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Iowa Strategic Prevention Framework State Incentive Grant Collaboration Agreement The following information provides guidance for Comprehensive Substance Abuse Prevention contractors on collaboration efforts before beginning the Strategic Prevention Framework process. Each funded Comprehensive Substance Abuse Prevention agency in the 23 identified counties of highest need is required to complete the following document and return to Julie Hibben, SPF SIG Project Director via e-mail at email@example.com by May 6, 2011. Key Project Staff At least one FTE must be hired as the SPF SIG Project Coordinator to lead the project and complete project requirements in each SPF SIG funded county. One staff member cannot be hired to serve more than one SPF SIG county. Each county will collectively decide which organization will hire and supervise this staff member as well as the office location where this staff is to be housed. Once this key staff member is hired, their contact information needs to be submitted to the SPF SIG Project Director. Additionally, one staff member from the Comprehensive Substance Abuse Prevention agency needs to serve as the SPF SIG Liaison until the Coordinator is hired or if the hired Coordinator is managed by another organization. At least one FTE will need to be hired to lead the completion of project work. This person can be hired by the prevention agency, Drug Free Community Program grantee or other substance abuse prevention coalition. Fill out the following information about the key project staff: 1. Name of Current SPF SIG Liaison at Comprehensive Agency: Phone Number: E-mail Address: 2. Will SPF SIG staff be hired internally or through a subcontract? 3. Where will the SPF SIG staff member(s) be housed? 4. Who will the newly hired SPF SIG staff member(s) report to? 1 Stakeholders Meeting The Comprehensive Substance Abuse Prevention agency is required to meet with the following stakeholders before this completed document is due to IDPH. Agencies can choose to hold one large meeting or multiple meetings but the following sectors need to be included: Drug Free Communities Support Youth Program grantee (if applicable) County and city officials (Board of Other substance abuse prevention Supervisors) coalitions Other substance abuse prevention Public health grantees (EUDL, STOP Act, etc.) Law enforcement Substance abuse treatment provider School districts if the funded prevention agency does Juvenile court/corrections not provide treatment services During the meeting(s), agencies will provide an overview of SPF SIG project, discuss SPF SIG priorities, how this project fits with the county priorities and SPF SIG funding. Each stakeholder should then be invited to participate in the SPF SIG project. If the invited stakeholder agrees to participate, ask what role they will have in the project. A variety of SPF SIG PowerPoint presentations, handouts, and other information can be located on the Iowa SPF SIG Workstation website at www.iowaspfsig.org. Agencies need to inform the SPF SIG Project Director via e- mail of meeting date(s), time(s) and location(s) at least one week before the meeting(s) occurs. IDPH SPF SIG Project Team members may attend the meetings or participate in the meetings via conference call. After the meeting(s) occurs, answer the following questions: 1. List the names of stakeholders included in the SPF SIG meeting(s). Describe the different organization roles in the project. How will these various organizations work together? Who will receive funding? 2. Describe how the SPF SIG funding will provide a countywide collaboration. 3. Is there a Drug Free Communities Support Program grantee in the funded county? If so, how will that grantee be funded and involved in the SPF SIG project? 4. What are the county priorities from the 2011 Community Health Needs Assessment & Health Improvement Planning (CHNA-HIP)? To learn more about this report, go to www.idph.state.ia.us/chnahip/default.asp. 2 5. Include a description of work being completed on underage drinking and binge drinking in the county. 6. List the active youth groups related to the CHNA-HIP priorities and discuss how these youth will assist with the SPF SIG project. 7. What are the goals of the Comprehensive Substance Abuse Prevention Action Plan? Description of Coalition(s) Involved Each SPF SIG funded county is required to involve at least one substance abuse prevention coalition. This involvement can include creating a subcommittee of an established countywide coalition to focus on the SPF SIG project. Due to the challenges of the SPF process, no new coalitions will be created for this SPF SIG project. If no countywide coalition exists, a Collaboration Council can be created to guide the project. If the county identified as highest need has a funded DFC grantee, IDPH requires that these grantees be given the opportunity for involvement in the SPF SIG project and receive SPF SIG funding. Additional information about coalition involvement and ideas for DFC involvement are included in the Iowa SPF SIG Expectations document. Answer the following questions about the coalition involved in the project. If more than one substance abuse prevention coalition is involved, copy and paste the set of questions and start a new section for each coalition. 