PERSONAL RESPONSIBILITY EDUCATION PROGRAM (PREP) APPLICATION - 2015-2016

NOTE: Please read this application in its entirety. Applicants will be held to all the expectations set forth in this document.

General Information The South Carolina Campaign to Prevent Teen Pregnancy (SC Campaign) was founded in 1994 to improve the health and economic well-being of individuals, communities, and the state of South Carolina by preventing teen pregnancy. To achieve its mission, the SC Campaign works with a variety of programs – public, private, school and community-based – in each of the state’s 46 counties. For more information regarding the SC Campaign visit www.teenpregnancysc.org. Questions? Contact Stig Rasmussen at [email protected], 803-771-7700, ext. 112.

PREP Grants The SC Campaign has funding available for the replication of teen pregnancy prevention best practices, including Evidence Based Programs (EBP) and adult preparation topics. PREP Funding is provided to the SC Department of Health and Environmental Control (SC DHEC) by the US Department of Health and Human Services Family and Youth Services Bureau.

This is a competitive grant application process. The following criteria will be used to select partners for the October 1, 2015 – September 30, 2016 grant year: 1. Number of youth to be reached. 2. Demographics (age, race/ethnicity) of youth to be reached that meet PREP goals. 3. High Risk Youth to be reached. Priority: Youth in foster care; youth involved in the criminal justice system; youth living in poverty, rural youth, etc. 4. Past experience with federal and/or state grants, and with the SC Campaign. 5. Overall quality of the proposal. 6. Appropriate fit of the selected strategy and EBP with the target population to be served. 7. Organizational stability and capacity to successfully plan, implement, evaluate, and sustain programs. Funding is expected to be similar to previous grant years where the award range was $10,000 to $30,000 with an average award amount of $20,000. Contracts are anticipated to take effect October 1, 2015 and end September 30, 2016.

Award Timeline:

1 Application for Funding Distributed, Friday, June 26, 2015. Funding applications will be available on the SC Campaign website under Funding Opportunities.

Work with SC Campaign TA staff to develop a funding proposal, June 29 – August 6 All applicants are encouraged to work with SC Campaign Technical Assistance (TA) staff to plan and complete a full proposal between June 29 and August 6.

Aaron Bryan (Midlands/Low Country) Chris Rollison (Low Country/Pee Dee) 803-771-7700 803-767-1158 [email protected] [email protected]

Meredith Talford (Upstate) Rena Dixon (Health Centers) 864-582-3400 803-771-7700 [email protected] [email protected]

Applicants Submit Application, Friday, August 7 To be considered for funding, all applications must be submitted by 5 pm, Friday, August 7, 2015, via email to Stig Rasmussen at [email protected]. Notification of Selection, Friday, September 4 The SC Campaign will review submissions and notify all organizations of their funding status. Attend Orientation Meeting, Thursday, October 1 (10am-12pm) This mandatory meeting for all grantees will provide information about the PREP grant, programming, evaluation and documentation requirements, and 2015-16 grant cycle implementation guidelines.

Contracts begin, Thursday, October 1 Pending signatures, 2015-16 grants will begin October 1, 2015 and end September 30, 2016.

SC Campaign To Prevent Teen Pregnancy Grantee Expectations: Each funded partner will be expected to:  Manage the program administration and implementation of the award as required by the Federal Grant Award Notice and the Federal Grant Administration Guidelines, as evidenced from the SC Campaign monitoring process.  Ensure individuals selected as staff for the program are deemed necessary to the success of the program, are selected as a result of an equal opportunity employment process upon which they are determined to be most qualified, have a title and a job description specific to the program, be provided a comparable market wage, and have a status of either an agency employee or a vendor with a signed agreement.  Ensure that the appropriate staff attends meetings, Summer Institute and trainings as recommended by their technical assistance provider.  Be responsive to communications and requests by staff of the SC Campaign.  Ensure individuals selected to serve as PREP Facilitators possess strong qualifications to do so, and are committed to the success of the facilitation. They should: o have experience working with youth in a respectful and engaging manner; o have schedules flexible enough to allow them to attend necessary trainings, and to conduct sessions at times convenient for the target audience; o commit to serving as a facilitator through this contract year; o be willing and able to complete and submit all necessary documentation and paperwork in a timely manner.

Purpose:

2 The purpose of this opportunity is to fund organizations to implement sustainable teen pregnancy prevention best practices. At a minimum, a funded organization must: 1. Implement an evidence based teen pregnancy prevention program (EBP) with fidelity in schools, community-based organizations, and/or clinics. 2. Distribute adult preparation materials provided by the SC Campaign (pending approval from each implementation site). This will ensure that teens and parents receive information on how to access additional resources on parent-child communication, healthy relationships, and healthy life skills.

