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2021 Law Enforcement School-Based Initiative
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Steps
1.
Requirements
(current)
This section is complete
This section is incomplete
2.
Key Facts
This section is complete
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3.
Area(s) Of Focus
This section is complete
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4.
Contact Information
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5.
Program Location(s)
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6.
Program Description
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7.
Goals
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8.
Program Budget
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9.
Attachments
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10.
Submission
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Requirements
Important
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This Application Is For Law Enforcement Only!
Name Of Your Organization/Agency
*
Name Of Program
*
Name of program for which you are applying for funding.
2021 Law Enforcement School-Based Education
In an effort to prevent violence and substance abuse, Jackson County COMBAT, is looking to fund Violence and/or Substance-Use Disorder Prevention programs that deliver Trauma-Informed Care and/or Trauma-Sensitive services to Jackson County residents.
COMBAT is urging Law Enforcement agencies applying for funding to establish new innovated anti-drug and anti-violence prevention programs within the schools other than DARE.
The requirements are that the program must be either evidence based or research based. The prevention programs must be developed in cooperation and collaboration with the school district. Please use this opportunity to broaden your scope of services.
Requirements
ALL Requirements Must Be Met At Time Of Applying
IMPORTANT:
The online application program will not permit you to continue to the next section of the website until you complete the section on which you are working.
Jackson County Requirments
A) Tax Clearance Required:
Chapter 10, 1003 of the Jackson County Codes states “No person, firm or corporation, residing in Jackson County, or otherwise legally within the taxing jurisdiction of the County, shall be eligible to provide any goods, contractual services or anything covered by this chapter, unless that person, form or corporation is duly listed and assessed on the County tax rolls and is in no way delinquent on any taxes payable to the County” (Ord. 3839, Eff. 11/28/06). If you need to register as a Business with Jackson County, please call (816) 881-3530 or (816) 881-4541. Exception: Governmental Jurisdictions in Jackson County.
B) Goal for Minority Hiring and Employment:
Chapter 93, Section 9304 of the Jackson County Code regarding COMBAT states “Any proceeds from the Anti-Drug Sales Tax creating jobs and employment shall have a twenty percent goal for minority hiring and employment” (Ord. 1795, Sec. 4; Ord. 1941 Effective April 24, 1991). Since this is a specific requirement for COMBAT, it is required during the application period and will be monitored.
Each funded organization must provide evidence of
liability insurance
coverage during the time of award of funding from Jackson County.
Applicant organizations must have on file a
Compliance Certificate
from Jackson County before any funding may be awarded.
Certificate Link
Jackson County Compliance Certificate Link
Use this link to complete certification
COMBAT Requirements
A)
Any organization requesting COMBAT funding must have an office in Jackson County and provide services to Jackson County residents in Jackson County.
B)
Applicant organizations must provide a copy of a letter from the Internal Revenue Service indicating current 501.c.3 tax-exempt status.
C)
An applying agency must be in existence for more than two years. 4. Applicant organizations must provide proof of current Good Standing with the Missouri Secretary of State.
D)
Applicant organizations must provide a copy of a certified final audit (within the past two fiscal years).
E)
Applicant organizations must provide a copy of a current IRS form 990 (within past two years) or extension letter.
F)
COMBAT funding is provided on a reimbursement basis, available upon submission of receipts and proof of payment at the end of each month.
G)
COMBAT funds cannot be used for capital purchases.
H)
All persons implementing COMBAT funded programming must have training in Trauma-Informed Care.
Staff Requirements
Staff assigned to COMBAT funded programs must have received Trauma Informed Care training. If a staff person has not received this training, the agency must show that this person has received that training within three (3) months of the beginning of the program, or that person’s salary will no longer be funded.
Acknowledgement
*
I have read all requirements for 2021 COMBAT Substance Abuse Prevention funding.
Agreed
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Key Facts
Key Facts About Violence
Preventing Violence
Violence is preventable, not inevitable. To prevent violence you must change the underlying conditions that contribute to violence in homes, schools and neighborhoods. In an attempt to change the underlying conditions contributing to violence and drug- abuse one must address trauma as it relates to public health.
Being a victim of violence and violent behaviors can be a precursor to addiction because of the way traumatic events affect the brain. Trauma makes the mind work in overdrive, causing near-constant fear, anxiety, and stress. A person who survives a traumatic experience may constantly function in a fight-or-flight survival mode. The brain may even continuously replay the memory of the traumatic experience, forcing the person to involuntarily relive the event.
