Request for Proposals (RFP) Strategic Prevention Framework Community Implementation

NEW JERSEY DEPARTMENT OF HUMAN SERVICES Division of Addiction Services Request for Proposals (RFP) Strategic Prevention Framework Community Implementation Proposal Due: February 11, 2009 _ Date of Issuance: December 15, 2008 Table of Contents Agency Purpose of Announcement Background Who Can Apply RFP Package How to Get a RFP Package Due Date Where to Send Proposals Mandatory Bidders’ Conference/Contacts for Further Information Contract Overview/Expectations General Contracting Information Proposal Requirements Required Documentation Review and Award Information Post Award Requirements Addendum to Request for Proposal for Social Service and Training Contracts Department of Human Services Statement of Assurances Certification Regarding Debarment, Suspension, Ineligibility Dates and Locations/Directions for Mandatory Bidder’s Conferences Community Readiness Tool 1 8 9 10 18 19 24 25 27 29 31 33 36 37 Agency The Department of Human Services (DHS) Division of Addiction Services (DAS) is issuing this Request for Proposals (RFP) Purpose of this Announcement DAS is soliciting applications from qualified private and public entities to work with a community to implement the New Jersey Strategic Prevention Framework (NJ SPF), a data driven planning process designed to effectively prevent alcohol and drug abuse in communities, with an emphasis on underage drinking Proposals must address the priority issue to reduce the harmful consequences of alcohol and drug use among 18 to 25 year olds Funding is targeted for community-level implementation of the NJ SPF DAS will fund approximately 12 to 15 projects for up to three years, based on availability of Federal funds and satisfactory project performance Awards are expected to range from approximately $200,000 to $300,000 yearly, depending upon the size of the targeted community, with a project start date of May 1, 2009 Note that these awards are strictly federally funded, and as such, applicants should NOT expect State funds to continue the award beyond the contract period Sustainability is a key component of the SPF process and contractees will receive extensive guidance and technical assistance in this area Cost sharing is not required Actual funding levels will depend on the availability of funds This will be a three year contract that is annually renewable Annual continuation and renewal are subject to availability of funds, satisfactory performance, as well as compliance and completion of all required/requested reports Background In October 2006, DAS was awarded a Strategic Prevention Framework State Incentive Grant (SPF-SIG) by the Substance Abuse Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (CSAP) DAS was designated by the Governor of New Jersey as the Single State Agency (SSA) responsible for the oversight and implementation of this grant SAMHSA’s SPF is a five-step process that enables States and communities to build infrastructure and implement interventions necessary for effective and sustainable substance abuse prevention The SPF-SIG provides funding to States to implement SAMHSA's SPF in order to:   prevent the onset and reduce the progression of substance abuse, including childhood and underage drinking, reduce substance abuse-related problems in communities, and;  build prevention capacity and infrastructure at the State/Tribal and community levels The purpose of New Jersey’s SPF is to develop and support a statewide, cross-system, data-driven alcohol and other drug prevention prioritization, implementation and evaluation infrastructure, which will guide and support communities across New Jersey to: Implement the five-step SPF planning process at the State and community level; Build sustainability and cultural competency into each step of the process; Implement evidence-based prevention programs, policies and practices based on epidemiological analysis and needs assessment; Evaluate results and communicate them to policymakers and the public; Efficiently coordinate multiple streams of prevention funding in order to achieve the targeted outcomes linked to each funding source, and maintain accountability; and Achieve changes in the substance abuse related problems, consumption patterns, and causal factors identified at the community level, and if possible, the State level Strategic Prevention Framework Research has shown that a broad array of evidence-based programs can effectively prevent substance abuse, promote mental health, and prevent related health and social problems by reducing risk factors and increasing protective factors The NJ SPF is a community-based approach to prevention within a population-based public health model that is based upon a series of guiding principles that can be utilized at the federal, State/tribal and community levels The NJ SPF requires States and communities to systematically: Assess their prevention needs based on epidemiological data, Build their prevention capacity, Develop a strategic plan, Implement effective community prevention programs, policies and practices, and Evaluate their efforts for outcomes This five step process is represented in Figure Central to the five (5) steps are two (2) concepts critical to long-term prevention efforts—cultural competence and sustainability Figure Five Steps of the Strategic Framework Process Drug and Alcohol Problems in New Jersey Alcohol and other drug abuse in New Jersey pose problems that cut across all geographic, socio-economic, racial, and cultural boundaries Epidemiological data on consumption and consequences for four