1. Name of coalition 2. Name of Coalition Coordinator: Coordinator Phone Number: Coordinator E-mail Address: 3. Description of coalition 4. Structure of coalition 5. Sectors involved in the coalition 6. Describe the funding streams the coalition receives. 7. Is the coalition SAFE or Community of Promise certified? 8. Include coalition mission statement. 3 9. List the goals of the coalition. 10. Discuss current coalition projects. 11. List the subcommittees of the coalition and include a description of each. 12. Explain how the SPF SIG project will fit into the coalition structure. 13. Do the coalition members match the cultural make up of the county? If not, how will these groups be represented? Agreement of Collaboration In order to show agreement with the above plan, a Memorandum of Understanding (MOU) is to be developed. The Comprehensive Substance Abuse Prevention Agency Director, the Drug Free Communities Support Program Coordinator (if applicable), the involved substance abuse prevention coalition coordinator and the county public health administrator are required to sign this document to show that they agree with the proposed collaboration. If SPF SIG counties do not have agreement from these required stakeholders, funding may not be distributed to the Comprehensive Substance Abuse Prevention agency and the next eligible county of highest need could be contacted to participate. An updated MOU needs to be submitted to IDPH each Fiscal Year of the project. A sample MOU can be found on the following page. 4 [Applicant Letterhead] Sample Memorandum of Understanding WHEREAS, [Comprehensive Substance Abuse Prevention Agency], [Partner 1], [Partner 2] and [Partner 3] have come together to collaborate for the Strategic Prevention Framework State Incentive Grant; and WHEREAS, the partners listed below have agreed to enter into a collaborative agreement in which [Comprehensive Substance Abuse Prevention Agency] will be the funded agency and the other agencies will be partners in this collaboration; and WHEREAS, the partners herein desire to enter into a Memorandum of Understanding setting forth the services to be provided by the collaborative; and WHEREAS, the Collaboration Agreement prepared and approved by the county through its partners is to be submitted to the Iowa Department of Public Health on or before May 6, 2011. I) Description of Partner Agencies For each member of the collaborative, provide some background on the agency or organization and its work regarding substance abuse prevention, specifically focusing on preventing binge drinking and underage alcohol use. II) History of Collaboration Provide a brief history of the collaborative relationship between the partners, including when and under what circumstances the relationship began. Describe the critical and long-range goals of the collaboration. III) Roles and Responsibilities NOW, THEREFORE, it is hereby agreed by and between the partners as follows: Clearly state the roles and responsibilities each organization or agency will assume to ensure the success of the project. Specify how often the collaborators will meet. Describe the resources each partner will contribute to the project either through time, in-kind contribution or with the use of grant funds, e.g. office space, project staff, training. Demonstrate a commitment on the part of all partners to work together to achieve stated project goals and to sustain the outcomes to the best of their abilities once grant funds are no longer available. 1) [Applicant X] will provide [specify type of program/assistance/service] including: 2) [Partner 1] will provide [specify type of program/assistance/service] including: 3) [Partner 2] will provide [specify type of program/assistance/service] including: 4) [Partner 3] will provide [specify type of program/assistance/service] including: 5 4) [Applicant X] and [Partner 1] will collaborate in the following manner: 5) [Applicant X] and [Partner 2] will collaborate in the following manner: 6) [Applicant X] and [Partner 3] will collaborate in the following manner: V) Timeline Responsibilities under this Memorandum of Understanding would coincide with the grant period, anticipated to be April 1, 2011 through June 30, 2011. VI) Commitment to Partnership 1) The partners agree to collaborate and provide [specify type of service through the collaboration] as listed in the attached Collaboration Agreement. 2) We, the undersigned have read and agree with this MOU. Further, we have reviewed the proposed Collaboration Agreement and approve it. By ____________________ By________________________ Comprehensive Substance Abuse Prevention Drug Free Communities Support Agency Director Program Coordinator (if applicable) Date __________________ Date _______________________ By________________________ By________________________ County Public Health Administrator *Substance Abuse Prevention Coalition Coordinator Date _______________________ Date _______________________ *Include a signature from each coalition coordinator if more than one coalition is participating in the project. 6
"SPF SIG Collaboration Agreement"