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COM 0193.000 1996-1998
~V Oi 4 ' ~ ~ :~I ~ Stephan K. Yemashiro _ Harry A. Takahashi Mayor Director l.t~IIltTif~J Q{ ~Mf11MT1: DEPARTMENT OF FINANCE 25 Aupuni Street. Room 118 Hilo, Haveit 98729-4252 (8087 Bel-8234 Fex [BOB] 981-8248 [IJ February 7, 1997 n ~ On ~ ~ Z ~ l -i-_ , The Honorable James Arakaki, Chairperson "~G ~ and Members of the County Council O ~ Hawaii County Council 25 Aupuni Street i 1-, Hilo, HI 96720 c.~ - o RE: APPROPRIATION OF FUNDS TO NON-PROFIT ORGANIZATIONS In compliance with Chapter 2, Article 25 of the Hawaii County Code, enclosed are applications from qualifying organizations and a list showing amounts requested for your review and appropriation of funds for FY 1997-98. Should you have any questions, please feel free to call. Sincerely, Harry A. Takahashi Finance Director aeb encls: Applications for Non-Profit Grant Funds and attachments List of Qualifying Organizations (Files available in the Clerk's Office) oDmo. ~s~~ xo. Bu r~ rt.er. ~ro: /~/SEDG ~i. 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C) m a '� ¶hese a14A4s WeYtie ro \-- 9.4u40, ,,A (96-98) C-193 BUD (ATTACHMENT)_ (3rd of 4) APPLICATION FOR NONPROFIT FUNDS CiVEP gar 1A Fiscal Year July 1, 1996 - June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: Kona Adult Day Center, Inc. NAME OF PROGRAM: Adult Day Care Mailing Address: P_n Rox 36n City, State, Zip: Kealakekua, HI 96750 Telephone: ( 808) 32?-7g77 FAX: (808) 322-0614 Attach current Internal Revenue tax-exemption certificate 501 (c) 3 Amount allocated by the Hawaii County in 1995: $ 10.000.00 3.31 % of Budget Agency Total Budget in 1995 $301,289.00 Amount requested of Hawaii County in 1996: $ 15,000.00 5,.66 % of Budget Agency Total Budget in 1996: $264,597.00 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: June 1 t o Tidy 31 History of funding with the County of Hawaii: New Applicant xx Participating agency since 1995 Firm conducting and date of agency's last financial review or audit: NAME: Javier i Islay, CPA, Personal & Rusinesc Managpmwmt,,Inc_ DATE: September 1995 ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Kota. AdiI.1 r nay ranter IPC_ Page #2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Geographic Area(s) Served: Agency's Mission Statement: 2. Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency (in quantitative terms, where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? Kona Adult Day Center, inc., P.O. Box 1360 Kealakekua, HI. 96750 (808) 322-7977 1996-97 Application County of Hawaii - Application for Non-Profit Grant Funds Narrative Report Organization Profile 1. Name: Kona Adult Day Center, Inc. Geographic Area Served: North, Central and South Kona. Kona Adult I)ay Center Mission: "Our mission i.c to provide health,social and recreational programs and activities that enable impaired adults to experience feelings of belonging,friendship,acceptance,accomplishment, and independence in a caring and secure social environment." 2. Programs: Kona Adult Day Center(KADC) programs encompass several types of services, ranging from social and recreational, to medical care, therapy and helping the individual maintain the highest level of functioning. The National Council on Aging defines adult day care as: "A community-based group program designed to meet the needs of functionally impaired adults through an individual plan of care. It is a structured, comprehensive program that provides a variety of services in a protective setting during any part of a day less than 24 hour care. Individuals who participate in day care attend on a planned basis during specified hours'. Adult Day Care assists its participants to remain in the community,enabling families and other caregivers to continue caring for an impaired member at home." Advocates of adult day care use the terms "continuum of care" and long-term care in describing the need for adult day care services in our communities. Adult day services provide care at a maintenance level,that is,limited but ongoing assistance and supervision at a fraction of the cost of either private hire nurses and private nursing home facilities. The cost effectiveness of adult day centers makes them a very important component in the continuum of care in West Hawaii. Kona Adult Day Center is the only adult day care facility on the west side of the Big island. 3 . Support: KADC services support the agency mission by providing each participant with an individualized plan of care. Activities programming include: arts and crafts, music therapy, group reminiscent therapy,pet and garden therapy,special projects,excursions, intergenerational therapy and group exercise. Health programming includes: individualized exercise and range of motion, care coordination, medication administration, health monitoring and supervision, nursing procedures, bowel and bladder training, hot lunches and snacks, massage and shiatsu, individual care planning and discharge planning, referral and information to families on other community services and providers of care. The health program is supervised by a registered nurse, certified in rehabilitation nursing. The activities program is supervised by an accredited activity director. Kona Adult Day Center offers a monthly caregiver support group, organized to help caregivers share ideas,frustrations and achievements. 4. Eligibility: Persons eligible for KADC services are those adults, 18 years and above, particularly those 60 and older,having either a physical or cognitive disability,requiring protective or supportive care. Participants must be able to function in a group setting without disruption. Kona Adult Day Center, Inc. Agency Profile, Page 2 5. Unduplicated: A total of 210 families have been served by KADC since opening in 12/88. 6. Objectives: a.To promote the individual's maximum level of independence; b.To maintain the individual's present level of functioning,preventing or delaying deterioration; c.To restore and rehabilitate the individual to his/her highest level of functioning; d.To support the caregiver through respite from continuous caregiving. 7. Evaluation: Evaluation of the KADC program is done annually through a written caregiver survey, as well as by written staff survey. Employee evaluation is done on an annual basis, and is a written assessment of the employees work provided by the immediate supervisor and the executive director. The adult day care program is licensed through the Department of Human Services and KADC must undergo an annual site visit and intensive program evaluation. 8. Resources: Kona Adult Day Center coordinates its service delivery with the following agencies and services in the community: Coordinated Services for the Elderly, Case Management Coordination Project/Nursing Home Without Walls, Department of Human Services Elderly Protective Services, Retired Senior Volunteer Program, Home Health Care, Interim Health Care, Hospice of Kona, Services for Seniors, Kailua-Kona Center for Independent Living, Hawaii County Nutrition Program, and the West Hawaii Alzheimer's Association. As well, Kona Adult Day Center has a purchase of service contract with the Department of Human Services to provide day care for three full-time participants. 9. Similarity Within Community: Kona Adult Day Center is the only adult day care program on the West side of the Big Island of Hawaii and offers the only services of this type within the community. Senior activity programs are available to functionally independent older adults through the Hawaii County Office on Aging. Nursing home care is provided by Hillhaven- Kona Health Care Center. 10. Accomplishments & Challenges 1995: **January - March Accomplishments * KADC receives a check for$5,000.00 from the Hawaii Hotel Association Annual Charity Walk. * KADC opens for "trial day" holiday opening, President's Day February 20th. Seven clients attended and the day was a great success. * KADC conference room used in March and June for"Osteoporosis Big Island Screening Project". Approximately 450 women will be examined. * Gannett Communities Fund approves a grant of$1,000.00 to KADC. * KADC surveys 450 residents of Hawaiian Ocean View Estates about their need for adult day care. Twelve families responded,with 6 were appropriate for day care. KADC program director to follow up. **April - June Accomplishments * Enrollment remains steady with thirty participants. * Once again KADC staff,their friends, and families participate in the annual Hawaii Hotel Association Charity Walk * KADC applies for County funding and Ms. i nos testifies on behalf of KADC at Hawaii County Council Meeting. Caregivers and Board Members attend for support. * KADC receives a check for$5,000.00 from Hillhaven Kona Community Advisory Board for tuition assistance. Kona Adult Day Center, Inc. Agency Profile, Page 3 • KADC opens their program on Holidays giving much needed respite to our caregivers. * Mary Jo Hill,KADC's program director, conducts two in-services on Alzheimer's disease for staff: "Complaints of a Dutiful Daughter",and "Caring is Not Enough" * Kona Kohala Chamber of Commerce mailout raises over$1,200.00. * West Hawaii Association of Life Underwriters volunteer to paint the interior of KADC. * KADC is accepted by Combined Federal Campaign in 1995. **July - September Accomplishments * Enrollment at KADC has risen to thirty-four. While private and government funding is at a premium,tuition assistance is available for individuals who are eligible for the KADC scholarship fund. This limited fund is a result of corporate donations and KADC volunteer fundraising. The fund is monitored by a committee of the Board of Directors. * A successful rummage sale was held on July 22nd. $1,50.00 profit was made. * The KADC facility was host to a workshop on HiV sponsored by Department of Health and Dr. Stephen Denzer. Thirty primary care physicians attended,which was excellent opportunity for local doctors to observe the facility. * As a result of community need,the Center has begun providing day care service on Holidays. Caregivers have expressed the difficulty presented by three day weekends,especially if their family member has Alzheimer's disease. The first Holiday opening was President's Day in February. The number of individuals attending has grown with each successive Holiday. Fourth of July attendance was eleven. This is an excellent service for caregivers who are self-employed or caregivers who simply need the day off for rest and relaxation. Holidays are staffed by a registered nurse, a health aide, activity assistant and office personnel. * Participants resumed weekly howling this month. Each Tuesday,ten KADC participants meet the clients from Hillhaven,Kona Krafts and Network Enterprises to match their skills at Kona Bowl. This community outing fulfills the individual's need for social,recreational and peer support. It is great exercise, too. * All participants, staff and volunteers enjoyed the Sixth Annual KADC Picnic at Keauhou Bay Park on August 17th. Everyone participates, regardless of disability or age. * "I)ig for Diamonds" fundraiser, held August 27th and 28th at Lanihau Center, successfully entertained the community,earned much-needed revenue for tuition assistance and raised public awareness of KADC services. * National Adult Day Care Center Week was celebrated September 17- 23, 1995. A variety of activities were organized for participants. The highlight of the week was an Open House on Friday with entertainment,refreshments and activities provided by the clients. **October - December Accomplishments * Annual Friends of KADC Membership Drive took place in November, successfully reaching our goal of$8,000.00 * "Papayas for Breakfast" Fundraising event, December 9th,turned out better than expected. Two hundred plus tickets were sold. Showcasing the papaya,the brunch included a dozen innovative dishes created by Chef Wong of the Keauhou Beach Hotel. A local artist sold limited edition prints, 1(X)%proceeds to KADC. Excellent entertainment. * Since opening day care on Holidays, attendance has grown each month. November 10th brought fourteen participants to the Center. * KADC facility was host to "Advanced Cardiac Life Support"Training workshop, organized by a local physician. Thirty people attended,many of whom had not been to the Center before. Kona Adult Day Center, Inc. Agency Profile, Page 4 * Staff participated in many outreach projects within the community to promote KADC. These included speaking before Hawaii Island United Way volunteers,an information booth at the Alzheimer's Association Memory Walk, King Kamehameha Beach Hotel, and an information table at the Kona Surf Resort for HIUW campaign,targeting all hotel employees. Challenges Encountered 1995 Cuts! Cuts! Cuts! Tuition funding from Department of Human Services, Case Management Coordination Project, Nursing Home Without Walls, and Services for Seniors has been cut dramatically, creating a challenge for the low-income and severely disabled clients to attend day care. Problems lead to innovative thinking and that is just what the KADC staff is doing to make it possible for participants to come to the Center. 11. Membership Dues: Membership is not considered dues but is considered a fundraising contribution. Members are referred to as "Friends of Kona Adult Day Center". Participants of the Center are not considered members. 12. Trade Affiliation: The Kona Adult Day Center is a free-standing adult day care facility and holds no affiliation with a national or statewide organization. 13. Benefits of Trade Affiliation: Not applicable. • HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: Kona Adult Day Center. Inc. Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) I. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? xx Yes No Being revised Date last revised: Nnvamber L995 3. Do your personnel policies contain an equal employment opportunity clause? xx Yes No 4. Do you have a written job description? xx Yes No Being revised Date last revised: January 1995 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) xx Yes No Being revised Date last revised: September 1995 6. Does the agency conduct regular evaluation of employees? xx Yes No _ In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. xx No change Increase in staff is projected Decrease in staff is projected Will increase staff appropriately with increase in clientele. (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. I o ', 0 nA o CO 4111111W ° > ¢� `� U a) -G' 5 0 0 U I o �, a) ~ o -. 0 Ca q Q Q 'o 0 cd cti Cd °' en 0 as w a SIMMO •••611I I, o CO 0 CZ M 0 CO .H V` 1-4 1-4 z Z z /IL Tkij KONA ADULT DAY CENTER 11 P.O. BOX 1360 KEALAKEKUA, HI 96750 (808) 322-7977 Salary Ranges POSITION STEP ENTRY 1 2 3 4 5 6 7 8 9 10 $12.00 $12.60 $13.44 $13.89 $14.59 $15.32 $16.08 $16.89 $17.73 $18.61 $19.55 EXEC.. DIRECTOR 2,080 2,184 2,293 2,408 2,528 2,655 2,787 2,927 3,073 3,227 3,388 24,960 26,208 27,518 28,894 30,339 31,856 33,449 35,121 36,877 38,721 40,657 $10.00 $10.50 $11.03 $11.58 $12.16 $12.76 $13.40 $14.07 $14.77 $15.51 $16.29 PROG. DIRECTOR 1,733 1,820 1,911 2,007 2,107 2,212 2,323 2,439 2,561 2,689 2,823 20,800 21,840 22,932 24,079 25,283 26,547 27,874 29,268 30,731 32,268 33,881 $8.00 $8.40 $8.82 $9.26 $9.72 $10.21 $10.72 $11.26 $11.82 $12.41 $13.03 SECRETARY 1,387 1,456 1,529 1,606 1,686 1,770 1,858 1,951 2,049 2,151 2,259 16,640 17,472 18,346 19,263 20,226 21,237 22,299 23,414 24,585 2.5,884 27,105 $10.00 $10.50 $11.03 $11.58 $12.16 $12.76 $13.40 $14.07 $14.77 $15.51 $16.29 STAFF NURSE(R.N.) 1,733 1,820 1,911 2,007 2,107 2,212 2,323 2,439 2,561 2,689 2,823 20,800 21,840 22,932 24,079 25,283 26,547 27,874 29,2.68 30,731 32,268 33,881 SENIOR $8.00 $8.40 $8.82 $9.26 $9.72 $10.21 $10.72 $11.26 $11.82 $12.41 $13.03 ACTIVITY 1,387 1,456 1,529 1,606 1,686 1,770 1,858 1,951 2,049 2,151 2,259 SPECIALIST 16,640 17,472 18,346 19,263 20,226 21,237 22,299 23,414 24,585 25,884 27,105 $5.00 $5.25 $5.51 $5.79 $6.08 $6.38 $6.70 $7.04 $7.39 $7.76 $8.14 ACTIVITY ASST. 867 910 956 1,003 1,053 1,106 1,161 1,219 1,280 1,344 1,412 10,400 10,920 11,466 12,039 12,641 13,273 13,937 14,634 15,366 16,134 16,941 $6.00 $6.30 $6.62 $6.95 $7.29 $7.66 $8.04 $8.44 $8.85 $9.31 $9.77 HEALTH ASST. 1,040 1,092 1,147 1,204 1,264 1,327 1,394 1,463 1,587 1,613 1,694 12,480 13,104 13,759 14,447 15,170 15,928 16,724 17,561 18,439 19,361 20,329 $5.00 $5.25 $5.51 $5.79 $6.08 $6.38 $6.70 $7.04 $7.39 $7.76 $8.14 ACTIVITY ASST/ 867 910 956 1,003 1,053 1,106 1,161 1,219 1,2.80 1,344 1,412 VAN DRIVER 10,400 10,920 11,466 12,039 12,641 13,273 13,937 14,634 15,366 16,134 16,941 "We extend the quality of life for your family" Kona Adult Day Center, Inc., P.O. Box 1360 Kealakekua, Hi. 967S0 (808) 322-7977 1996-97 Application County of Hawaii - Application for Non-Profit Grant Funds Narrative Report Human Resources S. Staff Development: Kona Adult Day Center encourages staff members to further their personal and career development through attendance at such local conferences,institutes,seminars, workshops, or selected courses at the universities as will also contribute to further service to KADC, and which are not in conflict with regular duties. Appropriate professional literature and videos will be provided to staff members by KADC executive director. Fortunately for KADC staff, participants, and, volunteers, the West Hawaii Office of the Hawaii County Office of Aging is located directly across the street. Staff and participants are able to attend the many workshops sponsored by Office of Aging which relate to issues for older adults. inservices are provided for staff members by appropriate professionals within the community. ** A list of 1995 subjects is attached. KADC executive director is a member of the Hawaii County Committee on Aging. KADC program director is a member of the Developmental Disabilities Council. 9. Challenges: The challenge faced by non-profit agencies in a rural, outer island setting, is availability of dynamic trainers and the financial feasibility of organizing workshops for their presentation. To offer professional training opportunities with high caliber speakers is expensive, hut, the experience gained by exposure to these teachers is invaluable. Ultimately,the agency clientele receive the benefit of knowledge gained by staff. Agency collaberation on workshops is one way to limit financial burden. 10. Position Qualifications: ** Please see second attached sheet. 1NSERVICES/OITTSERVICFS (1995) DATE SUBJECT PRESENTER A'CI'ENDED BY 1/12/95 Teaming for Aging Project/UAP Janene Suttie Mary Jo Hill (To promote inclusive/appropriate aging experiences for persons with developmental disabilities) 1/27/95 Exercises for Bodies That Don't IICOA Rose McSherry Behave When The Mind Is Willing 3/24/95 Teaming for Aging Project Mtg Janene Suttie Mary Jo Hill 3/29/95 Caring for Persons with Dementia Lou Ellen Ruocco,RN Mary Jo Hill Kathy Flemming Doris Tavares 4/20/95 Teaming for Aging Project Mtg. Janene Suttie Mary Jo Hill 5/26/95 Teaming for Aging Project Mtg. Janene Suttie Mary Jo Hill 6/14/95 Attitudes/Beliefs "Caring Is Not Mary Jo Hill Kathy Flemming Enough" Rose McSherry Doris Tavares Bob Tanaka Emma Kapehe Tammy Gomera 6/21/95 Bloodborne Pathogens & Universal Kathy Flemming, RN Mary Jo 11111 Precautions -Also- Doris Tavares Care Plans & The Care Planning Mary Jo 11111 Rose McSherry Process Emma Kapehe Tammy Gomera Bob Tanaka 6/23/95 Teaming for Aging Project Mtg. Janene Suttie Mary Jo Hill 6/26/95 Bloodborne Pathogens & Universal Kathy Flemming Marvaleen Gouveia Precautions/DNR Policy 6/29/95 Dealing with Alzheimer's Disease "A IICOA Mary Jo Hill Common Sense Approach to Commun- cation" 7/19/95 Bloodborne Pathogens & Universal Kathy Flemming Ivy Sylva Precautions 8/11/95 Does Alzheimer's Disease Run In Berkley Powell, MD Mary Jo Hill Your Family 8/12/95 Hawaii Assistive Technology Project Linda Cavis Mary Jo Hill Introduction to Services Supt. Grp. 9/22/95 Learning to live with Alzheimer's Frena Gray-Davidson Mary Jo 11111 Disease 10/3/95 Orientation to Alzheimer's Assn. Project Dana Staff Mary Jo 11111 Respite Grants 11/29/95 Coping With The Holidays/The Regan Tims-Hospice Mary Jo Hill Grieving Process Supt. Grp. Kona Adult Day Center Minimum Qualifications Executive Director: Experience in health, human or social services. Bachelors degree from an accredited college or university, or substantial evidence in work history of an ability to carryout the duties and responsibilities of the position. One year of administrative experience in health, human or social services. Experience in the adequate supervision of others. Program Director: Graduate from an accredited college/university. Prior work experience with the elderly. Experience in the supervision of others. Knowledge of community and good working • relationship with professional personnel and community agencies. Management capability. Demonstration of organizational and planning skill. Knowledge and experience in working with cognitively and physical impaired elderly/adults and ability to incorporate this knowledge into the planning of the program. Ability to exercise good judgment and tact in dealing with client, caregiver, and the public; to provide leadership and gain acceptance and cooperation of others; empathize with, understand and influence individuals toward program goals and objectives. Nursing Coordinator: Graduate from an accredited school of nursing or hospital diploma executive. Evidence in work or employment history of an aptitude for supervision. Two years clinical nursing experience. Willingness to work with cognitively and physically impaired adults, and willing to learn about their special needs. Ability to exercise good judgment and tact in dealing with clients, caregiver, and public. Possession of current knowledge and use of common medical equipment and a working familiarity with a general range of clinical nursing procedures and standards. Secret.ar y: High school diploma and certificate demonstrating secretarial training or equivalent experience. Typing skills of 60 words per minute, knowledge in the use of office equipment, and electronic machines, including computer experience. Good organizational skills. Flexibility and ability to accept direction. Ability to function as a member of a team. Sensitivity to the needs and concerns of the elderly, especially the frail elderly. Current Hawaii's driver license. Senior Activity Specialist: High school diploma or evidence to carry out responsibilities of the position by prior work experience. Experience working with people. Ability to work with impaired adults. Ability to accept direction. Evidence of ability to exercise good judgment, patience understanding. Valid driver's license within the State of Hawaii. Clean traffic abstract. and ability to drive safely and with good judgment. Medical clearance to assist in transfers of disabled adults. Activity Asst./Van Driver: High school diploma or evidence to carry out responsibilities of the position by prior work experience. Experience working with people. Ability to work with impaired adults. Ability to accept direction. Evidence of ability to exercise good judgment, patience, understanding. Valid driver's license within the State of Hawaii. Clean traffic abstract and ability to drive safely and with good judgment. Medical clearance to drive van and assist in transfers of disabled adults. Health Assistant: High school diploma or evidence in work history of an aptitude/ability to carry out the reasonability and duties of this position. Training and experience in basic principals of personal care and hygiene. Medical clearance to carry out human transfers ad to drive the van. Ability to exercise sound judgment, patience, and understanding in dealing with impaired adults. No work history of negligence or malpractice in caregiving or personal care. Ability and willingness to accept direction and guidance. Valid drivel's licetlSP in the Slate of Hawaii. Medical clearance from communicable diseases. Ability to exercise tact and confidentiality when dealing with clients, families, and the public. KONA ADULT DAY CENTER, INC. LIST OF STAFF EMPLOYEE POSITION BACKGROUND Robyn Enos Executive Director Santa Rosa Junior College Ilawaii Real Estate Lic.1978 Brokers License 1982 Coordinator for KKCII_(non- profit agency serving disabled KADC as of 6/2.5/90 Mary Jo Frill Program Director/ California State University, Care Coordinator Degree in Recreation Admin. Member Rehab Facilities of Ilawaii. KADC as of 12/1/93 Theresa K. Hemming Nursing Coordinator Bryn Mawr Hosp., School of nursing Grad. Wernersville State Hopital R.N./ Supervisor 21 yrs. Certified Gerontological Nurse Suzanne Maksel Secretary Wilton II. S. Grad. Connecticut Real Estate Lic. secretary/Custom Homes of Conn. Inc.KADC as of 12/16/91 Doris Tavares Senior Activity Person Koanweana H.S. Grad. Private caregiver for 6 yrs. KADC as of 12/3/92 Robert Tanaka Activity Assistant/ Konaewana H.S. Grad. Van Driver Weber College/Music Scholarship Cruise Director 1980-1994. KADC as of 6/30/94 Ivy Sylva Health Assistant/ Graduate Konaewana H. S. Activity Assistant Hawaii Community College Grad Para Medical Asst II , Nurse's asst. , Nurse's aide 91-91 KADC as of 1/19/94 Rose McSherry Activity Assistant/ Seaside H.S.- Hale 0 Lain/ Van Driver Care Home Operator-Clover land foster {come. Creative Care, Menlo Park Health Care KADC as of 6/18/92 Emma Kapehe Health Assistant Konawaena H. S. Eel ensive experience as personnel caregiver. KADC as of 1/3/89 BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Kona Adult Day Center, Inc. (Page #4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) I. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3 According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the agency's mission) for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the number "1" to the most important and dominant service or target population. 6 educational 7 victims of crime culture& arts 2 victims of health crises 5 3 the poor victims of social crises youth 3 the physically disabled 1 the aged 4 the mentally or emotionally disabled 12/95 Kona Adult Day Center, Inc. Board of Directors Name Residence Business Telephone Mike Asam 75-369 Hoene St. 75-159 l-Iualalai Rd. B: 329-3148 President Kailua-Kona,HI Kailua-Kona,III H: -0_ FI.C.F.C.U. 96740 96740 6 yrs. on BOD,4th yr. as President Marjorie Mulhall 78-7253 Puupele Place B:-O- Vice-President Kailua-Kona,Hi H: 322-9255 Retired Business 96740 6 yrs. on ROD, 6th yr. as V.P., Chairperson of Fundraising Committee Ken Apilado P.O. Box 892 P.O. Box 8 B: 322-9377 Treasurer Kealakekua,III Kcalakekua,III H: 322-9757 Bank of Hawaii 96750 96750 6 yrs. on BOD,6th yr. as Treasurer, Chairperson of Finance Committee Reginald Morimoto 78-6852 Walua Rd. P.O. Box 618 B: 322-3487 Secretary Kailua-Kona,HI Kealakekua,HI H: -0- First Hawaiian Bank 96740 96750 6 yrs. on ROD,4th yr. as Secretary Mike Matsukawa 75-167E Hualalai Rd.#2 B: 329-1385 Attorney-at-Law Kailua-Kona,HI 96740 H: -0- Chairperson of Planning Committee President for 2 yrs. '89-'91 Susan Entz 75-5729 Kuakini Hwy. B: 329-8817 MacDonalds Rest. Kailua-Kona,HI 96740 H: 329-00)2 6 yrs. on BOD Caryl Fujiwara P.O. Box 771 B: 323-2085 R.S.V.P. Kealakekua,HI 96750 H: 322-2352 3 yrs. on ROD Catherine Hamilton 72-1039 Mamalahoa Hwy. B: 326-9774 Clark Realty Corp. Kailua-Kona,HI 96740 H: 325-3424 2 yrs.on BOD Kona Adult Day Center, Inc. Board of Directors Page 2 Name Residence Business Telephone Mary Katayama,RN P.O. Box 66 13: 323-3101 Dept.of Education Capt.Cook, HI 96704 1-1: 323-3083 4 yrs. on BOD,2nd yr.Chairperson Operations Advisory Committee Sachi Noma P.O. Box 945 13: 323-2212 Kealakekua Development Capt.Cook, HI 96704 H: -0- 2 yrs. on ROD Susumu Oshima P.O. Box 48 B: 32V-3844 Oshima Store Kealakekua,HI 96750 H: -0- 6 yrs. on BOD Dr. Robin Seto, MD P.O. Box 667 B: 324-1133 Medical Advisor Kealakekua,HI 9675( H: -0- 6 yrs.as Medical Advisor Howard Tatsuno P.O. Box 533 B: -0- Reti red Teacher Kealakekua,HI 96750 H: 323-2790 6 yrs. on BOD Edwin Ueda P.O. Box 539 13: _0_ Businessman Kealakekua,HT 96750 I-I: 323-2548 3 yrs. on BOD Kaoru Uycda P.O. Box 735 B: -0- Dept. of Health Kealakekua,HI 6750 H: 323-3336 6 yrs. on BOD SECTION 3.03 of the KADC By-Laws states that a director"shall hold office until the next annual meeting and thereafter until their successors are duly elected or appointed and qualified". Kona Adult I.)ay('enter,Inc I'O. Ili t�/.(1, Kealakekua, ili. 96750 (R(5).122 7977 (199C, Ahhlication County of Hawaii - Application for Non-Profit Grant Funds Narrative Report Board of Directors 1. Board of Directors roster attached. 2. List of ROD Meetings: The KADC Board of Directors met once per month in 1995, except of the month of October. Fundraising,finance, personnel, advisory and tuition assistance fund committees met on a regular bask, as well. 3. By-Laws: According to the Kona Adult Day Center By--Laws, Article i Il, Section 3.01, the authorized number of corporate directors shall be the number elected initially and at each annual member's meeting or meetings. 4. Major Decisions 1995: * Applied for non-profit grant funding from Hawaii County and received $10,000.0(for 1995-96. * To accommodate needs of the working caregiver, KADC began opening for each State and Federal Holiday, providing service for between 8 and 16 participants. * Requested $22,000.00 pre-opening working capital loan from The Queen Emma Foundation be presented as donation to KADC, rather than due and payable. Request granted. * Upon advice of Board of Directors,Center Director wrote and sent eleven proposals to corporate and foundation donors. The proposals asked for grant money to assist with the tuition and fee adjustments which KADC allows low-income participants who would otherwise be unable to attend day care. * Updated Center Personnel Policies and Procedures. * initiated two major fundraising events: "Dig for Diamonds" in August 1995 and "Papayas for Breakfast" in December of 199.5. Both were successful in regard to finance and community education of adult day care services. * Agreed to join the"West Hawaii Palliative Care Alliance". Palliative care is the care of people with incurable and far-advanced disease, with focus on quality of life. * Studied Department of Health adult day health regulations in anticipation of applying for day health licensure. 5. Challenges & Actions 1995: Challenge: State cutback in funding of human service monies created a financial problem for KADC. Department of Human Services (Purchase of Service program) supports a small number of the participants at the Center. Effective July I, 1995,the number of individuals funded will decrease from eight to three, according to correspondence from i)1`IS. This means five current participants will be without funding. An additional problem is created, as Department of Human Service payment for tuition is only two-thirds of the tuition amount paid by private pay clientele. Thus, the Center board of directors and staff must constantly fundraise to make up the financial difference. Action: Boost private pay clientele to provide solid revenue base. improve marketing techniques, provider speakers to talk about benefits of adult day care to various community groups and civic clubs, personally meet with physicians,their nurses and the hospital discharge planner to advertise KADC services. Offer a staff incentive program for each participant referral provided. Kona Adult Day Center Page 2 Board of Directors 6. Planned Improvements: Expansion of Service Kona Adult Day Center has been servicing the frail and impaired elderly in our community since 1988. A review of the clients served reveals a higher percentage of clients requiring assistance with Activities of Daily Living. The Board of Directors and staff of the Center are considering a possible application to the Department of Health as a free-standing adult day health center. This means a more "medical" model adult day service as opposed to the current "social" model. Day health care facilities are eligible for medicaid reimbursement. 7. KADC Long Range Plans: * Creation of an active Endowment/Charitable Trust program. * Satellite day care facilities in South Kona area and Waimea area. * Ownership of the current KAI)C facility or purchase of property and building of facility owned by KADC. * Increase Tuition Assistance Fund. * Increase staff salaries and benefits. , • FUNDING: NEEDS DIVIDER SHEET AGENCY NAME: Kona Adult Day Gentpr. Tnr_ (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1 Briefly explain the purpose of your request 2. What alternative funding sources were considered and/or applied for? 3 What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7 Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question #7, what is the formula used to determine this amount or percentage? Kona Adult Day Center, Inc. l'.(). Box 1360, Kealakckua, Ili. 96750 (RN)322 7977 1996-97 Application County of Hawaii - Application for Non-Profit Grant Funds Narrative Report Funding Needs 1997 1. Funding Needs: Kona Adult Day Center is requesting $15,000 in financial support from the County of Hawaii in 1996-97. The purpose of this request is to provide support for the direct services to participants and their caregivers/families. The funds will be applied to the overall operational costs of services, including supplies, personnel, food, transportation, activity and therapy consultants, volunteer recruitment and retention, and family training sessions. The finance committee of the KADC Board of Directors will oversee the use of funds received by the County of Hawaii. 2. & 3. Alternative Funding: Alternative sources of funding are continually being sought. This includes Hawaiian Trusts and Foundations, proposals to corporate donors, continued fundraising activities. The impact of lack of funding for this program will effect the economically disadvantaged elderly and impaired adults in West Hawaii. They will have fewer choices for supportive care within the community. Lack of financial support from Hawaii County could mean the difference in planned expansion of services for participants and their families. This will eventually lead to early institutionalization, loss of work time for caregivers and possible neglect, abuse or exploitation of elderly and disabled adults. Kona Adult Day Center asks that Hawaii County share in the continued success of the day care ideals, to assist in the continuance of quality care for the frail, disabled and elderly in the community by providing $15,000 in financial support for 1996-79. 4. Budget Variances: Support& Revenue - variances of 15% or greater: Line #1 Contributions: Proposed amount is less, as$10,000 is the average revenue from donations over the past seven years. Line#3 Bequest:The Annual Kamegaki Invitational Golf Tournament was not held in 1995 and is scheduled for fall of 1996. Line#10 Others: Tuition and Fee Adjustment for current period is-$17,976.00. Proposed Adjustment is -$25,805.00, as low-income participants increase each year. Line# 12 HIt1W: The current amount of funding will he adjusted later in the year when all campaign donations have been collected. KADC has received $16,000.00 in the past. Expenses- there are no variances of 15% or greater. The Kona Adult Day Center is a private, non-profit, community-based service agency without connection to any larger multi-island organization. PROGR\ I INFORMATION DIVIDER SHEET Agency name: Kona Adult Day Center, Inc. (Page 6) Program name: Adult Day Care Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc.. ) Answer questions 1-8 on separate paper and attach. 