major substances (alcohol, marijuana, heroin, and cocaine) indicate that while declining for some, the burden of substance abuse in New Jersey is a pressing issue for certain populations in particular As a requirement of the Federal SPF-SIG, New Jersey established a State Epidemiological Outcomes Workgroup (SEOW) to apply systematic, analytical thinking about the causes of substance use problems in the State In a nine month process, the SEOW analyzed State and national epidemiological data collected over the past five (5) years and developed a state-level Epidemiological Profile These data point to a number of substance abuse problems in New Jersey First among the issues identified by the SEOW is the harmful consequences of alcohol and drug use among 18-25 year olds The State Epidemiological Profile for Substance Abuse can be found on the DAS website at: http://www.state.nj.us/humanservices/das/NJ_EPI_Profile_SubAbuse1_7_08.pdf Based on results from the National Survey on Drug Use and Health (NSDUH), alcohol consumption for 18 to 25 year olds, while declining over the past several years, continues to be at a higher rate than the national average and higher than that for any other substance used in New Jersey The 2005-2006 NSDUH indicated that 67% of New Jersey young adults (18 to 25 year olds) reported drinking in the past 30 days Approximately 45% of this age group reported binge drinking in the past month, a rate that exceeds the national average (42%) The 2005-2006 NSDUH also indicated 6.65% of New Jersey’s 18 to 25 year olds were dependent on alcohol in the past year, an increase from the prior year’s survey The 2003 New Jersey Household Survey indicated that 56% of 18 to 24 year olds used alcohol in the past month and 12.5% of this age group reported heavy drinking in the past month Data from the 2006 Survey of Social Norms from the CORE Institute indicate that, of New Jersey’s college students surveyed, 43% were binge drinking in the last two weeks The 2005-2006 NSDUH also indicated that 19.6% of 18 to 25 year olds in New Jersey reported illicit drug use in the past month Marijuana use in the past month was at 15.9% for 18 to 25 year olds According to the 2003 New Jersey Household Survey, heroin use among New Jersey 18 to 25 year olds was 5%, while it was only 2% for the same age group at the national level The 2006 Survey of Social Norms indicates that of New Jersey’s college students who were surveyed, 13% use marijuana on a monthly basis Cocaine use in the past year was at 6.1% for this age group According to data from the New Jersey Substance Abuse Monitoring System (NJSAMS) there were 12,554 substance abuse treatment admissions for 18 to 25 year olds in 2007 Heroin and other opiates was the most prevalent drug at admission (43%) for this group, followed by marijuana (26%) and alcohol (21%) Cocaine comprised 7% of admissions for this age group The five (5) counties with the greatest number of substance abuse admissions for this age group were Ocean (11%), Monmouth (10%), Camden (9%), Gloucester (6%) and Middlesex (6%) Intoxicated driving is also a concern in New Jersey Impaired driving is a severe threat to public safety The National Highway Traffic Safety Administration estimates alcohol was involved in 40% of fatal crashes in 2000 and the highest intoxication rates in fatal crashes were for drivers aged 21 to 24 years old (27%) Also, the Center for Disease Control and Prevention reports that alcohol-impaired driving is highest among persons aged 21 to 24 years old The rate of driving under the influence of alcohol among current drivers aged 18 or older in New Jersey between 2004 and 2006 was 11.3% (NSDUH) The Fatal Accident Reporting System (FARS) data for 2006 indicate that 44% of all fatal motor vehicle crashes involved alcohol in New Jersey, making it the 14 th highest percentage in the nation Data from New Jersey’s Intoxicated Driving Program for 2007 indicate that 28%, or 4,714 of the participants are 18 to 25 years old Consequently, based on the prevalence of substance use and misuse, the impact of the consequences, and perception that with effective intervention both the substance use and the resulting harm can be reduced, the NJ SPF- SIG Advisory Council, with input from CSAP, identified the reduction of harmful consequences of alcohol and drug use among 18 to 25 year olds as New Jersey’s priority problem The need for effective data driven approaches to prevent the onset and reduce the progression of substance abuse problems in New Jersey, especially underage drinking, is very clear New Jersey’s Implementation of the SPF The purpose of the NJ SPF is to institutionalize a data driven planning process throughout the State prevention system to decrease both underage drinking and the harmful consequences of alcohol and drug use among 18 to 25 year olds at the community level The NJ SPF is a public health, outcomes-based prevention approach that uses data to drive prevention decision-making The goals and objectives of the NJ SPF are being achieved through strong collaborations among State, community, and academic partners, who work together to implement the NJ SPF, and develop prevention expertise and infrastructure to sustain the process in selected communities Moving SAMHSA’s SPF from concept to practice is a process that State and community stakeholders must undertake in partnership In order to meet the requirements of the SPF-SIG and lay the groundwork for community implementation of the NJ SPF, DAS has successfully operationalized the NJ SPF at the State level and will provide the necessary leadership and technical