program
Oversight and Monitoring; and
7.Notify parties entering into this Agreement of all due dates in a timely manner in order for reports to be submitted
by the established due date.
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The Sponsoring Agency shall:
1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the
conduct of its business, including those of Federal, State, and local agencies having jurisdiction and/or authority;
2.Comply with all Federal and State laws relating to equal employment opportunity;
3.Keep as confidential and not divulge or make available to any individual or organization without the prior written
approval of DPS any information, data, instruments, documents, studies or reports given to or prepared or
assembled by the Sponsoring Agency under this Agreement;
4.Acknowledge that in receiving, storing, processing or otherwise dealing with any confidential information it will
safeguard and not further disclose the information except as otherwise provided in this Agreement;
5.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Procedures;
6.Secure local match as required, if applicable, pursuant to 14B NCAC 11B.0105, for approved JCPC funds;
7.Create and adopt individualized guidelines specific to the funded program, while also adhering to DPS JCPC
Policy and Procedures for all funded programs and for the specific program type for which they receive funding;
8.Ensure that state funds received are spent in accordance with the approved Program Agreement, or most recently
approved Program Agreement Revision, and be accountable for the legal and appropriate expenditure of those
state funds;
9.Maintain reports, records, and other information to properly document services rendered and outcomes; also
maintain an ability to send and receive electronic communication;
10.Have the capacity to use DPS electronic, internet-based system for tracking clients served;
11.Use generally accepted accounting procedures that guarantee the integrity of the expenditure of funds, maintain
reports, records, and other information to properly account for the expenditure of all State funds provided to the
Sponsoring Agency;
12.When refunds are requested from the North Carolina Department of Revenue for sales and/or use taxes paid by
the agency in the performance of the Program Agreement, or most recently approved Program Agreement
Revision, as allowed by NCGS §105-164.14(c), the agency shall exclude all refundable sales and use taxes from
reportable expenditures submitted to the County and DPS;
13.Submit Program Agreement Revisions, Third Quarter Accounting, Final Accounting and annual detailed
expenditures through NCALLIES. These reports must be in accordance with the submission process as outlined in
DPS JCPC Policy and Procedures and with the due dates established by DPS;
14.Make personnel, reports, records and other information available to DPS, the County, the JCPC, and/or the State
Auditor for oversight, monitoring and evaluation purposes;
15.Submit any other information requested by the JCPC, County or DPS;
16.Be responsible for the performance of all subcontractors as described in the JCPC Program Agreement, or most
recently approved Program Agreement Revision;
17. Indemnify and hold harmless DPS, the State of North Carolina, the County and any of their officers, agents and
employees, from any claims of third parties arising out of any act or omission of the Sponsoring Agency in
connection with the performance of the Program Agreement or most recently approved Program Agreement
Revision;
18.Receive permission and budgetary approval from DPS prior to using the Program Agreement, or most recently
approved Program Agreement Revision, as a part of any news release or commercial advertising and
acknowledge DPS funding in partnership with the County;
19.Comply with DPS trainings and requirements regarding the United States Department of Justice national
standards to prevent, detect, and respond to prison rape under the Prison Rape Elimination Act (PREA);
Reference: 14B NCAC 11B, and in compliance with DPS JCPC Policy 2: Operations: Program Operational
Requirements
20.Be deemed an independent contractor in the performance of services described in the Program Agreement, or
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most recently approved Program Agreement Revision, and as such shall be wholly responsible for the services to
be performed and for the supervision of its employees;
21.Represent that it has, or shall secure at its own expense, all personnel required in performing the services as
described in the Program Agreement. Such personnel shall not be employees of, or have any individual
contractual relationship with, DPS;
Sponsoring Agency and Use of Contractor(s)/Subcontractors
The Sponsoring Agency may engage with independent contractors as needed to perform services or support services
described in the Program Agreement. When independent contractors (funds are included in line item 190 of the
budget) are providing services as described in the Program Agreement, the sponsoring agency must:
22.Upload a signed Contract for Professional Services into NCALLIES once the Program Agreement (or
Program Agreement Revision) is approved by DPS;
23.Be responsible for the performance of all contractors or subcontractors as described in the Program
Agreement, or most recently approved Program Agreement Revision;
24.Hold any contractor or subcontractor to which the Sponsoring Agency provides State funds accountable for
the legal and appropriate expenditure of State funds, and to all applicable laws and DPS JCPC Policies and
Procedures; and
25.Ensure that all contractors or subcontractors provide all information necessary to comply with the standards
set forth in the Program Agreement or most recently approved Program Agreement Revision.
The JCPC shall:
1.Ensure the Sponsoring Agency uses JCPC funds for only the purposes DPS has approved in the JCPC Program
Agreement or most recently approved JCPC Program Agreement Revision;
2.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Code; N.C.G.S. §143B-801
(a);143B-602;143B-851
3.Review and locally approve Program Agreement Revision(s) received from the Sponsoring Agency and submit to
the County in a timely manner;
4.Review and locally approve Third Quarter Accounting forms and submit to the County in order to meet the due
date established by DPS (applicable only to JCPC funded agencies);
5.Submit any other information requested by the County or DPS; and
6.Monitor the Sponsoring Agency’s currently funded JCPC program(s) in accordance with DPS JCPC Policy 3.
Operations: Program Oversight and Monitoring
Reference: 14B NCAC 11B.0202 and DPS JCPC Policy 1, 7, 8, 9, 10, and 11.
The County shall:
1.Ensure the Sponsoring Agency is appropriately licensed, and either local public agencies, 501(c) (3) non-profit
corporations or local housing authorities (applicable only to JCPC funded agencies);
2.Use funds only for the purposes DPS has approved in the Program Agreement or most recently approved
Program Agreement Revision;
3.Disburse funds monthly and oversee funds to the Sponsoring Agency in accordance with 14B NCAC 11B.0108
4.Comply with DPS JCPC Policies and Procedures and the North Carolina Administrative Procedures;
5.Review and locally approve Program Agreement Revisions received from the Sponsoring Agency for final
approval from DPS; and
6.Review and locally approve Third Quarter and jointly submit Final Accounting forms for the JCPC and all funded
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programs according to the procedures and due dates established by DPS.
Reference: 14B NCAC 11B; DPS JCPC Policy 3, 7, 8, 9, 10, and 11
Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Choice of Law: The validity of this Program Agreement and any of its terms or provisions, as well as the rights and
duties of the parties to this Program Agreement, are governed by the laws of North Carolina. The parties, by signing
this Program Agreement, agree and submit, solely for matters concerning this Program Agreement, to the exclusive
jurisdiction of the courts of North Carolina and agree, solely for such purpose, that the exclusive venue for any legal
proceedings shall be Wake County, North Carolina. The place of this Program Agreement and all transactions and
agreements relating to it, and their situs and forum, shall be Wake County, North Carolina, where all matters, whether
sounding in Program Agreement or tort, relating to the validity, construction, interpretation, and enforcement shall be
determined.
Assignment: No assignment of the Sponsoring Agency's obligations or the Sponsoring Agency's right to receive
payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority,
DPS may:
(a) Forward the Sponsoring Agency's payment check(s) directly to any person or entity designated by the
Program Manager, or
(b) Include any person or entity designated by Sponsoring Agency as a joint payee on the Sponsoring Agency's
payment check(s).
In no event shall such approval and action obligate DPS or County Government to anyone other than the Sponsoring
Agency, and the Sponsoring Agency shall remain responsible for fulfillment of all Program Agreement obligations.
Beneficiaries: Except as herein specifically provided otherwise, this Program Agreement shall inure to the benefit of
and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the
enforcement of the terms and conditions of this Program Agreement, and all rights of action relating to such
enforcement, shall be strictly reserved to DPS, the County Government, and the Sponsoring Agency. Nothing
contained in this document shall give or allow any claim or right of action whatsoever by any other third person. It is the
express intention of DPS and County Government that any such person or entity, other than DPS or the County
Government, or the Sponsoring Agency receiving services or benefits under this Program Agreement shall be deemed
an incidental beneficiary only.
Property Rights
Intellectual Property: All deliverable items produced pursuant to this Program Agreement are the exclusive property of
DPS. The Sponsoring Agency shall not assert a claim of copyright or other property interest in such deliverables.
Physical Property: the Sponsoring Agency agrees that it shall be responsible for the proper custody and care of any
property purchased for or furnished to it for use in connection with the performance of this Program Agreement and will
reimburse DPS for loss of, or damage to, such property. At the termination of this Program Agreement, the Sponsoring
Agency, County Government, and JCPC shall follow the guidelines for disposition of property set forth in Administrative
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Code and JCPC policy.
Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process
Disbursements and Internal Controls
Reversion of Unexpended Funds
Any remaining unexpended funds DPS disbursed to the County for the Sponsoring Agency must be refunded/reverted
back to DPS at the close of fiscal year or upon termination of this Agreement.
Accountability for Funds
Audit Requirement - Local Government or Public Authority Requirements
Local Government or Public Authorities in accordance with N.C.G.S. §159-34 must have an audit performed in
conformity with generally accepted auditing standards. The audit shall evaluate the performance of a unit of local
government or public authority with regard to compliance with all applicable Federal and State agency regulations. This
audit, combined with the audit of financial accounts, shall be deemed to be the single audit described by the, "Federal
Single Audit Act of 1984".
Audit Requirement – Non-Governmental Entities: An audit, when required by law, or requested by the County or
DPS shall be performed in conformity with generally accepted auditing standards and audits of non-governmental
entities, both for-profit and not-for-profit, and must meet the requirements of OMB Circular A-133. At a minimum, the
required report shall include the financial statements prepared in accordance with generally accepted accounting
principles, all disclosures in the public interest required by law, and the auditor's opinion and comments relating to
financial statements. The audit report must be submitted to the State Auditor’s office as required by law, to the County
and DPS, and to other recipients as appropriate within nine (9) months after the end of the program’s fiscal year.
Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all
Program Agreements entered into by State agencies or political subdivisions in accordance with N.C.G.S. §147-64.7.
Additionally, as the State funding authority, DPS shall have access to persons and records as a result of all Program
Agreements entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of
DPS. State basic records retention policy requires all records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the Program Agreement is subject to Federal policy and
regulations, record retention may be longer than five years since records must be retained for a period of three years
following submission of the final Federal Financial Status Report, if applicable, or three years following the submission
of a revised final Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action,
or other action involving this Program Agreement has been started before expiration of the five-year retention period
described above, the records must be retained until completion of the action and resolution of all issues which arise
from it, or until the end of the regular five-year period described above, whichever is later.
No Overdue Tax Debt – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. The Sponsoring Agency shall be responsible for
the payment of all State, local, and Federal taxes. Consistent with N.C.G.S. § 143C-6-23 (c), not for profit
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organizations shall file with DPS and the County a written statement completed by that Sponsoring Agency's board of
directors or other governing body, stating whether or not the Sponsoring Agency has any overdue tax debts, as
defined by N.C.G.S. 105-243.1, at the Federal, State, or local level. This written statement, Certification of No
Overdue Tax Debts, shall be completed by the Sponsoring Agency to certify when there are no overdue taxes. If the
agency has overdue taxes, the Sponsoring Agency must notify DPS at the time of Program Agreement submission.
Conflict of Interest – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. Consistent with the N.C.G.S. §143C-6-23 (b), not
for profit organizations shall file with DPS and the County a copy of that Sponsoring Agency’s policy addressing
conflicts of interest that may arise involving the Sponsoring Agency’s management employees and the members of its
board of directors or other governing body. The policy shall address situations in which any of these individuals may
directly or indirectly benefit, except as the Sponsoring Agency’s employees or members of its board or other
governing body, from the Sponsoring Agency’s disbursing of State funds and shall include actions to be taken by the
Sponsoring Agency or the individual, or both to avoid conflicts of interest and the appearance of impropriety. The
policy shall be filed before the County or DPS may disburse any funds. The Sponsoring Agency shall also complete
the DPS Conflict of Interest Policy Statement (Form DPS 13 001) and upload the statement and the Sponsoring
Agency's policy addressing conflicts of interest to the JCPC Program Agreement upon submission.
Proof of 501(c) (3) – Not for profit organizations ONLY must comply with this section. This document must be
uploaded in NCALLIES when submitting a Program Agreement. Not for profit organizations must upload proof of
the Sponsoring Agency’s 501 (c) (3) status.
Amendment: This Agreement may not be amended orally or by performance. Any amendment must be requested in
writing by the Sponsoring Agency through submission of a Program Agreement Revision and executed by duly
authorized representatives of DPS, the County Government, JCPC and Sponsoring Agency.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this Program
Agreement violates any applicable law, each such provision or requirement shall continue to be enforced to the extent
it is not in violation of law or is not otherwise unenforceable and all other provisions and requirements of this Program
Agreement shall remain in full force and effect.
Termination for Cause: If, through any cause, the Sponsoring Agency shall fail to fulfill its obligations under this
Program Agreement in a timely and proper manner, DPS shall have the right to terminate this Program Agreement by
giving written notice to the Sponsoring Agency and specifying the effective date thereof. In that event, all finished or
unfinished deliverable items prepared by the Sponsoring Agency under this Program Agreement shall, at the option of
DPS, become its property and the Sponsoring Agency shall be entitled to receive just and equitable compensation for
any satisfactory work completed on such materials, minus any payment or compensation previously made.
Notwithstanding the foregoing provision, the Sponsoring Agency shall not be relieved of liability to DPS for damages
sustained by DPS by virtue of the Sponsoring Agency’s breach of this agreement, and DPS may withhold any
payment due the Sponsoring Agency for the purpose of setoff until such time as the exact amount of damages due
DPS from such breach can be determined. The filing of a petition for bankruptcy by the Sponsoring Agency shall be
an act of default under this Program Agreement.
Termination without Cause: DPS, the County Government, or the Sponsoring Agency may terminate this
Agreement at any time and without cause by giving at least thirty (30) days advance written notice to the other. If this
Program Agreement is terminated by DPS as provided herein, the Sponsoring Agency shall be reimbursed on a pro
rata basis for services satisfactorily provided to DPS under this Program Agreement prior to Program Agreement
termination.
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Waiver of Default: Waiver by DPS of any default or breach in compliance with the terms of this Program Agreement
by the Sponsoring Agency shall not be deemed a waiver of any subsequent default or breach and shall not be
construed to be modification of the terms of this Program Agreement unless stated to be such in writing, signed by an
authorized representative of DPS, County Government, the JCPC and the Sponsoring Agency.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes,
civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event, pandemic, or act of God.
Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and
warranties contained herein shall survive the Program Agreement expiration or termination date unless specifically
provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation.
END OF SECTION V – Terms of Agreement
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SECTION VI: BUDGET NARRATIVE
4-H Teen Court and At-Risk Youth Development Fiscal Year FY 21-22
Item #Justification Expense In Kind Expense
120 4-H Agent supervision 2 hr/wk @ 17.00/hr for 52 weeks and
Extension Secretary for clerical support 1 hr/wk @ 12.00/hr for
52 weeks
$2,392
120 Full-Time Teen Court Program Manager $2206.75/mo x 12=
$26481.00
$26,481
180 County Package: FICA @ 7.65% (1588), Wrk Comp. (610),
Reg Retirement (1987), Group Ins. @ 652.740/mo (7829), HSA
(0), Emp. Clinic @ 15/mo (180), Unemployment Ins. (265),
Incentives (0), Supplemental Retirement (300), Longevity (400)
Dental (360)
$13,519
260 Office Supplies $0
320 Cell phone for program coordinator. 60/mo = 720/yr $0
340 5000 copies @ .10 each for communication and program
promotion
$500
390 NCTCA Dues, training opportunities for youth volunteers and
clientele.
$0
410 Office Space (includes phone) $400/mo $4,800
450 American Income Life Insurance - 4-H Plan Supplemental
Medical Coverage - $1.00/youth for 100 youth and adult
volunteers - covers entire year.
$0
TOTAL $40,000 $7,692
Job Title
Annual Expense
Wages
Annual In Kind
Wages
4-H Agent and Extension Secretary for direct supervision and clerical support $2,392
4-H Teen Court Program Manager (4-H Program Assistant) - Responsibilities
include implementation of teen court program, management/recruitment of teen
court partners, volunteers and communication with youth and families.
$26,481
TOTAL $26,481 $2,392
173
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VII Program:4-H Teen Court and At-Risk Youth Development
Fiscal Year:FY 21-22 Number of Months:12
Cash In Kind Total
I. Personnel Services $40,000 $2,392 $42,392
120 Salaries & Wages $26,481 $2,392 $28,873
180 Fringe Benefits $13,519 $13,519
190 Professional Services* $0
*Contracts MUST be attached
II. Supplies & Materials $0 $0
210 Household & Cleaning $0
220 Food & Provisions $0
230 Education & Medical $0
240 Construction & Repair $0
250 Vehicle Supplies & Materials $0
260 Office Supplies and Materials $0 $0
280 Heating & Utility Supplies $0
290 Other Supplies and Materials $0
III. Current Obligations & Services $0 $500 $500
310 Travel & Transportation $0
320 Communications $0 $0
330 Utilities $0
340 Printing & Binding $500 $500
350 Repairs & Maintenance $0
370 Advertising $0
380 Data Processing $0
390 Other Services $0 $0
IV. Fixed Charges & Other Expenses $0 $4,800 $4,800
410 Rental or Real Property $4,800 $4,800
430 Equipment Rental $0
440 Service and Maint. Contracts $0
450 Insurance & Bonding $0 $0
490 Other Fixed Charges $0
V. Capital Outlay $0
[This Section Requires Cash Match]
510 Office Furniture & Equipment $0
530 Educational Equipment $0
540 Motor Vehicle $0
550 Other Equipment $0
580 Buildings, Structure & Improv. $0
Total $40,000 $7,692 $47,692
174
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VIII SOURCES OF PROGRAM REVENUE (ALL SOURCES)
FY 21-22 Harnett County Funding ID: 543-XXXX
Sponsoring Agency: Harnett County Government Program: 4-H Teen Court and At-Risk Youth Development
$40,000 DPS/JCPC Funds * This is the amount of your request on your application
10%Local Match Rate Is the Local Match Rate 10%, 20% or 30%?
County Cash (Specify Source)
Local Cash (Specify Source)
Local Cash (Specify Source)
$7,692 Local In-Kind Harnett County Government (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
$47,692 TOTAL $4,000 $7,692
Required Local Match Match Provided
We, the undersigned, have reviewed this JCPC Program Application to be presented to the Juvenile Crime Prevention Council of this County in
accordance with the procedures established by the local Juvenile Crime Prevention Council. Agencies seeking funding must be able to meet the
applicable requirements of the North Carolina General Statutes, Administrative Code, and the Division of Adult Correction and Juvenile Justice.
We understand and acknowledge that the approval process is first with the Juvenile Crime Prevention Council, second with the County Board of
Commissioners, and the final authority with the Department of Public Safety, Division of Adult Correction and Juvenile Justice.
All parties understand that the availability of funds is contingent upon the appropriation of those funds by the General Assembly of the State of
North Carolina.
/DPSSignature//DPSdt/
Chair, County Board of Commissioners or County Finance Director Date
/JCPCSignature//JCPCdt/
Chair, Juvenile Crime Prevention Council Date
/ProgramSignature/
Jackie Helton
/Programdt/
6/15/21
Program Manager Date
175
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
North Carolina Department of Public Safety
JCPC Program - Program Application
SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION
FUNDING PERIOD:FY 21-22 DPS/JCPC FUNDING # (cont only)243-XXXX
COUNTY:Harnett AREA:Central Area
Multi-County:No Multi-Components No
NAME OF PROGRAM:Extended Learning Program
SPONSORING AGENCY:Jehovah Rapha International,
SPONSORING AGENCY
PHYSICAL ADDRESS:
510 West Broad Street
Dunn NC 28334
SPONSORING AGENCY
MAILING ADDRESS:
PO Box 2182
Lillington NC 27546
TYPE:Non-Profit FEDERAL ID #46-0716566
COMPONENT ID #NAME OF PROGRAM COMPONENT PROGRAM TYPE TOTAL COST OF
EACH COMPONENT
32203 Academic Enrichment Program Tutoring/Academic Enhancement $ 20,471
Total cost of components:$ 20,471
Program Manager Name & Address (same person on signature page)
Name:Brandy Woods Title:
Mailing
Address:
PO Box 2182
City:Lillington Zip:27546
Phone:(910) 263-0582 Fax: E-mail:JRIinc@yahoo.com
Contact Person (if different from program manager)
Name:Brandy Woods Title:
Mailing
Address:
PO Box 2182
City:Lillington Zip:27546
Phone:(910) 263-0582 Fax: E-mail:JRIinc@yahoo.com
Program Fiscal Officer (cannot be program manager)
Name:Emily McKoy Title:
Mailing
Address:
PO Box 2182
City:Lillington Zip:27546
Phone:(910) 892-0510 Fax: E-mail:JRIinc@yahoo.com
176
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION I B PROGRAM COMPONENT DESCRIPTION
COMPONENT ID #COMPONENT INFORMATION
32203 NAME OF COMPONENT: Academic Enrichment Program
BRIEF DESCRIPTION: Activities are designed to support student academic and social-
emotional growth. JRI focuses on activities that help students meet state learning standards in
language arts, math, and science, while building critical thinking skills and positive character
traits. *Help students achieve standards in core academic subjects such as reading and math. *
Offer enrichment programs that supplement regular academic programs. *Provide educational
services for the families of participating students.
