FY22 JCPC COMM IN SCHOOLS TEEN COURT & MEDIATION PROG AGREEDocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
W OVA—
North Carolina Department of Public Safety
JCPC Program - Program Agreement
SECTION I A
SPONSORING AGENCY AND PROGRAM INFORMATION
FUNDING PERIOD:
FY 21-22
DPS/JCPC FUNDING # (cont only)
865-XXXX
COUNTY:
New Hanover
AREA:
Eastern Area
Multi -County:
No
Multi -Components
Yes
NAME OF PROGRAM:
Teen Court & Mediation (Restorative Justice)
SPONSORING AGENCY:
Communities In Schools of Cape Fear
SPONSORING AGENCY
20 N. 4th St. Suite 213
PHYSICAL ADDRESS:
Wilmington NC 28401
SPONSORING AGENCY
20 N. 4th St. Suite 213
MAILING ADDRESS:
Wilmington NC 28401
TYPE:
Non -Profit
(910) 343-1901
FEDERAL ID #120-3385755
E-mail: Louise@ciscapefear.org
COMPONENT ID # NAME OF PROGRAM COMPONENT PROGRAM TYPE TOTAL COST OF
EACH COMPONENT
33368 Teen Court Teen Court $ 69,402
33407 Mediation / Restorative Justice Mediation/Conflict Resolution $ 43,443
Total cost of components: $ 112,845
Program Manager Name & Address (same person on signature page)
Name:
Louise Hicks
Title:
Executive Director
Mailing
Address:
20 N. 4th St.
City:
Wilmington
Zip:
28401
Suite 213
Phone:
(910) 343-1901
Fax:
E-mail: Louise@ciscapefear.org
Contact Person (if different from program manager)
Name:
Louise Hicks
Title:
Executive Director
Mailing
Address:
20 N. 4th St.
City:
Wilmington
Zip:
28401
Suite 213
Phone:
(910) 343-1901
Fax:
E-mail: Louise@ciscapefear.org
Program Fiscal Officer (cannot be program manager)
Name:
Sue Tucker
Title:
Grants Manager
Mailing
Address:
20 N. 4th St.
City:
Wilmington
Zip:
28401
Suite 213
Phone:
(910) 343-1901
Fax:
E-mail: sue@ciscapefear.org
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION I B
PROGRAM COMPONENT DESCRIPTION
COMPONENT ID #
COMPONENT INFORMATION
33368
NAME OF COMPONENT: Teen Court
BRIEF DESCRIPTION: CIS Teen Court will provide New Hanover County youth with an
opportunity for diversion from juvenile court. Trained adult and teen volunteers will act as court
officials and hear complaints against eligible offenders who are currently enrolled in school,
admit guilt, and have no prior criminal history. Appropriate sentencing recommendations will be
made including community service, restitution, restorative justice, and participation in future
Teen Court proceedings and skill -building programs.
COMPONENT ID #
COMPONENT INFORMATION
33407
NAME OF COMPONENT: Mediation / Restorative Justice
BRIEF DESCRIPTION: The CIS Mediation/Restorative Justice program is designed to mediate
disagreements between youth ages 11-18, who have been referred by SROs, law enforcement
officials, school administrators, or juvenile court staff. Recognizing that students need to learn
how to resolve conflicts, staff trained in mediation and/or restorative Justice practices will guide
referred youth through a structured process in an effort to help them come to a positive
resolution.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION II
COMPONENT STATISTICAL INFORMATION
Multi -Components Yes
Component Service Statistics
PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name: Teen Court
Component ID #
33368
What is this component's maximum client capacity at any given time?
30
Frequency of client contact per month:
4
Anticipated Average Length of
Stay:
100
Days
y
Total Component Cost:
$69,402
- by
Estimated # to be served during funding period:
60
Estimated Average Cost Per Youth:
$1,157
Actual number of youth admitted FY 19-20:
0
Applies to
0
Number of admissions Juvenile Justice Referred
0% of total admissions
continuation
programs only.
0
Number of admissions Law Enforcement Referred
0% of total admissions
0
Number of admissions District Court Referred
0% of total admissions
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 01/09/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION III I COMPONENT SUMMARY
NAME OF COMPONENT: I Teen Court
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
The juvenile court system in New Hanover County lacks court diversion programs for first-time offenders. NC DPS
Division of Juvenile Justice County Databook 2019 reported 394 juvenile complaints and a delinquency rate of 15.69.
Of those, 216 (55%) were minor Class 1-3 offenses. These types of defendants are less likely to re -offend. The DPI
Consolidated Data Report 2019-2020 showed New Hanover County Schools had 74 reportable crimes, or 9.175 per
1.000, with 2,910 short-term suspensions and 10 long-term.
The New Hanover County Risk and Needs Assessment 2019-2020 shows 42.9% of juveniles have a risk level of 3 or
less. 61.2% have no prior adjudication. 87.1 % are age 12 or over at the time of their 1 st offense. 61.2% report
moderate to serious school discipline issues. 61.2% report rejection by peers, negative peer association, or gang
membership/affiliation. 59.9% report moderate to serious problems in school. 83% have mental health needs that have
been addressed or need more assessment. 30.8% have prior assaultive behavior and 43.3% have a history of alcohol
and substance use. 50.4% have prior referrals to juvenile court; 13% were under the age of 12 at referral. 46% have a
family history of criminality or court/gang involvement. 46% of parents report marginal or inadequate parenting skills;
while 21.4% report they are unable or unwilling to provide adequate supervision.
CIS Teen Court will offer an alternative to juvenile court and an opportunity for first time offenders to avoid a court
record/ It will provide comprehensive intervention and support to the juvenile participants, and will focus on diversion of
misdemeanor offenses. Per the Juvenile Reinvestment Report from the N.C. Commission on the Administration of Law
and Justice, evidence -based research suggests adolescents are less culpable than adults; the majority of youth
offenders age out of the behavior with full maturity. CIS Teen Court will offer the opportunity to learn skills to manage
negative behavior.
CIS Teen Court will provide juveniles with a multi -faceted plan including Restorative Circles, essays/apology letters,
future jury duty, monitoring of school attendance and academics, and referrals to restitution opportunities. Success in
sentence completion and program participation will be monitored, and participants will be tracked one-year post -
sentence completion to determine recidivism. CIS Teen Court will support protective factors to address the continuum
of risk and needs in New Hanover County by providing evidence- and/or research -based programs shown to be
effective with juvenile offenders; providing services that are outcome -based and evaluated; and collaborating with
SRO's, the WPD, and the NHC Sheriff's Office to detect gang participation and make referrals to diversion
programming. Additional benefits include addressing juvenile and family needs with a focus on prevention and
education, and providing opportunities for effective service provider collaboration.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
Our target population is youth, ages 11-18, who have been petitioned or law enforcement referred for misdemeanor
offenses. Partnerships with SROs, Juvenile Services, and District Court will allow these juvenile offenders the
opportunity to participate in the Teen Court program if the Court Intake Counselor finds they are eligible, willing to
admit responsibility for their actions, and willing to complete the program. If the offender successfully completes Teen
Court sentencing requirements within a 90 -day period, his/her record will be completely cleared. The program will also
provide opportunities, as applicable and at certain school sites, for participants to receive additional services at no
cost, including but not limited to Restorative Justice Circles and Integrated Student Supports. Additionally, at -risk youth
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION III
COMPONENT SUMMARY
NAME OF COMPONENT:
Teen Court
and first-time offenders will be encouraged to volunteer in the program at the end of their sentence, continuing
beneficial services and interaction with pro -social peers.
A secondary population served by Teen Court is the parents/guardians of these juveniles. Through deep -reaching
partnerships, CIS will strive to refer families to parenting education and support groups that focus on improving
parenting skills and parent/child relationships, whereby introducing a preventative component to this intervention, as
other siblings in the household may avoid the juvenile justice system by being exposed to better parenting and less
discord. By focusing both the juvenile and the family on developing better coping skills, positive social activities and
peer groups, and enhancing their knowledge and ability to have more positive interactions within their family, we will
reduce the risk of re -offending or having other family members enter the juvenile justice system.
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
The primary goal of the program is to reduce the number of juvenile offenders entering the court system.
Juveniles accept responsibility for their actions and are held accountable by their peers. Defendants will receive
sentences and for community service/restitution, jury duty at future Teen Court sessions, writing letters of apology, and
counseling/educational sessions to learn coping mechanisms, and learn effective communication skills with peers/
parents/authority figures. Opportunities will be provided for juvenile offenders to participate in Restorative Justice
Circles and in -school support services at no additional cost. Parents will be referred to programming to help them
learn parenting skills, positive disciplinary techniques, and communication skills in addition to problem -solving current
areas of concern. Through successful participation in Teen Court, a defendant can avoid a juvenile court record, which
would negatively affect his/ her opportunities to enter college, trade school, the military, or obtain employment.