support to ensure that selected community applicants implement the steps of the NJ SPF The State-level implementation of the NJ SPF over the past one and a half (1 ½) years is described below Conducting a Statewide Needs Assessment New Jersey assessed State prevention needs and resources through collection and analyses of epidemiological and other data The process included assessment of the magnitude of substance abuse in the State; identification of gaps in data collection; and identification of a priority issue based on data analyses by the SEOW In order to identify and rank appropriate data indicators on substance use and substance related consequences and describe the nature and extent of the problem, New Jersey called upon the NJ SPF-SIG Advisory Council, which represents both State and community partners in the prevention system The NJ SPF-SIG Advisory Council made the final decision on New Jersey’s priority problem, acting on data and recommendations furnished by the SEOW Building State and Community Prevention System Capacity New Jersey has been involved in engaging key stakeholders, coalitions and service providers to plan and implement the NJ SPF The NJ SPF-SIG Advisory Council was created to provide oversight and guidance for this project This infrastructure will be critical in sustaining the NJ SPF Members of the NJ SPF-SIG Advisory Council include representatives from:  Substance Abuse Mental Health Services Administration – Center for Substance Abuse Prevention (funder)  Governor’s Office  Division of Addiction Services, Department of Human Services  Governor’s Council on Alcoholism and Drug Abuse  Juvenile Justice Commission  New Jersey State Police  New Jersey Prevention Network  Northeast Center for Applied Prevention Technologies          (Lead Agency) Childhood Drinking Coalition County Alcohol and Drug Directors Department of Education Department of Health and Senior Services Division of Highway Traffic Safety Drug Enforcement Administration Department of Labor and Workforce Development Association for Student Assistance Professionals Camden County Cultural Competence Institute  Princeton Center for Leadership Training  Princeton House Behavioral Health  Rowan University  Rutgers University  New Jersey Office of Faith-Based Initiatives  Partnership for a Drug-Free New Jersey  Hispanic Family Center Developing a Comprehensive Statewide Strategic Plan The NJ SPF planning model is collaborative, diverse, and community-oriented This model considers community needs and resources as described by quantitative and qualitative data as well as State resources to address capacity building to improve communities’ ability to address priority substance problems The integration of State and community expertise in planning is an important component of New Jersey’s State Strategic Plan It is also flexible so that the emphasis within and across the State is ultimately determined by the specific needs and characteristics of New Jersey’s communities Using data from the State Epidemiological Profile and other information from key stakeholders, New Jersey’s State Strategic Plan identified the harmful consequences of alcohol and drug use among 18 to 25 year olds as the priority issue for the NJ SPF and described the process by which DAS would institutionalize the five (5) steps of the NJ SPF at the State level using a comprehensive approach to address alcohol and drug consumption and consequences, including underage drinking The New Jersey State Strategic Plan for Substance Abuse Prevention can be found at: http://www.state.nj.us/humanservices/das/xxxx.pdf Implementing Evidence-Based Prevention Programs and Infrastructure Development Activities The NJ SPF will allocate resources to communities to implement effective interventions and infrastructure development activities Through the NJ SPF, DAS has enhanced the State prevention infrastructure to provide ongoing support for community implementation through training and technical assistance provided by the Northeast Center for Applied Prevention Technologies (NECAPT), as well as staff from DAS Monitoring Process, Evaluating Effectiveness, Sustaining Effective Programs/Activities, and Improving or Replacing Those That Fail New Jersey’s DAS is accountable for all results of the NJ SPF DAS and its academic partner, the Institute for Families at Rutgers University, will provide ongoing monitoring and evaluation of all NJ SPF activities, as well as training and technical assistance regarding evaluation and performance measurement to NJ SPF contractees Through these efforts, New Jersey will assess project effectiveness, identify successes, encourage needed improvements, and promote cultural competency and sustainability of effective policies, practices, and programs Who Can Apply? The following eligibility criteria shall apply: Under the NJ SPF, DAS seeks to fund communities rather than agencies or programs As such, proposals may be submitted by partnerships, task forces, or coalitions with one entity acting as the lead or by an organization acting as the lead partner among a group of organizations The lead applicant must demonstrate collaboration and partnership with at least two (2) other outside entities Applicants may be community-based organizations, faith-based organizations, schools/universities, military organizations, other public entities (including tribal entities, local or county governments, etc.), or private non-profit organizations – all of whom must apply on behalf of their partnership, task force, or coalition Local government entities and nonprofit agencies may apply as the lead agency