177
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 01/09/2012
Department of Public Safety
SECTION II COMPONENT STATISTICAL INFORMATION
Multi-Components No
Component Service Statistics PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name:Academic Enrichment Program Component ID #
32203
What is this component's maximum client capacity at any given time?10
Frequency of client contact per month:10 Anticipated Average Length of
Stay:130 Days
Total Component Cost:$20,471 ÷ by Estimated # to be served during funding period:20
Estimated Average Cost Per Youth:$1,024
Applies to
continuation
programs only.
Actual number of youth admitted FY 19-20:0
0 Number of admissions Juvenile Justice Referred 0% of total admissions
0 Number of admissions Law Enforcement Referred 0% of total admissions
0 Number of admissions District Court Referred 0% of total admissions
178
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:Academic Enrichment Program
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
According to Risk Assessment Data, the target population have: behavior problems at school; low grades in school;
associate with negative peers; mental health issues that are being addressed and/or need more assessments; and
parent/guardian/custodian supervision skills that are marginal.
JRI will help address these issues by providing prevention and/or intervention services during out of school hours,
deterring these delinquent/undisciplined behaviors.
JRI Extended Program provides a high-quality out-of-school time program that engages students in exploration of
academic content in interesting and innovative ways.
Program activities are designed to support student academic, social and emotional growth. The program focuses on
activities that help students meet state learning standards in language arts, mathematics, science and social studies,
and build critical thinking skills and positive character traits. To honor youth voice, activities are designed to be
innovative, hands-on and relevant. They are built on learning goals that are shared with youth. The program strives to
create strong, transparent connections to college and career exploration and readiness. It also includes sessions that
promote health and wellness and support a student’s success in school.
*Help students achieve standards in core academic subjects such as reading and math. JRI will provide tutoring that
will help equip targeted youth with the educational skills necessary to be competitive in school.
*Offer enrichment programs that supplement regular academic programs. JRI will provide: mentoring, substance abuse
prevention, behavior modification, and family engagement activities.
*Provide educational services for the families of participating students.
JRI-JCPC Extended Learning Program is provided free of charge to students (and their families). Enrollment is on a
first-come, first-served basis, while also reserving space for students who are identified as most in need of support.
This is possible because the program is funded through the Harnett County JCPC grant, administered by the NC
Department of Public Safety and provided through JRI.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
Includes youth between the ages of six (6) and seventeen (17), who have been adjudicated delinquent or
undisciplined, juveniles under diversion contracts or plans, and/or juveniles at risk for delinquency or otherwise
jurisdiction of and referred by juvenile court, including but not limited to , Interstate Compact juveniles. Additionally,
youth attending Elementary through High School in the Harnett County area with “C” average or lower grades. Also,
recommendations from teachers, police officers, juvenile services, parents, and other sources are considered.
However, all youth are accepted into the program. Youth involved with the court system have the most priority and will
be admitted immediately. Parents/guardians of those admitted will also be targeted.
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
Extended Learning Program’s purpose is to provide a safe and nurturing environment for the youth of Harnett County.
The program will assist in educating the youth with homework, tutoring in specific subjects of weakness, and engage
179
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:Academic Enrichment Program
participants in behavior management/team building activities. Additionally, the program will provide substance abuse
prevention assistance and family engagement activities. JRI will continue to partner with Harnett County Schools,
Harnett County local Law Enforcement Agencies, private and government sectors to help bridge the educational gap
with the youth we are serving. The combined services will lower juvenile crime, lower behavior related infractions
(school or community based), improve social acceptance values, improve self- image/worth, and assist served families
with the opportunity to address their identified needs.
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
75% Clients will have no new adjudications for a complaint with an offense date after the admission date.
85% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
80% Clients will improve academic skills/performance.
80% Clients will reduce specific problem behaviors presented at referral and targeted in the individual service plan.
80% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
80% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
completion.
75% Clients will have no new complaints with an offense date after the admission date.
75% Clients will actively participate in tutorial and/or academic enhancement activities as intended by program design/
the service plan.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
JRI will strive to prevent and reduce the juvenile crime rate in Harnett County by focusing on identifying, tracking, and
educating youth served on their individual academic weaknesses while increasing their mental awareness, which in
turn will lower behavior related incidents in the classroom.
Our Extended Learning Program will coordinate with local schools and teachers to ensure the student is getting
academic and behavior management assistance according to their individual needs. Students will participate in group
Behavior Intervention sessions that will assist in peer relationship building skills. Students will be referred to individual
sessions if the need arises. If possible, youth will be paired with a mentor to assist in addressing individualized needs
and be a positive role model in the youth’s life. The program will provide a variety of parenting classes, including child
welfare trauma informed trainings to parents/guardians of youth being served.
180
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Academic Enrichment Program
1. Location: List physical address(es) and describe where program services are delivered.
510 West Broad Street Dunn, NC 28334. Programs will be held in the JRI Building and grounds.
2. Operation: Describe the daily/weekly schedule of program operation.
Tutoring: Hours of operations: M-F Extended Learning (7a.m.-8a.m. & 3p.m.-6p.m.) Remote Learning (8a.m.-3p.m.)
Full Day (7a.m.-6p.m.)
Field Trips: Dates and times vary
Mentoring: Individualized dates and times vary
Parent/Guardian Classes: Dates and times vary. Families are responsible for attending at least 1 activity per semester
to meet the program requirements.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
Full-Time: 1, Part-Time: 2, Volunteer-1, Contract-Staff: 0
Program Manager:
Must possess at least a Bachelor’s degree in a Human Service or related field, or a four (4) year degree in any other
field with at least two (2) years’ experience as a direct service professional in a juvenile serving agency. It is the
responsibility of the Program Manager to:
a. Ensure the program meets all appropriate standards and licensing requirements;
b. Ensure case oversight and supervision is provided to full-time staff, part- time staff, volunteers, interns, and
contractor(s);
c. Maintain sufficient information to allow for the determination of program effectiveness;
d. Cooperate with DPS Area Consultants and JCPC during monitoring and evaluation activities; and
e. Complete all reporting requirements as established by DPS.
Program Staff:
Must have at least an Associate’s Degree in a Human Services related field, or a high school diploma with at least one
(1) year of Human Service experience. Staff implementing curricula, or facilitating groups based on curricula, shall be
appropriately trained and qualified in both curricula content and facilitation techniques.
Volunteer Program Staff:
All volunteers providing direct services must have at least one (1) year of experience working with at-risk youth. JRI
may use professional or community volunteers to assist or augment services provided by paid staff.
We recruit volunteers to assist students in a variety of ways: small-group tutoring for academic skill practice,
apprenticeship or technical skill instruction, and enrichment projects. Other volunteers work behind the scenes on
administrative tasks.
All EL Program team members, paid instructors, and volunteers, are required to pass a fingerprint/background check.
181
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Academic Enrichment Program
4. Service Type SPEP: Describe implementation to include:
Primary Service: Remedial Academic Program; Secondary Service: None
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
Any youth or parent/guardian seeking to enroll their child in the Extended Learning Program will meet with the Program/
Education Coordinator, complete an admission application, complete an education agreement, agree to all rules, and
must attend at least 20 hours per week. If youth are referred by an agency, a referral form must be complete and sent
to JRI office. Staff will then contact the family to complete the necessary paperwork.
Once all paperwork is complete, the Education Coordinator will review all documents. If space is available, youth/
families will be notified. All approved applicants may begin attending the next business day. The Education Coordinator
shall place applicants on a waiting list if the program is full.
The Education/Program Coordinator may reject an applicant if there is any sex related crimes or if he/she feels after
consultation with authorities that the child/applicant could pose a severe security risk to other students.
Applicants must apply yearly.
Education and/or Program Coordinator will ensure that all program requirements are met prior to approval.
JRI offers a guided tour through the center to the parent/guardian and student. The enrollment procedure includes
defining (1) the philosophy and mission statement, (2) reviewing the daily routine/schedule and, (3) reviewing
enrollment package and parent/student handbook. Prior to the start date, the Program Director/Coordinator or In-Take
worker will conduct a meeting with the parent/guardian and their child.
Enrollment Process:
Referral Form (s) submitted
Intake-appointment scheduled & conducted within (15) days of the referral
Admissions Process:
Application; (Appendix 1)
Referral Form (Appendix 2)
Consent to Release of Information; (Appendix 3)
Participation Agreement Form signed by youth, parent/guardian, and staff; (Appendix 4)
Risk Assessment; (Appendix 5)
Individual Plan of Care/Service Plan signed by youth, parent/guardian, and staff; (Appendix 6)
Custodial declaration-if applicable;
Enter client tracking admission data in NCALLIES within seven (7) days of admissions decision; and
Respond to referring agency regarding their admission decision within fifteen (15) business days of receipt of the
referral REFERENCE: 14B NCAC 11C.0403.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
182
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Academic Enrichment Program
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
Education and/or Program Coordinator may terminate youth for the following reasons:
Successful termination:
Graduating school and/or successfully completing all assignments and grades have increased above a “C” for an
entire semester. (Verified with school); have no new adjudications for a complaint with an offense date after the
admission date; have no new complaints with an offense date after the admission date; and have reduced specific
problem behaviors presented at referral and targeted in the individual service plan.
Satisfactory termination:
Moved out of county
Unsuccessful completion and/or non-compliant termination
Quit School or repeated violation of JRI rules
Education and/or Program Coordinator will request a parent/guardian conference to discuss issues. Afterwards, he/she
will determine if it is necessary to implement a corrective action plan or terminate services. He/she will contact parent/
guardian and referring agency (if applicable) in writing with the mentioned information.
Termination Process:
Complete a written Termination Form (Appendix 7) within ten (10) business days for all juveniles terminated from the
program and submit a copy to the parent(s)/legal guardian(s), Court Services, if applicable, placed in the juvenile’s file
and other referring entities as appropriate; enter client tracking termination data in NCALLIES within seven (7) days of
termination decision; and prior to a juvenile being terminated for any reason other than Successful or Satisfactory
Completion, the program shall review the case status with the referring agency prior to a final termination decision.
Prior to the termination, JRI Staff, the juvenile, parent(s)/legal guardian(s), juvenile’s Court Counselor, and/or other
referring entity must be involved in the development and implementation of an After Care Plan.
How is the referring agency involved with the termination process?
The Education and/or Program Coordinator will determine termination procedures and contact parent/guardian and the
referral agency of compliance and termination. JRI will mail the follow up letter to the parent/guardian of the youth on
the status of their termination and also contact the referring agency. The parent/guardian will be notified of any
possible violations within 5 days of the violation and initiate a corrective action plan. If the corrective action plan is not
followed within 20 days, the parent/guardian will be notified in writing and by telephone that the child has been
terminated.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
The Extended Learning Program Education and/or Program Coordinator will communicate with Juvenile Court &
Counselors as needed to meet the individual needs of the youth served.
We will also work with additional organizations to help the youth and families to be well rounded citizens.
183
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Academic Enrichment Program
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
utilized in this component and how will parents/guardians be involved?
At JRI, Staff never hit, slap, spank or use any form of corporal punishment, even with parent/guardian permission or
request. We do not ridicule, belittle, or humiliate the student in any way. We believe in positive redirection and self
reflection for behavior management. Staff will develop and implement Individual Service Plan/Behavior Modification
Plans (Appendix 13) that use current best practice strategies for students who consistently display negative behaviors.
If a student has a BMP in place from an outside agency, JRI will comply with the plan in place.
We believe that positive interaction between adults and youth are essential to the development of a student’s social
and emotional health. Our goal is to teach the student to initiate self-control of their actions and to learn to make good
choices in their behaviors. Learning self-control is a normal part of growing up and our policy is never to embarrass or
ridicule a child when he or she misbehaves. Corporal or physical punishment is never allowed at JRI. Instead, we
practice preventive discipline by establishing a strong curriculum and ensuring engagement with classroom materials,
peers, and adults. We also try to give negative behavior minimal value by reinforcing more acceptable or alternative
behaviors and using redirection to more appropriate activities.
Extended Learning Program will assist youth in identifying positive behavior and consequences. We will use
Mindfulness Curriculum to teach problem solving skills, anger management techniques, conflict resolution, and social
skills. Our program will target specific goals such as bullying prevention; academic achievement; positive adjustment to
school; conflict resolution; substance abuse prevention; character development; and social/emotional learning.
Extended Learning will promote school success by focusing on social and behavioral characteristics, which can
positively influence academic outcomes. In addition, support community-wide initiatives to benefit the families we serve
as well as the community as a whole.
Students will be taught to be responsible for their own actions; they make the choice to follow the rules and enjoy the
rewards or to ignore the rules and accept the consequences. Appropriate behavior will be encouraged by verbal
praise, rewards and positive communications with parents. Whenever possible, natural and logical consequences will
be provided for inappropriate behavior.
JRI follows the NC Discipline and Behavior Management Policy.
JRI also utilizes a reward/merit system to encourage positive behaviors and social interactions amongst its
participants. Behavioral goals are indicated in each participants Individual Service Plan.
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
Extended Learning Program will structure out of school learning time to improve academic achievement. We will
coordinate with Harnett County School to use curriculums and textbooks that are currently being used within their
schools. In addition, we use the 21st Century School methods. We will partner with various organizations to provide
parent/guardian training on topics that will address every-day issues of communication, discipline, decision making,
relationships, healthy choices, healthy eating, money management, etc.
184
Form structure last revised 12/20/2013
Department of Public Safety
SECTION V Terms of Agreement
This section of the JCPC Program Application will ONLY be completed if approved for funding and will be
included in the required JCPC Program Agreement document for completion.
This Agreement is entered into by and between Department of Public Safety, (hereinafter referred to as the DPS), and
County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to
as the JCPC) and (hereinafter referred to as the Sponsoring Agency).
The DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows:
Term of Agreement
This Agreement shall become effective _______ and shall terminate ________.
Payment to Sponsoring Agency
All parties agree that services will be delivered as described in the approved Program Agreement and that funds will be
disbursed in an amount not to exceed the amount $___________ for the term of this agreement, unless amended by
an approved Program Agreement Revision.
Availability of Funds:
All parties to this Agreement agree and understand that the payment of the sums specified in this Program Agreement
budget, or most recently approved Program Agreement Revision, is dependent and contingent upon and subject to the
appropriation, allocation, and availability of funds for this purpose to DPS.
Responsibilities of the Parties
DPS shall:
1.Disburse funds monthly to County Governments, for payment to the Sponsoring Agency, from the fund
appropriation by the General Assembly;
2.Reserve the right to suspend payment to the County for any non-compliance by the Sponsoring Agency with any
reporting requirements set forth in DPS JCPC Policy and Procedures;
3.Notify in writing the County and Sponsoring Agency immediately if payments are suspended and again once
payments resume;
4.Pay only for work as described in the Program Agreement, or most recently approved Program Agreement
Revision, provided by the Sponsoring Agency and approved subcontractors;
5.Provide technical assistance, orientation and training to the Sponsoring Agency, the County and the JCPC;
6.Monitor Sponsoring Agency’s funded program(s) in accordance with DPS JCPC Policy 3. Operations: Program
Oversight and Monitoring; and
7.Notify parties entering into this Agreement of all due dates in a timely manner in order for reports to be submitted
by the established due date.
185
Form structure last revised 12/20/2013
Department of Public Safety
The Sponsoring Agency shall:
1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the
conduct of its business, including those of Federal, State, and local agencies having jurisdiction and/or authority;
2.Comply with all Federal and State laws relating to equal employment opportunity;
3.Keep as confidential and not divulge or make available to any individual or organization without the prior written
approval of DPS any information, data, instruments, documents, studies or reports given to or prepared or
assembled by the Sponsoring Agency under this Agreement;
4.Acknowledge that in receiving, storing, processing or otherwise dealing with any confidential information it will
safeguard and not further disclose the information except as otherwise provided in this Agreement;
5.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Procedures;
6.Secure local match as required, if applicable, pursuant to 14B NCAC 11B.0105, for approved JCPC funds;
7.Create and adopt individualized guidelines specific to the funded program, while also adhering to DPS JCPC
Policy and Procedures for all funded programs and for the specific program type for which they receive funding;
8.Ensure that state funds received are spent in accordance with the approved Program Agreement, or most recently
approved Program Agreement Revision, and be accountable for the legal and appropriate expenditure of those
state funds;
9.Maintain reports, records, and other information to properly document services rendered and outcomes; also
maintain an ability to send and receive electronic communication;
10.Have the capacity to use DPS electronic, internet-based system for tracking clients served;
11.Use generally accepted accounting procedures that guarantee the integrity of the expenditure of funds, maintain
reports, records, and other information to properly account for the expenditure of all State funds provided to the
Sponsoring Agency;
12.When refunds are requested from the North Carolina Department of Revenue for sales and/or use taxes paid by
the agency in the performance of the Program Agreement, or most recently approved Program Agreement
Revision, as allowed by NCGS §105-164.14(c), the agency shall exclude all refundable sales and use taxes from
reportable expenditures submitted to the County and DPS;
13.Submit Program Agreement Revisions, Third Quarter Accounting, Final Accounting and annual detailed
expenditures through NCALLIES. These reports must be in accordance with the submission process as outlined in
DPS JCPC Policy and Procedures and with the due dates established by DPS;
14.Make personnel, reports, records and other information available to DPS, the County, the JCPC, and/or the State
Auditor for oversight, monitoring and evaluation purposes;
15.Submit any other information requested by the JCPC, County or DPS;
16.Be responsible for the performance of all subcontractors as described in the JCPC Program Agreement, or most
recently approved Program Agreement Revision;
17. Indemnify and hold harmless DPS, the State of North Carolina, the County and any of their officers, agents and
employees, from any claims of third parties arising out of any act or omission of the Sponsoring Agency in
connection with the performance of the Program Agreement or most recently approved Program Agreement
Revision;
18.Receive permission and budgetary approval from DPS prior to using the Program Agreement, or most recently
approved Program Agreement Revision, as a part of any news release or commercial advertising and
acknowledge DPS funding in partnership with the County;
19.Comply with DPS trainings and requirements regarding the United States Department of Justice national
standards to prevent, detect, and respond to prison rape under the Prison Rape Elimination Act (PREA);
Reference: 14B NCAC 11B, and in compliance with DPS JCPC Policy 2: Operations: Program Operational
Requirements
20.Be deemed an independent contractor in the performance of services described in the Program Agreement, or
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most recently approved Program Agreement Revision, and as such shall be wholly responsible for the services to
be performed and for the supervision of its employees;
21.Represent that it has, or shall secure at its own expense, all personnel required in performing the services as
described in the Program Agreement. Such personnel shall not be employees of, or have any individual
contractual relationship with, DPS;
Sponsoring Agency and Use of Contractor(s)/Subcontractors
The Sponsoring Agency may engage with independent contractors as needed to perform services or support services
described in the Program Agreement. When independent contractors (funds are included in line item 190 of the
budget) are providing services as described in the Program Agreement, the sponsoring agency must:
22.Upload a signed Contract for Professional Services into NCALLIES once the Program Agreement (or
Program Agreement Revision) is approved by DPS;
23.Be responsible for the performance of all contractors or subcontractors as described in the Program
Agreement, or most recently approved Program Agreement Revision;
24.Hold any contractor or subcontractor to which the Sponsoring Agency provides State funds accountable for
the legal and appropriate expenditure of State funds, and to all applicable laws and DPS JCPC Policies and
Procedures; and
25.Ensure that all contractors or subcontractors provide all information necessary to comply with the standards
set forth in the Program Agreement or most recently approved Program Agreement Revision.
The JCPC shall:
1.Ensure the Sponsoring Agency uses JCPC funds for only the purposes DPS has approved in the JCPC Program
Agreement or most recently approved JCPC Program Agreement Revision;
2.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Code; N.C.G.S. §143B-801
(a);143B-602;143B-851
3.Review and locally approve Program Agreement Revision(s) received from the Sponsoring Agency and submit to
the County in a timely manner;
4.Review and locally approve Third Quarter Accounting forms and submit to the County in order to meet the due
date established by DPS (applicable only to JCPC funded agencies);
5.Submit any other information requested by the County or DPS; and
6.Monitor the Sponsoring Agency’s currently funded JCPC program(s) in accordance with DPS JCPC Policy 3.
Operations: Program Oversight and Monitoring
Reference: 14B NCAC 11B.0202 and DPS JCPC Policy 1, 7, 8, 9, 10, and 11.
The County shall:
1.Ensure the Sponsoring Agency is appropriately licensed, and either local public agencies, 501(c) (3) non-profit
corporations or local housing authorities (applicable only to JCPC funded agencies);
2.Use funds only for the purposes DPS has approved in the Program Agreement or most recently approved
Program Agreement Revision;
3.Disburse funds monthly and oversee funds to the Sponsoring Agency in accordance with 14B NCAC 11B.0108
4.Comply with DPS JCPC Policies and Procedures and the North Carolina Administrative Procedures;
5.Review and locally approve Program Agreement Revisions received from the Sponsoring Agency for final
approval from DPS; and
6.Review and locally approve Third Quarter and jointly submit Final Accounting forms for the JCPC and all funded
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programs according to the procedures and due dates established by DPS.
Reference: 14B NCAC 11B; DPS JCPC Policy 3, 7, 8, 9, 10, and 11
Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Choice of Law: The validity of this Program Agreement and any of its terms or provisions, as well as the rights and
duties of the parties to this Program Agreement, are governed by the laws of North Carolina. The parties, by signing
this Program Agreement, agree and submit, solely for matters concerning this Program Agreement, to the exclusive
jurisdiction of the courts of North Carolina and agree, solely for such purpose, that the exclusive venue for any legal
proceedings shall be Wake County, North Carolina. The place of this Program Agreement and all transactions and
agreements relating to it, and their situs and forum, shall be Wake County, North Carolina, where all matters, whether
sounding in Program Agreement or tort, relating to the validity, construction, interpretation, and enforcement shall be
determined.
