ࡱ> ; rMbjbj 4`ldldY|   8C?< 6n{ !$7$7$7$k%q&|&@lllllll$qt`m/k%k%//m7$7$4m333/R7$7$l3/l332ch7$_0Fe.ln06neuU0u\hh.ui-'0]'"3''-'-'-'mm1-'-'-'6n=(+./u-'-'-'-'-'-'-'-'-' : STATE OF NEW JERSEY DEPARTMENT OF CHILDREN AND FAMILIES Annex A PROGRAM DESCRIPTION Section 2.2 School Based Youth Services Program (SBYSP) Elementary School Managing Agency Name: _____________________________________________________________ Please note that additional information/addenda may be required in order to complete the contract package. Any specific requirements/stipulations pertaining to the program will be forwarded as applicable. Label all answers clearly as outlined below: Provide a brief program/component description and its purpose. The description should reflect the program requirements set forth in the initial RFP and any changes that may have resulted from negotiations. The Division of Family and Community Partnerships (FCP) Office of School-Linked Services (OSLS) contracts with private non-profit organizations, hospitals, colleges/universities and school districts throughout the State to provide a variety of prevention and support services for youth in New Jerseys public elementary, middle and high schools. SBYSP services operate in host schools and coordinate with existing school and community resources. All youth are eligible to participate, and services are provided before, during and after school. The goal of all programs within the OSLS is to implement prevention and intervention programs that are comprehensive, multifaceted, and build on the strengths of young people and assist them in achieving their educational and life goals. SBYSP services include: Mental Health Counseling; Employment Counseling; Substance Abuse Education/Prevention; Preventive Health Awareness including Pregnancy Prevention; Primary Medical Linkages; Learning Support; Healthy Youth Development; Recreation; and Information/Referral. In accordance with 42 U.S.C 602(a) (1)(A)(vi), to eligible Work First New Jersey, Temporary Assistance for Needy Families (TANF), students enrolled in the program will be made aware of statutory rape laws, reporting guidelines and resources. Program Availability SBYSPs are required to provide direct services to the school community September 1st through June 30th and maintain indirect program operations in July and August. During July and August, operating hours and staffing may be amended. The following indirect program operations are expected during July and August: Programs are to independently and/or in partnership with the host school implement a transition program to acclimate new students to the school. Program staff are to use this time for professional development related to the target population and program service delivery (e.g. live or web-based trainings, conferences, etc.). Programs are to review program data (program goals, student satisfaction, outcomes, etc.) to identify the programs strength and areas of needed improvement as part of an annual Continuous Quality Improvement process. Programs are to perform administrative program tasks to conclude the school year and prepare for the upcoming year (e.g. close/open student records, organize and plan program activities, update electronic and hardcopy files, etc.). In addition, programs have the option to directly and/or in partnership with the host school provide direct service activities that align with the school based model during July and August. SBYSP Elementary School Operating Hours Programs are required to operate for student access the first day of school through the last day (typically September-June). The following are the minimum operation hours required: 2 days/week availability before school hours, 5 days/week availability during school hours, and 3 days/week availability after school hours Note: If there are extenuating circumstances that may impact these operating hours, written approval is required by the Office of School Linked Services. Identify the target population served by this program/component (i.e. individuals who have been unemployed for the past 6-12 months). The target population is all youth currently enrolled in the SBYSP host school. Detail what the program intends to address through service delivery. State the results the program intends to achieve. A three-year evaluation of the SBYSP funded by the Anne E. Casey Foundation and conducted by the Academy for Educational Development (AED) indicates that participating youth demonstrated: Increased educational aspirations and higher accumulation of credits toward graduation Diminished feelings of unhappiness, sadness, depression and suicidal thoughts Improved sleep habits and less worrying Less destructive behavior and feelings of anger Decreased use of tobacco and alcohol More and improved interaction with families and friends Better use of contraceptives to prevent pregnancy and sexually transmitted diseases SEE ANNEX A 2.3 for the Expected Program Outcomes to be achieved Describe the method of service delivery (i.e. in the community, on site, etc.). PROGRAM APPROACH The theoretical framework for the delivery of all FCP funded services is grounded in the Department of Children and Families