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2024-152-E-Health Dept-Grow Your World-Opioid prevention in youth
Revised 01/24 1 [Departmental Use Only] TITLE GrowYourWorld-Opioi FY 2023-2024 NORTH CAROLINA SERVICES AGREEMENT NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this Twelfth day of December, 2023, (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and Grow Your World, (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type of project): Provide programs, services, or training to encourage early identification and intervention for children or adolecents who may be struggling with problematic use of drugs or mental health conditions. ii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 2 performance of these services. Provider is solely responsible for the professional quality, accuracy and timely completion and submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. vi) Should any documents, exhibits, or addenda be attached to this Agreement, the terms of this Agreement shall have priority in any conflict with or among the terms of such referenced documents, exhibits. vii) Should this Agreement involve project designs, the construction or creation of which is to be bid out or fulfilled by other contractors, and bidding or negotiation with contractors produce prices which, when added to the other elements of the approved total project cost, produce a cost that is in excess of the approved total project cost, the Provider shall participate with the County in negotiation and design adjustments to the extent such are necessary to obtain prices within the approved total project cost. All activity of the Provider with respect to these matters shall constitute Basic Services and shall be performed by the Provider without additional compensation. If negotiation and design adjustments fail to bring costs within the total project cost the County may reject all bids and Provider will redesign or reduce portions of the project in an effort to reduce the bid prices to within the total project cost and rebid the project. One such redesign is included within Basic Services. If this second letting for bids does not produce bids that are within the approved total project cost initially or after negotiations with the contractor the cost is not reduced to an amount within the total project cost, the Provider is not obligated to engage in further redesign. DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 3 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): Services and support programs, as listed in Exhibit A, 6. Early intervention, that serve persons with Opioid Use Disorder (OUD) or any co-occurring Substance Use Disorder (SUD) or mental health condition as stated in the National Settlement Agreement. First payment of one half of total contract ($10,000) will be paid upon receipt of invoice after signing of contract with the final amount to be paid once the final report and backup based on the submitted budget as shown in Exhibit C has been submitted and reviewed. Reports (Exhibit B) are to be submitted to Orange County Health Department April 15, 2024 (for services dated December 12, 2023 through March 31, 2024) and July 15, 2024 (for services dated April 1, 2024 through June 30, 2024). 4. Duration of Services a. Term. The term of this Agreement shall be from December 12, 2023 to June 30, 2024. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform its services in accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be December 12, 2023. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services satisfactorily (as determined by the County) performed pursuant to this Agreement. The maximum amount payable for Basic Services shall not exceed Twenty Thousand Dollars ($20,000). Payment for satisfactorily performed Basic Services shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Section 5(b). b. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. c. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 4 additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Orange County Health Director, Quintana Stewart) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance a. General Requirements. Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by County’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If County’s Risk Manager determines additional insurance coverage is required such additional insurance shall consist of Sexual Conduct and Physical Abuse Coverage rider (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 8. Indemnity a. Indemnity. To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 5 a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days’ prior written notice to the Provider. b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. Either party may terminate this Agreement upon notice to the other party that obligations pursuant to this Agreement are made impractical due to declarations of emergency by Orange County or by North Carolina due to events directly impacting Orange County. Both parties shall remain responsible for all payment and performance due up to the receipt of such notice, but shall have no further obligation or responsibility beyond that date provided the terminating party has taken all reasonable steps to complete the performance of its obligations. c. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. Upon request of the County, the Provider shall submit to County all relevant documentation, including but not limited to, job cost records, to support its claims for final compensation. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. e. Suspension. County may suspend the Basic Services and this Agreement at any time for County’s convenience and without penalty to County upon three (3) days’ notice to Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 6 Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. c. Non-Discrimination. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal non-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each Orange County policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Any violation of the Orange County Non-Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. e. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. g. Ownership of Work Product. Should Provider’s performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. All artwork and tangible projects created by Provider and participants in this program shall be the property of the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 7 h. Non-Appropriation. Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable or not appropriated for the performance of County’s obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability or non-appropriation of public funds. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement. In the event of a change in the County’s statutory authority, mandate or mandated functions, by state or federal legislative or regulatory action, which adversely affects County’s authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County’s legal authority. i. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. j. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Provider’s Name Attention: Kimberlee Quatrone Grow Your World P.O. Box 8181 901 W. Main Street Hillsborough, NC 27278 Carrboro, NC 27510 [SIGNATURE PAGE TO FOLLOW] DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 8 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: PROVIDER: By: _________________________________ Bonnie Hammersley, County Manager By: __________________________________ Sophie Suberman, Executive Director Printed Name and Title DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Revised 01/24 9 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Grow Your World Vendor Contact Person: Sophie Suberman Phone: 919-525-1374 Address: 901 West Main Street City Carrboro State: NC Zip: 27510 Department: Health Amount: $20,000 Purpose: Opioid prevention in youth Budget Code(s): 27411020-630000-92007 Vendor # 67337 Vendor Status with NCSOS: Current - Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 12-12-23 End Date 6-30-24 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. This agreement is approved as to technical form and content. Services related to this agreement have alread y begun or been completed. Description of the nature of the emergency condition that was addressed: These services are already being delivered due to the nature of the service and not wanting to keep services from the population while completing the contract. Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC 3/5/2024 3/18/2024 3/19/2024 3/19/2024 Revised 01/24 10 The following signature block is for hard copies only and is not required for Docusign contracts: Received for record retention: Office of the Clerk to the Board __________________________________________Date:________ DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Exhibits, page 1 EXHIBIT A TO NC MOA: HIGH-IMPACT OPIOID ABATEMENT STRATEGIES (“OPTION A” List) In keeping with the National Settlement Agreement, opioid settlement funds may support programs or services listed below that serve persons with Opioid Use Disorder (OUD) or any co-occurring Substance Use Disorder (SUD) or mental health condition. As used in this list, the words “fund” and “support” are used interchangeably and mean to create, expand, or sustain a program, service, or activity. 1.Collaborative strategic planning. Support collaborative strategic planning to address opioid misuse, addiction, overdose, or related issues, including staff support, facilitation services, or any activity or combination of activities listed in Exhibit C to the MOA (collaborative strategic planning). 2.Evidence-based addiction treatment. Support evidence-based addiction treatment consistent with the American Society of Addiction Medicine’s national practice guidelines for the treatment of opioid use disorder – including Medication-Assisted Treatment (MAT) with any medication approved for this purpose by the U.S. Food and Drug Administration – through Opioid Treatment Programs, qualified providers of Office-Based Opioid Treatment, Federally Qualified Health Centers, treatment offered in conjunction with justice system programs, or other community-based programs offering evidence-based addiction treatment. This may include capital expenditures for facilities that offer evidence-based treatment for OUD. (If only a portion of a facility offers such treatment, then only that portion qualifies for funding, on a pro rata basis.) 