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Home My WebLink About071822 agenda packetREGULAR MEETING Date: Monday, July 18, 2022 Time: 6:00 p.m. Location: Commissioners Meeting Room Harnett County Resource Center & Library 455 McKinney Parkway, Lillington Harnett County Board of Commissioners Page | 1 1.Call to order – Chairman Lewis Weatherspoon 2.Pledge of Allegiance and Invocation – Commissioner Brooks Matthews 3.Consider additions and deletions to the published agenda 4.Consent AgendaA.Minutesi.Regular Meeting Minutes of July 5, 2022 ii.Work Session Minutes of July 12, 2022 B.Budget AmendmentsC.Tax Rebates, Refunds and Releases – Motion to approve tax rebates, refunds and releases as requested by the Tax Administrator. D.The Home Builders Association of Raleigh –Wake County is requesting a fee waiver to support their Operation: Coming Home (OCH) initiative. The amount being requested is $1000 for the permit fee and $4840 for the water/sewer fee for a home to be built at lot 64 in Providence Creek for a wounded veteran. E.JCPC requests permission to submit county plan program agreements for the NC Department of Public Safety, Juvenile Crime Prevention Council programs for FY 2022-2023. F.Harnett County Emergency Services is seeking Board approval for a 3 year agreement with the City of Dunn for Harnett County Fire Marshal’s Office to conduct the City's Fire Inspections/Fire Plan Review. The City will compensate the county for this service. This agreement is for a three year period and can be renewed. G.Legal requests the Board of Commissioners adopt the Program Income Policy and Allowable Costs & Costs Principles Policies. These two policies are to ensure compliance with the U.S. Department of Treasury's federal regulations governing expenditures of ARP/CSLFRF funds. The Program Income Policy provides guidance to account for program income earned from the expenditure of funds pursuant to the ARP/CLSFRF award. The Allowable Costs & Costs Principles Policy provides rules and procedures as to those items of cost that are allowable or unallowable pursuant to Title 2 U.S. Code of Federal Regulations Part 200. HCBOC 071822 Pg. 1 Harnett County Board of Commissioners Page | 2 H. Administration requests the Board of Commissioners approve a local appropriation Grant Agreement with Harnett County Fire Chiefs Association in the amount of $120,000 for a Smoke Trailer. I. Administration requests the Board of Commissioners adopt the Harnett County Riverside Drainage Assessment Project Ordinance. J. The Harnett County Public Library requests the Board of Commissioners approve the Library Consolidation Agreement with the Town of Angier, the Town of Coats and the Town of Erwin. K. The Harnett County Public Library requests approval of the budget associated with the consolidation of the municipal libraries. 5. Public Comment Period Period of up to 30 minutes for informal comments allowing 3 minutes for each presentation. Please note the Harnett County Board of Commissioners adopted revisions to the Rules of Procedure, Rule 29. Public Comment Period on April 4, 2022. Speakers are requested to signup prior to the meeting. Speakers may sign up by contacting the clerk at mdcapps@harnett.org at least one hour prior to the start of the meeting or by utilizing the signup sheet at the back of the room. The signup form will be picked up by the clerk 5 minutes before the published meeting start time. 6. Motion to appoint two Commissioners to the Harnett County Economic Development Partnership. 7. County Manager’s Report – Brent Trout, County Manager A. Harnett County Veterans Services Activity Report B. Harnett County Department of Public Health Activities Summary C. Interdepartmental Budget Amendments 8. New Business 9. Closed Session 10. Adjourn CONDUCT OF THE JULY 18, 2022 MEETING Live audio of the meeting will be streamed on the Harnett County Government’s YouTube Channel at https://www.youtube.com/channel/UCU7mTF6HTD65x_98EhAMeMg/featured. HCBOC 071822 Pg. 2 Harnett County Board of Commissioners July 5, 2022 Regular Meeting Minutes Page 1 of 3 HARNETT COUNTY BOARD OF COMMISSIONERS Regular Meeting Minutes July 5, 2022 The Harnett County Board of Commissioners met in regular session on Tuesday, July 5, 2022 at 9:00 am, in the Commissioners Meeting Room, Harnett County Resource Center and Library, 455 McKinney Parkway, Lillington, North Carolina. Members present: Lewis W. Weatherspoon, Chairman Matt B. Nicol, Vice Chairman W. Brooks Matthews, Commissioner Members absent: Barbara McKoy, Commissioner Mark B. Johnson, Commissioner Staff present: Brent Trout, County Manager Dwight Snow, County Attorney Kimberly Honeycutt, Finance Officer Melissa Capps, Clerk Chairman Weatherspoon called the meeting to order at 9:00 am. Commissioner Matthews led the Pledge of Allegiance and provided the invocation. Chairman Weatherspoon called for any additions or deletions to the published agenda. Brent Trout, County Manager, stated we have one deletion, we would like to move Item 7. Motion to appoint two Commissioners to the Harnett County Economic Development Partnership to the July 18, 2022 meeting given the absences today. Commissioner Matthews made a motion to approve the agenda as amended. Vice Chairman Nicol seconded the motion. The motion carried unanimously. Vice Chairman Nicol made a motion to approve the consent agenda. Commissioner Matthews seconded the motion. The motion passed unanimously. The items on the consent agenda were as follows: A.Minutes i.Work Session Minutes of June 13, 2022 ii.Regular Meeting Minutes of June 20, 2022 iii.Work Session Minutes of June 28, 2022 B.Budget Amendments (Attachment 1) C.Administration requests the Board of Commissioners adopt a Resolution requesting NC DOT add Sherman Pines Drive to the secondary road system. (Attachment 2) Item 4Ai HCBOC 071822 Pg. 3 Harnett County Board of Commissioners July 5, 2022 Regular Meeting Minutes Page 2 of 3 D. Harnett County Emergency Services is seeking Board approval to donate two small cargo trailers to the Harnett County Chiefs Association. These trailers will be utilized by the Swift Water Rescue Team and the Honor Guard. These trailers have aged out of our fleet and are excess items. The trailers will be registered and insured under the Harnett County Chiefs Association. E. Harnett County Emergency Services on behalf of Buies Creek Fire Rescue is seeking Board approval to move forward with the demolition of an old building and replacement of that with a metal 45x50x14 with three 12x12 bay doors on the street side of the building with an 8x8 bay door at rear of building. The total cost of the project will be $223,596, Demolition cost $89,810 and new construction cost $133,786. F. The Harnett County Public Library respectfully requests to continue our membership of the NC Cardinal consortium. As a member of this consortium, the Harnett County Library and affiliate/branch libraries have access to a shared catalog with other participating library systems as well as an integrated library system and shared library material. This collaboration with the North Carolina State Library and other member libraries leverages federal and local funds to achieve operational efficiencies and savings for the library while providing more effective use of public library resources. G. The Harnett County Public Library respectfully requests permission to apply for the State Library of North Carolina’s Bright Ideas Grant. The general goal for this grant is to inspire and galvanize libraries with an opportunity that will allow for the design and implementation of creative solutions and innovative ideas to solve unique problems in their communities. If awarded, the Harnett County Library will use grant funds to strengthen capacity, expand access, and engage the Harnett County community with services and programs that improve physical and mental health as well as nutritional education. This grant is for up to $15,000 with no matching funds nor recurring expenses. H. General Services / Animal Services Director requests the Board of Commissioners approve a project ordinance for the amount of $26,750 for Professional Services. The project ordinance will set up funding for the Needs Assessment Study & Conceptual Design project. Shelter Planners of America (SPOA) intends to begin project as soon as possible following Board approval. (Attachment 3) I. DSS would like to use the $125,212.64 of ARPA Funding allocated to Harnett County FNS (Food and Nutrition Services) to pay overtime to employees during the months of July and August of 2022. The funding is to be used to support the counties efforts of administering the FNS program due to the workload increases brought on by the pandemic. These employees will not have a total of 80 hours or more during those two months but need the extra time to work to bring their caseloads current. Since the money has to be spent within July and August and can be spent to administer the program, DSS is requesting a waiver of the 80 hour requirement. J. Harnett Regional Water requests the Board approve an engineering consulting agreement (task order no. 2) with MBD Consulting Engineers PA out of Pinehurst, NC and Conway, SC. This agreement is for the North Harnett Wastewater Treatment Plant Capacity Upgrade Project. This is for the second engineering task order of the project which consists of the preliminary and final design phases. HCBOC 071822 Pg. 4 Harnett County Board of Commissioners July 5, 2022 Regular Meeting Minutes Page 3 of 3 K. Harnett Regional Water requests the Board approve the acceptance of grant funding in the amount $3,800,000 for the North Harnett Waste Water Treatment Plant Capacity Upgrade Project and adopt a Resolution agreeing to meeting the conditions of the grant. (Attachment 4) Chairman Weatherspoon opened the meeting for informal comments by the public, allowing up to 3 minutes for each presentation up to 30 minutes. The following people provided comments: 1. Alan Longman of 234 Hamilton Road, Bunnlevel, NC. 2. Elizabeth Longman of 234 Hamilton Road, Bunnlevel, NC. 3. Paul Johnson of 1002 Sander Road, Bunnlevel, NC. No one else spoke. The public comment period was closed. Commissioner Matthews stated based on the recommendations of the Harnett County Economic Development Director at the June 28, 2022 work session, I make a motion to adopt a Resolution to dissolve the Harnett County Economic Development Council and to form the Harnett County Economic Development Partnership. The motion was seconded by Chairman Weatherspoon and carried unanimously. (Attachment 5) Mr. Trout provided an update on the Library Consolidation efforts. Commissioner Matthews requested an update on the Riverside Project. Mr. Trout shared Coley Price Assistant County Manager, has been working with the County Engineer, looking at costs and I have been looking at the funding available in ARPA and we are likely looking an amendment in funding. State funding and NCDOT assistance was also discussed. Vice Chairman Nicol made a motion to adjourn at 9:15 am. The motion was seconded by Commissioner Matthews and carried unanimously. ____________________________________ ___________________________________ Lewis W. Weatherspoon, Chairman Melissa D. Capps, Clerk HCBOC 071822 Pg. 5 Attachment 1 HCBOC 071822 Pg. 6 HCBOC 071822 Pg. 7 HCBOC 071822 Pg. 8 HCBOC 071822 Pg. 9 Attachment 2 HCBOC 071822 Pg. 10 Attachment 3 HCBOC 071822 Pg. 11 Attachment 4 HCBOC 071822 Pg. 12 HCBOC 071822 Pg. 13 Attachment 5 HCBOC 071822 Pg. 14 Harnett County Board of Commissioners Work Session Minutes July 12, 2022 Page 1 of 3 HARNETT COUNTY BOARD OF COMMISSIONERS Minutes of Work Session July 12, 2022 The Harnett County Board of Commissioners met in work session on Tuesday, July 12, 2022 at 9:00 am, in the Commissioners Meeting Room, Harnett County Resource Center and Library, 455 McKinney Parkway, Lillington, North Carolina. Members present: Lewis W. Weatherspoon, Chairman Barbara McKoy, Commissioner Mark B. Johnson, Commissioner W. Brooks Matthews, Commissioner Member Absent: Matt B. Nicol, Vice Chairman Staff present: Dwight Snow, County Attorney Kimberly Honeycutt, Finance Officer Brent Trout, County Manager Melissa Capps, Clerk Chairman Weatherspoon called the Harnett County Board of Commissioners meeting to order at 9:00 am. Commissioner Matthews led the Pledge of Allegiance and invocation. The following agenda was before the Board of Commissioners: 1.Call to order – Chairman Lewis Weatherspoon 2. Pledge of Allegiance and Invocation – Commissioner Brooks Matthews 3. Update on Farm-City Week; Tim Mathews; Harnett County Extension Director 4.Discuss a request from the Home Builders Association of Raleigh – Wake County to waive fees for the construction of a home at 64 Providence Creek for a wounded veteran; Home Builders Association of Raleigh - Wake County 5.Discuss JCPC request for permission to submit county plan program agreements for the NC Department of Public Safety, Juvenile Crime Prevention Council programs for FY2022-2023; Kimberly Whitted, Juvenile Crime Prevention Council 6.Discuss Dunn Fire Inspections and Plan Review 3 Year Agreement; Larry Smith, Emergency Services Director 7. Discuss Library Consolidation and budget; Angela McCauley, Library Director 8.Discuss Program Income Policy and Allowable Costs & Costs Principles Policy; Christopher Appel, Senior Staff Attorney 9.Discuss Riverside Flood Project Ordinance; Coley Price, Assistant County Manager 10. County Manager’s Report - Brent Trout, County Manager Item 4Aii HCBOC 071822 Pg. 15 Harnett County Board of Commissioners Work Session Minutes July 12, 2022 Page 2 of 3 • July 18, 2022 Regular Meeting Agenda Review • Upcoming meetings and invitations 11. Closed Session 12. Adjourn Tim Mathews, Harnett County Extension Director, provided an update on Farm-City Week to be held November 14th-17th. Paul Kane with the Homebuilders Association of Raleigh-Wake County, Andy Ladner with US Veterans Court and Dallas Poulk with Mattamy Homes shared information regarding a request to waive fees for the construction of a home at 64 Providence Creek for a wounded veteran. Commissioner McKoy made a motion to add this item to the next consent agenda. The motion was seconded by Commissioner Johnson and carried unanimously. Kimberly Whitted, Juvenile Crime Prevention Council, provided information regarding a request to submit county plan program agreements for the NC Department of Public Safety, Juvenile Crime Prevention Council programs for FY2022-2023. Consensus of the Board was to place this item on the next consent agenda. Larry Smith, Emergency Services Director, provided information regarding a request for Board approval for a 3 year agreement with the City of Dunn for Harnett County Fire Marshal’s Office to conduct the City's Fire Inspections/Fire Plan Review. The City will compensate the County for this service. This agreement is for a three year period and can be renewed. Consensus of the Board was to place this item on the next consent agenda. Angela McCauley, Harnett County Library Director, provided information regarding Library Consolidation budgets for Angier, Coats, Erwin and Dunn. Additional discussion included salaries and next steps. Consensus of the Board was to place this item on the next consent agenda. Christopher Appel, Senior Staff Attorney, provided information on a request to adopt the Program Income Policy and Allowable Costs & Costs Principles Policies. These two policies are to ensure compliance with the U.S. Department of Treasury's federal regulations governing expenditures of ARP/CSLFRF funds. The Program Income Policy provides guidance to account for program income earned from the expenditure of funds pursuant to the ARP/CLSFRF award. The Allowable Costs & Costs Principles Policy provides rules and procedures as to those items of cost that are allowable or unallowable pursuant to Title 2 U.S. Code of Federal Regulations Part 200. Consensus of the Board was to place this item on the next consent agenda. Coley Price, Assistant County Manager, reviewed a Project Ordinance for the Riverside Flood Project. Consensus of the Board was to place this item on the next consent agenda. HCBOC 071822 Pg. 16 Harnett County Board of Commissioners Work Session Minutes July 12, 2022 Page 3 of 3 Brent Trout, County Manager, stated we did not receive the Bipartisan Infrastructure Law Grant we had requested for the Jetport. Janice Lane has been hired as the Human Resources Director and will be starting work on July 18th. Commissioner Matthews made a motion to go into Closed Session to discuss certain personnel matters. The motion is made pursuant to NC General Statute Section 143-318.11 (a)(6). The motion was seconded by Commissioner Johnson and carried unanimously. Following a motion to come out of Closed Session, Chairman Weatherspoon called the meeting back into open session. Commissioner Matthews moved to adjourn the meeting at 10:25 am. Commissioner McKoy seconded the motion that carried unanimously. ____________________________________ ___________________________________ Lewis W. Weatherspoon, Chairman Melissa D. Capps, Clerk HCBOC 071822 Pg. 17 Item 4B HCBOC 071822 Pg. 18 HCBOC 071822 Pg. 19 HCBOC 071822 Pg. 20 HCBOC 071822 Pg. 21 HCBOC 071822 Pg. 22 HCBOC 071822 Pg. 23 HCBOC 071822 Pg. 24 HCBOC 071822 Pg. 25 HCBOC 071822 Pg. 26 HCBOC 071822 Pg. 27 HCBOC 071822 Pg. 28 HCBOC 071822 Pg. 29 HCBOC 071822 Pg. 30 HCBOC 071822 Pg. 31 HCBOC 071822 Pg. 32 HCBOC 071822 Pg. 33 HCBOC 071822 Pg. 34 HCBOC 071822 Pg. 35 HCBOC 071822 Pg. 36 HCBOC 071822 Pg. 37 HCBOC 071822 Pg. 38 HCBOC 071822 Pg. 39 HCBOC 071822 Pg. 40 HCBOC 071822 Pg. 41 Bill #Taxpayer Name Bill Date Operator ID (Name) Release Date Orig Bill Amount($) Release Amount($) Bill Amount after Release($) RELEASE REASON: Adjustment 0002249148-2021-2021-0000-00-REG DEES, JON PHILLIP 7/28/2021 AMY GRIFFIN 6/7/2022 116.45 116.45 0.00 0002251859-2021-2021-0000-00-REG CLINE, SAMMY DEWAYNE 7/28/2021 APRIL DIAZ 6/6/2022 25.43 25.43 0.00 0002262817-2020-2020-0000-00-REG REARDON, DERICK LEE 11/18/2020 APRIL DIAZ 5/31/2022 59.00 59.00 0.00 0002262817-2021-2021-0000-00-REG REARDON, DERICK LEE 7/28/2021 APRIL DIAZ 5/31/2022 106.30 53.11 53.19 0002269384-2020-2020-0000-00-REG FAIRCLOTH, DAVID GENE 11/18/2020 APRIL DIAZ 6/13/2022 12.17 12.17 0.00 0002269384-2021-2021-0000-01-REG FAIRCLOTH, DAVID GENE 7/28/2021 APRIL DIAZ 6/13/2022 19.40 19.40 0.00 0002269533-2020-2020-0000-00-REG LEISTER, JAMES LYNN 11/18/2020 APRIL DIAZ 6/13/2022 160.16 160.16 0.00 0002269533-2021-2021-0000-00-REG LEISTER, JAMES LYNN 7/28/2021 APRIL DIAZ 6/13/2022 151.51 151.51 0.00 0002291280-2022-2018-0000-00-REG MAYS, ERIC LERONE 6/21/2022 APRIL DIAZ 6/21/2022 5.47 5.47 0.00 Subtotal 602.70 RELEASE REASON: Full rebate 0002176544-2021-2021-0000-00-REG TAYLOR, HARRIET M 7/28/2021 MARGARET WRIGHT 6/24/2022 153.03 153.03 0.00 0002279364-2021-2021-0000-00-REG WAMBSGANS, MICHAEL A 7/28/2021 AMY BAIN 6/13/2022 114.69 114.69 0.00 Subtotal 267.72 RELEASE REASON: Military 0002274016-2020-2020-0000-00-REG MUSALL, VIRGINIA MAE 8/12/2020 APRIL DIAZ 6/14/2022 11.70 11.70 0.00 Release Reason ALL 6/1/2022 Default Sort-By: Report Parameters: Tax District: Grouping: Bill #,Taxpayer Name,Release Date,Billing Date,Operator ID, Release Amount Data as of: 7/7/2022 6:45:13 PM TR-304 Bill Release Report NCPTS V4Date run: 7/8/2022 11:08:03 AM Release Date Start:Release Date End: 6/30/2022 PAGE 1 of 3 Item 4C HCBOC 071822 Pg. 42 Bill #Taxpayer Name Bill Date Operator ID (Name) Release Date Orig Bill Amount($) Release Amount($) Bill Amount after Release($) 0002283201-2021-2021-0000-00-REG GREER, VIRGINIA MAE 7/30/2021 APRIL DIAZ 6/14/2022 56.42 56.42 0.00 0002283377-2021-2021-0000-00-REG KIRBY, JUSTIN CHRISTOPHER 7/30/2021 STEPHANIE WILSON 6/14/2022 115.27 115.27 0.00 0002286071-2021-2021-0000-00-REG MCANDREWS, JOHN NICHOLAS 7/30/2021 TRACY CLARK 6/22/2022 23.30 23.30 0.00 0002286443-2021-2021-0000-00-REG MALAVE, OSCAR 7/30/2021 APRIL DIAZ 6/20/2022 67.86 67.86 0.00 0002287695-2021-2021-0000-00-REG BRUNS, ISAAC LEVI 7/30/2021 TAMMY HERRING 6/28/2022 30.96 30.96 0.00 Subtotal 305.51 RELEASE REASON: Ownership change 0001765427-2021-2016-0000-00-REG MURRAY, JERRY SHEROD 6/7/2021 MARGARET WRIGHT 6/20/2022 117.55 117.55 0.00 0001765427-2021-2017-0000-00-REG MURRAY, JERRY SHEROD 6/7/2021 MARGARET WRIGHT 6/20/2022 103.32 103.32 0.00 0001765427-2021-2018-0000-00-REG MURRAY, JERRY SHEROD 6/7/2021 MARGARET WRIGHT 6/20/2022 90.01 90.01 0.00 0001765427-2021-2019-0000-00-REG MURRAY, JERRY SHEROD 6/7/2021 MARGARET WRIGHT 6/20/2022 77.61 77.61 0.00 0001765427-2021-2020-0000-00-REG MURRAY, JERRY SHEROD 6/7/2021 MARGARET WRIGHT 6/20/2022 66.12 66.12 0.00 0001765427-2021-2021-0000-00-REG MURRAY, JERRY SHEROD 7/28/2021 MARGARET WRIGHT 6/20/2022 55.56 55.56 0.00 0002257922-2020-2020-0000-00-REG GOMEZ, YEZTLANECY 11/18/2020 MARGARET WRIGHT 6/24/2022 111.12 111.12 0.00 0002257922-2021-2021-0000-00-REG GOMEZ, YEZTLANECY 7/28/2021 MARGARET WRIGHT 6/24/2022 106.07 106.07 0.00 Subtotal 727.36 RELEASE REASON: Removal of SW Fee 0000042644-2022-2018-0000-00-REG HARRIS, ANGELA DENISE 6/28/2022 MARGARET WRIGHT 6/28/2022 101.32 70.00 31.32 0000042644-2022-2019-0000-00-REG HARRIS, ANGELA DENISE 6/28/2022 MARGARET WRIGHT 6/28/2022 99.58 70.00 29.58 0000042644-2022-2020-0000-00-REG HARRIS, ANGELA DENISE 6/28/2022 MARGARET WRIGHT 6/28/2022 112.47 85.00 27.47 Subtotal 225.00 PAGE 2 of 3 HCBOC 071822 Pg. 43 Bill #Taxpayer Name Bill Date Operator ID (Name) Release Date Orig Bill Amount($) Release Amount($) Bill Amount after Release($) RELEASE REASON: SMALL UNDERPAYMENT 0000017986-2022-2021-0070-00-REG FLOOD, PETER M 6/1/2022 KIMBERLY BAKER 6/1/2022 176.88 0.02 176.86 0000026242-2021-2021-0000-00-REG JACKSON, HAROLD 7/28/2021 IVR DPC 6/4/2022 24.90 0.21 24.69 0000034388-2021-2021-0000-00-REG MCCORMICK, MARTHA G 7/28/2021 IVR DPC 6/4/2022 22.14 0.17 21.97 0000036338-2021-2021-0000-00-REG MCNAIR, DANNIE 7/28/2021 KIMBERLY BAKER 6/24/2022 527.42 0.02 527.40 0000050186-2022-2021-0070-00-REG STANCIL, ALEX RAY 5/25/2022 KIMBERLY BAKER 6/6/2022 280.93 0.01 280.92 0002178311-2020-2020-0000-00-REG VIDINHA, MICHAEL JAMES 11/18/2020 KIMBERLY BAKER 6/21/2022 4.79 0.04 4.75 0002255972-2021-2021-0000-00-REG DESJARDINS, VIRGINIA WEGALE JTW 7/28/2021 IVR DPC 6/4/2022 23.66 0.19 23.47 0002261179-2019-2019-0000-00-REG MCDOUGALD, CURTIS EUGENE 8/16/2019 IVR DPC 6/24/2022 11.31 0.10 11.21 0002264823-2019-2019-0000-00-REG MCDOUGALD, CURTIS EUGENE 7/19/2019 IVR DPC 6/29/2022 7.67 0.06 7.61 0002276484-2020-2020-0000-00-REG MCDOUGALD, CURTIS EUGENE 8/12/2020 IVR DPC 6/24/2022 4.40 0.03 4.37 0002277607-2020-2020-0000-00-REG MURCHISON, MICAH JEREL 8/12/2020 IVR DPC 6/7/2022 6.90 0.06 6.84 0002279778-2021-2021-0000-00-REG TRAVIS BASS 7/28/2021 IVR DPC 6/2/2022 87.36 0.65 86.71 0002281270-2021-2021-0000-00-REG DICKER, NICHOLAS DENARD 7/28/2021 IVR DPC 6/24/2022 29.04 0.22 28.82 0002283337-2021-2021-0000-00-REG HILL, JOSEPH RANDOLPH 7/30/2021 TAMMY HERRING 6/9/2022 60.17 0.53 59.64 0002283907-2021-2021-0000-00-REG KLOBCAR, RUTH MCLEMORE 7/30/2021 KIMBERLY BAKER 6/3/2022 17.44 0.13 17.31 0002287141-2021-2021-0000-00-REG SMITH, TEMPIE MCCALL 7/30/2021 KIMBERLY BAKER 6/24/2022 10.53 0.07 10.46 0002287490-2021-2021-0000-00-REG F & J RENTALS 7/30/2021 YVONNE MCARTHUR 6/7/2022 31.22 0.23 30.99 0002287509-2021-2021-0000-00-REG MCDOUGALD, CURTIS EUGENE 7/30/2021 IVR DPC 6/24/2022 18.13 0.14 17.99 Subtotal 2.88 Total 2,131.17 PAGE 3 of 3 HCBOC 071822 Pg. 44 Board Report 7/18/2022 Approved___________________________ To: Harnett County Board of Commissioners Re: Consideration of Refund for Taxes, Interest and Penalities for all Muncipalities Adjustment Reason Bill Number Type Received Amount Refund Amount Name Adjustment 0002076840-2021-2021-0000-00 IND $155.71 $13.22 DUNN, JEFFREY JAMES William R. Tyson Tax Administrator HCBOC 071822 Pg. 45 S:\Clerk to the Board docs\AGENDAS\2022\071822\4d Fee waiver request for July 12 ws.docx Page 1 of 1 Board Meeting Agenda Item MEETING DATE: JULY 18, 2022 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Request to waive permit fees and sewer/water fees for a home to be built at lot 64 in Providence Creek for a wounded veteran. REQUESTED BY: Home Builders Association of Raleigh- Wake County REQUEST: The Home Builders Association of Raleigh –Wake County is requesting a fee waiver to support their Operation: Coming Home (OCH) initiative. The amount being requested is $1000 for the permit fee and $4840 for the water/sewer fee for a home to be built at lot 64 in Providence Creek for a wounded veteran. This will be the 13th Operation: Coming Home OCH project, and the fourth in Harnett County. The organization is planning to hold a groundbreaking event in July with a delivery of the home in November. OCH, is a non-profit organization; therefore Mattamy Homes donates the lot and oversees the build, while depending on our trade partners to donate labor and materials. We will deliver this home to a deserving veteran free of charge. We are asking for you to help donate to this cause by waving the $1000 permit fee and the $4840 water/sewer fee for this lot. We ask for the opportunity for this to be presented to the Commissioner on our behalf. I have provided a link to the OCH homepage for additional information about the program. https://www.hbawake.com/about-operation-coming- home.html FINANCE OFFICER’S RECOMMENDATION: COUNTY MANAGER’S RECOMMENDATION: Item 4D HCBOC 071822 Pg. 46 Juvenile Crime Prevention Council County Plan Harnett County FY 2022-2023 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: Funded Program Agreements JCPC Program Monitoring Reports JCPC Certification Item 4E HCBOC 071822 Pg. 47 2 I. 