1 How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7 Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When-were these rates last changed? Kona Adult Day('enter, Inc. P.D. !lox 1360, Kealakckua, Ili- 96750 (51)8)322 7977 I996-97 Application County of Hawaii - Application for Non-Profit Grant Funds Narrative Report Program Information 1.& 2. Kona Adult Day Center provides a program of adult day care to residents in North. Central and South Kona Districts. Target population includes impaired adults 18 years and older with the focus on those 60+. Until the past year, average age of Center clientele was 85. Adult day care has expanded to include younger individuals, i.e. a man in his mid-thirties with head injury and a man in his early-forties with Alzheimer's disease. Impaired adults are those whose cognitive or physical disability prevents them from performing one or more instrumental activities of daily living. Family caregivers receive much needed respite from continuous, home-based caregiving, thus preventing burn-out and premature institutional placement. Employers benefit from fewer work hour lost by employees who have a loved one cared for at home. Kona Adult Day Center offers two caregiver support groups per month and these are open to the community. 3. The specific objectives to he attained by Kona Adult Day Care are: a.40% of participants enrolled will have a diagnosis of Alzheimer's disease or related dementia. b. 100%of participants will have an individualized plan of care developed by the program's registered nurse, the activity coordinator, the care coordinator, plus the family and the physician. c. 100% of participants will have a plan of discharge. 4 . Program effectiveness is evaluated in the following way: a.The Executive Director and Pmgram Director conduct an annual evaluation including family/caregiver surveys,agency surveys and chart review. b. Department of Human Services conducts an annual site review and evaluates facility, client records, personnel files and more,for purposes of licensing. c. The Program Director and Nursing Director conduct care plan evaluation quarterly. d. The Activity Director conducts activities plan evaluation quarterly. S. Kona Adult Day Center is the sole provider of adult day care in West Hawaii. The program represents an integrated social-medical model adult day care, which serves both cognitively and physically impaired adults within a single program. 6. Specific accomplishments are listed in the Organization Profile Narrative,#10.As well,during 1995 the program expanded to include Holiday service. 7. Unduplicated count of this program's beneficiaries: last year actual 68 this year estimate 82 next year estimate 96 number of clients served since opening in December 1989 210 8. Effective February 1, 1995, a tuition increase of 5% was effective for new clients. A rate schedule is attached. Tuition for those participants currently enrolled at KADC will remain at the previous rate.The only ancillary service fee to he raised was bathing, which will change from $15.00 per bath to $20.00 per bath. Rates reviewed quarterly by Board of Directors. KONA ADULT I)AY CENTER FEES Daily rate: Regular tuition $45.00 When assistance is required with ambulation, transferring, toilet lug, and/or personal care $50.00 Hourly rate $10.00 Full-time rate (five days per week): Regular tuition $675.00 With assistance S725.00 Intake Fee: One true fee for processing of application $40.00 Trial clay intake fee $25.00 (the "trial day" intake fee is applied toward the regular intake fee of$40.00 when the participant enrolls in the program) Ancillary Services: Bathing $20.00/bath Feeding $35.00/mouth Act lye therapy $65.00/month Transportation by KADC: one way $4.00 s***Tuition assistance may be available through various means. Contact the Program Director for more information. **** 0 0 o 'O W O fA G aJ G Q •4 00 1-1 .-1 r1 CO Ir rd a •n N •• (il Aw o v COy 0.co COU 4) O ^ O .--1 a) x In W RI W .-, W G w ul 01 ..1 0 N 'U • 1-1 •• 01i 01 G ar G 0 k. 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M '-1 N •--1 .--1 N — 'O {i. .--1 1.4 W , - 4 - , 4 - V A 04 • 0 O NooN on O V1 0 n U --44 In co in -1 UM 1 N ---- - - _ —1—___— •0 N Oo -1 O N -1- O .D O k 0 0\ 00 .D ifl .D Cr) O ON r•-•W v� M N .d - N + .D CTf` X ifi Q I- C-1-1 cn H N co �' O I -t O .D a1 00,, P C r-1 M O O I N O •--1 O M 1— in 0o I co 7 in ('' rn in -4 00 ,D I .o N O n C� — . 4 c i 1.0 0 I-- 1H W L.) 1C' ri, N o o 0 U ,� E .D 00 00 0. in .-+ 0. N H W N .-4 N M N M -1 M W o H •.-1 >" - u P F, Q Q O 0 u • G ccd cdd G W Q F- U U r4 44 cd 0 4-4 •4 I-+ --, .-i •H — 0 m *74 h to cd Q 0 CO U) bA G' L-12 o u 00 •• • •• of � d H O �- (DPWu u a v H W cn W <4 <4 <4 .4 x I ARC-dba KONA KRAFTS APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996 - June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: Kona Association for Retarded Citizens, d.b.a.: Kona Krafts NAME OF PROGRAM: Adult Dav Program & Kona Krafts Group Home Mailing Address: P.O. Box 127 City, State, Zip: Kealakekua, Hawaii 96750 Telephone: (808) 323-2626 FAX: (808) 323-9444 Attach current Internal Revenue tax-exemption certificate 501 ( c ) 3: See attached. Amount allocated by the Hawaii County in 1995: $ 12,000 1.55 % of Budget Agency Total Budget in 1995 $773,107 Amount requested of Hawaii County in 1996: $ 15,000 2.47 % of Budget Agency Total Budget in 1996: $605,661 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: July 1, 1996 - June 30, 1997 History of funding with the County of Hawaii New Applicant X Participating agency since 1989 Firm conducting and date of agency's last financial review or audit: NAME: Jennifer Gossert, CPA - Hilo, Hawaii DATE: November 1995 ORGANIZATION INFORMATION SECTION (pages 2 -8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Kona Association for Retarded Citizens,dba: Kona Krafts Page#2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Kona Krafts Geographic Area(s) Served: West Hawaii Agency's Mission Statement: See attached. 2. Briefly describe the kinds of programs and services the agency provides. 3. How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title 6. What are the specific objectives of the agency (in quantitative terms, where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category (adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? Kona Krafts Application for Nonprofit Fund Grant Page 2A ORGANIZATION PROFILE: A. AGENCY PROFILE 1. Agency's Mission Statement: Kona Krafts is a private, non-profit organization for persons with disabilities, their advocates and families. We believe that people with disabilities are as individual in their desires, needs, abilities, and gifts as any other cross section of society. Kona Krafts is committed to helping persons with disabilities achieve the fullest possible independence arid participation in our society according to their wishes. 2. Briefly describe the kinds of programs and services the agency provides. A. Adult Day Program • Funded through Dept. of Health • Serves adults with developmental disabilities/mental retardation • Provides a variety of meaningful day activities • Provides community based employment opportunities • Provides training in personal care skills • Opportunities to access community resources B. Evaluation & Training Program • Serves adults with a variety of disabilities • Program focus is vocational training, employment development and placement C. Group Home Residential Program • Serves the residential needs of five adults with developmental disabilities • Provides training in habilitation skills • Program focus is toward maximum independent living skills and opportunities D. Kona Krafts • Serves adults with a variety of disabling conditions • Serves persons with no funding sources • Provides meaningful day activities via • Vocational training • Self care skills training • Employment opportunities • Use of leisure time • Home management • Accessing community resources Kona Krafts Application for Nonprofit Fund Grant Page 2B 3. How do these services support the agency's mission? Our services provide adults and children, challenged by developmental disabilities/mental retardation, opportunities for personal and economic growth. Exposure to and training in the major activities of life such as employment, use of leisure time, accessing of community resources, home management and personal care takes place on a daily basis at the facility, in the West Hawaii community and in the home environment. At the core of our service delivery is our belief that all persons, including those with disabilities, have the inherent right to full participation in all community activities. It is with this vision in mind that our services are provided. 4. Who is eligible for services? The target group which Kona Krafts has traditionally served has been children and adults with developmental disabilities and/or mental retardation, mental illness, and physical impairments.. Currently and generally, any adult or child with a certified disability who resides in the West Hawaii area is eligible to apply for our services and/or programs. Final eligibility for specific programs is determined through intake procedures by the referral/funding agency (State) for that particular program as follows: Adult Day Program • Consumer must be developmentally disabled and/or mentally retarded • Dept. of Health Central Intake worker determines eligibility for services Evaluation & Training Program • Consumer must be deemed disabled with potential for employment • DVR staff determines eligibility for services Group Home Residential Program • Resident must • Be developmentally disabled/mentally retarded • Desire independent living training/experience and support • Dept. of Health Central Intake worker determines eligibility for services Kona Krafts • Services offered to an adult with disabilities • Eligibility determined by staff of Kona ARC Kona Krafts Application for Nonprofit Fund Grant Page 2C 5. Provide an unduplicated count of the number of individuals served by the agency. List by program title? • Adult Day Program: 22 • Evaluation& Training Program: 11 • Group Home Residential Program: 5 (Also served above in the Adult Day Program) • Kona Krafts: 6 • Total unduplicated count: 39 6. What are the specific objectives of the agency (in quantitative terms, where possible)? • To serve as many consumers per year as our funding and resources allow • To provide exposure to and training in the major activities of life such as employment, use of leisure time, accessing of community resources, home management, personal care, etc., according to the individual needs and preferences set forth in each consumer's Individual Program Plan. • To provide competitive and supported employment opportunities as desired • To promote the full-inclusion of persons with disabilities in all community activities 7. How do you evaluate program/service effectiveness, and who does the evaluation? • Daily review and evaluation of training and services documentation by program staff • Quarterly review of consumer's progress toward meeting individual goals with consumer, parent, care provider, and program staff • Quarterly and annual fiscal and programmatic reports to Department of Health • Annual external program and fiscal audits of program performance by Dept. of Health monitors • Annual consumer/parent conferences and program plan reviews • Periodic review of agency services by Board of Directors 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? Kona Krafts believes that a"team effort" is, more often than not, the best way for any individual, including one with disabilities, to meet his needs and reach his goals. We apply this belief in two ways: • Each of our program participants is a part of a team of individuals which assists him in identifying his needs and desires and the activities which will allow him to make progress toward fulfilling them. Kona Krafts Application for Nonprofit Fund Grant Page 2D • The staff coordinating or facilitating the services and activities develops and fosters linkages between the client and resources within his community. • As an agency we commonly cooperate and collaborate with: • Department of Health DD Division • Department of Vocational Rehabilitation • West Hawaii Counseling Center • Department of Education • Rehabilitation Facilities of Hawaii, Inc. • State Employment Service • • Local health care providers • Hawaii Special Olympics • Brantley Center • Hilo ARC • The ARC of Hawaii • The ARC of Kauai • The ARC of Maui • Bethphage Mission Pacific, Inc. • As consumer needs are unique and individually determined, the resources developed and utilized vary accordingly as does the frequency of contact. 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? Last year, Bethphage, an organization that also works with developmentally disabled adults, arrived in Kona. Bethphage provides residential services to the target population. Kona Krafts, although we do provide residential services, has traditionally had a more vocational, day activities focus. We welcome Bethphage's addition to our community. 10. List specific accomplishments or challenges addressed by the agency this last year. • All consumers in the Adult Day Program met their programmatic goals • Three program participants who had always lived at home continue to enjoy independent apartment living and support through Kona Krafts • Adults who would not have been considered for program entry previously, now enjoy program participation • All program participants are now classified as employees. This means that they: • Are treated equally under the personnel policies • Receive paid vacations Kona Krafts Application for Nonprofit Fund Grant Page 2E 11. Does the agency have membership dues? If so, list current rates by category (adult, youth, honorary, etc.) • Regular Members: $10 Recommended annual donation • Associate Members: $5 Recommended annual donation 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? • Fixed yearly fee - no formula • Kona Krafts makes payment to the national ARC of$425 per year 13. What benefits and/or services are provided to the agency by the national or statewide organization? • Legislative lobbying and input • Consumer advocacy • Sharing of information re current and future practices/services • Coordination of state and national issues and efforts in the DD/MR field HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: Kona Association for Retarded Citizens, dba: Kona Krafts Page#3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? XX Yes No Being revised Date last revised: November 1995 3. Do your personnel policies contain an equal employment opportunity clause? XX Yes No 4. Do you have a written job description? XX Yes No Being revised Date last revised: November 1995 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) Salary ranges are contained in job descriptions that are attached. XX Yes No Being revised Date last revised: November 1995 6. Does the agency conduct regular evaluation of employees? XX Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. No change Increase in staff is projected XX Decrease in staff is projected Due to additional of a Medicaid Waiver Adult Day Health Program, the Adult Day Program population will be decreased when 12 persons move to the new program. Answer questions 8, 9 and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. 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', ..i:;:;!:1•j:1;I:i';i:i;i:i;i:;i:i:i: ''•..•..•..•:* ',...i.. ......., KONA KRAFTS Job Description JOB/POSITION TITLE: Executive Director Revised 10/95 STATUS: Regular, Full-time, Exempt PRIMARY PURPOSE: Under the direction of the Board of Directors, the Executive Director is responsible for all functions of daily operation and administration of the Agency including financial management, personnel recruitment and supervision, program development, public relations, contract procurement,and implementation and monitoring of Agency policies and procedures. ESSENTIAL DUTIES/FUNCTIONS: •Financial administration: administers budget and cost accounting; monitors expenditures; maintains financial records and reports for all programs and operations. •Personnel administration: develops staffing patterns,job descriptions, salary structure; ...recruits, promotes, and dismisses staff members; develops personnel policies; maintains personnel records, staff indoctrination, continuous in-service training and annual staff evaluations. •Performs,personally or via delegation, the following monthly reviews and checks: (a)that requests for funds and accounting documentation/authorization is kept in a legal and responsible manner;(b)that accounting documentation is properly filed;(c)that cash accounts reconciliations are conducted; (d) that the cash receipt log, bank deposits,and entries posted to the general ledger are reviewed for accuracy. 'Performs the following reviews every six months: (a)that the personnel records are reviewed on or before June 30th and on or before December 31st each calendar year and that all required documentation is consistently maintained and filed; (b)that the payroll records are reviewed on or before June 30th and on or before December 31 each calendar year and that all records are accurate and properly filed. •Implements and monitors Agency policies and procedures. •Directs and supervises Administrative staff in their assignments and duties. •Supervises all Staff and promotes positive morale and motivation. •Supervises and assists Programs Coordinator in designing and implementing vocational training programs. •Develops funding/financial resources and coordinates/plans new ventures related to raising monies and funding operational costs. *Develops,implements and monitors Facility Program plan including projected growth, development,research goals and objectives to benefit the Agency. •Reports to the Board of Directors monthly and as necessary the development of Agency programs, business operations, financial status of the Agency, and accomplishments made toward achieving facility goals and objectives. •Develops and submits annual financial budget for Board approval. 'Facilitates and coordinates repair/maintenance requests. 'Develops task organization,analysis and industrial standards. 'Establishes consumer pay rates and submits sub-minimum wage certificate paperwork. •Monitors and approves time sheets/cards. •Promotes positive professional image to general public, local businesses and industries, other agencies, agency employees, parents,advocates, and consumers. •Maintains a neat,orderly and safe work area. OTHER DUTIES/FUNCTIONS: *Attends meetings,seminars, conferences,etc... as required. "Performs duties as assigned by the Board of Directors. JOB DESCRIPTION: Executive Director Page 2 WORKING CONDITIONS: Indoors under regular office conditions Equipment Use: Various general office equipment and supplies, telephone,computer/typewriter. Work Hours: 7:30am. to 4:00pm., Monday-Friday. Hours, times and days may vary due to Agency need. MENTAL DEMANDS: Duties require attention to detail and the use of judgment. Also requires mathematical ability and concentration. Must be able to work at high volume and stress level. PHYSICAL DEMANDS: Frequent to continuous sitting. Must be able to visually check forms, contracts, time cards, etc... for completion and accuracy. COMMUNICATION DEMANDS: Frequent communication required with Board of Directors, Staff, other Agencies, consumers, etc Also requires composition of appropriate letters, reports, and memos. QUALIFICATION REOUIREMENTS: ,.,s Skills/Knowledge: •Knowledge of rehabilitation intervention and training techniques. •Knowledge of County, State,and Federal requirements, standards,and guidelines regarding vocational training facilities. •Knowledge in working with budgets. •Must have good communication and interpersonal skills, and the ability to communicate both orally and in writing. •Must be able to promote positive morale and motivation among staff. •Must have empathy,understanding and respect for individuals with disabilities. oak Education/Experience: •Masters degree in Human Service field and three years administrative experience. OR •BA degree (or equivalent years of education)and five years administrative experience in human service related agencies or in administration of private business. SALARY RANGE: Starting: $2,750.00/month After first Six months: $2,833.33/month After first year: $2,916.67/month($35,000.00/year) TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Auk Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Office Manager Revised 10/95 STATUS: Regular, Full-time PRIMARY PURPOSE: Under the direction of the Executive Director, the Office Manager is responsible for a variety of all clerical/secretarial functions and for financial accounting of all Kona Krafts'programs. ESSENTIAL DUTIES/FUNCTIONS: •Types reports,correspondence letters, memos, meeting minutes,etc... with accuracy,neatness and efficiency. Typed documents are proofed by Executive Director and/or Managers. •Answers telephone, refers calls to appropriate personnel,and takes messages exhibiting a highly professional and business profile. •Files documents, reports, memos, etc... in appropriate files. Maintains files in an orderly manner. Confidentiality is of utmost importance. •Greets general public and refers with announcement to appropriate personnel. •Keeps inventory of office supplies and submits purchase orders to Executive Director. •Assists with and facilitates special activities related to fundraisers, as assigned. *Attends meetings, conferences, seminars as assigned. *Maintains record keeping systems in accordance with generally accepted accounting principles and auditing standards. *Posts to the general ledger by using remittance advice and cash receipts logs/sales receipts rather than checks and cash. •Performs monthly reconciliations for cash accounts and subsidiary registers and ledgers prior to generating monthly financial statements to be submitted to the Board. •Compiles and executes monthly payroll,payroll reports, as well as quarterly and annual reports. •Maintains departmental accounts by grant award where appropriate. *Prepares deposits and reconciles bank deposits. Reconciles monthly bank statements. *Compiles various documents relating to the manufacture and sale of facility goods and services in a manner which documents costs. *Assists in preparation of annual budgets. *Prepares and reconciles invoices and monthly statements for accounts receivables and accounts payable. 'Controls purchasing through request and authorization system. 'Compiles and prepares schedules and reports for annual independent audits,internal audits, and County, State, Federal and United Way audits. *Maintains and reviews employee benefit plans and various insurance plans annually. *Keeps attendance records on consumer/workers and staff for payroll calculations. *Promotes a professional and positive image to consumers and public. OTHER DUTIES/FUNCTIONS: *Dispatches and coordinates for the Transportation Department. •Receives monies and maintains sales records for Kona Krafts. Balances cash box daily and makes bank deposit. *Maintains a neat, orderly, and safe work area. *Performs other duties as assigned by Executive Director. WORKING CONDITIONS: Indoors under regular office conditions Equipment Use: Computer/typewriter, telephone, adding machine various general office equipment and supplies. Work Hours: 8:00am. to 4:30pm., Monday-Friday. Hours, times and days may vary due to Agency need. JOB DESCRIPTION: Office Manager Page 2 A•w•. MENTAL DEMANDS: Duties require attention to detail, alertness and use of judgment. Also requires mathematical ability and concentration. Must be able to work at high volume and stress. PHYSICAL DEMANDS: Frequent to continuous sitting. Frequent fingering to type, using the adding machine,and to file and retrieve forms and records. Must be able to visually check forms for completion and accuracy. Occasional pushing and pulling of up to 25 pounds when accessing file drawers. COMMUNICATION DEMANDS: Frequent oral and/or written communication required with staff, consumer families, other agencies, callers, and visitors. Frequent composition of letters, reports, and memos. OUALIFICATION REOUIREMENTS: Amok Skills/Knowledge: •Must be able to communicate clearly,concisely, and effective both verbally and in writing. 'Must be proficient in use of office equipment. •Must be able to effective promote a positive, professional, diplomatic profile in communications to staff, consumers, and general public. •Must have empathy, understanding,and respect for individuals with disabilities. Education/Experience; *High school diploma or equivalent and two years of education in business,accounting, bookkeeping or a related field plus two years of full charge bookkeeping experience. 'Ability to type a minimum of 45 net words per minute. *Two years work experience may be substituted for each year of educational experience required. SALARY RANGE: Starting: $1,566.67/month After first Six months: $1,650.00/month After first year: $1,733.33/month ($20,800.00/year) TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been • extended, or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected ; of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Administrative Specialist Revised 10/95 STATUS: Regular, Full-time PRIMARY PURPOSE: Under the direction of the Executive Director, the Administrative Specialist assists the Executive Director with administrative and or special projects. Works closely with the Office Manager providing clerical and fiscal support. ESSENTIAL DUTIES/FUNCTIONS: Fiscal 'Assists with monthly billing: pre-lists all in-coming cash receipts in a manual cash receivables log, makes appropriate number of copies of billings, prepares billing for mailing, and files our copy. •Receives monies and maintains sales records for accounts. Retains custody of cash receipts. 'Receives monies and maintains sales records for GECKO and nursery sales. Balances cash box and makes a bank deposit. *Records cash receipts for Working and Group Home accounts in respective manual cash receipts logs. "Stamps all checks with restrictive endorsement stamp. 'Prepares deposit and takes to the bank. •Records deposits in respective manual cash receipts logs. 'Types checks for invoices prepared by Office Manager/Bookkeeper. Records checks in respective manual disbursements logs. ESSENTIAL DUTIES/FUNCTIONS: General •Assists Executive Director with administrative and or special projects. 'Types reports, correspondence letters, memos, reports, etc... with accuracy,neatness, and efficiency(typed documents are proofed by Executive Director and or Managers). •Answers telephones, refers callers to appropriate personnel and takes messages exhibiting a highly professional and business profile. •Delivers out-going mail to post office and picks up in-coming mail. Opens, dates,and distributes mail. 'Files documents,reports, memos, etc... in appropriate files. Maintains files in an orderly manner. Confidentiality is of utmost importance. 'Assists with and facilitates special activities such as membership drives, preparation of proposals, receives and maintains records of donations and donors. •Maintains and calculates manual vacation accrual log. *Maintains and reconciles consumers'lunch money accounts. 'Maintains "Request for Funds" form disbursement log. 'Assists with inventory of office supplies and submits purchase orders to the Executive Director. •Sets up personnel charts which are kept by the Executive Director. •Promotes professional positive image to consumers,families, and public. •Maintains a orderly, neat, and safe work area. OTHER DUTIES/FUNCTIONS: 'Attends meetings as assigned and or scheduled. WORKING CONDITIONS: Indoors under regular office conditions. Equipment Use: Computer/typewriter, telephones, adding machine, various general office equipment and supplies. Work Hours: 8:00am- 3:30pm(one hour lunch), Monday to Friday, Hours and times may vary due to Agency need. Job Description: Administrative Specialist Page 2 40,3/4 MENTAL DEMANDS: Duties require attention to detail, alertness, and use of judgment. Also requires mathematical ability and concentration. Must be able to work at high volume and stress. PHYSICAL DEMANDS: Frequent or continuous sitting. Frequent fingering to type, using the adding machine and to file and retrieve forms and records. Must be able to visually check forms and deposits for completion and accuracy. Occasional pushing and pulling of up to 25 pounds when accessing file drawers. COMMUNICATION DEMANDS: Frequent oral and/or written communication required with Staff, consumers, other Agencies, callers, and visitors. Frequent composition of letters and reports. QUALIFICATION REQUIREMENTS: Skills /Knowledge: ,0w4,. •Must have excellent organizational skills and be able to maintain an orderly work flow. •Must be proficient in the use of office equipment. 'Must be able to communicate clearly,concisely,and effectively both verbally and in writing. •Must be able to effectively promote a positive,professional,diplomatic profile in communication to Staff, consumers,and general public. •Must have empathy,understanding,and respect for individuals with disabilities. Education/Experience: *High School diploma or equivalent and two years of experience in office practices and .001, procedures. TRAINING: The employee is subject to a six month probationary training period. An interim evaluation will be completed at the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. Anikt SALARY RANGE: Starting: $7.00/hour After first Six months: $7.50/hour After first year: $8.00/hour As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Programs Coordinator *Qualified Mental Retardation Professional (QMRP) Revised 10/95 STATUS: Regular, Full-time PRIMARY PURPOSE: Under the direction of the Executive Director, the Programs Coordinator is responsible for designing and implementing consumer(mentally and/or physically disabled adults) programs, vocational assessments, and in-service training of Vocational Supervisors. Maintains and documents program records and liaison activities between residential setting, case workers, families, etc... and Kona ARC. ESSENTIAL DUTIES/FUNCTIONS: 'Facilitates, designs,coordinates and monitors consumer training programs,plans,objectives, reports, etc... for Kona ARC. •Develops and maintains meaningful record keeping systems and procedures to assure accountability to referring agencies and funding sources. 'Monitors the accurate recording of objective progress, training times, productivity rates, etc... Compiles information in monthly, quarterly, and annual reports. •Submits reports to appropriate agencies in a timely manner. 'Supervises Evaluation &Training(E&T) Supervisor, other Supervisors,and Consume/Program Support Worker. Checks time cards for accuracy. •Submits time cards and attendance on non-program consumers in a timely manner. *Provides case management for program and non-program consumers who have no social worker. Duties include: assists consumers in completion of Medicare,Medicaid, and Social Security applications; transports consumers to appointments; assists consumers with meds and other needs. 'Provides technical assistance re: work simplifications,community resources, etc.... 'Collaborates with the Executive Director in development of programs, grant writing,and requests for proposals to obtain program and service funding. "Conducts liaison activities with Group Home, Case Workers, parents/guardians,and advocates. 'Facilitates meetings with families, staff, etc..., to ensure consumer wants and needs are addressed. 'Promotes professional and positive image to consumers,families, and public. OTHER DUTIES/FUNCTIONS: •Provides or assists in the provision of orientation and in-service training regarding training technology, training techniques, approaches, procedures, and documentation. 'Implements vocational assessments of consumers. •Facilitates, schedules, and participates in Individual Program Plan(IPP)meetings and Division of Vocational Rehabilitation's Evaluation and Training program conferences. 'Determines goals and objectives as IPP has prioritized the needs and desires of Consumers and their families, advocates,representatives,etc... *Provides monthly programs and activity report for the Executive Director. 'Performs duties as assigned by Executive Director. * QUALIFIED MENTAL RETARDATION PROFESSIONAL (QMRP) shall: 'Oversees and ensures services are provided as contracted. 'Supervises Program Trainer and checks time cards for accuracy. 'Supervises and trains direct service staff who do not meet the minimum qualifications. •Ensures that all direct service staff undergo two training sessions per year. Training includes: education on procedures for dealing with consumer injury and education, to up grade skills ' and ensure that staff stay abreast of the most current techniques for dealing with persons with developmental disabilities and/or mental retardation. *Documents direct staff's training in respective personnel folders. JOB DESCRIPTION: Programs Coordinator Page 2 WORKING CONDITIONS: Indoors under regular office conditions Equipment Use: Car, computer, various general office equipment and supplies,telephone. Work Hours: 7:30am. to 3:30pm., Monday-Friday. Hours, times and days may vary due needs of the programs and or Agency. MENTAL DEMANDS: Duties require attention to detail, alertness, and use of judgment. Also requires some mathematical ability and concentration. PHYSICAL DEMANDS: Frequent sitting when working on reports or letters. Must be able to visually check forms and time cards for completion and accuracy. Must be able to retrieve and transmit information. Occasional pushing/pulling of up to 25 pounds to open and close file drawers. COMMUNICATION DEMANDS: Frequent communication, both orally and in writing, required with consumers, support staff, consumer families and other agency personnel. Requires composition of reports, letters,memos. ANN QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must have good communication and interpersonal skills, and the ability to communicate both orally and in writing. 'Must have an understanding of County, State,and Federal guidelines and regulations to which programs are subject. 'Must have knowledge of production and vocational training methods. *Must be able to promote positive morale and motivation among staff. 'Must have empathy,understanding and respect for individuals with disabilities. '"'*, Education/Experience: *BA or BS degree in Social Science field plus one year experience working directly with persons with developmental disabilities. Miscellaneous: 'Valid drivers license. SALARY RANGE: Starting: $1,916.67/month After first Six months: $2,000.00/month After first year: $2,083.33/month($25,000/year) TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Program Trainer Revised 10/95 STATUS: Regular, Full-time PRIMARY PURPOSE: Under the direction of and assisted by the Qualified Mental Retardation Professional (QMRP), the Program Trainer is responsible for helping to develop and implement Individual Habitation plans (1PP) of new admissions. Maintains records of attendance and provision of services. Oversees consumer meals and coordinates consumer transportation. ESSENTIAL DUTIES/FUNCTIONS: •Implements the IHP with two(2) weeks of admission, including a minimum of five(5)objectives per consumer which shall be approved by the Interdisciplinary Team(IDT). Any Community Long Term Care Branch(CLTCB)consumer on psychotropic medications shall have a behavior management Program developed and monitored by the IDT psychologist. 'Provides direct training and supervision to CLTCB consumers. •Maintains written daily records of attendance and provision of services. 