3.Recovery support services. Fund evidence-based recovery support services, including peer support specialists or care navigators based in local health departments, social service offices, detention facilities, community-based organizations, or other settings that support people in treatment or recovery, or people who use drugs, in accessing addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need to improve their health or well-being. 4.Recovery housing support. Fund programs offering recovery housing support to people in treatment or recovery, or people who use drugs, such as assistance with rent, move-in deposits, or utilities; or fund recovery housing programs that provide housing to individuals receiving Medication-Assisted Treatment for opioid use disorder. 5.Employment-related services. Fund programs offering employment support services to people in treatment or recovery, or people who use drugs, such as job training, job skills, job placement, interview coaching, resume review, professional attire, relevant courses at community colleges or vocational schools, transportation services or transportation vouchers to facilitate any of these activities, or similar services or supports. 6.Early intervention. Fund programs, services, or training to encourage early identification and intervention for children or adolescents who may be struggling with problematic use of drugs or mental health conditions, including Youth Mental Health Exhibit ADocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Exhibits, page 2 First Aid, peer-based programs, or similar approaches. Training programs may target parents, family members, caregivers, teachers, school staff, peers, neighbors, health or human services professionals, or others in contact with children or adolescents. 7. Naloxone distribution. Support programs or organizations that distribute naloxone to persons at risk of overdose or their social networks, such as Syringe Service Programs, post-overdose response teams, programs that provide naloxone to persons upon release from jail or prison, emergency medical service providers or hospital emergency departments that provide naloxone to persons at risk of overdose, or community-based organizations that provide services to people who use drugs. Programs or organizations involved in community distribution of naloxone may, in addition, provide naloxone to first responders. 8. Post-overdose response team. Support post-overdose response teams that connect persons who have experienced non-fatal drug overdoses to addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need to improve their health or well-being. 9. Syringe Service Program. Support Syringe Service Programs operated by any governmental or nongovernmental organization authorized by section 90-113.27 of the North Carolina General Statutes that provide syringes, naloxone, or other harm reduction supplies; that dispose of used syringes; that connect clients to prevention, treatment, recovery support, behavioral healthcare, primary healthcare, or other services or supports they need; or that provide any of these services or supports. 10. Criminal justice diversion programs. Support pre-arrest or post-arrest diversion programs, or pre-trial service programs, that connect individuals involved or at risk of becoming involved in the criminal justice system to addiction treatment, recovery support, harm reduction services, primary healthcare, prevention, or other services or supports they need, or that provide any of these services or supports. 11. Addiction treatment for incarcerated persons. Support evidence-based addiction treatment, including Medication-Assisted Treatment with at least one FDA-approved opioid agonist, to persons who are incarcerated in jail or prison. 12. Reentry Programs. Support programs that connect incarcerated persons to addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need upon release from jail or prison, or that provide any of these services or supports. DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Start Date: 12/12/2023 End Date: 6/30/2024 Description Count How were efforts supported?Notes Additional Information & Helpful Hints about this Measure # of Youth Mental Health First-Aid training programs held # of unique participants trained in Mental Health First-Aid A unique participant may participate in multiple support programs so there may be some duplication of unique participants when numbers across programs, project, sites, etc., are aggregated for the strategy- specific impact report. A participant may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Number of referrals do not equate to number of unique participants because one individual may receive multiple referrals. # of trainers who provide Youth Mental Health First-aid programs # of peer-based training