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. This fiscal year, the Harnett County JCPC has continued to emphasize prioritizing youth that have been referred by the Department of Juvenile Justice and to ensure the JCPC and funded programs met the requirements given by the NC Department of Public Safety. 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. Parent/Family Skill Building 2. Mentoring Services 3. Vocational/Independent Living Skills 4. Clinical Assessments 5. Substance Abuse Treatment 6. Sex Offender Treatment 7. Tutoring/Academic Enhancement 8. Restitution/Community Service 9. Teen Court/Restorative Justice 10. Mediation/Conflict Resolution 11. Group Home Care 12. Runaway/Respite Shelter Care 13. Juvenile Structured Day Programs 14. Interpersonal Skill Building 15. Individual/Family Counseling 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.) HCBOC 071822 Pg. 48 3 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. The publication of the Request for Proposals was on December 21, 2021 and the deadline date was March 1, 2022. 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 - $35,000 2. Harnett County Juvenile Restitution - $88,000 3. Harnett County Sheriffs Department PAL Program - $64,00 4. Healthy Choices - $24,591 5. PAL Academic Career Readiness and School Kids In Power (SKIP) - $92,954 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. The funding planning sessions for the past two fiscal years have been challenging and the JCPC has had to make difficult decisions to prioritize cost-effective dispositional alternatives and intervention programs available for youth to (1) provide intervention when juveniles come to the attention of the juvenile justice system; (2) prevent deeper engagement in the system; or (3) prevent interfaces with juvenile justice as a solution to reducing delinquent behaviors. The amount of funding available limited the JCPC’s ability to fund new initiatives or expand current initiatives at all sponsoring agency’s requested capacity. The JCPC makes the following additional recommendations to (or brings the following to the attention of) the Harnett County Board of Commissioners: 1. Part of each county’s responsibilities when partnering with NCDPS is to plan for a permanent funding stream for delinquency prevention programs to supplement the JCPC allocation. Harnett County requires that program providers provide a 10% match of allocated funds. In order for Harnett County to develop a strong array of JCPC services, the JCPC is recommending the following in Harnett County’s next budget planning sessions in FY 2022- 23 for FY 2023-24: a. That Harnett County increase its match to supplement the NCDPS/JCPC revenues. b. That Harnett County make the investment annually to assist the JCPC in enhancing the service array to prioritize needed programs that address risk and need factors identified by the JCPC Risk and Needs Assessment Committee. 2. The JCPC supports local coalitions, collaborations, partnerships, and projects to bring models of best practices to JCPC funded programs and other grass roots agencies. This serves to HCBOC 071822 Pg. 49 4 develop the professional capacity of those working with at-risk youth throughout the community, which is part of the JCPC’s mission to create awareness and a more efficient community response to juvenile crime and delinquency. 3. The local JCPC is committed to reducing racial and ethnic disparities to address the disproportionate number of minority youth who have contact with the juvenile justice system. The JCPC seeks to impact outcomes at decision points in the juvenile justice system through research, community planning and the development of strategies to educate referral agents on community intervention programs designed to address juvenile crime and delinquency before juvenile justice system entry. Respectfully Submitted, Kimberly Whitted Chairperson, Harnett County Juvenile Crime Prevention Council Date: July 06, 2022 HCBOC 071822 Pg. 50 5 II. Harnett County Funding Plan HCBOC 071822 Pg. 51 6 III. Harnett County Juvenile Crime Prevention Council Organization Name Organization Title Chairperson Kimberly Whitted Campbell University Director, Technology Infrastructure & Operations Vice-Chairperson Roseanne Teniente Public Consulting Group Human Services Consultant Secretary Matthew Willis Harnett County Register of Deeds Register of Deeds Number of Members: 18 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 August 16, 2021 12 Yes September 20, 2021 11 Yes October 18, 2021 10 Yes November 15, 2021 12 Yes December 20, 2021 10 Yes January 24, 2022 12 Yes February 21, 2022 12 Yes March 21, 2022 13 Yes April 18, 2022 11 Yes May 16, 2022 9 Yes June 21, 2022 11 Yes HCBOC 071822 Pg. 52 7 FY2021-22 Harnett County JCPC Committees Committee Description Member Assignments Risk and Needs Assessment Committee Evaluates community risk and needs and develops a continuum of services available to youth in Harnett County; Makes a recommendation to the JCPC for local programming needs to fill gaps of services; identifies protective factors that will enhance the lives of youth and families in the community; Develops Request for Proposals and presents written report and RFP at November meeting; Area Consultant will provide training and technical support. The written report and RFP is required and included in the JCPC Annual Plan and Certification. Rose Teniente Michael Onufer Millicent Williams Barbara McKoy Avis Watkins- Smith Monitoring Committee Evaluates the effectiveness of existing programs and makes recommendations to the Council for changes, if needed; including whether or not a program(s) should receive continue funding for the current fiscal year. Program Monitoring occurs during the December-January timeframe with monitoring reports being provided at the February meeting. Area Consultant will provide training and technical support. Matt Willis Cindy Delgado Carl Davis Dominic Alvarado Jermaine White Debbie Chiovitti Funding Committee After the RFP developed by the Risk and Needs Committee is advertised for 30 days, the Funding and Review Committee meets to review and score program applications. The committee participates in applicant interviews; deliberates funding amounts to applicants; and makes funding recommendations to the full Council. The Funding and Review Committee may meet at other times Cindy Delgado Tracy Hair Adrian Standish HCBOC 071822 Pg. 53 8 of the year to make recommendations for funding that may become available. Mary Spell Nominations/Bylaws Committee Identifies and recruits new members, as necessary; keeps youth serving agencies; recommends/recruits a slate of officers including securing each individual’s consent to serve; developing and presenting Bylaw changes for adoption, as directed by the Chair. Matt Willis Letitia Maynor Avis Watkins- Smith Kimberly Whitted Racial and Ethnic Disparities Committee Conducts relevant planning and define action steps to address disproportionate minority representation among juveniles in Harnett County; identify key partnership potential to address unsupervised youth and employment, mentorship or apprenticeship opportunities. Rose Teniente Michelle Bennett Kimberly Whitted Jermaine White Avis Watkins- Smith Public Awareness Committee Raises awareness of JCPC and community resources for at- risk youth and encourage program participation by youth, especially those involved in the court system; appropriates governmental and community boards to make the general public aware of existing services and the unmet needs in the community. Rose Teniente Lynn Herring HCBOC 071822 Pg. 54 9 IV. 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 Part I. 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. County Risk Factor Observations: FY Harnett County has seen an enormous decrease in the total number of youth dispositions in FY21, dropping to 93 from 197 in the previous fiscal year. Despite the decrease in the number of youth with dispositions, the total number of juvenile complaints in FY21 (476) is the highest number in the past 4 fiscal years, with nearly all originating outside the school environment. FY21 has seen upward trends in the number of youth assessed as being at the highest two risk levels (RL4 and RL5), which means that they are at higher risk of future offending. Of the 93 youth assessed with NC Juvenile Risk Assessment, 68% were assessed at RL4-5, and of the 79 assessed via the YASI Screening, 20.3% were assessed as high risk, compared to the state level of 16.7%. Previous delinquency for Harnett County has been trending upward, with 20% of youth having four or more prior referrals, up from 10% the previous year. Additionally, the percentage of youth with prior class F-1 felonies or A-1 misdemeanors has seen an increase to 17% in FY21, up from 12% the previous year. A larger percentage (19%) had been involved in prior assaults (without a weapon) up from 13% in FY20. The past two fiscal years have seen steady increases in substance use, with 36% of adjudicated youth having used substances or received some treatment for substance use, up from 22% in FY19. HCBOC 071822 Pg. 55 10 There was a noted increase in the percentage of youth that had ever run away from their home or placement, at 26% up from 17% percent the three previous fiscal years. Relationships with delinquent peers has been trending upward in Harnett County, with 29% regularly associating with delinquent peers at 29% and 8% of youth either being a gang member or associating with gang members (up from 14% and 2%, respectively, in FY19). There was an increase in the percentage of parents or guardians of youth that were unable to supervise their teens, despite their willingness to do so. Another risk factor for Harnett County is a lack of adequate supervision skills. 62% of youth adjudicated in FY21 came from homes assessed as having marginal supervision skills, up from 37% in FY19. Part II. 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. County Elevated Needs Observations: FY There were 93 dispositions in Harnett County for the fiscal year 2020-2021. Of the 93 youth with adjudications, 35% were considered medium needs, up from 26% in FY19-20. Another need centers around positive peer relationships. There was a marked decrease in positive peer relationships from the previous fiscal year, and there were significant increases in youth association with delinquent peers and gangs. Nearly half of the youth with dispositions exhibited serious school behavior problems (45%), with 14% below their normal grade level. The past two fiscal years have seen steady increases in substance use, with 36% of adjudicated youth having used substances or received some treatment for substance use, up from 22% in FY19. HCBOC 071822 Pg. 56 11 44% of youth needed more mental health assessment and treatment (up from 33% in the previous year), markedly higher than the state’s rate of 31%. Another need of Harnett County is enhanced development of parenting and supervision skills. 62% of youth adjudicated in FY21 came from homes assessed as having marginal supervision skills, up from 37% in FY19. This is also connected to the high rate of youth coming from homes with other household members having prior histories of criminal involvement and juvenile delinquency. Lastly 42% of the youth came from homes where household members had criminal histories, up from 34% last year, and 6% of families were under active court supervision or had known gang affiliation. Additionally, of the 79 youth assessed with the YASI assessment in FY21, 39.2% came from homes with prior criminal history, compared to the state rate of 26.2%. Part III. Summary of the Existing Community Resources The Harnett County JCPC funded the following programs in FY 2021-2022:  4-H Teen Court  Extended Learning  Harnett County Juvenile Restitution  Healthy Choices  PAL Academic Career Readiness and School Kids In Power (SKIP) Community Resources  WIOA Next Gen-Employment and Training services for youth age 16+  Sandhills Center (Harnett’s LME-MCO) offers behavioral health services, support, education, and events for parents and children, as well as free online screening and referrals.  Harnett County Schools Programs: o Mental Health Program o Behavior Intervention Program o School Counseling Team o Section 504 (Disability) Services, o School Social Work Attendance and Truancy Intervention Program o SafeSchools Alert (alert system for students, parents, and staff to report concerns of bullying or harm) o Say Something Program (teaches middle and high school students to recognize the warning signs of someone at-risk of hurting themselves or others and how to say something to a trusted adult to get help. The Say Something program aligns seamlessly with any school’s existing SEL curriculum, instruction, and HCBOC 071822 Pg. 57 12 programming. Students build essential SEL competencies, including how to empathize with others and seek help when needed (relationship skills) and how to identify problems and analyze situations, as well solve problems in an ethically- responsible manner (responsible decision-making).  Think Smart: Think Smart Outreach Center, Inc. is a non-profit youth organization serving youth grades K-12 in Harnett and surrounding counties.  Boys and Girls Club of Harnett County  Healthy Choices-Family Pride (Parent Skill-Building Program)  NC Extension: 4-H Programming  AMIKids: AMIKids is a nonprofit organization in North Carolina that provides an array of services for youth including mentoring, career and technical education, residential treatment, as well as day treatment including Juvenile Justice Day Treatment, Alternative Education (Charter, Infinity), After School, Delinquency Prevention, Family Services, and Pre-Apprenticeship. While the nearest office location is in Durham, AMIKids service providers are able to travel to meet youth and families in Harnett County. Community Resources available but difficult to access Part IV. Summary of Gaps and Barriers in the Continuum of Services Barriers to JCPC Programs 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. Other gaps in services include parent/family skill-building programs, vocational rehabilitation services, job training and mentoring programs for teens. A service missing in Harnett County includes sex offender treatment programs for youth. While the rate of court-involved youth that have sexually victimized others is low compared to other offenses (approximately 4.5% in FY21), the absence of treatment programs for these youth is a concern. HCBOC 071822 Pg. 58 13 Part V. 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 2022-2023: 1. Parent/Family skill-building programs 2. Mentoring programs 3. Job Training programs 4. Mental health assessment 5. Substance use treatment 6. Sex offender treatment 7. Restorative justice/restitution programs 8. Teen Court HCBOC 071822 Pg. 59 14 V. Harnett County Juvenile Crime Prevention Council Request for Proposals HCBOC 071822 Pg. 60 15 VI. Funding Decisions Summary VII. Funded Program Descriptions See the attached program agreements. HCBOC 071822 Pg. 61 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety North Carolina Department of Public Safety JCPC Program - Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 62 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 63 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 64 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 65 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 66 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 67 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 68 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 69 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 70 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 71 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 72 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 73 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 74 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 75 Form structure last revised 12/20/2013 Department of Public Safety SECTION V Terms of Agreement This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and Harnett County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to as the JCPC) and Dunn Police Athletic & Activities League, inc. (hereinafter referred to as the Sponsoring Agency). DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows: Term of Agreement This Agreement shall become effective Jul 1, 2021 and shall terminate Jun 30, 2022. 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 $99054 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. The Sponsoring Agency shall: 1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 76 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 77 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 78 Form structure last revised 12/20/2013 Department of Public Safety 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 Code and JCPC policy. Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 79 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 80 Form structure last revised 12/20/2013 Department of Public Safety 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. 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 81 Form structure last revised 12/20/2013 Department of Public Safety 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 82 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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 $9,600 120 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%) $5,206 180 Administrative Assistant FICA at 7.65% ($9,600 X 7.65%)$764 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 $9,600 $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 $96,352 $0 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 83 Form JCPC/PA 001 JCPC Program Agreement 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 $96,352 $96,352 180 Fringe Benefits $12,607 $12,607 190 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 84 Form JCPC/PA 001 JCPC Program Agreement 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 approved in 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 /DPSSignature//DPSdt/ Authorizing Official, Department of Public Safety Date The following signature certifies that this program agreement has been locally approved by the Board of County Commissioners. /CountySignature//Countydt/ Chair, County Board of Commissioners or County Finance Director Date The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention Council. /JCPCSignature//JCPCdt/ Chair, Juvenile Crime Prevention Council Date /ProgramSignature//Programdt/ Program Manager Date DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 7/28/2021 7/28/2021 8/2/2021 8/3/2021 HCBOC 071822 Pg. 85 I N T E R N A L R E V E N U E S E R V I C E P .O .B O X 2 5 0 8 C I N C I N N A T I ,O H 4 5 2 0 1 D E P A R T M E N T O F T H E T R E A S U R Y D a t e :A U G 2 1 20 14 D U N N P O L I C E A T H L E T I C &A C T I V I T I E S L E A G U E I N C P O B O X 1 0 6 5 D U N N ,N C 2 8 3 3 5 E m p l o y e r I d e n t i f i c a t i o n N u m b e r : 4 6 -4 2 5 8 7 8 8 D L N : 1 7 0 5 3 0 1 0 3 3 8 0 2 4 C o n t a c t P e r s o n : C U S T O M E R S E R V I C E I D #3 1 9 5 4 C o n t a c t T e l e p h o n e N u m b e r : (8 7 7 )8 2 9 -5 5 0 0 A c c o u n t i n g P e r i o d E n d i n g : D e c e m b e r 3 1 P u b l i c C h a r i t y S t a t u s : 1 7 0 (b ) ( 1 ) ( A ) ( v i ) F o r m 9 9 0 R e q u i r e d : y e s E f f e c t i v e D a t e o f E x e m p t i o n : M a y 1 5 ,2 0 1 3 C o n t r i b u t i o n D e d u c t i b i l i t y : Y e s A d d e n d u m A p p l i e s : N o D e a r A p p l i c a n t : W e a r e p l e a s e d t o i n f o r m y o u t h a t u p o n r e v i e w o f y o u r a p p l i c a t i o n f o r t a x e x e m p t s t a t u s w e h a v e d e t e r m i n e d t h a t y o u a r e e x e m p t f r o m F e d e r a l i n c o m e t a x u n d e r s e c t i o n 5 0 1 (c ) ( 3 )o f t h e I n t e r n a l R e v e n u e C o d e .C o n t r i b u t i o n s t o y o u a r e d e d u c t i b l e u n d e r s e c t i o n 1 7 0 o f t h e C o d e .Y o u a r e a l s o q u a l i f i e d t o r e c e i v e t a x d e d u c t i b l e b e q u e s t s ,d e v i s e s ,t r a n s f e r s o r g i f t s u n d e r s e c t i o n 2 0 5 5 ,2 1 0 6 o r 2 5 2 2 o f t h e C o d e .B e c a u s e t h i s l e t t e r c o u l d h e l p r e s o l v e a n y q u e s t i o n s r e g a r d i n g y o u r e x e m p t s t a t u s ,y o u s h o u l d Jc e e p i t i n y o u r p e r m a n e n t r e c o r d s . O r g a n i z a t i o n s e x e m p t u n d e r s e c t i o n 5 0 1 (c ) ( 3 )o f t h e C o d e a r e f u r t h e r c l a s s i f i e d a s e i t h e r p u b l i c c h a r i t i e s o r p r i v a t e f o u n d a t i o n s .W e d e t e r m i n e d t h a t y o u a r e a p u b l i c c h a r i t y u n d e r t h e C o d e s e c t i o n (s )l i s t e d i n t h e h e a d i n g o f t h i s \l e t t e r . ~..._ .—.^^.——,._,- , , .,■..,—«.»» »»...».