'Reviews and reports the progress of each consumer's programs on a monthly and annual basis, and as needed. 'Ensures nutritious lunch meals and modified diets, as prescribed by the physician, are provided. •Facilitates transportation to and from the CLTCB consumer's program site and residence is provided. *Ensures and supervises a Direct Service staff(including Trainer)to CLTCB consumers in ratios of 1:4 generally, and 1:3 for wheelchair using, behavioral, or medically fragile consumers. •Maintains an orderly, neat, and safe work area. 'Promotes professional and positive image to consumers,families,and public. OTHER DUTIES/FUNCTIONS: •Attends staff meetings, conferences, seminars as scheduled or assigned. *Promotes positive morale and motivation among staff. *Performs duties as assigned by QMRP. WORKING CONDITIONS: Indoors in an office setting/conditions. Equipment Use: Car or van, various general office equipment and supplies. Work Hours: 7:30am- 3:30pm, Monday - Friday. Hours, times, or days may vary due to needs of the program and/or Agency. MENTAL DEMANDS: Duties require frequent or continuous attention to detail alertness, and use of judgment. Also requires occasional mathematical ability and concentration. PHYSICAL DEMANDS: Frequent sitting when working on reports. Occasional pushing/pulling of up to 25 pounds to maintain and access file drawers. COMMUNICATION DEMANDS: Frequent communication required with consumers, QMRP, support staff, IDT, and other professionals. Requires composition of reports, letters,and memos. JOB DESCRIPTION: Program Trainer Page 2 Amok QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must have good communication and interpersonal skills,and the ability to communicate both orally and in writing. •Must have empathy, understanding,and respect for individuals with disabilities Education/Experience: •Special Education Teacher I credentials OR 02 years credits from an accredited college and three years teaching experience OR 02 years credits from an accredited college, 1 year experience in general teaching,and 1 year teaching developmentally disabled individuals. Agis Miscellaneous: •Valid drivers license. *Current and clear criminal abstract. SALARY RANGE: Starting: $1,646.67/month After first Six months: $1,733.33/month After first year. $1,906.67/month($22,880/year) TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Adult Day Program Supervisor Revised 10/95 STATUS: Regular, Full-time PRIMARY PURPOSE: Under the direction of the Programs Coordinator, the Adult Day Program Supervisor conducts and documents training programs that are relevant to consumers' (severely physically and/or mentally disabled adults) goals and objectives. Writes task analyses for tasks/activities geared to each consumer's abilities and needs. Provides direct training to consumers and facilitates/oversees training conducted by other staff when appropriate. ESSENTIAL DUTIES/FUNCTIONS: •Provides and/or facilitates direction and supervision of consumers involved in work tasks, goal training,and community access activities. *Coordinates the timely completion and submission of daily work logs, attendance records, communication logs, etc...using established forms and procedures. •Supervises ADP Worker/Aides in their consumer's goal training and support, record keeping, documentation, etc... •Coordinates transportation of consumers to and from community access activities. •Documents daily training programs and progress towards objectives/goals using methods, procedures,and reports established with Programs Coordinator. *Assists in personal care needs of participants ie... toileting,diapering,preparing lunches,feeding, dressing, etc •Maintains open lines of communications with other direct service staff and support staff,for purposes of sharing information and gaining input regarding consumer activities. *Assists Programs Coordinator in preparation of Individual Program Plans(IPP)including writing goals and observable/measurable quarterly objectives. •Checks and submits ADP Worker/Aide(s), as well as personal time cards. *Communicates daily with consumer families through log book. •Maintains an orderly, neat, and safe work area. •Promotes professional and positive image to consumers,families, and public. OTHER DUTIES/FUNCTIONS: *Participates in annual and periodic meetings with consumers,family members,case managers, Programs Coordinator, and significant others to identify strengths,needs,and goals of consumers. •Assists consumers safely on and off the bus. •Attends Staff meetings, conferences, and seminars as scheduled or assigned. •Performs other duties as assigned by Programs Coordinator. WORKING CONDITIONS: Indoors under regular office conditions. Indoors/outdoors under various conditions during community access activities. Equipment Use: Van or bus with wheel chair lift, wheelchair locks and tie downs, television VCR, various exercise equipment. Various general office supplies and equipment, telephone. Work Hours: 7:30am- 2:30pm, Monday - Friday. Hours, times, or days may vary due to needs of the program and/or Agency. No official time for lunch. MENTAL DEMANDS: Duties require continuous attention to detail and alertness when supervising, training and/or driving consumers. Occasional mathematical ability needed for calculating and checking time cards for accuracy. JOB DESCRIPTION: Adult Day Program Supervisor Page 2 ,••+k PHYSICAL DEMANDS: Requires pushing/pulling up to 150 pounds assisting consumers in wheelchairs. Occasional lifting of up to 50 pounds assisting consumers in and out of wheelchairs and carrying up to 15 pounds of equipment. Frequent walking when out on community access activities. COMMUNICATION DEMANDS: Requires continuous or frequent communication with consumers who may be non-verbal. Frequent communication both orally and written with consumer families/guardians, and support staff. QUALIFICATION REQUIREMENTS: Skills/Knowledge: A, *Must have knowledge of training methods. ., *Must be able to communicate clearly and concisely both orally and in writing. •Ability to communicate with non-verbal consumers. •Must have empathy, understanding,and respect for individuals with disabilities. Education/Experience: •Two year college degree preferred OR *High School graduate and 3 years experience working with individuals with disabilities. SALARY RANGE: Starting: $8.50/hour After first Six months: $9.00/hour After first year: $9.50/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended, or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: AN `"' Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Adult Day Program Worker/Aide Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Adult Day Program Supervisor, the Adult Day Program Worker/Aide provides one-on-one assistance in the direction and supervision of consumers(severely physically and/or mentally disabled adults)involved in goal training and community access activities. Attends to the personal care needs of individual consumers. Assists in the completion of daily logs, attendance,and communication logs. ESSENTIAL DUTIES/FUNCTIONS: •Provides direct one-one-one supervision of consumers during daily activities. •Participates in the implementation of training programs that are relevant to consumer's goals and objectives. •Assists with the timely completion of daily work logs, attendance records,communication logs, etc... using established forms and procedures. •Attends to personal care needs of individual consumers ie...toileting,diapering, preparing consumer lunches, feeding, dressing, etc 'Assists consumers on and off the bus. Supervises consumers on the bus while on community access activities. *Maintains an order, neat,and safe work area. *Promotes professional and positive image to consumers,families,and public. OTHER DUTIES/FUNCTIONS: •Assists Adult Day Program Supervisor in preparation of Individual Program Plans including writing of observable/measurable Quarterly objectives. *Participates in periodic meetings with consumers, Supervisor, Programs Coordinator,and significant others to review progress and modify goals as needs and desires change. •Attends staff meetings, seminars, conferences as assigned or scheduled. 'Performs other duties as assigned by Adult Day Program Supervisor. WORKING CONDITIONS: Indoors under regular office conditions. Indoors/outdoors under various conditions during community access activities. Equipment Use: Van or bus with wheelchair lift, wheelchair locks and tie downs, television VCR, various exercise equipment. Various general office supplies and equipment, telephone. Work Hours: 7:30am- 2:00pm, Monday - Friday. No official time for lunch. Hours, times, or days may vary due to needs of the program and/or Agency. MENTAL DEMANDS: Duties require continuous attention to detail and alertness when driving and supervising/training consumers. PHYSICAL DEMANDS: Requires pushing/pulling up to 150 pounds assisting consumers in wheelchairs. Occasional lifting of up to 50 pounds assisting consumers in and out of wheelchairs and carrying up to 15 pounds of equipment. Frequent walking when out on community access activities. JOB DESCRIPTION: Adult Day Program Worker/Aide Page 2 immik COMMUNICATION DEMANDS: Requires frequent communication with consumers who may be non-verbal. Frequent communication both oral and written with consumer families/guardians,and support staff. QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Ability to communicate with non-verbal consumers. •Must be able to communicate clearly and concisely both orally and in writing. •Must have empathy, understanding,and respect for individuals with disabilities. Education/Experience: OR h School diploma or equivalent plus one year specific work experience in this field ,— •Three years equivalent experience in this field. SALARY RANGE: Starting: $7.00/hour After first Six months: $7.50/hour After first year: $8.00/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six. month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Evaluation & Training Supervisor Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Programs Coordinator,the Evaluation&Training Supervisor evaluates, monitors and supervises consumers(Evaluation & Training participants with varying degrees of disabilities). Assesses, evaluates, and identifies the current strengths, needs, and goals of consumers. Develops job contacts and job matches for consumers. Visits work sites. Develops an individualized training program based on individual skills and employment goals. ESSENTIAL DUTIES/FUNCTIONS: •Assesses,evaluates and identifies the current strengths,needs and goals of E&T consumers. •Develops and implements pre-employment training plans for consumers including: (a)specific work skill training; (b)adjustment to work environment; (c)social integration;(d)community living skills. "Supervises, monitors, and evaluates E&T consumers using established forms and procedures. •Develops work sites and job matches according to E&T consumers'abilities and desires. 'Develops on-going support resources/persons in community. 'Develops and maintains record keeping systems and procedures to assure accountability to referring agencies and funding sources. •Advocates for persons with disabilities in the work place and in the community. *Maintains effective communications,written and orally,with the Department of Vocational Rehabilitation. •Completes required paperwork within stated timelines. •Maintains orderly, neat,and safe work area. *Promotes professional and positive image to consumers,families, and public. OTHER DUTIES/FUNCTIONS: 'Facilitates periodic meetings with consumer and family,staff case workers(DVR),and significant others to review consumer progress. •Develops transportation resources. 'Attends Staff meetings, conferences,and seminars as scheduled or assigned. 'Performs other duties as assigned by Programs Coordinator. WORKING CONDITIONS: Indoors under regular office conditions. Under various conditions at community work sites. Equipment Use: Provides own transportation, computer/typewriter, phone, various general office equipment and supplies. Work Hours: 20 hours per week, usually between 7:30 am -3:30pm., Monday - Friday. Hours,times, or days may vary due to needs of the program and/or Agency. MENTAL DEMANDS: Duties require attention to detail, concentration, and use of judgment. Also requires some mathematical ability. PHYSICAL DEMANDS: Frequent sitting while in meetings and working on reports. Must be able to visually check forms for completion and accuracy. Frequent fingering on computer. Occasional pushing/pulling of up to 25 pounds to open and close file drawers. JOB DESCRIPTION: Evaluation and Training Supervisor Page 2 Adok COMMUNICATION DEMANDS: Frequent communication with consumers, support staff, employers, and Division of Vocational Rehabilitation. Occasional composition of appropriate reports, letters, and memos. QUALIFICATION REQUIREMENTS: Skills/Knowledge: *Must be able to communicate clearly and concisely both orally and in writing. •Must have a working knowledge of production and vocational training methods. •Must have empathy, understanding,and respect for individuals with disabilities. Education/Experience: •AA Degree plus two years work experience in rehabilitation,social services,developmental odos, disabilities or comparable service area. OR •BS or BA Degree plus one year experience in rehabilitation,social services,developmental disabilities or comparable service area. OR •Any combination of education and/or experience that is deemed comparable to the above. Miscellaneous: *Valid driver's license and provide own transportation. SALARY RANGE: Starting: $8.50/hour After first Six months: $9.00/hour After first year: $9.50/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended, or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Evaluation & Training Worker Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Evaluation and Training Supervisor,the Evaluation&Training Worker evaluates, monitors, and supervises consumers (Evaluation&Training participants with varying degrees of disabilities). Assesses, evaluates, and identifies the current strengths, needs and goals of consumers. Develops job contacts and job matches for consumers. Visits work sites. Develops and individualized training program based on individual skills and employment goals. ESSENTIAL DUTIES/FUNCTIONS: •Assesses,evaluates and identifies the current strengths,needs and goals of E&T consumers. •Develops and implements pre-employment training plans for consumers including: (a)specific work skill training; (b)adjustment to work environment; (c)social integration;(d)community living skills. •Supervises, monitors, and evaluates E&T consumers using established forms and procedures. 'Develops work sites and job matches according to E&T consumers'abilities and desires. •Develops on-going support resources/persons in community. *Develops and maintains record keeping systems and procedures to assure accountability to referring agencies and funding sources. •Advocates for persons with disabilities in the work place and in the community. *Maintains effective communications,written and orally,with the Department of Vocational Rehabilitation. 'Completes required paperwork within stated timelines. •Maintains orderly,neat,and safe work area. *Promotes professional and positive image to consumers,families, and public. OTHER DUTIES/FUNCTIONS: •Facilitates periodic meetings with consumer and family,staff case workers(DVR),and significant others to review consumer progress. •Develops transportation resources. •Attends Staff meetings, conferences,and seminars as scheduled or assigned. 'Performs other duties as assigned by Evaluation&Training Supervisor. WORKING CONDITIONS: Indoors under regular office conditions. Under various conditions at community work sites. Equipment Use: Provides own transportation, computer/typewriter, phone, various general office equipment and supplies Work Hours: 20 hours per week, usually between 7:30 am-3:30pm., Monday - Friday. Hours, times, or days may vary due to needs of the program and/or Agency. MENTAL DEMANDS: Duties require attention to detail, concentration, and use of judgment. Also requires some mathematical ability. PHYSICAL DEMANDS: Frequent sitting while in meetings and working on reports. Must be able to visually check forms for completion and accuracy. Frequent fingering on computer. Occasional pushing/pulling of up to 25 pounds to open and close file drawers. AMMON JOB DESCRIPTION: Evaluation and Training Worker Page 2 Amok COMMUNICATION DEMANDS: Frequent communication with consumers, support staff, employers, and Division of Vocational Rehabilitation. Occasional composition of appropriate reports, letters,and memos. QUALIFICATION REOUIREMENTS: Skills/Knowledge: •Must be able to communicate clearly and concisely both orally and in writing. •Must have a working knowledge of production and vocational training methods. •Must have empathy, understanding,and respect for individuals with disabilities. Education/Experience: •AA Degree plus two years work experience in rehabilitation,social services,developmental ANN disabilities or comparable service area. OR •BS or BA Degree plus one year experience in rehabilitation,social services,developmental disabilities or comparable service area. OR •Any Combination of education and/or experience that is deemed comparable to the above. Miscellaneous: •Valid driver's license and provide own transportation. .00% SALARY RANGE: Starting: $7.50/hour After first Six months: $8.00/hour After first year $8.50/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended, or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "1 have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Yard Crew Vocational Supervisor Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Programs Coordinator, the Yard Crew Vocational Supervisor acts as a working supervisor in providing direction, supervision, instruction, and reinforcement of consumer crew members' (physically and/or mentally disabled adults)work activities. Facilitates completion of all tasks specified in yard maintenance contracts adhering to desired quality and production standards and safe practices. ESSENTIAL DUTIES/FUNCTIONS: •Facilitates completion of all tasks specified in yard maintenance contracts,following quality and production standards and safe practices. 'Directs, supervises,instructs and reinforces consumer crew members' work activities. 'Documents and participates in consumers' goal training. •Maintains and submits in a timely manner required records/logs regarding consumer work time, significant behavior, incidents/injuries, etc... •Calculates and submits, in a timely manner, consumer time sheets. "Communicates vital information regarding consumers to Programs Coordinator and other key persons. *Maintains an inventory of all tools, equipment and supplies used by the crew. *Facilitates regular maintenance and repairs of yard crew vehicle, tools,and equipment to insure that they can be used with safety. 'Maintains an orderly, neat, and safe work area. 'Transports crew members to and from work sites. *Promotes professional and positive image to consumers,families,and public. OTHER DUTIES/FUNCTIONS: 'Schedules daily, weekly, monthly, and/or quarterly yard maintenance visits. 'Works with Programs Coordinator in the coordination and management of training and production issues relevant to consumer crew members. 'Attends staff meetings, conferences, seminars as scheduled or assigned. 'Provides input at meetings regarding consumer strengths, needs, etc... 'Performs duties as assigned by Programs Coordinator or Executive Director. WORKING CONDITIONS: Frequently outdoors in various weather conditions. Indoors under regular office conditions when completing paperwork. Equipment Use: Truck or van, lawn mowers, riding lawn mowers, gas weed eaters, gas hedge trimmers, gas blowers, all yard maintenance hand tools. Occasional use of Round-up herbicide. Work Hours: 8:00am - 2:00pm, Monday - Friday. Hours, times, or days may vary due to Agency or yard maintenance contract needs. MENTAL DEMANDS: Duties require attention to detail, alertness, and working to a specific routine. Requires ability to concentrate under noisy conditions. Also requires some mathematical ability. JOB DESCRIPTION: Yard Crew Vocational Supervisor . Page 2 PHYSICAL DEMANDS: Requires pushing, pulling, lifting, and carrying up to 92 pounds of equipment,fertilizer,soil, yard clippings,etc... Driving to and from work sites. COMMUNICATION DEMANDS: Frequent verbal communication directing consumers and in accessing the needs of customers. Occasional written communication required for composing consumer progress reports. QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must be able to communicate clearly regarding instructions. •Must have empathy,understanding,and respect for individuals with disabilities. •Must be able to promote positive morale and motivation among crew members. ..r Education/Experience: •High School diploma or equivalent. OR •Two years experience in similar field of operations. Miscellaneous: •Valid driver's license. SALARY RANGE: Starting: $8.50/hour After first Six months: $9.00/hour After first year $9.50/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I haveread this job description and understand those duties and responsibilities that are expected of me." Amok Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Janitorial Vocational Supervisor(Keakealani) Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Programs Coordinator, the Janitorial Vocational Supervisor acts as a working supervisor in providing direction, supervision, instruction, and reinforcement of consumer crew members' (physically and/or mentally disabled adults)work activities. Facilitates completion of all tasks specified in janitorial maintenance contracts adhering to desired quality and production standards and safe practices. ESSENTIAL DUTIES/FUNCTIONS: •Facilitates completion of all tasks specified in janitorial maintenance contracts, following quality and production standards and safe practices. •Directs, supervises, instructs and reinforces consumer crew members' work activities. •Documents and participates in consumers' goal training. •Maintains and submits in a timely manner required records/logs regarding consumer work time, significant behavior, incidents/injuries, etc... *Calculates and submits,in a timely manner, consumer time sheets and personal time card. 'Communicates vital information regarding consumers to Programs Coordinator and other key persons. •Maintains an inventory of all tools, equipment and supplies used by crew. •Facilitates regular maintenance and repairs of janitorial crew's equipment. 'Maintains an orderly, neat, and safe work area. 'Promotes professional and positive image to consumers,families, and public. OTHER DUTIES/FUNCTIONS: 'Works with Programs Coordinator in the coordination and management of training and production issues relevant to consumer crew members. 'Attends staff meetings,conferences, seminars as scheduled or assigned. •Provides input at meetings regarding consumer strengths, needs, etc... •Performs duties as assigned by Programs Coordinator or Executive Director. •Provides transportation for crew to and from Kona Krafts and work site. WORKING CONDITIONS: Indoors under regular office conditions. Equipment Use: Vacuum cleaners, mops, mop buckets, brooms, ladders, general cleaning tools, and commercial cleaners. Occasional use of wax strippers and buffers. May also include a crew vehicle. Work Hours: 8:00am - 2:00pm, Monday - Friday. Hours, times, or days may vary due to Agency or janitorial maintenance contracts needs. MENTAL DEMANDS: Duties require attention to detail, alertness, and working to a specific routine. Also requires some mathematical ability and concentration. PHYSICAL DEMANDS: Requires pushing, pulling, lifting, and carrying up to 60 pounds of equipment, cleaners,furniture or objects. Also requires balance while working on ladders. JOB DESCRIPTION: Janitorial Vocational Supervisor Page 2 COMMUNICATION DEMANDS: Frequent verbal communication directing consumers and in accessing the needs of customers. Occasional written communication required for consumer progress reports. QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must be able to communicate clearly regarding instructions. 'Must have empathy, understanding,and respect for individuals with disabilities. •Must be able to promote positive morale and motivation among crew members. Education/Experience: OR h School diploma or equivalent. Anis •Two years experience in similar field of operations. Miscellaneous: •Valid driver's license if transporting crew. SALARY RANGE: Starting: $ 9.00 '— After first Six months: $ 9.50 After first year. $10.00 TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Mobile Janitorial Vocational Supervisor Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Programs Coordinator, the Mobile Janitorial Vocational Supervisor acts as a working supervisor in providing direction, supervision, instruction, and reinforcement of consumer crew members' (physically and/or mentally disabled adults)work activities. Facilitates completion of all tasks specified in janitorial maintenance contracts adhering to desired quality and production standards and safe practices. ESSENTIAL DUTIES/FUNCTIONS: •Facilitates completion of all tasks specified in janitorial maintenance contracts, following quality and production standards and safe practices. •Directs, supervises, instructs and reinforces consumer crew members' work activities. -Documents and participates in consumers' goal training. 'Maintains and submits in a timely manner required records/logs regarding consumer work time, significant behavior, incidents/injuries, etc... 'Calculates and submits, in a timely manner,consumer time sheets and personal time card. •Communicates vital information regarding consumers to Programs Coordinator and other key persons. •Maintains and inventory of all tools,equipment and supplies used by crew. *Facilitates regular maintenance and repairs of janitorial crew's equipment and vehicle. 'Provides transportation for crew to and from work sites. 'Maintains an orderly, neat, and safe work area. 'Promotes professional and positive image to consumers,families, and public. OTHER DUTIES/FUNCTIONS: •Schedules daily, weekly, monthly, and/or quarterly janitorial maintenance visits. •Works with Programs Coordinator in the coordination and management of training and production issues relevant to consumer crew members. •Attends staff meetings, conferences, seminars as scheduled or assigned. 'Provides input at meetings regarding consumer strengths, needs, etc... *Performs duties as assigned by Programs Coordinator or Executive Director. WORKING CONDITIONS: Indoors under regular office conditions. Occasional outdoor work. Equipment Use: Vacuum cleaners, mops, mop buckets, brooms, ladders, general cleaning equipment and tools, commercial cleaners, crew vehicle. Work Hours: 8:00am - 2:00pm, Monday - Friday. Hours, times, or days may vary due to Agency or janitorial maintenance contracts needs. MENTAL DEMANDS: Duties require attention to detail, alertness, and working to a specific routine. Also requires some mathematical ability and concentration. PHYSICAL DEMANDS: Requires pushing, pulling, lifting, and carrying up to 60 pounds of equipment, cleaners,furniture or objects. Also requires balance while working on ladders. JOB DESCRIPTION: Mobile Janitorial Vocational Supervisor . Page 2 COMMUNICATION DEMANDS: Frequent verbal communication directing consumers and in accessing the needs of customers. Occasional written communication required for consumer progress reports. QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must be able to communicate clearly regarding instructions. •Must have empathy, understanding,and respect for individuals with disabilities. •Must be able to promote positive morale and motivation among crew members. Education/Experience: OR h School diploma or equivalent. A.00,,, •Two years experience in similar field of operations. Miscellaneous: •Valid driver's license. SALARY RANGE: Starting: $8.50 After first Six months: $9.00 After first year: $9.50 TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Group Home Manager Revised 10/95 STATUS: Regular, Full-time PRIMARY PURPOSE: Under the direction of the Executive Director, the Group Home Manager is responsible for the overall operation of the Group Home adhering to Agency policies and procedures and governmental agency standards and regulations and assuming the civil rights of those residents (physically and/or mentally disabled adults). ESSENTIAL DUTIES/FUNCTIONS: 'Stimulates a family living situation in the Home. 'Transports or facilitates residents' participation in day programs, scheduled employment, recreation,and social activities,etc..., according to their individual supported living plans. 'Provides and or facilitates specific training and/or experience towards goals and objectives specified in the residents' individual plans. 'Collaborates and works with family members, etc, to promote residents' progress towards goal attainment. *Communicates and maintains good and cooperative relations with parents, guardians, or advocates of the residents, support staff, and the public. *Participates in the assessment of the residents' community and independent living skills,and in the development of an individual plan based on the residents'particular needs and desires. 'Utilizes positive behavior management techniques to modify negative behaviors,as necessary. *Documents daily training conducted and progress towards objectives and goals using methods established by the Programs Coordinator. 'Completes and submits quarterly reviews of progress and other required reports in a timely manner. 'Reviews residents'records monthly to assure data is accurate, concise, and updated. 'Coordinates preparation of healthy menus, shopping lists, shopping, and cooking. *Maintains the Home and reports all problems to the Executive Director. *Manages household money in accordance with Agency approved procedures. 'Monitors and supervises personal hygiene, clothing care and repair. 'Monitors and supervises medication and its recording. 'Makes and keeps appointments with doctors, dentists, counselors, etc 'Provides and/or facilitates regular recreational and social activities and opportunities per each resident's individual interests, needs and desires. 'Follows the procedures provided in the Group Home/Domiciliary Home policies in times of emergency, crisis and sickness. 'Supervises residents during the day when they do not attend their day programs, or when they are not scheduled to work because of illness, vacation, days off, etc "Maintains and facilitates the repair of Group Home vehicle. 'Maintains a neat, orderly, and safe work area. OTHER DUTIES/FUNCTIONS: *Provides training to Group Home Relief Managers. •Schedules Group Home Relief staff and submits schedules to Executive Director. "Checks Relief Managers' time cards for accuracy and submits in a timely manner. 'Attends staff meetings, conferences, and seminars as scheduled or assigned. 