Assignment: No assignment of the Sponsoring Agency's obligations or the Sponsoring Agency's right to receive
payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority,
DPS may:
(a) Forward the Sponsoring Agency's payment check(s) directly to any person or entity designated by the
Program Manager, or
(b) Include any person or entity designated by Sponsoring Agency as a joint payee on the Sponsoring Agency's
payment check(s).
In no event shall such approval and action obligate DPS or County Government to anyone other than the Sponsoring
Agency, and the Sponsoring Agency shall remain responsible for fulfillment of all Program Agreement obligations.
Beneficiaries: Except as herein specifically provided otherwise, this Program Agreement shall inure to the benefit of
and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the
enforcement of the terms and conditions of this Program Agreement, and all rights of action relating to such
enforcement, shall be strictly reserved to DPS, the County Government, and the Sponsoring Agency. Nothing
contained in this document shall give or allow any claim or right of action whatsoever by any other third person. It is the
express intention of DPS and County Government that any such person or entity, other than DPS or the County
Government, or the Sponsoring Agency receiving services or benefits under this Program Agreement shall be deemed
an incidental beneficiary only.
Property Rights
Intellectual Property: All deliverable items produced pursuant to this Program Agreement are the exclusive property of
DPS. The Sponsoring Agency shall not assert a claim of copyright or other property interest in such deliverables.
Physical Property: the Sponsoring Agency agrees that it shall be responsible for the proper custody and care of any
property purchased for or furnished to it for use in connection with the performance of this Program Agreement and will
reimburse DPS for loss of, or damage to, such property. At the termination of this Program Agreement, the Sponsoring
Agency, County Government, and JCPC shall follow the guidelines for disposition of property set forth in Administrative
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Code and JCPC policy.
Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process
Disbursements and Internal Controls
Reversion of Unexpended Funds
Any remaining unexpended funds DPS disbursed to the County for the Sponsoring Agency must be refunded/reverted
back to DPS at the close of fiscal year or upon termination of this Agreement.
Accountability for Funds
Audit Requirement - Local Government or Public Authority Requirements
Local Government or Public Authorities in accordance with N.C.G.S. §159-34 must have an audit performed in
conformity with generally accepted auditing standards. The audit shall evaluate the performance of a unit of local
government or public authority with regard to compliance with all applicable Federal and State agency regulations. This
audit, combined with the audit of financial accounts, shall be deemed to be the single audit described by the, "Federal
Single Audit Act of 1984".
Audit Requirement – Non-Governmental Entities: An audit, when required by law, or requested by the County or
DPS shall be performed in conformity with generally accepted auditing standards and audits of non-governmental
entities, both for-profit and not-for-profit, and must meet the requirements of OMB Circular A-133. At a minimum, the
required report shall include the financial statements prepared in accordance with generally accepted accounting
principles, all disclosures in the public interest required by law, and the auditor's opinion and comments relating to
financial statements. The audit report must be submitted to the State Auditor’s office as required by law, to the County
and DPS, and to other recipients as appropriate within nine (9) months after the end of the program’s fiscal year.
Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all
Program Agreements entered into by State agencies or political subdivisions in accordance with N.C.G.S. §147-64.7.
Additionally, as the State funding authority, DPS shall have access to persons and records as a result of all Program
Agreements entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of
DPS. State basic records retention policy requires all records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the Program Agreement is subject to Federal policy and
regulations, record retention may be longer than five years since records must be retained for a period of three years
following submission of the final Federal Financial Status Report, if applicable, or three years following the submission
of a revised final Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action,
or other action involving this Program Agreement has been started before expiration of the five-year retention period
described above, the records must be retained until completion of the action and resolution of all issues which arise
from it, or until the end of the regular five-year period described above, whichever is later.
No Overdue Tax Debt – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. The Sponsoring Agency shall be responsible for
the payment of all State, local, and Federal taxes. Consistent with N.C.G.S. § 143C-6-23 (c), not for profit
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organizations shall file with DPS and the County a written statement completed by that Sponsoring Agency's board of
directors or other governing body, stating whether or not the Sponsoring Agency has any overdue tax debts, as
defined by N.C.G.S. 105-243.1, at the Federal, State, or local level. This written statement, Certification of No
Overdue Tax Debts, shall be completed by the Sponsoring Agency to certify when there are no overdue taxes. If the
agency has overdue taxes, the Sponsoring Agency must notify DPS at the time of Program Agreement submission.
Conflict of Interest – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. Consistent with the N.C.G.S. §143C-6-23 (b), not
for profit organizations shall file with DPS and the County a copy of that Sponsoring Agency’s policy addressing
conflicts of interest that may arise involving the Sponsoring Agency’s management employees and the members of its
board of directors or other governing body. The policy shall address situations in which any of these individuals may
directly or indirectly benefit, except as the Sponsoring Agency’s employees or members of its board or other
governing body, from the Sponsoring Agency’s disbursing of State funds and shall include actions to be taken by the
Sponsoring Agency or the individual, or both to avoid conflicts of interest and the appearance of impropriety. The
policy shall be filed before the County or DPS may disburse any funds. The Sponsoring Agency shall also complete
the DPS Conflict of Interest Policy Statement (Form DPS 13 001) and upload the statement and the Sponsoring
Agency's policy addressing conflicts of interest to the JCPC Program Agreement upon submission.
Proof of 501(c) (3) – Not for profit organizations ONLY must comply with this section. This document must be
uploaded in NCALLIES when submitting a Program Agreement. Not for profit organizations must upload proof of
the Sponsoring Agency’s 501 (c) (3) status.
Amendment: This Agreement may not be amended orally or by performance. Any amendment must be requested in
writing by the Sponsoring Agency through submission of a Program Agreement Revision and executed by duly
authorized representatives of DPS, the County Government, JCPC and Sponsoring Agency.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this Program
Agreement violates any applicable law, each such provision or requirement shall continue to be enforced to the extent
it is not in violation of law or is not otherwise unenforceable and all other provisions and requirements of this Program
Agreement shall remain in full force and effect.
Termination for Cause: If, through any cause, the Sponsoring Agency shall fail to fulfill its obligations under this
Program Agreement in a timely and proper manner, DPS shall have the right to terminate this Program Agreement by
giving written notice to the Sponsoring Agency and specifying the effective date thereof. In that event, all finished or
unfinished deliverable items prepared by the Sponsoring Agency under this Program Agreement shall, at the option of
DPS, become its property and the Sponsoring Agency shall be entitled to receive just and equitable compensation for
any satisfactory work completed on such materials, minus any payment or compensation previously made.
Notwithstanding the foregoing provision, the Sponsoring Agency shall not be relieved of liability to DPS for damages
sustained by DPS by virtue of the Sponsoring Agency’s breach of this agreement, and DPS may withhold any
payment due the Sponsoring Agency for the purpose of setoff until such time as the exact amount of damages due
DPS from such breach can be determined. The filing of a petition for bankruptcy by the Sponsoring Agency shall be
an act of default under this Program Agreement.
Termination without Cause: DPS, the County Government, or the Sponsoring Agency may terminate this
Agreement at any time and without cause by giving at least thirty (30) days advance written notice to the other. If this
Program Agreement is terminated by DPS as provided herein, the Sponsoring Agency shall be reimbursed on a pro
rata basis for services satisfactorily provided to DPS under this Program Agreement prior to Program Agreement
termination.
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Waiver of Default: Waiver by DPS of any default or breach in compliance with the terms of this Program Agreement
by the Sponsoring Agency shall not be deemed a waiver of any subsequent default or breach and shall not be
construed to be modification of the terms of this Program Agreement unless stated to be such in writing, signed by an
authorized representative of DPS, County Government, the JCPC and the Sponsoring Agency.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes,
civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event, pandemic, or act of God.
Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and
warranties contained herein shall survive the Program Agreement expiration or termination date unless specifically
provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation.
END OF SECTION V – Terms of Agreement
191
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VI: BUDGET NARRATIVE
Extended Learning Program Fiscal Year FY 21-22
Item #Justification Expense In Kind Expense
120 Staff (9 hours/wk x 52 weeks x 11.25 rate/hr)$5,265
120 Extended Learning Coordinator (9 hours/wk x 52 weeks x 15
rate/hr)
$7,020
180 Employer’s share of: Social Security Contributions (FICA) and
Workers’ Compensation Contribution,
$1,000
230 Cost of educational supplies and materials for instructional
purposes. Costs of audio visual aids and supplies necessary
for supplying and maintaining a media center (library). Cost of
supplies and materials to be used for medical purposes.
$402
260 General office supplies and materials, such as but not limited to
paper, pencils, toner, adding machine paper, desk calendars,
etc. Such items should be of relatively little value, relatively
consumable and may not be subject to inventory control.
$250
310 Travel, lodging, registration for training, etc.$0
370 Direct advertising and publicity in newspapers, radio, video,
magazines, periodicals, outdoor advertising, pictures, mats,
websites, and related items.
$250
410 Rental of 1 classroom and office space @ $35 per day(3 days
per week)(52 weeks)=5,460
$5,460
450 Property & General Liability insurance (Fire and casualty and
general liability insurance costs.)
$824
TOTAL $7,991 $12,480
Job Title
Annual Expense
Wages
Annual In Kind
Wages
Staff (9 hours/wk x 52 weeks x 11.25 rate/hr)$5,265
Extended Learning Coordinator (9 hours/wk x 52 weeks x 15 rate/hr) $7,020
TOTAL $5,265 $7,020
192
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VII Program:Extended Learning Program
Fiscal Year:FY 21-22 Number of Months:12
Cash In Kind Total
I. Personnel Services $6,265 $7,020 $13,285
120 Salaries & Wages $5,265 $7,020 $12,285
180 Fringe Benefits $1,000 $1,000
190 Professional Services* $0
*Contracts MUST be attached
II. Supplies & Materials $652 $652
210 Household & Cleaning $0
220 Food & Provisions $0
230 Education & Medical $402 $402
240 Construction & Repair $0
250 Vehicle Supplies & Materials $0
260 Office Supplies and Materials $250 $250
280 Heating & Utility Supplies $0
290 Other Supplies and Materials $0
III. Current Obligations & Services $250 $250
310 Travel & Transportation $0 $0
320 Communications $0
330 Utilities $0
340 Printing & Binding $0
350 Repairs & Maintenance $0
370 Advertising $250 $250
380 Data Processing $0
390 Other Services $0
IV. Fixed Charges & Other Expenses $824 $5,460 $6,284
410 Rental or Real Property $5,460 $5,460
430 Equipment Rental $0
440 Service and Maint. Contracts $0
450 Insurance & Bonding $824 $824
490 Other Fixed Charges $0
V. Capital Outlay $0
[This Section Requires Cash Match]
510 Office Furniture & Equipment $0
530 Educational Equipment $0
540 Motor Vehicle $0
550 Other Equipment $0
580 Buildings, Structure & Improv. $0
Total $7,991 $12,480 $20,471
193
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VIII SOURCES OF PROGRAM REVENUE (ALL SOURCES)
FY 21-22 Harnett County Funding ID: 243-XXXX
Sponsoring Agency: Jehovah Rapha International, Program: Extended Learning Program
$7,991 DPS/JCPC Funds * This is the amount of your request on your application
10%Local Match Rate Is the Local Match Rate 10%, 20% or 30%?
County Cash (Specify Source)
Local Cash (Specify Source)
Local Cash (Specify Source)
$5460 Local In-Kind 1 BDW Properties, LLC (Specify Source)
$7020 Local In-Kind 2 Kidds Place Too, Inc (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
$20,471 TOTAL $799 $12,480
Required Local Match Match Provided
We, the undersigned, have reviewed this JCPC Program Application to be presented to the Juvenile Crime Prevention Council of this County in
accordance with the procedures established by the local Juvenile Crime Prevention Council. Agencies seeking funding must be able to meet the
applicable requirements of the North Carolina General Statutes, Administrative Code, and the Division of Adult Correction and Juvenile Justice.
We understand and acknowledge that the approval process is first with the Juvenile Crime Prevention Council, second with the County Board of
Commissioners, and the final authority with the Department of Public Safety, Division of Adult Correction and Juvenile Justice.
All parties understand that the availability of funds is contingent upon the appropriation of those funds by the General Assembly of the State of
North Carolina.
/DPSSignature//DPSdt/
Chair, County Board of Commissioners or County Finance Director Date
/JCPCSignature//JCPCdt/
Chair, Juvenile Crime Prevention Council Date
/ProgramSignature/
Brandy Woods
/Programdt/
6/14/21
Program Manager Date
194
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
North Carolina Department of Public Safety
JCPC Program - Program Application
SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION
FUNDING PERIOD:FY 21-22 DPS/JCPC FUNDING # (cont only)543-XXXX
COUNTY:Harnett AREA:Central Area
Multi-County:No Multi-Components No
NAME OF PROGRAM:Healthy Choices
SPONSORING AGENCY:Eleventh Judicial District ReEntry, Inc.
SPONSORING AGENCY
PHYSICAL ADDRESS:
1329 N. Brightleaf Blvd.Suite A-2
Smithfield NC 27577
SPONSORING AGENCY
MAILING ADDRESS:
PO Box 1153
Smithfield NC 27577
TYPE:Non-Profit FEDERAL ID #56-2106268
COMPONENT ID #NAME OF PROGRAM COMPONENT PROGRAM TYPE TOTAL COST OF
EACH COMPONENT
32457 Healthy Choices Interpersonal Skill Building $ 45,800
Total cost of components:$ 45,800
Program Manager Name & Address (same person on signature page)
Name:Dot Ehlers Title:Executive Director
Mailing
Address:
PO Box 1153
City:Smithfield Zip:27577
Phone:(919) 989-7278 Ext:1 Fax:(919) 989-8943 E-mail:reentrycp@gmail.com
Contact Person (if different from program manager)
Name:Dot Ehlers Title:Executive Director
Mailing
Address:
PO Box 1153
City:Smithfield Zip:27577
Phone:(919) 989-7278 Ext:1 Fax:(919) 989-8943 E-mail:reentrycp@gmail.com
Program Fiscal Officer (cannot be program manager)
Name:Antoan Whidbee Title:Board Treasurer
Mailing
Address:
PO Box 810
City:Smithfield Zip:27577
Phone:(919) 934-3222 Ext:1 Fax:(919) 989-8943 E-mail:reentrycp@gmail.com
195
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION I B PROGRAM COMPONENT DESCRIPTION
COMPONENT ID #COMPONENT INFORMATION
32457 NAME OF COMPONENT: Healthy Choices
BRIEF DESCRIPTION: Interpersonal skills group for youth. LifeSkills and TND are evidence
based curriculums that teach communication, managing stress & anxiety, decision making,
chemical dependency, peer pressure, thinking/feeling /acting process, anger management,
media influence, & conflict resolution. Virtual workshops are provided for parents including:
Substance Abuse Education/Prevention for Teens, Managing Emotions Birth thru Teens, and
Self Care for Parents. Workshops are 2 night series for 1.5 hrs.
196
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 01/09/2012
Department of Public Safety
SECTION II COMPONENT STATISTICAL INFORMATION
Multi-Components No
Component Service Statistics PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name:Healthy Choices Component ID #
32457
What is this component's maximum client capacity at any given time?20
Frequency of client contact per month:8 Anticipated Average Length of
Stay:90 Days
Total Component Cost:$45,800 ÷ by Estimated # to be served during funding period:20
Estimated Average Cost Per Youth:$2,290
Applies to
continuation
programs only.
Actual number of youth admitted FY 19-20:4
4 Number of admissions Juvenile Justice Referred 100% of total admissions
0 Number of admissions Law Enforcement Referred 0% of total admissions
0 Number of admissions District Court Referred 0% of total admissions
197
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:Healthy Choices
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
Youth often have difficulties during adolescence. For at-risk youth, these difficulties are compounded by poor
parenting skills, bad role models or possibly substance abuse and domestic violence. There may be inherent
difficulties such as learning disabilities, mental health issues, or anger management problems. These deficits manifest
in poor/disruptive school behavior, alcohol/substance abuse, unacceptable peers such as gangs, unruly behavior at
home & acting out against society. Disruptive youth are often expelled from services. Their behaviors worsens and the
criminal justice system is involved. We will intervene at all levels of dysfunction & provide youth with interpersonal skills
training, substance abuse education, anger management and problem solving skills.
Parents lack the education and skills to provide appropriate supervision, knowledge to identify substance abuse and
seek prevention skills, teach youth appropriate behavior, and provide safe non violent homes. Parents are provided 6
week workshops covering: Substance Abuse Education/Prevention for Teens, Managing Emotions-Birth through
Teens, and Self Care for Parents.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
Healthy Choices provides services to any at-risk youth ages 12 -18 and their parents iin an effort to build strong
healthy families. We will serve youth with the following risk factors: skill deficits; low self-esteem; behavior problems;
pro-drug attitudes; lack of academic motivation; psychological distubances; lack of peer refusal skills; and who reject
pro-social values. These are considered the most at-risk youth. Youth and families will be identified by the Juvenile
Justice, courts, schools, social services and parents. There will be continuous contact with referral and potential
referral agencies to ensure the target population is served.
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
The goal is to increase adaptive functioning and skills for youth and parents. Youth will be accessed with regard to risk
and needs. Services will address the deficits therefore improving youths’ ability to manage their anger, improve
behavior in school and home, increase problem solving skills, choose appropriate peers, address mental health needs,
and impart substance abuse and prevention education.
Parents will increase their knowledge of substance abuse including: changes in school behavior, attendance and
grades; changes in behavior at home; physical changes in appearance; and changes in peer associations. Substance
abuse risk factors will be identified and parents will learn tools to prevent or address substance abuse. Parents will be
provided knowledge to assist youth in identifying and managing emotions in effort to understand and improve youths’
behavior. Parents will receive assistance in identifying and providing self care techniques to increase their coping
skills. Increasing parents’ self care increases their energy and motivation to “hang in there” and manage problem
behaviors.
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
80% Clients will demonstrate improvement in targeted skills identified in the individual service plan.
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:Healthy Choices
80% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
completion.
80% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
80% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
80% Clients will have no new complaints with an offense date after the admission date.
80% Clients will reduce specific problem behaviors presented at referral and targeted in the individual service plan.
80% Clients will have no new adjudications for a complaint with an offense date after the admission date.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
Based on highlights of the FY 2020/2021 risk assessment data for Harnett County, we will address family domain risk
factors. These factors are an elevated percentage of adjudicated youth whose parents’ lack parenting and supervision
skills, elevated percentage of parents/custodians and siblings with a criminal history and an elevated percentage of
youth who report family discord. Youth are also in need of substance abuse education.
Parents lack the knowledge, skills and ability to provide appropriate supervision, to manage high risk situations, to
identify substance abuse, to demonstrate appropriate behaviors, to provide an example of healthy nonviolent
relationships and the ability to advocate for their children.
199
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Healthy Choices
1. Location: List physical address(es) and describe where program services are delivered.
ReEntry has partnered with the Harnett County Commissioners for permanent office space at Shawtown. Our office is
located at the Shawtown Community Center 645 Shawtown Road Lillington NC. Currently, due to the COVID-19
services are provided virtually. Limited in person appointments are provided as needed at our Shawtown office.
2. Operation: Describe the daily/weekly schedule of program operation.
We are providing intakes and family case management at our ReEntry office located at the Shawtown Community
Center. Youth groups are Monday nights 5-6:30. Parental workshops are on Thursday 6:30-8. Due to COVID-19
these services are currently provided virtually and face to face are provided as needed. All services will return to the
Shawtown office based on the decline in COVID-19 restrictions.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
1 Program Director/Case Manager (3/4-time)
Qualifications: BA in Social Work or human service field, 2 years experience with youth, or a combination of education
& experience, and a desire to implement a strength-based best practice model.
Responsibilities: Case Manager oversee caseload and will conduct intakes, advise family of program schedule,
conduct case management sessions, and act as liasion between NCDPS-DACJJ, Juvenile Court, DSS, Mental Health,
schools, and other referring agencies. Case manager will be present in Juvenile Court to schedule intake appointment
for each family.
1 group facilitator
Qualifications: BA in Social Work or human service field, 2 years experience with youth, or a combination of education
& experience, and a desire to implement a strength-based best practice model.
Responsibilities: Lead sessions utilizing the Strengthening the Family and/or TND curriculum. Group facilitators lead
family groups, parent only groups and youth only groups.
1 Services Quality Assurance Manager (part-time)
Qualifications: BA in Social Work or human service field, 2 years experience with youth, or a combination of education
& experience, and a desire to implement a strength based model.
Responsibilities: Program Development, Audit client records for compliance with NCDPS JCPC Policy Standards;
Monitoring Program compliance to the keep fidelity of the LifeSkills and TND curriculums.
NOTE: All program staff attend monthly treatment team meetings and receive guidance from the psychologist with
regard to clinical and implementation stratergies.
4. Service Type SPEP: Describe implementation to include:
Provides a service: Interpersonal skill building
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Healthy Choices
Juvenile Court referrals are our top priority because it allows us to intervene and possibly disrupt the anti-social
patterns of court/court counselor involved youth. We attend truancy court to identify other families in crisis. The case
manager provides court coverage. At-risk youth are targeted in Court, are referred by DSS , and Juvenile Court
Counselors. We have also collaborated with the Faith Community. The Case Manager will conduct a staffing with the
referring agency and a comprehensive psycho-social intake with the family and client in order to obtain a thorough
family history. Based on the referral, assessments, and psycho-social history youth the case manager will be assign
youth to group. During the intitial group session, we review program outline, complete pre-test, set goals, and group
rules. All releases will be signed during the intake process. Initial contact with families is made within 10 days of the
referral.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
Youth will be successfully terminated after completing at least 12 weeks of group and all case management
appointments.