on behalf of a partnership/coalition or task force The lead agency will accept fiduciary, coordinating and convening responsibility for the partnership/coalition If the applicant must secure a fiscal agent, a Memorandum of Agreement (MOA) with the fiscal agent must be included as part of this application Applicants must have a New Jersey address and be able to conduct business from a facility located in New Jersey Non public applicants must demonstrate that they are incorporated through the New Jersey Department of State, and provide documentation of their current non-profit status as applicable Applicants must not be suspended or debarred by DAS or any other State or Federal entity from receiving funds An applicant that is a current DHS/DAS contractee must be in compliance with the terms and conditions of its current contract Agencies that have been notified by DAS that they are currently “not in good standing” with DAS may apply, but will have fifteen points administratively deducted from their average score received after review Applicants must have all outstanding Plans of Correction (PoC) for deficiencies submitted to DAS for approval prior to submission Applicants must have a governing body that provides oversight as is legally permitted No member of the Board of Directors can be employed as a consultant to the successful applicant a NOTE: If, at the time of receipt of the proposal, the applicant does not comply with this standard, the applicant must submit evidence that it has begun to modify its structure and that the requirement will be met by the time the contract is executed If this required organizational structure is not in place before the start date, the contract will not be executed and the funding will be waived Applicants must also attend one (1) of the Mandatory Bidders’ Conferences/Trainings (see Attachment for dates/locations/directions) RFP Package The proposal package includes the following:  RFP including narrative instructions for this specific contract  DAS Contract Application How to Get a RFP Package  Contact Helen Staton Office of the Director DAS P.O Box 362 Trenton, NJ 08625 (609) 633-8781  Download the RFP from the DHS/DAS website at http://www.state.nj.us/humanservices/publicnotice.html Click on the link entitled “Grants, RFP’s, Public Notices” and download the RFP under “Request for Proposals (RFP’s)”  Download the contract application forms from the DAS website at http://www.state.nj.us/humanservices/das/dascontracts.htm  Attend one of the Mandatory Bidders’ Conferences/Trainings How will you ensure that your evaluation processes will be culturally competent? Describe how you will coordinate with the independent State Evaluator Budget Requirements – (10 points) What is your capability of doing financial reports and the frequency? (i.e what software programs are you utilizing for financial reporting?) To whom you report externally using electronic media? How often (i.e quarterly, monthly)? Do you file any external monthly or quarterly expenditure reports electronically? Do you bill Medicaid? List all of the agencies that you bill electronically Do any of your current and/or former paid employees and/or board members actively participate in lobbying activities? If so, please identify and detail any of the costs allocated to any of your state contracts? If your agency has any paid registered lobbyists, identify and detail any of the costs allocated to your DAS budget proposal Does your agency have a line of credit? If so, what is the amount of your agency’s line of credit? Who is the lender(s) who provides the line of credit? If an amount was borrowed, what was the reason; and, list month by month, for the last 12 months of credit utilization Is it expected to continue over the next 12 months? Please explain Are there any audits, other than the required single audit, pending or in progress? Who requested the audit? What is the firm’s name and telephone number? What type of audit is this? Applicants should allocate a minimum of five percent (5%) of their budget to fund technical assistance in the area of cultural competence The applicant must allocate $12,500 of their budget for community level evaluation services to be provided by the State Evaluator This amount will be transferred into a State account for payment to the Evaluator Required Documentation Applicants responding to this RFP shall submit their application organized in the following manner: Part I Cover letter Narrative DAS Application for Contract Funds including Board Resolution Validation form and two (2) original signed Standard Language Documents Part II - Appendices – Items to be included to augment and support your application: Agency Information a Copy of a Certificate of Incorporation in New Jersey; b Evidence of the applicant’s non-profit status; c Agency mission statement; d Job descriptions of key personnel and resumes if on staff; e Current salary ranges, if not included in the job descriptions; f Organizational chart; g Documentation of agency’s prior disciplinary action, if any; Agency Policies a Copy of agency code of ethics and/or conflict of interest policy Letters of Support/Affiliation Agreements; Fiscal Documentation a List of current members of the Board of Directors and officers, including their titles and terms of service (Complete utilizing the budget forms located in the DAS Application for Contract Funds); b Budget for initial 12 month period of the contract that should clearly delineate initial and operational costs for the period (Complete utilizing the budget forms located in the DAS Application for Contract Funds) c