'Performs duties as assigned by Group Home Manager or Executive Director. WORKING CONDITIONS: Indoors except for times of social and recreational activities. Equipment Use: Group Home vehicle, all tools and equipment for cooking, cleaning, and running a household. Work Hours: 40 hours/week, Monday -Friday. Hours, times and days may vary due to Agency or Group Home need. JOB DESCRIPTION: Group Home Manager Page 2 Auk MENTAL DEMANDS: Duties require attention to detail, alertness, and use of judgment. Also requires mathematical ability and concentration. Must be able to work at high volume and stress levels. PHYSICAL DEMANDS: Transports residents to and from sites. COMMUNICATION DEMANDS: Frequent communication required with residents, families, support staff, and other Agencies serving each resident. Also requires written communication of reports. QUALIFICATION REOUIREMENTS: Skills/Knowledge: •Must have good written and oral communication skills. •Must have good organizational skills and work at high volume and stress levels. ,,, •Must have empathy, understanding, and respect for individuals with disabilities. Education/Experience: *High School diploma or equivalent,plus two years of college level courses or seminars, workshops or equivalent in the field of developmental disabilities,special education, rehabilitation or related field. •Must have one year supervisory or management experience 'Training in positive behavioral management preferred. Miscellaneous: •Valid driver's license and current clear driving abstract. •Current first aid and CPR certificate. •Physical examination and current clear TB skin test or chest x-ray within 12 months. •Submits completed criminal history form(must have a clear history)and domiciliary application. SALARY RANGE: Starting: $1,308.88/month After first Six months: $1,391.67/month After first year: $1,475.00/month($17,700/year) TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Group Home Relief Manager Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Group Home Manager, the Group Home Relief Manager is responsible for the overall operation of the Group Home during weekend days and emergency fill-ins. Adheres to Agency policies and procedures, and governmental Agency standards and regulations and assumes the civil rights of those resident consumers (physically and/or mentally disabled adults). ESSENTIAL DUTIES/FUNCTIONS: *Stimulates a family living situation in the Home. •Transports or facilitates residents'participation in day programs, scheduled employment, recreation, and social activities, etc...,according to their individual supported living plans. *Provides and or facilitates specific training and/or experience towards goals and objectives specified in the residents' individual plan. *Collaborates and works with family members,etc, to promote residents' progress towards goal attainment. *Communicates and maintains good and cooperative relations with parents, guardians,or advocates of the residents, support staff, and the public •Participates in the assessment of the residents' community and independent living skills, and in the development of an individual plan based on the residents' particular needs and desires. *Utilizes positive behavior management techniques to modify negative behaviors,as necessary. •Documents daily training conducted and progress towards objectives and goals using methods established by the Programs Coordinator. *Assists Group Home Manager in completing required reports in a timely manner. •Coordinates preparation of healthy menus, shopping lists, shopping, and cooking. Manager. the Home and reports all problems to the Group Home *Manages household money in accordance with Agency approved procedures. •Monitors and supervises personal hygiene, clothing care and repair. *Monitors and supervises medication and its recording. •Makes and keeps appointments with doctors, dentists, counselors, etc *Provides and/or facilitates regular recreational and social activities and opportunities per each resident's individual interests, needs and desires. *Follows the procedures provided in the Group Home/Domiciliary Home policies in times of emergency, crisis and sickness. *Supervises residents during the day when they do not attend their day programs, or when they are not scheduled to work because of illness, vacation, days off, etc *Maintains and facilitates the repair of Group Home vehicle. *Maintains a neat,orderly, and safe work area. OTHER DUTIES/FUNCTIONS: *Attends staff meetings, conferences,and seminars as scheduled or assigned. *Performs duties as assigned by Group Home Manager or Executive Director. WORKING CONDITIONS: Frequently indoors except for times of social and recreational activities. Equipment Use: Group Home vehicle, all tools and equipment for cooking, cleaning, and running a household. Work Hours: Two 16 hour shifts, Saturday and Sunday. Hours, times, or days may vary due to Agency or Group Home needs. • • JOB DESCRIPTION: Group Home Relief Manager Page 2 Ark MENTAL DEMANDS: Duties require attention to detail, alertness, and use of judgment. Also requires mathematical ability and concentration. Must be able to work at high volume and stress levels. PHYSICAL DEMANDS: Transports residents to and from sites. COMMUNICATION DEMANDS: Frequent communication required with residents, families, support staff, and other Agencies serving each resident. Also requires written communication of reports. QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must have good written and oral communication skills. •Must have good organizational skills and work at high volume and stress levels. *Must have empathy, understanding, and respect for individuals with disabilities. Education/Experience: *High School diploma or equivalent,plus some college level courses or their equivalent. Miscellaneous: •Valid driver's license and current clear driving abstract. •Current first aid and CPR certificate. •Current physical examination and current clear TB skin test or chest x-ray within 12 months. •Submits completed criminal history form(must have a clear history) and domiciliary application. SALARY RANGE: Starting: $100.00/day After first Six months: $100.00/day After first year: $100.00/day TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended, or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected — of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Operations Manager STATUS: Regular,Full-time PRIMARY PURPOSE: Under the direction of the Executive Director,the Operations Manager manages and oversees the activities of the vocational training supervisors, bus drivers, bus aides, van drivers and other employees of Kona Krafts as designated by the Executive Director. ESSENTIAL DUTIES/FUNCTIONS: • Coordinates and oversees Keakealani janitorial and landscaping service crews. • Coordinates and oversees transportation services for consumers of Kona Krafts programs and the school bus routes. • Coordinates and oversees all mobile or fixed janitorial and landscape service crews. • Develops task organization, analysis, and industrial standards. • Ensures that consumers are tested twice yearly with respect to performance vs. industrial standards and assists in establishing pay rates. • Checks employee and consumer time cards for accuracy. • Bids on projects for the yard crew,janitorial crew, and nursery. • Facilitates and coordinates repair/maintenance requests. • Supervises the cement pots production, quality control, and sales. • Supervises nursery operations, appearance, and sales. • Provides customer service for cement pots/nursery sales. OTHER DUTIES/FUNCTIONS: • Performs duties as assigned by Executive Director • Maintains a neat, orderly, and safe work area. • Attends staff meetings, seminars, conferences as assigned or scheduled. • Promotes positive morale and motivation among staff. • Promotes a professional and positive image to consumers and the public. WORKING CONDITIONS: Indoors under office conditions and various other conditions. Outdoors under various conditions when supervising mobile and fixed crews. Equipment Use: Van,truck, various janitorial and landscape maintenance tools, equipment and supplies. Work Hours: 8:00 a.m. -2:00 p.m., Monday-Friday. Hours,times, or days may vary due to Agency needs. MENTAL DEMANDS: Duties require working to a flexible routine. Occasional writing and mathematical abilities are required. Duties require knowledge of basic repair work. JOB DESCRIPTION: Operations Manager Page 2 PHYSICAL DEMANDS: Requires pushing,pulling, lifting, and carrying up to 50 pounds. Also requires driving consumers and/or other employees to community sites. COMMUNICATION DEMANDS: Requires frequent communications, oral and written, with customers,contractors of Kona Krafts services, employees and consumers. (Note: Some consumers are non-verbal). QUALIFICATION REOUIREMENTS: Skills/Knowledee: Previous experience in the field. Must have empathy, understanding, and respect for individuals with disabilities. Education/Experience: High school diploma or equivalent. Experience in landscape maintenance,janitorial services, equipment maintenance and repair. AMI , Experience working with persons with disabilities. SALARY RANGE: Starting: $10.00/hour After first Six Months: $10.50/hour After first year: $11.00/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as deemed necessary. A probationary evaluation will be completed as deemed necessary by the Executive Director. After six months,the employee will be advised whether the probationary period has been successfully completed,probation has been extended or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona communityfor over three decades. As a member of ARC, we are committed to securing for all people with mental retardation/developmental disabilities the opportunity to choose and realize their goals of where they learn, work and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Bus/Van Driver Revised: 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Executive Director, but must work closely and cooperatively with the Office Manager and School Bus/Van Aide. The Bus/Van Driver provides transportation for school age special education students with developmental disabilities. Transportation includes: to and from school, and/or to and from work sites. ESSENTIAL DUTIES/FUNCTIONS: *Controls bus and passengers. *Adheres to maintaining transportation schedules,pickup and drop off times and points for each individual riding the bus. *Adheres to and maintains safety standards as established by State of Hawaii Department of Licensing and Kona Krafts. *Works closely with Bus Aide to insure that all riders are safe, secure and posing no risk to themselves or other riders. *Oversees performance of Bus Aide and provides necessary constructive feedback. *Conducts daily pre-trip inspection reports and records daily passenger attendance. •Completes all required paper work and time cards and submits to Office Manager in a timely manner. *Records trip information in "Trip Logs" and Attendance sheets. *Completes written incident reports following procedures in Manual. *Cooperates with other Bus Drivers and Office Manager to coordinate/facilitate accommodation of new and current passengers. •Communicates with parents and teachers regarding schedules, pick up and drop off times and points, and special needs of passengers. *Facilitates and coordinates routine maintenance and repairs of buses/vans. *Notifies Executive Director and Office Manager of any problems with buses/vans. *Notifies office of traffic and other delays so that parents/teachers can be notified as necessary. *Follows procedures set by Executive Director,Department. of Accounting&General Services and/or Department of Education in cases of accident,emergency,or injury. 'Maintains an orderly, neat, and safe work area. OTHER DUTIES/FUNCTIONS: •Participates in scheduled in-service training to improve driving and related skills. *Promotes a professional and positive image to passengers and the public. *Performs duties and follows rules and regulations as stipulated by Executive Director. WORKING CONDITIONS: Driving the bus in various weather conditions. Equipment Use: School Bus or Van, safety belts, car seats, wheelchair lift, wheelchair locks and tie downs,fire extinguisher, telephone Work Hours: 6:OOam-8:30pm, 2:00-4:OOpm., School days, Monday to Friday. Hours, times, or days may vary due to Agency or transportation needs. MENTAL DEMANDS: Duties require alertness, attention to detail, and use of judgment. Also requires ability to concentrate under noisy conditions. Some mathematical ability required. .. - oawiet. i1.n.ewY.i. .. ., W :.:.: .. a-.:..uu, 4 u , ' wxrv;=.e...,.„..... ..:.r,....,x.., - w• • JOB DESCRIPTION: Bus/Van Driver Page 2 PHYSICAL DEMANDS: Frequent or continuous sitting while driving. Must be able to visually check for traffic situations. May require pushing/pulling of 150 pounds when assisting passengers in wheelchairs. May require lifting of 50 pounds when assisting passengers into and out of car seats. COMMUNICATION DEMANDS: Frequent communication required with passengers (some non-verbal), parents, and teachers regarding schedules, pick up and drop off times and points. Occasional oral communication with mechanics when facilitating bus/van repairs and maintenance. Occasional composition of written incident reports. QUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must have empathy,understanding,and respect for individuals with disabilities. ,,,, Education/Experience: •Prior experience in field of work. • *Participation in Driver Improvement programs/classes Miscellaneous: *Valid and current Commercial Drivers License *Current PUC Medical certificate •Current and clear driving abstract. Amok •Current First Aid and CPR certificate •Current and clear criminal abstract •Current TB clearance SALARY RANGE: Starting: $7.25/hour After first Six months: $7.75/hour After first year: $8.25/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended, or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." oft Signed: Date: KONA KRAFTS Job Description JOB/POSITION TITLE: Bus/Van Aide Revised 10/95 STATUS: Regular, Part-time PRIMARY PURPOSE: Under the direction of the Executive Director, but must work closely and cooperatively with the Bus Driver and Office Manager. The Bus/Van Aide supervises and assists special education and developmentally disabled passengers. Manages behavior of passengers in a positive non-abusive manner. ESSENTIAL DUTIES/FUNCTIONS: •Controls passengers at all times. *Works closely with the Bus Driver to ensure that all passengers are safe, secure, and posing no risk to themselves or other passengers. *Loads and unloads passengers safely. •Operates a wheelchair lift system and supervises assistive device usage. *Assigns specific seats to riders and manages seating. *Sits in a seat where all riders can be seen and managed. *Manages behavior of passengers in a positive, non-abusive manner. *Determines the special needs of passengers. *Communicates effectively with passengers, parents,and teachers. *Makes sure passengers are met by a specified adult when dropped off after school. *Assists in emergency management. *Follows procedures set by Executive Director,Dept. of Accounting&General Services and/or Department of Education in cases of accident,emergency, or injury. *Assists Driver in facilitation of regular maintenance/service as required. •Promotes a professional and positive image to consumers and the public. *Maintains a neat, orderly and safe work area. OTHER DUTIES/FUNCTIONS: •Assists Driver in completion of written incident reports. *Completes and submits paperwork and time cards in a timely manner. *Participates in scheduled in-service training to improve Aide skills. • Performs duties and follows rules as stipulated by Executive Director. WORKING CONDITIONS: Riding in a bus and assisting passengers in various weather conditions. Equipment Use: Safety belts, car seats, wheelchair lifts, wheelchair locks and tie downs, fire extinguisher. Work Hours: 6:OOam-8:30pm, 2:00-4:OOpm., School days, Monday to Friday. Hours, times,or days may vary due to Agency or transportation needs. MENTAL DEMANDS: Duties require alertness and use of judgment. Also requires some mathematical ability and concentration. PHYSICAL DEMANDS: Frequent or continuous sitting and standing. Occasional lifting of up to 50 pounds when assisting passengers in and out of car seats. Occasional pushing/pulling of up to 150 pounds when assisting passengers in wheelchairs. Must be able to visually check on safety and needs of passengers. • • JOB DESCRIPTION: Bus/Van Aide Page 2 COMMUNICATION DEMANDS: Frequent communication required with passengers (some non-verbal),parents,and teachers. OUALIFICATION REQUIREMENTS: Skills/Knowledge: •Must have empathy,understanding,and respect for individuals with disabilities. •Must be able to communicate with developmentally disabled passengers. •Participation in Aide improvement programs/classes. Miscellaneous: •Current First Aid certificate and understanding of emergency procedures. *Current and clear criminal abstract. •Current TB clearance. SALARY RANGE: Starting: $5.25/hour After first Six months: $5.50/hour After first year: $6.00/hour TRAINING: The employee is subject to a six month probationary period. An interim evaluation will be completed as the three month interval. A probationary evaluation will be completed at the six month interval. At that time, the employee will be advised as to whether probation has been extended,or whether other administrative action will be taken. As a United Way Agency, Kona ARC has been serving the Kona community for over three decades. As a member of ARC we are committed to securing for all people with mental retardation/ developmental disabilities the opportunity to choose and realize their goals of where and how they learn, work, and play. "I have read this job description and understand those duties and responsibilities that are expected of me." Signed: Date: Kona Krafts Application for Nonprofit Fund Grant Page 3A B. HUMAN RESOURCES: 8. Please share information on training opportunities provided to staff and/or volunteers. • Staff receive a minimum of two training events per year. • Board training and orientation package is being developed by an ad hoc committee 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenge. As always, we are constantly asked to provide more services with less staff. In addition, program participants that are now being referred have significantly more severe mental and physical handicapping conditions. We are exploring new staffing directions, obtaining federal medicaid waiver funding, and researching new sources of grants and funding. 10. See attached job descriptions. BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Kona Association for Retarded Citizens, dba: Kona Krafts Page#4 C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the agency's mission) for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the number "1" to the most important and dominant service or target population. educational victims of crime culture & arts victims of health crises the poor victims of social crises youth 2the physically disabled the aged 1the mentally or emotionally disabled co ro 4 -i x 4 d z z - x 0 i c = w o w �o .° o a x AD CD CD CO O N ...„5.` `T7 to to 7 �' CO c C . A, = fp Qj tD CD \0 v t4 0 O 'tt x A) CO w -t. t1t� C O �. �• .1 O 'E a = Co CO eti fp co co v, 0 "t .- 4. P o F S cr C) co C) co C) n .1 .-0 et A' n A; a 0 n co ;moi _. r�-r CD N CC 0000. b_ ›. �' N AD ' Co,. - a `t' - _ =. -. - - _ coo o 8 R N ON >1 y fa O, N D cn LA 0 cc) rn CA c a fK 'Q 0 " - v ° o Go `< o ° o ri 0 F = A) a co q r w cn +-r 00 to .Q. w J •4 AD et, �c k< k< ca ca ca ca ca co ca ca ca ca .1.a i 0 Kona Krafts Application for Nonprofit Fund Grant Page 4A C. BOARD OF DIRECTORS 1. See attached listing of Board of Directors. 2. In the past year, there were 12 Board meetings and one Emergency meeting. Attendance totaled 101 members. Divided by 11 directors/officers, this equals 7.77 members per meeting—rounded to 8 members or 72 per cent. 3. According to the bylaws, the number of directors shall consist of not less than five nor more than 25 members. 4. The following are the major decisions made by the Board of Directors and actions taken or plans made to implement the decisions during the past year: • (01-09-95) In an effort to update and modernize the bylaws and mission statement, an Ad Hoc committee was selected and revisions made. The revised bylaws and mission statement were adopted by the Board on 06-15-96. • (06-15-95) In an effort to establish long range plans and goals, the Projects and Planning Committee was established. A survey was written and distributed to consumers, employees, parents, staff, and community members. • (06-15-95) In a fund raising effort, establishing a Friends of Kona Krafts was suggested. Members of the community are being contacted by the board to establish an "auxiliary-like" organization that will assist Kona Krafts. • (07-20-95) The Board decided to pursue application for Medicaid Waiver to secure funding for Kona Krafts. • (09-21-95) In an effort to secure a bank loan when the Executive Director is not available, the Board suggested and passed an amendment. The amendment states, "...that any two: president, vice president, treasurer, secretary, and executive director are authorized to borrow money in such an amount not to exceed in the aggregate at any one time, outstanding principal sum of $50,000." • (12-06-96) The Board decided to change the Executive Director's status to that of an employee rather than on a contractual basis. The same terms of compensation and fringe benefits as had been in existence were maintained. • (12-21-95) The Board decided not to submit a bid for student transportation contract due to the terms of the contract. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. Address a financial shortfall in programmatic areas by: • Obtain alternate funding through Medicaid Waiver by participating in a partnership with the Department of Health and Bethphage Mission Pacific, Inc. • Develop community/family resources in this area through a plan of building a "competent community" Kona Krafts Application for Nonprofit Fund Grant Page 4B 6. List planned improvements (to meet the agency's mission) for the coming year. • The Board of Directors to complete long range planning and produce a written, measurable plan. 7. What long range plans does the Board of Directors have for the agency? • A Projects and Planning Committee has been formed. They are developing a long range plan through communication and input with the community. FUNDING NEEDS DIVIDER SHEET AGENCY NAME: Kona Association for Retarded Citizens, dba: Kona Krafts Page#5 E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. Proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question#5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question#7, what is the formula used to determine this amount or percentage? Kona Krafts Application for Nonprofit Fund Grant Page 5A D. FUNDING NEEDS: 1. Briefly explain the purpose of your request. The funds requested will help support the Adult Day Program and the Kona Krafts group home. The funds from other available sources do not meet the minimum basic needs of the persons with disabilities in the West Hawaii area. Hawaii ranks 50`1'in the United States in moneys spent on persons with developmental disabilities/mental retardation. Therefore, it is essential to supplement those sparse funds in order to assist our citizens in achieving the highest level of independence. This will assist in insuring that people who are unable to speak for themselves will have the opportunity to pursue life in the West Hawaii community as you and I do. They will be able to make choices in how they work, where they live, how their leisure time is spent, etc. 2. What alternative funding sources were considered and/or applied for? We have attempted to receive funding from the Department of Health and the Department of Vocational Rehabilitation. These funds are not sufficient to provide minimal supports for our"target" population. 3. What alternatives have you considered if this County request is not funded or is not fully funded? Although Kona Krafts is in the process of developing its capacity to be self- supporting, it will not attain this goal overnight. It must, for now, rely on the tried and true funding resources that currently exist. We are again turning to the County for support because, at present, the alternatives are limited. Without the funding which the County has historically granted us, we will be forced to reduce the costs attached to the program's operation by reducing staff. This will in turn affect the range and type of services we can provide and the numbers of consumers to which we can offer them. 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. Budget Form 1: • Line #1: The increase in budgeted contributions is caused by reduction in funding from State, County, and charitable sources. • Line #5: Reduction in grants from governmental has caused this variance. Kona Krafts no longer has the Partnerships In Community Living Program. We also suffered funding cuts for our Adult Day Program (Dept. of Health funding) by $1,100 per program participant per year (times 22 participants). • Line #7: Reduction is due to lack of support funds for transportation costs that was anticipated last year. • Line #9: Increase is based upon last year's actual figures. Kona Krafts Application for Nonprofit Fund Grant Page 5B Budget Form 2: • Line #1: Salaries have been reduced due to reduction in staff. This reduction has been the result of funding cuts. • Line #2: Reduction is relative to #1 above. • Line #18: Reduction is due to funding cuts. • Line #20: Increase is due to anticipated increase from requirement to provide lunch for federally funded Adult Day Health program. • Line #24: Increase based on increase in cellular phone costs in order to provide for the safety and health of program participants who have health and behavior concerns. • Line #29: Reduction due to program cuts. • Line #35: Increase is due to HUD funded building repairs required in coming year. • Line #37: Increase based on last year's actual figures and anticipated need for new program services. • Line#39: Increase is based on HUD funded training costs to send Office Manager to Oahu for several day training seminar in HUD financial/project management. • Line #40: Increase based on #39. • Line #41: Reduction is due to funding cuts. • Line#42: Reduction is due to loss of Student Transportation contract. • Line#43: Increase is due to HUD training costs - see#39. • Line #49: Loss of Partnerships Li Community Living Program caused this decrease in support funding. 5. Do you receive any income (subsidy)from a neighbor island or a parent organization? If so, how much? We receive no income or subsidy of this kind. 6. If you answered Yes to question#5, what is the formula used to determine the amount or percentage? Not Applicable. 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? No. 8. If you answered Yes to question#7, what is the formula used to determine this amount or percentage? Not Applicable. PROGRAM INFORMATION DIVIDER SHEET AGENCY NAME: Kona Association for Retarded Citizens, dba: Kona Krafts Page#6 Program name: Adult Day Program & Kona Krafts Group Home Complete on program information for every program with County funding. (please paginate starting with page 1, page 6, etc.) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program (in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year? 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged, what are the rates for each specific program or service? Kona Krafts Application for Nonprofit Fund Grant Page 6A PROGRAM INFORMATION 1. Kona Krafts provides adults, challenged by developmental disabilities, mental retardation, mental illness, or physically handicapping conditions, opportunities for personal and economic growth. Exposure to and training in the major activities of life such as employment, use of leisure time, accessing community resources, home management, and personal care takes place on a daily basis at the facility, in the West Hawaii community and in the home environment. At the core of the program's services is our belief that "all persons, including those with disabilities, have the inherent right to full participation in all community activities" and it is with this vision in mind, that Our services are provided. Eligibility for Kona Krafts is usually determined by the size of our collective heart. 2. The target group which Kona Krafts has traditionally served has been children and adults with developmental disabilities and/or mental retardation, mental illness, and physical impairments. 3. A program plan is developed for each person by an interdisciplinary team which includes professionals in the field, staff, parents, family members, advocates, etc. Every effort is made to develop objectives which are distinctly measurable. 4. Program effectiveness is measured via the following: • Daily review and evaluation of training and services documentation by program staff • Quarterly review of consumer's progress toward meeting individual goals with consumer, parent, care provider, and program staff • Annual consumer/parent conferences and program plan reviews • Periodic review of agency services by Board of Directors 5. There is currently no other agency offering or providing vocational training for persons with developmental disabilities/mental retardation in West Hawaii. Bethphage Mission Pacific, Inc. also offers a residential group home program for five persons. With the five persons that Kona Krafts serves, this makes the capacity for all of West Hawaii ten persons who need any form of substantial support services in this area. This is far short of the available need in our community. 6. The following are the specific accomplishments for our program this past year: • Three program participants developed their own business which they pursued via open air markets in the community. By working other part time jobs (some at Kona Krafts), they are able to maintain independent living situations in the community. • Three consumers moved into independent living situations and away from home over a year ago. Through minimal ongoing support (not funded), Kona Krafts has managed to assist these individuals in their efforts to achieve the highest level of independence that they aspire to. Kona Krafts Application for Nonprofit Fund Grant Page 6B • Vocational, community, and other valuable life experiences were provided for individuals who would have not programming otherwise. • Remunerative employment was provided for twenty persons. 7. The unduplicated count for each program is as follows: Adult Day Program Kona Krafts Group Home last year actual 23 last year actual 5 this year estimate 22 this year estimate 5 next year estimate 22 next year estimate 5 8. The only program or service charge is $2 round-trip fee for bus service to Kona Krafts from anywhere in our service area. • 0 00 0 o O O .O N O 00 O O OI '"y GS ct 69 69 1 69 00 s9 VI 69 v9 00 Thrn r� y 0 N M (. A c ,c 69 EA EA CA N Q 6A rs, ,-, 4 a w 609 0 9 6 0 0 0`*o – v O HO o cn O Z a '0 o cn Cl, O F d rn 00 oo Cc' N o N w41O c. — N v c. U 69 69 69 69 a GSU CO O O O O Cr/ O O ON O O O O N 00 CA 69 6A C\ 0 69 Cr'. O '3 '4 O N W ti M o N O\ 00 N '4 ' 69 6q m 69 a Pr. 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W O a P~ Q Q Q W W C7 V 0 � ' = CU W !]� C]] W f� W CU Qi KONA LITERACY COUNCIL li APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996- June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: Kona Literacy Council NAME OF PROGRAM: Basic Skills Improvement at the Kai tua T.Parning Center Mailing Address: 75-5766 Kuakini Hwy. #703 City, State, Zip: _ Ka i lug-Kona , HI 96740 Telephone: (8 o 4 1 7 q-i tR n FAX: ( ) None Attach current Internal Revenue tax-exemption certificate 501 (c) 3 99 0215925 Amount allocated by the Hawaii County in 1995: $ n 0 % of Budget Agency Total Budget in 1995 $ /"11 3.g.;,2.(� Amount requested of Hawaii County in 1996: $ y c o o/0,D a ,�'3 % of Budget Agency Total Budget in 1996: $/g,jjg6: 00 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: Tan-ISe-, History of funding with the County of Hawaii: x New Applicant Participating agency since 19 Firm conducting and date of agency's last financial review or audit: NAME: Me1 nal Q wp119 Boyar, CPA DATIFebruary 14, 1994 • ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET KONA LITERACY COUNCIL Page #2 ORGANIZATION NAME: _ A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) ' 1. Agency Name: Geographic Area(s) Serve •d w ''• u, ,` Agency's Mission Statement: kinds of programs and services' ,' • agency provides. ` . 3, How do these services support the agency's mission? i' ' 4. ;Who is eligible for services? ' ,52' Provide an unduplicated count of the number of individuals served by the agency? List by program title. 17,:',.'' ,, *• `' " 6, What are the specific objectives of the agency(m quantitative terms, where possible)' p x , 4 "`',h '/ r :t t r # I. uo- ,,- p .+ n ,- ;.x „ r -' .,:.a yr r ',1-'''.1-..'-.,''.: -r ti `� ',1-Ioar do you evaluate prdgrants/services effectiveness, and who does'the evaluations ' ^� ; '• with to deliver agencyservices? 8. Whatother resources or providers do you coordinate Do you contract with these resources or providers? o How does this agency's services/programs vary from similar services/programs offered f� _,.:,!::,-,1:4'„ s. i R by�other agencies in the community? ,:.�{Yx �'�t',� ., }.v ZAP' -J 4 1 f ,„ t :,rtiak �`"' �„r' x ,:--s C. 4 i .,� ?:. .. ” r .'� ' %;:,,,,,,,;; ,'-'4 ° ! ' � � � thethis last ear. •� ` 10, `List specific accomplishments or challenges addressed byagencyy; , s, f ;k 11.. hoes the agency have membership dues? If so, list current rates by category(adult, .,'eT youth, honorary, etc.,.). h .112 Does the agency have a trade affiliation with a national or statewide organization? If.so, €b: what is the formula for national and/or state contributions and how often are dues paid? _".':k ':� ': - ` --: '. -:. s • ,,, 13. What benefits and/or services are provided to the agency by the national or statewide organization? ,: ,. >. F '��n C � .YP # .ye t 4, s �.}4 . a r t # , A. AGENCY PROFILE: 1. Agency Name: Kona Literacy Council Geographic Area Served: West Hawaii Agency's Mission Statement: The Kona Literacy Council's trained volunteer tutors provide free one-on-one, small group and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing and computation skills. The Kailua Learning Center was originally set up and funded from Sept. 1992 through August 1993 by a grant from the Department of Labor and Industrial Relations, ACT 68. Since then we have remained open through donations. 2. Briefly describe the kinds of programs and services the agency provides. The volunteer tutors at the Kailua Learning Center provide free: one-on-one reading instruction using Laubach and/or other materials to increase reading comprehension from the non-reading level through high school level; one-on-one computation skills instruction from arithmetic basics through algebra and geometry; preparation for passing the GED or Competency Based High School Diploma; computer-assisted learning which includes an Accent Improvement Program, Keyboarding, Reading Comprehension and Phonics Programs for adults and children, and a Spelling Program;English as a Second Language instruction for those students who cannot be accommodated in the ESL Classes; and the Laubach Tutor Training Workshop held twice a year. English as a Second Languages Classes which are supported by the Kona Community School for Adults are held at the Kailua Learning Center for two hours on Tuesday and Thursday mornings and for two hours on Monday and Wednesday evenings. There is open enrollment and no charge to the students. Previously, the Kona Literacy Council received a grant from the Hawaii Community Foundation for a Family,Literacy Program which held workshops for parents to help their children develop their reading skills. A Pre-employment Skills class for Pacific Rim ESL adults, sponsored by the Dept. of Labor& Industrial Relations&the Kona Community School, was held at the Learning Center. A grant from the Department of Education offered small group and one-on-one tutorial assistance to students who needed assistance with passing their GED or Competency Based High School Diploma, ESL students with no reading skills, and a bi-lingual ESL class for Spanish speaking adults. 3. How do these services support the agency's mission? The above literacy services support the Kona Literacy Council's mission of helping adults improve their basic reading, communication and computation skills, thereby enabling them to get better jobs, become more active community members, and life-long learners. Since 4. Who are eligible for services? Any adult, including immigrants, in the Kona\Kohala area who wishes to improve his/her basic skills is eligible for services. 5. Provide an unduplicated count of the number of individuals served by the agency? Since the Kailua Learning Center opened on September 1, 1992, we have had over 245 adults registered and taking part in the various literacy programs, 32 children and parents involved in last year's Family Literacy Project supported by the Hawaii Community Foundation, and over 50 ESL students in the two classes offered by the Kona Community School for Adults. There have been over 50 tutors and office help volunteering their services during this time. 6. What are the specific objectives of the agency(in quantitative terms, where possible? The specific objectives of the volunteer tutors of the Kona Literacy Council are to help students: raise their reading levels from 0 through 12; increase computation skills from arithmetic through Algebra and Geometry; develop communication, reading and writing skills of the ESL students; prepare adults for the GED exam;the Competency Based High School Diploma program;Fireman's test; driver's license test; and U.S. Citizen test. Some other personal goals of the students included; helping their children with their reading and homework; filing out job applications and other forms; learning to type and read the Bible. 7. How do you evaluate programs/services effectiveness, and who does the evaluation? A registration form was used as the initial testing instrument and the student was interviewed by the Student/Teacher Coordinator and goals were discussed in order to plan an appropriate study program and schedule. Materials used often had placement tests and/or assessment measures as part of the program. There were exercises to reinforce and assess understanding of learning materials and some method of monitoring results and advancing students were included in the print materials and software programs. All tutors have kept a folder up to date and recorded the date, number of hours and a brief record of materials and lessons covered and progress made by their students. The student/tutor coordinator compiled information about the students and tutors and submitted the information to Laubach International once a year. The English as a Second Language Class used the CASAS Assessment Tool as the formal testing implement administered by the ESL instructors. Reports were submitted three times a year to the Kona Community School for Adults. 8. What other resources or providers do you coordinate with to deliver agency services? Students are recommended by the Jobs Program- Department of Human Services, JobHelp Store (immigrants from the Pacific Basin)- Department of Labor & Industrial Relations, Kona Community School for Adults, Vocational Rehabilitation, Bridgehouse -West Hawaii Options for Living, Alternatives to Violence, Governor's Council for Literacy&Life Long Learning,West Hawaii Family Center, The Learning Center and Talent Search-University of Hawaii - Kona, and the public libraries. The Kona Literacy Council has received funds from many community organizations including the Rotary Club of Kona, West Hawaii Today, the Hawaii Hotel Association- Charity Walk, the West Hawaii Community Foundation, Sun Cablevision, GTE Hawaii Tel, Soroptomist, Keauhou Shopping Village, Kona Bridge Club, as well as donations from individuals. 