WASHINGTON DRUG & ALCOHOL COMMISSION, INC.
LIMITED TERM SINGLE SERVICE
PREVENTION GRANT REQUEST PROPOSAL
2017-2018
1
INTRODUCTION
The Washington Drug and Alcohol Commission, Inc. is requesting proposals from interested community organizations to conduct community projects during the 2017-2018 contract year for the prevention of alcohol, tobacco, and other drug (ATOD) abuse. Proposals must be submitted in the format indicated in this RFP to the Commission's office via e-mail to: may either type your proposal in the space provided on the form, or create your own proposal using the same format (on 8 ½ x 11” paper). Your proposal must bear the signature of the project applicant and an officer of the organization authorized to bind the applicant to the stated terms.
Organizations submitting proposals are advised that any agreement resulting from the proposal process will incorporate the finalized proposal as a part of the contract.
ELIGIBILITY
These limited term single service prevention grants are being made available by the Commission in an effort to recognize and support the local efforts ofany established community organization providing services in Washington County is eligible for consideration, and it is not necessary that applicants be incorporated as non-profit organizations or licensed as providers of drug and alcohol prevention services. Applicants may apply for funding for projects not exceeding a total cost of $2,000.
CRITERIA FOR SELECTION
At the direction of the Department of Drug and Alcohol Programs, all projects, services or activities proposed must be directly related to achievement of one or more of the three priorities established by DDAP. Washington Drug and Alcohol Commission require that the funds be used to focus on the following prevention priorities: driving under the influence, prescription drug misuse, and marijuana use. Both educational and alternative activities projects are encouraged. Experiential programs offering new choices to high-risk populations are desirable. Applicants should be aware that alternative activities projects must also include a prevention education component to be eligible for funding. Applying organizations must clearly demonstrate in their proposals how proposed services or activities will encourage recipients to choose an alcohol, tobacco, and other drug-free lifestyles.
Awards may be granted to those groups submitting proposals, which demonstrate strengths in the areas that follow. While these areas encompass a large part of the proposal evaluation, they are not the total determinate. The Commission reserves the right to accept or reject proposals as it deems appropriate. Any agreements entered into as a result of this proposal process are subject to the final approval of the Washington Drug & Alcohol Commission, Inc. Board of Directors.
A. Qualifications - Organizations submitting proposals for funding will be evaluated in part on the basis of their past performance in the community. Candidates are expected to have demonstrated success via past performance in the areas of program and service delivery for which they are seeking funding.
B. Relation to Commission’sPriorities – Proposals, objectives and action plan must relate clearly to achievement of at least one of the Commission’s three priorities.
C. Soundness of Approach - Proposing organizations must be prepared, via this proposal and past experience, to demonstrate the soundness of their programmatic approach. In order for an approach to be considered sound, an agency must be able to clearly demonstrate the need for its proposed services, and the agency's ability to fill those needs both quantitatively and qualitatively.
D. Cost - The cost of services will be weighed in evaluating submissions. Cost is not the sole determinate, but will be considered as one of the evaluating criteria.
E. Ability to Sustain Services - It is the Commission's intention that these grants be used to facilitate the development of programs and activities that will be on-going programs, and not "one-time" events. In so stating, applicants should attempt to clearly demonstrate how funds would be used in a manner that would permit ongoing activity to be the result, or how future funding would be secured to ensure the continuation of the project.
FUNDING PROCESS
Groups that receive funding under this RFP will enter into an agreement between the organization and the Washington Drug and Alcohol Commission, Inc. That agreement will specify the billing and reporting process to be used. Payment will be made only for those costs indicated in this proposal and agreed upon by the Commission.
The Commission, as part of this grant program, will require from grantees both a narrative report indicating numbers of people served, numbers and types of services provided, evaluation of program objective achievement, etc., and a fiscal report detailing expenditures and including original receipts/copies of canceled checks.
For technical assistance please call Barb Mundell-O'Hara at the Washington Drug & Alcohol Commission, 724-223-1181 x 113.
Reporting Requirements
1The project shall be responsible for the completion of a fiscal report detailing expenditure of those funds budgeted no later than June 30, 2018. This report will be completed on the form, 2017-2018 Grant Final Budget Report, and will bear the signature of the responsible project officer. Back up documentation (i.e. invoices) must be submitted for any expenditure, for equipment (see definitions), supplies, etc. Any funds remaining over fifty dollars must be returned to the Commission prior to June 30, 2018.
2The Project shall be responsible for the completion of a narrative report indicating what activities and events were undertaken with the grant award. This narrative shall include a complete description of the Project’s program, including pertinent dates, numbers of person served, types of service provided, objectives and priorities. Whenever possible, the Project will attempt to identify the numbers and percentages of women and minorities served, with particular attention being paid to services provided to women with children. This narrative will be submitted on the Prevention Grant Narrative Report form.
WASHINGTON DRUG & ALCOHOL COMMISSION INC.
COMMUNITY ATOD LIMITED TERM SINGLE SERVICE
PREVENTION GRANTS
REQUEST FOR PROPOSAL
2017-2018
Please complete this proposal form, either by typing the information in the space provided, or create your own proposal, being sure to follow this format. The requirements for individual sections are discussed below. Also complete the Letter of Agreement for a 2017-2018 Grant form and submit with your proposal.
A. Organization Information:
Name, address and phone number of the applying organization
Name: Click or tap here to enter text.
Address: Click or tap here to enter text.
Phone Number: Click or tap here to enter text.
E-mail Address: Click or tap here to enter text.
Organization Website: Click or tap here to enter text.