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
75% Clients will have no new adjudications for a complaint with an offense date after the admission date.
75% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
completion.
75% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
75% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
75% Clients will demonstrate improvement in developing and/or maintaining social and interpersonal interactions
during program participation.
75% Clients will have no new complaints with an offense date after the admission date.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
NC DPS Division of Juvenile Justice County Databook 2019 reported 394 juvenile complaints and a delinquency rate
of 15.69. Of those, 216 (55%) were minor Class 1-3 offenses. These types of defendants are less likely to re -offend.
The DPI Consolidated Data Report 2019-2020 showed New Hanover County Schools had 74 reportable crimes, or
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION III I COMPONENT SUMMARY
NAME OF COMPONENT: I Teen Court
9.175 per 1.000, with 2,910 short-term suspensions and 10 long-term. The New Hanover County Risk and Needs
Assessment 2019-2020 shows 42.9% of juveniles have a risk level of 3 or less. 61.2% have no prior adjudication. 87.1
% are age 12 or over at the time of their 1 st offense. Teen Court is specifically designed to serve youthful 1 st time
misdemeanor offenders who have a low likelihood of recidivism if they receive intervention and support, and an
opportunity to learn from their experience and gain new skills.
Per county Risk Data, 83% have mental health needs that have been addressed or need more assessment. CIS Teen
Court will complete a basic risk assessment at intake and will work with community partners to ensure emotional/
mental health needs or issues from trauma are referred for proper assessment and intervention.
Additional Risk Data shows that 61.2% report rejection by peers, negative peer association, or gang membership/
affiliation. 59.9% report moderate to serious problems in school. 30.8% have a history of prior assaultive behavior and
43.3% report alcohol and substance use. 50.4% have prior referrals to juvenile court; 13% were under the age of 12 at
referral. CIS Teen Court will provide sentencing requirements that engage defendants in positive social situations and
promote pro -social behaviors, which may include community service, apology letters, participation in mediations,
Restorative Justice Circles, and serving as a juror at future Teen Court sessions. Juveniles will also be required to
attend school, maintain satisfactory grades and show positive conduct, with compliance tracking.
The Risk and Needs Assessment further identified that 46% have a family history of criminality or court/gang
involvement, and 46% of parents report marginal or inadequate parenting skills. 21.4% of parents report they are
unable or unwilling to provide adequate supervision, and 72% of juveniles exhibited moderate to serious school
discipline issues. Addressing the needs of both the juvenile and family will be key to the success of CIS Teen Court. As
appropriate, parents will be referred to educational classes and/or parenting groups to learn the importance of peer
relationships and developing skills and confidence to help their teens establish new behavior patterns. In doing so, a
shared sense of purpose will be established as they work together to improve behaviors and interactions with one
another and their community. This multi -faceted family support approach will also help deter juveniles' siblings from
entering the juvenile court system.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION IV
COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:
Teen Court
1. Location: List physical address(es) and describe where program services are delivered.
The CIS Teen Court / Mediation (Restorative Justice) Coordinator and Assistant will work out of the CIS offices both at
The Harrelson Center, 20 N. 4th Street, Wilmington, NC 28401, and at the CIS WIRE Youth Center, 1102 Orange
Street, Wilmington, NC 28401, where they will meet with juvenile offenders and their families and complete
administrative duties to support the successful operation of CIS Teen Court. Through our existing and strong
relationship with New Hanover County Schools, they will also have access to space within the district's schools for
those meetings upon SRO referral, to enable ease of access for parents and juvenile offenders.
CIS Teen Court sessions will be held in designated areas within the New Hanover County Courthouse and/or New
Hanover County School facilities. Restorative Justice Circles and Mediations will be held at relevant school sites, or at
the CIS youth center, WIRE, at 1102 Orange Street. Parenting programs will be held according to the implementing
organizations' location and schedules.
2. Operation: Describe the daily/weekly schedule of program operation.
The CIS Teen Court / Mediation (Restorative Justice) Coordinator and Assistant will work out of the CIS offices both at
The Harrelson Center and 1102 Orange Street, where they will meet with juvenile offenders and their families and
complete administrative duties that will support the successful operation of CIS Teen Court. Through our existing and
strong relationship with New Hanover County Schools, they will also have access to space within the district's schools
for those meetings upon SRO referral, to enable ease of access for parents and juvenile offenders. The Coordinator
will available 5 days per week at either their office location or via cell phone, and at other times via cell phone if
needed. All records and equipment will be kept in a secured area that will be closed to the public. CIS Teen Court
sessions will be held in designated areas within the New Hanover County Courthouse and/or New Hanover County
School facilities. Restorative Justice Circles and Mediations will be held at relevant school sites, or at the CIS youth
center, WIRE, at 1102 Orange Street. Parenting programs will be held according to the implementing organizations'
schedules.
Referrals will be accepted daily from Student Resource Officers, DJJDP; Law Enforcement and/or District Court
Counselors. CIS Teen Court will be held at least once a month. In addition to traditional Teen Court proceedings held
monthly at the courthouse utilizing a full jury, attorney mentors, and a judge, tribunals may held when a defendant is
unable to participate in a full peer jury court room hearing due to an identified mental, emotional, learning or other
disability that makes it unlikely he/she can successfully participate in those proceedings. The same sentencing
guidelines and all other Teen Court processes will be adhered to during a tribunal. The other time a tribunal may be
used is when it is not appropriate or is detrimental to delay a case due to a lack of adequate peer jurors, attorney
mentors, and/or judges to hear a case. In that situation, at the discretion of the Teen Court Coordinator, a tribunal may
be held.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
The CIS Teen Court / Restorative Justice Coordinator and assistant will be supervised by the CIS Director of
Operations, Marrio Jeter. Along with the program coordinator, Mr. Jeter will attend JCPC meetings and provide reports
on program progress at monthly meetings. He will supervise the Teen Court Coordinator, providing feedback and
oversight, and ensuring compliance with program fidelity and grant reporting. CIS leadership will also be responsible
for community awareness of the Teen Court program and ensuring all other funding sources and in-kind supports are
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-5l FOl E6751 DE
SECTION IV
COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:
Teen Court
in place to support the program.
The CIS Teen Court / Restorative Justice Coordinator will have a minimum of a bachelor's degree in criminal justice,
education, or human services related field, and be a trained mediator. They will have extensive experience working
with at -risk youth and their families, possess excellent communication skills, be detail oriented, and work well with both
parents and teens. They will be responsible for all aspects of the program, including but not limited to maintaining and/
or building relationships with referring entities, accepting referrals, interviewing defendants/parents, recruiting/ training
volunteers, collecting data, referring to and scheduling, as needed, counseling/ education/support sessions, evaluating
defendants' completion of program, attending JCPC monthly meetings, and reporting outcomes to stakeholders.
The CIS Teen Court / Restorative Justice Assistant will have a minimum of a bachelor's degree in criminal justice,
education, or human services related field, and extensive experience working with at -risk youth and their families. In
addition to assisting with the facilitation of CIS Teen Court and Mediation / Restorative Justice programs, they will
support volunteer recruitment, marketing, community outreach, partnership development, and other duties as assigned.
The Administrative Support personnel will manage payroll for the project staff, manage accounts payable and
receivables as related to the project, and prepare monthly revenue and expense reports.
Teen Court Aides will be present for each of the CIS Teen Court Sessions, and will have experience volunteering with
prior Teen Court sessions. They will monitor student volunteers, confirm positions, record and confirm the adult jury
monitors, ensure jury sign -in sheets are renewed between defendants, maintain the sentencing and disposition sheet,
ensure required participant surveys are completed, and perform other administrative duties as assigned.
Adult volunteers, including local attorneys and judges will serve. as judges, attorney mentors, jury monitors and role
models. Teen volunteers will serve as attorneys and jury members.
4. Service Type SPEP: Describe implementation to include:
This program is a STRUCTURE ONLY.
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
Referrals may be made by school resource officers, law enforcement, juvenile justice, district court, or area attorneys
for youth ages 11-18 who have committed an offense of less than an Al misdemeanor. The Teen Court Coordinator
will make contact with the juvenile & their parent/guardian upon referral. A referral will not be accepted if the offender is
over 18 years of age at the time of offense, if the offender or parent/ guardian are not willing or able to complete all
requirements of the Teen Court process, or if the offender has a record of prior offenses. If the offense is outside the
parameters of offenses intended to be diverted to Teen Court, a referral to Juvenile Court would be made.