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? The Kona Literacy Council is the only agency on the west side of Hawaii which trains volunteer tutors to provide one-on-one tutoring to adults using the Laubach method. The trained volunteer tutors assist students at the Kailua Learning Center and since January, 1995 at the Lehua Computer-Assisted Learning Center located in the Kailua-Kona Public Library. (The computer-assisted learning center at the library was funded for set-up , Oct. 1994 - Sept. 1995, by a grant under the Library Literacy Program, Title VI of the Library Services and Construction Act -LSCA.) Some students have participated at both locations, while most new readers prefer being tutored one-on-one in a more private atmosphere provided at the Kailua Learning Center. The Kailua Learning Center is opened from Monday through Saturday, from 10:00 a.m. through 6:00 p.m. plus 7:00 p.m. to 9:00 p.m. two nights per week for a total of 52 hours per week, while the Lehua Learning Center's two computers are available for adults using the basic skills improvement software twenty hours per week. 10. List specific accomplishments or challenges addressed by the agency this year. 1. Continued operating the Kailua Learning Center in a centrally located area. 2. Registered and entered 60 new students for one-on-one tutoring in reading, math, preparation for the GED and Competency Based High School Diploma,ESL, Typing and accent improvement. 3. Three Family Literacy Workshops enrolling 32 parents and children. • 4, Two Tutor Training Workshops training 14 new tutors. 5. 24 students participating in the morning and evening ESL classes. 6. Pre-Employment Skills Class for 5 Pacific Rim ESL Students. 11. Does the agency have membership dues? If so, list current rates by category. The Kona Literacy Council solicits membership dues of$10 per year. New tutors who attend the twice-yearly Tutor Training Workshop contribute $10 of a $15 fee toward membership. 12. Does the agency have a trade affiliation with a national or statewide organization? If so what is the formula for national and/or state contributions and how often are dues paid? $50 of the amount collected from the members of the Kona Literacy Council is sent to National Laubach Literacy Action for annual dues. 13. What benefits and for and/or services are provided to the agency by the national or statewide organization. The national organization provides newsletters, literature on recently completed research, literacy campaigns, etc. Printed matter and books to teach adult readers are also made available. The benefit of affiliation with such a reputable organization provides credibility to our organization and its efforts on the local level. On the national level, we are a part of a national lobby that represent the interests of a national literacy campaign. HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: KONA LITERACY COUNCIL Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? Yes No Being revised Date last revised: I rf y 3. Do your personnel policies contain an equal employment opportunity clause? k Yes No 4. Do you have a written job description? X Yes No Being revised Date last revised: /6111 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) X Yes No Being revised Date last revised: 1 q '1 9 6. Does the agency conduct regular evaluation of employees? Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. xNo change Increase in staff is projected Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. BOARD OF DIRECTORS EXECUTIVE DIRECTOR I � I CLERICAL STAFF r I I PROGRAM DIRECTOR TUTOR TRAINER TUTORS SPECIAL PROJECTS 13. HUMAN RESOURCES: (Questions 8, 9, and 10) 8. Please share information on training opportunities provided to staff and/or volunteers. All tutors of the Kona Literacy Council are required to attend a twelve hour Laubach Tutor Training Workshop which is held twice a year; in the spring and fall. They learn how to help a non-reader and a beginning reader using teacher's manuals and student workbooks titled Laubach Way to Reading, levels 1-4 and Challenger, levels 3-8. When they are matched with a student, the Student-Tutor Coordinator assists with asserting reading level and an appropriate learning program. The coordinator is also available for consultation and support and supplying additional material if needed. Three times a year, general meetings are held with time devoted to tutoring challenges. There have been workshops and a teleconference offered for further training. Office staff receive hands on training. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. The dedicated volunteers of the Kona Literacy donated 2,550 hours last year. We are constantly recruiting new tutors and office staff and offer tutor training twice a year to keep up with the demand for good volunteer tutors. Some of our volunteers are snowbirds, leave the Island or obtain full time employment, leaving us with vacancies to fill. We recruit new tutors by newspaper articles and word of mouth. The Kona Literacy Council is not seeking funds for paid tutors and office staffs 10. Please provide a description of the minimum qualifications for each position. All tutors and office help are volunteers and need to have a minimum of a high school diploma or its equivalence. Tutors need to successfully complete a twelve hour tutor training workshop and are requested to make a commitment of at least one hour per week. Office help must make a commitment of at least one four-hour shift pet week. Most of our volunteer tutors have had previous teaching experience and all our dedicated volunteer tutors and office staff desire to improve their community by giving the gift of literacy. BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: KONA LITERACY COUNCIL i (Page #4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challeng s. 6, List planned improvements (to meet the agency's mission) for the coming year. 7. What long i ange plans does the Board of Directors have for the agency? I) FOCUS OF PROGRAM FOR WHICH COUNTY GPANT I2v',t)t_iEST'E.L) Indicate the most applicable classification(s) in order of importance. Give the number "1" to the most important and dominant service or target population. 1 edrrcational 10 victims of crime culture & arts 9 victims of health crises the poor 7 _ victims of social crises 5 youth 4 the physically disabled 6the aged 8 the mentally or emotionally disabled C. BOARD OF DIRECTORS: 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. All directors shall hold office until their respective successors are elected. The directors are elected at each annual meeting of the Board of Directors. (See By-Laws of the Kona Literacy Council for details.) Executive Director: Ruth Lair 75-5766 Kuakini Hwy. #703 Kailua-Kona, HI 96740 Tel: 326-7252 Retired Civil Engineer President: Barbara Pombrio 74-4358 Ahiahi St. Kailua-Kona, HI 96740 Tel: 325-7488 Teacher Vice-President: Margaret Finch 75-6082 Alii Drive Kailua-Kona, HI 96740 Tel: 329-9682 Retired Teacher Treasurer: Sandra Fassbender 75-5865 Walua Road Kailua-Kona, HI 96740 Tel: 329-0667 Business Manager Secretary Brenda Natina P.O. Box 4716 Kailua-Kona, HI 96745 Tel: 329-1922 Teacher Advisory Board: Marge Fordyce P.O. Box 2059 Kealakekua, HI 96750 Tel: 322-6066 UH-WH Talent Search - Director Tahiria Foster P.O. Box 236 Honokaa, HI 96727 Tel: 775-7497 Head Librarian Malia Gerard 74-5605 Luhia St. Kailua-Kona, HI 96740 Tel: 329-2418 Advertising - Sun Cablevision James Lightner 75-5593 Palani Rd, St. B12 Kailua-Kona, HI 96740 Tel: 329-9333 Manager - Lanihau Center Dan Roudebush 77-6384 Halawai Kailua-Kona, HI 96740 Tel: 326-2025 Computer Advisor Debbie Ward P.O. Box 789 Kailua-Kona, HI 96745 Tel: 329-5585 Advertising - West Hawaii Today Angel Pilago 74-5565 Luhia St. C-4 Kailua-Kona, HI 96740 Tel: 326-2855 JobHelp Store - Employment Office 2. List number of board meetings held in the prior year and attendance levels. Meetings of Board of Directors, Advisory Board and general membership: Feb.2, 1995 - 10 in attendance; May 25, 1995 - 14 in attendance; Oct. 26, 1995 - 8 in attendance. 3. According to the bylaws, how many directors must serve on the board? According to the bylaws, "The number of directors of the corporation shall not be less than three." 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. A. Continue leasing space at the Alii Sunset Plaza to use as a learning center and administrative office. B. Write grants for funding to GTE, Hotel Charity Walk, West Hawaii Foundation, Family Literacy - Hawaii Community Foundation, All State, Anheuser Busch, Chevron, and County Funding. C. Public Awareness speeches, for soliciting of funds and recruitment of volunteer tutors at Rotary, RSVP, Kona Bridge Club, Soroptomist. D. Conferences with community agencies to recruit students at JobHelp Store, Dept. of Labor& Industrial Relations, JOBS - Dept. of Human Services, Kona Community School for Adults, W. Hawaii Family Center, Bridgehouse, Alternatives to Violence, Vocational Rehab. E. Promote Kona Literacy Council by participating in the annual King Kamehameha Day Parade, Kona Coffee Festival Parade, 4th of July Parade, Community A-Fair, Festival of Christmas Trees, Hotel Charity Walk. F. Plan a rummage sale. G. Offer volunteer tutors of the Kona Literacy Council to work at the Lehua Learning Center- A Computer-Assisted Program at the Kailua-Kona Public Library after Title IV of the Library Services and Construction Act funding ended in Sept., 1995. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. The main challenge for the coming year is to keep open the Kailua Learning Center so that we can continue to help break the illiteracy cycle in our community. We will continue to write grants, solicit donations and participate in fund raising projects. 6. List planned improvements(to meet the agency's mission) for the coming year. A. Create greater awareness of services offered by the Kona Literacy Council and the Kailua Learning Center through direct solicitation of employers, civic organizations, labor unions, social service agencies, churches, health care providers, media, entertainment & community events. B. Continued leasing of space at the Alii Sunset Plaza to use a learning center and administrative office. C. Continue staffing the Kailua Learning Center from 10:00 am to 6:00 pm, Monday through Saturday. D. Increase development efforts for funding by soliciting corporations, foundations, direct mail, selling books, etc. E. Expansion of programs to reach more non-reading adults and meet anticipated goals of new readers. F. Help break the illiteracy cycle by providing more family literacy activities. G. Expansion of lending library to include videos and read along tapes. H. Acquisition of more basic skills software. I. Acquisition of air-conditioner and VCR to replace broken equipment. J. Acquisition of basic office supplies; i.e. toner and paper for copier machine, letterhead paper and envelopes, brochures, stamps, etc. K. Increased collaboration between existing agencies. 7. What long range plans does the Board of Directors have for the agency? The long range plans of the Board of Directors of the Kona Literacy Council is to keep open the Kailua Learning Center in order to continue to improve the basic skills of adults, including the foreign born, by offering free one-on-one tutoring. PROGRAM INFORMATION DIVIDER SHEET Agency name: KONA LITERACY COUNCIL (Page 6) Program name: Basic Skills Improvement at the Kailua Learning Center Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When-were these rates last changed? PROGRAM INFORMATION 1. How does the program help individuals, groups and/or the community? The Kona Literacy Council's trained volunteer tutors provide free one-on-one, small group and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing and computation skills. 2. Who is the target population for this program? Any adult, including immigrants, living in West Hawaii who wishes to improve his/her basic skills is eligible for services. 3. What are the specific objectives of the program (in quantitative terms, where possible)? The specific objectives of the volunteer tutors of the Kona Literacy Council are to help adult students: raise their reading levels from 0 through 12; increase computation skills from arithmetic through Algebra and Geometry; develop communication, reading and writing skills of the ESL students; prepare adults for the GED exam; the Competency Based High School Diploma program; Fireman's test; driver's license test; and U.S. Citizen test. Some other personal goals of the students included: helping their children with their reading and homework; filing out job applications and other forms; learning to type and read the Bible. Most of the 250 students who have studied with the volunteer tutors have made remarkable progress in their basic skills and self esteem thereby improving their lives and becoming better family members, workers and community members. 4. How do you evaluate program effectiveness, and who does the evaluation? A registration form was used as the initial testing instrument and the student was interviewed by the Student/Teacher Coordinator and goals were discussed in order to plan an appropriate study program and schedule. Materials used often had placement tests and/or assessment measures as part of the program. There were exercises to reinforce and assess understanding of learning materials and some method of monitoring results and advancing students were included in the print materials and software programs. All tutors have kept a folder up to date and recorded the date, number of hours and a brief record of materials and lessons covered and progress made by their students. The student/tutor coordinator compiled information about the students and tutors and submitted the information to Laubach International once a year. The English as a Second Language Class used the CASAS Assessment Tool as the formal testing implement administered by the ESL instructors. Reports were submitted three times a year to the Kona Community School for Adults for review. 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? The Kona Literacy Council is the only agency on the west side of Hawaii which trains volunteer tutors to provide one-on-one tutoring to adults using the Laubach method. The trained volunteer tutors assist students at the Kailua Learning Center and since January, 1995 at the Lehua Computer-Assisted Learning Center located in the Kailua-Kona Public Library. (The computer-assisted learning center at the library was funded for set-up , Oct. 1994 - Sept. 1995, by a grant under the Library Literacy Program, Title VI of the Library Services and Construction Act - LSCA.) Some students have participated at both locations, while most new readers prefer being tutored one-on- one in a more private atmosphere provided at the Kailua Learning Center. The Kailua Learning Center is opened from Monday through Saturday, from 10:00 a.m. through 6:00 p.m. plus 7:00 p.m. to 9:00 p.m. two nights per week for a total of 52 hours per week, while the Lehua Learning Center's two computers are available for adults using the basic skills improvement software twenty hours per week. 6. List specific accomplishments of this program last year. 1. Continued operating the Kailua Learning Center in a centrally located area. 2. Registered and entered 60 new students for one-on-one tutoring in reading, math, preparation for the GED and Competency Based High School Diploma, ESL, Typing and accent improvement. 3. Three Family Literacy Workshops enrolling 32 parents and children. 4. Two Tutor Training Workshops training 14 new tutors. 5. 24 students participating in the morning and evening ESL classes. 6. Pre-Employment Skills Class for 5 Pacific Rim ESL Students. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual 60 one-on-one 30 ESL classes this year estimate 65 one-on-one 35 ESL classes next year estimate 70 one-on-one 35 ESL classes 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? All services are free to the student. If books are used, and the student cannot afford them, Kona Literacy Council pays for the books. B. When were these rates last changed? It has always been the policy of the Kona Literacy Council to provide free services to the students. A 0 4 ,-4 61 % -4) ik 4 4 A? 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Q 4C2 C, v� Fes- O g zw FA , • a w z z � w Q w C 0< - m N N M r� °M° d Cv 0 t o w -1 - p 1 1 Oz1 0 ( o AIL' * . k N 0 N a 41 t, t-- 4c 1 a q . �� Ss-I ft 'ZI c 4 m ‘t(ri ..oi Z waw zz I- gcd ° z ° X 2 ° W o o `" a 7 w v4 '' VA z x ° 5a e � > 3 H OU o x0 • I < d d O � < H w I- 04 14 U a N (", !t kr, .0 Vl V1 Vl Vl or, Vl 0/ V Y in QJ t., 140 O o` ftwo w z w441 A A oa z 44 Uillib Z N 1 ,.. 0 �' c,, Maw E'' � 1Z)V � r w � C:2) o1 y QJ H F�1 y O Zi Nii.., N i C/D N ,, 4IT Oa 0 U o c, C7 B O0 V o o gellior W a rtlir o 0 a a v) O c W ¢• F- , t PATCH-P top chialdrentive APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996-June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: PAS, People Attentive to Children NAME OF PROGRAM: Child Care P snurrP nna Ppfarral Mailing Address: 78-6740 Alii Drive City, State, Zip: Kailua-Kona, HT 96740 Telephone: (808) 322-6818 FAX: ( 804 322-7407 Attach current Internal Revenue tax-exemption certificate 501 (c) 3 x Amount allocated by the Hawaii County in 1995: $ N/A N/A % of Budget Agency Total Budget in 1995 $ 1 ,658,603 Amount requested of Hawaii County in 1996: $ 10,086 .6 % of Budget Agency Total Budget in 1996: $ 1 ,582,909 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: July 1 , 1995 - .Tune 30, 1996 History of funding with the County of Hawaii: x New Applicant Participating agency since 19 Firm conducting and date of agency's last financial review or audit: NAME: Deloitte & Touche DATE: June 30, 199 5 ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: PATCH, People Attentive to Children Page#2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Geographic Area(s) Served: Agency's Mission Statement: 2. Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency(in quantitative terms, where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? ORGANIZATION INFORMATION SECTION(pages 2-8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: PATCH, People Attentive to Children Page #2 A. AGENCY PROFILE: (Answer on separate paper, staple to this divider sheet.) 1 . Agency Name : PATCH, People Attentive to Children Geographic Area (s) Served: PATCH serves the entire Island of Hawaii . Agency' s Mission Statement : The mission of PATCH is to improve the quality and availability of child care in Hawaii through education, demonstration and advocacy. 2 . Briefly describe the kinds of programs and services the agency provides . PATCH provides resources, counseling on how to choose child care, and child care referral services to parents. PATCH recruits, trains, and offers supportive services to child care providers through lending libraries and the USDA Food program. PATCH promotes "family friendly" policies with business and encourages their partnership in developing resources that will insure an adequate supply of child care providers to meet their work force needs . Further, through community awareness and advocacy PATCH assures that adequate community resources are focused on child care services and the needs of children, parents, and child care providers . 3 . How do these services support the agency' s mission? All of these services support the agency' s mission of improving the quality and availability of child care. For example, PATCH administers the USDA food program which is a partial reimbursement to licensed providers who serve nutritious meals . Serving nutritious meals and licensing improve the quality of care that children receive. The recruitment and training of child care providers, technical assistance and lending library materials for providers insure the availability of care for parents . Child care services are essential to insuring that an adequate work force exists to meet the needs of labor and business. Through public awareness campaigns and advocacy PATCH supports efforts that remove barriers that discourage persons from caring for children. This will increase the availability of child care. Page Two 4 . Who is eligible for services? Any parent (s) who is seeking child care or any person who is interested in becoming a child care provider or is presently providing child care is eligible for PATCH services . Classes are also open to the general public. 5 . Provide an unduplicated count of the number of individuals served by the agency. List by program title . Resource and Referral 1606 Recruitment of Providers 262 Training 322 USDA Food Program 72 Malihini Keiki Care 800 Outreach Activities 126 Total 3 , 188 6 . What are the specific objectives of the agency (in quantitative terms, where possible) ? The specific objectives of PATCH are to maintain a current and comprehensive data base of child care providers to meet the demands of parent (s) seeking care. This includes a well-trained and qualified listing of child care providers . 7 . How do you evaluate program/service effectiveness, and who does the evaluation? PATCH programs are evaluated through questionnaires and evaluations completed by the persons using the service. For example, upon the completion of a training class the participant is asked to complete a written evaluation. Questionnaires are included in all the packets that are sent to the parent (s) with a listing of available child care providers . Since the response rate on questionnaires is low, staff conduct follow-up phone calls to determine if the parent found care through a PATCH listing. The Department of Human Services evaluates our resource and referral services as these are contracted through a purchase of service contract . The Department of Education evaluates the USDA Food Program as they are the State' s lead agency for the disbursement of these funds . The PATCH Board of Directors is undertaking a major evaluation of PATCH' s resource and referral services in February of 1996 . 8 . What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? Page Three PATCH has coordinated services with The Institute for Family Enrichment who were offering training to child care providers. PATCH also coordinates services with the Hawaii Chapter of the Hawaii Association for the Education of Young Children. PATCH publishes a bimonthly newsletter and includes all known activities on the Big Island to persons having an interest in early childhood education and care . PATCH has a working agreement with the Food Bank that allows family child care providers who are also participating in the USDA Food Program to participate in their program. PATCH does not contract with other resources or providers . 9 . How does this agency' s services/programs vary from similar services/programs offered by other agencies in the community? PATCH is the only agency on the island of Hawaii offering child care resource and referral services. As such PATCH is the only agency maintaining a comprehensive data base of all child care providers on the island. PATCH is also the only agency offering training specifically designed for family child care providers and the only agency with an infant equipment lending library for providers . 10 . List specific accomplishments or challenges addressed by the agency this last year. PATCH has continued to serve the community which we consider a major accomplishment since our largest challenge was maintaining these services with 56% budget cuts on our state funded contracts. PATCH was forced to close their Hilo office and provide all Big Island services from their Kailua-Kona office. PATCH has just been granted a contract from the Governor' s Office of Children and Youth and this will allow us to re-open our Hilo office on February 1, 1996 . Our biggest challenge is to fund essential PATCH services in light of continuing State cutbacks . PATCH has also been challenged to increase their visibility in the community. We have just received grant monies that will allow us to produce an agency brochure and posters . 11. Does the agency have membership dues? If so, list current rates by category (adult, youth, honorary, etc. . ) . PATCH does not have membership dues. 12 . Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are Page Four dues paid? PATCH is a statewide agency. Presently the two Branch offices of PATCH on the Big Island are not financially supporting the overhead costs of PATCH on Oahu. 13 . What benefits and/or services are provided to the agency by the national or statewide organization? PATCH has a unique relationship with Child & Family Service that is unlike any other collaborative agreement in the State of Hawaii. In essence, PATCH is a subsidiary of Child & Family Service (CFS) . This agency provides accounting and human resource services to PATCH. PATCH maintains its own 501 (c) (3) status and Board of Directors which meets separately from the Board of CFS. PATCH is a member agency of Aloha United Way and Kauai Island United Way. PATCH is administered by an Executive Director from their home office on Oahu. HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: PATCH, People Attentive to Children Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? x Yes No Being revised Date last revised: June 1 , 1995 3. Do your personnel policies contain an equal employment opportunity clause? x Yes No 4. Do you have a written job description? x Yes No Being revised Date last revised: September 1995 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) x Yes No Being revised Date last revised: July 1 , 1995 6. Does the agency conduct regular evaluation of employees? x Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. No change Increase in staff is projected Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) Not Applicable 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. 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O O d MI O -a -1 O — co C -- + co C — 3 DI q — 3 + ,i — Dl CD CO f1 C7 7 + -11 OI 3 + -TI CD -. -+ -1 DI 3 CO -1 S. -,1 -I CD .-. n -I I •-. n 1 CD + CD -I CD Da NI -I D Dl Dl rn -+ N CD rn r- D1 CD M -a In 3 rn - .-. -a rn CD 'a 3 v + .+ vo .. vaa v .. o a N./ - •C a + .. a CD CD -a 3 -a N C .. C 7 3 •C CD -a CD N CD PATCH SALARIES - 1996 MONTHLY ANNUAL HOU= Executive Director $3 , 863 $46 , 359 $22.29 Training Services $2, 667 $32, 004 $15.39 Coordinator Program Specialist $1, 997 $23 , 964 $11.52 Program Coordinator $2,410 $28, 920 $13.90 Service Representative $1, 686 $20, 232 $ 9.73 Administrative $1, 840 $22, 080 $10.62 Secretary Program Secretary $1, 517 $18, 204 $ 8.75 Resource/Referral $ 8.50 Rep (20 hours) HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: PATCH, People Attentive to Children Page #3 7 . Please share information on training opportunities provided to staff and/or volunteers. Training opportunities for staff have been extremely limited due to the severe funding cuts that PATCH has received from the State in July of 1995 . PATCH does acknowledge that training is very important to the viability of an agency. PATCH staff are encouraged to attend training in their community that is offered free of charge . PATCH also encourages the staff to develop training opportunities collaboratively with other agencies . PATCH does not have voluntary staff on the Big Island. 8 . Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenge. PATCH employees were not covered under a retirement plan until December of 1995 when a 403 (b) plan was offered. Staff development continues to be a concern. Please see above section. PATCH is very grateful for the loyalty of their employees and that we have had no staff turnover on the Big Island for over two years . 10 . Please provide a description of the minimum qualifications for each position. (to be funded by this grant) Debra Worthing is the only person who would be funded under this grant . She is a high school graduate and is computer literate. She has been filling this position since October of 1993 . Prior to joining PATCH, she was a front desk manager for a hotel, worked in retail, and sold real estate. She has a marvelous ability to form positive working relationships with customers and her organizational skills and computer competency have made her a valuable employee of PATCH. This position requires a high school diploma, knowledge of parenting and community child care issues and resources, and two years of experience working with parents and interacting in a multi-cultural community. Page Two Computer data entry experience is also required. This person must be able to work independently and closely as a team. Excellent oral communication skills and the ability to think quickly when in conversation over the telephone are necessary skills. Ms . Worthing meets all of these requirements . BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: PATCH, People Attentive to Chi]dren (Page #4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the agency's mission) for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the number "1" to the most important and dominant service or target population. educational victims of crime culture& arts victims of health crises the poor 1 victims of social crises youth the physically disabled the aged the mentally or emotionally disabled PATCH Board of Directors Laurie Loomis (President), Attorney at Law Work: 524-5066 Law Offices of Laurie Loomis Fax: 531-3553 Pacific Tower #1300 1001 Bishop Street Honolulu, HI 96813 Term - 1/95 - 1/97 Lou Ann Wooddell (Vice-President) Ph: 262-7105 1541 Ulueo Street Kailua, HI 96734 Term - 1/95 - 1/97 Tom Ueno (Treasurer) Work: 591-0441 CPA Management Consultant Fax: 591-0813 844 Queens Street, Suite 307 Honolulu, HI 96813 Term - 1/95 - 1/97 Chris Jackson Work: 832-1958 Head Start Supervisor Fax: 832-2540 84-680 Kili Drive #302 Waianae, HI 96792 Term - 1/95 - 1/97 John McComas Work: 948-5093 Hawaii Medical Services Association Fax: 948-5055 Hui Kelu Street #3 Kanoeohe, HI 96744 Term - 1/95 - 1/97 Sheila Sumida Work: 525-8765 Vice President Fax: 525-5798 First Hawaiian Bank Human Resources Division P 0 Box 3200 Honolulu, HI 96847 Term - 4/94 - 4/96 Rob Welch Work: 543-8425 President and Chief Executive Officer Fax: 599-5711 Child and Family Service 200 N. Vineyard Boulevard, Building B Honolulu, HI 96817 Term - 1/95 - 1/97 Peggy Armstrong Work: 547-3126 Manager, Administrative Services Fax: 547-3145 BHP Hawaii, Inc. 733 Bishop Street, Suite #2700 Honolulu, HI 96813 Term - 1/95 - 1/97 Sharon Taba Work: 536-7702 Project Manager, Health & Education Fax: 528-2376 Collaboration Project Hawaii Medical Association 1360 South Beretania Honolulu, HI 96814 Term - 1/95 - 1/97 Fred Ferguson-Brey, Vice-President Work: 538-4562 c/o Hawaiian Trust Company, Ltd. Fax: 538-4693 P.O. Box 3170 Honolulu, HI 96802 Term - 1/95 - 1/97 LABELS\BODTERM.COM BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: PATCH, People Attentive to Children Page #4 C. BOARD OF DIRECTORS : (Answer on separate paper and attach. ) 1 . A current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations is attached. 2 . List number of board meetings held in the prior year and attendance levels . PATCH held ten Board meetings in fiscal year ' 95 and an average of 10 Board members attended. 3 . According to the bylaws, twelve (12) directors must serve on the board. 4 . List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. The Board of Directors made the following decisions : 1 . To diversify the funding base of PATCH a. Increase fee for service b. Develop a membership plan c . Continue the annual giving campaign 2 . Increase the visibility of PATCH a. Secure funding for a public relations campaign b. Conduct a marketing survey - results to assist in visibility campaign The following actions were implemented: 1 . Increase fee for service a. PATCH began charging for training classes b. PATCH began Malihini Keiki Care, a nanny service for hotel/resort guests c. Plans are being made to continue the annual giving campaign d. A membership plan is being developed 2 . Increase the visibility of PATCH a. Grant monies have been secured to produce an agency brochure and poster. b. A marketing survey is being conducted in February of 1996 Page Two 5 . Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. In the coming year the most foreseeable challenge is the continued decline in State funding. This past July PATCH lost 56% of their funding from their State Purchase of Service contracts. There are also concerns over the funding of the USDA Food Program from the Federal Government . The PATCH Board of Directors is committed to the continuation and growth of the agency. The strategies that are outlined above define how we will meet this challenge. 6 . List planned improvements (to meet the agency' s mission) for the coming year? PATCH is collaborating with the Professional Family Child Care Association to encourage the passage of legislation that will allow family child care in homes governed by covenants and restrictions . This will increase the availability of child care. We are also planning a public awareness campaign that will increase the visibility of PATCH and the importance of early childhood education and care. PATCH is also planning to increase training opportunities for child care providers . Recent research shows that training equates to increased quality care. 7 . What long range plans does the Board of Directors have for the agency? The long range strategic plan for PATCH includes : 1) Increasing the stability and availability of quality child care statewide for children from birth to 12 years. 2) Providing services to parents seeking care including consumer education from a current and comprehensive data base. 3) Encouraging connections with business and labor by providing support in determining work/family strategies and offering fee for service "enhanced referral . " 4) Diversifying the PATCH funding base. 5) Developing a public relations and marketing strategy that will increase the agency' s visibility and reputation as a premier provider of service . Page Three 6) Developing a Board Development program. 7) Collaborating with agencies that meet community needs innovatively. FUNDING NEEDS DIVIDER SHEET AGENCY NAME: PATCH, People Attentive to Chi]hren (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item,in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question#7, what is the formula used to determine this amount or percentage? FUNDING NEEDS DIVIDER SHEET AGENCY NAME:PATCH, People Attentive to Children (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach) 1 . Briefly explain the purpose of your request . PATCH is requesting monies to fund our child care resource and referral services in Kailua-Kona (West Hawaii . ) This program is presently funded through a purchase of service contract with the Department of Human Services (DHS) , State of Hawaii . During July of 1995 the State cut this contract by 56%, resulting in the closing of the Hilo office, a reduction of hours at the Kailua- Kona office, and the coverage of all services from the Kailua-Kona office only. The State' s economic picture has not improved and PATCH' s child care resource and referral purchase of service contract has the lowest priority for funding of all contracts at DHS. It is clear to PATCH that this contract will be cut further and, thus, services to the island of Hawaii will be cut . PATCH needs to find funding alternatives other than the State for this much needed program. Because PATCH has received funding from the Governor' s Office of Children and Youth through federal Child Care Development Block Grant monies, we are able to re-open the Hilo office. However, these monies became available on January 1, 1996, and continue only through December 31, 1996 . 