Youth will be satisfactorily terminated after completing 9 weeks of group and at least 1 case management appointment.
Youth will be terminated unsuccessfully for attending less than 9 groups and case management appointments.
Youth will be terminated for non-compliance for failure to attend or participate.
Youth may terminated successfully or satisfactory if changes in their plan are made beyond their control, such as
moving, out of home placement or case is closed by juvenile court.
Youth will not be penalized for parents lack of participation in the parenting workshops.
How is the referring agency involved with the termination process?
Monthly staffings are conducted and/or progress reports submitted to the juvenile court counselors or other referring
agency to monitor program compliance. The referring agency may participate in all family review meetings to address
concerns. Juvenile court counselors may refer cases back to court for non-compliance. Cases referred from Truancy
Court are reviewed as scheduled by the court.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
We are present in juvenile court and truancy court to target and screen appropriate cases and to schedule an intake
appointment with each family. A referral form is completed and submitted to ReEntry by the referring agency. The
Case Manager will make initial contact with families, conduct intake, family case management sessions, and schedule
school visits as needed. The CM maintains ongoing contact with the assigned juvenile court counselor for each youth,
with additional contacts as needed for critical cases. Each month, the CM and/or supervisor meet with Juvenile Court
Counselors to staff cases regarding attendance, participation, successes, or concerns. Monthly progress reports are
submitted to Juvenile Court or other referring agencies and client tracking is updated.
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
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Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Healthy Choices
utilized in this component and how will parents/guardians be involved?
LifeSkills is an 8 week evidence based program which assist youth in identifying faulty thinking patterns, impact of
behavior and consequences. Youth are taught problem solving skills, anger management techniques, conflict
resolution, and social skills. Increased knowledge and skill utilization should decrease inappropriate behavior.
Project TND- Towards No Drug Abuse This program is a 6 weeks evidence based model and will supplement the
LifeSkills curriculum. It is facilitated in a group setting. Students will increase interpersonal skills, adaptive coping and
self-management skills, decision-making and critical thinking, and increased knowledge of the negative consequences
of drug use.
Six weeks of educational workshops will be provided to parents. Topics will include information on helping youth to
identify and manage their emotions and the effects on their behavior. Parents are provided information on identifying
substance abuse through behavioral changes, identifying risk factors and resources for substance abuse prevention/
education and treatment. Self care techniques are provided for parents to assist them with managing their behavior, to
energize themselves, to model appropriate behavior, adequate supervision and pro-social skills.
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
We will utilize two different evidence-based curriculums. LifeSkills is an 8 week evidence based interpersonal skills
curriculum. Additionally we provide Project TND- Towards No Drug Abuse model a 6 week evidence based
curriculum. This will provide 14 weeks of interpersonal skills training. An educational 6 week track will be provided for
parents.
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Department of Public Safety
SECTION V Terms of Agreement
This section of the JCPC Program Application will ONLY be completed if approved for funding and will be
included in the required JCPC Program Agreement document for completion.
This Agreement is entered into by and between Department of Public Safety, (hereinafter referred to as the DPS), and
County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to
as the JCPC) and (hereinafter referred to as the Sponsoring Agency).
The DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows:
Term of Agreement
This Agreement shall become effective _______ and shall terminate ________.
Payment to Sponsoring Agency
All parties agree that services will be delivered as described in the approved Program Agreement and that funds will be
disbursed in an amount not to exceed the amount $___________ for the term of this agreement, unless amended by
an approved Program Agreement Revision.
Availability of Funds:
All parties to this Agreement agree and understand that the payment of the sums specified in this Program Agreement
budget, or most recently approved Program Agreement Revision, is dependent and contingent upon and subject to the
appropriation, allocation, and availability of funds for this purpose to DPS.
Responsibilities of the Parties
DPS shall:
1.Disburse funds monthly to County Governments, for payment to the Sponsoring Agency, from the fund
appropriation by the General Assembly;
2.Reserve the right to suspend payment to the County for any non-compliance by the Sponsoring Agency with any
reporting requirements set forth in DPS JCPC Policy and Procedures;
3.Notify in writing the County and Sponsoring Agency immediately if payments are suspended and again once
payments resume;
4.Pay only for work as described in the Program Agreement, or most recently approved Program Agreement
Revision, provided by the Sponsoring Agency and approved subcontractors;
5.Provide technical assistance, orientation and training to the Sponsoring Agency, the County and the JCPC;
6.Monitor Sponsoring Agency’s funded program(s) in accordance with DPS JCPC Policy 3. Operations: Program
Oversight and Monitoring; and
7.Notify parties entering into this Agreement of all due dates in a timely manner in order for reports to be submitted
by the established due date.
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The Sponsoring Agency shall:
1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the
conduct of its business, including those of Federal, State, and local agencies having jurisdiction and/or authority;
2.Comply with all Federal and State laws relating to equal employment opportunity;
3.Keep as confidential and not divulge or make available to any individual or organization without the prior written
approval of DPS any information, data, instruments, documents, studies or reports given to or prepared or
assembled by the Sponsoring Agency under this Agreement;
4.Acknowledge that in receiving, storing, processing or otherwise dealing with any confidential information it will
safeguard and not further disclose the information except as otherwise provided in this Agreement;
5.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Procedures;
6.Secure local match as required, if applicable, pursuant to 14B NCAC 11B.0105, for approved JCPC funds;
7.Create and adopt individualized guidelines specific to the funded program, while also adhering to DPS JCPC
Policy and Procedures for all funded programs and for the specific program type for which they receive funding;
8.Ensure that state funds received are spent in accordance with the approved Program Agreement, or most recently
approved Program Agreement Revision, and be accountable for the legal and appropriate expenditure of those
state funds;
9.Maintain reports, records, and other information to properly document services rendered and outcomes; also
maintain an ability to send and receive electronic communication;
10.Have the capacity to use DPS electronic, internet-based system for tracking clients served;
11.Use generally accepted accounting procedures that guarantee the integrity of the expenditure of funds, maintain
reports, records, and other information to properly account for the expenditure of all State funds provided to the
Sponsoring Agency;
12.When refunds are requested from the North Carolina Department of Revenue for sales and/or use taxes paid by
the agency in the performance of the Program Agreement, or most recently approved Program Agreement
Revision, as allowed by NCGS §105-164.14(c), the agency shall exclude all refundable sales and use taxes from
reportable expenditures submitted to the County and DPS;
13.Submit Program Agreement Revisions, Third Quarter Accounting, Final Accounting and annual detailed
expenditures through NCALLIES. These reports must be in accordance with the submission process as outlined in
DPS JCPC Policy and Procedures and with the due dates established by DPS;
14.Make personnel, reports, records and other information available to DPS, the County, the JCPC, and/or the State
Auditor for oversight, monitoring and evaluation purposes;
15.Submit any other information requested by the JCPC, County or DPS;
16.Be responsible for the performance of all subcontractors as described in the JCPC Program Agreement, or most
recently approved Program Agreement Revision;
17. Indemnify and hold harmless DPS, the State of North Carolina, the County and any of their officers, agents and
employees, from any claims of third parties arising out of any act or omission of the Sponsoring Agency in
connection with the performance of the Program Agreement or most recently approved Program Agreement
Revision;
18.Receive permission and budgetary approval from DPS prior to using the Program Agreement, or most recently
approved Program Agreement Revision, as a part of any news release or commercial advertising and
acknowledge DPS funding in partnership with the County;
19.Comply with DPS trainings and requirements regarding the United States Department of Justice national
standards to prevent, detect, and respond to prison rape under the Prison Rape Elimination Act (PREA);
Reference: 14B NCAC 11B, and in compliance with DPS JCPC Policy 2: Operations: Program Operational
Requirements
20.Be deemed an independent contractor in the performance of services described in the Program Agreement, or
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most recently approved Program Agreement Revision, and as such shall be wholly responsible for the services to
be performed and for the supervision of its employees;
21.Represent that it has, or shall secure at its own expense, all personnel required in performing the services as
described in the Program Agreement. Such personnel shall not be employees of, or have any individual
contractual relationship with, DPS;
Sponsoring Agency and Use of Contractor(s)/Subcontractors
The Sponsoring Agency may engage with independent contractors as needed to perform services or support services
described in the Program Agreement. When independent contractors (funds are included in line item 190 of the
budget) are providing services as described in the Program Agreement, the sponsoring agency must:
22.Upload a signed Contract for Professional Services into NCALLIES once the Program Agreement (or
Program Agreement Revision) is approved by DPS;
23.Be responsible for the performance of all contractors or subcontractors as described in the Program
Agreement, or most recently approved Program Agreement Revision;
24.Hold any contractor or subcontractor to which the Sponsoring Agency provides State funds accountable for
the legal and appropriate expenditure of State funds, and to all applicable laws and DPS JCPC Policies and
Procedures; and
25.Ensure that all contractors or subcontractors provide all information necessary to comply with the standards
set forth in the Program Agreement or most recently approved Program Agreement Revision.
The JCPC shall:
1.Ensure the Sponsoring Agency uses JCPC funds for only the purposes DPS has approved in the JCPC Program
Agreement or most recently approved JCPC Program Agreement Revision;
2.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Code; N.C.G.S. §143B-801
(a);143B-602;143B-851
3.Review and locally approve Program Agreement Revision(s) received from the Sponsoring Agency and submit to
the County in a timely manner;
4.Review and locally approve Third Quarter Accounting forms and submit to the County in order to meet the due
date established by DPS (applicable only to JCPC funded agencies);
5.Submit any other information requested by the County or DPS; and
6.Monitor the Sponsoring Agency’s currently funded JCPC program(s) in accordance with DPS JCPC Policy 3.
Operations: Program Oversight and Monitoring
Reference: 14B NCAC 11B.0202 and DPS JCPC Policy 1, 7, 8, 9, 10, and 11.
The County shall:
1.Ensure the Sponsoring Agency is appropriately licensed, and either local public agencies, 501(c) (3) non-profit
corporations or local housing authorities (applicable only to JCPC funded agencies);
2.Use funds only for the purposes DPS has approved in the Program Agreement or most recently approved
Program Agreement Revision;
3.Disburse funds monthly and oversee funds to the Sponsoring Agency in accordance with 14B NCAC 11B.0108
4.Comply with DPS JCPC Policies and Procedures and the North Carolina Administrative Procedures;
5.Review and locally approve Program Agreement Revisions received from the Sponsoring Agency for final
approval from DPS; and
6.Review and locally approve Third Quarter and jointly submit Final Accounting forms for the JCPC and all funded
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programs according to the procedures and due dates established by DPS.
Reference: 14B NCAC 11B; DPS JCPC Policy 3, 7, 8, 9, 10, and 11
Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Choice of Law: The validity of this Program Agreement and any of its terms or provisions, as well as the rights and
duties of the parties to this Program Agreement, are governed by the laws of North Carolina. The parties, by signing
this Program Agreement, agree and submit, solely for matters concerning this Program Agreement, to the exclusive
jurisdiction of the courts of North Carolina and agree, solely for such purpose, that the exclusive venue for any legal
proceedings shall be Wake County, North Carolina. The place of this Program Agreement and all transactions and
agreements relating to it, and their situs and forum, shall be Wake County, North Carolina, where all matters, whether
sounding in Program Agreement or tort, relating to the validity, construction, interpretation, and enforcement shall be
determined.
Assignment: No assignment of the Sponsoring Agency's obligations or the Sponsoring Agency's right to receive
payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority,
DPS may:
(a) Forward the Sponsoring Agency's payment check(s) directly to any person or entity designated by the
Program Manager, or
(b) Include any person or entity designated by Sponsoring Agency as a joint payee on the Sponsoring Agency's
payment check(s).
In no event shall such approval and action obligate DPS or County Government to anyone other than the Sponsoring
Agency, and the Sponsoring Agency shall remain responsible for fulfillment of all Program Agreement obligations.
Beneficiaries: Except as herein specifically provided otherwise, this Program Agreement shall inure to the benefit of
and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the
enforcement of the terms and conditions of this Program Agreement, and all rights of action relating to such
enforcement, shall be strictly reserved to DPS, the County Government, and the Sponsoring Agency. Nothing
contained in this document shall give or allow any claim or right of action whatsoever by any other third person. It is the
express intention of DPS and County Government that any such person or entity, other than DPS or the County
Government, or the Sponsoring Agency receiving services or benefits under this Program Agreement shall be deemed
an incidental beneficiary only.
Property Rights
Intellectual Property: All deliverable items produced pursuant to this Program Agreement are the exclusive property of
DPS. The Sponsoring Agency shall not assert a claim of copyright or other property interest in such deliverables.
Physical Property: the Sponsoring Agency agrees that it shall be responsible for the proper custody and care of any
property purchased for or furnished to it for use in connection with the performance of this Program Agreement and will
reimburse DPS for loss of, or damage to, such property. At the termination of this Program Agreement, the Sponsoring
Agency, County Government, and JCPC shall follow the guidelines for disposition of property set forth in Administrative
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Code and JCPC policy.
Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process
Disbursements and Internal Controls
Reversion of Unexpended Funds
Any remaining unexpended funds DPS disbursed to the County for the Sponsoring Agency must be refunded/reverted
back to DPS at the close of fiscal year or upon termination of this Agreement.
Accountability for Funds
Audit Requirement - Local Government or Public Authority Requirements
Local Government or Public Authorities in accordance with N.C.G.S. §159-34 must have an audit performed in
conformity with generally accepted auditing standards. The audit shall evaluate the performance of a unit of local
government or public authority with regard to compliance with all applicable Federal and State agency regulations. This
audit, combined with the audit of financial accounts, shall be deemed to be the single audit described by the, "Federal
Single Audit Act of 1984".
Audit Requirement – Non-Governmental Entities: An audit, when required by law, or requested by the County or
DPS shall be performed in conformity with generally accepted auditing standards and audits of non-governmental
entities, both for-profit and not-for-profit, and must meet the requirements of OMB Circular A-133. At a minimum, the
required report shall include the financial statements prepared in accordance with generally accepted accounting
principles, all disclosures in the public interest required by law, and the auditor's opinion and comments relating to
financial statements. The audit report must be submitted to the State Auditor’s office as required by law, to the County
and DPS, and to other recipients as appropriate within nine (9) months after the end of the program’s fiscal year.
Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all
Program Agreements entered into by State agencies or political subdivisions in accordance with N.C.G.S. §147-64.7.
Additionally, as the State funding authority, DPS shall have access to persons and records as a result of all Program
Agreements entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of
DPS. State basic records retention policy requires all records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the Program Agreement is subject to Federal policy and
regulations, record retention may be longer than five years since records must be retained for a period of three years
following submission of the final Federal Financial Status Report, if applicable, or three years following the submission
of a revised final Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action,
or other action involving this Program Agreement has been started before expiration of the five-year retention period
described above, the records must be retained until completion of the action and resolution of all issues which arise
from it, or until the end of the regular five-year period described above, whichever is later.
No Overdue Tax Debt – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. The Sponsoring Agency shall be responsible for
the payment of all State, local, and Federal taxes. Consistent with N.C.G.S. § 143C-6-23 (c), not for profit
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organizations shall file with DPS and the County a written statement completed by that Sponsoring Agency's board of
directors or other governing body, stating whether or not the Sponsoring Agency has any overdue tax debts, as
defined by N.C.G.S. 105-243.1, at the Federal, State, or local level. This written statement, Certification of No
Overdue Tax Debts, shall be completed by the Sponsoring Agency to certify when there are no overdue taxes. If the
agency has overdue taxes, the Sponsoring Agency must notify DPS at the time of Program Agreement submission.
Conflict of Interest – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. Consistent with the N.C.G.S. §143C-6-23 (b), not
for profit organizations shall file with DPS and the County a copy of that Sponsoring Agency’s policy addressing
conflicts of interest that may arise involving the Sponsoring Agency’s management employees and the members of its
board of directors or other governing body. The policy shall address situations in which any of these individuals may
directly or indirectly benefit, except as the Sponsoring Agency’s employees or members of its board or other
governing body, from the Sponsoring Agency’s disbursing of State funds and shall include actions to be taken by the
Sponsoring Agency or the individual, or both to avoid conflicts of interest and the appearance of impropriety. The
policy shall be filed before the County or DPS may disburse any funds. The Sponsoring Agency shall also complete
the DPS Conflict of Interest Policy Statement (Form DPS 13 001) and upload the statement and the Sponsoring
Agency's policy addressing conflicts of interest to the JCPC Program Agreement upon submission.
Proof of 501(c) (3) – Not for profit organizations ONLY must comply with this section. This document must be
uploaded in NCALLIES when submitting a Program Agreement. Not for profit organizations must upload proof of
the Sponsoring Agency’s 501 (c) (3) status.
Amendment: This Agreement may not be amended orally or by performance. Any amendment must be requested in
writing by the Sponsoring Agency through submission of a Program Agreement Revision and executed by duly
authorized representatives of DPS, the County Government, JCPC and Sponsoring Agency.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this Program
Agreement violates any applicable law, each such provision or requirement shall continue to be enforced to the extent
it is not in violation of law or is not otherwise unenforceable and all other provisions and requirements of this Program
Agreement shall remain in full force and effect.
Termination for Cause: If, through any cause, the Sponsoring Agency shall fail to fulfill its obligations under this
Program Agreement in a timely and proper manner, DPS shall have the right to terminate this Program Agreement by
giving written notice to the Sponsoring Agency and specifying the effective date thereof. In that event, all finished or
unfinished deliverable items prepared by the Sponsoring Agency under this Program Agreement shall, at the option of
DPS, become its property and the Sponsoring Agency shall be entitled to receive just and equitable compensation for
any satisfactory work completed on such materials, minus any payment or compensation previously made.
Notwithstanding the foregoing provision, the Sponsoring Agency shall not be relieved of liability to DPS for damages
sustained by DPS by virtue of the Sponsoring Agency’s breach of this agreement, and DPS may withhold any
payment due the Sponsoring Agency for the purpose of setoff until such time as the exact amount of damages due
DPS from such breach can be determined. The filing of a petition for bankruptcy by the Sponsoring Agency shall be
an act of default under this Program Agreement.
Termination without Cause: DPS, the County Government, or the Sponsoring Agency may terminate this
Agreement at any time and without cause by giving at least thirty (30) days advance written notice to the other. If this
Program Agreement is terminated by DPS as provided herein, the Sponsoring Agency shall be reimbursed on a pro
rata basis for services satisfactorily provided to DPS under this Program Agreement prior to Program Agreement
termination.
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Waiver of Default: Waiver by DPS of any default or breach in compliance with the terms of this Program Agreement
by the Sponsoring Agency shall not be deemed a waiver of any subsequent default or breach and shall not be
construed to be modification of the terms of this Program Agreement unless stated to be such in writing, signed by an
authorized representative of DPS, County Government, the JCPC and the Sponsoring Agency.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes,
civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event, pandemic, or act of God.
Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and
warranties contained herein shall survive the Program Agreement expiration or termination date unless specifically
provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation.
END OF SECTION V – Terms of Agreement
209
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VI: BUDGET NARRATIVE
Healthy Choices Fiscal Year FY 21-22
Item #Justification Expense In Kind Expense
120 1/2 Time Case Manager @ $25/hr x 960/hours a year $24,000 $24,000
120 1- Quality Assurance Manager @ $20/hr x 13 hrs month $3,200
120 1 Group Facilitator @ $20/hour x 55/hrs. each ($1,100)$1,100
220 Food for wkly group $100 month for 12 months $130
320 Phone services $150 mo x 12 $1,800
330 Electric 183 mo. X12 $2200 $2,200
410 Office Space $900 month x 12 months $10,800
430 copier maintenance $278
450 Professional Liability Insurance $2,292
TOTAL $35,000 $10,800
Job Title
Annual Expense
Wages
Annual In Kind
Wages
1- Case manager/program director completes intakes, providment, attends
client staffing, provides court coverage and facilitate groups 30 hours week at
$25/hr
$24,000
1- Quality Assurance Manager @ $20/hr x 13 hrs. mo. $3200 $3,200
1 group facilitator $20/hr. for 55 hr $1,100
TOTAL $28,300
210
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VII Program:Healthy Choices
Fiscal Year:FY 21-22 Number of Months:12
Cash In Kind Total
I. Personnel Services $28,300 $28,300
120 Salaries & Wages $28,300 $28,300
180 Fringe Benefits $0
190 Professional Services* $0
*Contracts MUST be attached
II. Supplies & Materials $130 $130
210 Household & Cleaning $0
220 Food & Provisions $130 $130
230 Education & Medical $0
240 Construction & Repair $0
250 Vehicle Supplies & Materials $0
260 Office Supplies and Materials $0
280 Heating & Utility Supplies $0
290 Other Supplies and Materials $0
III. Current Obligations & Services $4,000 $4,000
310 Travel & Transportation $0
320 Communications $1,800 $1,800
330 Utilities $2,200 $2,200
340 Printing & Binding $0
350 Repairs & Maintenance $0
370 Advertising $0
380 Data Processing $0
390 Other Services $0
IV. Fixed Charges & Other Expenses $2,570 $10,800 $13,370
410 Rental or Real Property $10,800 $10,800
430 Equipment Rental $278 $278
440 Service and Maint. Contracts $0
450 Insurance & Bonding $2,292 $2,292
490 Other Fixed Charges $0
V. Capital Outlay $0
[This Section Requires Cash Match]
510 Office Furniture & Equipment $0
530 Educational Equipment $0
540 Motor Vehicle $0
550 Other Equipment $0
580 Buildings, Structure & Improv. $0
Total $35,000 $10,800 $45,800
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VIII SOURCES OF PROGRAM REVENUE (ALL SOURCES)
FY 21-22 Harnett County Funding ID: 543-XXXX
Sponsoring Agency: Eleventh Judicial District ReEntry, Inc. Program: Healthy Choices
$35,000 DPS/JCPC Funds * This is the amount of your request on your application
10%Local Match Rate Is the Local Match Rate 10%, 20% or 30%?