programs held # of unique participants trained in peer-based program A unique participant may participate in multiple support programs so there may be some duplication of unique participants when numbers across programs, project, sites, etc., are aggregated for the strategy- specific impact report. A participant may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Number of referrals do not equate to number of unique participants because one individual may receive multiple referrals. # of trainers who provide peer-based programs # of other early intervention training programs held # of unique participants trained in other early intervention programs A unique participant may participate in multiple support programs so there may be some duplication of unique participants when numbers across programs, project, sites, etc., are aggregated for the strategy- specific impact report. A participant may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Number of referrals do not equate to number of unique participants because one individual may receive multiple referrals. # of trainers who provide other early intervention programs Custom, strategy-specific measures may be entered in this row. Custom, strategy-specific measures may be entered in this row. Custom, strategy-specific measures may be entered in this row. Process Measure Count Additional Information & Helpful Hints about this MeasureNotes 6. Early Intervention Insert Start and End Date for this Strategy (MM/DD/YYYY) Process measures answer the question, “How much did you do?”. Please quantify the process measures relevant to your implementation of this strategy. Indicate whether the count represents efforts supported only by opioid settlement funds or efforts supported by multiple funding sources including opioid settlement funds. Process measures should reflect numbers from the 2024 fiscal year (i.e., July 1, 2023-June 30, 2024). STRATEGY-SPECIFIC PROCESS MEASURES DEMOGRAPHICS: Provide the following information on race and ethnicity for the # of unique participants trained during the 2024 fiscal year (i.e., July 1, 2023-June 30, 2024). Exhibit B: Grow Your World Reporting Form Scope of Work Required Reporting. Provider must report the following metrics by April 15, 2024 (for December 12 - March 31) and July 15, 2024 (for April 1 - June 30). In addition to the metric reporting, submit one success story (250 word limit) from a person who has benefitted from the Strategy (de-identified unless the person has agreed in writing to be identified) during the fiscal year 23-24. This story is to be submitted by July 15, 2024. DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC # of unique participants trained A unique participant may participate in multiple support programs so there may be some duplication of unique participants when numbers across programs, project, sites, etc., are aggregated for the strategy- specific impact report. A participant may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Number of referrals do not equate to number of unique participants because one individual may receive multiple referrals. American Indian/Alaska Native Non-Hispanic Asian Non-Hispanic Black Non-Hispanic Native Hawaiian or Other Pacific Islander Non-Hispanic White Non-Hispanic Hispanic Some Other Race or Multiple Races Unknown Sum total of unique participants served (Autocalculated) Does sum total (C37) match the reported # of unique participants (C27)? (Autocalculated)Yes Description Count Quality Measure Percent (Autocalculated)Notes Additional Information & Helpful Hints about this Measure # of unique participants trained, who are satisfied w/ training # of unique participants trained # of unique participants trained, who feel more confident in supporting children and adolescents who may be struggling # of unique participants trained # of unique participants trained, who improved skills in supporting children and adolescents who may be struggling # of unique participants trained # of unique participant trained, who improved knowledge in supporting children and adolescents who may be struggling # of unique participants trained STRATEGY-SPECIFIC QUALITY MEASURES Of the # of unique participants trained in the count above, how many people identified as: Quality measures answer the question, “How well did you do it?”. Please quantify the quality measures relevant to your implementation of this strategy. Quality measures should reflect numbers from the 2024 fiscal year (i.e., July 1, 2023-June 30, 2024). % of participants who are satisfied w/ training Incomplete assessments may be used by trainers to determine satisfaction with training % of participants who feel more confident in supporting children and adolescents who may be struggling Incomplete pre/post assessments may be used by trainers to determine a change in confidence % of participants who improved skills in supporting children and adolescents who may be struggling Incomplete pre/post assessments may be used by trainers to determine a change in skill % of participants who improved knowledge in supporting children and adolescents who may be struggling