2 . What alternative funding sources were considered and/or applied for? PATCH is a new applicant for Hawaii Island United Way funding. PATCH has also applied for funding to support operations through the Hawaii Hotel Association' s Charity Walk. 3 . What alternatives have you considered if this County request is not funded or is not fully funded? PATCH presently has an office in Kailua-Kona that serves West Hawaii and an office in Hilo that serves East Hawaii. If this County request is not funded or is only partially funded, PATCH will again consider closing the Hilo office as we did when we received 56% budget cuts from the State. PATCH would then center their operations in Kailua-Kona. Unfortunately, our experience over the past five months since closing the Hilo office has been a decline in utilization of our services and the recruitment of very few child care providers . Therefore, Page Two the number of child care providers has decreased and parents are unable locate child care. 4 . Give a brief explanation for any variances of 15% or greater per line item in the current vs . proposed budget . Not applicable If the agency is a part/branch of a larger multi-island organization please answer the following questions: 5 . Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? No. 6 . If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7 . Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? No. 8 . If you answered Yes to question #7, what is the formula used to determine this amount or percentage? PROGRAM INFORMATION DIVIDER SHEET Agency name: PATCH, People Attentive to Children (Page 6) Program name: Child Care Resource and Referral Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When-were these rates last changed? PROGRAM INFORMATION DIVIDER SHEET Agency name: PATCH, People Attentive to Children (page 6) Program name : Child Care Resource and Referral Complete on program information for every program with County funding. (please paginate starting with page l,page 6, etc . ) Answer questions 1-8 on separate paper and attach. 1 . How does the program help individual, groups and/or the community? This program helps persons who are employed, seeking employment or attending a training program who are in need of child care. These persons contact PATCH and a listing is made available to them of child care providers in their area who have vacancies . The resource and referral program representative also assists parent (s) in determining available child care options and how to select the best care for their child. Because of this service parent (s) are able to start and/or continue working without worrying about child care . Child care keeps Hawaii working. 2 . Who is the target population for this program? The target population is parent (s) seeking child care. 3 . What are the specific objectives of the program (in quantitative terms, where possible) /? The specific objective of this program is to maintain a current and comprehensive data base of early childhood education and care providers that will meet the needs of parents seeking such care. 4 . How do you evaluate program effectiveness, and who does the evaluation? Monthly utilization reports are evaluated. PATCH staff call the parents who have received listings from us to determine if they were able to locate care. 5 . How does this program' s content vary from similar (or same) programs offered by other agencies in the community? Page Two There are not other agencies offering this service in the State of Hawaii . 6 . List specific accomplishments of this program last year. PATCH completely computerized their child care resource and referral services. 7 . Provide information on the unduplicated count of this program' s beneficiaries : last year actual 1006 this year estimate 1800 next year estimate 2000 8 . If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program. ) A. When were these rates last reviewed? B. When were these rates last changed? PATCH does not charge a fee for this service. REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a grant, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accredited in accordance with applicable requirements of Federal, State and County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the services provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(a)(1). 5) Have by-laws or policies that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one year's experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity, by addressing educational concerns, culture and the arts, the needs of the poor, youth, the aged, those with physical or emotional disabilities,victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. Conditions for Grantees Page 8 A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance, the committees of the Council, their staffs, and the legislative auditor access to records, reports, files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. 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CO O O ..) 0 r C U) ... ., C C.) j O N N N a)ro E N id N O O 000 C J W a a) y 0 (� n 0) 'o 2 c al F2 H LU > a ° oa m 2 n o �c f) v o a)12 a m cin co ca ce a co w m o0 0 0 • u rn 5 E E o E a) O O o V To N 0) 0) C 0) '? o 0 '3 3 , (u W 2 O " o e c ((o co a) W w Q w a a` z a` can) 0 x 2 _ ce PATH-forrptrailsoHH cy APPLICATION FOR NONPROFIT FUNDS Fiscal Year Juty 1, 1996- June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SU MARY: ORGANIZATION NAME: PA-Tft 1 t c. ( PEcPE 5 %7 c# c / i Olt- NAME OF PROGRAM: `8r&is 1072_3(KE rJ��rL5 tf� c' � Mailing Address: RO- 6 Z City, State, Zip: -Koie 4 '6'7 Telephone: (gs) S 3 FAX: ( 3) T� S - S"S-r.6• Attach current Internal Revenue tax-exemption certificate 501 (c) 3 Amount allocated by the Hawaii County in 1995: $ 0 % of Budget Agency Total Budget in 1995 $ sf c / 4-0S Amount requested of Hawaii County in 1996: $ 65-, 4 9.0 7 % of Budget Agency Total Budget in 1996: $ y/, 4 S-4, This application for County of Hawaii non-profit grant finding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year History of funding with the County of Hawaii: New Applicant Participating agency since 19 Firm conducting and date of agency's last financial review or audit: NAME: DATE: ORGA.'vIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Ph- I II —1- n c - Page #2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) L . Agency Name: (5 c 4-�i It crt ED Geographic Area(s) Served: Agency's Ivfission Statement: 2. . Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title, 6. What are the specific objectives of the agency(in quantitative terms, where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? . 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the forrsula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? ORGANIZATION PROFILE ANSWERS PAGE 2 Organization Name: P.A.T.H. (Peoples Advocacy for Trails Hawaii) A. AGENCY PROFILE: Answers: 1. P.A.T.H. All schools aroun.:: the Big Island will be served by the Big Island Bike/Pedestrian Education Programs . Mission Statement To promote Bicycle Safety Education and a safe environment on roadways and trails for recreation, fitness, and alternative modes of transportation. 2. We provide a. Eike/ Pedestrian Safety Education Program at three grade levels. The levels are 1st, 4th, and 5th gn de.These programs provide students safety information and teach skills that are very important to children who are having first experiences in traffic situations. Our first grade program teaches bike/pedestrian safety skills that children face every day.Taking the bus, and areas around the bus, b:cycling on roadways and proper means of communization on roadways. The fourth grade pro`_am teaches hands on bike skills developed from the nationally recognized Program "Basics Bicycling". The fifth grade program reviews the lessons of the fourth grade program to find cut retained knowledge. PATH provides state, county, and community advocacy efforts toward de'-eloping safe places to recreate and alliterative modes of transportation. PATH is involved in ongoing community projects, including rra4 development such as the old Walua Road project. 3. To promote E:cyde Safety Education not only to the students but through safety information brought home for parents review enlightening parents on safety. Ongoing advocacy has help create greater awareness cf the need for a safe environment. 2 4. All first, fourth. and fifth grade students on the Big Island of Hawaii are eligible for programs at no cost to the pary_ts. 5. First grade e/Pedestrian Safety Procram teaches 2000 students. The fourth grade Bike Education Safety 1rogram teaches 2000 students. The fifth grade Review program teaches 2000 students. 6. The objectives of PATH are to promote bicycle safety education, to promote safe places to recreate and to promote alternative modes of transportation. These objectives are accomplished through individu_, community, county, and state advocacy efforts, and the Big Island Bicycle/Pedestrian_ Education Program in which over 6000 students participated in 1995. Additionally these objectives are accomplished via projects such as the Walua Road (trail) Project, the safety packet, helmet program, the Utility Corridor Project, all of which PATH is undertaking at this time. 7. By pre and pest written tests and by testing of specific safety instructions given by instructors during hands on instruction. Evaluation is done by instructors and reviewed by Program Coordinator. 8. We have worked with County, State and Federal agencies on funding of BIB/PEP with federal 402 safety funds, county bike registration funds and State STE-TEA funds. Resources include Mayors Advisory Committee, State Bike Coordinator, and County Council Members. The BIB/PEP is implemented in collaboration with Island wide schools. 9. There is no other organization on the Big Island involved in Bike/Pedestrian Safety Education to our knowledge. 10. The specdic accomplishments include bringing Safety Education to approximately 6000 students island wide, a program now in its fourth year of operation. Island wide promotion of 2 safety through se•:z-_1 events that encourage helmet use and proper "rules of the road" techniques, as well as fun and i_e recreating. Contracting with the county to develop the old Walua Road into a connecting trail __oviding an alternative route to Iturzkini Hwy for bicycle and foot traffic. 11. PA.T.H. has zual membership dues of: $12.00 for individuals and $20.00 per family. There are approximately 'j members in the organization island wide. Membership is an area targeted for development in 1.;':7-6. 12. PA.T.H. has no affiliation with any other organization. 13. not applicable 3 s j HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: p 7 - Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) ' 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? • V Yes V No Being revised Date last revised: Jbr 1°1'1 la 3, Do your personnel policies contain an equal employment opportunity clause? Yes No 4. Do you have a written job description? 1 Yes No . Being revised Date Iast revised: -T-A-^, NI q 5, Do you have written salary ranges for each job description? (If yes, attach salary ranges.) Yes No Being revised Date last revised: A r3 i.4.4 b 6. Does the agency conduct regular evaluation of employees? . V1/4 Yes No. v In the process of being developed 7. What is the staffing pattern in County, thnded programs for this year compared to next year?? Please provide a brief explanation. V No change Increase in staff is projected Decrease in staff is projected (Answer quesdona 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to eddresg the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. HUMAN RESOURCES ANSWERS PAGE 3 ANSWERS: 8. We train in_=.actors in "Adult Effective Cycling" so they will have good understanding of safety. Lesson clans are gone over with instructor for teaching purposes. Teaching experience with element_:grade level students a requirrnent. 9. PATH adop:rd Personnel Policies and revised job descriptions at its January 1996 Board meeting. The_e materials include salary ranges and staff evaluation forms and policies. The internal operons of PATH will improve with the addition of these tools. Centralized c=ce space will allow for greater access by staff and volunteers to PATH resources (computer, re-_ords, copy machine, phone, etc). Hiring of a r_ez staff position in March, that of Executive Director,will bring many challenges and greater resources to the PATH organization. 10. Minimum Q-.�. ifications for instructors position include: Knowledge of bicycles and some safety unders=nding on roadways for all instructors. Training in "Adult Effective Cycling" for instructors and experience teaching youth. For Program Coordinator: written and communicati= skills are a must. Coordinator must have fundraising and grant writing experience, e=erience in developing and administering a budget, experience in public affairs, legislative prz._esses and media relations, high personal integrity and energy and general management rperience,including the supervision of staff. 4 BOARD OF DIRECTORS DIVIDER.SHEET AGENCY NAME: P . - Al C-- (Page 44) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a currt listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to tz.e bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. S. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the agency's mission) for the coming year. 7. What long rangy plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most wplicable classification(s) in order of importance. Give the number "1" to the most important: and dominant service or target population. educational victims of crime culture & ars victims of health crises _ the poor __victims of social crises a youth __,_the physically disabled the aged the mentally or emotionally disabled Board of Directors Peoples Advocacy for Trails Hawaii February 1995 through February 1996 Officers: Barbara Bush,Pres dent (1995/96) P.O.Box 263, ILlua-Kona, HI 96745 (808) 328-8540 -n. 326-7400 bus. Vice President, K.awaii Island United Way Scott Sharpe, Past=resident (1994/95) 77-363 Sunset E ve,Kailua -Kona,HI 96740 (808) 3298033 l- n. Self Employed Toni Fortin Blair, Secretary C/O P.O.Box 6.. Kailua Kona, HI 96745 (808) 882-1428 =_m Retired Directors: Gerry Rott 75-240 Nani I a ua Drive, Ste# 8, Kailua-Kona,HI 96740 (808) 329-2991 -us. 334-0905 Owner, Gerry R.tt &Associates (Realtor/Broker) Linda Jane Kelley P.O.Box 1583, I .ilua-Kona,HI 96745 (808) 329-7327 =m. 329-3309 bus. Sales,B & L Bi _ & Sport Laura Mallory Sayre P.O.Box 1285, Kailua-Kona,HE 96745 (808) 329-8067 =us. 325-5456 hrn. Dental Hygienist Frank Sayre P.O.Box 1285, I .ilua-Kona,HI 96745 (808) 329-8067 _ss. 325-5456 him Dentist Ron Reilly P.O.Box 458, V=icano,HI 96785 (808) 967-8603 ==n. Kau Hospital L technician Marlina Lee 75-6052 Alli Dr_-e,Kailua-Kona, HE 96740 (808) 326-2582 '_-.is. 334-3000 hrn. Co-Owner,The Club rev.1/30/96 1. b.All terms are an__- al terms.Action will be taken on a bylaw amendment regarding adoption of three year rotatin`hoard terms at the 1996 annual meeting(3/96). 2. Board meetings were held as follows: February 1995 - 100°_ (annual meeting) March 1995 - 90% April 1995 - 70% May 1995 - 60% June 1995 - (no meet.:-..2) July 1995 - 50% August 1995 - 40% September 1995 - 70° October 1995 - 60% November 1995 - 90° December 1995 - 80° January 1995 - 100% 3. A minimum of 3 .=hectors. Action will be taken cr. a bylaw amendment at the 1996 annual meeting(3/96) regarding revision of number of board me-n= ers to be between 3 and 20. 4. The Board decide-i: A. To fund the Big Island Bike Educational Program through the 1995/96 school year from its reserves with a rr�:imal of outside funds. The major source ofEnding for the program for the school years 1993/94 and 1994/95 was 80% STIP (State Transponztion Improvement Project)monies matched by 20% County Funding through a contract with the County Public Works Department.These monies were no longer available to us as of • June 1995. The Board. decided to fund the program out of reserves and the$18,000. from the Parks and Recreation Depa_—=Hent on a current contract. (approximately 20% funding).An additional amount of$12,000 may Be available to PATH through the Motor Vehicle Safety Office(state) for partial • funding of this 1995/ 6 school year program. (These funds have not yet been released to PATH, decussions are in process.) B. To undertake the Walua Road Improvement Project in partnership with the county. The county contracted with PATH to develop the old Walua Road sections now unused by vehicular traffic into a passable _ail running parallel to Kuakini Hwy. The County offered $20,000. toward the 2 project. PATH is under;king to develop the trail with the help of community donations of goods and materials and volunteer skill and labor. C.To reorganize and =�:ccus its staff to better address the broad scope of PATH the PATH mission. In order to do this an Ex:zutive Director will be Hired in March 1996 and an office space will be opened in the Old Industrial area, Kailua-Kona. We anticipate these de`sions will offer PATH greater visibility which will lead toward improved community awareness and participation in the various projects, events and programs PATH offers to the community. We anticipate many c_: enges with these operational changes,including staff reorganization,program examination and evalt_a.zon resulting in potential changes to the programs, and improved internal operations. 6. The Board feels th :with the decision to develop the Executive Director position and central office location there will be :any improvements accomplished this year which will further enhance the PATH mission. Some of these Have been stated previously such as the development of greater community awareness and particir.z=on.For a group with an advocacy and educational mission, community involvement is critical. 7. To develop, fund =d implement the Executive Director position on an ongoing basis. To evaluate, enhance, and procure funding of Big Island Bike and Pedestrian Education Programs. To progress on the Road trail development, first phase to be completed in 1996. Discussions and planning to continue sc completion of the long range project can be accomplished within 5 years. To continue involverr_t- :in the Alli Drive Redesign Project.A project geared toward the design of Alli Drive once the Alli B—mss Road is undertaken. Currently PATH is involved in advocating for greater shoulder space (6'ea&._ _de)with the sewer and resurfacing project. 3 To develop a safety inf.:=nation and helmet program. Implementation of this program will be with the collaboration of retailers. schools and BIB/PEP To develop a Utility Cc odor program in collaboration with HELCO and the County. This will allow for use of the utility co=dors as trails and a means of transportation between points. 4 FUNDING NEEDS DIVIDER SHEET AGENCY NAME: PA-77-/- -LC.___ (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. . 2. •What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully . funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the • .. current vs. proposed budget. • • • if the agency is a part/branch of a larger multi-island organization, please answer the following questions: • 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If. so, how much? 6. if you answered Yes to question#5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization tO share • in operational expenses? If yes, how much? 8. If you answered Yes to question#7, what is the formula used to determine this amount or • . • . percentage? • • • • • • • FUNDING NEEDS PAGE 3 1. Our request is :For the county to continue support of a program that is into its fourth year. The purpose of our request .or funds is other sources of funding have been either exhausted or allocated to other projects. We have committed our incoming funds from fundraising and any new funding sources to continue programs. Our island has the highest farglity rate in the State for bicyclists and pedestrians and one of the highest in the country according to Federal Highway Safety Administration reports. Our purpose is to bring safety education to the children and families on our island. Education is our priority because of the immediate impact on road users. 2. We are currently securing Highway Safety 402 funds. We have a current contract with the County Parks and Rec. Dept. for $18,000 which expires in June 1996. We are also seeking corporate donations, from supplies to monetary sums. Our program continues to be supported from many sources,including PATH reserves. 3. We have always had county support in our effort to keep these programs viable. County support has enabled P.A.T.H. to secure other avenues of funding for the safety programs. We continually seek other alternatives for funding. Any support that the County can give in funding shows support and makes fundraising efforts a little easier. If we find that we have insufficient funds we may have to eliminate one more of our programs. P.A.T. H. has committed several thousand dollars in startup of programs and the continuation of these programs this past year. 4. The only variance would come in the way of realignment of organization and the need to Hire an Executive Director to administrate P.A.T.H. business. This employee would be responsible for P.A.T.H. business including administration of the three safety programs. We would eliminate the 5 position of Program _cordinator cutting that budget it= to lesser total amount based on executive directors total time spm t on programs. Extra responsibility would shift to lead instructor. G PROGRAM IN FORMATION DIVIDER SHEET Agency name: P A-771- _-,1 C (Page 6) ice. /PED657P/ Rt-ERT isr rin ) Program name: 1�' 1'& �5e -ADD IKr' �� �''= j14 lcic�e Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer question sl_8 on separate paper And attach. l • How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the prograrn(in quantitative terms, where possible)? . 4, How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar(or same) programs offered by other agencies in the community? 6: List.specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: • Inst year actual this year estimate next year estimate 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) • A. When were these rates last reviewed? B. Whet.were these rates last changed? PROGRAM INFORMATION PAGE 6 1. The program heIos individuals by giving much needed information and training to students who are having th first contact in traffic situations.These programs can save lives by equipping children with the necessary tools needed to avoid injury or death.The programs supply parents with information as what side of the road to ride a bike on (with traffic)which we have found most students get M rong on tests before given the safety programs.The programs through information sharir__and hands on training help to make the island a safer place for everyone. 2. The target p`emulation for the program is first, fourth, and fifth grade students around the island. Parents also receive safety information for review with students. 3. Teach Bike 'P edestrian Safety to children. Rules of the Road, safe bike handling skills, safety around and on the tus,wearing protective gear such as helmets, shoes and safety vests. 4. Program effcc veness is evaluated through pre and post tests in classrooms. Instructors in the hands on bike sa e v class test students (on course) to check skills learned during safety course. Review of tests is cine by program coordinator to check programs effectiveness. 5. This program:s the only one of its kind on the island. 6. Last year the B_:e/Pedestrian Safety Program taught safety to 6000 students on Hawaii Island. 7. Last year act-,:z.: ---- 6000 students and through hand outs their parents. This year esti-rte ---- 6000 Next year es`=ate 6000 8. Not applicable_ The BIB/PEP is offered free through the island wide schools. 8 REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a gra t, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accreted in accordance with applicable requirements of Federal, State and County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the s+e:•vices provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(a)(1). 5) Have by-laws or polices that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one years experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity,by addressing educational concerns, culture and the arts,the needs of the poor,youth, the aged, those with physical or emotional disabilities,victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. Conditions for Grantee page S A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance,the committees of the Council, their staffs, and the legislative auditor access to records, reports,files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. Policy limits shall be a minimum of$300,000 for bodily injury and $50,000 for property damage. 7) Purchase motor vehicle liability insurance in the 'minimum amounts of$100,000 for liability per person, per accident $25,000 for property damage; and$300,000 comprehensive, per occurrence. 8) Name the County as additional insured and file certificates of insurance or copies of the policies with the Department of Finance. Please refer to the attached Ordinance and the Hawaii County Code regarding grants to non-profit organizations. w o v ,r,-, O (n t I�� g I ix '.9 Iu C o .� 64 _ , 0. .z. W 0. ' Z z U o - WW v f o N rn r( m zo -1 � r \z ooo bo Zt`Io r:1*. 'J � N 2 V C �' J . a N .1 ' '4 4. Z cY i - 1 1, ` In In V) rq i aGsr x z C7 ; c e4c: G� g fn, r4 ? H c c z x 1 cI V w „ xOc0 avfO J I- ur. w c a, r. i ^ <{ C,' Cr — c.1 M .-, \ f` oo c� = - M = -, Z - _ U U! _. 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Over the years we have increased _ar scope to address the needs of the entire Island and State of-Hawaii; therefore, have change _e name to Peoples Advocacy Trails Hawaii. PATH has an ongoing commitment to encour__ a safe environment for walking, jogging and bicycling on roadways for sports, fitness training, :___eation, healthy lifestyles, and alternative modes of transportation. PATH promotes the developrr_e__. of paved bicycle / pedestrian paths, and shared safety awareness on our roadways for motonis__, _-clists and pedestrians. PATH has the necess_:- equipment, transportation and supplies to provide services relating to a bicycle education prb,:-_.= for the 1995-96 school year. PATH has been ins— ental in improving road conditions, and has provided coordinated island wide testimony and :_ou_ to R1'vI Towill during the preparation of the State Bike Plan Hawaii. We have actively encou_�e= the formation of Mayor Stephen Yamashiro's Advisory Committee on Bicycle and Pedestr.`_ S-1..ety, and two PATH board members currently serve on this committee. In 1992 PATH mou.n_e-d a fund raising effort and coordinated private and public funding to bring and active "hands on" cle education program to schools on the Big Island. This was the first time that a modem patory bicycle safety program had been made available to Big Island schools. Various pro_ formats were researched and the Bike Education Director chose a program called " The 3-ics of Bicycling " as being the most suitable to adapt to Big Island conditions. This Bike program was developed by the Bicycle Federation of America in cooperation with the \_.h Carolina Department of Transportation Bicycle Program, and consists of a total of seven 5O este classes delivered to 4th grade students. A carefully graded series of up- beat and supportive lessc__s bring live traffic scenes to the classroom, on-bike lessons teach traffic skills on a plavgrci_nd c: empty parking lot, and help students understand key concepts needed to - operate safely in traffic a_ a bicyclist now and as motorist later. In September of 94, Bi` :siand Bicycle Education (BIBE) expanded their Program to include a fifth grade review of the fou grade Bike Ed Program and a first grade Bicycle / Pedestrian Alert Program which are curre_.rly offered to all schools in the county of Hawaii. II. SERVICES 1.BIBE'S fourth grade bicycle "Traffic Safety Program" consist of the following: a. Two staff inst_-uctor:J. b. Instructional mate s. c. Teaching aids (TV. 'JCR, Video Cassette Recorder, props, etc. ) . d. 35 bicycles, single creed "Bl\EK" type, two different sizes. e. 35 helmets & safer- rest. f. A step van for stor" and transportation of bicycles. 2. The first grade "Bike I Pedestrian Alert Program" consist of the following: • a. One Instructor. b. Teaching aids (TV, VCR, Video Cassette Recorder, Props, etc.) . c. Instructional matels / Handouts 3. The fifth grade "Review Program" consist of the following: a. One Instructor. b. Teaching aids (T:. VCR, Video) c. Instructional Mate= s / Handouts d. Student Survey I. REQUIREMENTS AND PROCEDURES A. Qualifications. 1. P. A. T. H. has developed the necessary equipment, staffing, and the logistical experience required to deliver the program. With the experience gained during the 92/93 pilot program P. A. T. H. has comc:eted the 93/94 and 94/95 school years. 2. BIB/PEP is using m _erials from "Bicycle Federation of America" a national organization. 3. Resumes 4. Certificate "Effective Cycling Instructor" 5. Insurance 1. Policies a. General liability - Bc lily Injury $1,000,000 b. Automotive liability - Bodily Injury $100,000 each person/$300,000 each accident c. Workers Compensa_on - Bodily Injury$100,000 each employee/$100,000 each accident d. Temporary Disabili- 3 4 TH GRADE BIKE ED TRAFFIC SAFETY PROGRAM PROGRAM FORMAT * The course is di:ded into seven 50 minute class periods. * Audio visual and ore-course testing is presented to the children by their regular teacher during the first twc classes. *The next five classes consist of on-bike instruction with simulated traffic situations. *The classes prog==ss from easy to more difficult bike handling skills and traffic concepts. *Bike Ed instruct_:s present the material using their own practical bicycling knowledge and experience. They also directly observe the degree to which children have grasped the concepts and are able to demonstrate correct use of the skills. Personalized coaching and support is an integral part of the orogram. PROGRAM OBJECTIVES At the end of this course, students will be able to: 1. Follow the rules of the road * Describe the most important laws they must follow: - Obey traffic signs and lights - Ride with traffic, on the right side of the road. - Ride at night only with a working head light and tail light or rear reflector. - Yield to pedestrians and all emergency vehicles. * Identify key traffic signs and signals and know their meaning 2. Ride cooperatively - State reasons wh7 communication between road users is important. - Communicate with others using eye contact and hand signals. - Describe ways rcad users communicate with other such as turn signals and road position. - Negotiate with other road users using car nunic_llons skills to determine who will yield. - Identify high risk situations and respond to there _ooropritely without endangering themselves or others. 3. Handle their bikes skillfully - Ride straight with one or both hands on the handlebars. - Ride straight while briefly looking back over left shoulder. - Stop on demand without swerving, falling over, a: colliding with anything or anyone. - Swerve in a controlled manner to avoid a hazard. - Scan ahead and behind while riding in a straight l:e. 4. Identify the appropriate bicycle equipment and clothing for riding: - Bicycle type , size and fit. - Basic mechanical condition of a bicycle. - Bicycle helmet fit and positioning. - Conspicuous clothing. 3 1st GRADE BIKE /PEDESTRIAN ALERT PROGRAM PROGRAM FORMAT * The course is dig-_ded into four 30 minute lessons * Each lesson is d�dicate to specific topics * Lesson One: Wing / Bus Safety *Lesson Two: Pe`=strian Crossing * Lesson Three: B:Acle Safety *Lesson Four: Sect Belts, Bicycle Safety and how to be safety conscious in all aspects. *The curriculum =fifers a variety of activities including coloring, projects, videos, carpet board, Instructor - student discussion and story time. PROGRAM OBJECTIVES At the end of the :essons students will have an understanding to the following: *Recognize emergency vehicles *Recognize traffic signs and meanings *Reasons for wal:rig facing traffic *Keep as far off tr e roadways as possible *Never play in or-ear the street * Conspicuous cic±ing * Bus safety: waiti g, riding, departing * Wait far from the curb * Carry books & s•.plies in back pack if possible * Form a single line *Wait Until the bu.s comes to a complete stop * Listen to the bus =river 4 * Keep your voice low and your hands to yourself * Sit down when _.e bus is moving * When departing, move immediately to the sidewalk *If you need to c_o ss the street, wait for the bus driver to signal you to cross * Cross only in front of the bus * Recognize crossm g signals * Recognize people who can help * Step by step cro_.sing- Stop, look, listen, walk *Role play with a^_ imaginary curb on the play ground * Walk, do not run, across the street *Making eye con-._ct with the driver of a stopped car while you are crossing * Importance of wearing a helmet * Bicycle helmet E: and positioning. * Bicycle Safety C beck * Obey signs and _=gnals *Ride with traffic * Hand signals * Watch for road ..zards * Watch for parked cars and driveways *Importance of wearing seat belts * Never share the belt with another person * Demo- how to 1:�ckle a safety belt *If the shoulder s-ap crosses your throat or face, put it behind you, and use only the lap part *Lap belt fits acrc ss the hips not stomach *Whenever you into a vehicle, fasten the safety belt 5 5th GRADE REVIEW PROGRAM PROGRAM FORMAT M The course is one 40 minute class period * Audio visual and pre-course testing * Check hand signals, and retained knowledge of rules of the road * Post test PROGRAM OBJECTIVES 1. To identify and record retention of last years fourth grade "Traffic Safety Program" 2. To review key objectives of the fourth grade "Traffic Safety Program". 3. To evaluate fourth grade program effectiveness. 