In addition, funded organizations are encouraged to: 3. Assemble or demonstrate an existing work group that is representative of the community and includes agencies that are ready and willing to increase communication about and support for a comprehensive community approach to prevent adolescent pregnancy and STIs. 4. Increase the number and utilization of teen friendly condom access points in the community. 5. Improve education and informational offerings for parents to increase parent- child communication about love, sex and relationships. 6. Expand access to quality, teen friendly family planning services for adolescents that include prescription of highly reliable family planning methods.

For more information on the above activities and to better inform your application, the SC Campaign strongly encourages you to review the publication “Accelerating Progress” http://www.teenpregnancysc.org/path-forward-accelerating-progress and view the archived webinar http://www.teenpregnancysc.org/webinar/Accelerating-Progress/lib/playback.html

Application Checklist: Please complete and return the following documents:

 Section 1: Organization Information  Section 2: Program Narrative  Section 3: Other Information  Section 4: Budget Narrative  Attachments: o Letters of Support from each EBP implementation site and/or agency that will allow access to their youth. o Letter of Support from the community work group (if applicable). o Letters of Support from the agency providing oversight of the condom access points (if applicable). o Letters of Support from the agency providing oversight of parent education (if applicable). o Letters of Support from health center providing teen friendly reproductive health services (if applicable).

3 Please thoroughly complete Sections 1-4 of the grant application as requested in the directions. Please follow the directions precisely and answer in complete sentences. You are encouraged to contact a SC Campaign TA Provider if you have questions about proposed activities.

SECTION 1: Organization Information

Organization Name:

Physical Address:

City: State: Zip:

Contact Name: Email: Title:

Contact Phone:

Website Address:

IRS Assigned ID # (EIN): 501(c)(3) ☐yes ☐ no DUNs #: Other: please name

About the organization: Brief history; its mission, vision, and goals: (1,000 character limit) a) Organizational annual budget: $ $500,000 or more in federal dollar expenses? ☐yes ☐ no b) Organizational financial management system (QuickBooks, etc.): c) Years in operation: # Staff in organization: d) Previous funding from the SC Campaign (place an X)? ☐Yes ☐ No If yes, what/when e) Previous implementation of evidence-based curricula? ☐Yes ☐ No If yes, what curriculum and where was it implemented? f) Past experience with federal and/or state grant management (place an X)? ☐Yes ☐ No If yes, when?

4 SECTION 2: PROGRAM NARRATIVE

Population and Target Area

A. The Target Population is the group which is identified as being most in need of the program you are proposing. What are your Target Population demographics?

Ages: to ______

Race and Ethnicity:

% African-American % Caucasian % Hispanic % Other

Gender: % Male % Female

B. The Target Area is the part of the state (e.g. zip code) and community where the need is greatest. The Target population and Target area you identify must be the same throughout the application. Describe the geographical Target Area, including county, community, and zip code(s).

Project Activities

For each Activity (1-6 below), please check which ones you will be completing. Please note activities 1-2 are required, and therefore already checked.

Required Activities:

1. We will implement the below checked Evidence-Based Program (EBP) with fidelity. (please indicate which program(s) your organization will implement and answer the following questions)

The following table provides descriptions of the three EBPs that can be implemented through PREP. The SC Campaign recommends that applicants become familiar with these programs to ensure program implementation meets the needs of the target population.

A. Seventeen Days – DVD Age/ Setting Min. # To learn more about each program and to review the evaluation entry Gender Participants and exit surveys go to the following URLs: 14-18 Health centers 150 Program: yr. old that provide http://www.seventeendays.org/ sexually reproductive active health services Evaluation: females Entry: Entry Survey I & II (17 Days, Safer Choices) (some non- healthcare Exit: Exit Survey I & II (17 Days, Safer Choices) 5 settings will be considered but must demonstrate ability to link youth to a health center) Setting: Indicate the setting(s) in which you plan to implement Seventeen Days. Include specific names of each setting (i.e. name of the school, community based organizations, etc). A letter of support from each implementation site and or the agency/organization that is allowing access to their youth must be included with this application. Health Center: Community:

If implementing in a community setting, how will you link youth to a health center?

Evaluation: Has each of the above implementation sites reviewed and approved the required entrance and exit surveys for this EBP? Yes No Has your organization ever implemented this EBP? Yes No

Please explain why you have selected this EBP:

Anticipated number of youth to be served with this EBP:

List all the adaptations or changes you anticipate making to Seventeen Days. All adaptations MUST be approved by the SC Campaign prior to implementation. Adaptations that significantly alter the core components of the EBP will not be approved.