Annualized budget for the operational cost associated with the second 12 month period (Complete utilizing the budget forms located in the DAS Application for Contract Funds d Overall agency budget with cost allocation plan with appropriate statistics and basis (Complete utilizing the budget forms located in the DAS Application for Contract Funds) e Most recent and previous single audit report (A133) or certified statements (only two copies to be included with original proposal); f Any other audits performed in the last two years (only two copies to be included with original proposal); g If there are any audits pending or in progress, list the firm completing this audit(s), contact name and telephone number; h Most recent IRS Form 990/IRS Form 1120, and Pension Form 5500, if applicable (only two copies to be included with original proposal); i List of all contracts and grants to be awarded to the agency by the Federal, State, local government or a private agency during the contract term, including awarding agency name, amount, period of performance, and purpose of the contract/grant, as well as a contact name for each award and the phone number; j Affirmative Action Certificate of Employee Information Report and /or newly completed AA 302 form; k N.J.S.A 52:34-13-2 Source Disclosure Certification Form (replaces Executive Order 129 form); l Certification Regarding Debarment, Suspension, Ineligibility (Attachment 3) m List of the names and addresses of those entities providing support and/or money to help fund the program for which the proposal is being made, including the funding amount Review and Award Information A) Schedule The following summarizes the application schedule: December 15, 2008 Notice of Availability of Funds January 5, and 7, 2009 Mandatory Bidders’ Conference (attend only) February 11, 2009 Deadline for receipt of applications - no later than 5:00 p.m March 20, 2009 Award announcement May 1, 2009 Anticipated award start date B) Screening for Eligibility, Conformity and Completeness DAS staff will screen applications for eligibility and conformity with the specifications in this RFP The initial screen will be conducted to determine whether or not the application is eligible for review To be eligible for review by the Review Committee, staff will verify with the proper authority and through a preliminary review of the application that: the applicant is not debarred or suspended by DHS or any other State or Federal entity from receiving funding; the applicant is incorporated nonprofit organization in the State of New Jersey; all outstanding PoC’s have been submitted to DAS, if applicable; Board requirements have been met; and the application is included and complete Those applications that fail this eligibility screen will not be reviewed Those applications found eligible for review will be distributed to the Review Committee as described below C) Review Committee DAS will convene a committee consisting of government staff who will conduct a review of each proposal, in accordance with the review criteria Committee members may be unfamiliar with some or all of the applicants All potential reviewers will complete conflict of interest forms Those with conflicts or the appearance of conflicts will be disqualified from participating in the review The Review Committee will score applications and recommend for funding in the priority order of the scores (highest score = most highly recommended) A minimum score of 70 must be achieved in order to be considered for funding D) Funding Recommendations The Chair of the Review Committee will convey the recommendations to the Director of DAS who will make the final decision on the award Applicants are advised that awards may be made conditional upon changes suggested by the Review Committee and/or DAS staff The requested changes, along with their requested implementation dates, will be communicated to the prospective awardees prior to award Post Award Requirements A) Documentation Upon award announcement, the successful applicant must submit one (1) copy of the following documentation (if not already submitted with the application) in order to process the contract in a timely manner: 10 11 12 13 14 15 16 17 18 19 20 Proof of insurance naming the State of New Jersey, Department of Human Services, Division of Addiction Services, PO Box 362, Trenton, NJ 08625-0362 as an additional insured; Board Resolution authorizing who is approved for entering into a contract and signing related contract documents; Two (2) signed originals of the Department of Human Services Standard Language Document; Current Agency By-laws; Current Personnel Manual or Employee Handbook; Copy of Lease or Mortgage; Certificate of Incorporation; Conflict of Interest Policy; Affirmative Action Policy; Affirmative Action Certificate of Employee Information Report and/or newly completed AA 302 form (AA Certificate must be submitted within 60 days of submitting completed AA302 form to Office of Contract Compliance); A copy of all applicable licenses; Local Certificates of Occupancy; Most recent State of New Jersey Business Registration; Procurement Policy; Current Equipment inventory of items purchased with DHS funds (Note: the inventory shall include: a description of the item, a State identifying number or code, original date of purchase, date of receipt, location at the Provider Agency, person(s) assigned to the equipment, etc ); All Subcontracts or Consultant Agreements, related to the DHS Contracts, signed and dated by both parties; Business Associate Agreement (BAA) for Health Insurance Portability Accountability Act of 1996 