B. History of the Organization:
Briefly describe the history of the organization, its inception, historic mission, past accomplishments, and current services:
Click or tap here to enter text.
C. Contact Person Information:
Name of contact person:Click or tap here to enter text..
Address of contact person: Click or tap here to enter text.
Phone number of contact person:Click or tap here to enter text.
E-Mail address of contact person:Click or tap here to enter text..
D. Target Population:
Indicate whom, from a demographic point of view, the organization serves. Clearly indicate special services that are available to special populations such as the impoverished, handicapped, minorities, children/youth, women or the elderly. Also, state clearly if the proposed services are to target these same groups or a group new to the organization’s experience.
Click or tap here to enter text.
E. Geographic Area to be served:
Please clearly specify the service area. If proposed services are available to the total population of Washington County, so indicate. If the organization works in a specific locale: i.e. the Mon Valley, Burgettstown, etc. please list the specify area.
Click or tap here to enter text.
F. Demonstration of need: Briefly discuss the need for the proposed services for the target population in the specific service area.
Click or tap here to enter text.
G. The project must relate to at least one of the priorities list below. Please check all
priorities that apply to the project.
☐ Driving Under the influence ☐Prescription Drug Misuse ☐ Marijuana Use
H. Service Objective(s)
Construct one or more service objectives.
- Click or tap here to enter text.
I. Action Plan
Describe the activities that will be provided to meet the service objective(s), including time line for completion. Be as concrete and specific as possible.
Click or tap here to enter text.
J. Anticipated number of persons to be served: Click or tap here to enter text.
If possible, describe in terms of age, gender and target population. Otherwise, simply indicate the total number of persons anticipated to benefit from the services and briefly stat how the number was derived.
Click or tap here to enter text.
K. Describe how the proposed project will reduce alcohol, tobacco, or other drug problems:
Discuss how the proposed project will serve the community in decreasing demand for drugs and alcohol, increase awareness of the hazards of abuse, aid individuals in making informed choices, etc. in reference to the three priorities identified above for the project.
Click or tap here to enter text.
L. Other attempts at funding:
If the organization has sought other funding for this project, please indicate what funds were requested and the outcome of those attempts.
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M. Other sources of funds:
If the organization receives other funds to provide services the same as, or similar to, those proposed here, please indicate the source and levels of funding.
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N. Total cash request from the Commission: $ Click or tap here to enter text.
Using the Proposed Budget sheet to breakdown the funds that will be requested to use for the project. These funds cannot be used for salaries, electronic equipment or gift cards to be paid/purchased with the funds.
Proposed Budget
A. Equipment: List all equipment intended to be purchased under this proposal. In doing so, specify item, unit cost, number of items and total costs for each line. No electronic purchase permitted.
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B. Supplies:List all supplies intended to be purchased under this proposal. In doing so, specify item, unit cost, number of items and total costs for each line.
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C. Other Costs: Indicate by category any other expenses anticipated to be funded under this proposal. For example, telephone, postage, transportation and other services would be included. Funds may not be used to pay for salaries or for the use of gift cards.
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Total Budgeted: Click or tap here to enter text.
D. Agency Audit: If available, please attach to the proposal packet a copy of the most recent audit of the organization. This requirement applies only to those groups that have audits completed routinely.
By typing your name in the spacebelow, youagree that you are the
responsible party for the grant and will submit all reports due
on or before June 30, 2018.
Applicant Signature :Click or tap here to enter text.
Date: Click or tap here to enter text.
Attest Signature: Click or tap here to enter text.
Date: Click or tap here to enter text.
Director/Board President Signature: Click or tap here to enter text.
Date: Click or tap here to enter text.
Attest Signature:Click or tap here to enter text.
Date: Click or tap here to enter text.
2017-2018 Prevention Grant Narrative Report
Due by June 30, 2018
Project:Click here to enter text.Total Award: Click here to enter text.
Name of Organization: Click here to enter text.
Person submitting this report: Click here to enter text.
Contact numberClick here to enter text.
Date of program: Click here to enter text.
Targeted audience or open to public? Choose an item. if targeted, targeted to whom? Click here to enter text.
Number of persons attending: Click here to enter text.
Demographic Information of those attending: (ages served, percentage of male/female, minorities served, women with children, area of the county targeted, etc.) Click here to enter text.
Project addressed which priorities? Check all that apply:
☐Driving under the influence ☐Prescription drug misuse ☐Marijuana use
How did the project encourage recipients to choose an alcohol, tobacco and other drug free lifestyle? Click here to enter text.
Description of the project: Click here to enter text.
How will this project be continued to be sustained? Click here to enter text.
Attach photos, videos, PR articles, announcements and flyers when submitting this report.
2017-2018 Grant Final Budget Report
A. Equipment: List all equipment purchased under this grant. In doing so, specify item, unit cost, number of items and total costs for each line. In the difference column please indicate the balance remaining (surplus or negative amount from each line item). No electronics purchases permittedand you must provide an original receipt for all expenses made with grant money.
Description of Item / BudgetedAmount / Expended Amount / Difference / Receipt
Attached?
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B. Supplies:List all supplies purchased under this grant. Specify item, unit cost, number of items and total costs for each line.In the difference column please indicate the balance remaining (surplus or negative amount from each line item). You must provide an original receipt for all expenses made with grant money.
Description of Item / BudgetedAmount / Expended Amount / Difference / Receipt
Attached?
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C. Other Costs: Indicate by category any other expenses funded under this proposal. For example, telephone, postage, transportation and other services would be included. Funds may not be used to pay for salaries or for the use of gift cardsand you must provide an original receipt for all expenses made with grant money.