B. Making Proud Choices! - Curriculum 11-13 Middle schools; 150 Program: yr. old after-school http://www.selectmedia.org/programs/choices.html male program; or and community Evaluation: female Entry School Based: Entry Survey - In School (Making Proud Choices)

Entry Community Based: Entry Survey - Out of School (Making Proud Choices)

Exit: Exit Survey I & II (17 Days, Safer Choices, Making Proud Choices) Setting: Indicate the setting(s) in which you plan to implement Making Proud Choices! Provide specific names of each setting (i.e. name of the school, community based organizations, etc). A letter of support from each implementation site and or the agency/organization that is allowing access to their youth must be included with this application. Middle School: Community:

6 Evaluation: Has each of the above implementation sites reviewed and approved the required entrance and exit surveys for this EBP? Yes No Has your organization ever implemented this EBP? Yes No

Please explain why you have selected this EBP:

Anticipated number of youth to be served with this EBP:

List all the adaptations or changes you anticipate making to Making Proud Choices! All adaptations MUST be approved by the SC Campaign prior to implementation. Adaptations that significantly alter the core components of the EBP will not be approved.

C. Safer Choices - Curriculum 9th & High school 150 Program: 10th ONLY; http://recapp.etr.org/recapp/index.cfm?fuseaction= grade must complete pages.ebpDetail&PageID=131 male all 5 components and including levels Evaluation: female 1&2 Entry: Entry Survey I & II (17 Days, Safer Choices)

Exit: Exit Survey I & II (17 Days, Safer Choices, Making Proud Choices) Setting: Indicate the setting in which you plan to implement Safer Choices. Provide the names of each school. A letter of support from each school that is allowing access to their youth must be included with this application. High School:

Evaluation: Has each of the above implementation sites reviewed and approved the required entrance and exit surveys for this EBP? Yes No

Has your organization ever implemented this EBP? Yes No

Please explain why you have selected this EBP:

Anticipated number of youth to be served with this EBP:

List all the adaptations or changes you anticipate making to Safer Choices. All adaptations MUST be approved by the SC Campaign prior to implementation. Adaptations that significantly alter the core components of the EBP will not be approved.

2. We will distribute adult preparation materials provided by the SC Campaign and SC DHEC (pending approval from each implementation site). 7 To ensure teens and parents receive information on how to access additional resources on parent child communication and healthy relationships, the SC Campaign and SC DHEC will provide public awareness and education materials to each grantee to distribute to youth and/or parents. Examples of the adult preparation materials distributed in years past can be found in the Appendix at the end of this application. Additional materials may be added in the 2015-16 grant year.

Our organization has viewed materials from previous years and agrees to post and distribute to youth and parents as approved.

Encouraged, but NOT Required Activities:

3. We will a ssemble or demonstrate an existing work group that is representative of the community and includes agencies that are ready and willing to increase communication about and support for a comprehensive community approach to prevent adolescent pregnancy and STIs.

A. Do you already have an existing work group that is willing to support a comprehensive community approach to prevent adolescent pregnancy and STIs? Yes - List of member organizations: o - What additional organizations, if any, will be invited to join the work group?

No - What organizations will be invited to serve on this newly assembled work group? o B. Who is/will be the organization leading this group? (if it is not the applicant, a letter of support must accompany this application)

C. How will this work group be used to support the quality implementation of the selected EBP, adult preparation topics, and other encouraged activities (if applicable)?

D. How often does this work group plan to meet?

4. Increase the number and utilization of teen friendly condom access points in the community.

A. Are there existing free condom distribution sites/access points in this geographic target area? Yes - Currently, how many are there? - How many of these are teen friendly?

No

8 B. What assurances will be made to ensure the condom access points are teen friendly?

C. How will the target population in the targeted geographic area be made aware of the teen friendly condom access points?

D. What agency will manage the condom access points? (if it is not the applicant, a letter of support must accompany this application)

E. Anticipated number of teen friendly condom access points by September 2016, including new and existing (if any).

5. Improve education and informational offerings for parents to increase parent-child communication about love, sex and relationships.

A. In this geographic target area, are there existing programs targeting the parents of the target population? Yes - What agencies are conducting these programs?

No B. What educational and informational activities will be offered to increase the likelihood of parent- child communication about love, sex and relationships? (consider homework assignments, public awareness materials, parent education sessions, parent-child events, etc).

C. How will you ensure parents are accessing these education and informational offerings?

D. What agency(ies) will offer programs/information for parents? (if it is not the applicant, a letter of support must accompany this application)

E. Anticipated number of activities conducted by September 2016.

6. Expand access to quality, teen friendly family planning services for adolescents that include prescription of highly reliable family planning methods.