$0 County Cash n/a (Specify Source)
Local Cash (Specify Source)
Local Cash (Specify Source)
$10,800 Local In-Kind ReEntry (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
$45,800 TOTAL $3,500 $10,800
Required Local Match Match Provided
We, the undersigned, have reviewed this JCPC Program Application to be presented to the Juvenile Crime Prevention Council of this County in
accordance with the procedures established by the local Juvenile Crime Prevention Council. Agencies seeking funding must be able to meet the
applicable requirements of the North Carolina General Statutes, Administrative Code, and the Division of Adult Correction and Juvenile Justice.
We understand and acknowledge that the approval process is first with the Juvenile Crime Prevention Council, second with the County Board of
Commissioners, and the final authority with the Department of Public Safety, Division of Adult Correction and Juvenile Justice.
All parties understand that the availability of funds is contingent upon the appropriation of those funds by the General Assembly of the State of
North Carolina.
/DPSSignature//DPSdt/
Chair, County Board of Commissioners or County Finance Director Date
/JCPCSignature//JCPCdt/
Chair, Juvenile Crime Prevention Council Date
/ProgramSignature/
Dot Ehlers
/Programdt/
6/7/21
Program Manager Date
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
North Carolina Department of Public Safety
JCPC Program - Program Application
SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION
FUNDING PERIOD:FY 21-22 DPS/JCPC FUNDING # (cont only)543-XXXX
COUNTY:Harnett AREA:Central Area
Multi-County:No Multi-Components No
NAME OF PROGRAM:Harnett County Juvenile Restitution/Community Service Program
SPONSORING AGENCY:Harnett County Government
SPONSORING AGENCY
PHYSICAL ADDRESS:
200 Alexander Drive
Lillington NC 27546
SPONSORING AGENCY
MAILING ADDRESS:
POB 940
Lillington NC 27546
TYPE:Public FEDERAL ID #56-6000306
COMPONENT ID #NAME OF PROGRAM COMPONENT PROGRAM TYPE TOTAL COST OF
EACH COMPONENT
31969 Harnett County Juvenile Restitution/Community
Service Program
Restitution/Community Service $ 92,759
Total cost of components:$ 92,759
Program Manager Name & Address (same person on signature page)
Name:Barry Blevins Title:Program Manager
Mailing
Address:
POB 940
City:Lillington Zip:27546
Phone:(910) 893-7536 Fax:(910) 814-8263 E-mail:bblevins@harnett.org
Contact Person (if different from program manager)
Name:Henry Evans Title:Program Coordinator
Mailing
Address:
POB 940
City:Lillington Zip:27546
Phone:(910) 814-6155 Fax:(910) 814-8263 E-mail:hlevans@harnett.org
Program Fiscal Officer (cannot be program manager)
Name:Henry Evans Title:Program Coordinator
Mailing
Address:
POB 940
City:Lillington Zip:27546
Phone:(910) 814-6155 Fax:(910) 814-8263 E-mail:hlevans@harnett.org
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION I B PROGRAM COMPONENT DESCRIPTION
COMPONENT ID #COMPONENT INFORMATION
31969 NAME OF COMPONENT: Harnett County Juvenile Restitution/Community Service Program
BRIEF DESCRIPTION: Community-based program to hold at-risk and court involved juveniles
accountable for their delinquent or undisciplined behavior. Juveniles are required to perform
symbolic community service or work to make monetary restitution to their victims.
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 01/09/2012
Department of Public Safety
SECTION II COMPONENT STATISTICAL INFORMATION
Multi-Components No
Component Service Statistics PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name:Harnett County Juvenile Restitution/Community Service Program Component ID #
31969
What is this component's maximum client capacity at any given time?90
Frequency of client contact per month:4 Anticipated Average Length of
Stay:90 Days
Total Component Cost:$92,759 ÷ by Estimated # to be served during funding period:90
Estimated Average Cost Per Youth:$1,031
Applies to
continuation
programs only.
Actual number of youth admitted FY 19-20:54
35 Number of admissions Juvenile Justice Referred 64.81% of total admissions
0 Number of admissions Law Enforcement Referred 0% of total admissions
0 Number of admissions District Court Referred 0% of total admissions
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Form JCPC/PA 004 JCPC Program Application
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Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:Harnett County Juvenile Restitution/Community Service Program
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
According to the North Carolina Department of Public Safety Division of Juvenile Justice Raising the Age Report
presented in the Spring of 2018, the overall juvenile crime rate in North Carolina has decreased from 41.87% in 1998
to 19.16% in 2016. Detention center admissions have decreased by 67% since 2006. Youth Development Centers
(YDC) admissions have decreased by 58% during the same time period. With the juvenile delinquency rate
continuing a steady decline, there is more emphasis focused on community based programming working with
prevention and intervention.
Per the 2019 County Databook released by the North Carolina Department of Public Safety, Division of Juvenile
Justice, the total number of delinquent complaints filed in Harnett County was 438. Of the 438, 280 were class 1-3
misdemeanors; 150 were class F thru I Felonies and A1 misdemeanors; 18 were Status Offenders; and there were 8
class A-E Felonies.
The intention and purpose of the Harnett County Juvenile Restitution/Community Service Program is to accept
juveniles into the program that have been ordered to pay monetary restitution to a victim or perform symbolic
community service. This program serves as a community-based sanction level 1 and 2 alternative to detention or
youth development centers for court involved youth. This program also serves as an alternative to Juvenile Court
through intake diversions as well as Teen Court and Law Enforcement diversions.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
Harnett County Juvenile Restitution/Community Service Program will serve youth between the ages of 6-18 referred by
Juvenile Court Counselors Office,Juvenile Court ,Teen Court and Law Enforcement.
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
To provide a community-based alternative to detention or youth development centers to hold youth accountable for
their actions and restore them back into the community. These youth are at-risk or already involved with in the juvenile
justice system. It is the goal of this program that the youth achieve maximum growth as well as learn accountability for
their actions in the least restrictive setting.
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
75% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
completion.
75% Clients will demonstrate accountability by actively participating in restitution/community service activities.
75% Clients will have no new complaints with an offense date after the admission date.
85% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
75% Clients will complete restitution or community service within the timeframe permitted by JCPC policy.
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SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:Harnett County Juvenile Restitution/Community Service Program
75% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
75% Clients will have no new adjudications for a complaint with an offense date after the admission date.
75% Clients successfully/satisfactorily completing the program will have no new adjudications in the 6 months
following completion.
75% Clients successfully/satisfactorily completing the program will have no new complaints in the 6 months following
completion.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
Based on highlights of the FY 2019-2020 Risk Assessment data for Harnett County, the elevated Risk Assessment are
as follows: 83.76% of youth are age 12 or older when the 1st delinquent offense is alleged in a complaint; 56.35% of
youth have serious school behavior problems; and 63.45% of youth that entered Department of Public Safety, Juvenile
Services Division lack pro-social peers and/or regularly and/or sometimes associate with negative/delinquent peers.
Based on highlights of the FY 2019-2020 Needs Assessment data for Harnett County, the elevated Needs
Assessments are as follows: 64.08% of youth sometimes and/or regularly associates with delinquent peers and/or
rejected by positive peers; 57.65% of youth have serious behavior problems in school which is a result of poor school
attendance and chronic suspensions from school; 73.45% of youth reported having mental health needs are currently
being addressed and/or need further mental health assessing; youth reported domestic discord in their home and
youth Family Supervision Skills are marginal.
Juveniles enrolled in this program for school related offenses will learn that their refusal to follow school guidelines
indeed has consequences. Juveniles who successfully complete this program will gain personal as well as social
recognition. This will lead to higher self esteem, which will decrease the need of juvenile to associate with persons or
groups that are predisposed for criminal activity.
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Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Harnett County Juvenile Restitution/Community Service Program
1. Location: List physical address(es) and describe where program services are delivered.
Physical address is 200 Alexander Drive, Lillington, NC 27546. Program activities take place at various private and
public worksites within Harnett County.
2. Operation: Describe the daily/weekly schedule of program operation.
Program office hours are 8am to 5pm. Program staff working with juveniles work flexible hours including Saturdays.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
1 F/T Program Coordinator
Qualifications: Must possess at least a Bachelors degree or higher with previous experience working with at-risk
juveniles.
Responsibilities: Oversight for the daily scheduling of staff and juveniles; fiscal management of resources; recruitment
of worksites; completion of daily, monthly, quarterly and annual reports to state DPS-Juvenile Justice Division office;
training of worksite supervisors; attends all juvenile court dates; processes all diversion contracts as it relates to
community service/restitution through the intake counselors office or teen court; preparing program agreements; daily
transportation and supervision of juveniles at community worksites; safety training to juveniles as it relates to proper
use and safety of program equipment; monitoring purchases and expenditures.
1 P/T Program Assistant
Qualifications: Must possess at least an Associates degree or extensive experience working with at risk juveniles.
Responsibilities: Provides daily transportation and supervision of juveniles at community worksites; safety training to
juveniles as it relates to proper use and safety of program equipment;completion of daily program progress reports.
4. Service Type SPEP: Describe implementation to include:
Primary Service: Restitution / Community Service; Secondary Service: None
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
Referral Process: Referrals can only come from Juvenile Court, Juvenile Intake, Teen Court and Law Enforcement
Referral packets submitted by Juvenile Services(intake diversions, deferred prosecution or juvenile court) and Teen
Court must include a referral form, family data sheet and information disclosure form. Program coordinator will
complete the North Carolina Assessment of Risk (NCAR) form after meeting with juvenile and parent/guardian.
Referral packets submitted by Law Enforcement must include a referral form, family data sheet, an incident report and
information disclosure form. Program coordinator will complete the NCAR after meeting with the juvenile and parent/
guardian.
Screening Process: All referrals are reviewed by program coordinator to confirm that the youth is mentally and
physically appropriate for community service work groups/sites. Juvenile`s work assignments will be age and ability
appropriate. Referring agency (Juvenile Services/intake/Teen Court/Law Enforcement) have also taken into account
the juvenile`s age and abilities prior to making the referral.
Admission Process: Once the program coordinator receives a completed referral packet from the referring agency,
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Harnett County Juvenile Restitution/Community Service Program
program coordinator will contact juvenile and parent/guardian within 7 business days to set up program intake. Intake
consist of completing several program waivers/forms such as the following: Individual Service Plan; Release of
Confidential Information Waiver; Equipment Waiver; Production Release Waiver; Community Service/Restitution
Contract; NCAR; Social History and Medical Treatment Waiver. Once all forms have been completed and signed, the
program coordinator will enter the juvenile into the NC ALLIES database within 10 days. Juvenile will also be entered
into program database within same time period.
Why a referral may not be accepted: Juvenile has reached their 18th birthday or juvenile is mentally or physically
unable to participate in program activities.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
Program Coordinator is responsible for decisions concerning a juveniles successful, satifactory, unsuccessful or non-
compliant termination from this program.
Termination Process: Upon termination, Program Coordinator completes a written termination form within 10 business
days for all juveniles terminated from the program and submits a copy to the parents/legal guardians. Information will
be entered into NCALLIES Client Tracking data base within 7 days of the terminations decision.
Successful Termination: Indicates a high level of juvenile participation in program activities and achievement of
behavior improvement goals.
Satisfactory Termination: Indicates an acceptable level of juvenile participation and behavior improvement even though
the juvenile did not complete all program activities and did not meet all behavior goals.
Unsuccessful Completion: Failure to meet specific goals and requirements or make sufficient progress in the program.
Non-Compliant Termination: Unexcused absences or refusing to participate in treatment activities.
How is the referring agency involved with the termination process?
Program staff confers with supervising court counselor or with referring agency upon juvenile`s termination from
program. Supervising court counselor is required to sign termination documentation before paperwork is included in
legal file with the Harnett County Clerk of Court. When terminations are for juveniles placed on diversion contracts or
referrals from Teen Court or Law Enforcement, the referring agency receives a copy of the juvenile`s successful
termination. If a juvenile fails to satisfy the requirements of the diversion contract, the intake counselor or referring
agency is notified by letter and/or email.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
Juvenile Services,Teen Court Coordinator and Law Enforcement Officers will be given monthly written reports on all
juveniles served. Program staff contact Juvenile Services,Teen Court Coordinator and referring Law Enforcement
Officer as needed to address negative behavior of juveniles.
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Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:Harnett County Juvenile Restitution/Community Service Program
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
utilized in this component and how will parents/guardians be involved?
The intention of this program is to show program participants that their inappropriate and illegal acts have victims and
that the victims do suffer monetary and/or emotional loss by their actions. By requiring the juvenile to perform
symbolic community service or work to pay actual monetary restitution to the victim(s), the juveniles see that their
actions do indeed have consequences. Participation by the juvenile in this program is intended to deter future criminal
activity. Parent/guardian is given daily and monthly updates on how their child is progressing in the program. Parent/
guardian is advised of any inappropriate behavior. Parent/guardian is asked to help program staff address those
inappropriate behaviors. While the purpose of this program is to primarily address negative behavior of the juvenile
referred, program staff, with the help of the referring agency, may refer parent/guardian to programs that may
strengthen areas that they feel they are difficient in. Areas such as job skills, parenting skill, anger management, etc…
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
This program is based on philosophy of restorative justice. The model of justice that focuses on crime as an act
against another individual or community. Juveniles that participate in program are held accountable for their
delinquent or undisciplined acts through symbolic community service or work to compensate the victims of their
criminal acts. Completion of required community service and/or restitution satisfies their debt to the victim of their
crime or the community as a whole. Per CTF Tracking Data for the FY 2019/2020, 98.53% of juveniles served by this
program had been successfully or satisfactorily terminated.
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Department of Public Safety
SECTION V Terms of Agreement
This section of the JCPC Program Application will ONLY be completed if approved for funding and will be
included in the required JCPC Program Agreement document for completion.
This Agreement is entered into by and between Department of Public Safety, (hereinafter referred to as the DPS), and
County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to
as the JCPC) and (hereinafter referred to as the Sponsoring Agency).
The DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows:
Term of Agreement
This Agreement shall become effective _______ and shall terminate ________.
Payment to Sponsoring Agency
All parties agree that services will be delivered as described in the approved Program Agreement and that funds will be
disbursed in an amount not to exceed the amount $___________ for the term of this agreement, unless amended by
an approved Program Agreement Revision.
Availability of Funds:
All parties to this Agreement agree and understand that the payment of the sums specified in this Program Agreement
budget, or most recently approved Program Agreement Revision, is dependent and contingent upon and subject to the
appropriation, allocation, and availability of funds for this purpose to DPS.
Responsibilities of the Parties
DPS shall:
1.Disburse funds monthly to County Governments, for payment to the Sponsoring Agency, from the fund
appropriation by the General Assembly;
2.Reserve the right to suspend payment to the County for any non-compliance by the Sponsoring Agency with any
reporting requirements set forth in DPS JCPC Policy and Procedures;
3.Notify in writing the County and Sponsoring Agency immediately if payments are suspended and again once
payments resume;
4.Pay only for work as described in the Program Agreement, or most recently approved Program Agreement
Revision, provided by the Sponsoring Agency and approved subcontractors;
5.Provide technical assistance, orientation and training to the Sponsoring Agency, the County and the JCPC;
6.Monitor Sponsoring Agency’s funded program(s) in accordance with DPS JCPC Policy 3. Operations: Program
Oversight and Monitoring; and
7.Notify parties entering into this Agreement of all due dates in a timely manner in order for reports to be submitted
by the established due date.
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Department of Public Safety
The Sponsoring Agency shall:
1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the
conduct of its business, including those of Federal, State, and local agencies having jurisdiction and/or authority;
2.Comply with all Federal and State laws relating to equal employment opportunity;
3.Keep as confidential and not divulge or make available to any individual or organization without the prior written
approval of DPS any information, data, instruments, documents, studies or reports given to or prepared or
assembled by the Sponsoring Agency under this Agreement;
4.Acknowledge that in receiving, storing, processing or otherwise dealing with any confidential information it will
safeguard and not further disclose the information except as otherwise provided in this Agreement;
5.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Procedures;
6.Secure local match as required, if applicable, pursuant to 14B NCAC 11B.0105, for approved JCPC funds;
7.Create and adopt individualized guidelines specific to the funded program, while also adhering to DPS JCPC
Policy and Procedures for all funded programs and for the specific program type for which they receive funding;
8.Ensure that state funds received are spent in accordance with the approved Program Agreement, or most recently
approved Program Agreement Revision, and be accountable for the legal and appropriate expenditure of those
state funds;
9.Maintain reports, records, and other information to properly document services rendered and outcomes; also
maintain an ability to send and receive electronic communication;
10.Have the capacity to use DPS electronic, internet-based system for tracking clients served;
11.Use generally accepted accounting procedures that guarantee the integrity of the expenditure of funds, maintain
reports, records, and other information to properly account for the expenditure of all State funds provided to the
Sponsoring Agency;
12.When refunds are requested from the North Carolina Department of Revenue for sales and/or use taxes paid by
the agency in the performance of the Program Agreement, or most recently approved Program Agreement
Revision, as allowed by NCGS §105-164.14(c), the agency shall exclude all refundable sales and use taxes from
reportable expenditures submitted to the County and DPS;
13.Submit Program Agreement Revisions, Third Quarter Accounting, Final Accounting and annual detailed
expenditures through NCALLIES. These reports must be in accordance with the submission process as outlined in
DPS JCPC Policy and Procedures and with the due dates established by DPS;
14.Make personnel, reports, records and other information available to DPS, the County, the JCPC, and/or the State
Auditor for oversight, monitoring and evaluation purposes;
15.Submit any other information requested by the JCPC, County or DPS;
16.Be responsible for the performance of all subcontractors as described in the JCPC Program Agreement, or most
recently approved Program Agreement Revision;
17. Indemnify and hold harmless DPS, the State of North Carolina, the County and any of their officers, agents and
employees, from any claims of third parties arising out of any act or omission of the Sponsoring Agency in
connection with the performance of the Program Agreement or most recently approved Program Agreement
Revision;
18.Receive permission and budgetary approval from DPS prior to using the Program Agreement, or most recently
approved Program Agreement Revision, as a part of any news release or commercial advertising and
acknowledge DPS funding in partnership with the County;
19.Comply with DPS trainings and requirements regarding the United States Department of Justice national
standards to prevent, detect, and respond to prison rape under the Prison Rape Elimination Act (PREA);
Reference: 14B NCAC 11B, and in compliance with DPS JCPC Policy 2: Operations: Program Operational
Requirements
20.Be deemed an independent contractor in the performance of services described in the Program Agreement, or
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Department of Public Safety
most recently approved Program Agreement Revision, and as such shall be wholly responsible for the services to
be performed and for the supervision of its employees;
21.Represent that it has, or shall secure at its own expense, all personnel required in performing the services as
described in the Program Agreement. Such personnel shall not be employees of, or have any individual
contractual relationship with, DPS;
Sponsoring Agency and Use of Contractor(s)/Subcontractors
The Sponsoring Agency may engage with independent contractors as needed to perform services or support services
described in the Program Agreement. When independent contractors (funds are included in line item 190 of the
budget) are providing services as described in the Program Agreement, the sponsoring agency must:
22.Upload a signed Contract for Professional Services into NCALLIES once the Program Agreement (or
Program Agreement Revision) is approved by DPS;
23.Be responsible for the performance of all contractors or subcontractors as described in the Program
Agreement, or most recently approved Program Agreement Revision;
24.Hold any contractor or subcontractor to which the Sponsoring Agency provides State funds accountable for
the legal and appropriate expenditure of State funds, and to all applicable laws and DPS JCPC Policies and
Procedures; and
25.Ensure that all contractors or subcontractors provide all information necessary to comply with the standards
set forth in the Program Agreement or most recently approved Program Agreement Revision.
The JCPC shall:
1.Ensure the Sponsoring Agency uses JCPC funds for only the purposes DPS has approved in the JCPC Program
Agreement or most recently approved JCPC Program Agreement Revision;
2.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Code; N.C.G.S. §143B-801
(a);143B-602;143B-851
3.Review and locally approve Program Agreement Revision(s) received from the Sponsoring Agency and submit to
the County in a timely manner;
4.Review and locally approve Third Quarter Accounting forms and submit to the County in order to meet the due
date established by DPS (applicable only to JCPC funded agencies);
5.Submit any other information requested by the County or DPS; and
6.Monitor the Sponsoring Agency’s currently funded JCPC program(s) in accordance with DPS JCPC Policy 3.
Operations: Program Oversight and Monitoring
Reference: 14B NCAC 11B.0202 and DPS JCPC Policy 1, 7, 8, 9, 10, and 11.
The County shall:
1.Ensure the Sponsoring Agency is appropriately licensed, and either local public agencies, 501(c) (3) non-profit
corporations or local housing authorities (applicable only to JCPC funded agencies);
2.Use funds only for the purposes DPS has approved in the Program Agreement or most recently approved
Program Agreement Revision;
3.Disburse funds monthly and oversee funds to the Sponsoring Agency in accordance with 14B NCAC 11B.0108
4.Comply with DPS JCPC Policies and Procedures and the North Carolina Administrative Procedures;
5.Review and locally approve Program Agreement Revisions received from the Sponsoring Agency for final
approval from DPS; and
6.Review and locally approve Third Quarter and jointly submit Final Accounting forms for the JCPC and all funded
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Department of Public Safety
programs according to the procedures and due dates established by DPS.