Incomplete pre/post assessments may be used by trainers to determine a change in knowledge Incomplete Custom, strategy-specific measures may be entered in this row. Incomplete Custom, strategy-specific measures may be entered in this row. Incomplete Custom strategy-specific measures may be entered in this row DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Description Count Outcome Measure Percent (Autocalculated for Most Measures)Notes Additional Information & Helpful Hints about this Measure # of unique participants trained, who report using skills/knowledge gained in training # of unique participants trained # of unique participants trained, who report getting the social and emotional support they need # of unique participants trained % of short-term suspensions N/A % of short-term suspensions This measure is the number of out-of-school short-term suspensions in educational facilities for all grades per 100 students. It is collected by NC Department of Public Instruction and an indicator for HNC 2030. Visit this link to download Table S9 for the 2021-22 report. # of community overdose reversals using naloxone # of community overdose reversals using naloxone N/A STRATEGY-SPECIFIC OUTCOME MEASURES (PROGRAM-LEVEL) Incomplete Custom, strategy-specific measures may be entered in this row. Outcome measures answer the question, “Is anyone better off?”. Outcome measures can be at the program- or population-level. Please quantify the outcome measures relevant to your implementation of this strategy. Outcome measures should reflect numbers from the 2024 fiscal year (i.e., July 1, 2023-June 30, 2024). % of participants who report getting the social and emotional support they need Incomplete Consider asking participants the Behavioral Risk Factor Surveillance System question, "How often do you get the social and emotional support you need?" 1. Always 2. Usually 3. Sometimes 4. Rarely 5. Never The # of participants who answer "Always" and "Usually" can be summed to find # of participants who have OUD, served who report getting the social and emotional support they need A unique participant may participate in multiple support programs so there may be some duplication of unique participants when numbers across programs, project, sites, etc., are aggregated for the strategy- specific impact report. A participant may receive services across local government boundaries (e.g., a person with OUD may reside in one county and receive services in another county). Number of referrals do not equate to number of unique participants because one individual may receive multiple referrals. Incomplete Custom, strategy-specific measures may be entered in this row. Incomplete Custom, strategy-specific measures may be entered in this row. Incomplete Custom, strategy-specific measures may be entered in this row. % of participants who report using skills/knowledge gained in training Incomplete DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Grow Your World Opioid Settlement Funds Budget, 2024 DEAH Day Perscription for Healthy Drugs Opioid Overdose Prevention Trainings Opioid Coping Claw Machine Item Narrative Supporting Documents Amount Artist Stipends Pays two collaborating artists for their work creating the DEAH Day project. Payroll documentation $1,500.00 Materials + Reimbursements Child Safe Pill Bottle Tops, Spray Spray Paint, Glue, Arts Materials Payroll documentation $508.60 Payroll Fees and Taxes Payroll taxes and fees for artist stipends.Payroll documentation $112.50 Zines - Printing & Marketing Design & Print Zine for public presentations and public awareness Receipt $350.00 Artist Stipends Pays two collaborating artists for their work creating the Perscription for Healthy Drugs project.Payroll documentation $2,400.00 Materials + Reimbursements Pill bottels, pill bottle wraps, affirmations and skills for healthy ways to produce endorphins.Payroll documentation $294.17 Payroll Fees and Taxes Payroll taxes and fees for artist stipends.Payroll documentation $180.00 Zines - Printing & Marketing Receipt $250.00 Training Cost Eighty five (85) people will receive certification from the , which costs $20.00 per person Training Receipts $1,700.00 Facilitator Stipends Provides tech support and encouragement to complete trainings. Hosts events and ensures questions are answered. Along with ensuring each particnant has Narcan.Payroll documentation $1,000.00 Trainee Stipends Provides trainees $25 stipends for completing the training. Total for eight-five (85) trainees.Donation Tracking Spreadsheet $2,975.00 Certificates Pays for each attendee to receive a printed certificate when they complete their training.Receipt $174.25 Payroll Fees and Taxes Payroll taxes and fees for facilitator stipends.$75.00 Claw Machine Mini Crane Claw Vending machine as arts installation to create interactive early intervention exhibit. This will serve as a public display and engagement opportunity at public events.Receipt $1,583.85 American Heart Association's First Aid for Opioid Overdoses Online course Exhibit CDocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC Materials for Takeaways/Machine Funding will go to research and develop items that support healthy coping skills along with GYW's Perscription for Healthy Drugs Receipt $1,000.00 Artist Stipends Pays two collaborating artists for their work creating the Opioid Coping Claw Machine.Payroll documentation $2,950.00 Payroll Fees and Taxes Payroll taxes and fees for artist stipends.