To be eligible for Teen Court, offenders must admit responsibility for their actions and be willing to complete the
program. An intake appointment will be arranged to review program guidelines, participation requirements, completion
dates, expected outcomes, obtain informed consent to participate, review consequences for non-compliance and
obtain signatures agreeing to terms. A court date will be set for the offender at this appointment during which a
sentence will be delivered by a jury of the offender's peers.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION IV I COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT: I Teen Court
The Teen Court Coordinator will be responsible for conferring with the referral source for each case to ensure the
referral is appropriate for Teen Court and that all relevant, required information has been provided to hear the case and
determine sentencing. If the parent and student refuse to participate in the Teen Court Program, the Teen Court
Coordinator will immediately notify the referral source. It is also the responsibility of the Teen Court Director to monitor
all sentencing completion in determining the defendant's successful or unsuccessful completion of the Teen Court
Program.
Upon arrival to Teen Court, the juvenile will meet with students assigned as their attorneys and their adult attorney
mentor. The trial, designed to mirror a genuine court proceeding, will begin and mitigating/ aggravating factors will be
presented. The sentence may include up to 20 hours of community service/restitution, participation on the jury of future
Teen Court sessions, participation in Restorative Justice Circles, letters of apology, maintaining all lawful commands of
parents, and school attendance and grades.
The defendant and their parent will be required to sign the Sentencing Form at the conclusion of their hearing and will
then be referred to the County's Restitution Program for completion of community service. Offenders must complete
their sentence within a maximum of 90 days, stay in school and not re -offend during their stay in Teen Court. Parents
are required to attend intake, attend court with their child, and attend any supports to which they are referred. If a
juvenile fails to complete his/her sentencing terms as required, his/her case will be sent back to referring agency for
further disposition.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
Upon sentencing completion, an exit interview will be conducted with both the defendant and their parent/guardian to
review the defendant's progress. Emphasis will be placed on lessons learned, and on developing plans and goals for
the future. The juvenile will be followed for 1 year after sentence completion to track recidivism. The Teen Court
Coordinator will meet with/notify the referring agency as to the successful program completion of the juvenile. Any
action other than a successful completion will be reviewed with the referring agency, parent and juvenile. Any juvenile
offender who does not successfully complete Teen Court and comply with all guidelines will be deemed non-compliant,
terminated from Teen Court and referred back to the referring agency. Reasons for unsuccessful completions would be
if the offender re -offended either at school or within the community between their intake appointment and the 90 -day
deadline for completion, or not completing any aspect of the program within the agreed-upon 90 -day window.
Other terminations will include:
- Refusal to participate in the program (at which point the offender will be referred back to the initial referring agency).
- Moving out of state / County
- Involuntary commitment of the offender
How is the referring agency involved with the termination process?
The Court Intake Counselor, Law Enforcement, School Resource Officer, and/or District Attorney's Office will be
notified by the Teen Court Coordinator of successful sentence completion. Any action other than a successful
completion will be reviewed with the referring agency, parent, and the juvenile, who will then be referred back to the
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION IV
COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:
Teen Court
referring party for disposition.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
Referrals may be made by school resource officers, law enforcement, juvenile justice, district court, or area attorneys
for youth ages 11-18 who have committed their first offense of less than an Al misdemeanor. The Teen Court
Coordinator will make contact with the juvenile & their parent/guardian upon referral. A referral will not be accepted if
the offender is over age 18 at the time of the offense, if the offender or parent/ guardian is not willing or able to
complete all requirements of the Teen Court process, or if the offender has a record of prior offenses. If the offense is
outside the parameters of offenses intended to be diverted to Teen Court, referral to Juvenile Court would be made.
The Teen Court Coordinator will be responsible for conferring with the referral source for each case to ensure the
referral is appropriate for Teen Court and that all relevant, required information has been provided to hear the case and
determine sentencing. If the parent and student refuse to participate in the Teen Court Program, the Teen Court
Coordinator will immediately notify the referral source. It is also the responsibility of the Teen Court Director to monitor
all sentencing completion in determining the defendant's successful or unsuccessful completion of the Teen Court
Program.
The program coordinator will be in constant contact with the referral source throughout the intake, enrollment, and teen
court process. The defendant and their parent will be required to sign the Sentencing Form at the conclusion of their
hearing and will then be referred to the Restitution Program for completion of their sentence, which must be completed
within a maximum of 90 days. They must also stay in school and not re -offend during their Teen Court participation.
Parents are required to attend intake and court with their child, and attend any supports to which they are referred. If a
juvenile fails to complete his/her sentencing terms as required, his/her case will be sent back to the referring agency
for further disposition. Continued communication with the referring entity will be critical for feedback to the program
coordinator.
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
utilized in this component and how will parents/guardians be involved?
A structured service plan of learning (Sentence) will be developed for defendants to address behavior problems, drug -
alcohol prevention and peer pressure. Sentencing will hold youth accountable for future actions including school
attendance, achieving satisfactory grades, and not committing further offenses. Educational workshops for youth will
provide skills to improve juvenile's decision making, communication, conflict resolution, and gang and drug resistance,
thereby reducing negative behaviors. Participation in future Teen Court jury duty will increase the defendant's access
to positive peers. Completion of community service will provide exposure to pro -social activities , positive role models
and volunteerism, supporting positive character development.
By attending the referred parenting classes as applicable, parents/guardians can learn better disciplinary techniques
and communication that can be applied when working with their children, thus empowering them to become more
effective, proactive parents. Youth listen to and are influenced by their peers. Juveniles who are held accountable for
their behavior by their peers are more likely to listen and make changes to their behavior. Volunteer jurors recognize
and "reward" positive behaviors such as after-school involvement, satisfactory grades, commitment to stay in school,
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION IV I COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT: I Teen Court
and future goals, as seen in their jury verdict. In order to complete their constructive sentence, juveniles and their
families work on family accountability and relationships.
Healthy attitudes concerning family, discipline, consequences and education are encouraged and reinforced in peer
circles and parenting groups. Community Service allows youth to work and learn from adults who support community
activities and allows them to be exposed to positive activities that also serve others.
Incentives, usually in the form of a snack prior to the start of each Teen Court session or a year end gathering for
recognition of service, is provided to students who volunteer their time to hear the cases of their peers. The use of
incentives helps contribute to their commitment to the program and shows they are appreciated and valued as part of
the Teen Court process.
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
CIS Teen Court program will use the National Youth Court Guidelines - authored by Tracy Godwin with Michelle
Heward and Thomas Spina. According to the National Center for Mental Health Promotion and Youth Violence
Prevention, "these best practice guidelines were developed by a panel of experts in the following program areas:
program planning and community organization, program staffing and funding, legal issues, identified respondent
population and referral process, program services and sentencing options, volunteer recruitment and management,
volunteer training, operations and case management, and program evaluation. Guidelines were developed to promote
best practices, effectiveness, and program accountability."
Restorative practices to deal with crime and wrongdoing are recognized as evidence -based practices according to
extensive research and there is support now too that restorative justice is evidence -based for school discipline.
The Council of State Governments issued a report in 2014 and recommends restorative practices for school discipline
and states that it is evidence based along with other interventions including Positive Behavioral Interventions and
Support (PBIS). p. 14 (http://csgjusticecenter.org/wpcontent/uploads/2014/06/
The_School_Discipline_Consensus_Re port.pdf)
The CIS Model of Integrated Students Supports is supported by research from organizations including Child Trends
and the Everyone Graduates Center at Johns Hopkins University. Child Trends asked the question, "Does ISS Work?"
and embarked on a comprehensive and rigorous review of the "theoretical, empirical, practice and evaluation findings
that underlie integrated students supports as an approach". (Child Trends White Paper, February 2014) Key findings
support the CIS Model. Emerging evidence from quasi -experimental studies (including CIS National) finds that ISS
can contribute to decreases in grade retention and school dropout, and increases in attendance, math achievement
and overall GPA. As a student -centered approach, ISS is firmly grounded in the research on child and youth
development. Providing an array of academic and non-academic supports in a coordinated manner (as in the CIS
Model) is more effective than a focus on one or a few supports. Child Trends concludes that evidence supports the
effectiveness and cost-effectiveness of integrated student supports to improve educational outcomes.
Additionally, all mediation and Restorative Justice Circle facilitators will have been formally trained and/or certified to
implement the respective intervention / support with fidelity.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION II
COMPONENT STATISTICAL INFORMATION
Multi -Components Yes
Component Service Statistics
PROGRAM COMPONENT INFORMATION - APPLICATION YEAR
Component Name: Mediation / Restorative Justice
Component ID #
33407
What is this component's maximum client capacity at any given time?