Reference: 14B NCAC 11B; DPS JCPC Policy 3, 7, 8, 9, 10, and 11
Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Choice of Law: The validity of this Program Agreement and any of its terms or provisions, as well as the rights and
duties of the parties to this Program Agreement, are governed by the laws of North Carolina. The parties, by signing
this Program Agreement, agree and submit, solely for matters concerning this Program Agreement, to the exclusive
jurisdiction of the courts of North Carolina and agree, solely for such purpose, that the exclusive venue for any legal
proceedings shall be Wake County, North Carolina. The place of this Program Agreement and all transactions and
agreements relating to it, and their situs and forum, shall be Wake County, North Carolina, where all matters, whether
sounding in Program Agreement or tort, relating to the validity, construction, interpretation, and enforcement shall be
determined.
Assignment: No assignment of the Sponsoring Agency's obligations or the Sponsoring Agency's right to receive
payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority,
DPS may:
(a) Forward the Sponsoring Agency's payment check(s) directly to any person or entity designated by the
Program Manager, or
(b) Include any person or entity designated by Sponsoring Agency as a joint payee on the Sponsoring Agency's
payment check(s).
In no event shall such approval and action obligate DPS or County Government to anyone other than the Sponsoring
Agency, and the Sponsoring Agency shall remain responsible for fulfillment of all Program Agreement obligations.
Beneficiaries: Except as herein specifically provided otherwise, this Program Agreement shall inure to the benefit of
and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the
enforcement of the terms and conditions of this Program Agreement, and all rights of action relating to such
enforcement, shall be strictly reserved to DPS, the County Government, and the Sponsoring Agency. Nothing
contained in this document shall give or allow any claim or right of action whatsoever by any other third person. It is the
express intention of DPS and County Government that any such person or entity, other than DPS or the County
Government, or the Sponsoring Agency receiving services or benefits under this Program Agreement shall be deemed
an incidental beneficiary only.
Property Rights
Intellectual Property: All deliverable items produced pursuant to this Program Agreement are the exclusive property of
DPS. The Sponsoring Agency shall not assert a claim of copyright or other property interest in such deliverables.
Physical Property: the Sponsoring Agency agrees that it shall be responsible for the proper custody and care of any
property purchased for or furnished to it for use in connection with the performance of this Program Agreement and will
reimburse DPS for loss of, or damage to, such property. At the termination of this Program Agreement, the Sponsoring
Agency, County Government, and JCPC shall follow the guidelines for disposition of property set forth in Administrative
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Code and JCPC policy.
Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process
Disbursements and Internal Controls
Reversion of Unexpended Funds
Any remaining unexpended funds DPS disbursed to the County for the Sponsoring Agency must be refunded/reverted
back to DPS at the close of fiscal year or upon termination of this Agreement.
Accountability for Funds
Audit Requirement - Local Government or Public Authority Requirements
Local Government or Public Authorities in accordance with N.C.G.S. §159-34 must have an audit performed in
conformity with generally accepted auditing standards. The audit shall evaluate the performance of a unit of local
government or public authority with regard to compliance with all applicable Federal and State agency regulations. This
audit, combined with the audit of financial accounts, shall be deemed to be the single audit described by the, "Federal
Single Audit Act of 1984".
Audit Requirement – Non-Governmental Entities: An audit, when required by law, or requested by the County or
DPS shall be performed in conformity with generally accepted auditing standards and audits of non-governmental
entities, both for-profit and not-for-profit, and must meet the requirements of OMB Circular A-133. At a minimum, the
required report shall include the financial statements prepared in accordance with generally accepted accounting
principles, all disclosures in the public interest required by law, and the auditor's opinion and comments relating to
financial statements. The audit report must be submitted to the State Auditor’s office as required by law, to the County
and DPS, and to other recipients as appropriate within nine (9) months after the end of the program’s fiscal year.
Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all
Program Agreements entered into by State agencies or political subdivisions in accordance with N.C.G.S. §147-64.7.
Additionally, as the State funding authority, DPS shall have access to persons and records as a result of all Program
Agreements entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of
DPS. State basic records retention policy requires all records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the Program Agreement is subject to Federal policy and
regulations, record retention may be longer than five years since records must be retained for a period of three years
following submission of the final Federal Financial Status Report, if applicable, or three years following the submission
of a revised final Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action,
or other action involving this Program Agreement has been started before expiration of the five-year retention period
described above, the records must be retained until completion of the action and resolution of all issues which arise
from it, or until the end of the regular five-year period described above, whichever is later.
No Overdue Tax Debt – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. The Sponsoring Agency shall be responsible for
the payment of all State, local, and Federal taxes. Consistent with N.C.G.S. § 143C-6-23 (c), not for profit
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organizations shall file with DPS and the County a written statement completed by that Sponsoring Agency's board of
directors or other governing body, stating whether or not the Sponsoring Agency has any overdue tax debts, as
defined by N.C.G.S. 105-243.1, at the Federal, State, or local level. This written statement, Certification of No
Overdue Tax Debts, shall be completed by the Sponsoring Agency to certify when there are no overdue taxes. If the
agency has overdue taxes, the Sponsoring Agency must notify DPS at the time of Program Agreement submission.
Conflict of Interest – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. Consistent with the N.C.G.S. §143C-6-23 (b), not
for profit organizations shall file with DPS and the County a copy of that Sponsoring Agency’s policy addressing
conflicts of interest that may arise involving the Sponsoring Agency’s management employees and the members of its
board of directors or other governing body. The policy shall address situations in which any of these individuals may
directly or indirectly benefit, except as the Sponsoring Agency’s employees or members of its board or other
governing body, from the Sponsoring Agency’s disbursing of State funds and shall include actions to be taken by the
Sponsoring Agency or the individual, or both to avoid conflicts of interest and the appearance of impropriety. The
policy shall be filed before the County or DPS may disburse any funds. The Sponsoring Agency shall also complete
the DPS Conflict of Interest Policy Statement (Form DPS 13 001) and upload the statement and the Sponsoring
Agency's policy addressing conflicts of interest to the JCPC Program Agreement upon submission.
Proof of 501(c) (3) – Not for profit organizations ONLY must comply with this section. This document must be
uploaded in NCALLIES when submitting a Program Agreement. Not for profit organizations must upload proof of
the Sponsoring Agency’s 501 (c) (3) status.
Amendment: This Agreement may not be amended orally or by performance. Any amendment must be requested in
writing by the Sponsoring Agency through submission of a Program Agreement Revision and executed by duly
authorized representatives of DPS, the County Government, JCPC and Sponsoring Agency.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this Program
Agreement violates any applicable law, each such provision or requirement shall continue to be enforced to the extent
it is not in violation of law or is not otherwise unenforceable and all other provisions and requirements of this Program
Agreement shall remain in full force and effect.
Termination for Cause: If, through any cause, the Sponsoring Agency shall fail to fulfill its obligations under this
Program Agreement in a timely and proper manner, DPS shall have the right to terminate this Program Agreement by
giving written notice to the Sponsoring Agency and specifying the effective date thereof. In that event, all finished or
unfinished deliverable items prepared by the Sponsoring Agency under this Program Agreement shall, at the option of
DPS, become its property and the Sponsoring Agency shall be entitled to receive just and equitable compensation for
any satisfactory work completed on such materials, minus any payment or compensation previously made.
Notwithstanding the foregoing provision, the Sponsoring Agency shall not be relieved of liability to DPS for damages
sustained by DPS by virtue of the Sponsoring Agency’s breach of this agreement, and DPS may withhold any
payment due the Sponsoring Agency for the purpose of setoff until such time as the exact amount of damages due
DPS from such breach can be determined. The filing of a petition for bankruptcy by the Sponsoring Agency shall be
an act of default under this Program Agreement.
Termination without Cause: DPS, the County Government, or the Sponsoring Agency may terminate this
Agreement at any time and without cause by giving at least thirty (30) days advance written notice to the other. If this
Program Agreement is terminated by DPS as provided herein, the Sponsoring Agency shall be reimbursed on a pro
rata basis for services satisfactorily provided to DPS under this Program Agreement prior to Program Agreement
termination.
226
Form structure last revised 12/20/2013
Department of Public Safety
Waiver of Default: Waiver by DPS of any default or breach in compliance with the terms of this Program Agreement
by the Sponsoring Agency shall not be deemed a waiver of any subsequent default or breach and shall not be
construed to be modification of the terms of this Program Agreement unless stated to be such in writing, signed by an
authorized representative of DPS, County Government, the JCPC and the Sponsoring Agency.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes,
civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event, pandemic, or act of God.
Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and
warranties contained herein shall survive the Program Agreement expiration or termination date unless specifically
provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation.
END OF SECTION V – Terms of Agreement
227
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VI: BUDGET NARRATIVE
Harnett County Juvenile Restitution/Community Service Program Fiscal Year FY 21-22
Item #Justification Expense In Kind Expense
120 Salaries for Full-time Coordinator-$22.1416 per hour@40 hours
a week@52 weeks /1 Part-time Program Assistants @ $9.621
an hour x 19.99 hours a week x 52 weeks
$58,274
180 401K - $935 FICA - $4457, State Retirement - $4929, Medical
Insurance - $10104, Dental Insurance - $384, Life Insurance -
$62, Unemployment - $284, Worker Compensation - $1674,
Employee Clinic - $180, Other Post Employment Expenses -
$120
$23,129
210 Uniforms-shirts/hoodies for program coordinator and program
assistant
$300
220 Food for juveniles while engaged in work activities $200
250 Gas and maintenance for two program vehicles $2,000
260 Office supplies such as envelopes, pens, copier paper, etc......$50
290 Restitution supplies (ex. gloves, trash bags, safety vest,
goggles, etc...)
$250
310 Hotel Fees and Meals for Conferences and Trainings $310
320 Cell phones, postage, faxes, internet access for iPad, etc..$1,796
390 Restitution Earned and Paid to Victims -5000; Training-
Registration-100, Background Checks for volunteers-75
$5,175
430 Copier Contract $400, Lease of Computer $400, Lease of iPad
$192, Post Office Box Rental $20
$1,012
450 Insurance-Policy covering juveniles while participating in
program activities
$178
490 Dues and Subscriptions - Association Dues $85
TOTAL $92,759
Job Title
Annual Expense
Wages
Annual In Kind
Wages
Program Coordinator (52 weeks@40 hours per week@22.1461 per hour)$48,274
1 Program Assistant(52 weeks @ 19.99 hours per week @ 9.621 per hour)$10,000
TOTAL $58,274
228
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VII Program:Harnett County Juvenile Restitution/Community Service Program
Fiscal Year:FY 21-22 Number of Months:12
Cash In Kind Total
I. Personnel Services $81,403 $81,403
120 Salaries & Wages $58,274 $58,274
180 Fringe Benefits $23,129 $23,129
190 Professional Services* $0
*Contracts MUST be attached
II. Supplies & Materials $2,800 $2,800
210 Household & Cleaning $300 $300
220 Food & Provisions $200 $200
230 Education & Medical $0
240 Construction & Repair $0
250 Vehicle Supplies & Materials $2,000 $2,000
260 Office Supplies and Materials $50 $50
280 Heating & Utility Supplies $0
290 Other Supplies and Materials $250 $250
III. Current Obligations & Services $7,281 $7,281
310 Travel & Transportation $310 $310
320 Communications $1,796 $1,796
330 Utilities $0
340 Printing & Binding $0
350 Repairs & Maintenance $0
370 Advertising $0
380 Data Processing $0
390 Other Services $5,175 $5,175
IV. Fixed Charges & Other Expenses $1,275 $1,275
410 Rental or Real Property $0
430 Equipment Rental $1,012 $1,012
440 Service and Maint. Contracts $0
450 Insurance & Bonding $178 $178
490 Other Fixed Charges $85 $85
V. Capital Outlay $0
[This Section Requires Cash Match]
510 Office Furniture & Equipment $0
530 Educational Equipment $0
540 Motor Vehicle $0
550 Other Equipment $0
580 Buildings, Structure & Improv. $0
Total $92,759 $92,759
229
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VIII SOURCES OF PROGRAM REVENUE (ALL SOURCES)
FY 21-22 Harnett County Funding ID: 543-XXXX
Sponsoring Agency: Harnett County Government Program: Harnett County Juvenile Restitution/
Community Service Program
$81,000 DPS/JCPC Funds * This is the amount of your request on your application
10%Local Match Rate Is the Local Match Rate 10%, 20% or 30%?
$8,759 County Cash Harnett County (Specify Source)
$3,000 Local Cash Harnett County (Specify Source)
Local Cash (Specify Source)
Local In-Kind (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
$92,759 TOTAL $8,100 $11,759
Required Local Match Match Provided
We, the undersigned, have reviewed this JCPC Program Application to be presented to the Juvenile Crime Prevention Council of this County in
accordance with the procedures established by the local Juvenile Crime Prevention Council. Agencies seeking funding must be able to meet the
applicable requirements of the North Carolina General Statutes, Administrative Code, and the Division of Adult Correction and Juvenile Justice.
We understand and acknowledge that the approval process is first with the Juvenile Crime Prevention Council, second with the County Board of
Commissioners, and the final authority with the Department of Public Safety, Division of Adult Correction and Juvenile Justice.
All parties understand that the availability of funds is contingent upon the appropriation of those funds by the General Assembly of the State of
North Carolina.
/DPSSignature//DPSdt/
Chair, County Board of Commissioners or County Finance Director Date
/JCPCSignature//JCPCdt/
Chair, Juvenile Crime Prevention Council Date
/ProgramSignature/
Barry Blevins
/Programdt/
6/9/21
Program Manager Date
230
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
North Carolina Department of Public Safety
JCPC Program - Program Application
SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION
FUNDING PERIOD:FY 21-22 DPS/JCPC FUNDING # (cont only)243-XXXX
COUNTY:Harnett AREA:Central Area
Multi-County:No Multi-Components Yes
NAME OF PROGRAM:PAL Academic Career Readiness
SPONSORING AGENCY:Dunn Police Athletic & Activities League, inc.
SPONSORING AGENCY
PHYSICAL ADDRESS:
1501 S. Clinton Ave.
Dunn NC 28334
SPONSORING AGENCY
MAILING ADDRESS:
PO Box: 1238
Dunn NC 28335
TYPE:Non-Profit FEDERAL ID #46-4258788
COMPONENT ID #NAME OF PROGRAM COMPONENT PROGRAM TYPE TOTAL COST OF
EACH COMPONENT
32111 PAL (SKIP) School Kids In Power Tutoring/Academic Enhancement $ 54,480
32112 PAL Academic Career Readiness Vocational Skills $ 54,479
Total cost of components:$ 108,959
Program Manager Name & Address (same person on signature page)
Name:Rodney Rowland Title:Executive Director
Mailing
Address:
PO Box: 1238
City:Dunn Zip:28335
Phone:(910) 892-1873 Fax: E-mail:director@dunnpal.org
Contact Person (if different from program manager)
Name:Rodney Rowland Title:Executive Director
Mailing
Address:
PO Box: 1238
City:Dunn Zip:28335
Phone:(910) 892-1873 Fax: E-mail:director@dunnpal.org
Program Fiscal Officer (cannot be program manager)
Name:Emmett Aldredge III Title:Board President
Mailing
Address:
PO Box: 1238
City:Dunn Zip:28335
Phone:(910) 892-1873 Fax: E-mail:emmett.aldredge3@arc3gases.com
231
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION I B PROGRAM COMPONENT DESCRIPTION
COMPONENT ID #COMPONENT INFORMATION
32111 NAME OF COMPONENT: PAL (SKIP) School Kids In Power
BRIEF DESCRIPTION: Tutoring and Academic Enrichment for youth 10-17 years old to
increase grades in school in reading and math, increase school attendance, decrease school
suspensions and increase positive social interactions. The SKIP Program through Dunn PAL
provides services to help supplement Youths' school curriculum by providing hands on learning
to include College and Career Readiness Classes. The program also provides an opportunity
for field trips designed to be an educational enrichment experience.
COMPONENT ID #COMPONENT INFORMATION
32112 NAME OF COMPONENT: PAL Academic Career Readiness
BRIEF DESCRIPTION: The Career Readiness Program works with youth 13-19 years old in
training and skills development in a specific job trade. This program will expose youth to work
and college related experiences: teach youth proper etiquette in dress, manners, interview
skills, communications skills, money management and job skills. Youth partner with local
companies for work experience. We will work and partner with Central Carolina Community
College, Harnett County Schools, and Harnett NC Works.
232
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 01/09/2012
Department of Public Safety
SECTION II COMPONENT STATISTICAL INFORMATION
Multi-Components Yes
Component Service Statistics PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name:PAL (SKIP) School Kids In Power Component ID #
32111
What is this component's maximum client capacity at any given time?20
Frequency of client contact per month:12 Anticipated Average Length of
Stay:60 Days
Total Component Cost:$54,480 ÷ by Estimated # to be served during funding period:20
Estimated Average Cost Per Youth:$2,724
Applies to
continuation
programs only.
Actual number of youth admitted FY 19-20:0
0 Number of admissions Juvenile Justice Referred 0% of total admissions
0 Number of admissions Law Enforcement Referred 0% of total admissions
0 Number of admissions District Court Referred 0% of total admissions
233
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:PAL (SKIP) School Kids In Power
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
According to the North Carolina Department of Public Safety Division of Juvenile Justice 2016 Annual Report for the
sixth consecutive year the juvenile delinquency rate (juvenile crime) in the State of North Carolina has decreased. Also
according to this report, over that six-year period, the State has experienced a 28% decrease in juvenile delinquency.
In addition, there are fewer youth being committed by the court to long-term stays in the Division of Juvenile Justice's
youth development centers. In 2016 187 youth were committed to youth development centers which were the lowest
level ever recorded and represents a 48% decrease since 2010. Overall, over the last decade, juvenile commitments
have dropped almost every year. With the juvenile delinquency rate being decreased from previous years, there is
more emphasis focused on community based programming working with prevention and intervention.
According to the North Carolina Department of Public Safety Division of Juvenile Justice 2016 Annual Report, Juvenile
Gang Involvement/affiliation has been on the rise since 2014 increasing a half percent each year.
Due to Raise The Age, NC (Ages 16-17) we will add more youth into the Juvenile Services Division.
Low classroom grades and test scores of students in school, in-school and out-of-school suspensions as well as
excessive absences and trouble in school lead to juvenile problems both in school and in the community. Lack of
positive social interaction with both peers and adults lead to juvenile problems. Juvenile Gang Affiliation being on the
rise leads to Juvenile Crime and all the above stated. Lack safe places and supervised learning instruction for youth
after school.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
The target population will be ages 10-17 boys and girls in Elementary through High School in the Harnett County area
in keeping with PAL's Mission Statement. Those targeted are youth with minor court involvement, At-Risk of Court
Involvement and may be referred by any of the following sources (Parents, Court Counselors, Police Officers, School
Teachers, School Counselors and Administration staff, Community Leaders, Youth Themselves, Guardians, relatives,
etc.). There is application process to be completed prior to admission. We will target youth via multiple resources to
include (newspaper, social media outlets, schools, online outlets and personal contact).
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
The program will assist in educating the youth it serves with their homework, tutoring youth on specific subjects of
weakness, and computer training with internet access to improve the youth grades in public school. We hope to lower
youth problems in school and in the community by working with area schools, parents and law enforcement. In working
with multiple resources in the government and private sector we hope to help provide sound education along with work
experience to get youth to work and thus lower juvenile crime and lower youth problems such as lack of respect for
authority, lack of socially acceptable values and improving positive self image.
1. Provide a safe environment
2. Provide safe and supervised programs
3. Keep constant communication with all stake holders (Community and School)
4. Enhance Police and Community Relations to give positive interaction with youth
234
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:PAL (SKIP) School Kids In Power
5. Provide a learning environment on each youths level
6. Provide hands on learning for youth
7. Track progress for success, deficiencies and enhancements
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
80% Clients will reduce specific problem behaviors presented at referral and targeted in the individual service plan.
80% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
80% Clients will actively participate in tutorial and/or academic enhancement activities as intended by program design/
the service plan.
80% Clients will have no new complaints with an offense date after the admission date.
80% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
completion.
80% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
80% Clients will improve academic skills/performance.
80% Clients will have no new adjudications for a complaint with an offense date after the admission date.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
SKIP component will work with youth ages 10-17 years old who are At-Risk of becoming 1st time delinquent juveniles
or have a first offense currently. We will also work with youth who are At-risk or involved with negative and/or
delinquent peers. We also work with youth and their families to fill in the gap of lack of parental supervision. We will
accomplish this as stated below.
Youth (ages 10-17) tutoring and homework assistance are priority risk factors in Harnett County. We will address lack
of respect for authority, absence of positive role models and lack of socially acceptable values in the SKIP component.
PAL will strive to prevent and reduce juvenile crime in Harnett County by focusing on identifying, tracking and
educating the youth on their academic weaknesses which will make them strong mentally and lower problems in the
classroom. PAL will coordinate with schools and teachers to ensure the student is getting help in the proper classes.
Individual and group sessions will be provided to ensure quality performance of each student. A comprehensive
mentoring program is in place to provide each student a mentor to help with homework and access with them in school.
This is a partnership with Dunn Area Chamber of Commerce, local churches and citizens in the community that
provide mentors and they are assigned to work with youth to help with grades and be positive role models.
Furthermore, helping educate the parents is a vital role for them successfully working with their children.
