Details Matter

Name of Project Coordinator Resume of PC Date of hire Contact info for those involved in the

initiative If no PC hired, describe process of

recruitment Justification of cost that includes salary

and benefits of staff

Task # Product/ Milestones

Reporting Requirements

Provide a narrative description of successes, barriers, challenges and next steps for each task. Reference any supporting

documents submitted separately as attachments.

Cost of Task(s)

Justification of Cost(s)

Task 1 Hire/Identify a Program Coordinator

1) Submit Resumes for Program Coordinator position 2) Submit contact information for all individuals involved with this contract.

Jane Smith is the Alcohol Prevention Initiative Program Coordinator for Region 6 that includes, Upson , Crisp, and Peach County. Please see Task 1: Attachment 1 for Jane Smith’s resume. Please see Task 1: Attachment 2 for contact information for individuals involved with this contract.

$8083.33 100% of Jane Smith’s time is dedicated to the alcohol Initiative. Monthly pay for Ms. Smith is $ 3,233.33. Salary for PC$ was pro-rated for October and paid in full for Nov/Dec. Cost includes all FICA/benefits.

List of attendees Specific travel costs associated with each

attendee (include mileage, lodging, per diem for each attendee)

Task #

Product/ Milestone

s

Reporting Requirements

Provide a narrative description of successes, barriers,

challenges and next steps for each task. Reference any

supporting documents submitted separately as

attachments.

Cost of Task(s)

Justification of Cost(s)

Task 2 Attend Georgia Strategic Prevention System (GASPS)Orientation

Provide a list of individual(s) who attended the training.

On November 22, 2011, Region 6 Program Coordinator, Jane Smith registered for the Strategic Prevention System (GASPS) Orientation.Region 6 Program Coordinator, Jane Smith attended the Georgia Strategic Prevention System (GASPS) Orientation in Macon Georgia on December 2, 2011. Please see Task 2: Attachment 1 for the list of individuals who attended the training. There were no challenges or barriers in attending the GASPS orientation.

$246 mileage of 320 miles @.50; meals @ $22; hotel room at Macon Hotel $74

List of attendees Specific travel costs associated with each

attendee (include mileage, lodging, per diem for each attendee)

Task #

Product/ Milestones

Reporting Requirements

Provide a narrative description of successes, barriers, challenges and next steps for each task. Reference

any supporting documents submitted separately as attachments.

Cost of

Task(s)

Justification of Cost(s)

Task 3 Attend required initial training convened by the Office of Prevention Services and Programs (OPSP) adhering to all registration, logistical and learning assignments.

Provide list of individuals who attended the training and their role in this project.

On November 22, 2011, Region 6 Program Coordinator, Jane Smith registered for the Georgia Strategic Prevention System (GASPS) Strategic Prevention Framework training overview. Region 6 Program Coordinator, Jane Smith, attended the Georgia Strategic Prevention System (GASPS) Strategic Prevention Framework training overview in Macon Georgia on December 7, 2011. On December 12, Region 6 Program Coordinator attended the GASPS Coalition Building Webinar for regions 5 and 6 Please see Task 3: Attachment 1 for the list of individuals who attended the training. There were no challenges or barriers in attending GASPS and SPF Overview trainings.

$246 mileage of 320 miles @.50; meals @ $22; hotel room at Macon Hotel $74

Organizational Chart Alcohol Initiative Staffing chart Description for each staff member

associated with the Alcohol Initiative. Their individual role with the project/ what

they do Amount of time dedicated to the initiative Amount paid from this contract for their

contribution to the initiative Make sure to describe the tasks they helped

complete throughout the report

Task #

Product/ Milestones

Reporting Requirements

Provide a narrative description of

successes, barriers, challenges and next steps for each task.

Reference any supporting documents

submitted separately as attachments.