-- i : i i i . . l F o r i m p o r t a n t i n f o r m a t i o n a b o u t y o u r r e s p o n s i b i l i t i e s a s a t a x -e x e m p t o r g a n i z a t i o n ,g o t o w w w .i r s .g o v /c h a r i t i e s .E n t e r "4 2 2 1 -P C "i n t h e s e a r c h b a r t o v i e w P u b l i c a t i o n 4 2 2 1 -P C ,C o m p l i a n c e G u i d e f o r 5 0 1 (c )(3 )P u b l i c C h a r i t i e s , w h i c h d e s c r i b e s y o u r r e c o r d )c e e p i n g ,r e p o r t i n g ,a n d d i s c l o s u r e r e q u i r e m e n t s . S i n c e r e l y , D i r e c t o r ,E x e m p t O r g a n i z a t i o n s L e t t e r 9 4 7 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 86 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 87 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 88 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 89 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 90 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592HCBOC 071822 Pg. 91 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592HCBOC 071822 Pg. 92 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592HCBOC 071822 Pg. 93 Certificate Of Completion Envelope Id: 7D5D741CEB2C4FE4B6EEE47D39085592 Status: Completed Subject: DPS eSignature Request for Harnett 243-23366 PAL Academic Career Readiness Source Envelope: Document Pages: 32 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 DPS-DJJ Community Programs AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-05:00) Eastern Time (US & Canada) 3040 Hammond Business Pl Raleigh, NC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.21 Record Tracking Status: Original 7/28/2021 12:02:22 PM Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Location: DocuSign Signer Events Signature Timestamp Captain Rodney Rowland director@dunnpal.org dunnpal.org Security Level: Email, Account Authentication (None)Signature Adoption: Drawn on Device Using IP Address: 65.191.171.195 Sent: 7/28/2021 12:02:24 PM Viewed: 7/28/2021 12:03:03 PM Signed: 7/28/2021 12:03:37 PM Electronic Record and Signature Disclosure: Accepted: 7/31/2019 11:20:27 PM ID: 5de52e88-bd6d-48ff-9edb-033865f625ba Kimberly Whitted kwhitted@campbell.edu Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 76.182.58.128 Sent: 7/28/2021 12:03:38 PM Viewed: 7/28/2021 12:15:03 PM Signed: 7/28/2021 12:15:49 PM Electronic Record and Signature Disclosure: Accepted: 7/28/2021 12:15:03 PM ID: a6857dd9-690b-428c-9e35-b5ca3f564adc Kimberly Honeycutt khoneycutt@harnett.org Finance Officer Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 24.159.160.130 Sent: 7/28/2021 12:15:51 PM Viewed: 8/2/2021 11:44:06 AM Signed: 8/2/2021 3:08:28 PM Electronic Record and Signature Disclosure: Accepted: 8/2/2021 3:08:13 PM ID: 38b2354f-7433-4797-87c8-5a2cd34e8500 Cindy Porterfield cindy.porterfield@ncdps.gov Director of Juvenile Community Programs NC Dept of Public Safety Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 199.90.60.4 Sent: 8/2/2021 3:08:30 PM Viewed: 8/3/2021 11:27:37 AM Signed: 8/3/2021 11:27:42 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign HCBOC 071822 Pg. 94 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/28/2021 12:02:24 PM Certified Delivered Security Checked 8/3/2021 11:27:37 AM Signing Complete Security Checked 8/3/2021 11:27:42 AM Completed Security Checked 8/3/2021 11:27:42 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure HCBOC 071822 Pg. 95 CONSUMER DISCLOSURE From time to time, NC Dept of Public Safety (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM Parties agreed to: Captain Rodney Rowland, Kimberly Whitted, Kimberly Honeycutt HCBOC 071822 Pg. 96 electronically from us. 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HCBOC 071822 Pg. 98 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety North Carolina Department of Public Safety JCPC Program - Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 99 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 100 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 101 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 102 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 103 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 104 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 105 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 106 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 107 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 108 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 109 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 110 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 111 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 112 Form structure last revised 12/20/2013 Department of Public Safety SECTION V Terms of Agreement This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and Harnett County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to as the JCPC) and Dunn Police Athletic & Activities League, inc. (hereinafter referred to as the Sponsoring Agency). DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows: Term of Agreement This Agreement shall become effective Jul 1, 2021 and shall terminate Jun 30, 2022. 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 $99054 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. The Sponsoring Agency shall: 1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 113 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 114 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 115 Form structure last revised 12/20/2013 Department of Public Safety 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 Code and JCPC policy. Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 116 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 117 Form structure last revised 12/20/2013 Department of Public Safety 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. 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 118 Form structure last revised 12/20/2013 Department of Public Safety 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 119 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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 $9,600 120 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%) $5,206 180 Administrative Assistant FICA at 7.65% ($9,600 X 7.65%)$764 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 $9,600 $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 $96,352 $0 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 120 Form JCPC/PA 001 JCPC Program Agreement 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 $96,352 $96,352 180 Fringe Benefits $12,607 $12,607 190 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 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 121 Form JCPC/PA 001 JCPC Program Agreement 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 approved in 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 /DPSSignature//DPSdt/ Authorizing Official, Department of Public Safety Date The following signature certifies that this program agreement has been locally approved by the Board of County Commissioners. /CountySignature//Countydt/ Chair, County Board of Commissioners or County Finance Director Date The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention Council. /JCPCSignature//JCPCdt/ Chair, Juvenile Crime Prevention Council Date /ProgramSignature//Programdt/ Program Manager Date DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 7/28/2021 7/28/2021 8/2/2021 8/3/2021 HCBOC 071822 Pg. 122 I N T E R N A L R E V E N U E S E R V I C E P .O .B O X 2 5 0 8 C I N C I N N A T I ,O H 4 5 2 0 1 D E P A R T M E N T O F T H E T R E A S U R Y D a t e :A U G 2 1 20 14 D U N N P O L I C E A T H L E T I C &A C T I V I T I E S L E A G U E I N C P O B O X 1 0 6 5 D U N N ,N C 2 8 3 3 5 E m p l o y e r I d e n t i f i c a t i o n N u m b e r : 4 6 -4 2 5 8 7 8 8 D L N : 1 7 0 5 3 0 1 0 3 3 8 0 2 4 C o n t a c t P e r s o n : C U S T O M E R S E R V I C E I D #3 1 9 5 4 C o n t a c t T e l e p h o n e N u m b e r : (8 7 7 )8 2 9 -5 5 0 0 A c c o u n t i n g P e r i o d E n d i n g : D e c e m b e r 3 1 P u b l i c C h a r i t y S t a t u s : 1 7 0 (b ) ( 1 ) ( A ) ( v i ) F o r m 9 9 0 R e q u i r e d : y e s E f f e c t i v e D a t e o f E x e m p t i o n : M a y 1 5 ,2 0 1 3 C o n t r i b u t i o n D e d u c t i b i l i t y : Y e s A d d e n d u m A p p l i e s : N o D e a r A p p l i c a n t : W e a r e p l e a s e d t o i n f o r m y o u t h a t u p o n r e v i e w o f y o u r a p p l i c a t i o n f o r t a x e x e m p t s t a t u s w e h a v e d e t e r m i n e d t h a t y o u a r e e x e m p t f r o m F e d e r a l i n c o m e t a x u n d e r s e c t i o n 5 0 1 (c ) ( 3 )o f t h e I n t e r n a l R e v e n u e C o d e .C o n t r i b u t i o n s t o y o u a r e d e d u c t i b l e u n d e r s e c t i o n 1 7 0 o f t h e C o d e .Y o u a r e a l s o q u a l i f i e d t o r e c e i v e t a x d e d u c t i b l e b e q u e s t s ,d e v i s e s ,t r a n s f e r s o r g i f t s u n d e r s e c t i o n 2 0 5 5 ,2 1 0 6 o r 2 5 2 2 o f t h e C o d e .B e c a u s e t h i s l e t t e r c o u l d h e l p r e s o l v e a n y q u e s t i o n s r e g a r d i n g y o u r e x e m p t s t a t u s ,y o u s h o u l d Jc e e p i t i n y o u r p e r m a n e n t r e c o r d s . O r g a n i z a t i o n s e x e m p t u n d e r s e c t i o n 5 0 1 (c ) ( 3 )o f t h e C o d e a r e f u r t h e r c l a s s i f i e d a s e i t h e r p u b l i c c h a r i t i e s o r p r i v a t e f o u n d a t i o n s .W e d e t e r m i n e d t h a t y o u a r e a p u b l i c c h a r i t y u n d e r t h e C o d e s e c t i o n (s )l i s t e d i n t h e h e a d i n g o f t h i s \l e t t e r . ~..._ .—.^^.——,._,- , , .,■..,—«.»» »»...».-- i : i i i . . l F o r i m p o r t a n t i n f o r m a t i o n a b o u t y o u r r e s p o n s i b i l i t i e s a s a t a x -e x e m p t o r g a n i z a t i o n ,g o t o w w w .i r s .g o v /c h a r i t i e s .E n t e r "4 2 2 1 -P C "i n t h e s e a r c h b a r t o v i e w P u b l i c a t i o n 4 2 2 1 -P C ,C o m p l i a n c e G u i d e f o r 5 0 1 (c )(3 )P u b l i c C h a r i t i e s , w h i c h d e s c r i b e s y o u r r e c o r d )c e e p i n g ,r e p o r t i n g ,a n d d i s c l o s u r e r e q u i r e m e n t s . S i n c e r e l y , D i r e c t o r ,E x e m p t O r g a n i z a t i o n s L e t t e r 9 4 7 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 123 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 124 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 125 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 126 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592 HCBOC 071822 Pg. 127 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592HCBOC 071822 Pg. 128 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592HCBOC 071822 Pg. 129 DocuSign Envelope ID: 7D5D741C-EB2C-4FE4-B6EE-E47D39085592HCBOC 071822 Pg. 130 Certificate Of Completion Envelope Id: 7D5D741CEB2C4FE4B6EEE47D39085592 Status: Completed Subject: DPS eSignature Request for Harnett 243-23366 PAL Academic Career Readiness Source Envelope: Document Pages: 32 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 DPS-DJJ Community Programs AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-05:00) Eastern Time (US & Canada) 3040 Hammond Business Pl Raleigh, NC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.21 Record Tracking Status: Original 7/28/2021 12:02:22 PM Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Location: DocuSign Signer Events Signature Timestamp Captain Rodney Rowland director@dunnpal.org dunnpal.org Security Level: Email, Account Authentication (None)Signature Adoption: Drawn on Device Using IP Address: 65.191.171.195 Sent: 7/28/2021 12:02:24 PM Viewed: 7/28/2021 12:03:03 PM Signed: 7/28/2021 12:03:37 PM Electronic Record and Signature Disclosure: Accepted: 7/31/2019 11:20:27 PM ID: 5de52e88-bd6d-48ff-9edb-033865f625ba Kimberly Whitted kwhitted@campbell.edu Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 76.182.58.128 Sent: 7/28/2021 12:03:38 PM Viewed: 7/28/2021 12:15:03 PM Signed: 7/28/2021 12:15:49 PM Electronic Record and Signature Disclosure: Accepted: 7/28/2021 12:15:03 PM ID: a6857dd9-690b-428c-9e35-b5ca3f564adc Kimberly Honeycutt khoneycutt@harnett.org Finance Officer Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 24.159.160.130 Sent: 7/28/2021 12:15:51 PM Viewed: 8/2/2021 11:44:06 AM Signed: 8/2/2021 3:08:28 PM Electronic Record and Signature Disclosure: Accepted: 8/2/2021 3:08:13 PM ID: 38b2354f-7433-4797-87c8-5a2cd34e8500 Cindy Porterfield cindy.porterfield@ncdps.gov Director of Juvenile Community Programs NC Dept of Public Safety Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 199.90.60.4 Sent: 8/2/2021 3:08:30 PM Viewed: 8/3/2021 11:27:37 AM Signed: 8/3/2021 11:27:42 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign HCBOC 071822 Pg. 131 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/28/2021 12:02:24 PM Certified Delivered Security Checked 8/3/2021 11:27:37 AM Signing Complete Security Checked 8/3/2021 11:27:42 AM Completed Security Checked 8/3/2021 11:27:42 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure HCBOC 071822 Pg. 132 CONSUMER DISCLOSURE From time to time, NC Dept of Public Safety (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM Parties agreed to: Captain Rodney Rowland, Kimberly Whitted, Kimberly Honeycutt HCBOC 071822 Pg. 133 electronically from us. 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HCBOC 071822 Pg. 135 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety North Carolina Department of Public Safety JCPC Program - Program Agreement 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 136 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 137 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 138 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 139 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 140 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 141 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 142 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 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. DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 143 Form structure last revised 12/20/2013 Department of Public Safety SECTION V Terms of Agreement This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and Harnett County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to as the JCPC) and Eleventh Judicial District ReEntry, Inc. (hereinafter referred to as the Sponsoring Agency). DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows: Term of Agreement This Agreement shall become effective Jul 1, 2021 and shall terminate Jun 30, 2022. 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 $35000 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. The Sponsoring Agency shall: 1.Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 144 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 145 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 146 Form structure last revised 12/20/2013 Department of Public Safety 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 Code and JCPC policy. Reference: 14B NCAC 11B.0110; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 147 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 148 Form structure last revised 12/20/2013 Department of Public Safety 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. 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 149 Form structure last revised 12/20/2013 Department of Public Safety 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 150 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 151 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 152 Form JCPC/PA 001 JCPC Program Agreement 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 approved in 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 /DPSSignature//DPSdt/ Authorizing Official, Department of Public Safety Date The following signature certifies that this program agreement has been locally approved by the Board of County Commissioners. /CountySignature//Countydt/ Chair, County Board of Commissioners or County Finance Director Date The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention Council. /JCPCSignature//JCPCdt/ Chair, Juvenile Crime Prevention Council Date /ProgramSignature//Programdt/ Program Manager Date DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 7/28/2021 7/28/2021 8/2/2021 8/3/2021 HCBOC 071822 Pg. 153 DocuSignEnvelope |D.9467732A-CAB8-4F08-A1l 163C507C5A2 II]TERNAI, .?EVE}.TU' SEPJ/ICE -f /rmcf r: nTD?aT,'l:!!Jl[rv- P. 0. 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D, A- Dcl{}qrt{c rDii -: ;505 Ccnbact TelePlo;r $':abarl (877) 8;9-550n .Iccou:l'.:.i, rr'1 Feri< ;3 !irr,1i rrg ; June 3ii I'oufioa:icn S:ac::: C:aisiilcacr.s: s0, (a) i1j Advance ltuiiag Perjoci Btgirls: Cctcher 8, 7998 Aiivancf R'-rLirtg Pericd Etlds; .]1If,e JU. ;iUJ -Mrlex3r;m Appl^:c: No Dear APPIica:rt: Rase,iorri::i:lrliallonyorlsuptrlie"dl.a'dassr]llli:igy.:urcpera:ions,,l.{-']i-'ea:+state. i.,r, yor'rr: ...pri-I';il"'"rot tLit'gt'it:io:r'of t,.*'tpi:'''t' xei ha"re deLe:'r';;eC ycu afe exen,pL tro,n teOer-ai-irr."** lax i:irle:: sec:icn SUllai ot L,e Inler;:al icvenue Code as an crgarl.:.zacion describeC in secrion 501 ici {j) ' - Becauge yc! airl:r newly created r;'YganizaL)'o!1' $e are llt: nou rrakirl' a .:::rrri i.e1-a,]:Lrinalicr: of y':u: fnilndaLion sCstus undar sp:;t:l'lr 5OP {'1) oi :1.1 {:ode ' i{owever, ve lr.a1-i det-crnlrLed that you can.rqasor)ah1i. ex?cci \::.bI} a pr'rri'lli1- ^..nF^ire,.l ^'*ar.zaiiI;;;;;t;;; 'i:r st'ctions 5os iai (1) aad i?0{bl i1} (;r) 1'.J-i ' Aer:ordlngly- during al-r adTa::ce -t-.tii:lg lierro-l ycu +:11 'be Lreabed i'':j a cubLir:l,y suppcrt:ed atr-n"'ci"'' a1:: 1oc is-a p:'iva:= Jo'inihLj-rr' f ir j= '1"'ac;c' ;;i;;-;"r;"'J l.';-i-." L:<i erids o;i she da'-e's showi:' abor;=' 'rlillhan -c0 days ai:er L.ile eild of y:ut advance :;uli-lg peri'c'J' f..ou a"j1:i gerrd u6 Lhe infc;:rraii""-"."i.a t0 det;rar,ne !,ihelher yo'-r have net lhe -'ja'r: j.re' nears cli t:1:e a::l':caii" '"pi""' Le-st '3tLr::'! ''i-r: a''iv:lc'-. r''ililrg pelicti' "f lou e$:abl":sb rhae toir h;";;;;;-; pJ:-i"fy.sup'CrLel ors:;:tz':'ti'ci, '*e x:li c:assi- fy ycu as a Ee.cr,ao" iiti"iii:'o. sos(al {:; orgaoizaL;c; aN Long as you rDncirrJe Eo nE€i: ihe rsqriiren*"Lt "l lhe appiicable euppo::t t-es:' }f 1'ou do na: rit3eE t]ie public suppor." ,.!qrit"*o.,"" a'ui:.n' tbe arlva..ce rulirrg pericd, '*e 'vi-: l classify you a6, pti'"t. foun'lat:on icr futurc perirCs- Alqo' if ee iia'seify ;;;";;-I ;.i"r,-= rttrrautio", .re \{i1i rieai you as a privare forurdalica {::crrr your oeqiir.lnq car'e for purpr-ises of seciior 50?idi ari +940' Graniofs e,tiri cont.r:i;uto]--r fliay rely oir cr:: riet'tlr,i:laLij:}l\ Lha: )'cu " nci "' ".ir.,,:" f 3rrn,f:rt:; r:r: tnril 90 d.ays iir:er ehe erC ci )lcur edvancc ruli':r; !' '-^od' t: you sen<l ttg En: J:e.Ili:ej i:riormaL:or' uiEh':':' thc -'i iai's ' g::1rr:l7t :l;'-' corl--:ibu'ig=" ro-t'=o^'Jirrue Lo -':e11- ott:he arl"'a:tce 'ieiel-ni:1aLra:r t:n'-:1 iig ''tki a iirtal del:eLmi.r13tion cf you:: fortn<rai-iori Elet-u5 ' ll v/e pr:bl-islr a ECt:Ce in the 1riEerl]al lr>velrre Er-lll.e[j-r scaEingr [i',.?t se l,etr€r i01-'; rDo/CG) DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 154 DocuSign Envelope lD.9467732A-CAB8-4F08-A1p 363C507C5A2 ), LE-fi Ni',li J ull:c i.i.L L)r s TR I-r1 :{i:.\Ti 7 !jil1 no loQge;- i::eal ylu as a p..&"1.ic1.; suppcrlted ctgarrizatlol, 3rantolt; .':ri .oui:ributors i*a-r-.irL rely,:ir r.:ir:* Ce-utlninaLicl] afLer "le- di-r€ ir'e pub-i.i''ri'r L]re ncLi.ce. .Ia adr,lirrc.n, .if yor,: lose ycur s.atxs as a pub!.icly Eupiarhed olcan-i- UAiiOr. ard a gr;nto: .r1'coitr:ibnlat was resI:r:nsiJ:1e for, cr was aFaz^e:i, the acl c.r'fai-l;r1.e tC aci:, Eha'; resulLed in your iosg of 'Eu'Jh $'iaElis, ahal ?'ll:soli ma, iiota ::e1y oa i:jll€t deEelmirlaEi{:n fronr iiLe {iaer". oi tni act r:r fai.l ur1 iii ACE ' hfic, i.i a !rar.:cl o). contribu'.:cr lear.:reci:hat !{e had given ncci.e Lhat -'.'f-J *o.r1,i be reiovei frOrr clacsi{ieaEiC:: as a prrirliCly SuppolLed' organizat-:r>ri, tii'n' l)ral:;:er-rc:i rna-i ilot rely cn this dete:tnj.natlor as oi Eile riate ha or she acquired eucli kni>trledge. rlyouchs]l.jelloursouxcegofsr:pport.ycrr::p1ilp.ses/Charac{.el,.rneEicd of cperalior, please let. us knoi so we cail consider file effeci cf the chriiqe ol your: (:xeillp: 5Eai.'jS al1d foundabicB shal'.is . T.f yoa a*erld_your organizatj"r!-1 lccur.'.erl ir: i:y).:T :. piease seird rrs a c'ipY of -"be .a;cenCr'C dccume:i1 ot i:':''rt;:': ' A1*o, iel: lis Lrt;,, al-i chenges 'in y'cu:: Iialrl? or adi:ess ''' 1. :531 , '.,'.f i: ara l: able for sccial s"lcrr;f-y Lixes uI"!i'r-As uL udrrrc-; r :Il ar'cu::!= cl S'00 or mf,te '/cL: -) ' ' t':the lrederai fr,slrr:aqQe Contribtrtionc Act ( *r"nrrfyoutemployeeeduringacalendarye-ar-Ycltalect):iiebLelorL';'et'axi*p""",i i:r,ler ii,: ie.ferai Untmp)optLerrl fax 'hc:- {fl-ri}:'i' or-oariizail-,,]ns thaE are liot- privaie fcunelalior:s aI(' n(ll Bu,lject Lc r- i pr!- ,.rc* i.ri.arLicr: sxciue iaxes'urrcl-er ChrpLe:. 42 of the ir,[ernal iieventte ']c';t' i{o'.Jeve:, '.'?11 a:c iJ: a'l:.':la'i:r'.i1'r:-rer'3fj:-rrr c''5t: I*ij:ra1 erJIje La("' -i il".r -t,"r* *a-y qrn=,,irns ab.ruL er,ciie . trliitio)rrlr':iit'-, a:- ullier f eder-al iaxes ' l:lease. let'- ,.:s kncs. Dcnors rla7,led''tct crnt.ribn:il::13 io y<t! as pro';iCecl in secticn 1]0 r:'i lht.l tnaerna] Beverru+ ilorle. ]l.quEsi5, 1e3acies, de'r-ts::;' llissfers' cr gifL:: l:c yotr o: fo! your use a.re- dedlciil)i,e for fitieral est*aLe aril SifE cax p'.]Ipcsa:j ll' *'hey "".t . i-fr,i' applical;le prr:visicrs of sections 2055 , 21tjb ' ,l;id 2s22 cf the '"t:t ' Doacrs rllay deducl cu!1.i.libuLioas L' ltcf, oniy ta bhl1 exl-^qi that bhi: j : ccrrr_rj.5ui.ionr: ;.r::c ,lif ts, wtth i:6 call€i(iel.ailon receiv€..- IickeE pur:oa::l , ,:i:c e:rniIar pa?-mejtljs r;1 conlr*Ctiq,-, ldiCh lundraisinq eYenls flay;ltt rlccessrr':.,.'r' guillify 'as cieeuctjble ceni.riblltions, depenciing on iLe .:r.rcumElat'Lc3s. i{:'':L:lie ir:ling".ai-?,16, p.,rbii_shed in Cumu.Iatj.vr: Eul1el-in t961-i, or1 page i04, gli,+:rr guidelinen .ugrli:ng ilhen Laxpaye:rs ltay deducL pa:'Ire6is for a&rlesron L:'. oi 6ther patt.:,cipaEJ-cn in. fundraising ar:Li-vit'ies lcr :hc:1iy' you aie not rcqui:.ed t.c f.i.ie fo:nr 9?0, Return oE c::gt'tllizaLion Exer:.i:r: I:,ottt IncomB ?ax, lf yeur gross reas-:Fts eac-:r ye6r a::e rormaliy s25.0t)c cr iacrr. lf yolr receiwe a Patm l-lO ;ackage i:r ti--e ,naiI, sintrIy atiil.lh ahe f dltre1 Pr-i-'!'.-r:a, c}lt.:Ii :..:e ha>. r:. :.hl l.r Icl:.r:; : c i:ii:ar- e :'1a: 1'nlrE ':i' :rr I 'J:os3 l'ce:;rl i' ':'c nr;z.mal.1y $?5, J,:)0 ,;l ies-q, atrd Si!t: ihe r-eiultl. Eecaus€ you *rll b€ Lr,rii:.13 as a public cha:alt:, llcr re;uri: tiiing purFoses dLlring y;rr e::cir:'c a<ivaace :r;i i-::g p"rloa, l.,ot shou:c fj.l_e Fo:m 990'tcr each year i:'r 1,r-':r sivance ruliag;r...r"ioil i:hat i,ou ex(cei :he $25,6flJ lili:rg thre;;lio1C e'r=n j.f lcnr souices oI 6..!; (,ri rio ::ot* sa:l$irw {:.s, F'tjb}}c suppor'fi Lesi sper-:i-f j.e'i in i:}l€ headi;g of thi3 ,. tilLcr. I.ett-ct: l0{5 i;.1-\./CC) DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 155 DocuSignEnvelopelD:9467732A-CAB8-4F08-A1A 63C507C5A2 -:.- Er.gv5ltli{ .iLD;c r.11, IJIST;{I{_'! nEE}n,p.y If ;r r;tiirlr. rs reqfutred, j i B)r,i-cl. h€ filed bl7 tie lsti da:/ oI Lhe j .ir:hrnuith after the ::iri of ycur a.nual a.counling peirod" l penai:}- of g.i,l ., uayis cirarged sheu areELln iq fjled laie, rarleie tJrere.i$ ri:sonaile cr,ri,,. for'the Cejay, HolliriveI, l-,Ile I]ld(ittun pentlty chargee caar{ri cxceed SL0,oot :: _. r.f-i. E,:.- .]z i-.: -,..r 4-r --,e /CJj., wlri:ic:.-: :. le .;:. -j-.:or:qar:lzaaions r"il:ie: r;:'css ::eceipt.r exceeci:,g $:l , 000, 0c1-.i ir;. atr)/ ytar.., Lirc -r,e[alr_yis s1c0 per dn? pe" return, l;riess Lhere is ressona,b}: c":use fol ihe dera;,The max.i-mum pena:i1' f;)r afl organlza:iori. .rith grass iecelEr6 exce€iiilg$:,cnc,000 shal-l ;rot exceed $50,000. tlis pe;ralty rEy aisc l:e crargid rI areturi is ncl cenpieie, ^9c, please be sure ycur ietu;ir is complete be_(crl,: vou:ile ir Y'cu a)ie n.i l:equ:.yed to f j;.e iederal i-ncorns E,fx a+;,.rrns rrnlegg y{-,u diesubjecl: ic E]:e t:ax cii ur)re:l-ateal business j.;:co$e :rncr:r ;ect.icn 5 j._1 of a;i;r cocle.7i'.ttl:1Ie 6uh-i.t: Lo this tax, ycl: ru.st fj.ic .1;1 ir:aaf,1i u:;{ !eLuf-n oii i,_,:.:rr90-.'i. Iixernir:. t:'ltr,izaLion Eusines-s rncone 1'ax !eL,-1r:l- rn thi,s LetLe: rv,: arelot 6e|'e1:nj-ni:r:l rrJ:ather anlr of your preeeEt or proirori3d art-iriiaes dr. uiirc-lateg rrr:.de or Lcsixess as dcfined in secaiol 5r3 oi i:li* Cooe. YDU are:-..t,liye-d Lc nake your a:utual fdt'J-i;t avaiia"b,ie fcr pr.&Iiclnspe:Licn for thte€ yeals aftcr lhe::erurn j.s due. Eol are alio requi.r:r:; lor.ake available.r cayy r:f your: exur,ptLon ai:-;l.Lcatio*, ary sr.:FpcrLilg cir:cr;r,rrnls, a]1(i thig exE:{Jr-rrj,r J.ettsr. Fail"':re LC r.ake Lilei;e ric:jlaenEs'availahle fr::prrlrlj-= inspecL|-"r may s'.i):je r:r ycu !.., n'!i1l:.1t1, r:t lil) 1:ir day f ct e,rr:: : ;..,:ile:- .i x n la:. 1-. i.,) cc;r;)i' {-l; := a :,r.trin,rnr cf JtC, j,:i :r, uhe cdsE Jf iar.aua.]. r€:ur:l) . - l-au lee: er-- enr;:aye: rCe:l.tl::ciLrJn r.un;rtr er-ln j i you l.:ve no er:..r ,...ees.rr an enplcyer id*nciSicai-ion.:rurni:e:: was rc: err.iered oi1 yor.lr app)lc:ltio:r 'rre will asriigr-i ar n',::rber t.o r/cu ana ailwise you of iL:. pLease r:se l*:L t1u;nL=:: onall l:et:.jrns yci; :iie ana. ln. all correspond.erlce ?.ith Elle rrrlcrnal iieven.rirllerJi-ce. If rt saj"d in :hp ire;:d:nq oi thj-c leLLe:. tllau an .;C.deed,.ir,,t aopires. :.j-..1dJ:eI)Cur.l eIc l:rs,t.j is .,r: :r:ucEr aJ pa:: cJ 3i.: s :eci.er, Recause this leLter couiri heip us::escivs anlr +lssricns abo.lit rr'our-- ij.:en!islaf,us anC fcit:irJation staLus, you shoul.i keep it in yrriir Fe17narlent aaa"r,"l.,_ - L€ t- Ler io45 i i 13,/cc) DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 156 D1OMTVENI OF PUAL C SAFEP NOT F'OR PR*FIT DPS CONFLTCT OF INTEREST POI,ICY STA"IEII,{EIiT This document is only required frcrn not for profit organizations ONLY: ltt ctt'c'csrclsrtca tt'itft tha j)i.