15
Frequency of client contact per month:
4
Anticipated Average Length of
Stay:
90
Days
y
Total Component Cost:
$43,443
- by
Estimated # to be served during funding period:
40
Estimated Average Cost Per Youth:
$1,086
Actual number of youth admitted FY 19-20:
0
Applies to
0
Number of admissions Juvenile Justice Referred
0% of total admissions
continuation
programs only.
0
Number of admissions Law Enforcement Referred
0% of total admissions
0
Number of admissions District Court Referred
0% of total admissions
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 01/09/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION III I COMPONENT SUMMARY
NAME OF COMPONENT: I Mediation / Restorative Justice
1. Statement of the Problem: In concise terminology, describe how the program will address continuum need(s) in
the county.
Conflict between youth in a school or community setting is a natural occurrence and is typically thought of in a
negative way, however that perception can be re -framed to view conflict as an opportunity for growth. Mediation and
restorative justice practices are tools that can be utilized to help facilitate this growth and to promote positive conflict
resolutions. Conflict presents itself in almost every facet of our lives at some point, so we should equip youth at an
early age with skills they need to positively resolve conflict, whereby avoiding escalation of the conflict, or leading to
more negative, potentially criminal behaviors.
Peer relationships are the focal point of adolescent development and our youth need to be educated in conflict
resolution in an effort to support healthy relationships and yield positive outcomes. When conflicts occur, most youth
lack the developmental maturity to resolve issues without adult guidance. Not only is it important to work with youth to
help build their skills, but it is necessary to create and support climates where mediation/conflict resolution is fostered.
Implementing restorative justice practices within our schools is one strategy proven to yield success on this front.
Mediation and Restorative Justice are philosophies of repairing the harm done by crime by involving the parties
affected by the crime. Using Restorative Justice principles, trained staff will facilitate a structured process through
which the victim and juvenile offender, and other parties involved (or affected by the offense), sit down together in a
safe environment with a neutral, trained facilitator. Through this process, the juvenile is held accountable for the
offense, the victim can discuss the impact of the offense, and both parties negotiate together what should be done to
repair the harm that was done. Program participation will be voluntary and confidential. Using these models, juveniles
are diverted from court, but are still held accountable for their actions.
Juveniles need to learn from an early age how to resolve disputes. Frequently, disputes that could be resolved quickly
and easily turn into major disagreements because students have never been taught valuable conflict resolution skills
and techniques. Youth need to learn in a structured setting how to use techniques to resolve issues in a peaceful,
respectful manner. Many times, juveniles are charged with crimes due to the fact that there are few alternative
solutions. A diversionary program such as this can assist juveniles after adjudication. There are few resources to
address criminal behavior in juveniles prior to adjudication and as a result, many students fail to understand the
consequences of their behavior and continue to re -offend. These children continue to experience high rates of school
suspensions, create victims within the community, and are repeatedly referred into the criminal justice system.
2. Target Population: Describe the target population, including age, and the steps taken to insure that the target
population is served.
The target population for the CIS Mediation / Restorative Justice Program is middle and high school students (ages 11
to 18) referred by New Hanover County Schools administrators, school resource officers/law enforcement, or juvenile
court counselors. This program is designed to serve youth on diversion plans, or youth that are at -risk, and will accept
clients involved in verbal and physical altercations. Youth who are at risk for becoming involved in more serious
infractions at school, in the community, or with law enforcement would also benefit from this program.
Participants will have the opportunity to work through their dispute in a face-to-face setting with a trained, adult
facilitator guiding them through the process. They would then have the opportunity to continue to work with the
facilitator either individually, or together as needed. Many of our students live close together and bring neighborhood
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION III
COMPONENT SUMMARY
NAME OF COMPONENT:
Mediation / Restorative Justice
problems into the schools, or vice versa. By creating a program allowing for referrals from the schools and the juvenile
system, we aim to divert problems that may continue in the community until they are dealt with and a resolution is
found.
By utilizing mediation / restorative justice tools, guided by a trained facilitator, participating youth will gain an
understanding of what drives their conflict, as well as how to appropriately and safely find resolutions thereto. Parents
and families can also benefit from engaging in this work. School administration and the SROs will be involved in
student referrals at the school level. When fights take place, the SRO and administration will determine if they are
appropriate for referral to mediation / restorative justice intervention. Juvenile court counselors and probation officers
would make direct referrals to the mediation program as a means of diversion. This would be a first step, prior to teen
court referral, if deemed appropriate for referral, following the School -Justice Partnership Agreement guidelines.
3. Program Goal(s): Provide a brief statement to describe the overall purpose of the program.
The overall purpose of the program is to provide youth with life-long conflict resolution skills. We aim to work with youth
who have behavior programs, anger issues, and/or poor social skills. If students can learn how to resolve conflicts,
referrals to School Resource Officers and Juvenile Court should be lower. This in turn would keep students in school
and hopefully keep them on track for graduation from high school.
Through Mediation/Restorative Justice practices, students will be given the opportunity to think in a creative manner
about how to resolve their conflicts without resorting to name calling, fighting, angry feelings, or even sad feelings
because of feeling unable to control their issues. Mediation/Restorative Justice will provide a healthy atmosphere in
which students will be guided through a structured process and allowed the opportunity to focus their energy and
attention on positively affecting change. The focus becomes one of problem solving rather than getting even or hurting
others in some way. The Mediation/Restorative Justice Program would be offered as an alternative prior to a referral to
teen court in some situations.
The Mediation/Restorative Justice process provides participants with a structured way to settle an issue within the
school or community, and the outcomes/resolutions will be the solutions that have been agreed upon by all parties
involved. As with most agreements, juveniles usually follow through more readily when they are involved in developing
a solution that they feel comfortable with. If students have more control over the outcome, they typically will more
readily follow through with the agreed upon resolution plan. Other goals of this program include the following:
1) Provide mediation or restorative justice services to New Hanover County juveniles to reduce the number of criminal
complaints sent to the criminal justice system, and to reduce the number of school suspensions.
2) Provide mediation and restorative justice services as a court diversion program.
3) Provide a safe, impartial atmosphere for juveniles to learn how to resolve conflicts.
4) Teach our youth how to address conflicts in peaceful manner.
5) Using interventions early on to resolve conflicts that could escalate into more serious conflict.
4. Measurable Objective(s): State in measurable terms (%) the intended effect of the program on specific
undisciplined and/or delinquent behaviors. Example: anticipated reductions in court referrals, runaway behavior,
disruptive behavior at school, anticipated improved school attendance and academic achievement. These objectives
must include impact on participants.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION III I COMPONENT SUMMARY
NAME OF COMPONENT: I Mediation / Restorative Justice
75% Clients will have no new adjudications for a complaint with an offense date after the admission date.
75% Clients will demonstrate accountability for their actions within the scope of the mediation process.
75% Clients will successfully or satisfactorily complete services as intended by the program design/service plan.
75% Clients successfully/satisfactorily completing the program will have no new complaints in the 12 months following
completion.
75% Clients will have no new complaints with an offense date after the admission date.
75% Clients will enter into a mediation agreement.
75% Clients successfully/satisfactorily completing the program will have no new adjudications in the 12 months
following completion.
5. Elevated Risks and Needs: Describe how you will address one or more of the Elevated Risk and Needs of
adjudicated juveniles listed in the local JCPC Request for Proposal.
This program will address behavior problems, poor peer relationships, and youth with aggressive behaviors. Schools,
SROs, juvenile court counselors, or probation officers may refer students to mediation for verbal or physical
altercations. During the mediation and/or restorative justice sessions, the trained adult facilitator will guide the juvenile
offender and victim through a structured process through which they will address the cause of the altercation and work
to repair the relationship. By teaching juveniles how to peacefully resolve their issues, we can prevent their conflicts
from becoming physical or continuing to cause other disruptive behaviors or feelings.
Designed as an option for resolving issues prior to being referred to Teen Court or to Juvenile Court, this program will
help to prevent school fights, community problems, and/or behaviors that result in charges of assault, affray and
disorderly conduct. Schools and juvenile court staff may use the program as a preventive measure when they realize
juveniles are having problems, but before those problems culminate in assaultive or disruptive behavior. The mediation/
restorative justice process provides an opportunity to assist participants in understanding the underlying issues related
to their problem, a chance for the offender to take full responsibility, and a chance for the offender and the victim to
enter into an agreement which will repair the harm that has already been done.
Upon receiving a referral, the participants will be contacted by the program coordinator to schedule a meeting.