Core Values, the New Jersey Standards for Prevention Programs: Building Success through Family Support, the nationally recognized Strengthening Families Program. In addition, the programs within the Office of School Linked Services are also grounded in the Youth Thrive framework. All contracted providers are expected to integrate these elements into their direct service operations as appropriate: DCF Core Values Children are, first and foremost, protected from abuse and neglect Children do best when they have strong families, preferably their own, and when that is not possible, a stable relative, foster or adoptive family Relevant services are offered to meet the identified needs of children and families and promote child development, education, physical and mental health Most families have the capability to change with the support of individualized services Partnerships with people and agencies involved in a childs life are essential to ensure child safety, permanency and well-being, and build strong families New Jersey Standards for Prevention Programs The New Jersey Standards for Prevention Programs: Building Success through Family Support articulate the Departments approach to child abuse prevention and intervention: Standards for Prevention Programs: Building Success through Family SupportConceptual StandardsPractice StandardsAdministrative StandardsFamily centered Community based Culturally sensitive & competent Early Start Developmentally appropriate Participants as partners Empowerment and strength based approachesFlexible and responsive Partnership approach Links with informal and formal supports Universally available and voluntary Comprehensive & integrated Easily accessible Long term and adequate intensitySound program structure & practices Committed caring staff Data collection & documentation Measurable outcomes & program evaluations Adequate funding and long range plans Participant and community collaboration SBYSP operating procedures SBYSP operations and service delivery are driven by an established program model as outlined in the SBYSP Operational Manual. Below are a few pertinent highlights: All programs are encouraged to utilize evidence based/informed curricula, assessments and best practice strategies wherever possible. All curricula used in the program are specified in the NJ SBYSP Program Report. The SBYSP provides and promotes services that are safe, non-stigmatizing, culturally sensitive, supportive, and appropriate; Student feedback and input are incorporated into the overall program design and service delivery; The Office of School Linked Services is responsible for the administration of healthy youth development programs for school aged youth. Programs utilize a behavioral health approach to strengthen youth as they move towards adulthood. In accordance with  HYPERLINK "http://www.nj.gov/dcf/families/Keystone-Law-FAQ.pdf" NJ A3435, Boys and Girls Clubs Keystone Law signed January 19, 2016, NJ DCF ensure programs made available to school aged youth are accessible. As such, students 16 years and older are permitted to self-consent for school based programming made available to them on school grounds. Students under age 16 require parental/guardian consent to participate in the program. Regardless of consent requirement, all programs are expected to engage parents/guardians in programming. If and when students travel off school grounds, parental/guardian consent is required for all school aged youth regardless of age of consent. Parent/Caregiver Engagement is an essential time for youth as they begin transitioning to independence. Through engagement and partnership students, parents/caregivers and other trusted adults can learn to become supportive resources for each other during this phase. If in crisis and as applicable, a student may be seen once in the life time of the program without parental consent. Signed authorization from a parent/guardian is required in order to continue services; Signed release of information forms are valid for one (1) year and must be renewed upon expiration. All forms are retained in student records. All programs adhere to strict guidelines regarding confidentiality. Students and families are informed verbally and in writing prior to the disclosure of confidential information, about legal and ethical circumstances that will permit or require the release of such information without consent, including N.J.S.A. 9:6-8.40 which states that every citizen is mandated to report any suspected or actual incidence of child abuse or neglect. All such forms are valid for one year and retained in the students SBYSP record; Individual student records are confidential and maintained in a secured and locked location within the SBYSP space. Progress notes and attendance logs are maintained to document student development and participation throughout the program; Only students who are currently enrolled in the host school may participate in SBYSP. Participation is voluntary, and students may withdraw at any time. However, every effort is made to engage youth and maintain their involvement in the program; DCF also promotes the engagement of fathers in the lives of their children; The