('.{;.5. t43{'-6-33 {h), ct,ar}) (ir{tn/ac sh*l/.{ilc witlt tke Slolc ogent:y/{irrtnlar tt co|tt'o.f-lhe {ir*yltc':; ilgefic1- 1tt/it't u.cltlre,s.sing t:an/lit'ts of inlerasl lhul mayori.sc involt'ing lha (irunlea's ltLtpogcilrcnt eiltpler)ccs rtnd lhe ntcmher.r o./'its hoard o.f'tliratlors or olhar gavernin! bodr. 'l'hc axLcpl 6s tlrc {irun!cc'.t ctuplol,ccs tsr mcnthars ol'its httttrtl or o{her grtrtrning hot/1',.front lha {}rantee'.s rlisbursing o/'stute.fitntl.r ctnd shall inc:ltrdc tlttiotls lct be laliett ht: tlte (}t'*nfea rtr lhe indivithru! , or futtlt to ut,t;iLl ttsnflids o.l'inlarcsl anrl the ilppa{trdlt}te tf itttproltrielr. Agcttt:1' conflict 9J'inttrest trta!il61,shctll bc sttbntittct{ lo lhe f)eStat'inlcilf o./ hrhlit'Sr{b4' OPS}lo n'oid ctttl' tlaIu.t' v iIh tht tji.vhur,scmcnt o/ I)I)S .l('l'('./itncls- 'l'hc Gruntaa shtll suhptit thi.s.fisrw (liol./i* I'rr;fit l)l'S *;n.t'lict of"lntcrtst llolic:1' Slulamcnl !;tsrnr Dl'S' l3 00IS alongtt'ith the og:et?('),'s conflict o{inlerest polil:v'hcn ttppl.t:inglbr./irnding- Accordingly, no member or board lnember of the private. notiprof'it entiry t'nay receive directly or indirectly, an.v funds received fronr lhe State of Narlh Catolina, except for duirv. authorized stall compensation and benefits, and reimbllrsen:lent tbr expenses actgally incurred in connectiou r,vith the prir,ate, nonprofit entity's business and in accorda:rce wilh linal approved grant agreetnents. WHEREAS, {N*me af *titv}desires to require its Board of Directors and'dranaging ernplo,vees to avoid conflicts of interest nr the appearance of icrproprie[' in the disbr-rrseuent of State fr-ir-rds; THEREFORE, no member of the Board of llir*ctors or statI members ol said private. nonprofit entity shail participate in the solicitation. nesotiatiot"t. fonlatiotl, arvard. arbitration. tloclification, or seltlemenl of any contract or grant lunded in rvholc or in pirrt b;,* State lirnds or olany dispute:rrising under such coutt"act or gt'ant n{ren t}:e directot'or staff members stands to benefit. eitlier directly or indirectly. trour such grant or contract; PROYIDED. no merlber of the Board of Dilectors or statl'metnbers shall be deemed to benefit directly or indirectly fi'om an-y contract or grant llnderl in whole or in par1b1' State funds if heishe receives only the salarl- or stipend due to hitl,'her in the nonnal course of employurent rvith, or service to. said pdvate, nonprofit entity. F|RTHEIi.I\{ORE, said private. nonprofit entity has rvritten cont)ict ot- intere st prilicies and reporting procedures applicable to boarcl menrbers, sterlf merrbet's anti volunteers rvho have any interest or aoy autirority regarding the resources of the private, nonprofit entily. Tliese policies lrave been comrnunicated to board tretnbers, staff mernbers and volunteers ancl tull disclosure has becn provided lor any possible appearance of carlflict of interest thal may exist. Forrn DPS i 3 001 Not for Proiit DPS Conllicl ol Intercst Polict' Stalement Form structr.ire lasi t'cvised .lrr11'?02{) NC Depadn.rent of Pr.rblic Safety Pase 1 of3 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 157 NOT F'OR PROI]IT DPS CONFLICT OF INI'EREST POLICY STATEMENT The foltowifig senr€s to identify anrl datanrefit flny personal interest staff members, offiierc, sndinen$ers af the Boord af Directors ru*y have Tltis doeunrcntis als* to be ased to tlisclose finy traqsdctlans thot moy resalt in personal, ftnanclnl, pt'afessian*l ttxtllorlwliticat gilin ut tlw Wtewe o!frPfl. The ststentent requires th$ atlpersolrn{ relatioishipt tn* ffi{ty inippropriatety infiuenee (bi*s) tetisns be dlsclosed. Relttionsiips, be it person*i, linwcinl, prclessionsl awllor politicul arc_tequired to be tlisclosetl i np$, ConJtia ,neflns a eonfiict or the fippeflrunce of rt contlict befi*een the priattte intcrests anrt fficill rcsponsilsilities o{ a person in u positiotr oftrasl, Persons'in a position of ffast itrclude staffnrcntbers ot the Board af Directots- Pr.iv*te, nonprofit entities shall make full diselosure by notice in writing to the full Gcvernirg Boarf,rConncil *II confficts of interest, if "yes- is tnswered to nny of the fallowing, see pftge 3: (Check alt thnt apply) YES NO 1, A Board member is relatecl to a stalf metnber.D 2. A ,strfrrr*"ber in a supervisory <;apacity is related to another staff member whorrt he/she supewises.ii i<.--7 1,"\l i. A staff member is related to anotlter staff rtrernber.D A boald member or staff member has or firay have petsonal, financial, professionalo an#or political gain at the expense cr benefit of the private, nonprofit entity' 4.n l\,?lta\ Ihele is a business entity i1whish a staff, boartl, or'{an:ily nrenrtrcr palticipates that may be vielved as having direct or indirest inf'luenu,e over tlte priya!e,. nonprot!eqtilY's husinqls. *'---- 5.I X e a staff, board, or.larnily mcmber nray be viewed as having direct or indilect linanciai gain fi'ont personal or Lrusitress irrvesturents/interest i1real properly held by that statt, board, ot talnily ntetlber, il C7 i,/\ A stafl'or board rnetnber received honorarium or other compeusation outside of the scope of enrpii-ryrnenUoperations rvith lhe ,rr.rirra$4 nnrrgrjfi.t e.r*-i,ly tEot r..e"at s rr,'.+Vgsrs Jc. rT'*Je ltir. u tr 8. A staff or board tnetnber securerl employment with a competitor or other sirnilar private, nonprofit cntity.i-t R7tl! Ongoing, paid consttlting u'ork orttsidc oJ'the staff trretlrher's cnrrent etnployment ol board member's with youl privatc, nonprollt entity exisls. 9. L]lVt/*\ .[iornt IJPS 13 U0t Nor tol' Prafit t]PS ConfiLct of'l[tet'est Policy Statcment Fornl structilre last revised Jrtty 2020 NC IJcpartnrcnt ot'Public Safbty Page 2 o{'3 1l DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 158 NOT FOR PROFIT DPSCONT.LICToFINTERESTPOLICYSTATEMENT 1. If .Jres,, is checked to any of the aforementioned items, the JCPC Program Manug"r and Board chair must ensure details for any transaction that exists are described and attached to this foim' 2. If this statement fails to list a transaction that may exist that is non-financial in natut€, please attzch details. 3. Details must include at least the name, and, address, or persons involved, and a description of the relationship and the transaction' Note: Failure to disclose any conflict of interest transaction that exists or is potential within your private, nonprofit entity may result in the cessation of any further DPS JCPC State funds' County: Agency's Name: (Legal Applicant) juilia,O b f-lrL, nr4* Federal rax ID #t fb S ! t") b?,b< Private, NonProfit EntrtY Name: Executive Director's Print Name: Sign Board Chair's Print Name: Sign Sworn to and subscribed before me on the Day of the date of said certification 0q /;l -a ( {a Form DPS 13 001 Not for Pi'ofit DPS Conflict of Interest Policy Statement Form structure last levised July 2020 NC Department of Public Safetv (Date of Si ,"st*ffi Page 3 of3 DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 159 Eleventh Judiciol District ReEntry lnc No Overdue Tax Debts' Date of Certification 07 I 74 I 2071 To: State Agency Head and Chief Fiscal Officer Certification: We certify that the Eleventh Judicial District ReEntry forganization's NarneJ does not have any overdue tax debts, as defined by N.C.G.S. 105'743.1, at the federal, State, or locat levet. We further understand that any person who makes a fatse statement in violar-ion of N.C-G-S . 143C-6-73(c) is guilt-y of. a crimJnal offense punishabl.e as provi.ded by N.C.G.S. 143C-144. Sworn Statement: David McCrae [name of Boord Choir] dnd DorOthy Ehters [name of Second Authorizing officiatl being duty sworn, say that we are the Board Chair and Executive Director [Titte of the Second Authorizing Officiatl, respectivety, of 11'h Judicial. District ReEntry lnc. forganizotion's Name] of Liltington and Smithfietd tcityl in the State of NC [state]i and that the foregoing certification is true, accurate and complete to the best of our knowtedge and was made and subscribed by us. We also and understand that any misuse of State funds wiil be reported for further action. Board Chair al.tsl ,l Date I I 3l-4rr Date I I Sworn to and subscribed before of said certification. My Commission Expires: '1-l -/ i i .-r "). ,1 (Notary and Seal) lf there are any questions, ptease contact the Department of Pubtic Safety that funded the program agreement. lf needed, you may contact the North Carotina Office of State Budget and Management, NCGrants@osbm.nc.gov - (91 9) 807 -4795 MS&NCD Form 0008 Eff. Juty 1,2005 Revised Juty 18,7A06'7/07'9/08,7/10 Thjs form is avaitabte in electronic format (Microsoft Word document] at http://ncarts.org/qrants/grant-forms/ rizing Officiat Signature ry,*;"irs DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 160 DocusignEnvelopelD 9467732A-CAB8-4F08-A'1A'63C507C5A2 eie:uqrthiudiglgl,glstyrc! feZnliytlnci': ,, - :,,' ,il,','r";;*u"s",il*i P.t5t Of{ics Fsr 1i5I ca|tFLrcrar:tr\ryr:RgiT poLt.,y :ruil;;1;|rt'Jff: Eleyenrl 'udics Disrr.rrReEnrry, Irc. ills) ses,alol ro* X?;#&;?ffiffi;E;qd 6 g1 1c6ral or prcciysd intetcsr by e staffr$embcr.sr jtuard h{crnber in rn acio:r S:r .nr.iJ.-s ir:, or ha: dla aPp3i::trci of rsulrirg il, gesw.J, orymrzarianal oc prcftrsion*.i gair- A confli.cr of jnrer{sr ocrrrs whcn an a:rplo;re e or Boerd Ma.nbcr hgr r dirccr'or. Sduciary inrer.es|in erorl'rel trlerionship, A confuct of inrrest could ur cl; ia . r Owntr'sUp ltith e xnernber of the Board c} Dirr*crs ot an u:tclc,;ee wherc one or rhc oiher l:s supca,isory *urhoriry ove' the ochu or wjro a dient qho rcreivrs se:rices t Erploy.ql*rl c_f o1 by " a:"SE: c{ rlre Eoard of Dii:crors or r:r e-.npioyea wirere oria or Ae olher tas . superrfucry aurhoricy o,rer r!.e other cr virl a diq:t pho recdves seryiceJ r . Contaelrl relrricnsiri wir]r a i,::eribu of rhe Eorxl ,:f'Dueln.r +. o *rplolee ,.tu.. gru or rire orl',cr las.nipani:or7 ar.rCroriy over th.e oLlrer or rvidr a clierr who recuyes srrvices . Crcditor or dcErpr.te a mcrnb* Cthe bcard of Direrrors c.r xn ernplolce r,here one or rle ortrcq bss sapr<tlscsty authcriy ortr Ac ori:er or r+,ju( a<hear who icceiv.i senlces t . Conr,rltarive sr cc?iJuncr rtiacionsirip wirn a me.nbcr of rheloard o.rDirccrnrs or an cmplo;rcc where ole -or tLe o[ki Iu supcrv:-soy audorirl ofc dre orh* or wirh * cijarr wllo rec*ver scnrcas Tlc dclloiuon uf conflict of interesr includ.s *n, biar or rhc alp.tarance ol birs rn a dec,iron rr:hing process rlar rvould rcllt.t -a d,,z' roir lle]'cd b)' : me*b:: cIl\c crga.rrizr:ior, i:r grcup, ,{r axar:rir, ior'i.rrsc,uce. m:ghc Lvclve a pet:orlwiro rs an enrpiuyci ard e Bori'd hle.nbcr, or r,pctsoo rho is re.trnployee l:d wiro ltes fara'ly m'-mbas i-r consiitanus Enplol,ee Rcsp o nsibilro Il ;s in .rl:e iL:iet*r of ihe cro-r-nr:adoo, i,-rdii{iual srafi an<i tsoard membls ri srrengt}ren rrusc a-nd :onflde,tca in earh oile;, co expcCite resolurion c?problems, ro n::igace 6c efftc: l,r.d ro minimjze otgan-4tionaI alrl ra&riduai rcless clac ca:r be catrseC by a conflicr ofurteres: ;.-t:riFr:I3- aru:. ii'iri r:y l;;iili;i of :',:isic.r, i,ver Lne a?De:rirlce oi'e coniiic; oiiatcrsa Tlris erg+.i,;1jsn scrvcr LIrc coarmuniry as a ,a'1c.1e m.rher ihen only servi.rg * special iatercst grolp, TLe rppearance of r ronfiict of uit-resc (er cause embar.essmenl'to rhe orgmiz:tion and jtoprrd,zc dre crcdibiliry of the orgoniznrion. Any confucc of I'rreresr, potcntirl corfiicrofitlrerrtt,orthiapocrreacsofeco:rI.icc'oftrieressistoberrpori*dtoycursu?efliscrimmedietdy, Eraploycer rc rc :niintern indq,r,rtdeocc and objecrivicv rrjth c[enrs, tht tcarn':air;r, rnd oryanrzacioa EropJoyees are csi]sd tc nrriqtarr a seose.of fairness, c:viliq, crfuc.r, anl rersor:-ai laiegnf.egcl drougL hw, reguiaion, ot crrstorn dces::orrcquire rjrern .-Li -.rriJ'r!- w. v-' ) Employ:e$, membels oi earploycei immadrate iamill urd 4rerc5ers of &c Boatd are pra\ibired fror:: acceprirg giiir, a. Persbrureceiving btnefitsfiou rhe.orguizarion b, &rv pcrsch ot orgarri4doa pafor+ng qr seelmg ro perfoaa sesiccs u.nder conrr*ct ryir! -Jre orgenizarioc c lcrsors ivho are olirere/ise :n a posirion-t,.r benalrr (dnr tLe acrians of any unpicyee of'rhe . 'c:ganiz-ation . Bmployees rnap rvid: the pricr writtae app:ovr-i of rheir.+l^oerruor, recrlvi honoraru (ol icctura: ;:rd ollcr s,ich lctiyirjes tyhj.le on persc:nl da1s, cornpei:siroy rrte. annsal Jeavc; at7*t,e wilhoutXay, If tire enployee a acting in aay o$icial .a!xaL?, honcraria received hy ur tlnplol'rc rn Onnecliou vith acririti.es relethg tu enrlolmenr wjrL the orgairizarion are to I,e piiC ro the.orgrnizadon DocuSign Envelope ID: B131A854-04E8-485E-BB90-68ED6E7C5AA6 HCBOC 071822 Pg. 161 Certificate Of Completion Envelope Id: B131A85404E8485EBB9068ED6E7C5AA6 Status: Completed Subject: DPS eSignature Request for Harnett 543-10619 Healthy Choices Source Envelope: Document Pages: 26 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 DPS-DJJ Community Programs AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-05:00) Eastern Time (US & Canada) 3040 Hammond Business Pl Raleigh, NC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.21 Record Tracking Status: Original 7/28/2021 12:11:45 PM Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Location: DocuSign Signer Events Signature Timestamp Dot Ehlers reentrycp@gmail.com Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 99.116.73.79 Signed using mobile Sent: 7/28/2021 12:11:48 PM Viewed: 7/28/2021 12:14:10 PM Signed: 7/28/2021 12:14:43 PM Electronic Record and Signature Disclosure: Accepted: 7/28/2021 12:14:10 PM ID: a8e4bd21-3770-43d4-97db-5883c17d028d Kimberly Whitted kwhitted@campbell.edu Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 76.182.58.128 Sent: 7/28/2021 12:14:45 PM Viewed: 7/28/2021 12:16:21 PM Signed: 7/28/2021 12:16:39 PM Electronic Record and Signature Disclosure: Accepted: 7/28/2021 12:16:21 PM ID: b0df4d46-539a-4901-8ef8-260785d6b973 Kimberly Honeycutt khoneycutt@harnett.org Finance Officer Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 24.159.160.130 Sent: 7/28/2021 12:16:41 PM Viewed: 8/2/2021 11:45:39 AM Signed: 8/2/2021 3:07:09 PM Electronic Record and Signature Disclosure: Accepted: 8/2/2021 3:07:01 PM ID: b696446f-3422-4b8e-bc14-d3272b5613e2 Cindy Porterfield cindy.porterfield@ncdps.gov Director of Juvenile Community Programs NC Dept of Public Safety Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 199.90.60.4 Sent: 8/2/2021 3:07:11 PM Viewed: 8/3/2021 11:27:50 AM Signed: 8/3/2021 11:27:57 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign HCBOC 071822 Pg. 162 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/28/2021 12:11:48 PM Certified Delivered Security Checked 8/3/2021 11:27:50 AM Signing Complete Security Checked 8/3/2021 11:27:57 AM Completed Security Checked 8/3/2021 11:27:57 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure HCBOC 071822 Pg. 163 CONSUMER DISCLOSURE From time to time, NC Dept of Public Safety (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM Parties agreed to: Dot Ehlers, Kimberly Whitted, Kimberly Honeycutt HCBOC 071822 Pg. 164 electronically from us. 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HCBOC 071822 Pg. 166 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety North Carolina Department of Public Safety JCPC Program - Program Agreement 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 167 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 168 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 169 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 170 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 171 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 172 Form JCPC/PA 001 JCPC Program Agreement 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 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 173 Form JCPC/PA 001 JCPC Program Agreement 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 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 174 Form JCPC/PA 001 JCPC Program Agreement 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 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 175 Form JCPC/PA 001 JCPC Program Agreement 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 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 176 Form structure last revised 12/20/2013 Department of Public Safety SECTION V Terms of Agreement This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and Harnett County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to as the JCPC) and Harnett County Government (hereinafter referred to as the Sponsoring Agency). DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows: Term of Agreement This Agreement shall become effective Jul 1, 2021 and shall terminate Jun 30, 2022. 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 $40000 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. 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; DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 177 Form structure last revised 12/20/2013 Department of Public Safety 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 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; DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 178 Form structure last revised 12/20/2013 Department of Public Safety 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 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 179 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 180 Form structure last revised 12/20/2013 Department of Public Safety 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 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 181 Form structure last revised 12/20/2013 Department of Public Safety 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. 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. DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 182 Form structure last revised 12/20/2013 Department of Public Safety 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 183 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 184 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 HCBOC 071822 Pg. 185 Form JCPC/PA 001 JCPC Program Agreement 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 approved in 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 /DPSSignature//DPSdt/ Authorizing Official, Department of Public Safety Date The following signature certifies that this program agreement has been locally approved by the Board of County Commissioners. /CountySignature//Countydt/ Chair, County Board of Commissioners or County Finance Director Date The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention Council. /JCPCSignature//JCPCdt/ Chair, Juvenile Crime Prevention Council Date /ProgramSignature//Programdt/ Program Manager Date DocuSign Envelope ID: 20FBF7CA-EFED-4B99-ACC2-9ED842FD6906 7/29/2021 7/29/2021 8/2/2021 8/3/2021 HCBOC 071822 Pg. 186 Certificate Of Completion Envelope Id: 20FBF7CAEFED4B99ACC29ED842FD6906 Status: Completed Subject: DPS eSignature Request for Harnett 543-11764 4-H Teen Court and At-Risk Youth Development Source Envelope: Document Pages: 20 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 DPS-DJJ Community Programs AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-05:00) Eastern Time (US & Canada) 3040 Hammond Business Pl Raleigh, NC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.21 Record Tracking Status: Original 7/28/2021 12:21:11 PM Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Location: DocuSign Signer Events Signature Timestamp Jackie Helton jhelton@harnett.org Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 71.65.255.137 Signed using mobile Sent: 7/28/2021 12:21:12 PM Viewed: 7/29/2021 6:23:43 PM Signed: 7/29/2021 6:24:54 PM Electronic Record and Signature Disclosure: Accepted: 7/29/2021 6:23:43 PM ID: 5a660b91-407b-4390-94cd-5ba8e1e96149 Kimberly Whitted kwhitted@campbell.edu Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 76.182.58.128 Sent: 7/29/2021 6:24:55 PM Viewed: 7/29/2021 6:27:32 PM Signed: 7/29/2021 6:27:46 PM Electronic Record and Signature Disclosure: Accepted: 7/29/2021 6:27:32 PM ID: 00bc1773-552b-452f-a571-ad7b102a220c Kimberly Honeycutt khoneycutt@harnett.org Finance Officer Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 24.159.160.130 Sent: 7/29/2021 6:27:47 PM Viewed: 8/2/2021 11:57:52 AM Signed: 8/2/2021 3:05:13 PM Electronic Record and Signature Disclosure: Accepted: 8/2/2021 11:57:52 AM ID: d0df7e18-72e7-44db-88f5-8e05ed30852c Cindy Porterfield cindy.porterfield@ncdps.gov Director of Juvenile Community Programs NC Dept of Public Safety Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 199.90.60.4 Sent: 8/2/2021 3:05:14 PM Viewed: 8/3/2021 11:28:05 AM Signed: 8/3/2021 11:28:10 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign HCBOC 071822 Pg. 187 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/28/2021 12:21:12 PM Certified Delivered Security Checked 8/3/2021 11:28:05 AM Signing Complete Security Checked 8/3/2021 11:28:10 AM Completed Security Checked 8/3/2021 11:28:10 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure HCBOC 071822 Pg. 188 CONSUMER DISCLOSURE From time to time, NC Dept of Public Safety (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM Parties agreed to: Jackie Helton, Kimberly Whitted, Kimberly Honeycutt HCBOC 071822 Pg. 189 electronically from us. 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HCBOC 071822 Pg. 191 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety North Carolina Department of Public Safety JCPC Program - Program Agreement 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 DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 192 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 193 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 194 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 195 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety 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. 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 196 Form JCPC/PA 001 JCPC Program Agreement 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 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, DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 197 Form JCPC/PA 001 JCPC Program Agreement 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 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 198 Form JCPC/PA 001 JCPC Program Agreement 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 199 Form structure last revised 12/20/2013 Department of Public Safety SECTION V Terms of Agreement This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and Harnett County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to as the JCPC) and Harnett County Government (hereinafter referred to as the Sponsoring Agency). DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows: Term of Agreement This Agreement shall become effective Jul 1, 2021 and shall terminate Jun 30, 2022. 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 $81000 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. 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; DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 200 Form structure last revised 12/20/2013 Department of Public Safety 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 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; DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 201 Form structure last revised 12/20/2013 Department of Public Safety 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 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 202 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 203 Form structure last revised 12/20/2013 Department of Public Safety 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 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 204 Form structure last revised 12/20/2013 Department of Public Safety 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. 