235
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:PAL (SKIP) School Kids In Power
1. Location: List physical address(es) and describe where program services are delivered.
Dunn PAL Main Office/Education Building
1501 S. Clinton Ave.
Dunn, NC 28334
Dunn PAL Main Office/Education Building is where students each have a hot meal each day in our cafeteria, attend
computer classes, do their homework and enrichment classes. The PAL Education Building is where our students
meet each day to finish homework and have some enrichment sessions to include STEAM (Science, Technology,
Engineering, Arts and Math).
2. Operation: Describe the daily/weekly schedule of program operation.
Snack/Lunch - Monday, Tuesday, Wednesday and Thursday = 3:00-3:30 pm
Tutoring/Homework help - Monday, Tuesday, Wednesday and Thursday = 3:30-4:30 pm
Enrichment Classes - Monday, Tuesday, Wednesday and Thursday = 4:30-5:30 pm
The schedule is basic and subject to change depending on activities for the day.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
After-school Instructors will work with youth in a group setting with their homework and specific course subjects.
Staff will also be able to assist parents with the proper way to help their children as it relates to helping them with their
homework. This will be two paid part-time positions working no more than 35 hours a week. Instructors will also
conduct hands on learning through Media Arts and STEM classes as well as educational field trips.
Must have prior experience in helping youth with homework. Must be willing to help youth. Teacher Certificate
preferred.
____________________________________________________________________________________________
Alternative Instructor I - Current Employee has been employed since April 2018. She has a Masters in Psychology,
EMT/CPR Certified & Effective teacher training certified.
Duties & Responsibilities- Youth intake, parent intake, assist with after school tutoring/homework help & enrichment.
Coordinate with school teachers & collect surveys, assessments & report cards.
_______________________________________
Alternative Instructor II-Recent hire. She has a degree in BS in Criminal Justice & AAS Certified Paralegal. 1 year
experience substitute teacher at Ramsey St Alternative School, 1 year community sport paraprofessional at Great
Expectations Mental Health Services, 2 years experience Residential Treatment Supervisor/Qualified Professional at
Children's Home Inc in Franklin, NC. 2 years experience as a Youth Program Assistant III at Meridiam Behavior Health
in Silva, NC.
Duties and Responsibilities- Attend Harnett County JCPC meetings
Attend monthly meetings
Attend juvenile court regularly and admit any referrals from juvenile court
Prepare notes, reports etc in juvenile court on deferred youth
Maintain NC Allies JCPC grant data bases
Provide intake, progress and termination documentation of deferred youth and regularly communicate with juvenile
court, law enforcement and any other referrals of youth
236
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:PAL (SKIP) School Kids In Power
Assist with after school tutoring/homework help and enrichment. Coordinate with school teachers and collect surveys,
assessments and report cards
_______________________________________
Administrative Assistant- Employed since June 2015
Duties and Responsibilities- Answer phones, data entry, process payments, may assist Alternative Instructor II as
needed and attend JCPC meetings with Alternative Instructor II
_______________________________________
After School/Summer Program Coordinator-Employed since May 2019
Duties and Responsibilities- Oversees Alternative Instructor I, II and all after school/summer staff
Partner with schools for student education, may attend JCPC meetings
Reports to Executive Director and acts as liaison for schools & service agencies
Interacts with parents about any concerns
Processes any disciplinary actions of youth in after school/summer programs
4. Service Type SPEP: Describe implementation to include:
Primary Service: Remedial Academic Program; Secondary Service: Work experience
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
Any youth or parent seeking to enroll in this program will have to meet with the After-school Coordinator, complete an
admission application, complete an education agreement, agree to all rules and must attend 12 hours a week. The
approval of the admission process takes 2-3 days. The referral process for Dunn PAL is implemented by a referral
form that their parent/guardian, court counselors, law enforcement, school staff or social services can complete and
send to Dunn PAL. Dunn PAL will then have the student and parent/guardian complete a full application and submit it
to Dunn PAL for membership. Since Dunn PAL is voluntary, it will be the responsibility of the parent/guardian to assure
completion. Each youth is tracked in our on-line database and must re-apply every year from the date the membership
is received. Anyone may also register on-line at Dunn PAL's website www.dunnpal.org. The After-school Coordinator
may place a student on a waiting list if the program is full. The Coordinator may reject an applicant if there is any sex
related crimes or the coordinator feels after consultation with authorities that the child could pose a severe security risk
to other students. After the initial admission process is complete the student will begin attending the next business day.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
A youth can be terminated at anytime for rule violations, moving out of county, quitting school or graduation from
school. Termination can also occur if the youth satisfactory completes all assignments and grades are increased above
a C for the entire semester. A student may also be terminated if they fail to complete the required 12 hours a week
attendance that was explained at admission. The After-school Coordinator checks all grades at school and checks to
see if youth in in compliance with all terms set out prior to admission. The After-school Coordinator makes all
determinations on criteria being followed. The After-school Coordinator or his/her designee will determine termination
procedures and contact parent/guardian and the referral agency of compliance either successful, satisfactory,
unsuccessful or non-compliant termination.
237
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:PAL (SKIP) School Kids In Power
A successful termination is student completing all assignments and complete the year, satisfactory is completing all
assignments, unsuccessful is not completing assignments and the year also moving out of area, non-compliant is not
attending and/or suspension of rules while attending.
How is the referring agency involved with the termination process?
The After-school Coordinator checks all grades at school and checks to see if youth are in compliance with all terms
set out prior to admission. The After-school Coordinator makes all determinations on criteria being followed. The After-
school Coordinator or his/her designee will determine termination procedures and contact parent/guardian and the
referral agency of compliance either successful, satisfactory, unsuccessful or non-compliant termination. The JCPC
Coordinator, After-school program Coordinator and the referring agency/juvenile court counselor will coordinate
ongoing concerns and courses of action to include termination.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
The SKIP component will communicate with Juvenile Court/services and referring agency through the After-school
Coordinator, Mentor Coordinator and Youth Advocate of the Dunn Police Athletic/Activities League (Dunn PAL). The
SKIP Component will also partner with various organizations to help youth to be well rounded.
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
utilized in this component and how will parents/guardians be involved?
The component will work with the local school systems and youth through the After-school Coordinator to help better
educate the youth in the program, thus increasing grades and reducing drop out rates. Dunn PAL SKIP is partnering
with the Dunn Area Chamber of Commerce, local churches and citizens to add the mentoring program with the tutoring/
academic enhancement component. Each youth will be matched with an adult or peer and
have one-to-one assistance.
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
Structuring out of school time to improve academic achievement, We use the US Department of Education 21st
Century Community Learning Centers model. Curriculum will be followed by the Harnett County School System.
School textbooks and online resources will be used. Professional Development will also be used online https://y4y.ed.
gov/ and Harnett County Schools. We also have a Professional Development facilitator on site.
238
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 01/09/2012
Department of Public Safety
SECTION II COMPONENT STATISTICAL INFORMATION
Multi-Components Yes
Component Service Statistics PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name:PAL Academic Career Readiness Component ID #
32112
What is this component's maximum client capacity at any given time?20
Frequency of client contact per month:12 Anticipated Average Length of
Stay:60 Days
Total Component Cost:$54,479 ÷ by Estimated # to be served during funding period:20
Estimated Average Cost Per Youth:$2,724
Applies to
continuation
programs only.
Actual number of youth admitted FY 19-20:0
0 Number of admissions Juvenile Justice Referred 0% of total admissions
0 Number of admissions Law Enforcement Referred 0% of total admissions
0 Number of admissions District Court Referred 0% of total admissions
239
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:PAL Academic Career Readiness
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
Academic enrichment for youth ages 13-19 to increase grades in school reading and math, increase school
attendance, decrease school suspensions and increase positive social interactions. Through Dunn PAL we will
provide services to help supplement the youths' school curriculum by providing hands on learning to include College
and Career Readiness. The program also provides an opportunity for youth to engage in work-site learning experience.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
The target population will be youth in grades 9-12 in Harnett County. In keeping with the Dunn PAL's mission those
targeted are youth who are considered at-risk. These youth may be referred by any of the following sources; Juvenile
Court Counselors, parents, counselors, police officers, teachers, community leaders, youth themselves, guardians/
parents, relatives, etc. There is an instruction process to be completed prior to job placement. We will target youth by
connecting with schools, personal contact and the media.
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
The program will assist youth in educating them on their workforce skill set and the best career for them. We hope to
lower youth problems in school and in the community by working with schools, law enforcement, parents and
employers. In working with multiple resources in the government and private sector, we hope to help provide excellent
career readiness training where youth will learn essential skills along with the ultimate goal to get youth employed
while lowering the juvenile crime rate and lower youth problems at school and home.
-Provide a safe environment
-Provide safe and supervised programs
-Keep constant communication with all stake holders (community and school)
-Enhance Police and Community Relations to give positive interaction with youth.
-Provide a learning environment on each youth's level.
-Provide hands on learning for youth.
-Track progress for success, deficiencies and enhancements.
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
80% Clients will actively participate in vocational skill building activities as intended by the program design/service
plan.
80% Clients will reduce specific problem behaviors presented at referral and targeted in the individual service plan.
80% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
80% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
80% Clients will have no new complaints with an offense date after the admission date.
80% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
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SECTION III COMPONENT SUMMARY
NAME OF COMPONENT:PAL Academic Career Readiness
completion.
80% Clients will increase overall knowledge of vocational skills or readiness to enter the workforce.
80% Clients will have no new adjudications for a complaint with an offense date after the admission date.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
The Career Readiness Program will work with youth ages 13-19 who are identified through Raise The Age as being at-
risk of becoming first time delinquent juveniles or have a first offense currently, we also will be proactive in finding
resources and training for youth who may have reports of substance abuse issues, work with other providers on mental
health issues and work with youth that have low to serious behavior problems at school. We will also work with
youth who are at-risk or involved with negative and/or delinquent peers or have a lack of parental supervision. We will
accomplish this as stated below:
We will address lack of respect for authority, absence of positive role models and lack of socially acceptable values.
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:PAL Academic Career Readiness
1. Location: List physical address(es) and describe where program services are delivered.
Dunn PAL Main Office/Education Building
1501 S. Clinton Ave.
Dunn, NC 28334
Location is now under one roof. The Career Readiness Instructor and STEM Instructor will work together and meet
with each other daily about the youth. They will also exchange youth weekly so both personnel work with all the youth
weekly.
The Career Readiness Instructor will visit in-person and email to the various employers in Harnett County and
development 30 day notes and evaluations on the youth progress assigned to each location. The Career Readiness
Instructor will also conduct training to the various employers on working with youth assigned as interns.
2. Operation: Describe the daily/weekly schedule of program operation.
Snack/Lunch - Monday, Tuesday, Wednesday, Thursday and Friday = 3:00-3:30 pm
Enrichment/STEM Classes - Monday, Tuesday, Wednesday, Thursday and Friday = 3:30-4:15 pm
College & Career Readiness - Monday, Tuesday, Wednesday, Thursday and Friday = 4:15-5:30 pm
Enrichment (Field Trips) College and Career Readiness classes and field trips - Fridays = 3:30-5:30 pm
The schedule is basic and subject to change depending on activities for the day.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
We will employ two individuals who will coordinate and operate this program:
1) Career Readiness Instructor
2) STEM Instructor
These instructors will provide instruction as it relates to :business etiquette, resume writing, literacy/financial literacy,
and help them with work-based learning.
Both Career Readiness Instructors will work with youth in a group setting on career classes to include work experience
placement with local companies Staff will also be able to assist parents with the proper way to help their children as it
relates to helping them with their homework. This will be two paid part-time positions working no more than 35 hours a
week. Instructors will also conduct hands on learning through Media Arts and STEAM classes as well as Harnett
County Workforce Development along with educational field trips.
Must have prior experience in helping youth with career related classes. Must be willing to help youth. Teacher
Certificate preferred.
____________________________________________________________________________________________
Career Readiness Instructor I - Qualifications: Degree in Business preferred, EMT/CPR Certified and Effective teacher
training certified preferred.
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:PAL Academic Career Readiness
Duties and Responsibilities- Attend Harnett County JCPC meetings
Attend monthly meetings, Attend juvenile court regularly & admit any referrals from juvenile court
Prepare notes, reports etc in juvenile court on deferred youth, Maintain NC Allies JCPC grant data bases
Provide intake, progress and termination documentation of deferred youth and regularly communicate with juvenile
court, law enforcement and any other referrals of youth, work (coordinate) with Harnett County Schools CTE
Department, CCCC and Harnett County Workforce Development, Teach Career Classes and place youth with
prospective businesses and monitor progress. Recruit business to participate in the Job Experience portion of the
program. Coordinate with school teachers and collect surveys, assessments & report cards.
___________
STEM Instructor I--- Degree in Mass Communications and/or Education Preferred or equivalent experience in the field.
EMT/CPR Certified and Effective teacher training certified preferred.
Duties and Responsibilities- Attend monthly meetings, Prepare notes, reports, lesson plans, schedule, recruit youth for
the program, help recruit businesses to participate, recruit outside businesses to speak with youth and help with
planned activities, help Provide intake, progress and termination documentation of deferred youth and regularly
communicate with juvenile court, law enforcement and any other referrals of youth. Assist with the overall needs of the
Career Readiness Program. Coordinate with school teachers and collect surveys, assessments and report cards
__________
Administrative Assistant- Employed since June 2015
Duties and Responsibilities- Answer phones, data entry, process payments, may assist both instructors as needed &
attend JCPC meetings.
4. Service Type SPEP: Describe implementation to include:
Primary Service: Job Training; Secondary Service: Remedial Academic Program
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
Any youth or parent seeking to enroll in this program will have to meet with PAL staff and our partner, Harnett
Workforce Development (Job Link) to complete an assessment, application, agree to all rules and must be committed
to daily involvement. The referral process for Dunn PAL is implemented by a referral form that their parent/guardian,
counselor, law enforcement, school staff or social services can complete. Each youth's progress will be tracked
through communication with our career readiness instructor, Job Link, employer partner and our online database.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
A youth can be terminated at anytime for rule violations, moving out of the county, quitting school or graduation from
school. Termination can also occur if the youth satisfactory completes all assessments, classroom training and work-
based learning, thus becoming full-time employed with a trade or industry.
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SECTION IV COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:PAL Academic Career Readiness
A successful termination is student completing all assignments and complete the year, satisfactory is completing all
assignments, unsuccessful is not completing assignments and the year also moving out of area, non-compliant is not
attending and/or suspension of rules while attending.
How is the referring agency involved with the termination process?
The Career Readiness and the STEM Instructor will communicate with juvenile services via in-person, telephone,
email and 30 day progress notes. Communicate with Harnett County Workforce Development (Job Link) in-person,
telephone, email, in-person training and 30 day progress notes. Communicate with teachers in-person, telephone,
email and 30 day progress notes. Communicate with employer partners in-person, telephone, email and 30 day
progress notes.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
The Career Readiness and the STEM Instructor will communicate with juvenile services via in-person, telephone,
email and 30 day progress notes. Communicate with Harnett County Workforce Development (Job Link) in-person,
telephone, email, in-person training and 30 day progress notes. Communicate with teachers in-person, telephone,
email and 30 day progress notes. Communicate with employer partners in-person, telephone, email and 30 day
progress notes.
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
utilized in this component and how will parents/guardians be involved?
The component will work with local school systems and youth through the Career Readiness and STEM instructors to
help better the youth in the program (s), thus reducing drop out rates and helping them learn a trade and become
employed. Dunn PAL Career Readiness is partnering with the Dunn Chamber of Commerce, local churches and
community to enhance this component. Each youth will be matched with a job
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
The Dunn PAL's Career Readiness program is based on the Harnett County workforce development model and
Harnett County Schools CTE model. This is where we combine employment, training and supportive services and
programs into a market-based system that meets the needs of the workforce and industry.
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SECTION V Terms of Agreement
This section of the JCPC Program Application will ONLY be completed if approved for funding and will be
included in the required JCPC Program Agreement document for completion.
This Agreement is entered into by and between Department of Public Safety, (hereinafter referred to as the DPS), and
County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to
as the JCPC) and (hereinafter referred to as the Sponsoring Agency).
The DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows:
Term of Agreement
This Agreement shall become effective _______ and shall terminate ________.
Payment to Sponsoring Agency
All parties agree that services will be delivered as described in the approved Program Agreement and that funds will be
disbursed in an amount not to exceed the amount $___________ for the term of this agreement, unless amended by
an approved Program Agreement Revision.
Availability of Funds:
All parties to this Agreement agree and understand that the payment of the sums specified in this Program Agreement
budget, or most recently approved Program Agreement Revision, is dependent and contingent upon and subject to the
appropriation, allocation, and availability of funds for this purpose to DPS.
Responsibilities of the Parties
DPS shall:
1.Disburse funds monthly to County Governments, for payment to the Sponsoring Agency, from the fund
appropriation by the General Assembly;
2.Reserve the right to suspend payment to the County for any non-compliance by the Sponsoring Agency with any
reporting requirements set forth in DPS JCPC Policy and Procedures;
3.Notify in writing the County and Sponsoring Agency immediately if payments are suspended and again once
payments resume;
4.Pay only for work as described in the Program Agreement, or most recently approved Program Agreement
Revision, provided by the Sponsoring Agency and approved subcontractors;
5.Provide technical assistance, orientation and training to the Sponsoring Agency, the County and the JCPC;
6.Monitor Sponsoring Agency’s funded program(s) in accordance with DPS JCPC Policy 3. Operations: Program
Oversight and Monitoring; and
7.Notify parties entering into this Agreement of all due dates in a timely manner in order for reports to be submitted
by the established due date.
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The Sponsoring Agency shall:
1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the
conduct of its business, including those of Federal, State, and local agencies having jurisdiction and/or authority;
2.Comply with all Federal and State laws relating to equal employment opportunity;
3.Keep as confidential and not divulge or make available to any individual or organization without the prior written
approval of DPS any information, data, instruments, documents, studies or reports given to or prepared or
assembled by the Sponsoring Agency under this Agreement;
4.Acknowledge that in receiving, storing, processing or otherwise dealing with any confidential information it will
safeguard and not further disclose the information except as otherwise provided in this Agreement;
5.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Procedures;
6.Secure local match as required, if applicable, pursuant to 14B NCAC 11B.0105, for approved JCPC funds;
7.Create and adopt individualized guidelines specific to the funded program, while also adhering to DPS JCPC
Policy and Procedures for all funded programs and for the specific program type for which they receive funding;
8.Ensure that state funds received are spent in accordance with the approved Program Agreement, or most recently
approved Program Agreement Revision, and be accountable for the legal and appropriate expenditure of those
state funds;
9.Maintain reports, records, and other information to properly document services rendered and outcomes; also
maintain an ability to send and receive electronic communication;
10.Have the capacity to use DPS electronic, internet-based system for tracking clients served;
11.Use generally accepted accounting procedures that guarantee the integrity of the expenditure of funds, maintain
reports, records, and other information to properly account for the expenditure of all State funds provided to the
Sponsoring Agency;
12.When refunds are requested from the North Carolina Department of Revenue for sales and/or use taxes paid by
the agency in the performance of the Program Agreement, or most recently approved Program Agreement
Revision, as allowed by NCGS §105-164.14(c), the agency shall exclude all refundable sales and use taxes from
reportable expenditures submitted to the County and DPS;
13.Submit Program Agreement Revisions, Third Quarter Accounting, Final Accounting and annual detailed
expenditures through NCALLIES. These reports must be in accordance with the submission process as outlined in
DPS JCPC Policy and Procedures and with the due dates established by DPS;
14.Make personnel, reports, records and other information available to DPS, the County, the JCPC, and/or the State
Auditor for oversight, monitoring and evaluation purposes;
15.Submit any other information requested by the JCPC, County or DPS;
16.Be responsible for the performance of all subcontractors as described in the JCPC Program Agreement, or most
recently approved Program Agreement Revision;
17. Indemnify and hold harmless DPS, the State of North Carolina, the County and any of their officers, agents and
employees, from any claims of third parties arising out of any act or omission of the Sponsoring Agency in
connection with the performance of the Program Agreement or most recently approved Program Agreement
Revision;
18.Receive permission and budgetary approval from DPS prior to using the Program Agreement, or most recently
approved Program Agreement Revision, as a part of any news release or commercial advertising and
acknowledge DPS funding in partnership with the County;
19.Comply with DPS trainings and requirements regarding the United States Department of Justice national
standards to prevent, detect, and respond to prison rape under the Prison Rape Elimination Act (PREA);
Reference: 14B NCAC 11B, and in compliance with DPS JCPC Policy 2: Operations: Program Operational
Requirements
20.Be deemed an independent contractor in the performance of services described in the Program Agreement, or
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most recently approved Program Agreement Revision, and as such shall be wholly responsible for the services to
be performed and for the supervision of its employees;
21.Represent that it has, or shall secure at its own expense, all personnel required in performing the services as
described in the Program Agreement. Such personnel shall not be employees of, or have any individual
contractual relationship with, DPS;
Sponsoring Agency and Use of Contractor(s)/Subcontractors
The Sponsoring Agency may engage with independent contractors as needed to perform services or support services
described in the Program Agreement. When independent contractors (funds are included in line item 190 of the
budget) are providing services as described in the Program Agreement, the sponsoring agency must:
22.Upload a signed Contract for Professional Services into NCALLIES once the Program Agreement (or
Program Agreement Revision) is approved by DPS;
23.Be responsible for the performance of all contractors or subcontractors as described in the Program
Agreement, or most recently approved Program Agreement Revision;
24.Hold any contractor or subcontractor to which the Sponsoring Agency provides State funds accountable for
the legal and appropriate expenditure of State funds, and to all applicable laws and DPS JCPC Policies and
Procedures; and
25.Ensure that all contractors or subcontractors provide all information necessary to comply with the standards
set forth in the Program Agreement or most recently approved Program Agreement Revision.
