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Contingency Relief Fund Budget Form <br />Organization Name: Lokahi Treatment Centers <br />Project Name: <br />Substance Abuse, Mental Health, Domestic Violence and Anger Management Treatment Programs in <br />Kona <br />Other Cash <br />Expense Description <br />p p <br />RF Gran <br />C t <br />Total Expense <br />, , <br />Expense Justification <br />Sources <br />Evidence -Based Treatment Curriculum and <br />$ 500.00 <br />$ 500.00 <br />$ 1,000.00 <br />Materials to guide clients through structured recovery <br />Client Workbooks <br />programs and support measurable ro ress. <br />Essential for clients to complete program assignments, <br />Writing Materials (journals, notebooks, pens, <br />$ 500.00 <br />$ 500.00 <br />$ 1,000.00 <br />practice journaling as part of their recovery process, and <br />and other writing supplies) <br />participate in evidence -based exercises during individual <br />1. <br />and group sessions to support therapeutic engagement. <br />Purchase/licensing of standardized, evidence -based <br />Clinical Assessment Instruments (Substance <br />$ 500.00 <br />$ 500.00 <br />$ 1,000.00 <br />assessment tools for client intake and evaluation to <br />Use and Mental Health) <br />ensure accurate diagnosis, individualized treatment <br />planning, and compliance. <br />Urinalysis and Breathalyzer Testing Supplies <br />$ 1,000.00 <br />$ 1,000.00 <br />$ 2,000.00 <br />Required toxicology testing to monitor sobriety, <br />and Lab Fees <br />a <br />reinforce accountability, and inform treatment. <br />Portable devices for clients to use during counselor <br />sessions to review/sign assessments, treatment plans, <br />External Computer Tablets <br />$ 250.00 <br />$ 250.00 <br />$ 500.00 <br />and other documentation. The intent is not to provide <br />each client with a personal device, but to have shared <br />tablets available for client use within our Kona office. <br />Reliable technology for staff to maintain high -quality <br />2 Desktop Computers with Microsoft Programs <br />service delivery. Computers support secure electronic <br />(Word, Excel, Outlook, PowerPoint), $1,000/ea <br />$ 1,000.00 <br />$ 1,000.00 <br />$ 2,000.00 <br />health record access, assessment scoring, and care <br />coordination. Programs ' gr ms enable accurate reporting, <br />communication and data analysis. <br />Folding Chairs <br />g <br />$ 250.00 <br />$ 250.00 <br />$ 500.00 <br />Expands seating for group therapy and educational <br />sessions, ensuringsafe and inclusive participation. <br />Printer/Fax Machine Supplies <br />$ 750.00 <br />$ 750.00 <br />$ 1,500.00 <br />Enables staff to securely print, fax, and copy treatment <br />tans, consent forms, and client materials. <br />Tables <br />$ 250.00 <br />$ 250.00 <br />$ 500.00 <br />Provides workspace for group activities, counseling <br />sessions, and client education materials. <br />Admin/Overhead Expenses - Max. 10% of <br />request: <br />EXPENSES TOTAL <br />5,000.00 <br />$$ <br />5 000.00 <br />J <br />$ 10 000.00 <br />„Z <br />`x..t �µ st$ a. ,s ^� Y< A`� #�V ;L,`{.��•, �.�; i'`�'t, � `.��, .'��'"r <br />4 Sv> `"i *`.G. •>: i9. �if> <br />v , `�:;r^?:';•.':a %i;?;, ,�; ; r; �za s>'� rs,.i,.:'�° :." " ";��'�.xr;�2,yxx•q �,.,,, a>.;�'s<,c ,{ •'•`�`�s,•� s;.x:`�`x ..a�� sz;ss.�t.,ss,.�'��:,,„ <br />�x s <br />a.> r z'' •?f;<., xw. 35ura <<*.:i <br />