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. DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 205 Form structure last revised 12/20/2013 Department of Public Safety 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 DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 206 Form JCPC/PA 001 JCPC Program Agreement 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 $1140 (cell phones for program coordinator and assistant at $95 x 12months), postage and faxes $200, internet access for iPad $456 ($38 x 12 months) $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 DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 207 Form JCPC/PA 001 JCPC Program Agreement 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 DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 HCBOC 071822 Pg. 208 Form JCPC/PA 001 JCPC Program Agreement 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 approved in 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 /DPSSignature//DPSdt/ Authorizing Official, Department of Public Safety Date The following signature certifies that this program agreement has been locally approved by the Board of County Commissioners. /CountySignature//Countydt/ Chair, County Board of Commissioners or County Finance Director Date The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention Council. /JCPCSignature//JCPCdt/ Chair, Juvenile Crime Prevention Council Date /ProgramSignature//Programdt/ Program Manager Date DocuSign Envelope ID: 9E998559-F352-42C2-B1AB-70FF84D648B0 8/13/2021 8/13/2021 8/20/2021 8/23/2021 HCBOC 071822 Pg. 209 Certificate Of Completion Envelope Id: 9E998559F35242C2B1AB70FF84D648B0 Status: Completed Subject: DPS eSignature Request for Harnett 543-10591 Harnett County Juvenile Restitution/Community Service P Source Envelope: Document Pages: 18 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 DPS-DJJ Community Programs AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-05:00) Eastern Time (US & Canada) 3040 Hammond Business Pl Raleigh, NC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.21 Record Tracking Status: Original 8/13/2021 2:23:22 PM Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Location: DocuSign Signer Events Signature Timestamp Barry Blevins bblevins@harnett.org Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.86.10.234 Sent: 8/13/2021 2:23:23 PM Viewed: 8/13/2021 3:27:55 PM Signed: 8/13/2021 3:29:04 PM Electronic Record and Signature Disclosure: Accepted: 8/13/2021 3:27:55 PM ID: bdfa65fa-7a80-4e3a-b756-0b552add3bd7 Kimberly Whitted kwhitted@campbell.edu Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 76.182.58.128 Sent: 8/13/2021 3:29:05 PM Viewed: 8/13/2021 3:36:16 PM Signed: 8/13/2021 3:36:36 PM Electronic Record and Signature Disclosure: Accepted: 8/13/2021 3:36:16 PM ID: bdbe6bfd-3820-4ce0-b11b-41588f783ab1 Kimberly Honeycutt khoneycutt@harnett.org Finance Officer Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 24.159.160.130 Sent: 8/13/2021 3:36:37 PM Viewed: 8/20/2021 3:15:01 PM Signed: 8/20/2021 3:18:45 PM Electronic Record and Signature Disclosure: Accepted: 8/20/2021 3:18:37 PM ID: 33e5c170-dd59-43d3-bd2c-226cfa589256 Cindy Porterfield cindy.porterfield@ncdps.gov Director of Juvenile Community Programs NC Dept of Public Safety Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 199.90.60.4 Sent: 8/20/2021 3:18:47 PM Viewed: 8/23/2021 10:01:56 AM Signed: 8/23/2021 10:02:06 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign HCBOC 071822 Pg. 210 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 8/13/2021 2:23:23 PM Certified Delivered Security Checked 8/23/2021 10:01:56 AM Signing Complete Security Checked 8/23/2021 10:02:06 AM Completed Security Checked 8/23/2021 10:02:06 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure HCBOC 071822 Pg. 211 CONSUMER DISCLOSURE From time to time, NC Dept of Public Safety (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign, Inc. (DocuSign) electronic signing system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the â€˜I agreeâ€™ button at the bottom of this document. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after signing session and, if you elect to create a DocuSign signer account, you may access them for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below. Withdrawing your consent If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign â€˜Withdraw Consentâ€™ form on the signing page of a DocuSign envelope instead of signing it. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM Parties agreed to: Barry Blevins, Kimberly Whitted, Kimberly Honeycutt HCBOC 071822 Pg. 212 electronically from us. 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HCBOC 071822 Pg. 214 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety North Carolina Department of Public Safety JCPC Program - Program Agreement SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION FUNDING PERIOD:FY 21-22 DPS/JCPC FUNDING # (cont only)1443XXXX COUNTY:Harnett AREA:Central Area Multi-County:No Multi-Components No NAME OF PROGRAM:Harnett County Sheriffs Department PAL Program SPONSORING AGENCY:Harnett County Government SPONSORING AGENCY PHYSICAL ADDRESS: 200 Alexander Drive Lillington NC 27546 SPONSORING AGENCY MAILING ADDRESS: PO Box 940 Lillington NC 27546 TYPE:Public FEDERAL ID #56-6000306 COMPONENT ID # NAME OF PROGRAM COMPONENT PROGRAM TYPE TOTAL COST OF EACH COMPONENT 32168 PAL Tutoring Tutoring/Academic Enhancement $ 58,500 Total cost of components:$ 58,500 Program Manager Name & Address (same person on signature page) Name:Samantha Blalock Title:Program Manager Mailing Address: PO Box 399 City:lillington Zip:27546 Phone:(910) 893-9111 Ext:0138 Fax:E-mail:sblalock@harnett.org Contact Person (if different from program manager) Name:Mark Hornsby Title: Mailing Address: 2564 old us 421 City:lillington Zip:27546 Phone:(910) 890-5534 Fax:E-mail:dhornsby@harnett.org Program Fiscal Officer (cannot be program manager) Name:Cindy Blaylock Title:Board Treasurer Mailing Address: 345 Caulter Brown Rd City:Lillington Zip:27546 Phone:(910) 237-4580 Fax:E-mail:blaylockcj@gmail.com DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 215 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION I B PROGRAM COMPONENT DESCRIPTION COMPONENT ID #COMPONENT INFORMATION 32168 NAME OF COMPONENT: PAL Tutoring BRIEF DESCRIPTION: The Harnett County Sheriffs PAL program is an after school crime prevention program that utilizes educational, athletic, and recreational activities to create trust and understanding between the community, law enforcement officers and the youth. The PAL Tutoring component will offer tutoring and homework assistance to middle and high school students in underserved areas of Lillington and Western Harnett County. DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 216 Form JCPC/PA 001 JCPC Program Agreement 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 Tutoring Component ID # 32168 What is this component's maximum client capacity at any given time?10 Frequency of client contact per month:6 Anticipated Average Length of Stay:140 Days Total Component Cost:$58,500 ÷ by Estimated # to be served during funding period:20 Estimated Average Cost Per Youth:$2,925 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 DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 217 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION III COMPONENT SUMMARY NAME OF COMPONENT:PAL Tutoring 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. PAL Tutoring Program will provide tutoring services to expose youth in the catchment area to opportunities that may improve academic performance and reduce behavioral issues in their home, school and community. 2. Target Population: Describe the target population, including age, and the steps taken to insure that the target population is served. The program will target middle and high school students in Lillington and western Harnett County. Elementary students have access to Boys and Girls Club tutoring activities on our campus. There is a need for middle and high school students to have access to academic enrichment activities. 3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program. To prevent the kids of Harnett County from entering/ re entering the justice system, prevent substance use disorders, and help youth live more productive and successful lives. 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. 70% Clients will have no new adjudications for a complaint with an offense date after the admission date. 70% Clients will actively participate in tutorial and/or academic enhancement activities as intended by program design/ the service plan. 70% Clients will improve academic skills/performance. 70% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months following completion. 70% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following completion. 70% Clients will successfully or satisfactorily complete services as intended by the program design/service plan. 70% Clients will reduce specific problem behaviors presented at referral and targeted in the individual service plan. 70% Clients will have no new complaints 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 PAL program will directly address the needs of adjudicated juveniles by providing them with a positive environment, tutoring and mentorship. The program utilizes educational, athletic, and recreational activities to create positive relationships between law enforcement and youth, and to give the youth a positive outlet. PAL Tutoring will DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 218 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION III COMPONENT SUMMARY NAME OF COMPONENT:PAL Tutoring 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 and behavioral improvement so they will have the opportunity to thrive in their home, school and community. Program staff will coordinate with local schools and teachers to ensure the student is getting academic and behavior management assistance according to their individual needs. 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. DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 219 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION IV COMPONENT NARRATIVE (attach for each component) NAME OF COMPONENT:PAL Tutoring 1. Location: List physical address(es) and describe where program services are delivered. The tutoring component will be housed in a remodeled elementary school located at 645 Shawtown Road Lillington NC, 27546. The program will have an individual room with a capacity of up to 10 youth per session. The campus is shared with the Harnett County Boys and Girls Club and a representative from Workforce Development. 2. Operation: Describe the daily/weekly schedule of program operation. The program will operate Tuesday through Thursday from 3:00pm to 7:00pm 3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and position(s) responsibilities relative to this component. 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 and submit to background screening. PAL 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 may work behind the scenes on administrative tasks. Current Roles: Director - Deputy Mark Hornsby Responsibilities: Plans day to day operations, fundraising, budgeting, and mentorship Experience : 30 years in law enforcement 10 year volunteer with Dunn PAL program DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 220 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION IV COMPONENT NARRATIVE (attach for each component) NAME OF COMPONENT:PAL Tutoring Program Manager/Tutoring Coordinator - Vacant Position Pending Funding Responsibilities: program development and implementation; plan and deliver daily activities Experience: Bachelors degree in human service field 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. Referrals: The program will receive a written referral form for juveniles or family members to participate in the program. The program shall: 1. Receive a written referral form to identify individual program and juvenile or family needs. The referral form shall indicate the reason for referral and the concern(s) to be addressed and, provide other information as needed by the program to facilitate screening and admission decisions. 2. Program Staff will schedule initial appointment with the juvenile and the parent(s)/legal guardian(s) within fifteen (15) business days of the referral to schedule. Admissions: Programs shall develop admission criteria covering age and gender appropriateness, the primary reasons for which juveniles are considered for admission and any applicable admission restrictions. All JCPC funded admissions will include: Application; Referral Form Consent to Release of Information; Participation Agreement Form signed by youth, parent/guardian, and staff; Risk Assessment; Individual Plan of Care/Service Plan signed by youth, parent/guardian, and staff; Staff will 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. 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 Staff may terminate youth for the following reasons: Successful termination: At end of 20 week mark, student has successfully completed assignments and grades have increased by 1 or more grade levels for the 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. DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 221 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION IV COMPONENT NARRATIVE (attach for each component) NAME OF COMPONENT:PAL Tutoring Satisfactory termination: Moved out of county Unsuccessful completion and/or non-compliant termination Quit School or repeated violation Harnett PAL rules Program Staff 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 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 will review the case status with the referring agency prior to a final termination decision. Prior to the termination, Program 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. Program Staff will determine termination procedures and contact parent/guardian and the referral agency of compliance and termination. Program Staff 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 from the PAL Tutoring Program. How is the referring agency involved with the termination process? N/A 7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring agencies including how client progress will be communicated. The PAL Tutoring Program will communicate with Juvenile Court Counselors as needed to meet the individual needs of the youth served. We will collaborate with other organizations in order to improve support networks around youth involved in the 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? Harnett PAL Tutoring Program Staff will 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 yout in any way. Program Staff supports positive redirection and self reflection for behavior management. Staff will develop and implement Individual Service DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 222 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION IV COMPONENT NARRATIVE (attach for each component) NAME OF COMPONENT:PAL Tutoring Plan/Behavior Modification Plans that use current best practice strategies for youth who consistently display negative behaviors. We will align our behavioral expectations of students with the Harnett County School System. We believe that positive interaction between adults and youth are essential to the development of a student’s social and emotional health. Program Staff is responsible for teaching youth initiate self-control over 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 Harnett PAL Tutoring Program. Program Staff will practice preventive discipline by establishing a strong curriculum and ensuring engagement with classroom materials, peers, and adults. Program Staff recognizes that youth come to the Program bring their own experiences and traumas. Program Staff will reinforce more acceptable or alternative behaviors and using redirection to more appropriate activities when youth displays undesired behaviors. Youth 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. As a country, we are spending a tremendous amount of money toward incarceration and treatment for substance use disorders. Early intervention programs not only prevent youth entering the justice system and SUD's, but it can give the youth a productive and more successful life going forward. Harnett PAL Tutoring Program will strategize delivery of tutoring services that meet NCDPS standards and give youth a positive outlet, mentorship, and educational opportunities that can drastically change their life and perspective. As we grow, we are interested in incorporating parent education so we can lean in to the youth's environment to support long-term change and growth. DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 223 Form structure last revised 12/20/2013 Department of Public Safety SECTION V Terms of Agreement This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and Harnett County, (hereinafter referred to as the County), the County’s Juvenile Crime Prevention Council (hereinafter referred to as the JCPC) and Harnett County Government (hereinafter referred to as the Sponsoring Agency). DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows: Term of Agreement This Agreement shall become effective Jul 1, 2021 and shall terminate Jun 30, 2022. 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 $39500 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. 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; DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 224 Form structure last revised 12/20/2013 Department of Public Safety 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 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; DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 225 Form structure last revised 12/20/2013 Department of Public Safety 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 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. DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 226 Form structure last revised 12/20/2013 Department of Public Safety 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 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 DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 227 Form structure last revised 12/20/2013 Department of Public Safety 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 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. DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 228 Form structure last revised 12/20/2013 Department of Public Safety 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. 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. DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 229 Form structure last revised 12/20/2013 Department of Public Safety 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 DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 230 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION VI: BUDGET NARRATIVE Harnett County Sheriffs Department PAL Program Fiscal Year FY 21-22 Item #Justification Expense In Kind Expense 120 Director (30% of time committed to program) $50,000 x 30% = $15,000 $15,000 120 Tutoring Coordinator 30 hrs x $20 = $600 x 40 weeks $24,000 180 FICA $24,000 x 7.65%$1,836 220 Food, snacks, drinks for 145 days at $17.25 per day/session = $2,500 $2,500 230 Paper, pencils,and school supplies $500, Smartboard $2700, Flat screen TV $850, Personal laptop for assistant $800, Computer software $314, student computers 15 x $200 = $8,164 $8,164 340 Brochures and posters $1,000 370 Advertising in local publications $500 410 Tutoring Space, 1 room x $500 per month x 8 months $4,000 450 Liability Insurance Annually $1,500 TOTAL $39,500 $19,000 Job Title Annual Expense Wages Annual In Kind Wages Director (30% of time committed to program) $50,000 x 30% = $15,000 $15,000 utoring Coordinator 30 hrs x $20 = $600 x 40 weeks $24,000 TOTAL $24,000 $15,000 DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 231 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety SECTION VII Program:Harnett County Sheriffs Department PAL Program Fiscal Year:FY 21-22 Number of Months:8 Cash In Kind Total I. Personnel Services $25,836 $15,000 $40,836 120 Salaries & Wages $24,000 $15,000 $39,000 180 Fringe Benefits $1,836 $1,836 190 Professional Services* $0 *Contracts MUST be attached II. Supplies & Materials $10,664 $10,664 210 Household & Cleaning $0 220 Food & Provisions $2,500 $2,500 230 Education & Medical $8,164 $8,164 240 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 $1,500 $1,500 310 Travel & Transportation $0 320 Communications $0 330 Utilities $0 340 Printing & Binding $1,000 $1,000 350 Repairs & Maintenance $0 370 Advertising $500 $500 380 Data Processing $0 390 Other Services $0 IV. Fixed Charges & Other Expenses $1,500 $4,000 $5,500 410 Rental or Real Property $4,000 $4,000 430 Equipment Rental $0 440 Service and Maint. Contracts $0 450 Insurance & Bonding $1,500 $1,500 490 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 $39,500 $19,000 $58,500 DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F HCBOC 071822 Pg. 232 Form JCPC/PA 001 JCPC Program Agreement 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: 1443XXXX Sponsoring Agency: Harnett County Government Program: Harnett County Sheriffs Department PAL Program $39,500 DPS/JCPC Funds * This is the amount approved in 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) $19,000 Local In-Kind Harnett County Sheriffs Office (Director Salary); Harnett PAL (Space for Program) (Specify Source) Other (Specify Source) Other (Specify Source) Other (Specify Source) Other (Specify Source) $58,500 TOTAL $3,950 $19,000 Required Local Match Match Provided /DPSSignature//DPSdt/ Authorizing Official, Department of Public Safety Date The following signature certifies that this program agreement has been locally approved by the Board of County Commissioners. /CountySignature//Countydt/ Chair, County Board of Commissioners or County Finance Director Date The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention Council. /JCPCSignature//JCPCdt/ Chair, Juvenile Crime Prevention Council Date /ProgramSignature//Programdt/ Program Manager Date DocuSign Envelope ID: 56683086-AEAA-4C6C-BB8C-7F7FFA76584F 11/16/2021 11/16/2021 11/16/2021 11/18/2021 HCBOC 071822 Pg. 233 Certificate Of Completion Envelope Id: 56683086AEAA4C6CBB8C7F7FFA76584F Status: Completed Subject: DPS eSignature Request for Harnett 1443-23559 Harnett County Sheriffs Department PAL Program Source Envelope: Document Pages: 19 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 DPS-DJJ Community Programs AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-05:00) Eastern Time (US & Canada) 3040 Hammond Business Pl Raleigh, NC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.7 Record Tracking Status: Original 11/16/2021 12:08:20 PM Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Location: DocuSign Signer Events Signature Timestamp Samantha Jo Blalock sblalock@harnett.org Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.86.10.234 Sent: 11/16/2021 12:08:21 PM Viewed: 11/16/2021 12:10:03 PM Signed: 11/16/2021 12:18:07 PM Electronic Record and Signature Disclosure: Accepted: 11/16/2021 12:10:03 PM ID: 2246be7d-b360-4b1e-afd8-8370ecfcd219 Kimberly Whitted kwhitted@campbell.edu Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 152.38.26.204 Sent: 11/16/2021 12:18:08 PM Viewed: 11/16/2021 12:23:13 PM Signed: 11/16/2021 12:23:45 PM Electronic Record and Signature Disclosure: Accepted: 11/16/2021 12:23:13 PM ID: ae5a2039-4d5d-48f7-b0ad-c2d9fc155b29 Kimberly Honeycutt khoneycutt@harnett.org Finance Officer Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 24.159.160.130 Sent: 11/16/2021 12:23:46 PM Viewed: 11/16/2021 12:39:43 PM Signed: 11/16/2021 3:55:05 PM Electronic Record and Signature Disclosure: Accepted: 11/16/2021 12:39:43 PM ID: 7b28e26c-eb54-4ed5-aa6c-4fdb50168b99 Cindy Porterfield cindy.porterfield@ncdps.gov Director of Juvenile Community Programs NC Dept of Public Safety Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 174.212.98.249 Signed using mobile Sent: 11/16/2021 3:55:07 PM Viewed: 11/18/2021 2:31:31 PM Signed: 11/18/2021 2:31:42 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign HCBOC 071822 Pg. 234 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 11/16/2021 12:08:21 PM Certified Delivered Security Checked 11/18/2021 2:31:31 PM Signing Complete Security Checked 11/18/2021 2:31:42 PM Completed Security Checked 11/18/2021 2:31:42 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure HCBOC 071822 Pg. 235 CONSUMER DISCLOSURE From time to time, NC Dept of Public Safety (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign, Inc. (DocuSign) electronic signing system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the â€˜I agreeâ€™ button at the bottom of this document. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after signing session and, if you elect to create a DocuSign signer account, you may access them for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below. Withdrawing your consent If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign â€˜Withdraw Consentâ€™ form on the signing page of a DocuSign envelope instead of signing it. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM Parties agreed to: Samantha Jo Blalock, Kimberly Whitted, Kimberly Honeycutt HCBOC 071822 Pg. 236 electronically from us. How to contact NC Dept of Public Safety: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by email send messages to: david.pozun@ncdps.gov To advise NC Dept of Public Safety of your new e-mail address To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must send an email message to us at david.pozun@ncdps.gov and in the body of such request you must state: your previous e-mail address, your new e-mail address. We do not require any other information from you to change your email address.. In addition, you must notify DocuSign, Inc. to arrange for your new email address to be reflected in your DocuSign account by following the process for changing e-mail in the DocuSign system. To request paper copies from NC Dept of Public Safety To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an e-mail to david.pozun@ncdps.gov and in the body of such request you must state your e-mail address, full name, US Postal address, and telephone number. We will bill you for any fees at that time, if any. To withdraw your consent with NC Dept of Public Safety To inform us that you no longer want to receive future notices and disclosures in electronic format you may: i. decline to sign a document from within your DocuSign session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an e-mail to david.pozun@ncdps.gov and in the body of such request you must state your e-mail, full name, US Postal Address, and telephone number. We do not need any other information from you to withdraw consent.. 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Acknowledging your access and consent to receive materials electronically HCBOC 071822 Pg. 237 To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please verify that you were able to read this electronic disclosure and that you also were able to print on paper or electronically save this page for your future reference and access or that you were able to e-mail this disclosure and consent to an address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format on the terms and conditions described above, please let us know by clicking the â€˜I agreeâ€™ button below. By checking the â€˜I agreeâ€™ box, I confirm that: • I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC CONSUMER DISCLOSURES document; and • I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and • Until or unless I notify NC Dept of Public Safety as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to me by NC Dept of Public Safety during the course of my relationship with you. HCBOC 071822 Pg. 238 Program: 4-H Teen Court and At-Risk Youth Development Teen Court is a community resource for the diversion of cases in which juveniles have allegedly committed certain offenses for hearing by a jury of their peers. The juvenile may be assigned counseling, restitution, curfews, community service or other rehabilitative measures. Monitoring meeting: 2/9/22 Youth served per Program Agreement: 28 Youth actually served in 1st 6 months: 5 On track: No Why not: Low referrals from Juvenile Justice and the school system. School resource officers have been limited with their interactions with students and involvement with school discipline issues. The number of referrals from Juvenile Justice has been reduced because youth/cases are not eligible for their service. Covid has also had an impact on services. Measurable Objectives: Objectives goals are set between 75-95%. All goals have been met with 100%. Intake forms and client documentation was provided for program assessment. Per the Program Enhancement Plan (PEP), additional pandemic protocols were needed and the program manual needed to be updated. This is currently being updated. Financials: Statements were presented and were up-to-date with financial information. There was a refund of 3,990.00 due in September. There were no staff vacancies. Funding is on track with proposed program agreement. Court Counselor review: Two court counselors reported making no referrals, although there is regular communication between agencies and services are easily accessible. One stated that there were no juveniles for this service and other stated no cases have been applicable, but has encouraged law enforcement to make direct referrals and provided brochure. Recommended for funding: Yes with conditions that referrals will increase this year as Covid conditions improve. HCBOC 071822 Pg. 239 Program: Dunn PAL Academic Career Readiness/SKIP Program provides tutoring and vocational skills for children. Youth served per Program Agreement: 40 total Youth actually served in 1st 6 months: 56 ( SKIP: 35 Career Readiness: 21) On track: Yes Monitoring date: 2/7/22 Measurable Objectives: Objectives have all been met and exceeded the program’s set goals. Example: Clients will have no new adjudications for a complaint with an offense date after the admission date. Goal: 80% Actual: 100% Program provided grade reports, attendance data, and documentation for client’s progress. Observations: There were discrepancies in numbers on the monthly reports for clients served. They were advised to update and correct this data on monthly reports so it is consistent. Documentation was received with client names and other information visible. This information needs to be blacked out for confidentiality reasons. In the Program Enhancement Form (PEP) it was recommended for the agency to provide more staff training and to address staff turnover. Dunn PAL stated stated that there has been staff trainings and they were asked to provide documentation to verify trainings. We have not received this information as of 2/14/22 There were job vacancies, but they have since been filled. Financials: According to financial reports, the program appears to be on track with funding and not over or under expended. Some financial data was provided and it was requested to send additional information by submitting a stand-alone expense report to include monies received and expenditures. We have not received this information as of 2/14/22 Court Counselor review: Approximately counselors have not used Dunn PAL as a resource. Those familiar with the program state that services are easily accessible and communication between agencies is good. Recommended for funding: Yes HCBOC 071822 Pg. 240 Program: Healthy Choices Program Healthy Choices is an interpersonal skills group for youth. Evidenced based curriculum is used to teach communication, stress and anxiety management, decision making skills, anger management, and conflict resolution. Workshops/meetings are provided for parents as well. Monitoring meeting: 2/9/22 Youth served per Program Agreement: 20 Youth actually served in 1st 6 months: 1 client through 12/21 but currently serving 8 On track: No Why not: Low referrals from Juvenile Justice and Truancy Court, and Covid related issues. The program has begun working with STAR Academy and has received several referrals in just a few weeks. This partnership should increase the number of youth served to line up more with the Program Agreement. TND and Life Styles curriculums are currently used in groups. Measurable Objectives: Objectives goals are set at 80%. All goals have been met and some have exceeded expectation with 100% Per the Program Enhancement Plan (PEP), additional training for staff was requested. Training is now provided every other month for staff to learn about the curriculum programs and how to implement them. Pre and post-test information, attendance, and grades are all used to assess the program. The program is providing more mentoring to students this current year. The program has worked hard to find new referral sources by contacting community resources and school personnel. Financials: Statements were presented and were up-to-date with financial information. Expenditures and revenues are consistent with the Program Agreement. There were no staff vacancies, but contractual employees are used to assist with program delivery. Court Counselor review: Referrals are not consistent between counselors. Some counselors have made and others have not made referrals to this program. It was stated that no cases have been applicable to refer, although the program has been used in the past. Another stated communication is good and services are easily accessible. Juveniles reported that they enjoy the group sessions and the virtual meetings make it easy to attend since transportation can be a problem for some. Recommended for funding: Yes with conditions that referrals will continue to increase this year as Covid conditions improve HCBOC 071822 Pg. 241 Program: Harnett County Juvenile Restitution/Community Service Program Restitution works with juveniles who have been ordered to pay monetary restitution to a victim or perform community service. The program serves as a community based sanction to hold youth accountable for their actions in the least restrictive settings. Monitoring meeting: 2/7/22 Youth served per Program Agreement: 90 Youth actually served in 1st 6 months: 26 ( ages 10-13: 8 ages 14-17: 18) On track: No Why not: Low referrals, number of diversions from Juvenile Justice, and Covid related issues. Measurable Objectives: Objectives have all been met and exceeded the program’s set goals. Example: Clients will complete restitution or community service within the timeframe permitted by JCPC policy. Goal: 75% Actual: 92.86%. Six and 12 month follow-up data included for documentation purposes. Financials: Statements were presented and up-to-date with expenditures. A program assistant has not been hired due to lower than normal referrals Court Counselor review: Accessibility, communication, and services are strong. Easy to work with and quick to respond. Recommended for funding: Yes without conditions HCBOC 071822 Pg. 242 Juvenile Crime Prevention Council Certification Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Form structure last revised August 2020 NC Department of Public Safety Page 1 of 4 Fiscal Year: _____________ County: Harnett Date: 07/06/2022 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, Representative 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 biennial planning process which includes a needs assessment, monitoring of programs and funding allocation process? Yes B. Is this Biennial Plan presented to the Board of County Commissioners and to DPS? Yes C. Is the Funding Plan approved by the full council and submitted to Commissioners for their approval? Yes HCBOC 071822 Pg. 243 Juvenile Crime Prevention Council Certification (cont'd) Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Form structure last revised August 2020 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 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 June 30, 2021. 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 Contact Harnett County Schools for person under 21 representatives, non-profit organizations, and need to replace individuals that have cycled off the JCPC for various reasons. HCBOC 071822 Pg. 244 Juvenile Crime Prevention Council Certification (cont'd) Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Form structure last revised August 2020 NC Department of Public Safety Page 3 of 4 Harnett County FY 2022-23 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 Asst. to the Chief of Police W F 3) Local Sheriff or designee Dominic Alvarado Deputy M 4) District Attorney or designee Michael Onufer ADA W M 5) Chief Court Counselor or designee Chief Court Counselor Designee 6) Director, Local Management Entity/Managed Care Organization (LME/MCO), or designee Mary Spell Care Coordinator Specialist B F 7) Director DSS or designee 8) County Manager or designee 9) Substance Abuse Professional 10) Member of Faith Community Kimberly Whitted Director, Technology Infrastructure & Operations B F 11) County Commissioner Barbara McKoy 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 14) Chief District Judge or designee 15) Member of Business Community 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 W M 19) County Commissioner appointee 20) County Commissioner appointee Rosanne Teniente Human Services Consultant F HCBOC 071822 Pg. 245 Juvenile Crime Prevention Council Certification (cont'd) Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Form structure last revised August 2020 NC Department of Public Safety Page 4 of 4 21) County Commissioner appointee Cindy Delgado Success Coach/Dropout Prevention, Harnett County Schools W F 22) County Commissioner appointee Matthew Willis Register of Deeds, Harnett County 23) County Commissioner appointee Debbie Chiovitti W F 24) County Commissioner appointee 25) County Commissioner appointee HCBOC 071822 Pg. 246 S:\Clerk to the Board docs\AGENDAS\2022\071822\4f.1 agendaform Dunn Inspections 3 year contract.docx Page 1 of 1 Board Meeting Agenda Item MEETING DATE: July 18, 2022 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Dunn Fire Inspections and Plan Review 3 year agreement REQUESTED BY: Larry Smith, Emergency Services REQUEST: Harnett County Emergency Services is seeking Board approval for a 3 year agreement with the City of Dunn for Harnett County Fire Marshals Office to conduct the City's Fire Inspections/Fire Plan Review. The City will compensate the county for this service. This agreement is for a three year period and can be renewed. FINANCE OFFICER’S RECOMMENDATION: COUNTY MANAGER’S RECOMMENDATION: Item 4F HCBOC 071822 Pg. 247 1 STATE OF NORTH CAROLINA COUNTY OF HARNETT FIRE PREVENTION CODE ENFORCEMENT MUNICIPAL AGREEMENT CITY OF DUNN THIS AGREEMENT, made and entered into this first day of July, 2022, by and between the City of Dunn, North Carolina, a municipal corporation organized and existing under the laws of the State of North Carolina (hereinafter, " City '') and the County of Harnett, North Carolina, a body politic and political subdivision of the State of North Carolina (hereinafter, "County"). Witnesseth WHEREAS, City is required to provide fire prevention code enforcement services according to N.C. General Statute § 160D-1105 and the North Carolina State Fire Prevention Code - Section 106; and WHEREAS, County desires to provide to City the required fire prevention code inspections and services; and WHEREAS, City and County have reached an agreement for County to provide fire prevention code inspections and services as described herein and the parties desire to set forth the terms and conditions in this Agreement. NOW, THEREFORE, in consideration of the public safety and welfare, the mutual benefits, representations, and agreements contained herein and for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree, each with the other, as follows: 1. County agrees to provide City the following fire prevention code enforcement services within City's territorial jurisdiction: A. Fire prevention code enforcement within day care centers, rest homes, foster homes, and hospitals, when required by State or County agencies; B. Non-residential and subdivision site plan approval for fire prevention code compliance, upon request from City officials; C. Response to complaints and requests for fire inspections of individual businesses; D. Periodic Fire Prevention Code inspections in existing buildings, structures and premises to which the current North Carolina State Building Code, Fire Prevention, is applicable; E. New construction plan review of fire protection equipment and certification of compliance inspections upon request from the appropriate building official(s) or contractor; and F. Other fire prevention code enforcement inspections and services as may be required by State law. 2. City agrees that County, by and through the Harnett County Fire Marshal's office, shall have the exclusive right to perform the above enumerated fire prevention code enforcement services for as long as this Agreement remains in force and effect. City further agrees to fully cooperate with the Harnett County Fire Marshal's office in providing these services. HCBOC 071822 Pg. 248 2 3. City agrees that County will have and may exercise the same inspection and enforcement powers within City's regulatory and extraterritorial jurisdiction as are applicable within County's jurisdiction. 4. This Agreement shall become effective July 1, 2022, subject to the mutual agreement of both parties, and shall continue for a period of three years from July 1, 2022 through June 30, 2025, unless terminated by either party in accordance with paragraph 8 of this Agreement. 5. Compensation for the services provided pursuant to this Agreement shall be $48,239.04 for fiscal year 2023 and increase at a rate of three percent (3%) annually thereafter. County shall invoice City each year month, in twelve equal installments per fiscal year, for said services and each invoice is due and payable to County within thirty (30) days of the date of the invoice. City shall pay an additional charge of one and one-half percent per month (18% annually), not to exceed the maximum rate allowed by law for any payment not received by County more than thirty (30) days from the date of invoice. 6. This Agreement, as written or as may be amended, shall be effective from the date first specified above. 7. The City Attorney shall provide legal support and representation for City for all enforcement actions taken by the Harnett County Fire Marshal's office on behalf of City on issues arising from enforcement actions taken within and on behalf of City's jurisdiction by the Fire Marshal. To the fullest extent allowable by North Carolina law, County shall have no liability regarding such enforcement actions and City shall hold County harmless for any and all claims, liabilities, losses, damages, costs, or expenses of whatever kind arising out of or relating to the provision of services provided by County to City hereunder, except for those acts caused by the negligence of County. To the fullest extent allowable by North Carolina law, County shall hold City harmless for any and all claims, liabilities, losses, damages, costs, or expenses of whatever kind arising out of or relating to the provision of services provided by County to City, except for those acts caused by the negligent acts or omissions of City. City and County waive special, incidental, indirect, or consequential damages, including lost profits, good will, revenues or savings, for claims, disputes or other matters in question arising out of or relating to this Agreement. This limitation of liability, covering matters contemplated by and occurring during the term of this Agreement, will survive the expiration or termination of this Agreement. 8. This Agreement may be terminated for any reason by either party upon advanced written notice to the other party, by certified mail at least ninety (90) days prior to the date of desired termination. Termination shall not relieve City of financial obligations incurred prior to termination. 9. Nothing contained in this Agreement shall create a contractual relationship with or cause of action in favor of a third party against either Party. 10. In the event any provision of this Agreement is adjudged to be not enforceable or found invalid, such provision shall be stricken and the remaining provisions shall be valid and enforceable. 11. This Agreement represents the entire agreement between County and City and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may only be amended by written instrument signed by County and City. HCBOC 071822 Pg. 249 3 12. All notices or other communications which shall be made pursuant hereto shall be in writing and shall be deemed to be given and received (a) when hand delivered to the address stated below, or (b) three (3) days after being mailed to the address stated below, postage prepaid by certified or registered mail of the United States, return receipt requested to the address set forth below: To City: City of Dunn 401 E. Broad Street Dunn, NC 28334 Attn: City Manager To County: Harnett County Fire Marshal PO Box 370 Lillington, NC 27546 With a copy to: Harnett County Legal Services PO Box 238 Lillington, NC 27546 Attn: County Staff Attorney Either party to this Agreement may change its designated person or designated address at any time and from time to time by giving notice of such change to the other party in the manner set forth above. 13. This Agreement shall be governed by the laws of the State of North Carolina, The North Carolina State Courts located in Harnett County, North Carolina shall have jurisdiction to hear any dispute under this Agreement and legal or equitable proceedings by either party must be filed in Harnett County, North Carolina. 