Participants will initially meet individually with the program coordinator and, if applicable, the CIS Student Support
Specialist at their school, in an effort to prepare them for an eventual face to face meeting with the other youth(s)
involved. These meetings will take place at a designated office at the participants' school. When the facilitator feels the
participants are ready, the face-to-face mediations/restorative justice session(s) will occur. The first part of the session
provides an opportunity for the participants to meet and learn more about each other and how they have been harmed
during the altercation, etc. Next, the participants will inform each other about why and how the conflict occurred. This
allows an opportunity to gain much needed information from each other and to more fully understand what led them to
this situation. After this, each participant identifies their losses; and finally, the parties enter into an agreement that
spells out what actions will be taken to repair the damage done by the behavior. The mediator/facilitator or the referring
agency may determine additional sessions are required for both clients, or individually, and will plan accordingly. If the
agreement is fulfilled and the parties are satisfied, the case will be closed and follow up will be provided to ensure the
participants continue to honor the agreements that they have agreed to follow.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION IV
COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:
Mediation / Restorative Justice
1. Location: List physical address(es) and describe where program services are delivered.
Mediations/Restorative Justice activities will take place in an office at the participants' school. Preferably, this space
will allow for a conference table where students and the mediator can meet in a quiet, professional location. The space
needs to be in an environment free from noise and from the traffic of other activities at the school so that the meetings
can remain confidential, and in a safe zone, where students feel comfortable speaking and following through as they
attend meetings. If school space is not available, they will take place at the CIS Youth Center, WIRE, 1102 Orange
Street, Wilmington, NC 28401.
2. Operation: Describe the daily/weekly schedule of program operation.
Mediations / Restorative Justice sessions will be held at the participants' school during the school day, or outside of
school hours at the CIS Youth Center, WIRE, 1102 Orange Street, Wilmington, NC 28401. The Teen Court /
Restorative Justice Program Coordinator will process referrals, schedule intakes, consult with the referring agencies,
and follow up with parents, completing all required NC Allies documentation and any other tasks deemed appropriate.
If applicable, they will coordinate with the CIS Student Support Specialist on site at the school to schedule restorative
sessions and will provide training for staff as needed, utilizing the assistance of Professor Kim Cook from UNC
Wilmington.
3. Staff Positions: Describe paid or volunteer position qualifications, (certifications, degrees, work experience) and
position(s) responsibilities relative to this component.
The Teen Court / Restorative Justice Program Coordinator will be the trained mediator and will manage this program.
They will have at least a bachelor's degree or higher in political science, criminal justice, law, social work, sociology,
counseling, or of similar background. The program coordinator will also complete mediation training, and ensure the
training is kept current. Additionally, existing CIS school-based staff who are trained in restorative practices may
facilitate sessions at their school sites.
The successful Teen Court / Restorative Justice Program Coordinator will be self-directed and responsible for making
school administrators, school resource officers, and juvenile court staff aware of the opportunities for providing this
program. They will have extensive experience working with at -risk youth and families and be willing to go the extra mile
as needed in an effort to plan and implement this program. They must be professional in working with youth, parents,
and school administrators, as well as SRO's and court staff. They will attend any JCPC required conferences or
seminars, as well all DPS required program orientations and trainings, and will document program data in NC Allies as
required by all JCPC funded programs.
4. Service Type SPEP: Describe implementation to include:
This program is a STRUCTURE ONLY.
5. Admission Process: Describe the specific referral, screening, admission process (including timeline), the staff
responsible for making decisions about admissions and reasons why a referral may not be accepted.
Referrals will be received from school administrators, school resource officers, juvenile court counselors, or law
enforcement officials. This program may be used by juvenile counselors as part of the diversion plans. The program
coordinator will receive and process the referral, then schedule the intake sessions at the participant's school. During
this intake, all agreements will be signed and materials explaining the program activities and goals will be given to
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION IV
COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:
Mediation / Restorative Justice
youth and parents as needed. All information will be documented in NC Allies.
It is extremely important for the program coordinator to meet with the student who is being referred within the week that
the referral is received, or at the beginning of the next week if the referral is received at the end of a given week, to
ensure timely conflict resolution. Mediation/restorative justice sessions should begin immediately after it is determined
that a referral is appropriate - middle and high school youth do not need to wait for several weeks for a conflict to be
resolved. The ideal is for all sessions to begin and be completed within a ten-day time period, though support services
may continue as needed. This program will provide the flexibility of serving clients on a one-time basis, or by providing
additional follow-up sessions as needed. For some cases, the resolution may be resolved and the terminations made
after one session. For others, the mediation process may require additional sessions or more activities for completion
of the program.
6. Termination Process: Describe the termination process to include the staff responsible for making decisions and
the criteria for a successful termination, satisfactory termination, unsuccessful completion and non-compliant
termination.
Once the mediation/restorative justice sessions have been completed, the program coordinator will follow up with the
youth for a minimum of 30 days after termination to ensure the conflict remains resolved, and will include the referring
agency in this process. Youth will be allowed to participate in additional sessions if the conflict is not completely
resolved, or if the agreement needs to be revisited. The program coordinator and/or session facilitator and the referring
agency will determine if one session is adequate for the clients or if additional hours/work needs to be involved. The
program coordinator will remain in contact with the referring agency while these needs are assessed. After 90 days,
clients will be terminated unless the referral source requests another mediation or unless youth needs additional
support/reinforcement of mediation concepts. If the conflict is resolved, the termination will be successful. If the
problem continues after several attempts at mediation during the 90 -day period, the termination will be considered
unsuccessful. Non-compliant termination would result if there is no progress and the mediation is never completed.
How is the referring agency involved with the termination process?
The program coordinator will also follow up with the referring agency as needed during this process to find out if the
problem has been resolved, and to determine if there are any positive or negative behavior changes. The referring
agency will be involved as the plan for the client is developed. Emails and phone calls are considered essential during
this process. Weekly follow-up with the referral agency may be needed in some cases. The referring agency will be
contacted to determine any additional assistance that is needed in working with clients.
7. Referring Agency Interaction: Describe the interaction with juvenile court counselors and/or other referring
agencies including how client progress will be communicated.
The program coordinator will be in constant contact with the referral source throughout the intake, enrollment, and
mediation/restorative justice process. Additionally, they will communicate weekly with referral sources and participants
after the mediation/restorative justice sessions have been completed. The agreement plan will be discussed with the
referring source to discuss progress and to determine if the plan has been successfully completed. All parties will be
allowed to provide feedback as to whether or not there are additional issues between participants. Communication will
be made when the referral is received, after intake, after mediation, and follow up communication during the 30 days.
Communication with the referring agency will be critical for feedback to the program coordinator.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION IV
COMPONENT NARRATIVE (attach for each component)
NAME OF COMPONENT:
Mediation / Restorative Justice
8. Intervention/Treatment: Describe specifically what the component will do to redirect inappropriate youth behavior
or how the component will address the identified needs of the youth and family. What interventions will typically be
utilized in this component and how will parents/guardians be involved?
Parents will be notified of whether a client is eligible or ineligible to participate in mediation/restorative justice sessions.
Parental consent will be required and program sessions and activities will vary depending upon the need of the
individual client. Mediation/Conflict resolution sessions, Restorative Justice Circles, and social skill building will be the
focus of the program. Some cases may be successfully resolved after the first session. However, the mediator or
session facilitator will determine what the plan will consist of, and whether or not additional sessions should be
required. If inappropriate behavior is observed during this program, every effort will be made to schedule additional one
-to-one meetings with students. Some students may need the additional support in an effort to prepare them for the
actual mediation. If a parent does not give consent or if a student refuses to cooperate, they will not participate in the
program. During this process other issues could arise indicating the need for other services, such as the services of
the school counselor or social worker, or additional mental health supports. If there are needs that indicate immediate
danger, the necessary agencies will be contacted. Parent/guardians will be involved as needed.
9. Best Practice Model: Describe what model or evidence-supported/best practice the program is based upon.
Evidence -based practices/programs to be implemented within the CIS Mediation/Restorative Justice Program include,
but are not limited to, Mediation, Restorative Practices, and the CIS model of integrated student supports.
Mediation is a restorative process that provides an opportunity for the victim to meet the offender in a safe space to
resolve a conflict assisted by a trained mediator. The models to be used are victim -offender mediation and basic
mediation. Using these models, juveniles are diverted from court, but held accountable for their actions.
Restorative practices to deal with crime and wrongdoing are recognized as evidence -based practices according to
extensive research, which supports that restorative justice is also evidence -based for school discipline. In its 2014
report, the Council of State Governments recommends restorative practices for school discipline, stating that it is
evidence -based along with other interventions including Positive Behavioral Interventions and Supports (PBIS).
The CIS Model of Integrated Students Supports is supported by research from organizations including Child Trends
and the Everyone Graduates Center at Johns Hopkins University. As a student -centered approach, ISS is firmly
grounded in the research on child and youth development. Providing an array of academic and non-academic
supports in a coordinated manner (as in the CIS Model) is more effective than a focus on one or a few supports. Child
Trends concludes that evidence supports the effectiveness and cost-effectiveness of integrated student supports to
improve educational outcomes.