SBYSP supports and upholds the code of conduct and behavioral expectations of the host school. Students who are suspended or expelled from school may not participate in program activities without the consent of school administrators; Emergency procedures for all sites are aligned with the procedures established by each local school district. In addition, all programs must maintain an answering service with alternative emergency phone numbers, procedures and contact information in languages appropriate to the student population. Copies of all emergency procedures are retained on file at the SBYSP site; SBYSP utilize an array of outreach, program marketing and resource connection strategies to inform and educate the school community about SBYSP services such as: coordinate and integrate services with host school activities whenever possible develop sustainable collaborative relationships with diverse community groups, organizations and government agencies that promote positive youth development and provide relevant services to youth and families All promotional materials, including brochures, posters and advertisements, are labeled New Jersey Department of Children and Families Funded Program SBYSP provides an annual program orientation to relevant school administrators and faculty (Superintendent, Principal, Director of Student Services, etc.) to highlight program operation and previous years level of service and outcomes. SBYSP is expected to demonstrate strong linkages to the community. SBYSPs ensure there is a mechanism (i.e. Community Liaison Board) in place to address the needs and services available to youth within the community. The mechanism can consist of a gathering of volunteer members (e.g. students; parents; school board members; teachers; and community partners) who meet at specified intervals to advise, assist, support and advocate for the program. CORE SERVICES DEFINED The program integrates health promotion, competence building, and positive youth development strategies into an array of services that seek to increase protective factors for all participating students. Mental Health Counseling: Individual, family and group clinical and non-clinical counseling services are offered to all students. NJ SBYSP mental health counseling provides students with trauma informed short-term counseling to address the emotional and physical development issues that can impede the students good health, academic success and ability to maintain healthy relationships. NJ SBYSP Clinical Counseling is directed towards contemporary issues to get students through the school day with an emphasis on crisis counseling, situational adjustment, stress management, family and/or social functioning, bullying and other forms of peer victimization; anger management; self-harming behaviors, violence prevention; anxiety, teen dating abuse, short-term depression, sexual identity/orientation, etc. NJ SBYSP does not provide services which address mental health symptoms and associated functional impairment or psycho social adjustments. Students and/or families requiring this level of support are to be referred out for appropriate care. E.g. clinical treatment for long-term depression, suicidal ideations, sexual abuse, substance abuse, anxiety, etc. NJ SBYSP can be utilized as a voluntary member of the support team for a student receiving Out-Patient Mental Health services. NJ SBYSP does not prescribe, monitor or administer psychotropic medication. Pursuant to New Jersey statute, Administrative Code, and established practice, all clinical counseling services are provided by licensed clinicians or other professionals under the direct supervision of a licensed clinician. Such supervision is readily apparent and documented in each youths SBYSP record. All SBYSP sites must provide adequate space to conduct private counseling sessions. Although none are specified by DCF at this time, SBYSP in elementary schools are expected to identify and administer an age appropriate evidence-based/evidence informed assessment tool to demonstrate outcome achievement. Specify any assessment tool(s) administered to students beyond DCF required tools:  FORMTEXT       Copies of all assessment tools and relevant tool administration procedures are retained in each youth s record. The anonymously administered Impact Evaluation is retained in a general record for one fiscal year. Students who require long-term or more in-depth mental health treatment are referred to appropriate service providers within the community. Students that leave the program for any reason (including but not limited to graduation) are prepared for transition that includes guidance in how to access formal and informal supports in the community when needed. Preventive Health Services: SBYSP programs focus on the early identification and elimination of risk factors that impact or compromise student health. Workshops, classes, small groups and multi-media presentations regarding relevant health-related topics are provided, including but not limited to the prevention of pregnancy, substance abuse (including alcohol, tobacco and other drugs), pregnancy prevention, sexually transmitted diseases, and violence (including bullying). Primary Medical Health Services: Programs ensure and facilitate access to appropriate medical services within the community, including physical examinations, immunizations, hearing, dental, vision, family planning, health assessments, etc. Specify how students access medical services:  FORMCHECKBOX  Info/Referral Only  FORMCHECKBOX  Transport  FORMCHECKBOX  Bus Pass/Voucher  FORMCHECKBOX  Mobile Health Unit  FORMCHECKBOX  Services Provided on Site (see Other Service Options) Learning Support: Learning or academic support is central to the program goal of enhancing student competence and reducing drop-out rates. Activities include: various enrichment and literacy programs; homework assistance; tutoring; life skills; and addressing the needs of incoming students. Healthy Youth Development: The underlying philosophy of healthy youth development is holistic, preventative and positive. The focus is on providing asset and skill development activities that support youth in developing a sense of competence, usefulness, belonging and empowerment. Activities also promote healthy lifestyles and positive social interaction and may include: sports; fine arts; vocational education; and service learning. Information/Referral: All programs maintain an up to date information and referral directory of available local, county and state supported services and resources. SBYSP staff follow-up on referrals to ensure that services are accessible, appropriate and responsive to the needs of the student population at the host school. Programs ensure that promotional and access information regarding New Jerseys Youth Helpline 2NDFLOOR is readily available to all students. Programs ensure promotion and awareness of the NJ Strategy for Youth Suicide Prevention located on DCF web-site. Recreation: Recreational activities promote physical health and positive youth development, and typically include games; sports; and cultural, seasonal and educational field trips to foster positive peer relationships and healthy social skills development. Other SBYSP Service Options The following services exceed minimum program expectations and are not provided by all SBYSP sites. The provision of these services reflects the unique needs of students enrolled in the SBYSP. Check all that apply to this contract. If the Contract/Managing Agency operates more than one SBYSP site, indicate where the service component is offered:  FORMCHECKBOX  Violence Prevention: Effective approaches to reducing violent behavior balance security and discipline with positive supports, skill building, parent and community involvement, and a positive school environment. SBYSP efforts focus on reducing factors that place students at risk for perpetrating violence and address the individual, relational, and societal issues that influence youth. Due to their pervasive nature, the topics of bullying, aggressive classroom behavior, gun use, and organized gang activity are highlighted. Consistent with the mission of DFCP, attention is also focused on other forms of peer victimization, including sexual harassment and dating violence. This service component is available at the following sites:  FORMTEXT        FORMCHECKBOX  Mentoring: Mentoring programs provide struggling adolescents with trained, caring adults or peers who provide support, guidance, advice and companionship over an extended period. Mentoring programs encourage youth to focus on their education; provide support during crises; offer constructive ways to spend free time; and expose them to career paths and options. Mentors seek to supplement or enhance, but not replace, the roles of parents, guardians and teachers. This service component is available at the following sites:  FORMTEXT        FORMCHECKBOX  On Site Primary Medical Services: By offering medical services in one centralized location on school grounds, programs seek to eliminate barriers that often prevent youth from accessing care. A variety of examinations and medical screenings are provided, including but not limited to: immunizations; hearing, dental, and vision exams; wellness checks; family planning; comprehensive health assessments; and referrals to relevant treatment providers. Indicate if services are provided by professional medical personnel:  FORMCHECKBOX  Nurse Practitioner  FORMCHECKBOX  Doctor  FORMCHECKBOX  Dentist  FORMCHECKBOX  Other  FORMTEXT        FORMCHECKBOX  On Staff  FORMCHECKBOX  Sub-Contract  FORMCHECKBOX  Pro Bono This service component is available at the following sites:  FORMTEXT        FORMCHECKBOX  Other Program Services (Identify here and Describe below):  FORMTEXT        FORMTEXT       This service component is available at the following sites:  FORMTEXT       STAFF REQUIREMENTS SBYSP services are delivered by qualified staff who provide a combination of counseling, support and concrete services depending on each students unique needs. Full-time employees are required to work a minimum of 35 hours/week September 1st-June 30th. Work hours shall be compensated in accordance with actual hours worked on program related activities during the months of July 1st-August 31st. Required 100% program obligated full-time positions for