14. The relationship of the parties established by this Agreement is solely that of independent contractor, and nothing contained in this contract shall be construed to: (i) give any party the power to direct or control the day-to-day activities of the other; (ii) constitute such parties as partners, joint ventures, co-owners, or otherwise as participants in a joint or common undertaking; (iii) make either party an agent of the other for any purpose whatsoever; or (iv) give either party the authority to act for, bind, or otherwise create or assume any obligation on behalf of the other. [Remainder of This Page Intentionally Left Blank] HCBOC 071822 Pg. 250 4 IN WITNESS WHEREOF, the parties hereto, through their duly authorized representatives or officers have executed this Agreement as to the date and year first above written. CITY OF DUNN By: ______________________________ ___________________, City Manager Attest: _________________________________ (SEAL) _______________________, Clerk COUNTY OF HARNETT By: ______________________________ Brent Trout, County Manager Attest: __________________________________ (SEAL) Jaime Bell-Raig, Clerk HCBOC 071822 Pg. 251 S:\Clerk to the Board docs\AGENDAS\2022\071822\4g.1 Agenda Request - ARPA Policies - Program Income & Allowable Costs.docx Page 1 of 1 Board Meeting Agenda Item MEETING DATE: July 18, 2022 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Adopt the Program Income Policy and Allowable Costs & Costs Principles Policy REQUESTED BY: Christopher Appel – Legal Department REQUEST: Adopt the Program Income Policy and Allowable Costs & Costs Principles Policies. These two policies are to ensure compliance with the U.S. Department of Treasury's federal regulations governing expenditures of ARP/CSLFRF funds. The Program Income Policy provides guidance to account for program income earned from the expenditure of funds pursuant to the ARP/CLSFRF award. The Allowable Costs & Costs Principles Policy provides rules and procedures as to those items of cost that are allowable or unallowable pursuant to Title 2 U.S. Code of Federal Regulations Part 200. FINANCE OFFICER’S RECOMMENDATION: COUNTY MANAGER’S RECOMMENDATION: Item 4G HCBOC 071822 Pg. 252 1 County of Harnett Program Income Policy Effective July 18, 2022 PURPOSE AND SCOPE The County of Harnett enacts the following procedures for its use of program income earned from the expenditure of ARP/CSLFRF funds to ensure compliance with the Uniform Guidance, including, but not limited to, 2 C.F.R. § 200.307, the ARP/CSLFRF award, and all applicable Federal regulations governing the use of program income. The County agrees to administer program income according to the requirements set forth in this policy and as required by the Federal regulations and State law. The responsibility for following this policy lies with the ARP/CSLFRF Management Team who are charged with the administration and financial oversight of the ARP/CSLFRF award. Questions on the use and/or reporting of program income should be directed to the Finance Department. DEFINITIONS a. ARP/CLSFRF award means the Federal program governing the use of Coronavirus State and Local Fiscal Recovery Funds as provided in the Assistance Listing and as administered by the U.S. Department of Treasury pursuant to the American Rescue Plan Act of 2021 (“ARPA”), Pub. L. No. 117-2 (Mar. 11, 2021). b. ARP/CSLFRF funds means the portion of Federal financial assistance from the Coronavirus State Fiscal Recovery Funds and Coronavirus Local Fiscal Recovery Funds (collectively “CSLFRF”) awarded to the County pursuant ARPA. c. Federal award means the Federal financial assistance that a recipient receives directly from a Federal awarding agency or indirectly from a pass-through entity, as described in § 200.101. The Federal award is the instrument setting forth the terms and conditions of the grant agreement, cooperative agreement, or other agreement for assistance. d. Federal awarding agency means the Federal agency that provides a Federal award directly to a non-Federal entity. e. Federal financial assistance means the assistance that non-Federal entities receive or administer in the form of grants, cooperative agreements, non-cash contributions, direct appropriations, food commodities, or other financial assistance, including loans. HCBOC 071822 Pg. 253 2 f. Federal program means all Federal awards which are assigned a single Assistance Listings Number. g. Non-Federal entity means a State, local government, Indian tribe, Institution of Higher Education (IHE), or nonprofit organization that carries out a Federal award as a recipient or subrecipient. h. Period of performance means the total estimated time interval between the start of an initial Federal award and the planned end date, which may include one or more funded portions, or budget periods. The period of performance for the ARP/CSLFRF award ends December 31, 2026. i. Program income means gross income earned by the non-Federal entity that is directly generated by a supported activity or earned as a result of the Federal award during the period of performance except as provided in § § 200.307(f). PROGRAM INCOME OVERVIEW For purposes of this policy, program income is the gross income earned by the County that is directly generated by a supported activity or earned as a result of the ARP/CSLFRF award during the period of performance, which closes December 31, 2026. 2 CFR 200.1. Program income includes, but is not limited to, the following sources of income: • The collection of fees for services performed. • Payments for the use or rental of real or personal property. • The sale of commodities or items fabricated under the Federal award. • The payment of principal and interest on loans made under the Federal award. Program income does not include fees or revenue from the following: • The use of rebates, credits, discounts, and interest earned on any of them. • Governmental revenues, such as taxes, special assessments, levies, or fines. • Proceeds from the sale of real property, equipment, or supplies.1 USE OF PROGRAM INCOME Program income earned pursuant to expenditures of ARP/CSLFRF funds is the property of US Treasury and shall be accounted for in one of three ways pursuant to 2 C.F.R. § 200.307(e). Deduction Method: Program income must be deducted from total allowable costs to determine net allowable costs. Program income shall be used to reduce Treasury’s obligation under the ARP/CSLFRF award rather than to increase the funds committed a project. Program income shall be used for current costs. The County shall track and account for program income during the period of performance and shall reimburse Treasury, as required. 2 C.F.R. § 200.307(e)(1). HCBOC 071822 Pg. 254 3 Addition Method: With prior approval, program income may be added to the total amount of the ARP/CSLFRF award, thereby increasing the total amount of the award. Program income must be expended on an eligible project or program. 2 C.F.R. § 200.307(e)(2). Pursuant to the terms of the ARP/CSLFRF award, the repayment of principal and interest on loans made with CSLFRF funds that will mature or be forgiven on or before December 31, 2026, may be accounted for using the addition method (see Section VI). Matching or Cost Sharing Method: With prior approval, program income may be used to meet the cost sharing or matching requirement of the Federal award. The amount of the Federal award shall not change. 2 C.F.R. § 200.307(e)(3). Unless the ARP/CSLFRF award otherwise stipulates, or the County has received prior approval, the County shall apply the deduction method to account for the use of program income. ALLOCATION OF PROGRAM INCOME The County shall only expend program income on costs that are reasonable, allocable, and allowable under the terms of the ARP/CSLFRF award. To adhere to these requirements, the County shall comply with the cost principles included in 2 C.F.R. § 200, as outlined in the County’s Allowable Costs and Costs Principles Policy. The County shall allocate program income to the ARP/CSLFRF award in proportion to the pro rata share of the total funding (e.g., if ARP/CSLFRF funds cover half of a project’s cost, with general revenue covering the other half, the unit shall allocate 50% of any program income earned to the ARP/CSLFRF award and account for its use pursuant to § 200.307). REPAYMENT OF PRINCIPAL AND INTEREST ON LOANS MADE WITH ARP/CSLFRF FUNDS Treasury expects that a significant share of loans made with ARP/CSLFRF funds will be repaid. Accordingly, it has issued guidance on how to appropriately account for the repayment of principal and interest. The County agrees to appropriately account for the return of loan funds according to the ARP/CSLFRF award terms, as follows: • For Loans that mature or are forgiven on or before December 31, 2026: The County may add the repayment of principal and interest (program income) to the ARP/CSLFRF award. When the loan is made, the County shall report the principal of the loan as an expense. The County shall expend the repayment of principal only on eligible uses and is subject to restrictions on the timing of the use of ARP/CSLFRF funds pursuant to the ARP/CSLFRF award. Interest payments received prior to the end of the period of performance will be considered an addition to the total award and may be used for any purpose that is an eligible use. The County is not subject to restrictions under 2 CFR 200.307(e)(1) (the deduction method) in accounting for the use of program income. HCBOC 071822 Pg. 255 4 • For Loans with maturities longer than December 31, 2026: The County is not required to separately account for the repayment of principal and interest on loans that will mature after the ARP/CSLFRF award’s period of performance. The County may use ARP/CSLFRF funds for only the projected cost of the loan. The County may estimate the subsidy cost of the loan, which equals the expected cash flows associated with the loan discounted at the County’s cost of funding. The cost of funding can be determined based on the interest rates of securities with a similar maturity to the cash flow being discounted that were either (i) recently issued by the County or (ii) recently issued by a unit of state, local, or Tribal government similar to the County. If the County has adopted the Current Expected Credit Loss (CECL) standard, it may also treat the cost of the loan as equal to the CECL-based expected credit losses over the life of the loan. The County may measure projected losses either once, at the time the loan is extended, or annually over the covered period. Under either approach, the County is not subject to restrictions under 2 CFR 200.307(e)(1) (the deduction method) and need not separately track repayment of principal or interest. • Revolving Loan Funds: The County shall treat the contribution of ARP/CSLFRF funds to a revolving loan fund according to approach described above for loans with maturities longer than December 31, 2026. The County may contribute ARP/CSLFRF funds to a revolving loan only if the loan is determined to be for eligible use and the ARP/CSLFRF funds contributed represent the projected cost of loans made over the life of the revolving loan fund. ADDITIONAL PROGRAM INCOME REQUIREMENTS (a) Identifying, Documenting, Reporting, and Tracking. To ensure compliance with the requirements of program income as outlined by the Federal regulations, the terms and conditions of the ASP/CSLFRF award, and the requirements set forth herein, each department shall identify potential sources of program income and properly report the program income for the period in which it was earned and dispersed. Program income shall be accounted for separately. The County shall not comingle program income earned from programs supported by ARP/CSLFRF funds with the general award of ARP/CSLFRF funds the County received from Treasury. Any costs associated with generating program income revenue shall be charged as expenditures to the ARP/CSLFRF award. (b) Program Income Earned After the Period of Performance. The County shall have no obligation to report program income earned after the period of performance (December 31, 2026). However, the County shall report program income expended after the period of performance if that program income was earned on or before December 31, 2026. (c) Subawards. The County agrees to ensure that any subrecipient of ARP/CSLFRF funds abides by the award of the terms and conditions of this policy and is aware that the subrecipient is responsible for accounting for and reporting program income to the County. HCBOC 071822 Pg. 256 5 (d) Compliance with State law. Program income shall not be expended for purposes prohibited under State law. (e) Subject to Audit. The County recognizes that its use of program income may be audited and reviewed for compliance with Federal laws and regulations, State law, and the terms of the ARP/CSLFRF award. IMPLEMENTATION OF POLICY The Finance Officer will adopt procedures to identify potential program income during the project eligibility and allowable cost review, document actual program income, and follow the requirements in this policy related to the treatment of program income. HCBOC 071822 Pg. 257 1 County of Harnett Allowable Costs and Costs Principles Policy Effective July 18, 2022 ALLOWABLE COSTS AND COSTS PRINCIPLES POLICY OVERVIEW Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, commonly called Uniform Guidance (UG), specifically Subpart E, defines those items of cost that are allowable, and which are unallowable. The tests of allowability under these principles are: (a) the costs must be reasonable; (b) they must be allocable to eligible projects under the Coronavirus State and Local Fiscal Recovery Funds of H.R. 1319 American Rescue Plan Act of 2021 (ARP/CSLFRF); (c) they must be given consistent treatment through application of those generally accepted accounting principles appropriate to the circumstances; and (d) they must conform to any limitations or exclusions set forth in these principles or in the ARP/CSLFRF grant award as to types or amounts of cost items. Unallowable items fall into two categories: expenses which are by their nature unallowable (e.g., alcohol), and unallowable activities (e.g., fund raising). Harnett County shall adhere to all applicable cost principles governing the use of federal grants. This policy addresses the proper classification of both direct and indirect charges to ARP/CSLFRF funded projects and enacts procedures to ensure that proposed and actual expenditures are consistent with the ARP/CSLFRF grant award terms and all applicable federal regulations in the UG. Responsibility for following these guidelines lies with ARP/CLSFRF Management Team who are charged with the administration and financial oversight of the ARP/CSLFRF. Further, all County employees and officials who are involved in obligating, administering, expending, or monitoring ARP/CSLFRF grant funded projects should be well versed with the categories of costs that are generally allowable and unallowable. Questions on the allowability of costs should be directed to the Finance Department. As questions on allowability of certain costs may require interpretation and judgment, local government personnel are encouraged to ask for assistance in making those determinations. GENERAL COST ALLOWABILITY CRITERIA All costs expended using ARP/CSLFRF funds must meet the following general criteria: 1. Be necessary and reasonable for the proper and efficient performance and administration of the grant program. HCBOC 071822 Pg. 258 2 A cost must be necessary to achieve a project object. When determining whether a cost is necessary, consideration may be given to: ○ Whether the cost is needed for the proper and efficient performance of the grant project. ○ Whether the cost is identified in the approved project budget or application. ○ Whether the cost aligns with identified needs based on results and findings from a needs assessment. ○ Whether the cost addresses project goals and objectives and is based on program data. A cost is reasonable if, in its nature and amount, it does not exceed that which would be incurred by a prudent person under the circumstances prevailing at the time the decision to incur the cost was made. For example, reasonable means that sound business practices were followed, and purchases were comparable to market prices. When determining reasonableness of a cost, consideration must be given to: ○ Whether the cost is a type generally recognized as ordinary and necessary for the operation of Harnett County or the proper and efficient performance of the federal award. ○ The restraints or requirements imposed by factors, such as: sound business practices; arm’s-length bargaining; federal, state, and other laws and regulations; and terms and conditions of the ARP/CSLFRF award. ○ Market prices for comparable goods or services for the geographic area. ○ Whether individuals concerned acted with prudence in the circumstances considering their responsibilities to Harnett County, its employees, the public at large, and the federal government. ○ Whether Harnett County significantly deviates from its established practices and policies regarding the incurrence of costs, which may unjustifiably increase the ARP/CSLFRF award’s cost. 2. Be allocable to the ARP/CSLFRF federal award. A cost is allocable to the ARP/CSLFRF award if the goods or services involved are chargeable or assignable to the ARP/CSLFRF award in accordance with the relative benefit received. This means that the ARP/CSLFRF grant program derived a benefit in proportion to the funds charged to the program. For example, if 50 percent of a local government program officer’s salary is paid with grant funds, then the local government must document that the program officer spent at least 50 percent of his/her time on the grant program. If a cost benefits two or more projects or activities in proportions that can be determined without undue effort or cost, the cost must be allocated to the projects based on the proportional benefit. If a cost benefits two or more projects or activities in proportions HCBOC 071822 Pg. 259 3 that cannot be determined because of the interrelationship of the work involved, then the costs may be allocated or transferred to benefitted projects on any reasonable documented basis. Where the purchase of equipment or other capital asset is specifically authorized by the ARP/CSLFRF, the costs are assignable to the Federal award regardless of the use that may be made of the equipment or other capital asset involved when no longer needed for the purpose for which it was originally required. 3. Be authorized and not prohibited under state or local laws or regulations. 4. Conform to any limitations or exclusions set forth in the principles, federal laws, ARP/CSLFRF award terms, and other governing regulations as to types or amounts of cost items. 5. Be consistent with policies, regulations, and procedures that apply uniformly to both the ARP/CSLFRF federal award and other activities of Harnett County. 6. Be accorded consistent treatment. A cost MAY NOT be assigned to a federal award as a direct cost and also be charged to a federal award as an indirect cost. And a cost must be treated consistently for both federal award and non-federal award expenditures. 7. Be determined in accordance with generally accepted accounting principles (GAAP), unless provided otherwise in the UGG. 8. Be net of all applicable credits. The term “applicable credits” refers to those receipts or reduction of expenditures that operate to offset or reduce expense items allocable to the federal award. Typical examples of such transactions are purchase discounts; rebates or allowances; recoveries or indemnities on losses; and adjustments of overpayments or erroneous charges. To the extent that such credits accruing to and received by the local government related to the federal award, they shall be credited to the ARP/CSLFRF award, either as a cost reduction or a cash refund, as appropriate and consistent with the award terms. 9. Be adequately documented. SELECTED ITEMS OF COST The UGG examines the allowability of fifty-five (55) specific cost items (commonly referred to as Selected Items of Cost) at 2 CFR § 200.420-.475. ARP/CSLFRF Management Team members responsible for determining cost allowability must be familiar with the Selected Items of Cost. Harnett County must follow the applicable regulations when charging these specific expenditures to the ARP/CSLFRF grant. Finance Department personnel will check costs against the selected items of cost requirements to ensure the cost is allowable and that all process and documentation requirements are followed. In addition, State laws, Harnett County regulations, and program-specific rules may deem a cost as unallowable, and Finance Department personnel must follow those non-federal rules as well. Exhibit A identifies and summarizes the Selected Items of Cost. HCBOC 071822 Pg. 260 4 DIRECT AND INDIRECT COSTS Allowable and allocable costs must be appropriately classified as direct or indirect charges. It is essential that each item of cost be treated consistently in like circumstances either as a direct or an indirect cost. Direct costs are expenses that are specifically associated with a particular ARP/CSLFRF-eligible project and that can be directly assigned to such activities relatively easily with a high degree of accuracy. Common examples of direct costs include salary and fringe benefits of personnel directly involved in undertaking an eligible project, equipment and supplies for the project, subcontracted service provider, or other materials consumed or expended in the performance of a grant-eligible project. Indirect costs are (1) costs incurred for a common or joint purpose benefitting more than one ARP/CSLFRF-eligible project, and (2) not readily assignable to the project specifically benefited, without effort disproportionate to the results achieved. They are expenses that benefit more than one project or even more than one federal grant. Common examples of indirect costs include utilities, local telephone charges, shared office supplies, administrative or secretarial salaries. For indirect costs, Harnett County may charge a 10 percent de minimis rate of modified total direct costs (MTDC). According to UGG Section 200.68 MTDC means all direct salaries and wages, applicable fringe benefits, materials and supplies, services, travel, and up to the first $25,000 of each subaward (regardless of the period of performance the subawards under the award). MTDC EXCLUDES equipment, capital expenditures, charges for patient care, rental costs, tuition remission, scholarships and fellowships, participant support costs and the portion of each subaward in excess of $25,000. SPECIAL PROVISIONS FOR STATE AND LOCAL GOVERNMENTS There are some special provisions of the UG that apply only to states, local governments, and Indian Tribes. § 200.444 General costs of government. (a) For states, local governments, and Indian Tribes, the general costs of government are unallowable (except as provided in § 200.475). Unallowable costs include: (1) Salaries and expenses of the Office of the Governor of a state or the chief executive of a local government or the chief executive of an Indian tribe; (2) Salaries and other expenses of a state legislature, tribal council, or similar local governmental body, such as a county supervisor, city council, school board, etc., whether incurred for purposes of legislation or executive direction; (3) Costs of the judicial branch of a government; (4) Costs of prosecutorial activities unless treated as a direct cost to a specific program if authorized by statute or regulation (however, this does not preclude the allowability of other legal activities of the Attorney General as described in § 200.435); and HCBOC 071822 Pg. 261 5 (5) Costs of other general types of government services normally provided to the general public, such as fire and police, unless provided for as a direct cost under a program statute or regulation. (b) For Indian tribes and Councils of Governments (COGs) (see definition for Local government in § 200.1 of this part), up to 50% of salaries and expenses directly attributable to managing and operating Federal programs by the chief executive and his or her staff can be included in the indirect cost calculation without documentation. § 200.416 Cost allocation plans and indirect cost proposals. (a) For states, local governments and Indian tribes, certain services, such as motor pools, computer centers, purchasing, accounting, etc., are provided to operating agencies on a centralized basis. Since Federal awards are performed within the individual operating agencies, there needs to be a process whereby these central service costs can be identified and assigned to benefitted activities on a reasonable and consistent basis. The central service cost allocation plan provides that process. (b) Individual operating agencies (governmental department or agency), normally charge Federal awards for indirect costs through an indirect cost rate. A separate indirect cost rate(s) proposal for each operating agency is usually necessary to claim indirect costs under Federal awards. Indirect costs include: (1) The indirect costs originating in each department or agency of the governmental unit carrying out Federal awards and (2) The costs of central governmental services distributed through the central service cost allocation plan and not otherwise treated as direct costs. (c) The requirements for development and submission of cost allocation plans (for central service costs and public assistance programs) and indirect cost rate proposals are contained in appendices V, VI and VII to this part. § 200.417 Interagency service. The cost of services provided by one agency to another within the governmental unit may include allowable direct costs of the service plus a pro-rated share of indirect costs. A standard indirect cost allowance equal to ten percent of the direct salary and wage cost of providing the service (excluding overtime, shift premiums, and fringe benefits) may be used in lieu of determining the actual indirect costs of the service. These services do not include centralized services included in central service cost allocation plans as described in Appendix V to Part 200. HCBOC 071822 Pg. 262 6 COST ALLOWABILITY REVIEW PROCESS Preapproval Cost Allowability Review Before an ARP/CSLFRF-funded project is authorized, the Finance Department must review the proposed cost items within an estimated project budget to determine whether they are allowable and allocable and whether cost items will be charged as direct or indirect expenses. This review will occur concurrently with the review of project eligibility and before obligating or expending