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION V Terms of Agreement
This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and New
Hanover County, (hereinafter referred to as the County), the County's Juvenile Crime Prevention Council (hereinafter
referred to as the JCPC) and Communities In Schools of Cape Fear (hereinafter referred to as the Sponsoring
Agency).
DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows:
Term of Agreement
This Agreement shall become effective Jul 1, 2021 and shall terminate Jun 30, 2022.
Payment to Sponsoring Agency
All parties agree that services will be delivered as described in the approved Program Agreement and that funds will be
disbursed in an amount not to exceed the amount $92345 for the term of this agreement, unless amended by an
approved Program Agreement Revision.
Availability of Funds:
All parties to this Agreement agree and understand that the payment of the sums specified in this Program Agreement
budget, or most recently approved Program Agreement Revision, is dependent and contingent upon and subject to the
appropriation, allocation, and availability of funds for this purpose to DPS.
Responsibilities of the Parties
DPS shall:
1. Disburse funds monthly to County Governments, for payment to the Sponsoring Agency, from the fund
appropriation by the General Assembly;
2. Reserve the right to suspend payment to the County for any non-compliance by the Sponsoring Agency with any
reporting requirements set forth in DPS JCPC Policy and Procedures;
3. Notify in writing the County and Sponsoring Agency immediately if payments are suspended and again once
payments resume;
4. Pay only for work as described in the Program Agreement, or most recently approved Program Agreement
Revision, provided by the Sponsoring Agency and approved subcontractors;
5. Provide technical assistance, orientation and training to the Sponsoring Agency, the County and the JCPC;
6. Monitor Sponsoring Agency's funded program(s) in accordance with DPS JCPC Policy 3. Operations: Program
Oversight and Monitoring; and
7. Notify parties entering into this Agreement of all due dates in a timely manner in order for reports to be submitted
by the established due date.
The Sponsoring Agency shall:
1. Comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the
Form structure last revised 12/20/2013
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
conduct of its business, including those of Federal, State, and local agencies having jurisdiction and/or authority;
2. Comply with all Federal and State laws relating to equal employment opportunity;
3. Keep as confidential and not divulge or make available to any individual or organization without the prior written
approval of DPS any information, data, instruments, documents, studies or reports given to or prepared or
assembled by the Sponsoring Agency under this Agreement;
4. Acknowledge that in receiving, storing, processing or otherwise dealing with any confidential information it will
safeguard and not further disclose the information except as otherwise provided in this Agreement;
5. Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Procedures;
6. Secure local match as required, if applicable, pursuant to 14B NCAC 11 B.0105, for approved JCPC funds;
7. Create and adopt individualized guidelines specific to the funded program, while also adhering to DPS JCPC
Policy and Procedures for all funded programs and for the specific program type for which they receive funding;
8. Ensure that state funds received are spent in accordance with the approved Program Agreement, or most recently
approved Program Agreement Revision, and be accountable for the legal and appropriate expenditure of those
state funds;
9. Maintain reports, records, and other information to properly document services rendered and outcomes; also
maintain an ability to send and receive electronic communication;
10. Have the capacity to use DPS electronic, internet-based system for tracking clients served;
11. Use generally accepted accounting procedures that guarantee the integrity of the expenditure of funds, maintain
reports, records, and other information to properly account for the expenditure of all State funds provided to the
Sponsoring Agency;
12. When refunds are requested from the North Carolina Department of Revenue for sales and/or use taxes paid by
the agency in the performance of the Program Agreement, or most recently approved Program Agreement
Revision, as allowed by NCGS §105-164.14(c), the agency shall exclude all refundable sales and use taxes from
reportable expenditures submitted to the County and DPS;
13. Submit Program Agreement Revisions, Third Quarter Accounting, Final Accounting and annual detailed
expenditures through NCALLIES. These reports must be in accordance with the submission process as outlined in
DPS JCPC Policy and Procedures and with the due dates established by DPS;
14. Make personnel, reports, records and other information available to DPS, the County, the JCPC, and/or the State
Auditor for oversight, monitoring and evaluation purposes;
15. Submit any other information requested by the JCPC, County or DPS;
16. Be responsible for the performance of all subcontractors as described in the JCPC Program Agreement, or most
recently approved Program Agreement Revision;
17. Indemnify and hold harmless DPS, the State of North Carolina, the County and any of their officers, agents and
employees, from any claims of third parties arising out of any act or omission of the Sponsoring Agency in
connection with the performance of the Program Agreement or most recently approved Program Agreement
Revision;
18. Receive permission and budgetary approval from DPS prior to using the Program Agreement, or most recently
approved Program Agreement Revision, as a part of any news release or commercial advertising and
acknowledge DPS funding in partnership with the County;
19. Comply with DPS trainings and requirements regarding the United States Department of Justice national
standards to prevent, detect, and respond to prison rape under the Prison Rape Elimination Act (PREA);
Reference: 14B NCAC 118, and in compliance with DPS JCPC Policy 2: Operations: Program Operational
Requirements
20. Be deemed an independent contractor in the performance of services described in the Program Agreement, or
most recently approved Program Agreement Revision, and as such shall be wholly responsible for the services to
be performed and for the supervision of its employees;
21. Represent that it has, or shall secure at its own expense, all personnel required in performing the services as
described in the Program Agreement. Such personnel shall not be employees of, or have any individual
Form structure last revised 12/20/2013
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
contractual relationship with, DPS;
Sponsoring Agency and Use of Contractor(s)/Subcontractors
The Sponsoring Agency may engage with independent contractors as needed to perform services or support services
described in the Program Agreement. When independent contractors (funds are included in line item 190 of the
budget) are providing services as described in the Program Agreement, the sponsoring agency must:
22. Upload a signed Contract for Professional Services into NCALLIES once the Program Agreement (or
Program Agreement Revision) is approved by DPS;
23. Be responsible for the performance of all contractors or subcontractors as described in the Program
Agreement, or most recently approved Program Agreement Revision;
24. Hold any contractor or subcontractor to which the Sponsoring Agency provides State funds accountable for
the legal and appropriate expenditure of State funds, and to all applicable laws and DPS JCPC Policies and
Procedures; and
25. Ensure that all contractors or subcontractors provide all information necessary to comply with the standards
set forth in the Program Agreement or most recently approved Program Agreement Revision.
The JCPC shall:
1. Ensure the Sponsoring Agency uses JCPC funds for only the purposes DPS has approved in the JCPC Program
Agreement or most recently approved JCPC Program Agreement Revision;
2. Comply with DPS JCPC Policy and Procedures and the North Carolina Administrative Code; N.C.G.S. §1436-801
(a);143B-602;143B-851
3. Review and locally approve Program Agreement Revision(s) received from the Sponsoring Agency and submit to
the County in a timely manner;
4. Review and locally approve Third Quarter Accounting forms and submit to the County in order to meet the due
date established by DPS (applicable only to JCPC funded agencies);
5. Submit any other information requested by the County or DPS; and
6. Monitor the Sponsoring Agency's currently funded JCPC program(s) in accordance with DPS JCPC Policy 3.
Operations: Program Oversight and Monitoring
Reference: 14B NCAC 118.0202 and DPS JCPC Policy 1, 7, 8, 9, 10, and 11.
The County shall:
1. Ensure the Sponsoring Agency is appropriately licensed, and either local public agencies, 501(c) (3) non-profit
corporations or local housing authorities (applicable only to JCPC funded agencies);
2. Use funds only for the purposes DPS has approved in the Program Agreement or most recently approved
Program Agreement Revision;
3. Disburse funds monthly and oversee funds to the Sponsoring Agency in accordance with 14B NCAC 11 B.0108
4. Comply with DPS JCPC Policies and Procedures and the North Carolina Administrative Procedures;
5. Review and locally approve Program Agreement Revisions received from the Sponsoring Agency for final
approval from DPS; and
6. Review and locally approve Third Quarter and jointly submit Final Accounting forms for the JCPC and all funded
programs according to the procedures and due dates established by DPS.
Reference: 14B NCAC 11 B; DPS JCPC Policy 3, 7, 8, 9, 10, and 11
Form structure last revised 12/20/2013
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Choice of Law: The validity of this Program Agreement and any of its terms or provisions, as well as the rights and
duties of the parties to this Program Agreement, are governed by the laws of North Carolina. The parties, by signing
this Program Agreement, agree and submit, solely for matters concerning this Program Agreement, to the exclusive
jurisdiction of the courts of North Carolina and agree, solely for such purpose, that the exclusive venue for any legal
proceedings shall be Wake County, North Carolina. The place of this Program Agreement and all transactions and
agreements relating to it, and their situs and forum, shall be Wake County, North Carolina, where all matters, whether
sounding in Program Agreement or tort, relating to the validity, construction, interpretation, and enforcement shall be
determined.