6 SALVATION ARMY-KONA D ° ST E: APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996 - June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: West Hawaii AIDS Foundation NAME OF PROGRAM: HIV Education and Prevention Program Mailing Address: P.O. Box 3460 City, State, Zip: _ Kailua-Kona, HI 96745 Telephone: (808) 322-171$ FAX: ( 808) 177-0762 Attach current Internal Revenue tax-exemption certificate 501 (c) 3 Amount allocated by the Hawaii County in 1995: $ 7,500 3 % of Budget Agency Total Budget in 1995 $ 250,708 Amount requested of Hawaii County in 1996: $ 8,250 3 % of Budget Agency Total Budget in 1996: $ 250,708 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: June to July History of funding with the County of Hawaii: New Applicant x Participating agency since 19)5 Firm conducting and date of agency's last financial review or audit: NAME: Taketa, Iwata, Hara & Associates DATE: December 1995 INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY DISTRICT DIRECTOR 2 CUPANIA CIRCLE MONTEREY PARK, CA 91755-7406 Employer Identification Number: Date: 99-0305807 NOV j F 19n3 Case Number: 953274043 WEST HAWAII AIDS FOUNDATION Contact Person: P 0 BOX 3461 TYRONE THOMAS KAILUA-KONA, HI 96745 Contact Telephone Number: (213) 894-2289 Accounting Period Ending: DECEMBER 31, Foundation Status Classification: 170 (B) (1) (A) (VI) Advance Ruling Period Begins: APRIL 22, 1993 Advance Ruling Pericd Ends: DECEMBER 31, 1997 Addendum Applies: NO Dear Applicant: Based on information you supplied, and assuming your operations will be as stated in your application for recognition of exemption, we have determined you are exempt from federal income tax under section 501 (a) of the Internal Revenue Code as an organization described in section 501 (c) (3) . Because you are a newly created organization, we are not now making a final determination of your foundation status under section 509 (a) of the Code. However, we have determined that you can reasonably expect to be a publicly supported organization described in sections 509 (a) (1) and 170 (b) (1) (A) (vi) . Accordingly, during an advance ruling period you will be treated as a publicly supported organization, and not as a private foundation. This advance ruling period begins and ends on the dates shown above. Within 90 days after the end of your advance ruling period, you must send us the information needed to determine whether you have met the require- ments of the applicable support test during the advance ruling period. If you establish that you have been a publicly supported organization, we will classi- fy you as a section 509 (a) (1) or 509 (a) (2) organization as long as you continue to meet the requirements of the applicable support test. If you do not meet the public support requirements during the advance ruling period, we will classify you as a private foundation for future periods. Also, if we classify you as a private foundation, we will treat you as a private foundation from your beginning date for purposes of section 507 (d) and 4940. Grantors and contributors may rely on our determination that you are not a private foundation until 90 days after the end of your advance ruling period. If you send us the required information within the 90 days, grantors and contributors may continue to rely on the advance determination until we make a final determination of your foundation status. If we publish a notice in the Internal Revenue Bulletin stating that we Letter 1045 (DO/CG) -2- WEST HAWAII AIDS FOUNDATION will no longer treat you as a publicly supported organization, grantors and contributors may not rely on this determination after the date we publish the notice. In addition, if you lose your status as a publicly supported organi- zation, and a grantor or contributor was responsible for, or was aware of, the act or failure to act, that resulted in your loss of such status, that person may not rely on this determination from the date of the act or failure to act. Also, if a grantor or contributor learned that we had given notice that you would be removed from classification as a publicly supported organization, then that person may not rely on this determination as of the date he or she acquired such knowledge. If you change your sources of support, your purposes, character, or method of operation, please let us know so we can consider the effect of the change on your exempt status and foundation status. If you amend your organizational document or bylaws, please send us a copy of the amended document or bylaws. Also, let us know all changes in your name or address. As of January 1, 1984, you are liable for social securities taxes under the Federal Insurance Contributions Act on amounts of $100 or more you pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA) . Organizations that are not private foundations are not subject to the pri- vate foundation excise taxes under Chapter 42 of the Internal Revenue Code. However, you are not automatically exempt from other federal excise taxes. If you have any questions about excise, employment, or other federal taxes, please let us know. Donors may deduct contributions to you as provided in section 170 of the Internal Revenue Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Donors may deduct contributions to you only to the extent that their contributions are gifts, with no consideration received. Ticket purchases and similar payments in conjunction with fundraising events may not necessarily qualify as deductible contributions, depending on the circumstances. Revenue Ruling 67-246, published in Cumulative Bulletin 1967-2, on page 104, gives guidelines regarding when taxpayers may deduct payments for admission to, or other participation in, fundraising activities for charity. You are not required to file Form 990, Return of Organization Exempt From Income Tax, if your gross receipts each year are normally $25, 000 or less. If you receive a Form 990 package in the mail, simply attach the label provided, check the box in the heading to indicate that your annual gross receipts are normally $25, 000 or less, and sign the return. If you are required to file a return you must file it by the 15th day of the fifth month after the end of your annual accounting period. We charge a penalty of $10 a day when a return is filed late, unless there is reasonable Letter 1045 (DO/CG) -3- WEST HAWAII AIDS FOUNDATION cause for the delay. However, the maximum penalty we charge cannot exceed $5,000 or 5 percent of your gross receipts for the year, whichever is less. We may also charge this penalty if a return is not complete. So, please be sure your return is complete before you file it. You are not required to file federal income tax returns unless you are subject to the tax on unrelated business income under section 511 of the Code. If you are subject to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter we are not determining whether any of your present or proposed activities are unre- lated trade or business as defined in section 513 of the Code. You need an employer identification number even if you have no employees. If an employer identification number was not entered on your application, we will assign a number to you and advise you of it. Please use that number on all returns you file and in all correspondence with the Internal Revenue Service. This determination is based on evidence that your funds are dedicated to the purposes listed in section 501 (c) (3) of the Code. To assure your continued exemption, you should keep records to show that funds are spent only for those purposes. If you distribute funds to other organizations, your records should show whether they are exempt under section 501 (c) (3) . In cases where the recipient organization is not exempt under section 501 (c) (3) , you must have evidence that the funds will remain dedicated to the required purposes and that the recipient will use the funds for those purposes. If we said in the heading of this letter that an addendum applies, the addendum enclosed is an integral part of this letter. Because this letter could help us resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter. Sincerely yours, 4 Richard R. Orosco District Director Letter 1045 (DO/CG) Form aaC ConsentFixing Period of Limitation Upon OMB No.1545-0056 , 11assessment of Tax Under Section 4940 of the To be used wtth Form (Rovised9-50) Internal Revenue Code 1023.Submit In Department of the Treasury duplicate. Internal Revenue Service (See instructions on reverse side.) Under section 6501(cX4) of the Internal Revenue Code, and as part of a request filed with Form 1023 that the organization named below be treated as a publicly supported organization under section 170(bX1XAXvi) or section 509(a)(2)during an advance ruling period, _ West Hawaii AIDS Foundation (Exact legal name of organization as shown in organizing document) District Director of Internal Revenue,or P.O. Box 3461 Ka i lua—Kona III 96745 and the Assistant Commissioner (Employee Plans and (Number,street,city or town,state,and ZIP code) Exempt Organizations) Consent and agree that the period for assessing tax(imposed under section 4940 of the Code)for any of the 5 tax years in the advance ruling period will extend 8 years,4 months,and 15 days beyond the end of the first tax year. However, if a notice of deficiency in tax for any of these years is sent to the organization before the period expires,the time for making an assessment will be further extended by the number of days the assessment is prohibited, plus 60 days. Ending date of first tax year Dac . r...3 L ..19.93. y,and ye,fr} Name of organization(as shown in organizing document) Daterr West Hawa " " IDS F un-d tion tel-'' - 7—i L._- Officer or truste(7)- 1A Ah rity(0 sign 1 Signature ► /T"1 --c'L/� ?reJ 1 °tetTi_..., K For IRS use only District Director or Assistant Commissioner(Employee P s and Exempt Organizations) Date 1 LC1-1-T Q. 0 -.? - c() By b. IR— -L�l l ti For Paperw•r Reduction Act Notice,see page 1 of the Form 1023 Instructions. �_ 1.<&% '1 VlG7 111-1-1t5I 0 West fiaiwai S � ( 15 s ti� )\i 7 AD5Fot'tvtdthiov s ► I � o 2. l_-- 1<Li I Vi '. r'Li LAA11<11 January 29,1996 Director of Finance Dept. Of Finance County of Hawaii 25 Aupuni Street Hilo, Hawaii 96720 Dear Sir: This letter serves as a statement certifying that item B. Current Charter or Articles of Incorporation, and C.Bylaws or Policies, have been previously submitted to the County Director of Finance and are still in force without revisions. If you have any questions regarding this application, please call me. Sincerely, Cheryl Taupu Executive Director P.O. Box 3460 • Kailua-Kona, Hawaii 96745 Phone (808) • FAX (808) Nidimigliel ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: West Hawaii AIDS Foundation Page #2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Geographic Area(s) Served: Agency's Mission Statement: 2. Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency(in quantitative terms, where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category (adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? ORGANIZATIONAL INFORMATION SECTION ORGANIZATION PROFILE ORGANIZATION NAME: West Hawaii AIDS Foundation A. AGENCY PROFILE: L AgencyNamc West Hawaii AIDS Foundation Geographic Area(s) Served: WHAF's service area encompasses North and South Kohala,Waimea/Kamuela,southward through North and South Kona,Hawaii Ocean View Estates and Naalehu. Agency's Mission Statement: The West Hawaii AIDS Foundation is dedicated to ensuring and maintaining the highest quality of life for people living with HIV and AIDS,preventing its spread through education and advocating for all those whose lives have been affected by this disease. 2 Briefly describe the kinds ofprograms and services the agency provides. The West Hawaii AIDS Foundation(herein after WHAF),provides comprehensive HIV support and case management services. These services included intake and initial assessment; ongoing assessment and counseling for HIV infected individuals and their families. Issues addressed included but are not limited to:mental health,substance abuse, healthcare,housing,behavior,nutrition,benefits, family issues,and education regarding secondary infection of HIV/AIDS. Case management services also include liaison between Hospice,Nursing Home Without Walls,and other home healthcare providers,as well as public welfare agencies and other appropriate service providers including physicians and dentist. WHAF's volunteer program recruits, trains and coordinates placement of volunteers. Services offered by the volunteer program include but are not limited to: transportation to needed services,in-home support,assistance with daily living;educational presentations and outreach throughout West Hawaii. 3. How do these services support the agency's mission? The services WHAF provides fulfills all of WHAF's mission,in that WHAF is proactive in insuring and maintaining quality healthcare and other services that enhance the quality of life for clients. WHAF is looked to in the community as leaders in advocating for quality service for clients as well as ensuring that client rights are protected. WHAF has also taken the lead in West Hawaii in planning and implementing HIV/AIDS educational and prevention services. These include presentations to schools,civic groups,work place and twice yearly AIDS update conferences for health and human services providers. 4. Who is eligible for services? Case management and volunteer services are provide to anyone who is HIV infected and their family. This includes family of origin and/or extended family,including partners or significant others. Education and prevention presentations are available to clients,as well as the general population. All services are free of charge. 5 Provide an unduplicated count of the number ofindividuals served by the agency?List by program. Program Number served Case management 40 Clients Education&Outreach 1,383 People 6. What are the speciflcobjectives ofthe agency(n quantitative terms where possible)? 1. To provide case management services to a minimum of 40 HIV-infected individuals,their families,caregivers,and significant others. 2. Provide housing assistance and/or help obtaining housing for qualified individuals. 3. Provide medical information,referrals and assist in accessing treatment, including alternative treatments. 4. Provide a minimum of 50 prevention/educational outreach services to groups identified as , , high risk for HIV infection. 5. Provide educational outreach to 1,500 individuals in the general community. 6. Provide educational outreach to physicians and other service providers in the community with emphasis on the services available to those infected with HIV. 7. Recruit and train a minimum of 30 Volunteer AIDS Caregivers per year. 8. Facilitate and/or provide individual and group counseling. Including groups for families, friends and caregivers. 9. Develop and maintain cohesive relationships with organizations, agencies,and individuals in West Hawaii and the State who provide services to individuals infected with HIV. 7. flow do you evaluate programs/services effectiveness,and who does the evaluation? The overall organization is evaluated once a year. This is done by providing two separate evaluations. One evaluation is done by the clients and the other is done by the community. The community consist of,but is not limited to: physicians,dentist, alternative care Amok, providers,hospice,home healthcare agencies and family,friends and caregivers of clients. The educational programs are evaluated by participants and attendees of educational presentations. 8. What otherresources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? WI-IAF works cooperatively with Hospice of Kona and North Hawaii, Kohala Home Healthcare,Nursing Home Without Walls,and other home healthcare agencies that provide in-home care to clients. WIIAF also contracts with naturalpathic physicians,acupuncturist and massage therapist, and pharmacist to provide services to clients. These contracts are primarily paid for through the Ryan White Care Act,a federal fund specifically for qualified I-IIV infected individuals 2 and their families. Some services are paid for through fundraising efforts and limited State funding. 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? There is only one other agency on the Big Island that offers similar services. This agency is the Big Island AIDS Project in East Hawaii. Although both agencies have similar missions and provide similar services,and at time have shared clients,both agencies are responsible for separate areas. WHAF's service area is West Hawaii and BIAP services East Hawaii. The Dept.Of Health and the American Red Cross have one HIV educator each. Because of the size of the West Hawaii and the diverse communities, these two people are inadequate to provide HIV education so vital to stopping the spread of HIV/AIDS. Because of the State's financial crisis,both these positions most likely will be eliminated after June 30,1996. 10. List specific accomplishments or challenges addressed by the agency this last year. WHAF,like every other non-profit agency receiving State funding,received substantial cuts in State funding. At the same time,WHAF experienced a 5%increase in clients. Our greatest challenge has been to provide quality services in accordance to our mission,with less fund and no increase in staffing. Despite a 17%cut in State funding,WHAF has had several significant accomplishments. These include: 1. No reduction in client services 2. Leadership positions in Statewide coalitions and organizations (Executive Director is co-chair ACCT and the Volunteer/Education Coordinator is on the Board of NOVL ) 3. Expanded the educational program 4. Remained a visible presence in the community and Statewide WHAF has faced our financial challenges and through fund-raising efforts in the community and grants such as those through the County,we have been able to maintain quality services in West Hawaii and in fact increased our educational efforts. H Does the agency have membership dues? If so,list current rates by category(adult; youth,honorary, etc) No 12 Does the agencyhave a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? As stated previously,staff members are affiliated with organizations related to the work of the agency. Of these affiliations, the only dues paid are to the ACCT. The dues are$25.00 per member per year. 13. What benefits and/or services are provided to the agency by the national or statewide organization? 3 By being a member of ACCT,WHAF is able to advocate of funds and policies that directly benefit clients. One example of this is the Ryan White Care Act Funds.ACCT contracts with the State for Ryan White Care Act funds. WHAF receives a portion of those funds that provide direct client services. WHAF is also involved in the development and implementation of the formula that is used to divide said funds Statewide. ACCT also provides information on other funds that are available and information on the constant changes on HIV/AIDS and issues specific to HIV/AIDS. Participation in NOVL enhances WHAF's ability to recruit and train volunteers to provide services to clients. Volunteers provide free services which save taxpayer's money and enable WHAF to serve our community in numerous ways,from personal care attendants to administrative aides. 4 HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: West Hawaii nrns Fnnndati nu. Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? ✓Yes No Being revised Date last revised: 1'21 9 5 3. Do your personnel policies contain an equal employment opportunity clause? ,Z Yes No 4. Do you have a written job description? V Yes No Being revised Date last revised: S/ I5 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) Yes No V Being revised Date last revised: 6. Does the agency conduct regular evaluation of employees? Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. No change Increase in staff is projected Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. ORGANIZATIONAL CHART Board of Directors Executive Director Office/Business Mgr. Nurse Case Mgr. Case Mgr.I Volunteer/Education Coord. ' Volunteers HUMAN RESOURCES Answers to questions 8, 9, and 10. 8. Please share information on training opportunities provided to staff and/or volunteer& All staff members are encouraged to attend trainings related to their job duties. Examples of trainings attended by staff: Weinberg training for executive directors - Executive director attended eighty hours of this training specifically designed for executive directors. Subjects covered included non-profit management,employment laws and human resource management. Monthly case manager's training- Case managers attend these trainings to upgrade their knowledge of HIV disease and issues related to HIV/AIDS. The Nurse Case Manager attends medical related trainings and the Case Manager I attends trainings related to public benefits and psy/social issues. The Volunteer/Education Coordinator attends quarterly NOVL meetings where speakers present subjects relevant to recruitment,training,and retention of volunteers. The coordinator also attends the quarterly AIDS educators meeting where discussions and presentations are made on the HIV education. The Office/Business Manger attends training seminars related to office management, grants and grants management and other educational opportunities related to the position. Volunteers including Board members are offered ongoing training to update their knowledge and skills in HIV/AIDS related issues. All staff and volunteers are encouraged to attend the twice yearly conferences that are a joint project of the AIDS Education Project and WHAF. Staff and volunteers are also encouraged to share information pertaining to educational events that might be of benefit to other staff and volunteers of the Foundation. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concerns or challenges. In the area of volunteers,the challenge is to recruit committed volunteers. One successful strategy for recruiting volunteers,is a quarterly recruitment drive. WHAF places and mans tables at West Hawaii shopping centers and have been able to recruit volunteers. (These tables also provide educational materials and are part of our educational outreach efforts.) To retain volunteers,the coordinator keeps in close contact with volunteers and publishes a by-monthly newsletter. WHAF also shows its appreciation for volunteers by it's Volunteer of the Month program and by a yearly Volunteer Appreciation Dinner. A challenge for staff is the ever changing,ever evolving nature of HIV disease. Medically, treatments for the various syndromes of HIV are constantly discovered and reported on. WHAF subscribes to several periodicals and monthly newsletter to keep inform. Thereby keeping our clients and the community informed. In this time of budget cuts,the staff is in constant contact with public welfare agencies and others knowledgeable in benefits to keep informed about benefits for clients. 1 One of the major concerns that organizations such as WHAF has,is grief and loss and the burnout related to working in a field where the outcome is death. Generally,in health and human services,clients are expected to"recover,"but in AIDS work, clients eventually die. WHAF encourages staff to attend seminars and workshops related to stress and burnout. WHAF also provides opportunities for staff to discuss grief issues in a group specifically developed by staff. Once a year the staff attends a two day retreat designed to encourage self care. 10. Please provide a description of the minimum qualification for each position? Executive Director. Requires a combination of education and experience substantially equivalent to graduation from collage and three years experience in human services directly related to program development,developing funding sources and case management. Knowledge of community agencies and resources preferred. Nurse Case Manger. Graduate from accredited School of Nursing and/or equivalent. Must have State of Hawaii licensed to practice nursing. Two years minimum experience in client care coordination and highly knowledgeable in HIV disease and current treatments. Case Manager I: BA in Human Services or Social Work and a minimum of one year of experience providing community based Social or Health Care Services. Extensive knowledge of public benefits required. Volunteer/Education Coordinator A combination of education and experience equivalent to graduation from high school and a minimum of two years Social Service experience. Must be American Red Cross certified HIV prevention instructor. Must possess extensive knowledge of the community and its resources. Must work cooperatively with staff,clients and with other agencies and service providers. Office/Business Manager. A combination of education and experience equivalent to graduation from high school and a minimum of three years of diversified general office experience. Computer literacy word processing,database management and financial tracking including, accounts payable and accounts receivable required. 2 Human Resources 1) Description of Education Volunteer/Education Coordinator 1987 -Graduate of Kamehameha Schools. 1987-89-Attended University of Hawaii-Ililo Presently enrolled in UH-West Hawaii Workshops and seminars related to job description: 05/22-26/95 -WHAF training of AIDS Educator (Staff) 06/15-16/95 -Working With Indigenous Populations 07/19/95 -NOVL Training of Volunteer Coordinators "Burnout Prevention Training" 07/21/95 -NOVL Training of Volunteer Coordinators "How To Succeed With Volunteers I" 08/25-27/95 -Training of AIDS Educators 09/27/95 -HIV Risk Reduction Educational Training (USCM) 09/29/95 -NOVL Training of Volunteer Coordinators "How To Succeed With Volunteer II" 10/19/95 -Cultural Issues in HIV& AIDS 10/25&27/95 -HIV 101 - Training of Volunteer Educators 11/17/95 -"Think First" training for HIV education of Teens Volunteer Educators Proof of High School diploma or equivalent Proof of American Red Cross HIV/AIDS educator training or equivalent 2) Work Experience Volunteer/Education Coordinator Related to HIV& AIDS education: Volunteer educator with WHAF from 1992-1995 (date of hire) Facilitated & Chaired 1995 World AIDS Day Events Committee Coordinated and assisted in training of 25 volunteers since 7/95 Coordinated and staffed 6 separate AIDS educational tables in 6 different area shopping centers and public events Coordinated and presented in day long AIDS educational presentations at KTA Keauhou Coordinated and staffed AIDS educational table at a local church Coordinated and presented HIV/AIDS prevention to a Catholic youth group Coordinated and staffed an AIDS educational table at the Statewide Hawaiian Civic Club Convention Prior work experience includes various managerial positions in private businesses and clerk/typist for the DOH and Family Support Services. Volunteer Educators Prior work experience in HIV/AIDS not required but desired. 3) Minimum Qualifications required for each position Volunteer/Education Coordinator A combination of education and experience equivalent to graduation from high school and minimum of two years Social Service experience, working directly with clients and families. Knowledge of HIV disease, extensive knowledge of community and it's resources. Proven to be effective in establishing and maintaining rapport with staff, clients and with other agency's staff. VolunteerEducators High School diploma or equivalent. American Red Cross HIV instructor's certificate or equivalent. Must be able to work with people from different cultural and ethnic backgrounds. Must take direction fro WHAF staff and adhere to WHAF policy and procedures. 2 BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: West Hawaii AIDS Foundation (Page #4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the'agency's mission) for the coining year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the number "1" to the most important and dominant service or target population. educational victims of crime culture& arts 1-1 victims of health crises 9) the poor 5 victims of social crises a youth Le the physically disabled ci the aged I the mentally or emotionally disabled West Hawaii AIDS Foundation Board of Directors Kendall Clawson-President Una Greenaway- Treasurer 76-228 A Oma Pl. P.O.Box 999 Kailua-Kona,Hawaii 96740 Capt.Coo,Hawaii 96704 H 329-9614 H 328-9379 B 322-9705 B 323-3222 DOH-HIV Tester Counselor Kona Historical Society Elected 10/94, Presidency Expires 3/96 Elected 3/95, Treasurer Term Expires 3/96 Board Term Expires 3/96 Board Term Expires 3/97 Tom Stigar- Secretary Joey Robertson P.O.Box 390774 76-6246 Alii Dr.No.368 Kailua-Kona,Hawaii 96739 Kailua-Kona,Hawaii 96740 H 329-9259 H 326-3368 B 329-4481 B 329-3610 Banker-Central Pacific Bank Hair Stylist Elected 3/95,Secretary Term Expires 3/96 Elected 9/95,Board Term Expires 9/97 Board Term Expires 3/97 Skip Burns Carrie Covington 82-751 A Kamakani St. 73-1190 Mahilani Dr. Capt.Cook,Hawaii 96704 Kailua-Kona,Hawaii 96740 H 323-3296 H 325-1020 Realtor-Alii Lani Registered Nurse-Kona Hospital Elected 4/95,Board Term Expires 4/97 Elected 8/95,Board Term Expires 8/97 Mary O'Malia Philip Hema 73-4404 Paiaha St. 87-3192 Road D Kailua-Kona,Hawaii 96740 Capt.Cook,Hawaii 96704 3 325-5518 H 328-8561 P 925-1388 C936-4372 B 329-0638 Community Volunteer Tour Greeter Elected 10/95,Board Term Expires 10/97 Elected 9/95,Board Term Expires 9/97 Joel Miller Joanne Perry P.O.Box 1403 82-6157 Kololeke Pl. Kealakekua,Hawaii 96750 Capt.Cook,Hawaii 96704 H 322-6008 H 323-3940 B 322-1791 B 322-0033 Small Business Owner DOH-Mental Health Dept. Elected 6/95,Board Term Expires 6/97 Elected 2/95,Board Term Expires 6/97 Michael Traub 75-5759 Kuakini Hwy.,Ste.202 Kailua-Kona,Hawaii 96740 B 329-2114 Elected 10/93,First Term Expired 10/95, Elected 10/95,,Second Term Expires 10/97 1 Board of Directors 2. List number of Board Meetings held in the prior year and attendance level. DATE ATTENDANCE 01/19/95 8 02/03/95 7 02/31/95 7 03/02/95 7 03/16/95 5 03/19/95 8 04/13/95 6 05/11/95 6 06/06/95 7 07/13/95 6 07/19/95 6 08/10/95 8 09/11/95 8 10/12/95 5 10/19/95 8 11/09/95 7 12/21/95 6 3 According to the bylaws;how many directors must serve on the board? No fewer than three, with a fixed number of 15. 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions 1995 was a year of changes for our board. Many of the funding members moved on, and our attention was focused on reestablishing and recreating our goals for the future. Some of the decisions that we made were designed to encourage strategic planning, goal setting, task completion, and communication. Additionally, the board was faced with an overwhelming fiscal crisis following large budget cuts by the state of Hawaii. It became apparent that the board needed to commit to expanding our fundraising efforts in order to not only provide the organization with a fiscal net, but to eventually make dependency on the state obsolete. We planned several fund- raisers, including a large event that will bring in at least$5,000 to the organization. Further actions have included expanding board development and delegating responsibility based upon utilizing the skills and assets of the individual board members. This was accomplished by encouraging the board officers to take leadership roles seriously and by nurturing communication between the board members and between board and staff. 2 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges The two greatest challenges that our board will face in the coming year are 1) an on- going fiscal crisis and 2)maintaining commitment to completion to tasks. Both of these issues are related and linked in that the issue of limited funding is ongoing and unlikely to change,and follow through and task completion is crucial for the growth of the board and the organization. The board would like to focus the majority of its energy on providing the staff with ample fiscal resources,thereby increasing the range of services that the organization can provide. We are all committed to the issue of AIDS,and believe that our staff is doing an excellent job of integrating new ideas and strategies into their program. By making task completion and fund-raising our board's major goals for the year,we believe that we will enhance their efforts by setting a positive example,and eliminating the stress of funding issues, 6. List planned improvements(to meet the agency's mission)for the coming year. Some of the things that we have planned for the year are to develop and expand the board's"prevention advisory committee," encourage growth and new ideas on the board by focusing on board development,and by making the fund development committee the focal point of our efforts. We are also examining ways in which we can utilize and enhance the experience of our clients by designing our client liaison committee. 7. What long range plans does the Board of Directors have for the agency? First and foremost,we would like to stabilize our financial situation by keeping our proverbial fingers on the pulse of fiscal opportunities that will allow our agency to flourish without obstacles. We would like to see expansion take place into other arenas such as housing,health services and youth services,as well as developing a network that will supply West Hawaii residence with more effective and positive resources in AIDS education and prevention. Ultimately, this organization is poised . .e for great things,and we are fortunate enough to have dedicated staff that maintains constant willingness to look forward. The board is committed to nurturing and supporting the growth and expansion of WHAF into a truly full-service provider of AIDS related programs. 3 FUNDING NEEDS DIVIDER SHEET AGENCY NAME: West Hawaii AIDS Foundation (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question #7, what is the formula used to determine this amount or percentage? E FUNDING NEEDS- 1. EEDSL Briefly explain the purpose of your request According to the Dept.Of Health's AIDS Surveillance Quarterly Report,as of December 31, 1995, Hawaii County reported 236 cases of AIDS. This is an increase of 25%. Because HIV infection is not reportable,no one knows how many people in Hawaii County are HIV infected. The cure for AIDS has yet to be discovered. Education is the only defense against the spread of HIV and AIDS. This past year WHAF,has taken a proactive approach to HIV and AIDS prevention and education.Unfortunately WHAF will not be able to maintain this level educational for too much longer without need funds This request,as with WHAF's last request,is for funds to continue much needed HIV/AIDS education and prevention services in West Hawaii. As mentioned previously,WHAF received a 17% cut in funding from the State. The County awarded WHAF$7,500 of a$22,770 grant request. Despite this shortfall in funding,WHAF has been able to increase its overall education and prevention services for the first two quarters of the present fiscal year, reaching 1,383 people. If funded WHAF proposes to increase its effort in the community by offering more HIV/AIDS educational presentations. 2 What alternative funding sources were considered and/or applied for? WHAF has applied to the Hawaii Island United Way(HIUW),and the Dept.Of Health(DOH.) The total amount awarded from both sources to date is$16,000. WHAF intends to again apply to HIUW and DOH. WHAF is also researching possible funding sources through the Hawaii Community Foundation and other sources. 3. What alternatives have you considered if this County request is not funded or is not fully funded? If this request is not funded or is not fully funded by the County,WHAF will have to lessen the amount of educational services it presently offers,thereby lessening the amount of community members it plans educate. 4 Give a brief explanation for any variances of 15%or grater per line item in the current vc proposed budget N/A If the agency is a part/branch of a larger multi island organization,please answer the following question: Questions 5 through 8 are nonapplicable. 1 PROGRAM INFORMATION DIVIDER SHEET Agency name: West Hawaii_AIDS Foundation (Page 6) Program name: AIDS Education and Prevention Program Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When-were these rates last changed? PROGRAM INFORMATION Z How does the program help individuals groups and or the community? The WHAF's HIV/AIDS Education and Prevention Program help individuals,groups and/or the community,understand the complex issues regarding HIV disease. Educators offer education presentation on basic HIV/AIDS prevention;the different manifestations of HIV disease;medical treatment and psy/social issues related to HIV/AIDS. In as much as possible, WHAF presentations are culturally and ethnically appropriate. This allows WHAF to reach the as many multi-ethnic and multi-cultural community members a possible. The primary goal of WHAF's educational efforts is to give as many community members as possible,the information necessary to stop the spread of HIV/AIDS. 2 Who is the target population for this program? The primary target population for this program are individuals and groups identified as at high risk for HIV infection. These include,gays,bisexuals and transgendered individuals; substances abusers and their sexual partners,and teenagers. The secondary target population is the community at-large. 