any ARP/CSLFRF funds. • Harnett County personnel must submit proposed ARP/CSLFRF projects to the ARP/CSLFRF Management Team for review. In addition to other required information, all proposed project submissions must delineate estimated costs by cost item. • Along with a general review of project eligibility and conformance with other governing board management directives, the Finance Officer must review estimated costs for specific allowable cost requirements, budget parameters, indirect rates, fringe benefit rates, and those activities/costs that require pre-approval by the US Treasury. • If a proposed project includes a request for an unallowable cost, the Finance Department will return the proposal to the requesting party for review and, if practicable, resubmission with corrected cost items. • Once a proposed project budget is pre-approved by the Finance Department, County personnel responsible for implementing the project must conform actual obligations and expenditures to the pre-approved project budget. Post-expenditure Cost Allowability Review Once an expenditure is incurred related to an eligible project, and an invoice or other demand for payment is submitted to the local government, the Finance Officer must perform a second review to ensure that actual expenditures comprise allowable costs. • All invoices or other demands for payment must include a breakdown by cost item. The cost items should mirror those presented in the proposed budget for the project. If an invoice or other demand for payment does not include a breakdown by cost item, the Finance Department will return the invoice to the project manager and/or vendor, contractor, or subrecipient for correction. • The Finance Department must review the individual cost items listed on the invoice or other demand for payment to determine their allowability and allocability. • If all cost items are deemed allowable and properly allocable, the Finance Department must proceed through the local government’s normal disbursement process. HCBOC 071822 Pg. 263 7 • If any cost item is deemed unallowable, the Finance Department will notify the project management and/or vendor, contractor, or subrecipient that a portion of the invoice or other demand for payment will not be paid with ARP/CSLFRF funds. The Finance Department may in their discretion, and consistent with this policy, allow an invoice or other demand for payment to be resubmitted with a revised cost allocation. If the local government remains legally obligated by contract or otherwise to pay the disallowed cost item, it must identify other local government funds to cover the disbursement. The Harnett County Board of Commissioners must approve any allocation of other funds for this purpose. • The Finance Department must retain appropriate documentation of budgeted cost items per project and actual obligations and expenditures of cost items per project. COST TRANSFERS Any costs charged to the ARP/CSLFRF federal award that do not meet the allowable cost criteria must be removed from the award account and charged to an account that does not require adherence to federal UGG or other applicable guidelines. Failure to adequately follow this policy and related procedures could result in questioned costs, audit findings, potential repayment of disallowed costs and discontinuance of funding. HCBOC 071822 Pg. 264 8 EXHIBIT A Selected Items of Cost Uniform Guidance General Reference Allowability Advertising and public relations costs 2 CFR § 200.421 Allowable with restrictions Advisory councils 2 CFR § 200.422 Allowable with restrictions Alcoholic beverages 2 CFR § 200.423 Unallowable Alumni/ae activities 2 CFR § 200.424 Not specifically addressed Audit services 2 CFR § 200.425 Allowable with restrictions Bad debts 2 CFR § 200.426 Unallowable Bonding costs 2 CFR § 200.427 Allowable with restrictions Collection of improper payments 2 CFR § 200.428 Allowable Commencement and convocation costs 2 CFR § 200.429 Not specifically addressed Compensation – personal services 2 CFR § 200.430 Allowable with restrictions; Special conditions apply (e.g., § 200.430(i)(5)) Compensation – fringe benefits 2 CFR § 200.431 Allowable with restrictions Conferences 2 CFR § 200.432 Allowable with restrictions Contingency provisions 2 CFR § 200.433 Unallowable with exceptions Contributions and donations 2 CFR § 200.434 Unallowable (made by non-federal entity); not reimbursable but value may be used as cost sharing or matching (made to non-federal entity) Defense and prosecution of criminal and civil proceedings, claims, appeals and patent infringements 2 CFR § 200.435 Allowable with restrictions HCBOC 071822 Pg. 265 9 Depreciation 2 CFR § 200.436 Allowable with qualifications Employee health and welfare costs 2 CFR § 200.437 Allowable with restrictions Entertainment costs 2 CFR § 200.438 Unallowable with exceptions Equipment and other capital expenditures 2 CFR § 200.439 Allowability based on specific requirement Exchange rates 2 CFR § 200.440 Allowable with restrictions Fines, penalties, damages and other settlements 2 CFR § 200.441 Unallowable with exceptions Fund raising and investment management costs 2 CFR § 200.442 Unallowable with exceptions Gains and losses on disposition of depreciable assets 2 CFR § 200.443 Allowable with restrictions General costs of government 2 CFR § 200.444 Unallowable with exceptions Goods and services for personal use 2 CFR § 200.445 Unallowable (goods/services); allowable (housing) with restrictions Idle facilities and idle capacity 2 CFR § 200.446 Idle facilities - unallowable with exceptions; Idle capacity - allowable with restrictions Insurance and indemnification 2 CFR § 200.447 Allowable with restrictions Intellectual property 2 CFR § 200.448 Allowable with restrictions Interest 2 CFR § 200.449 Allowable with restrictions Lobbying 2 CFR § 200.450 Unallowable Losses on other awards or contracts 2 CFR § 200.451 Unallowable (however, they are required to be included in the indirect cost rate base for allocation of indirect costs) Maintenance and repair costs 2 CFR § 200.452 Allowable with restrictions HCBOC 071822 Pg. 266 10 Materials and supplies costs, including costs of computing devices 2 CFR § 200.453 Allowable with restrictions Memberships, subscriptions, and professional activity costs 2 CFR § 200.454 Allowable with restrictions; unallowable for lobbying organizations Organization costs 2 CFR § 200.455 Unallowable except federal prior approval Participant support costs 2 CFR § 200.456 Allowable with prior approval of the federal awarding agency Plant and security costs 2 CFR § 200.457 Allowable; capital expenditures are subject to § 200.439 Pre-award costs 2 CFR § 200.458 Allowable if consistent with other allowabilities and with prior approval of the federal awarding agency Professional services costs 2 CFR § 200.459 Allowable with restrictions Proposal costs 2 CFR § 200.460 Allowable with restrictions Publication and printing costs 2 CFR § 200.461 Allowable with restrictions Rearrangement and reconversion costs 2 CFR § 200.462 Allowable (ordinary and normal) Recruiting costs 2 CFR § 200.463 Allowable with restrictions Relocation costs of employees 2 CFR § 200.464 Allowable with restrictions Rental costs of real property and equipment 2 CFR § 200.465 Allowable with restrictions Scholarships and student aid costs 2 CFR § 200.466 Not specifically addressed Selling and marketing costs 2 CFR § 200.467 Unallowable with exceptions Specialized service facilities 2 CFR § 200.468 Allowable with restrictions Student activity costs 2 CFR § 200.469 Unallowable unless specifically provided for in the federal award HCBOC 071822 Pg. 267 11 Taxes (including Value Added Tax) 2 CFR § 200.470 Allowable with restrictions Termination costs 2 CFR § 200.471 Allowable with restrictions Training and education costs 2 CFR § 200.472 Allowable for employee development Transportation costs 2 CFR § 200.473 Allowable with restrictions Travel costs 2 CFR § 200.474 Allowable with restrictions Trustees 2 CFR § 200.475 Not specifically addressed HCBOC 071822 Pg. 268 Board Meeting Agenda Item MEETING DATE: July 18, 2022 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Local Appropriation for Harnett County Chief's Association REQUESTED BY: Administration REQUEST: Hamett County has allocated funds to be used towards the purchase of a smokehouse trailer. The County will be responsible for monitoring and reporting on the use of these funds. Administration requests the Board of Commissioners approve a local appropriation Grant Agreement with The Harnett County Chief's Association in the amount of $120,000 to be used towards the purchase of a smokehouse trailer. FINANCE OFFICER'S RECOMMENDATION: COUNTY MANAGER'S RECOMMENDATION: Page I of I Item 4H HCBOC 071822 Pg. 269 1 Capital Improvements Funding Contract Fiscal Year Begins July 1, 2022 Ends June 30, 2023 This Capital Improvements Funding Contract (the “Contract”) is hereby entered into by and between the County of Harnett (the "County") Harnett County Chief’s Association (the "Association") (referred to collectively as the “Parties”). 1. Contract Documents: This Contract consists of the following documents: (a) This Contract (b) The General Terms and Conditions (Attachment A) (c) Mobile Concepts Specialty Vehicles Quote (Attachment B) These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in Paragraph 1, above, with the first-listed document having the highest precedence and the last-listed document having the lowest precedence. If there are multiple Contract Amendments, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This Contract shall be effective on July 1, 2022. 4. Association’s Duties: The Association shall use the funds for the purpose of capital improvements to purchase and replace the Harnett County Chief’s Association’s smokehouse trailer with a Safety House #NexGen 35iBed trailer as outlined Attachment B. Failure to perform Association’s Duties as outlined may result in suspension of current funding, return of the awarded funds to the County, and/or disqualification to receive funds in future fiscal years. 5. County’s Duties: The County shall pay the Association in the manner and in the amount specified in the Contract Documents. The total amount paid by the County to the Association under this Contract is $120,000.00. This amount consists of $120,000.00 in County funds. The funds are to be paid by the County to the Association within thirty (30) days of the execution of this Contract. 6. Reversion of Funds: Any unexpended Contract funds shall revert to the County upon termination of this Contract. 7. Reporting Requirements: Association shall submit a financial report and a program performance report detailing the expenditures of County provided funds and the accomplishments of the Association on a quarterly basis. Failure to comply with Reporting Requirements outlined in this section may result in suspension of current funding, return of the awarded funds to the County, and/or disqualification to receive County funds in future fiscal years. 10. Disbursements: As a condition of this Contract, the Association acknowledges and agrees to make disbursements in accordance with the following requirements: (a) Implement adequate internal controls over disbursements; (b) Pre-audit all vouchers presented for payment to determine: • Validity and accuracy of payment • Payment due date • Adequacy of documentation supporting payment • Legality of disbursement (c) Assure adequate control of signature stamps/plates; (d) Assure adequate control of negotiable instruments; and (e) Implement procedures to insure that account balance is solvent and reconcile the account monthly. 11. Signature Warranty: The undersigned represent and warrant that they are authorized to bind their principals to the terms of this Contract. HCBOC 071822 Pg. 270 2 The Association and the County have executed this Contract in duplicate originals, with one original being retained by each party. HARNETT COUNTY CHIEF’S ASSOCIATION __________________________________________________________________________________________________ Signature Date ____________________________________________________________________ _______________ Printed Name Title COUNTY ___________________________________________________________________________________________________ Signature Date ______________________________________________________________ _______________ Printed Name Title This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. ________________________________________________________________________________________________ Signature of County Finance Officer Date HCBOC 071822 Pg. 271 ATTACHMENT A GENERAL TERMS AND CONDITIONS Relationships of the Parties Independent Contractor: The Association is and shall be deemed to be an independent contractor in the performance of this Contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees. The Association represents that it has, or shall secure at its own expense, all personnel required in performing the services under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with, the County. Assignment: No assignment of the Association's obligations or the Association's right to receive payment hereunder shall be permitted. Beneficiaries: Except as herein specifically provided otherwise, this Contract 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 contract, and all rights of action relating to such enforcement, shall be strictly reserved to the County and the Association. 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 the County and Association that any such person or entity, other than the County or the Association, receiving services or benefits under this Contract shall be deemed an incidental beneficiary only. Indemnity and Insurance Indemnification: The Association agrees to indemnify and hold harmless 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 Association in connection with the performance of this Contract to the extent permitted by law. Default and Termination Termination Without Cause: The Parties may terminate this Contract without cause by giving thirty (30) days written notice to the non- terminating party. Any funds not expended at the time of the termination shall be returned to County within thirty (30) days. Termination for Cause: If, through any cause, the Association shall fail to fulfill its obligations under this Contract in a timely and proper manner, the County shall have the right to terminate this contract by giving written notice to the Association and specifying the effective date thereof. Notwithstanding the foregoing provision, the Association shall not be relieved of liability to the County for damages sustained by the County by virtue of the Association’s breach of this Contract, and the County may withhold any payment due the Association for the purpose of setoff until such time as the exact amount of damages due the County from such breach can be determined. The filing of a petition for bankruptcy by the Association shall be an act of default under this contract. Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the Association 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 contract unless stated to be such in writing, signed by an authorized representative of the County and the Association and attached to the contract. Availability of Funds: The parties to this Contract agree and understand that the payment of the sums specified in this Contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this purpose to the County. 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 or act of God. Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation. HCBOC 071822 Pg. 272 Compliance with Applicable Laws Compliance with Laws: The Association shall 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. Oversight Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as the funding authority, the County shall have access to persons and records as a result of all contracts or grants 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 the County. State basic records retention policy requires all grant records to be retained for a minimum of five (5) years or until all audit exceptions have been resolved, whichever is longer. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this Contract 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. Miscellaneous Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties to this contract, are governed by the laws of North Carolina. The Association, by signing this Contract, agrees and submits, solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for such purpose, that the exclusive venue for any legal proceedings shall be Harnett County, North Carolina. The place of this Contract and all transactions and agreements relating to it, and their situs and forum, shall be Harnett County, North Carolina, where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement shall be determined. Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form and executed by duly authorized representatives of the County and the Association. Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract 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 contract shall remain in full force and effect. 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. Gender and Number: Masculine pronouns shall be read to include feminine pronouns and the singular of any word or phrase shall be read to include the plural and vice versa. Time of the Essence: Time is of the essence in the performance of this Contract. Sales/Use Tax Refunds: If eligible, the Association and all subcontractors shall: (a) ask the North Carolina Department of Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-164.14; Advertising: The Association shall not use the award of this Contract or the County as a part of any news release or commercial advertising without the express written permission of the County. HCBOC 071822 Pg. 273 ATTACHMENT B HCBOC 071822 Pg. 274 HCBOC 071822 Pg. 275 HCBOC 071822 Pg. 276 HARNETT COUNTY RIVERSIDE DRAINAGE ASSESSMENT PROJECT ORDINANCE BE IT ORDAINED by the Board of Commissioners of Harnett County, North Carolina, sitting as the governing board for Harnett County. Section 1. The Riverside Community of Harnett County, located in the southeastern portion of the County, has experienced long-term drainage issues. The citizens of the community have requested assistance in identifying and remediating flooding and drainage in the low- lying areas. The Soil & Water Conservation District staff have conducted site visits to assess the drainage needs and organized community meetings to hear the concerns of the citizens. The staff of the District, along with a third party, conducted a watershed analysis to further assist in identifying drainage improvements in the Riverside community. The Harnett County Board of Commissioners on July 18, 2022 voted to approve the Harnett County Riverside Drainage Assessment Project Ordinance. This project ordinance will allow the county to continue the implementation of the assessment and remediation of the drainage issues. Section 2. The officers of this unit are hereby directed to proceed with the capital project and the budget contained herein. Section 3. The following amounts are hereby appropriated for this project: Professional $ 50,000 Construction 500,000 Contingency 200,000 Total $ 750,000 Section 4. The following revenues are anticipated to be available to complete this project: Interfund Transfer – Displaced ARPA $ 750,000 Section 5. The Finance Officer is hereby directed to maintain within the Capital Project Fund sufficient specific detailed accounting records to satisfy the requirements of the grantor agency, the grant agreements, and federal regulations. Section 6. Funds may be advanced from the General Fund for the purpose of making payments as due. Section 7. Copies of this capital project ordinance shall be furnished to the Clerk to the Governing Board, and to the Budget Officer and the Finance Officer for direction in carrying out this project. Duly adopted this ___ day of _________, 2022. _________________________________ Lewis W. Weatherspoon, Chairman Harnett County Board of Commissioners ATTEST:________________________________ Melissa Capps, Clerk to the Board Harnett County Board of Commissioners Item 4I HCBOC 071822 Pg. 277 Item 4J HCBOC 071822 Pg. 278 HCBOC 071822 Pg. 279 HCBOC 071822 Pg. 280 HCBOC 071822 Pg. 281 HCBOC 071822 Pg. 282 HCBOC 071822 Pg. 283 HCBOC 071822 Pg. 284 HCBOC 071822 Pg. 285 HCBOC 071822 Pg. 286 HCBOC 071822 Pg. 287 HCBOC 071822 Pg. 288 HCBOC 071822 Pg. 289 HCBOC 071822 Pg. 290 Item 4K HCBOC 071822 Pg. 291 HCBOC 071822 Pg. 292 HCBOC 071822 Pg. 293 HCBOC 071822 Pg. 294 HCBOC 071822 Pg. 295 HCBOC 071822 Pg. 296 HCBOC 071822 Pg. 297 HCBOC 071822 Pg. 298 HCBOC 071822 Pg. 299 HCBOC 071822 Pg. 300 Item 7AHCBOC 071822 Pg. 301 July 1, 2021 - June 30, 2022 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun TOTAL AVG. Front Desk - Check-in Appointments 855 1324 1597 1296 1090 1166 1165 954 1102 1181 1159 1072 13961 1163.4 Health Clinics Adult Women Wellness Clinic 7 1 6 1 2 0 2 4 4 3 4 2 36 3 Care Coordination for Children (CC4C)118 120 123 127 119 138 147 168 145 136 132 164 1637 136.42 Child Health - Sick Clinic 107 171 214 179 135 179 141 108 162 126 150 121 1793 149.42 Child Health - Well Clinic 84 140 131 109 76 73 60 105 113 89 80 73 1133 94.417 County Employee Health Clinic 143 177 148 138 139 151 177 96 98 126 141 120 1654 137.83 Family Planning 149 135 113 137 127 123 147 118 148 139 131 120 1587 132.25 Immunizations 166 267 897 1163 268 223 171 161 154 136 117 112 3835 319.58 COVID Vaccines 439 535 675 648 1486 1218 563 218 100 462 317 190 6851 570.92 Maternity (Prenatal Clinic)151 170 144 97 125 78 134 140 140 125 107 163 1574 131.17 OB Care Management (OBCM)110 206 173 153 170 206 222 243 172 176 167 168 2166 180.5 Postpartum Home Visits 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Refer/Repeat Pap 0 0 0 0 0 0 2 2 1 5 0 1 11 0.9167 STD Services 97 105 95 79 83 67 82 95 114 105 82 101 1105 92.083 TB Services 78 77 66 73 82 39 55 42 87 49 52 75 775 64.583 Welcome Baby Home Visits 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total Services 1649 2104 2785 2904 2812 2495 1903 1500 1438 1677 1480 1410 24157 2013.1 Reportable Disease Cases Tuberculosis 0 0 0 1 0 2 0 0 0 0 0 0 3 0.25 HIV - (Quarterly report)4 0 0 0 0 0 0 0 0 0 0 0 4 0.3333 AIDS - (Quarterly report)0 0 0 0 0 0 0 0 0 0 0 0 0 0 SYPHILIS - (Quarterly report)2 3 4 1 0 7 4 4 7 3 3 4 42 3.5 OTHER STD's 90 61 44 20 15 26 22 11 17 17 12 12 347 28.917 Other (salmonella, campylobacter, etc)1 2 3 4 9 4 1 2 3 5 4 3 41 3.4167 Total Services 97 66 51 26 24 39 27 17 27 25 19 19 437 36.417 Health Education Outreach 288 484 352 533 273 197 214 223 310 238 166 309 3587 298.92 Laboratory Clients 584 797 720 604 722 644 847 698 808 694 751 777 8646 720.5 Laboratory Tests 1147 1157 1098 987 1158 1052 1180 1134 1338 1216 1254 1277 13998 1166.5 HIV Tests 132 110 106 91 99 89 102 106 107 128 105 116 1291 107.58 WIC Active Participation 3497 3479 3480 3586 3580 3572 3599 3577 3716 3598 3542 39226 3566 Vital Statistics Births In County 25 25 38 24 37 37 36 37 56 38 28 41 422 35.167 Births Out of County 100 75 127 128 125 137 163 112 270 129 93 117 1576 131.33 Deaths 53 69 70 60 60 63 79 62 62 37 63 53 731 60.917 Environmental Health Applications Received 125 131 119 126 104 72 69 100 156 128 64 113 1307 108.92 Permits Issued 88 83 113 84 98 76 56 83 117 93 69 81 1041 86.75 Completions Issued 60 58 56 64 73 52 47 77 79 74 88 81 809 67.417 Repair Permits Applied 9 15 6 4 4 6 5 8 13 19 6 8 103 8.5833 Permits Denied 1 0 0 1 0 2 1 1 0 0 3 1 10 0.8333 Food and Lodging Establishments Inspected/Reinspected 67 80 76 40 43 59 40 64 66 47 91 70 743 61.917 Visits /Construction/Critical 28 48 42 23 18 18 33 35 41 90 42 59 477 39.75 Complaints 0 4 6 2 0 4 0 3 1 2 2 4 28 2.3333 Private Water Supplies Well Applications Received 12 3 1 2 3 3 2 6 6 2 6 1 47 3.9167 updated 7/08/2022 Activities Summary Harnett County Department of Public Health Item 7B HCBOC 071822 Pg. 302 Item 7C HCBOC 071822 Pg. 303 HCBOC 071822 Pg. 304 HCBOC 071822 Pg. 305 HCBOC 071822 Pg. 306 HCBOC 071822 Pg. 307 HCBOC 071822 Pg. 308