Experiencing these feelings all the time can be overwhelming and incredibly distressing for someone trying to recover from a violent crime or abusive relationship. Many survivors of trauma turn to drugs or alcohol to find relief.
Violence & Trauma
Those who have been affected by violence as victims, witnesses, and even perpetrators present special challenges and have increased risk for both committing and being victimized by future violence related behaviors. It is becoming increasingly clear that, to successfully intervene with those who have been affected by violence in the past, it is necessary to recognize and address past associations with violence. The Missouri Department of Mental Health began work in 2012 to create Trauma Informed agencies that understand the role of violence and victimization and use appropriate responses to effectively address those affected, facilitating their participation in interventions. Programs that deliver Trauma Informed or Trauma Specific services can address those who have already been directly affected by violence as well as their families and communities. These services require the inclusion of staff, consultants and partners with the appropriate training and credentials to identify, refer and/or serve those affected. "Training in Trauma Informed Care is mandatory for successful applicants to this competition."
Related Links
Centers For Disease Control & Prevention Violence Prevention
CDC Violence Prevention Tip Sheet
Missouri Department of Mental Health Trauma-Informed Care
National Institute on Drug Abuse
Prevention Institute
Addiction & Violence
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Area(s) Of Focus
Area(s) Of Focus
Check Violence Issue Your Agency Will Address
*
Bullying
Child Abuse
DARE
Diversion Programs
Domestic Violence
Drug Use Prevention
Electronic Aggression (Cyber Bullying)
Ex-Offenders & Violence
Gang Violence
Parenting & Family Interventions
Perpetrators of Violence
Restorative Justice With Conflict Resolution
School Attendance/Truancy
Sexual Assault
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Suicide Prevention
Teen-Dating Violence
Victim Support Services
Youth-Oriented Programs
Other
Other
If you checked "Other" please specify the area of focus here.
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Contact Information
Contact Information
Agency
*
Funding Type
*
Check One
D.A.R.E.
Other
Other
Specify Funding Type Here
Funding Request
*
Amount of COMBAT funding being applied for
Organization's Mailing Address
*
City
*
State
*
Zip Code
*
Phone
*
Website Address
*
Write "NONE" if no site exists
Primary Contact
Person preparing and submitting this application
Name
*
Title
*
Phone
*
e-mail
*
Program Coordinator
Individual who will directing program that would receive COMBAT funding
Name
*
Phone
*
e-mail
*
Organization's Executive Director
Police Chief/Sheriff
Name
*
Phone
*
e-mail
*
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Program Location(s)
Program Service Locations
Address(es) where program services will be provided. List only those locations where the COMBAT-funded program's services will be available, not all locations where your organization provides services.
Location 1
School District
*
School Name
*
Physical Address
*
City
*
State
*
Zip
*
Program Phone
*
Description of Services to be provided at this site
*
Location 2
School District
School Name
Physical Address
City
State
Zip
Program Phone
Description of Services to be provided at this site
Location 3
School District
School Name
Physical Addresss
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 4
School District
School Name
Physical Address
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 5
School District
School Name
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 6
School District
School Name
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 7
School District
School Name
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 8
School District
School Name
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 9
School District
School Name
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 10
School District
School Name
City
State
Zip
Program Phone
Description Of Services to be provided at this site
Location 11
School District
School Name
City
State
Zip
Program Phone
Description of services to be provided at this site
Location 12
School District
School Name
City
State
Zip
Program Phone
Description of services to be provided at this site
More
Additional Locations
If more than 12 program addresses, please list remainder here with name, street address, city, state, zip and phone number.
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Program Description
Program Description
I) Program Purpose Statement
If funded, this will be the program description used by COMBAT. Include the Purpose, Goal, Need/Target population, Services/Intervention Activities to be provided and Expected Outcome of your program. Be sure to specify whether the program will focus on substance abuse prevention or violence prevention.
Summary
*
II) Discuss Program Goal(s):
Goals are typically broad general statements that describe what the program plans to accomplish. Goals, establish the overall direction for and focus of a program. Goals define the scope of what the program should achieve and serves as the foundation for developing program objectives.
Goals
*
III) Discuss The Need
What problem or opportunity does the program addresses? Who experiences it?
List prevalent risk-factors that will be addressed in your 2021 proposal.
List which protective-factors will be utilized in buffering prevalent risk-factors.