A. In this geographic target area, are there existing high-quality, teen friendly family planning services for adolescents that includes prescription of highly reliable family planning methods, including IUDs and implants, and STI testing to adolescents for free or low cost? Yes (if it is not the applicant, please include a letter of support from the health center) - What is the name of the health center(s)? No B. Will the above health center(s) be interested in receiving training and technical assistance from the SC Campaign to improve the provision of high quality teen friendly 9 reproductive health services? Yes No C. Describe the process your agency/community will use to refer youth to teen friendly reproductive health services.

D. Anticipated number of youth referred for reproductive health services.

Section 3: Additional Information

Capacity

A. A. What are the title and responsibilities of each staff person needed to implement the selected activities with fidelity and quality? Please indicate which required and/or encouraged activities each staff person will oversee.

B. Will you need to hire additional staff? How will they be selected? What qualifications will they need to have (e.g., minimum education needed; years of experience)?

C. What training/professional development/technical assistance do you anticipate staff will need in order to implement each activity with high quality? Please note, the SC Campaign will also be able to provide training and technical assistance to community partners identified in this application.

D. Training and technical assistance will be provided based on requests by the grantee and needs identified by the SC Campaign. Does your organization commit to fully participating in trainings, meetings and technical assistance as required? Yes No

E. Do you currently have a system in place to: - Document staff work-time (i.e. timesheets)? Yes No - Track staff expenses and reimbursements (i.e. filing of receipts, reimbursement request forms, etc)? Yes No F. If applicable, provide a list of any additional funding sources that will be used to support this program.

10 Partnerships

A. Based on the activities and agencies identified above, please provide a list summarizing the local organizations with which you will be partnering or sub-contracting and a brief description of the services/program aspects they will provide or share (add rows if necessary). Please attach a Letter of Support (LOS) from each organization listed.

Name of Partnering Agency Description of services/role on project LOS included?

1. 2. 3. 4. 5.

B. Describe how your program will collaborate with, but not duplicate, existing services/programs for the target population (if some are available). If no other programs are available, please explain how you will collaborate with non-traditional partners in your community for the benefit of your program.

Plan

A. For each required or encouraged activity selected above, provide a sequential list of planned action steps and timeline that must be accomplished in order to meet stated goals (add rows as needed).

Items to include on in your action steps: - If you anticipate any EBP adaptations. - Process and outcome evaluation, including:  Fidelity monitoring  Administering pre-tests and post-tests.  Dates to submit evaluation documents to USC  Whether students will complete pre/post tests online or using a hard copy

Note: The University of South Carolina will provide the evaluation tools, methods, and data analysis. The tools and methods will be explained in detail after funding has been awarded. All completed evaluation documents must be submitted to USC within two weeks of program end. The PREP Project requires that data be gathered from all participants in the program.

Action Steps Timeline 1. Evidence Based Program Implementation a. b. c. d. e. f. 11 g. 2. Adult Preparation a. b. c. d. e. f. g. 3. Work Group a. b. c. d. e. f. g. 4. Teen Friendly Condom Access Points a. b. c. d. e. 5. Education and Information to Increase Parent-Child Communication a. b. c. d. e. f. g. 6. Access to Teen Friendly Reproductive Health Services a. b. c. d. e. f. g.

SECTION 4: BUDGET NARRATIVE

October 1, 2015 through September 30, 2016 (Insert Agency Name)

For every item in your budget, explain the rationale for the expense (e.g., how each expense was calculated and how it relates to the success of the project.) Add rows as necessary.

NOTE: These funds cannot be used to pay for food or entertainment. Please round to the nearest $1.00

12 Budget Item Narrative Amount

$ A) Staff $

$

B) Incentives $ (totaling no more $ than $25/youth served) $

$ C)Equipment $

$ D) Supplies $

E) Curriculum/ $ Educational Materials $

TOTAL PROGRAM COSTS $

F) Training/ $ Professional Development $

1 $ G) Travel (DO NOT include registration for up to 2 staff travel $ 2 to Summer Institute ) $

TOTAL TRAINING AND TRAVEL COSTS: $

H) Other $ Expenses $

TOTAL OTHER EXPENSES: $

TOTAL BUDGET: $

Amount expected to be Amount expected to be Amount expected to be Amount expected to be expensed by 12-31-15 expensed by 3-31-16 expensed by 6-30-16 expensed by 9-30-16

$ $ $ $

This timeline must be in line with the action steps outlined in the Plan section.

1 Travel costs should align with South Carolina GSA rates 2 The SC Campaign will provide two scholarships per grantee to cover the registration fee to Summer Institute. 13 14 Appendix: Examples of Adult Preparation Education Materials

15