The JCPC shall:
1.Ensure the Sponsoring Agency uses JCPC funds for only the purposes DPS has approved in the JCPC Program
Agreement or most recently approved JCPC Program Agreement Revision;
2.Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Code; N.C.G.S. §143B-801
(a);143B-602;143B-851
3.Review and locally approve Program Agreement Revision(s) received from the Sponsoring Agency and submit to
the County in a timely manner;
4.Review and locally approve Third Quarter Accounting forms and submit to the County in order to meet the due
date established by DPS (applicable only to JCPC funded agencies);
5.Submit any other information requested by the County or DPS; and
6.Monitor the Sponsoring Agency’s currently funded JCPC program(s) in accordance with DPS JCPC Policy 3.
Operations: Program Oversight and Monitoring
Reference: 14B NCAC 11B.0202 and DPS JCPC Policy 1, 7, 8, 9, 10, and 11.
The County shall:
1.Ensure the Sponsoring Agency is appropriately licensed, and either local public agencies, 501(c) (3) non-profit
corporations or local housing authorities (applicable only to JCPC funded agencies);
2.Use funds only for the purposes DPS has approved in the Program Agreement or most recently approved
Program Agreement Revision;
3.Disburse funds monthly and oversee funds to the Sponsoring Agency in accordance with 14B NCAC 11B.0108
4.Comply with DPS JCPC Policies and Procedures and the North Carolina Administrative Procedures;
5.Review and locally approve Program Agreement Revisions received from the Sponsoring Agency for final
approval from DPS; and
6.Review and locally approve Third Quarter and jointly submit Final Accounting forms for the JCPC and all funded
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programs according to the procedures and due dates established by DPS.
Reference: 14B NCAC 11B; DPS JCPC Policy 3, 7, 8, 9, 10, and 11
Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Choice of Law: The validity of this Program Agreement and any of its terms or provisions, as well as the rights and
duties of the parties to this Program Agreement, are governed by the laws of North Carolina. The parties, by signing
this Program Agreement, agree and submit, solely for matters concerning this Program Agreement, to the exclusive
jurisdiction of the courts of North Carolina and agree, solely for such purpose, that the exclusive venue for any legal
proceedings shall be Wake County, North Carolina. The place of this Program Agreement and all transactions and
agreements relating to it, and their situs and forum, shall be Wake County, North Carolina, where all matters, whether
sounding in Program Agreement or tort, relating to the validity, construction, interpretation, and enforcement shall be
determined.
Assignment: No assignment of the Sponsoring Agency's obligations or the Sponsoring Agency's right to receive
payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority,
DPS may:
(a) Forward the Sponsoring Agency's payment check(s) directly to any person or entity designated by the
Program Manager, or
(b) Include any person or entity designated by Sponsoring Agency as a joint payee on the Sponsoring Agency's
payment check(s).
In no event shall such approval and action obligate DPS or County Government to anyone other than the Sponsoring
Agency, and the Sponsoring Agency shall remain responsible for fulfillment of all Program Agreement obligations.
Beneficiaries: Except as herein specifically provided otherwise, this Program Agreement shall inure to the benefit of
and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the
enforcement of the terms and conditions of this Program Agreement, and all rights of action relating to such
enforcement, shall be strictly reserved to DPS, the County Government, and the Sponsoring Agency. Nothing
contained in this document shall give or allow any claim or right of action whatsoever by any other third person. It is the
express intention of DPS and County Government that any such person or entity, other than DPS or the County
Government, or the Sponsoring Agency receiving services or benefits under this Program Agreement shall be deemed
an incidental beneficiary only.
Property Rights
Intellectual Property: All deliverable items produced pursuant to this Program Agreement are the exclusive property of
DPS. The Sponsoring Agency shall not assert a claim of copyright or other property interest in such deliverables.
Physical Property: the Sponsoring Agency agrees that it shall be responsible for the proper custody and care of any
property purchased for or furnished to it for use in connection with the performance of this Program Agreement and will
reimburse DPS for loss of, or damage to, such property. At the termination of this Program Agreement, the Sponsoring
Agency, County Government, and JCPC shall follow the guidelines for disposition of property set forth in Administrative
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Code and JCPC policy.
Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process
Disbursements and Internal Controls
Reversion of Unexpended Funds
Any remaining unexpended funds DPS disbursed to the County for the Sponsoring Agency must be refunded/reverted
back to DPS at the close of fiscal year or upon termination of this Agreement.
Accountability for Funds
Audit Requirement - Local Government or Public Authority Requirements
Local Government or Public Authorities in accordance with N.C.G.S. §159-34 must have an audit performed in
conformity with generally accepted auditing standards. The audit shall evaluate the performance of a unit of local
government or public authority with regard to compliance with all applicable Federal and State agency regulations. This
audit, combined with the audit of financial accounts, shall be deemed to be the single audit described by the, "Federal
Single Audit Act of 1984".
Audit Requirement – Non-Governmental Entities: An audit, when required by law, or requested by the County or
DPS shall be performed in conformity with generally accepted auditing standards and audits of non-governmental
entities, both for-profit and not-for-profit, and must meet the requirements of OMB Circular A-133. At a minimum, the
required report shall include the financial statements prepared in accordance with generally accepted accounting
principles, all disclosures in the public interest required by law, and the auditor's opinion and comments relating to
financial statements. The audit report must be submitted to the State Auditor’s office as required by law, to the County
and DPS, and to other recipients as appropriate within nine (9) months after the end of the program’s fiscal year.
Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all
Program Agreements entered into by State agencies or political subdivisions in accordance with N.C.G.S. §147-64.7.
Additionally, as the State funding authority, DPS shall have access to persons and records as a result of all Program
Agreements entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of
DPS. State basic records retention policy requires all records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the Program Agreement is subject to Federal policy and
regulations, record retention may be longer than five years since records must be retained for a period of three years
following submission of the final Federal Financial Status Report, if applicable, or three years following the submission
of a revised final Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action,
or other action involving this Program Agreement has been started before expiration of the five-year retention period
described above, the records must be retained until completion of the action and resolution of all issues which arise
from it, or until the end of the regular five-year period described above, whichever is later.
No Overdue Tax Debt – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. The Sponsoring Agency shall be responsible for
the payment of all State, local, and Federal taxes. Consistent with N.C.G.S. § 143C-6-23 (c), not for profit
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organizations shall file with DPS and the County a written statement completed by that Sponsoring Agency's board of
directors or other governing body, stating whether or not the Sponsoring Agency has any overdue tax debts, as
defined by N.C.G.S. 105-243.1, at the Federal, State, or local level. This written statement, Certification of No
Overdue Tax Debts, shall be completed by the Sponsoring Agency to certify when there are no overdue taxes. If the
agency has overdue taxes, the Sponsoring Agency must notify DPS at the time of Program Agreement submission.
Conflict of Interest – Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. Consistent with the N.C.G.S. §143C-6-23 (b), not
for profit organizations shall file with DPS and the County a copy of that Sponsoring Agency’s policy addressing
conflicts of interest that may arise involving the Sponsoring Agency’s management employees and the members of its
board of directors or other governing body. The policy shall address situations in which any of these individuals may
directly or indirectly benefit, except as the Sponsoring Agency’s employees or members of its board or other
governing body, from the Sponsoring Agency’s disbursing of State funds and shall include actions to be taken by the
Sponsoring Agency or the individual, or both to avoid conflicts of interest and the appearance of impropriety. The
policy shall be filed before the County or DPS may disburse any funds. The Sponsoring Agency shall also complete
the DPS Conflict of Interest Policy Statement (Form DPS 13 001) and upload the statement and the Sponsoring
Agency's policy addressing conflicts of interest to the JCPC Program Agreement upon submission.
Proof of 501(c) (3) – Not for profit organizations ONLY must comply with this section. This document must be
uploaded in NCALLIES when submitting a Program Agreement. Not for profit organizations must upload proof of
the Sponsoring Agency’s 501 (c) (3) status.
Amendment: This Agreement may not be amended orally or by performance. Any amendment must be requested in
writing by the Sponsoring Agency through submission of a Program Agreement Revision and executed by duly
authorized representatives of DPS, the County Government, JCPC and Sponsoring Agency.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this Program
Agreement violates any applicable law, each such provision or requirement shall continue to be enforced to the extent
it is not in violation of law or is not otherwise unenforceable and all other provisions and requirements of this Program
Agreement shall remain in full force and effect.
Termination for Cause: If, through any cause, the Sponsoring Agency shall fail to fulfill its obligations under this
Program Agreement in a timely and proper manner, DPS shall have the right to terminate this Program Agreement by
giving written notice to the Sponsoring Agency and specifying the effective date thereof. In that event, all finished or
unfinished deliverable items prepared by the Sponsoring Agency under this Program Agreement shall, at the option of
DPS, become its property and the Sponsoring Agency shall be entitled to receive just and equitable compensation for
any satisfactory work completed on such materials, minus any payment or compensation previously made.
Notwithstanding the foregoing provision, the Sponsoring Agency shall not be relieved of liability to DPS for damages
sustained by DPS by virtue of the Sponsoring Agency’s breach of this agreement, and DPS may withhold any
payment due the Sponsoring Agency for the purpose of setoff until such time as the exact amount of damages due
DPS from such breach can be determined. The filing of a petition for bankruptcy by the Sponsoring Agency shall be
an act of default under this Program Agreement.
Termination without Cause: DPS, the County Government, or the Sponsoring Agency may terminate this
Agreement at any time and without cause by giving at least thirty (30) days advance written notice to the other. If this
Program Agreement is terminated by DPS as provided herein, the Sponsoring Agency shall be reimbursed on a pro
rata basis for services satisfactorily provided to DPS under this Program Agreement prior to Program Agreement
termination.
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Waiver of Default: Waiver by DPS of any default or breach in compliance with the terms of this Program Agreement
by the Sponsoring Agency shall not be deemed a waiver of any subsequent default or breach and shall not be
construed to be modification of the terms of this Program Agreement unless stated to be such in writing, signed by an
authorized representative of DPS, County Government, the JCPC and the Sponsoring Agency.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes,
civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event, pandemic, or act of God.
Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and
warranties contained herein shall survive the Program Agreement expiration or termination date unless specifically
provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation.
END OF SECTION V – Terms of Agreement
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SECTION VI: BUDGET NARRATIVE
PAL Academic Career Readiness Fiscal Year FY 21-22
Item #Justification Expense In Kind Expense
120 Administrative Assistant - $12 x 16 hrs week x 50 weeks, plus
FICA
$10,364
120 Career Readiness STEM Instructor - PT $13.50 hr., 24 hours a
week, 44 weeks excluding holidays
$14,256
120 Career Readiness Coordinator $14 hours a week, 40hours a
week, 52 weeks, excluding holidays
$29,120
120 SKIP After-school Tutoring Coordinator -$14.00 hr, 40 hours a
week, 52 weeks, excluding holidays
$29,120
120 SKIP After-school Tutoring Instructor- PT $13.50 hr., 24 hours
a week 44 weeks excluding holidays
$14,256
180 FICA for Four Staff at 7.65% each ($86,752 x 7.65%)$6,637
180 Unemployment and workman's comp for four staff at 6% each
($86,652 x 6%)
$5,206
TOTAL $108,959
Job Title
Annual Expense
Wages
Annual In Kind
Wages
Career Readiness STEM Instructor-(PT) working directly with youth clients on
STEM Enrichment, helping increase grades, working with CTE Program
$14,256
Administrative keeping up with paperwork for JCPC $10,364 $0
SKIP After-school Tutoring Instructor - (PT) Working with youth on homework,
tutoring, enrichment classes.
$14,256
SKIP After-school Tutoring coordinator and court counselor Liaison -monitors
program for success. develops programs to implement, supervises staff, recruit
volunteers, reports on program related to after-school tutoring and homework.
$29,120
Career Readiness Coordinator -working with juvenille court and counselors,
reporting on grant, working with youth on homework, tutoring, enrichment
classes to include college and career
$29,120
TOTAL $97,116 $0
252
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VII Program:PAL Academic Career Readiness
Fiscal Year:FY 21-22 Number of Months:12
Cash In Kind Total
I. Personnel Services $108,959 $108,959
120 Salaries & Wages $97,116 $97,116
180 Fringe Benefits $11,843 $11,843
190 Professional Services* $0
*Contracts MUST be attached
II. Supplies & Materials $0
210 Household & Cleaning $0
220 Food & Provisions $0
230 Education & Medical $0
240 Construction & Repair $0
250 Vehicle Supplies & Materials $0
260 Office Supplies and Materials $0
280 Heating & Utility Supplies $0
290 Other Supplies and Materials $0
III. Current Obligations & Services $0
310 Travel & Transportation $0
320 Communications $0
330 Utilities $0
340 Printing & Binding $0
350 Repairs & Maintenance $0
370 Advertising $0
380 Data Processing $0
390 Other Services $0
IV. Fixed Charges & Other Expenses $0
410 Rental or Real Property $0
430 Equipment Rental $0
440 Service and Maint. Contracts $0
450 Insurance & Bonding $0
490 Other Fixed Charges $0
V. Capital Outlay $0
[This Section Requires Cash Match]
510 Office Furniture & Equipment $0
530 Educational Equipment $0
540 Motor Vehicle $0
550 Other Equipment $0
580 Buildings, Structure & Improv. $0
Total $108,959 $108,959
253
Form JCPC/PA 004 JCPC Program Application
Form structure last revised 12/31/2012
Department of Public Safety
SECTION VIII SOURCES OF PROGRAM REVENUE (ALL SOURCES)
FY 21-22 Harnett County Funding ID: 243-XXXX
Sponsoring Agency: Dunn Police Athletic & Activities League, inc. Program: PAL Academic Career
Readiness
$99,054 DPS/JCPC Funds * This is the amount of your request on your application
10%Local Match Rate Is the Local Match Rate 10%, 20% or 30%?
County Cash (Specify Source)
$9,905 Local Cash The Dunn Police Athletic League will match cash
on the grant
(Specify Source)
Local Cash (Specify Source)
Local In-Kind (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
Other (Specify Source)
$108,959 TOTAL $9,905 $9,905
Required Local Match Match Provided
We, the undersigned, have reviewed this JCPC Program Application to be presented to the Juvenile Crime Prevention Council of this County in
accordance with the procedures established by the local Juvenile Crime Prevention Council. Agencies seeking funding must be able to meet the
applicable requirements of the North Carolina General Statutes, Administrative Code, and the Division of Adult Correction and Juvenile Justice.
We understand and acknowledge that the approval process is first with the Juvenile Crime Prevention Council, second with the County Board of
Commissioners, and the final authority with the Department of Public Safety, Division of Adult Correction and Juvenile Justice.
All parties understand that the availability of funds is contingent upon the appropriation of those funds by the General Assembly of the State of
North Carolina.
/DPSSignature//DPSdt/
Chair, County Board of Commissioners or County Finance Director Date
/JCPCSignature//JCPCdt/
Chair, Juvenile Crime Prevention Council Date
/ProgramSignature/
Rodney Rowland
/Programdt/
6/3/21
Program Manager Date
254
Juvenile Crime Prevention Council Certification
Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification
Form structure last revised January 29, 2021
NC Department of Public Safety Page 1 of 4
Fiscal Year: 2021-2022_____________
County: Harnett Date: 06/11/2021
G.S. 143B-853 allows for a 2-year funding cycle for programs that meet the requirements of the
statute and have been awarded funds in a prior funding cycle. Indicate below if the JCPC plans to
allow for a 1-year or 2-year funding cycle.
(Check 2-year if the JCPC has a mixture of 1-year and 2-year funding.)
1-Year Funding: FY 21-22 2-Year Funding: FY and FY
CERTIFICATION STANDARDS
STANDARD #1 - Membership
A. Have the members of the Juvenile Crime Prevention Council been appointed by
county commissioners? Yes
B. Is the membership list attached? Yes
C. Are members appointed for two-year terms and are those terms staggered? Yes
D. Is membership reflective of social-economic and racial diversity of the community? Yes
E. Does the membership of the Juvenile Crime Prevention Council reflect the
required positions as provided by N.C.G.S. §143B-846? No
If not, which positions are vacant and why?
Person up to age 21, Person up to age 21/Youth Advocate, Representive United Way/other non-profit
STANDARD #2 - Organization
A. Does the JCPC have written Bylaws? Yes
B. Bylaws are attached or on file (Select one.)
C. Bylaws contain Conflict of Interest section per JCPC policy and procedure. Yes
D. Does the JCPC have written policies and procedures for funding and review? Yes
E. These policies and procedures attached or on file. (Select one.)
F. Does the JCPC have officers and are they elected annually? Yes
JCPC has: Chair; Vice-Chair; Secretary; Treasurer.
STANDARD #3 - Meetings
A. JCPC meetings are considered open and public notice of meetings is provided. Yes
B. Is a quorum defined as the majority of membership and required to be present in
order to conduct business at JCPC meetings? Yes
C. Does the JCPC meet six (6) times a year at a minimum? Yes
D. Are minutes taken at all official meetings? Yes
E. Are minutes distributed prior to or during subsequent meetings? Yes
STANDARD #4 - Planning
A. Does the JCPC conduct a minimum of biennial planning process which includes
a needs assessment, monitoring of programs and funding allocation process? Yes
B. Is this Annual or Biennial Plan presented to the Board of County Commissioners
and to DPS? Yes
255
Juvenile Crime Prevention Council Certification (cont'd)
Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification
Form structure last revised January 29, 2021
NC Department of Public Safety Page 2 of 4
STANDARD #5 - Public Awareness
A. Does the JCPC communicate the availability of funds to all public and private
non-profit agencies which serve children or their families and to other interested
community members? ( RFP, distribution list, and article attached) Yes
B. Does the JCPC complete a minimum of biennial needs assessment and make
that information available to agencies which serve children or their families, and
to interested community members? Yes
STANDARD #6 – No Overdue Tax Debt
A. As recipient of the county DPS JCPC allocation, does the County certify that it
has no overdue tax debts, as defined by N.C.G.S. §105-243.1, at the Federal,
State, or local level? Yes
Briefly outline the plan for correcting any areas of standards non-compliance.
Having complied with the Standards as documented herein, the Juvenile Crime Prevention Council may
use up to $15,500 of its annual Juvenile Crime Prevention fund allocation to cover administrative and
related costs of the council. Budget pages (sections VI and VII) printed from NCALLIES detailing the
expenditure's must be attached to this certification.
The JCPC Certification must be received by DPS by June 30th annually.
JCPC Administrative Funds
SOURCES OF REVENUE
DPS JCPC
Only list requested funds for
JCPC Administrative Budget. $15,500
Local
Other
Total $15,500
JCPC Chairperson Date
Chairman, Board of County Commissioners Date
DPS Designated Official Date
C. Is the Funding Plan approved by the full council and submitted to Commissioners
for their approval? Yes
Contact Harnett County Schools for person under 21 representatives and contact other non-profit
organizations for participation
06/11/2021
256
Juvenile Crime Prevention Council Certification (cont'd)
Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification
Form structure last revised January 29, 2021
NC Department of Public Safety Page 3 of 4
Harnett County FY 2021-2022
Instructions: N.C.G.S. § 143B-846 specifies suggested members be appointed by county commissioners to serve on local
Juvenile Crime Prevention Councils. In certain categories, a designee may be appointed to serve. Please indicate the person
appointed to serve in each category and his/her title. Indicate appointed members who are designees for named positions.
Indicate race and gender for all appointments.
Specified Members Name Title Designee Race Gender
1) School Superintendent or designee Jermaine White Asst.
Superintendent B M
2) Chief of Police or designee Tracy Hair Assistant to the
Chief of Police W F
3) Local Sheriff or designee Dominic
Alvarado
Sheriff's Deputy
M
4) District Attorney or designee Michael Onufer ADA M
5) Chief Court Counselor or designee Millicent
Williams
Chief Court
Counselor B F
6) Director, Local Management
Entity/Managed Care Organization
(LME/MCO), or designee
Mary Spell
Care
Coordinator
Specialist
B
F
7) Director DSS or designee Paul Polinski Director, DSS
8) County Manager or designee Letitia Maynor Finance
Accounting
Specialist
F
9) Substance Abuse Professional Melinda
McDonald
10) Member of Faith Community Kimberly
Whitted
Director,
Technology
Infrastructure &
Operations
B F
11) County Commissioner Barbara McKoy County
Commissioner B F
12) Two persons under the age of 21, or
one person under the age of 21 and
one member of the public
representing the interests of families
of at-risk juveniles
13) Juvenile Defense Attorney Chris Hicks Attorney W M
14) Chief District Judge or designee Resson Faircloth Judge W M
15) Member of Business Community Jim Burgin Business
executive W M
16) Local Health Director or designee Avis Watkins-
Smith
Social Worker B F
17) Rep. United Way/other non-profit
18) Representative/Parks and Rec. Carl Davis Director
19) County Commissioner appointee Roseane
Teniente
Project Manager
F
257
Juvenile Crime Prevention Council Certification (cont'd)
Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification
Form structure last revised January 29, 2021
NC Department of Public Safety Page 4 of 4
20) County Commissioner appointee Cindy Delgado Success
Coach/Dropout
Prevention,
Harnett County
Schools
W F
21) County Commissioner appointee Adrian Standish Lead Family
Support
Advocate
W F
22) County Commissioner appointee Lynn Herring Principal,
Harnett County
Schools
W F
23) County Commissioner appointee Matthew Willis Register of
Deeds, Harnett
County
W M
24) County Commissioner appointee Kelly Burns W M
25) County Commissioner appointee
258
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264
265
266
267
268
269
270
271
272
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