compliance, if applicable, signed and dated; Updated single audit report (A133) or certified statements, if differs from one submitted with application; Updated IRS Form 990, if differs from one submitted with application; Updated Pension Form 5500, if applicable, if differs from one submitted with 21 22 23 24 application; Copy of Annual Report; Department of Human Services Statement of Assurances (attached to this RFP); Source Disclosure Certification form (replaces Executive Order 129 compliance forms); and Certification Regarding Debarment, Suspension, Ineligibility (attached to this RFP) B) Award Requirements Awardees must adhere to the following: Enter into a contract with DAS and comply with applicable DHS and DAS contracting rules and regulations; Comply with all applicable State and Federal assurances, certifications and regulations regarding the use of these funds; Inform the Program Management Officer of any publications/publicity based on the award; Comply with all appropriate State licensure regulations; and Comply with the Americans with Disabilities Act requirements C) Training/Technical Assistance and Site Visits All of the successful applicants will receive training and technical assistance for both the planning and implementation phases The support will include various tools and materials (e.g., a profile of local substance use and abuse data) as well as regional and state training events There will be an opportunity to interact with peers and mentors engaged in similar prevention efforts DAS Program Management Officers will conduct site visits to monitor the progress in accomplishing responsibilities and corresponding strategy for overcoming these problems An awardee’s failure to comply with reporting requirements may result in loss of the contract The awardee will receive a written report of the site visit findings and will be expected to submit a plan of correction Attachment STATE OF NEW JERSEY DEPARTMENT OF HUMAN SERVICES ADDENDUM TO REQUEST FOR PROPOSAL FOR SOCIAL SERVICE AND TRAINING CONTRACTS Executive Order No 189 establishes the expected standard of responsibility for all parties that enter into a contract with the State of New Jersey All such parties must meet a standard of responsibility which assures the State and its citizens that such parties will compete and perform honestly in their dealings with the State and avoid conflicts of interest As used in this document "provider agency" or "provider" means any person, firm, corporation, or other entity or representative or employee thereof which offers or proposes to provide goods or services to or performs any contract for the Department of Human Services In compliance with Paragraph of Executive Order No 189, no provider agency shall pay, offer to pay, or agree to pay, either directly or indirectly, any fee, commission, compensation, gift, gratuity, or other thing of value of any kind to any State officer or employee or special State officer or employee, as defined by N.J.S.A 52:13D-13b and e, in the Department of the Treasury or any other agency with which such provider agency transacts or offers or proposes to transact business, or to any member of the immediate family, as defined by N.J.S.A 52:13D-13i, of any such officer or employee, or any partnership, firm, or corporation with which they are employed or associated, or in which such officer or employee has an interest within the meaning of N.J.S.A 52:13D13g The solicitation of any fee, commission, compensation, gift, gratuity or other thing of value by any State officer or employee or special State officer or employee from any provider agency shall be reported in writing forthwith by the provider agency to the Attorney General and the Executive Commission on Ethical Standards No provider agency may, directly or indirectly, undertake any private business, commercial or entrepreneurial relationship with, whether or not pursuant to employment, contract or other agreement, express or implied, or sell any interest in such provider agency to, any State officer or employee or special State officer or employee having any duties or responsibilities in connection with the purchase, acquisition or sale of any property or services by or to any State agency or any instrumentality thereof, or with any person, firm or entity with which he is employed or associated or in which he has an interest within the meaning of N.J.S.A 52:13D-13g Any relationships subject to this provision shall be reported in writing forthwith to the Executive Commission on Ethical Standards, which may grant a waiver of this restriction upon application of the State officer or employee or special State officer or employee upon a finding that the present or proposed relationship does not present the potential, actuality or appearance of a conflict of interest No provider agency shall influence, or attempt to influence or cause to be influenced, any State officer or employee or special State officer or employee in his official capacity in any manner which might tend to impair the objectivity or independence of judgment of said officer or employee No provider agency shall cause or influence, or attempt to cause or influence, any State officer or employee or special State officer or employee to use, or attempt to use, his official position to secure unwarranted privileges or advantages for the provider agency or any other person The provisions cited above shall not be construed to prohibit a State officer or employee or special State officer or employee from receiving gifts from or contracting with provider agencies under the same terms and conditions