all separately funded programs Program Director/Coordinator Qualifications include: Masters Degree with 2 years supervisory experience and a history of working in collaboration with youth and community. Programs funded prior to FY 2013 that still employ a Director with a Bachelors degree have been afforded grand-parent status for the duration of that individuals employment. All new hires must possess the required education. Mental Health Practitioner Qualifications include: MSW, BSW (an undergraduate degree is permissible ONLY when the Director is LCSW); MS, MA in a related field (e.g. counseling, psychology, etc.); and experience working with youth and families. Mental health service providers that do not have a LCSW or doctorate degree in Psychology must be clinically supervised by someone who does. Clinical supervision may be provided by the Managing Agency, a contracted agency, through a consultant agreement, or by other licensed staff Youth Development Specialist Qualifications include: Bachelor Degree in a related field or Associate Degree with documentation of at least 3 years full-time experience as a youth service worker Optional positions based on program design Health Educator/Nurse Practitioner Qualifications include: Advanced Practice Nurse (APN), Physicians Assistant, BSN, Bachelor or Masters Degree in a related field & experience working with youth health issues. Detail how customers access services. Cite any physical limitations that might preclude program admission or referral acceptance Discuss referral procedures and discharge planning with respect to the continuum of care Cite negative and planned discharge procedures Indicate specific documents needed for referrals, when applicable Only students who are currently enrolled in the host school may participate in SBYSP programs. Students can access services before, during and after school hours. Participation is voluntary, and students may withdraw at any time, however, every effort is made to engage youth and maintain their involvement in the program. Program referrals may be received from a variety of sources including but not limited to parents/guardians, peers, school staff, peer or student. NOTE: Referrals may not be mandated and/or written into any mandated plan. Families may participate in school-based activities in support of their student as deemed appropriate within the scope of the program. Students require age appropriate consent record to participate in the SBYSP. Students in crisis may be seen once without parental consent. Signed consent authorization must be on record for continued service. SBYSP support and up holds the code of conduct of the host school. Students who are suspended or expelled from school may not participate in program activities without the consent of school administrators. Describe the neighborhood(s) and the building(s) where each program site(s) is located. Detail accessibility to mass transportation. Identify the program catchment area. All sites have a clearly defined identity that includes the SBYSP acronym in the name (e.g. SBYSP Tigers Den). Signs in or around the host school are readily visible to assist students in locating and accessing the program. The SBYSP space is designed and organized with the input of students and families. The atmosphere and dcor is professional, youth appropriate, fun, welcoming and non-stigmatizing. All sites provide sufficient space to accommodate the provision of SBYSP Services. Such accommodations minimally include: - Reception area - Designated area for confidential or private counseling - Recreational/Group meeting space - Work stations for program staff SBYSP is located within the school building or in an annex location on school grounds. Identify the school where the SBYSP(s) funded under this contract operate: School #1:  FORMTEXT       Indicate the grades available in this elementary:  FORMCHECKBOX  K-4  FORMCHECKBOX  K-5  FORMCHECKBOX  K-6  FORMCHECKBOX  K-8  FORMCHECKBOX  Other: _______  FORMTEXT       #Students Enrolled in the SchoolProgram Name (include the SBYSP acronym) :  FORMTEXT       Street Address:  FORMTEXT      Phone Number:  FORMTEXT      Email:  FORMTEXT       FORMCHECKBOX  Located in School Facility  FORMCHECKBOX  Located on School Campus (i.e. mobile trailer, Annex Building, etc.) School #2:  FORMTEXT       Indicate the grades available in this elementary:  FORMCHECKBOX  K-4  FORMCHECKBOX  K-5  FORMCHECKBOX  K-6  FORMCHECKBOX  K-8  FORMCHECKBOX  Other: _______  FORMTEXT       #Students Enrolled in the SchoolProgram Name (include the SBYSP acronym) :  FORMTEXT       Street Address:  FORMTEXT      Phone Number:  FORMTEXT      Email:  FORMTEXT       FORMCHECKBOX  Located in School Facility  FORMCHECKBOX  Located on School Campus (i.e. mobile trailer, Annex Building, etc.) School #3:  FORMTEXT       Indicate the grades available in this elementary:  FORMCHECKBOX  K-4  FORMCHECKBOX  K-5  FORMCHECKBOX  K-6  FORMCHECKBOX  K-8  FORMCHECKBOX  Other: _______  FORMTEXT       #Students Enrolled in the SchoolProgram Name (include the SBYSP acronym):  FORMTEXT       Street Address:  FORMTEXT      Phone Number:  FORMTEXT      Email:  FORMTEXT       FORMCHECKBOX  Located in