$221.25 Materials + Reimbursements Books, Workbooks, Articles for parents, transporation mitigation Receipts $1,250.00 Facilitator Stipend 2-3 Facilitators to provides tech support and encouragement to complete trainings. Hosts events and ensures questions are answered. Along with ensuring each particnant has Narcan.Payroll Documentation $2,500.00 Parent Stipends Incentive for Parents who are working or who often do not participate in groups to to come particnate and learn ways to keep their families safe.Donation Tracking Spreadsheet $500.00 Food Incentite to assure basic needs are met during the training.Receipts $759.00 Payroll Fees and Taxes Payroll taxes and fees for facilitators' stipends.$187.48 Parenting Parent Group TOTAL EXPENSES $20,000.00 DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC 08/02/2023 Business Insurers of Carolinas 501 Eastowne Drive, Suite 250 PO Box 2536 Chapel Hill NC 27515 Sara Averette (919) 968-4611 (919) 968-8991 saverette@business-insurers.com Grow Your World 901 W Main St Carrboro NC 27510 United States Liability Insurance Company 25895 CL238239417 A Y NPP1597181C 08/01/2023 08/01/2024 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 AbUSE & MOLESTATION 100,000 A NPP1597181C 08/01/2023 08/01/2024 1,000,000 A Professional Liability NPP1597181C Per Occurence 1,000,000 Orange County, its officers, offical agents and employees are included as additional insured in reference to the General Liability policy per written contract. Orange County Attn: Risk Management 300 W Tryon Street Hillsborough NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Original Printing Issued July 16, 2023 WC000001A INFORMATION PAGE Insurer. Markel Insurance Company 10275 West Higgins Road Rosemont , IL 60018 800-431-1270 POLICY NO. MWC0151790-05 1.The Insured: Grow Your World Individual Partnership Corporation or X Nonprofit Mailing address: 901 W Main St Carrboro , NC 27510-1510 Other workplaces not shown above: See attached Location Schedule 2.The policy period is from 07/01/2023 to 07/01/2024 at the insured's mailing address 3.A. Worker Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: NORTH CAROLINA B.Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3 A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C.Other States Insurance: Part Three of the policy applies to the states, if any, listed here: AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, NE, NV, NH, NJ, NM, NY, NC, OK, PA, RI, SC, SD, TN, TX, UT, VT, VA, WV and WI D.This policy includes these endorsements and schedules: WC000001A, WC990601, WC990602, WC990603, WC000000C, WC000308, WC000404, WC000406, WC000414A, WC000419, WC000421F, WC000422C, WC000424, WC000425, WC320301D, MJWC1000, MIL 1214, MPIL 1083, MPIL 1007 01 20 4.The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit Classifications Code No. Premium Basis Total Estimated Annual Remuneration Rate Per Remuneration Estimated Annual Premium Minimum Premium: $ Total Estimated Annual Premium: Expense Constant Countersigned by WC000001A © 1987 National Council on Compensation Insurance *DOCID-56956748* 008718-015088-56956748-07172023 1 of 28 *MWC0151790-05* MWC0151790-05 DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC WC 99 06 01 EXTENSION OF INFORMATION PAGE Worker's Compensation and Employer's Liability Policy Schedule Of Premium Information Policy Number: MWC0151790-05 Issued to: Grow Your World Effective Date: 07/01/2023 - 07/01/2024 Coverage Provided By: Markel Insurance Company Carrier Code: 22616 Period of Operation: 07/01/2023 - 07/01/2024 State of Operation: NC Code Classification Premium Basis Total Estimated Annual Remuneration Rate Per $100 of Remuneration Estimated Annual Premium Class code Description 8864 Social Services Organizations - All Employees and Salespersons, Drivers $75,000.00 Manual Premium Total Manual Premium 9812 Employers Liability 9848 ELL Minimum Subject Premium Total Subject Premium Modified Premium 9889 Schedule Rating Standard Premium 0900 Expense Constant 9740 Terrorism 9741 Catastrophe (other than Certified Acts of Terrorism) Estimated Annual Premium Total Amount Due © 1991 National Council on Compensation Insurance. 2 of 28 DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC WC 99 06 02 EXTENSION OF INFORMATION PAGE Worker's Compensation and Employer's Liability Policy LOCATION SCHEDULE Policy Number: MWC0151790-05 Issued to: Grow Your World Effective Date:07/01/2023 to 07/01/2024 Coverage Provided By:Markel Insurance Company Carrier Code 22616 Other workplaces not shown above: Location FEIN PHONE SIC CODE ENTITY TYPE 1 901 W Main St Carrboro, NC 27510-1510 841845124 919-471-2132 8322 Nonprofit © 1991 National Council on Compensation Insurance. 3 of 28 DocuSign Envelope ID: D5EE8B89-BEC9-47CA-86AA-BB69819758EC