Assignment: No assignment of the Sponsoring Agency's obligations or the Sponsoring Agency's right to receive
payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority,
DPS may:
(a) Forward the Sponsoring Agency's payment check(s) directly to any person or entity designated by the
Program Manager, or
(b) Include any person or entity designated by Sponsoring Agency as a joint payee on the Sponsoring Agency's
payment check(s).
In no event shall such approval and action obligate DPS or County Government to anyone other than the Sponsoring
Agency, and the Sponsoring Agency shall remain responsible for fulfillment of all Program Agreement obligations.
Beneficiaries: Except as herein specifically provided otherwise, this Program Agreement shall inure to the benefit of
and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the
enforcement of the terms and conditions of this Program Agreement, and all rights of action relating to such
enforcement, shall be strictly reserved to DPS, the County Government, and the Sponsoring Agency. Nothing
contained in this document shall give or allow any claim or right of action whatsoever by any other third person. It is the
express intention of DPS and County Government that any such person or entity, other than DPS or the County
Government, or the Sponsoring Agency receiving services or benefits under this Program Agreement shall be deemed
an incidental beneficiary only.
Property Rights
Intellectual Property: All deliverable items produced pursuant to this Program Agreement are the exclusive property of
DPS. The Sponsoring Agency shall not assert a claim of copyright or other property interest in such deliverables.
Physical Property: the Sponsoring Agency agrees that it shall be responsible for the proper custody and care of any
property purchased for or furnished to it for use in connection with the performance of this Program Agreement and will
reimburse DPS for loss of, or damage to, such property. At the termination of this Program Agreement, the Sponsoring
Agency, County Government, and JCPC shall follow the guidelines for disposition of property set forth in Administrative
Code and JCPC policy.
Reference: 14B NCAC 11B.01 10; DPS JCPC Policy 9. Fiscal Accounting and Budgeting: Final Accounting Process
Form structure last revised 12/20/2013
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
Disbursements and Internal Controls
Reversion of Unexpended Funds
Any remaining unexpended funds DPS disbursed to the County for the Sponsoring Agency must be refunded/reverted
back to DPS at the close of fiscal year or upon termination of this Agreement.
Accountability for Funds
Audit Requirement - Local Government or Public Authority Requirements
Local Government or Public Authorities in accordance with N.C.G.S. §159-34 must have an audit performed in
conformity with generally accepted auditing standards. The audit shall evaluate the performance of a unit of local
government or public authority with regard to compliance with all applicable Federal and State agency regulations. This
audit, combined with the audit of financial accounts, shall be deemed to be the single audit described by the, "Federal
Single Audit Act of 1984".
Audit Requirement — Non -Governmental Entities: An audit, when required by law, or requested by the County or
DPS shall be performed in conformity with generally accepted auditing standards and audits of non-governmental
entities, both for-profit and not-for-profit, and must meet the requirements of OMB Circular A-133. At a minimum, the
required report shall include the financial statements prepared in accordance with generally accepted accounting
principles, all disclosures in the public interest required by law, and the auditor's opinion and comments relating to
financial statements. The audit report must be submitted to the State Auditor's office as required by law, to the County
and DPS, and to other recipients as appropriate within nine (9) months after the end of the program's fiscal year.
Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all
Program Agreements entered into by State agencies or political subdivisions in accordance with N.C.G.S. §147-64.7.
Additionally, as the State funding authority, DPS shall have access to persons and records as a result of all Program
Agreements entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of
DPS. State basic records retention policy requires all records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the Program Agreement is subject to Federal policy and
regulations, record retention may be longer than five years since records must be retained for a period of three years
following submission of the final Federal Financial Status Report, if applicable, or three years following the submission
of a revised final Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action,
or other action involving this Program Agreement has been started before expiration of the five-year retention period
described above, the records must be retained until completion of the action and resolution of all issues which arise
from it, or until the end of the regular five-year period described above, whichever is later.
No Overdue Tax Debt — Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. The Sponsoring Agency shall be responsible for
the payment of all State, local, and Federal taxes. Consistent with N.C.G.S. § 143C-6-23 (c), not for profit
organizations shall file with DPS and the County a written statement completed by that Sponsoring Agency's board of
directors or other governing body, stating whether or not the Sponsoring Agency has any overdue tax debts, as
defined by N.C.G.S. 105-243.1, at the Federal, State, or local level. This written statement, Certification of No
Form structure last revised 12/20/2013
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
Overdue Tax Debts, shall be completed by the Sponsoring Agency to certify when there are no overdue taxes. If the
agency has overdue taxes, the Sponsoring Agency must notify DPS at the time of Program Agreement submission.
Conflict of Interest — Not for profit organizations ONLY must comply with this section. This form must be
uploaded in NCALLIES when submitting a Program Agreement. Consistent with the N.C.G.S. §143C-6-23 (b), not
for profit organizations shall file with DPS and the County a copy of that Sponsoring Agency's policy addressing
conflicts of interest that may arise involving the Sponsoring Agency's management employees and the members of its
board of directors or other governing body. The policy shall address situations in which any of these individuals may
directly or indirectly benefit, except as the Sponsoring Agency's employees or members of its board or other
governing body, from the Sponsoring Agency's disbursing of State funds and shall include actions to be taken by the
Sponsoring Agency or the individual, or both to avoid conflicts of interest and the appearance of impropriety. The
policy shall be filed before the County or DPS may disburse any funds. The Sponsoring Agency shall also complete
the DPS Conflict of Interest Policy Statement (Form DPS 13 001) and upload the statement and the Sponsoring
Agency's policy addressing conflicts of interest to the JCPC Program Agreement upon submission.
Proof of 501(c) (3) — Not for profit organizations ONLY must comply with this section. This document must be
uploaded in NCALLIES when submitting a Program Agreement. Not for profit organizations must upload proof of
the Sponsoring Agency's 501 (c) (3) status.
Amendment: This Agreement may not be amended orally or by performance. Any amendment must be requested in
writing by the Sponsoring Agency through submission of a Program Agreement Revision and executed by duly
authorized representatives of DPS, the County Government, JCPC and Sponsoring Agency.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this Program
Agreement violates any applicable law, each such provision or requirement shall continue to be enforced to the extent
it is not in violation of law or is not otherwise unenforceable and all other provisions and requirements of this Program
Agreement shall remain in full force and effect.
Termination for Cause: If, through any cause, the Sponsoring Agency shall fail to fulfill its obligations under this
Program Agreement in a timely and proper manner, DPS shall have the right to terminate this Program Agreement by
giving written notice to the Sponsoring Agency and specifying the effective date thereof. In that event, all finished or
unfinished deliverable items prepared by the Sponsoring Agency under this Program Agreement shall, at the option of
DPS, become its property and the Sponsoring Agency shall be entitled to receive just and equitable compensation for
any satisfactory work completed on such materials, minus any payment or compensation previously made.
Notwithstanding the foregoing provision, the Sponsoring Agency shall not be relieved of liability to DPS for damages
sustained by DPS by virtue of the Sponsoring Agency's breach of this agreement, and DPS may withhold any
payment due the Sponsoring Agency for the purpose of setoff until such time as the exact amount of damages due
DPS from such breach can be determined. The filing of a petition for bankruptcy by the Sponsoring Agency shall be
an act of default under this Program Agreement.
Termination without Cause: DPS, the County Government, or the Sponsoring Agency may terminate this
Agreement at any time and without cause by giving at least thirty (30) days advance written notice to the other. If this
Program Agreement is terminated by DPS as provided herein, the Sponsoring Agency shall be reimbursed on a pro
rata basis for services satisfactorily provided to DPS under this Program Agreement prior to Program Agreement
termination.
Waiver of Default: Waiver by DPS of any default or breach in compliance with the terms of this Program Agreement
by the Sponsoring Agency shall not be deemed a waiver of any subsequent default or breach and shall not be
Form structure last revised 12/20/2013
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
construed to be modification of the terms of this Program Agreement unless stated to be such in writing, signed by an
authorized representative of DPS, County Government, the JCPC and the Sponsoring Agency.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes,
civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event, pandemic, or act of God.
Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and
warranties contained herein shall survive the Program Agreement expiration or termination date unless specifically
provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation.