as are offered or made available to members of the general public subject to any guidelines the Executive Commission on Ethical Standards may promulgate Attachment Department of Human Services Statement of Assurances As the duly authorized Chief Executive Officer/Administrator, I am aware that submission to the Department of Human Services of the accompanying application constitutes the creation of a public document and as such may be made available upon request at the completion of the RFP process This may include the application, budget, and list of applicants (bidder’s list) In addition, I certify that the applicant:  Has legal authority to apply for the funds made available under the requirements of the RFP, and has the institutional, managerial and financial capacity (including funds sufficient to pay the non Federal/State share of project costs, as appropriate) to ensure proper planning, management and completion of the project described in this application  Will give the New Jersey Department of Human Services, or its authorized representatives, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with Generally Accepted Accounting Principles (GAAP) Will give proper notice to the independent auditor that DHS will rely upon the fiscal year end audit report to demonstrate compliance with the terms of the contract  Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain This means that the applicant did not have any involvement in the preparation of the RFP, including development of specifications, requirements, statement of works, or the evaluation of the RFP applications/bids  Will comply with all federal and State statutes and regulations relating to nondiscrimination These include but are not limited to: 1.) Title VI of the Civil Rights Act of 1964 (P.L 88-352;34 CFR Part 100) which prohibits discrimination on the basis of race, color or national origin; 2.) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C 794; 34 CFR Part 104), which prohibits discrimination on the basis of handicaps and the Americans with Disabilities Act (ADA), 42 U.S.C 12101 et seq.; 3.) Age Discrimination Act of 1975, as amended (42 U.S.C 6101 et seq.; 45 CFR part 90), which prohibits discrimination on the basis of age; 4.) P.L 2975, Chapter 127, of the State of New Jersey (N.J.S.A 10:5-31 et seq.) and associated executive orders pertaining to affirmative action and non-discrimination on public contracts; 5.) federal Equal Employment Opportunities Act; and 6.) Affirmative Action Requirements of PL 1975 c 127 (NJAC 17:27)  Will comply with all applicable federal and State laws and regulations  Will comply with the Davis-Bacon Act, 40 U.S.C 276a-276a-5 (29 CFR 5.5) and the New Jersey Prevailing Wage Act, N.J.S.A 34:11-56.27 et seq and all regulations pertaining thereto  Is in compliance, for all contracts in excess of $100,000, with the Byrd Anti-Lobbying amendment, incorporated at Title 31 U.S.C 1352 This certification extends to all lower tier subcontracts as well  Has included a statement of explanation regarding any and all involvement in any litigation, criminal or civil  Has signed the certification in compliance with federal Executive Orders 12549 and 12689 and State Executive Order 34 and is not presently debarred, proposed for debarment, declared ineligible, or voluntarily excluded Will have on file signed certifications for all subcontracted funds  Understands that this provider agency is an independent, private employer with all the rights and obligations of such, and is not a political subdivision of the Department of Human Services  Understands that unresolved monies owed the Department and/or the State of New Jersey may preclude the receipt of this award Applicant Organization Signature: Chief Executive Officer or Equivalent Date Typed Name and Title 6/97 Attachment READ THE ATTACHED INSTRUCTIONS BEFORE SIGNING THIS CERTIFICATION THE INSTRUCTIONS ARE AN INTEGRAL PART OF THE CERTIFICATION Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by an Federal department or agency Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal Name and Title of Authorized Representative Signature Date This certification is required by the regulations implementing Executive order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions Instructions for Certification By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below The certification in this clause is a material representation of facts upon which reliance was placed when this transaction was entered into If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverage sections of rules implementing Executive Order 12549 You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous A participant may decide the method and frequency by which it determines the eligibility of its principals Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings Except for transactions authorized under paragraph of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment Attachment Dates and Locations/Directions for Mandatory Bidder’s Conferences/Trainings Note that all applicants MUST attend one (1) of the Mandatory Bidder’s Conferences/Trainings in order to be eligible to apply for funding Mandatory Bidders’ Conferences/Trainings will be held on January 5, 6, and 7, 2009 in three locations to meet the travel needs of interested parties Attendance is required at one (1) of the Mandatory Bidders’ Conferences/Trainings Attendance at one (1) of these Mandatory Bidder’s Conferences/Trainings will provide applicants an opportunity to ask questions about the RFP requirements or the award process, as well as clarify any changes that