Need
*
IV) Expected Effects
What changes resulting from the program are anticipated?
What must the program accomplish to be considered successful?
Effects
*
V) When will this COMBAT-funded program be offered?
*
-- Select One --
Year round
School-Based Project
List months, days of the week and times when COMBAT program will be offered
VI) Total Number of Classes & Students
5th Grade Classes
Total Number Of Classes
6th Grade Classes
Total Number Of Classes
7th Grade Classes
Total Number Of Classes
5th Grade Students
Total Number Of 5th Grade Students
6th Grade Students
Total Number Of 6th Grade Students
7th Grade Students
Total Number Of 7th Grade Students
TOTAL CLASSES
Total Number Of 5th, 6th & 7th Grade Classes Combined
TOTAL STUDENTS
Total Number Of 5th, 6th & 7th Grade Students Combined
Other Grades/Classes
Describe if (and how) your COMBAT-funded program will serve studnets in grades other than 5th, 6th and 7th.
VII) Evidence-Based Progamming
Please describe any/all evidence-based programming that will be utilized in the COMBAT-funded services, and any staff that have received training in such programs.
Evidence-Based Program
Staff Members
Staff members trained in this evidence-based programming
Evidence-Based Program
Staff Members
Staff members trained in this evidence-based programming
Evidence-Based Program
Staff Members
Staff members trained in this evidence-based programming
Evidence-Based Program
Staff Members
Staff members trained in this evidence-based programming
VIII) Who will be performing the program evaluation?
Agency Name
Agency Address
Responsibilities
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Goals
Progam Goals
Briefly describe the short-term/immediate and long-term goals you plan on achieving.
Short-Term Goals
Long-Term Goals
Indicators Of Success
Both for short- and long-term goals
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Program Budget
Program Budget Information
Restrictions
1)
COMBAT funds may not be used to provide capital improvements (Article 6, Section 23 of the Mo. Constitution).
2)
Funds may not be used to pay salaries for functions that have traditionally been performed by volunteers.
3)
COMBAT funds may not be used to pay rent, utilities, equipment or for out of town travel.
Personnel (Salaries)
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Fringe Benefits
Maximum 10% of Salaries (Describe Benefits Below)
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Description of Fringe Benefits
Auditing/Accounting Services
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Evaluation
COMBAT Budget
Propsed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Postage
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Printing
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Meeting Expense
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Mileage (Local Travel)
COMBAT Budget
Proposed
Other
Other Funding Amoung
Total
Total Cost
Funding Sources
Number of Other Sources
Training
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Memberships
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Insurance
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Program Supplies
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Indirect (Max. 7% Of Total)
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Other
Specify
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Other
Specify
COMBAT Budget
Propsed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
Other
Specify
COMBAT Budget
Proposed
Other
Other Funding Amounts
Total
Total Cost
Funding Sources
Number of Other Sources
TOTAL PROPOSED BUDGET
COMBAT Budget
Proposed
Other
Other Funding Amount
Total
Total Cost
Funding Sources
Number of Other Sources
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Attachments
Required Documents
MUST BE PROVIDED
hese documents MUST be attached in the spaces below before submitting. PDF, Word and Excel documents are accepted.
Attachment 1
*
Jackson County Compliance Report Form completed and signed or existing certificate (if you have one).
Download This Form (PDF)
Attachment 2
*
Copy of Paid Jackson County Property tax receipt or current exemption certificate.
Attachment 3
*
Copy of evidence of liability insurance coverage for at least $1 million.
Attachment 4
*
Copy of current IRS Form 990 (within past two fiscal years 2018 or 2019).
Attachment 5
*
Copy of full Certified Financial Audit (within past two fiscal years 2018 or 2019).
Attachment 6
*
Copy of letter indicating current IRS 501(c)(3) tax-exempt status (if applicant is not a governmental agency, e.g., city, school district or court in Jackson County).
Attachment 7
*
Certificate of Good Standing from the Missouri Secretary of State.
Attachment 8
*
List of Staff with titles and copies of certifications
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Submission
Acknowledgement
*
By clicking "Agree," you agree and acknowledge that information and statements provided in this application are, to the best of your knowledge, true and accurate.
Agree
By typing your name in the "Signature" box below, you acknowledge that this "electronic signature" is valid and binding upon you to the same force and effect of a traditional handwritten signature.
Signature
*
Date
*
Date
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Receive an email copy of this form.
Email address
This field is not part of the form submission.
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