END OF SECTION V — Terms of Agreement
Form structure last revised 12/20/2013
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION VI: BUDGET NARRATIVE
Teen Court & Mediation (Restorative Justice)
Fiscal Year
FY 21-22
$7,200
Teen Court / Restorative Justice Program Coordinator
Item #
Justification
Expense
In Kind Expense
120
Program Director - Project Management and oversight; .15 FTE
$7,200
120
Teen Court / Restorative Justice Program Coordinator; 1 FTE
$40,000
TOTAL
120
Teen Court / Restorative Justice Assistant; 20 hours per week;
$17 per hour
$17,680
120
Administrative support - payroll / accounts payable & receivable
- 2 hours per week; $21 per hour
$2,184
120
Value of in-kind volunteers (teens @ 8/hour; professionals /
adults @ $23.07/hour)
$20,000
180
FICA @.0765%; Worker's Comp @.0168%; SUI @.0084%
$6,820
180
Pro -rated Medical Benefits @ $288.75 per month
$3,465
220
Food/Refreshments as needed for teen court nights, training,
special teen court functions, and end of year activities
$3,000
260
Consumable office supples (paper, ink, misc. supplies)
$3,000
290
Student materials for Teen Court sessions estimated @ $30
per month x 12 months
$360
310
Local mileage, travel & / training for all project staff and
volunteers, and some school staff
$6,036
320
Phone, internet
$500
390
Deputy for court 20 nights x $40 = $800; Teen Court Assistants
�(2) for 20 nights x 90 = 1800;
$2,600
TOTAL
$92,345
$20,500
Job Title
Annual Expense
Wages
Annual In Kind
Wages
Program Director
$7,200
Teen Court / Restorative Justice Program Coordinator
$40,000
Teen Court / Restorative Justice Program Assistant
$17,680
Administrative Support - payroll / accounts payable & receivable
$2,184
Teen Court / Restorative Justice volunteers
$20,000
TOTAL
$67,064
$20,000
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION VII Program: Teen Court & Mediation (Restorative Justice)
Fiscal Year: FY 21-22
$0
Number of Months: 12
$0
430 Equipment Rental
Cash
In Kind
Total
I. Personnel Services
$77,349
$20,000
$97,349
120 Salaries & Wages
$67,064
$20,000
$87,064
180 Fringe Benefits
$10,285
$10,285
190 Professional Services"
$0
*Contracts MUST be attached
II. Supplies & Materials
$6,360
$6,360
210 Household & Cleaning
$0
220 Food & Provisions
$3,000
$3,000
230 Education & Medical
$0
240 Construction & Repair
$0
250 Vehicle Supplies & Materials
$0
260 Office Supplies and Materials
$3,000
$3,000
280 Heating & Utility Supplies
$0
290 Other Supplies and Materials
$360
$360
III. Current Obligations & Services
$8,636
$500
$9,136
310 Travel & Transportation
$6,036
$6,036
320 Communications
$500
$500
330 Utilities
$0
340 Printing & Binding
$0
350 Repairs & Maintenance
$0
370 Advertising
$0
380 Data Processing
$0
390 Other Services
$2,600
$2,600
IV. Fixed Charges & Other Expenses
$0
410 Rental or Real Property
$0
430 Equipment Rental
$0
440 Service and Maint. Contracts
$0
450 Insurance & Bonding
$0
490 Other Fixed Charges
$0
V. Capital Outlay $0
[This Section Requires Cash Match]
510 Office Furniture & Equipment $0
530 Educational Equipment $0
540 Motor Vehicle $0
550 Other Equipment $0
580 Buildings, Structure & Improv. $0
Total $92,345 $20,500 $112,845
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
DocuSign Envelope ID: OABBA8B6-6129-4473-8AB8-51 F01 E6751 DE
SECTION VIII SOURCES OF PROGRAM REVENUE (ALL SOURCES)
FY 21-22 New Hanover County Funding ID: 865-XXXX
Sponsoring Agency: Communities In Schools of Cape Fear Program: Teen Court & Mediation (Restorative
Justice)
$92,345 DPS/JCPC Funds * This is the amount approved in your application
20% Local Match Rate Is the Local Match Rate 10%, 20% or 30%?
County Cash
(Specify Source)
Local Cash
(Specify Source)
Local Cash
(Specify Source)
$20,500 Local In -Kind Volunteers; CIS Cape Fear
(Specify Source)
Other
(Specify Source)
Other
(Specify Source)
Other
(Specify Source)
Other
(Specify Source)
$112,845 TOTAL $18,469
$20,500
Required Local Match
Match Provided
cuSigned by:�E7A4BD9F419...
Ei:',
6/21/2021
Authorizing Official, Department of Public Safety
Date
Thefollowing signature certifies that this program agreement has been locally approved by the Board of County Commissioners.
(DocuSigned by: �' "L
E
6/14/2021
741AAC4C4DDE460...
Chair, County Board of Commissioners or County Finance Director
Date
The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention
Council.
DocuSigned by:
(�(VrUU*"if
6/10/2021
3DDSE15 MA2540C...
Chair, Juvenile Crime Prevention Council
Date
by:
EDocuSigned
0-01sf f Ws
6/10/2021
3D778065587B45F...
Program Manager
Date
Form JCPC/PA 001 JCPC Program Agreement
Form structure last revised 12/31/2012
Department of Public Safety
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DocuSign
Certificate Of Completion
Envelope Id: OABBA8B6612944738AB851 F01 E6751 DE Status: Completed
Subject: DPS eSignature Request for New Hanover 865-23641 Teen Court & Mediation (Restorative Justice)
Source Envelope:
Document Pages: 35 Signatures: 4 Envelope Originator:
Certificate Pages: 5 Initials: 0 DPS-DJJ Community Programs
AutoNav: Enabled 3040 Hammond Business PI
Envelopeld Stamping: Enabled Raleigh, NC 27603
Time Zone: (UTC -05:00) Eastern Time (US & Canada) djjdp.applicationsupport@ncdps.gov
IP Address: 207.4.107.21
Record Tracking
Status: Original Holder: DPS-DJJ Community Programs
6/10/2021 5:19:06 PM djjdp.applicationsupport@ncdps.gov
Signer Events Signature
LOUISE E HICKS DocuSigned by
Louise@ciscapefear.org lb3D778065587B4,5F.uls-E -ESecurity Level: Email, Account Authentication .
(None)
Electronic Record and Signature Disclosure:
Accepted: 6/4/2020 3:49:54 PM
ID:62e44c5f-6edb-4650-bOc5-dc41ab71686a
J H Corpening II
julius.h.corpening@nccourts.org
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 6/10/2021 6:11:19 PM
ID:3078a66c-9555-46d4-9c3b-c2a00bd5f4d0
Lisa Wurtzbacher
Iwurtzbacher@nhcgov.com
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 6/14/2021 11:11:06 AM
ID:50f16af6-5f06-4c15-8c76-e41499c4d8a8
Cindy Porterfield
cindy.porterfield@ncdps.gov
Director of Juvenile Community Programs
NC Dept of Public Safety
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Signature Adoption: Pre -selected Style
Using IP Address: 107.12.48.62
DocuSigned by:
fk (rpuu," N
3DD8E15D4A2540C...
Signature Adoption: Pre -selected Style
Using IP Address: 204.152.2.232
CDocuSigned by:
74 1`� C4DDE46
Signature Adoption: Pre -selected Style
Using IP Address: 70.63.86.17
by:
[DI-Sig"Id
798FUMBDU419. .
Signature Adoption: Pre -selected Style
Using IP Address: 199.90.60.4
Location: DocuSign
Timestamp
Sent: 6/10/2021 5:19:09 PM
Viewed: 6/10/2021 5:58:25 PM
Signed: 6/10/2021 5:59:48 PM
Sent: 6/10/2021 5:59:49 PM
Viewed: 6/10/2021 6:11:19 PM
Signed: 6/10/2021 6:11:30 PM
Sent: 6/10/2021 6:11:31 PM
Viewed: 6/10/2021 7:58:55 PM
Signed: 6/14/2021 11:11:36 AM
Sent: 6/14/2021 11:11:38 AM
Viewed: 6/21/2021 10:17:49 AM
Signed: 6/21/2021 10:17:59 AM
In Person Signer Events
Signature
Timestamp
Editor Delivery Events
Status
Timestamp
Agent Delivery Events
Status
Timestamp
Intermediary Delivery Events
Status
Timestamp
Certified Delivery Events
Status
Timestamp
Carbon Copy Events
Status
Timestamp
Witness Events
Signature
Timestamp
Notary Events
Signature
Timestamp
Envelope Summary Events
Status
Timestamps
Envelope Sent
Hashed/Encrypted
6/10/2021 5:19:09 PM
Certified Delivered
Security Checked
6/21/2021 10:17:49 AM
Signing Complete
Security Checked
6/21/2021 10:17:59 AM
Completed
Security Checked
6/21/2021 10:17:59 AM
Payment Events
Status
Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM
Parties agreed to: LOUISE E HICKS, J H Corpening II, Lisa Wurtzbacher
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