Cost of

Task(s)

Justification of Cost(s)

Task 4 & 5

Organizational and Initiative charts

1) Submit an organizational chart. 2) Submit an alcohol prevention initiative staffing chart

Please see Task 4 & 5: Attachment 1 for an organization chart of the Community Agency Against Alcohol and Drugs. Please see Task 4 & 5: Attachment 2 for an Alcohol Prevention Initiative staff chart

$100 Internet Service

Provide (For Each County you propose to serve) the coalition name, contact names for coalition/collaborative coordinators, meeting roster (to verify your attendance) and minutes for coalition meetings

Include meeting dates, your rationale for involvement with this coalition as well as any orientation/training provided the coalition

Include MOUs with coalition If no coalition, describe efforts to establish a

coalition in that community

Task # Product/ Milestones

Reporting Requirements

Provide a narrative description of successes, barriers, challenges and next

steps for each task. Reference any supporting documents submitted

separately as attachments.

Cost of

Task(s)

Justification of Cost(s)

Task 6 Join, establish and/or convene a Substance Abuse Prevention/ Drug-Free Community Coalition (aside from a Family Connection Collaborative)

1) Submit meeting minutes and signature roster along with MPR reports. 2) If the Coalition has to be established provide thorough description of monthly progress.

The Program Coordinator notified target communities (via email and telephone) in each selected region 6 county to inform them about The Community Agency Against Alcohol and Drugs becoming a GASPS provider . Ms. Smith conducted research to identify Substance Abuse Prevention Coalition/Drug-Free Community Coalitions in Upson, Crisp and Peach counties and met with the Family Connection Coordinators in those counties on November 29 & 30 and Dec.1, 2011. On December 9, 2011, Ms. Smith attended the Peach Co. Family Connection Collaborative meeting and provided meeting attendees with information about the Alcohol Prevention Initiative . The Collaborative set aside time for the PC to speak to the meeting attendees about the Alcohol Prevention Initiative. Through this meeting it was determined there is not a local Substance Abuse Prevention/Drug-Free Community Coalition; however, the collaborative has a goal to reduce marijuana and alcohol use in their community. The PC will attend collaborative meetings for Upson and Crisp in January. Please see Task 6: Attachment 1 & 2 –Peach County meeting minutes and sign-in sheets.

$635 Travel to coalition meetings 450 miles @ .50 = $225;$160 phone; $100 Underage drinking & Binge drinking pamphlets; $150 office supplies used to provide training related to SPF & the API to community coalition members and stakeholders

Describe in detail the efforts to convene CPAW, include meeting minutes, dates, rosters, etc.

Submit signed agreements/MOUs Submit sub-group meeting minutes (if

you have more than one representative for each sub-group a. Epi b. Planning and Operational c. Evaluation and Sustainability

Task #

Product/ Milestones Reporting Requirements

Provide a narrative description of successes, barriers,

challenges and next steps for each task. Reference any

supporting documents submitted separately as

attachments.

Cost of

Task(s)

Justification of Cost(s)

Task 7 & 8

Establish and convene the Community Prevention Alliance Workgroup (CPAW) consisting of the following three sub-workgroups within one month of contract enactment:a. Epi Workgroupb. Planning and Operational Workgroupc. Evaluation and Sustainability Workgroup

1) Signed Membership Agreements from CPAW. 2) Submit sub-workgroup meeting minutes and signature roster along with MPR reports.

The PC reviewed the Strategic Prevention Framework (SPF) and Orientation information to help prepare for the formation of the CPAWs and how each sub-workgroup will be incorporated in the SPF model. Following the Peach County collaborative meeting, the PC identified members who are interested in participating in the CPAW. The first meeting will be January 20, 2012. Task 7- Attachment 1 contains MOUs. CPAW members for Upson and Crisp will be identified after the January collaborative meetings.

$0 The CPAW members were identified during the completion of Task 6.

Task 6 is ongoing. Your participation should continue beyond attending one meeting to get your name on the roster.

Tasks 7 & 8 are ongoing and should be completed monthly.

You are expected to submit/attach the information requested in the “Reporting Requirements” column to support your narrative.

Attachments should be labeled by the corresponding task

Your monthly report is due monthly