may be made to this RFP This ensures that all potential applicants will have equal access to information The Mandatory Bidders’ Conferences/Trainings will also provide training on the NJ SPF, which will aid applicants understanding of the SPF process and ensure thoughtful submission of proposals All trainings will be held from 1:00 – 4:00 Neither lunch nor refreshments will be provided Please note that no food or beverages (other than water) are allowed at the Jewish Community Center of Paramus January 5, 2009 - South Gloucester County Office New Jersey Department of Education 1492 Tanyard Road Sewell, NJ 08080 Directions: http://www.nj.gov/education/counties/directions/glo.htm January 6, 2009 – Central Monmouth County Agriculture Building 4000 Kozloski Road Freehold, NJ 07728 Directions: (park behind the building): http://www.nj.nrcs.usda.gov/contact/Directions_Freehold.html January 7, 2009 – North The Jewish Community Center of Paramus E 304 Midland Avenue, Paramus, NJ 07652 Directions: http://www.jccparamus.org/aboutus7.htm Attachment Community Readiness Tool From the Tri-Ethnic Center for Prevention Research Community Readiness Questions The term “this issue” used in the example questions refers to substance use among 1825 year olds in your community A COMMUNITY EFFORTS (Programs, Activities, Policies, etc.) Using a scale from 1-10, how much of a concern is this issue in your community, with one being not at all and ten being a very large concern? Please explain Please describe the efforts that are currently available in your community to address this issue? How long have these efforts been going on in your community? Using a scale from to 10, how aware are people in the community of these efforts, with one being no awareness and ten being very aware? Please explain What are the strengths of these efforts? What are the weaknesses of these efforts? Who these programs serve? (For example: individuals of a certain age group, ethnicity, etc.) Would there be any segments of the 18-25 year old population in your community for which these efforts/services may appear inaccessible? (For example: ethnicity, income level, geographic location, etc.) What formal or informal policies, practices and laws related to this issue are already in place in your community, and for how long? (Prompt: An example of formal would be school, police, or courts and an example of informal would be like the police not responding to a particular part of town, etc.) 10 Are there segments of the community for which these policies, practices and laws may not apply? (Prompt: for example, due to socioeconomic status, ethnicity, age, etc.) 11 Is there a need to expand these policies, practices and laws? If yes, are there plans to expand? Please explain 12 How does the community view these policies, practices and laws? B LEADERSHIP 13 Who are the leaders specific to this issue in your community? 14 Using a scale from to 10, how much of a concern is this issue to the leadership in your community, with one being not at all and ten being a very large concern? Please explain 15 How are the “leaders” in your community involved in efforts regarding this issue? Please explain (For example: Are they involved in a committee, task force, etc.? How often to they meet?) 16 Would the leadership support additional efforts? Please explain C COMMUNITY CLIMATE 17 What is the community’s attitude about this issue? 18 What are the primary obstacles to efforts in your community? 19 Is there ever a time or circumstance in which members of your community might think that this issue should be tolerated? D KNOWLEDGE ABOUT THE ISSUE 20.How knowledgeable are community members about this issue Please explain (Such as: dynamics, signs, symptoms, statistics, effects on family and friends, etc.) 21.What type of information is available in your community regarding this issue? 22.What local data on this issue are available in your community? 23 How people obtain this information in your community? E RESOURCES FOR PREVENTION EFFORTS 24 To whom would an individual affected by this issue turn first for help and why? 25 On a scale from 1-10, what is the current level of expertise and training among those in your community working on this issue? Please explain 26 Do efforts that address this issue have a broad base of volunteers? 27 What is the community’s and/or local business’ attitude about supporting efforts with people volunteering time, making financial donations, and/or providing space? 28 How are the current efforts funded? Please explain 29 Are you aware of any proposals or action plans that have been submitted for funding to address this issue in your community? If yes, please explain 30 Do you know if there is any evaluation of these efforts? If yes, using a scale from to 10, how sophisticated is the evaluation effort, with one being not at all and ten being very sophisticated? 31.Are the evaluation results being used to make changes in programs, activities, or policies or to start new ones? ... communities must develop a strategic plan that articulates not only a vision for the prevention activities, but also strategies for organizing and implementing prevention efforts The strategic plan must... available in your community? 23 How people obtain this information in your community? E RESOURCES FOR PREVENTION EFFORTS 24 To whom would an individual affected by this issue turn first for help and... of Community: For purposes of this announcement a broad definition of ? ?community? ?? has been adopted A community is a group of individuals defined by a common interest or purpose For example, a community