School Facility  FORMCHECKBOX  Located on School Campus (i.e. mobile trailer, Annex Building, etc.) Detail the programs emergency procedures. Provide any after-hours telephone numbers, emergency contacts, and special instructions. Emergency procedures for all sites are aligned with the procedures established by each local school district. In addition, all programs maintain an answering service with alternative emergency phone numbers, procedures and contact information in languages appropriate to the student population. Copies of all emergency procedures are retained on file at the SBYSP site. Provide the total number of unduplicated customers served in the previous contract period for each of the contracted programs. Unduplicated customers refers to the practice of counting a customer receiving services only once within a service cycle. Indicate the number of unduplicated customers achieving results. Indicate how the information was captured and measured. See the Level of Service Annex A 2.5 form to determine the minimum LOS and complete the necessary sections. All programs track the unduplicated number of students served and the number of events across the (annual) contract term. Unduplicated Students Served is a total count of all students enrolled in school base and participate in 1 or more individual, group or recreational/drop in activities. This information will be entered and tracked in the web-based management and information system supplied by DCF. Events SBYSPs are expected to plan a minimum of 4 activities/events each school year to promote student, family and community engagement and education. An event to promote father engagement (i.e. September--Dads Take Your Child to School Day) Three additional events/activities, such as: dinner and movie night; family game night; volunteer appreciation; spring cleaning; workshops (e.g. community safety, social media, and employment), etc. Programs can certainly develop events/activities not listed. ` U w  ! 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Prevention (emphasis on bullying prevention) April: Child Abuse Prevention Reporting Requirements Monthly Service Reports Monthly service reports are entered in the prescribed web-based management and information system (MIS) by the fifteenth day of each month for the preceding month in which services were provided. Biannual Program Reports Reports are completed twice each state fiscal year. Due January 15th for service activities taking place July 1st-December 31st and includes program outcomes from the prior complete state fiscal year. Due July 15th for service activities taking place January 1st-June 30th. The Office of School Linked Services downloads quarterly Level of Service reports from the MIS for review and distribution to the DCF Contract Administrator. COMMUNICATION All programs must maintain open lines of communication with the DCF Office of School-Linked Services, the student population and the community. To that end, all programs must have a multi-function voice mail system and internet connection with the capability to access emergency phone numbers and provide information in all languages as appropriate. All SBYSP Directors/Coordinators (and where appropriate, Managing Agency Chief Program Administrators) must have fully functioning email and telephonic voice mail accounts. The Office of School-Linked Services is notified of any changes in email addresses or telephone numbers. SBYSP administrators are also required to attend periodic meetings convened by the Division of Family and Community Partnerships when notified. The Office of School Linked Services and DCF Contract Administrator are notified of all changes to administrative or program operations as described and specified in this contract, including site location, student population, personnel and curricula. OPERATIONAL & FUNDING Restrictions Matching funds of 25% of the funded amount support program operations and are provided through any community-based organization, private, or public entity in the form of cash or in-kind donations. Funds May Be Used To: Support the costs of staff, materials, supplies and equipment; Renovate space within a school building (e.g. painting, carpet replacement, etc.); Purchase equipment and supplies for the site; Sub-contract with other community-based organizations for the provision of needed services; Cover administrative costs (up to a maximum of 10% of the grant funding); Cover the cost for the installation of a multi-function voice mail system with the ability to access emergency phone numbers, provide information in other languages, as appropriate, etc.; Cover costs associated with establishing an Internet connection, if the school is not connected at the time of the original grant award; and Purchase evidence based/evidence informed curricula/assessment tools. Funds May Not Be Used To: Construct a new facility; Purchase a modular unit; Purchase a vehicle, contraceptives or abortion services; Supplant or duplicate currently existing services or programs As needed, contract modifications are to be submitted in accordance with DCF contract policies.     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