3. What are the specific objectives of the program (in quantitative terms where possible)? If funded,WHAF proposes to provide 60 HIV/AIDS educational presentations in West Hawaii. These presentations are projected to reach 1,000 individuals. 4. How do you evaluate program effectiveness and who does the evaluation? The overall effectiveness of the any AIDS educational effort is difficult to evaluate,if not impossible. This is due to the of the nature of HIV disease and the subject matters(sexual behavior and substance use/abuse), and peoples unwillingness to discuss these subjects. Evaluations of educational presentations are much easier to produce. WHAF has develoed and uses an evaluation tool that asked participants of HIV/AIDS presentations to grade the presentation or educational event. The questions asked include content of the presentation, clarity of information,and understanding of information presented. The evaluation also asks for information about the presenter that includes knowledge,rapport with group,poise and sincerity. 5. How does this programs content vary from similar(or same)programs offered by other agencies in the community? Because WHAF is the only comprehensive AIDS service organization in West Hawaii,WHAF has more up-to-date information available to present to the target population as well as the general public. The guidelines set forth in WHAF's Education and Prevention Program, generally are more flexible with regards to context. Educators are very knowledgeable and are open and direct about the various issues regarding HIV/AIDS. As such, contents of WHAF's educational presentations are only limited by those requesting educational information. Due to State or National guidelines,other programs may not have this flexibility. 1 WHAF has a diverse group of educators that are representative of the multi-culture and multi-ethnic populations of West Hawaii. These include women,women of color,gays and gays of color and youth. 6. List specific accomplishments of this program last year. The program has been in existence since July 1,1995,and has provided 24 educational presentations. These include educational presentations to: I. healthcare agencies such as Hui Malama Ola Na Oiwi II. students at the University of Hawaii III. students at the University of the Nations IV. KTA employees V. the Hawaiian Civic Club VI. a Catholic youth group VII. inservice for teachers and counselors of the Dept.Of Education. 7. Provide information on the unduplicated count of this programs beneficiaries- Anis last year actual 734 this year estimate 1,000 next year estimate 1,000 8. If fees for programs or services are charger, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) N/A 2 <t% 11JV( \ I LY,Ll CLI S o P i WesH-Jciwcii'i s �' \4s ALPS Fouuidafiovx S + � 1'J � January 29, 1995 Director of Finance Dept. Of Finance County of Hawaii 25 Aupuni Street Hilo, Hawaii 96720 Dear Sir: I have reviewed the Requirements and Conditions as listed on pages 7 and 8 of the Application for Non-Profit Grant Funds. The West Hawaii AIDS Foundation meets all of the eligibility requirements set forth on page 7,and is in compliance with all the conditions, or in the case of item 4&5, is willing to comply with all the conditions on page 8. If you have any questions regarding this application please call me. Sincerely, Cheryl Taupu Executive Director P.O. Box 3460 • Koko-Kona, Hawaii 96745 Phone (808) WNW!! • FAX (808)J69■Wel1 9.2a4-11.5 S.,-,---b 1 tea, t CID ..v r) w N --- O 00 v O, to -P 1..J N ' 1 O = . o VIz Cz 0 Z z , � c z a H � � tri oil r:i -ri CI O z r' < _� �' z MI tlri Z 0 r [ .. C) [ Ct ti 0 Z 6 Cri vo H Si z n a` z H a N I ►-I n N n C7 00 C/] O1 N.) L1 CO J-� . It O O O O O U, �O J Z O Cy H H z N.) 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Cil H r Ni Z W In 0 '.0 In LJ-1 0 0 0 0 0 0 7z XI 0 0 0 0 0 0 do 3 00 0 0 0 0 0 L z. 0 •. 4 r r ` WEST HAWAII AIDS FOUNDATION STATEMENT OF OPERATIONS FOR GRANTS DOH FY 94/95 FOR THE NINE PERIODS ENDED JUNE 30, 1995 + PERIOD TO DATE ++ YEAR TO DATE + ACTUAL CURR BUDGET BUDGET VAR ACTUAL CURR BUDGET BUDGET VAR REVENUE GRANTS DOH FY 94/95 (659.67) 22,181.60 (22,841.27) 172,058.81 199,634.00 (27,575.19) TOTAL REVENUE (659.67) 22,181.60 (22,841.27) 172,058.81 199,634.00 (27,575.19) EXPENSES PAYROLL EXPENSES GROSS PAYROLL 16,333.00 12,222.24 (4,110.76) 99,425.49 110,000.00 10,574.51 PAYROLL TAXES 842.91 (842.91) (1,587.60) 1,587.60 EMPLOYER FICA 1,393.14 1,070.00 (323.14) 4,099.68 9,630.00 5,530.32 STATE UNEMPLOYMENT TAX 1,134.42 286.00 (848.42) 2,697.53 2,574.00 (123.53) WORKER'S COMP INS. 2,507.00 211.12 (2,295.88) 2,507.00 1,900.00 (607.00) TDI 913.80 59.76 (854.04) 1,370.70 538.00 (832.70) MSA (680.64) 826.00 1,506.64 5,069.80 7,434.00 2,364.20 TOTAL PAYROLL EXPENSE 22,443.63 14,675.12 (7,768.51) 113,582.60 132,076.00 18,493.40 OPERATING EXPENSES RENT-OFFICE & EQUIP 2,016.68 1,930.00 (86.68) 19,547.50 17,370.00 (2,177.50) REPAIRS & MAINTENANCE 1,606.89 100.00 (1,506.89) 3,541.60 900.00 (2,641.60) TELEPHONE 253.20 250.00 (3.20) 3,333.00 2,250.00 (1,083.00) INSURANCE 335.00 945.00 610.00 2,842.00 8,505.00 5,663.00 UTILITIES-ELECTRIC 479.21 150.00 (329.21) 1,462.00 1,350.00 (112.00) PROFESSIONAL SERVICES 1,134.07 75.00 (1,059.07) 3,602.00 675.00 (2,927.00) STAFF TRAINING 179.00 50.00 (129.00) 2,248.18 450.00 (1,798.18) TRAVEL EXPENSES 4,000.27 800.48 (3,199.79) 9,009.03 7,204.00 (1,805.03) PUBLICATIONS & PRINTING 176.76 250.00 73.24 1,825.00 2,250.00 425.00 DUES/SUBSCRIPTIONS/FEES (346.00) 346.00 PROGRAM ACTIVITIES (64.97) 60.00 124.97 381.99 540.00 158.01 OFF EXPENSE 295.14 125.00 (170.14) 2,585.93 1,125.00 (1,460.93) :LIENT SERVICES 9,100.21 2,096.12 (7,004.09) 13,309.90 18,865.00 5,555.10 ADVERTISING 177.73 50.00 (127.73) 353.49 450.00 96.51 AUDIT 6,000.00 425.00 (5,575.00) 6,000.00 3,825.00 (2,175.00) PUBLIC EDUCATION 841.82 100.00 (741.82) 841.82 900.00 58.18 INTEREST EXPENSE 50.00 50.00 450.00 450.00 TOTAL OPERATING EXPENSES 26,185.01 7,456.60 (18,728.41) 70,883.44 67,109.00 (3,774.44) TOTAL EXPENSES 48,628.64 22,131.72 (26,496.92) 184,466.04 199,185.00 14,718.96 NET INCOME FROM OPERATIONS 3,081.71 14,963.08 (11,881.37) 129,359.65 134,667.00 (5,307.35) EARNINGS BEFORE INCOME TAX 3,081.71 14,963.08 (11,881.37) 129,359.65 134,667.00 (5,307.35) NET INCOME (LOSS) 3,081.71 14,963.08 (11,881.37) 129,359.65 134,667.00 (5,307.35) Cr= I<L% '1 VlG-A I11'LA L1 s 0 WsfHciwcu'i s ALPS FodcdiovN 0 C- 14,11'1 L'-CI r�Ll'UtiC11 January 29,1995 Director of Finance Dept.Of Finance County of Hawaii 25 Aupuni Street Hilo,Hawaii 96720 Dear Sir: As instructed,this letter serves to explain the 15%or more difference between our current and proposed budget. All increases except for the additional 10%we are requesting from the County,are due to the anticipated receipt of funds from the Dept. Of Health. These funds are from the Federal Government through the Centers of Disease Control and Prevention. Line item #1,Salaries 27%increase to the Education Volunteer Coordinator's salary. Line item #8, FICA an increase of 63%.(Charged to DOH) Line item #9,Unemployment insurance same as line 8. (Charged to DOH) Line item 1113,relater to lines 1,8,and 9. (Charged to DOH) Line items #16&17,Other 37%increase. (Charged to DOH) Line items #18&23,supplies 38%increase.(Charged to DOH and County) Line item i°24, telephone 15%increase.(Chared to DOH) Line item #26,Rent 37% increase.(Charged to DOH and County) Line item 37,printing 109% increase.(Charged to DOH) Line item #38,publications increase by 109%.(Charged to DOH) Line item 40,per diem increase by 222%.(Charged to DOH and County) *DOH will absorb the higher portion of the increased percentages. Also please note that the financial statement included in this application is for the nine months fiscal year beginning October 1,1994,and ending June 30,1995. If you have any questions regarding the budgetary portion of this application,please call Karen Hong or myself. Sincerely, 44‘ Cheryl Taupu Executive Director P.O. Box 3460 • Kailua-Kona, Hawai'i 96745 Phone (808) 326-2391 • FAX (808) 329-6917 WEST HI AIDS FOUNDATION APPLICATION FOR NON-PROFIT FUNDS Fiscal Year July 1, 1996 - June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATIONAL SUMMARY: ORGANIZATION NAME: The Salvation Army Kona Interim Home NAME OF PROGRAM: F.A.M.E. (Family/Adolescent Management/Education) Mailing Address: 74-5045 Hua'ala Street, Kailua-Kona, HI 96740 Telephone: (808) 329-0559 FAX: (808) 329-8393 Internal Revenue tax-exemption certificate 501 (c) 3: attached and following this page Amount allocated by Hawaii County in 1995: $ 27,000.00 7%of Budget Agency Total Budget in 1995: $386,825.00 Amount Requested of Hawaii County in 1996: $ 35,000.00 9.3% of Budget Agency Total Budget in 1996: $377,270.00 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February , 1996. BY: (Signature) (Print) Council Chairperson Agency Fiscal Year: July 1 - June 30 History of Funding with the County: New Applicant X Participating agency since 1995 Firm conducting and date of agency's last financial review or audit: NAME: Chinaka, Siu & Co., CPAs DATE: June 30, 1995 ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME:The Salvation Army Page 2 A.AGENCY PROFILE 1. Agency Name:The Salvation Army Kona Interim Home Geographic Areas Served:West Hawaii,from Kailua-Kona south to Manuka State Park,north to Kohala and north and east to Waimea Agency's Mission Statement:For the most part,serving chronically dysfunctional families in crisis.the overall goal of our shelter and outreach counseling programs is to provide a secure setting for reconciliation between fgtnily members and on-going support to the family leading to improved performance at school,at work and in various pro-social activities;all this within the framework of the moral principles and applications espoused by The Salvation Army and the service guidelines/requirements established in our funding contracts. 2. Programs and Services Provided? Residential care providing both emergency short-term and long- term(group home)care to male and female youth,ages 10- 17;and outreach counseling and other support services to youth and"families-in-transition". 3. Do services support the Mission Statement? All services support our community's need and the • State's requirements for on-line emergency crisis intervention to at-risk youth and their families,and are consistent with the general charter and purposes of The Salvation Army. 4. Eligibility? Male and female youth,ages 10- 17,and their families. 5. Performance? For the 7/1/94 to 6/30/95 period,by major programs- Youth Served Families/Others Served Shelter Programs* 139 139 Outreach Programs** 4007 2238 * Include Ho'okala Program for direct-police referrals to the shelter ** Include Youth Gang Prevention Program as well as Ho'okala Program when no shelter services were provided,only primary assessment and 2-week follow-up activities 6. Program Evaluation? It's difficult to establish quantitative objectives because many of the successes we enjoy in one program,e.g.,prevention/outreach, should and do result in lowering the numbers we serve in another program,e.g.,shelter intakes. The primary objective to all of our programs is to impact youth and families before or in the early stages of any mandated'system involvement'for the purpose of preventing any further family disintegration.We believe that the whole family should be offered counseling and follow-up services for sustainable results. 7. Effectivity? We are evaluated by our funding sources. We are evaluated by The Salvation Army Divisional Headquarters.Most importantly,we are evaluated by our clients,school officials and others who receive the direct benefit of the services we provide. 8. Network Enterprise? We do not contract with other service providers. There are,however,some private agencies and State offices and departments that provide complementary services to ours and with whom we interface for optimum client impact. We routinely network with Family Support Services,Child and Family Services,DHS,CPS,Kamehameha Schools,The 4H,The Crisis Line,YWCA,Konawaena High and Intermediate,Kealakehe Intermediate,The University of the Nations and a few local churches. 9. Service Exclusivity? We are the only emergency shelter currently serving DHS,the Police and the Family Court in West Hawaii. 10. Recent Accomplishments? At the schools,our work in the classrooms teaching and facilitating interpersonal skills; so,too,do we continue to play a major role in organizing and coordinating"The Battle of the Bands",a pro-social activity involving youth from all of our islands.We continue to teach parenting skills ("Missing Pieces for Puzzled Parents")as a first-line prevention program,not just to prospective parents but, also,to acting parents. 11. Membership Dues? No,and no fees are charged to any of our clients. 12. Organization Affiliation? The Salvation Army,to which we pay 10%of our total income for administrative,fiscal and program oversight. 13. Organizational Benefits? Given above. HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: The Salvation Army Kona Interim Home Page 3 B. HUMAN RESOURCES: 1. Organizational Chart? Attached and following this page. 2. Up-to-date Personnel Policies? Yes, and written by The Salvation Army Territory Headquarters. 3. Do personnel policies contain an equal opportunity clause? Yes. 4. Job Descriptions? Yes,and some are currently being revised. Date of last revision was 6/91. 5 Salary Ranges for each position? Yes. They are revised yearly to accommodate merit and/or cost-of-living increases approved by The Salvation Army Division Headquarters. 6. Employee Evaluations? Done every 12 months from the anniversary date of the employee or from the date of his or her last increase. 7. Staffing Profile from this to next year? Planned and budged to go from 10.7 FTE's to 10.0 FTEs. 8. Staff Training Opportunities? Most of our training is done in-house. This year, we anticipate participating in various staff training exercises with our sister operation,The Salvation Army Hilo Interim Home. All of our volunteers are trained in-house and are encouraged to attend other training sponsored by agencies with whom we interface and from whom we've received training scholarships. 9. Challenges within Human Resources? Because of and,fortuitously, prompted by funding constraints in both the public and private sectors, individual providers must discern exactly what services or array of services they are most eminently equipped to supply. This exercise and challenge, we believe,would be best accomplished within the community and, more specifically, through the input and other assistance that a special non-partisan local selection board could provide. The board's charter would be to first prioritize the services the community desires and then recommend the agencies that are most able to supply those services at the lowest costs and highest effectivity. Additionally, local churches could be used as a conduit for certain social needs,with church volunteers being trained and supported by a cadre from the professional social service agencies. 10. Minimum Qualifications? A college degree and 2 years'experience of which 1 year was in a supervisory position for the Program Director. Outreach counselors, at the minimum, should have a minimum of 2 years'experience in family crisis intervention. Shelter workers should have a high school diploma and 1 year's experience at a residential care facility for teenagers. 0 mN VC O re V = O O re >- • C E 0-, O O O m ! dl o = En .Q ,as i 'EC 2 .a pEa 03003 0 Y O GT g r C0H0 Y } 0 N H N L. 0 W C O O o` m '.= C am EE c `o Q E mo < = o` o roE 1 0 O m E ZCoc > � .s °Tori Ori 2 o .°c o *QQE .comL' Lsoo- JY• Y ` = 2V 1- YYCL -, O 9 L O =c0 > A E 'a o 0 o _ I cf0 0szt ,,�E m g =ti E VI m2 " E mrg � 1v c E' C E YCL -, Q JO Y2 IL 0 o co 0 C13 EU m = 0co co 11 0 or BOARD OF ADVISORS DIVIDER SHEET AGENCY NAME: The Salvation Army Kona Interim Home Page 4 C. BOARD OF DIRECTORS 1. Current list and addresses? Attached and following this page. 2. Scheduled Board Meetings and average attendance last year? 9 meetings, with an average attendance of 11, including agency or facility managers. 3. Number of directors required by bylaws? 9 4. Major Actions of the Advisory Board? We share an advisory board with The Salvation Army Kona Corps, i.e., Day Care Center, Thrift Store and Church. The advisors can only recommend to The Salvation Army that certain changes be made or programs implemented. One major action plan endorsed by our Advisory Board last year involved the opening of a free health clinic to those in our community who are homeless or underinsured for certain emergency medical services. 5. Foreseeable challenges? Late payments on State contracts continue to impact our cash flow and that of other social service (POS) providers. Any assistance that our Board and other influential people in our community can be to remedy this situation will be encouraged. 6. Planned service improvements? With budget constraints, few are possible. We will attempt to network/interface with other agencies serving youth and familiest for better client follow-up and support. 7. Long range plans? Under current and forecasted public funding constraints, major efforts must first be directed to keeping our doors open and to avoid the elimination of essential community services. To do this, we believe, the local political apparatus must be stronger in influencing State legislative decisions. D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED X Educational/Prevention (F.A.M.E.) X Youth X Victims of Crime, i.e., certain CPS, DHS, school and other referrals X Victims of Social Crisis X Certain emotionally disabled youth and their families • • THE SALVATION ARMY - Kona Advisory Board Fax. 329-9749' . • Foix 3Z(' ZRSZ John Austin Kailua-Kona, HI 96740 Property Committee Chairman 329-1346, home 328-8154 P.O. Box 390190 home address P.O. Box 740 Kailua-Kona, HI 96739 Captain Cook, HI 96704 324-6405, fax. 324-6705 . • David Rees-Thomas Ann Brye(inactive) Calvary Community Church Kona Ranch House Restaurant P.O.•Box 5226 75-5653 Ololi St. Kailua-Kona, HI 96745 Kailua-Kona, HI 96740 329-1448, home 329-8987 • 325-6655, home 329-7061 Scott Reich Ken Clewett Merrill Lynch Pierce Fenner& Smith Inc University of the Nations Keauhou Shopping Village 75-5851 Kuakini Hwy. 73-6831 Alii Dr. - Kailua-Kona, HI 96740 ` Kailua Kona,HI. 96740 326-4447, home 329-2301 322-6000, home 329-2143 fax. 329-3287 home address 75-908 Hiona home address 75-5787 Kakalina St. Holualoa, HI 96725 Richard Denison Wilton Wong Chairman Finance Committee Chairman P.O. Box Drawer AZ Bank of Hawaii . Kailua-Kona, HI 96745-9048 75-5742 Huolalai Rd. 329-4277, home 329-6320 Kailua-Kona,.96740 fax.329-1669 326-3927, home 329-4693 home address 75-5865 Walua Rd. 96740 home address 75-362 Hoene fax 329-683 Wattie Hedemann Donna Ruden Secretary 75-6016 Alii Dr.#135 P.O. Box 280 Kailua-Kona, HI 96745 Kailua-Kona, HI 96740 322-3984 327-7908 voice mail . 329-8655 home Dr. Kevin Kunz Michael Zola ` • Kona-Kohala Medical Associates 75-5744 Alii Dr. Sute. 223 75-137 Huglalai Rd. Kailua-Kona, Hawaii 96740 tea- I? THE SALVATION ARMY A CALIFORNIA CORPORATION BOARD OF DIRECTORS KENNETH L. HODDER, CHAIRMAN OF THE BOARD AND DIRECTOR 615 SLATERS LANE ALEXANDRIA, VA 22313 PETER H. CHANG, PRESIDENT AND DIRECTOR 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 JOHN M. BATE, VICE-PRESIDENT 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 ALBERT E. AVERY, TREASURER AND DIRECTOR 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 EVELYN J. HUNTER, SECRETARY AND DIRECTOR 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 BILL D. LUTTRELL, DIRECTOR 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 JOE NOLAND, DIRECTOR 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 JERRY W. GAINES, ASST TREASURER AND DIRECTOR 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 ********** SHARON M. ROBERTSON, ASST SECRETARY 30840 HAWTHORNE BLVD. RANCHO PALOS VERDES, CA 90274 Revised 09/01/94 FUNDING NEEDS DIVIDER SHEET FUNDING NAME: The Salvation Army Kona Interim Home Page 5 E. FUNDING NEEDS 1. Purpose of request? Attached and following this page. 2. Alternative funding sources? None were considered for this particular need. 3. Alternatives? If not funded, we would have to eliminate most, if not all, of our classroom work at the local schools. As funded for FY 95-96, we have to use unrestricted funding to pay for F.A.M.E.'s operational expenses. We have not budgeted unresticted funds to cover any of F.A.M.E.'s operational expenses for FY 96-97.; which is to say, any funding level at less than what we've requested will result in our allocating no more than .5 FTE to this program. 4. Budget variances of 15% or greater? None, as this budget compares with and matches for total funding the amount we requested last year. Our award was for $8,000 less than we requested.) This budget would allow for the equivalent of 1.0 FTE at the schools and full funding of the program's operational expenses. 5. Income Subsidy? No. 6. N/A 7. Any shared expense? No. 8. N/A FUNDING NEEDS PURPOSE OF REQUEST AGENCY NAME: The Salvation Army Kona Interim Home Purpose: The Salvation Army Kona Interim Home is asking for funding to sustain our F.A.M.E. (Family/Adolescent Management/Education ) outreach program to the students at Konawaena High School and our 2 local intermediate schools. This program is centered around a curriculum we developed for prospective parents titled, "Missing Pieces for Puzzled Parents". This is a 6-session course and has been expanded to include "Self-Image Builders", role playing, group brainstorming and other techniques aimed at increasing constructive group dynamic as the product of individual confidence and accountability. Parents are encouraged to participate with their children in these exercises, and, in the curriculum and classes, we are constantly looking for more and better ways to promote family togetherness and harmony. Our results since we started this outreach in April of 1994 have been outstanding. PROGRAM INFORMATION DIVIDER SHEET AGENCY NAME: The Salvation Army Kona Interim Home Page 6 PROGRAM NAME: F.A.M.E. (Family/Adolescent Management/Education) F. PROGRAM BENEFITS 1. Program benefits? Teenage pregnancy remains a major problem in our community, and one of our program goals is to equip prospective teenage parents for the rigors of parenthood. Our experience is that teenagers (all of us) must first be confident and willing to accept responsibility for their actions if they are to become successful and loving parents.Where conflicts exist between the teenager and his or her parent, we want to facilitate reconciliation; they need one another, and the program surfaces what they now have in common(because of the pregnancy or the active desire to become pregnant), not what has separated them. This is a program/curriculum that is 'group interactive" in its configuration and, in that setting, promotes cooperative enterprise as the solution for challenges too difficult for the teenager to handle alone; and it also serves as a healing agent to the teenager's family. 2. Target population? Teenagers and their parents. 3. Specific Objectives? We're too early in the program to quantify our results. The feedback from the teachers,though, has been very positive. One of the results of the program should be that pregnant teenagers remain in school, i.e., feel supported in that venue, and that what was once perceived as a family crisis will be latter described as a total-family blessing. 4. Effectivity? At present, we mostly rely upon the feedback of teachers and parents, and that feedback has been very favorable. We will follow-up on the teenagers as they become parents for other quantifiable results. 5. Comparisons? As far as we know, ours is the only parenting course offered to prospective parents at the local high school and intermediate schools. We have joined with Family Support Services and others in presenting parenting skills in other venues and plan other such cooperative enterprise in the months ahead. 6. Program Accomplishments? Over 700 students have received training since April, 1994. 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O zO 0 i= aw g4 Inc.: oc.c C¢ -sr • SOCIAL MINISTRY FOOD BANK all (96-98) C-193 BUD (ATTACHMENT) (4th of 4) _ APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996- June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: Hawaii Island Catholic Social Ministry - HAWAII ISLAND FOOD BANK NAME OF PROGRAM: HAWAII ISLAND FOOD BANK Mailing Address: 140 Holomua Street City, State, Zip: Hilo, Hawaii 96720 Telephone: (808) 935-3050 FAX: (80) 935-3794 Attach current Internal Revenue tax-exemption certificate 501 (c)3 yes Amount allocated by the Hawaii County in 1995: $35 000.00 8 % of Budget Agency Total Budget in 1995 $450,065.00 Amount requested of Hawaii County in 1996: S 35.000.00 8 % of Budget Agency Total Budget in 1996: $327,098.00 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: 1996/1997 history of fuming with the County of Hawaii: New Applicant x Participating agency since 1992 Firm conducting and date of agency's last financial review or audit: NAME: Choo, Osada & Lee, CPAs, Inc. DATE: January 24, 1996 ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Hawaii Island Catholic Social MinistryPage #2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Hawaii Island Food Bank Geographic Area(s) Served: County of Hawaii (Islandwide) Agency's Mission Statement: To Int the wester ci all u '11P b good foed/gr+ocery i�cts in Hatt& Canty, to all evaite the needs of the to gry ad needy with this surplus ad to ed.rate the carnality abaft this problem ad that we cal do abcut it. 2. Briefly describe the kinds of programs and services the agency prov 3, How do these services support the agency's mission? 4. Who is eligible for services? S. provide artendupseated minto€the a ofWoo? ria , List by program titer 6. What are the specific objectives of the term&we possible)? 7. How do you evaiv pe Mr who diet tit evaluation. 8. What other ram M' d`F td -1 services? Do you contract €taouroeret pro" Y �' 9. How = ` ' • ; , ' ,. vary f' sial vi offered W y 10. • • oe champs addressed bar the air thist r. yea b a• dues? Ifs*,he aura 11. 6 Ems• l 1. Does the agency membenbip youth,honorary,e1eTefi 12. Does the agency haves trade a with a national or atatiwidaOrganization? If so, what is the formula fbr national and/or stoma contributions and how otalt are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? County Grant FY 1996/97 Organization Information Section Organization Profile 2. Briefly describe the kinds of programs and services the agency provides. The Hawaii Island Food Bank has two warehouse facilities in Hilo and Kona that services and distributes food to its member agencies to feed the needy and the hungry through outreach services and/or programs such as: hot meals, outreach packages, care boxes and snack programs. 3. How do these services support the agency's mission? By distributing food to its 116 member agency network (islandwide), the Food Bank maintains' its mission by working and educating food donors and individuals in reclaiming edible food products that would have been wasted, allowing member agencies to obtain and distribute the food and recipients receiving the food. 4. Who is eligible for the services? Non-Profit organizations that have a 501 c or 501 c 3 tax exempt status, Letters of incorporation, by-laws, a funding source, and a purpose of feeding the needy and the hungry are eligible to receive food from the food bank. As for recipients, there is no requirements except they must fill out an intake sheet with the outreach or pantry that is a member agency of the Food Bank who is providing the distribution of food boxes, hot meals, or snacks. 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. Program Title: Food Distribution through Outreach Programs (total amounts) of snack, food boxes and hot meals programs In Fiscal Year 1995/96 the Food Bank distributed food to its 116-118 member agencies islandwide. Number of requests per month was 8,000. Number of people per month was 4,200. Number of Emergency Food requests per year was 100,000. Number of meals per month was 47,000. Estimated amounts for Fiscal Year 1996/1997 are: Number of requests per month will be 8,500. Number of people per month will be 4,400. Number of Emergency Food requests per year will be 110,000. Number of meals per month will be 51,000. 6. What are the specific objectives of the agency (in quantitative terms)? The Food Bank's specific objectives is to follow its mission statement in rescuing edible foods from being wasted and distributing the food to those in need. Since the mission statement is three-fold, the Food Bank continues to educate and advocate the issues of the wasting of food products, hunger and poverty in Hawaii County through education and awareness. In addition to following its mission, the Food Bank is critically looking at customer relations and satisfaction and also improving its warehouses' conditions in making the warehouse consistently flow and look more like a "supermarket" atmosphere for its member agencies. 7. How do you evaluate programs/services effectiveness, and who does the evaluation? The Food Bank evaluates its member agencies that have pantries or on-site feeding programs by conducting a yearly on-site evaluation. A physical on-site visit and interview is done by reviewing the facility in ensuring that rules and regulations set forth by the Food Bank is upheld. Normally the on-site evaluation is done by the Food Bank Director and/or staff person trained to do an On-site Evaluation and also the Agency Advisory Board Chair (trained by the Director) can conduct the yearly On-site Evaluation. The measure of effectiveness of the food pantry/member agency distributing food to those in need is assessed by the On-site Evaluation intake/questionnaire sheet, its monthly agency reports that reports how many people have been served by the member agency and at the monthly member agency meeting, when each agency updates the Food Bank and others about their outreach programs and reports the numbers of people they are serving and the kinds of services they are providing. • 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? None applicable. 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? None applicable. 10. List specific accomplishments or challenges addressed by the agency this last year. In Fiscal Year 1995/96 the Food Bank was faced with major financial crisis that caused a re-organization and streamlining of its budget. Budget cuts were made in expenses and efforts in generating revenue/income was necessary to maintain the operations of its warehouse facilities and also to continue the rescuing and distribution of food to those in need. In addition to the financial challenges, the Food Bank established several other objectives in increasing revenue in its Share Maintenance Contribution by looking into improving and increasing customer service, agency relations, and also implementing warehouse systems to increase efficiency and productivity amongst warehouse staff and volunteers. In addition, great efforts was made in increasing the level accuracy and efficiency in the accounting and bookkeeping systems by upgrading computer accounting hardware and software, improving internal controls, and implementing professional and technical training for its in-house bookkeeper by having a finance officer overseeing the Food Bank's financial "picture" on a day to day basis. 11. Does the agency have membership dues? If so, list current rates by category (adults, youth honorary, etc...) The yearly membership dues that member agencies contribute to the Food Bank is $10.00. This allows for the services to be continued to them. 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national/or state contributions and how often are dues paid? The Food Bank is an affiliate member of Second Harvest which is a national Food Banking Network that governs member Food Banks across the nation. The Hawaii Island Food Bank is only an affiliate and does not pay any membership dues or contributes to the organization. 13. What benefits and/or services are provided to the agency by the national or statewide organization. If though the Hawaii Island Food Bank does not a membership dues to Second Harvest, but belongs to the Hawaii State - Food Bank Network, the benefits or services received are the following: * National Food Corporation Products - e.g. USDA; Kellogs * Food Bank Warehouse Rules and Regulations-Standards * Food Banking Information * Promotional/Fund Raising Information * Invites to National Food Bank Conventions * To "tag on" the national name for public relations HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: Page Island Food Bei Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? x Yes No Being revised Date last revised: are 1995 3. Do your personnel policies contain an equal employment opportunity clause? x Yes No 4. Do you have a written job description? x Yes No Being revised Date last revised: June 1995 5. Do you have written salary ranges for each job description?(If yes, attach salary ranges.) x Yes No Being revised Date last revised: Itkerter 1995 6. Does the agency conduct regular evaluation of employees? x Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. x No ehmge Increase in staff is projected Decrease in staff is projected (Answer questions It,9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. f c z-t D a n 0c 0. -, C CO C a m � ' co _ X -• C 0 SID nCI ---4 ....: Pa = CAS VI s c.)._ CD o b C > O a C) 0 . cep a On ceo 0 O = -t ~ O d •"' n. O O O n a) O pr o O O G v Sy' 70 c Y o 4 °c (0 = Pa = cv 3 0 o rt. et a ^ I 0 E. 0 1 CD R "t O I 1 O C i Pa n R 1�+ Q o a) a P2 n .... CD SW co CPO .,CD a .., .... 0 CO 0 Pa a Ity f AiNtivolt , ° „ .44., .., it(:2.:.reaki.(.3)* ) _ t* ,ha Hawaii Island Food Bank Hawaii Island Catholic Social Ministry - Hawaii Island Food Bank Current Fiscal Year 1995/96 Salary Ranges Updated: November 1, 1995 Name Position FY 95/96 FY 96/97 Alissa Alcosiba Program Director $30,000 $30,000 Helen Luta WH Warehouse Supervisor $27,040 $24,000 Nani Camacho EH Warehouse Supervisor $25,390 $24,000 Nan Elmer Office Mgr/Bookkeeper $16,802 $16,802 Lau Subica EH Warehouse Ass't $ 4,368 $ 4,368 Andrea Renshaw WH Warehouse Ass't $ 4,032 $ 4,032 Total $107,632.00 $103,202.00 *Subject to change 140 Holomua Street • Hilo,Hawaii 96720 • Ph. (808)935-3050 • Fax(808)935-3794 Box 2125 • Kealakekua, Hawaii 96750 • Ph. (808)322-1418 • Fax(808)322-3812 HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: WAREHOUSE ASSISTANT Reports to: Warehouse Supervisor Supervises: Warehouse volunteers Purpose of the Position: To assist the Warehouse Supervisor in ensuring an efficient, safe and sanitary warehoue for the collection, storage, and distribution of donated products, and that the operation meets all state and local government food safety and sanitation standards and regulations. Duties and Responsibilities: 1. Scanning duties of reclamation items. 2. Receiving food into warehouse. 3. Assist with distribution of products to member agencies. 4. Stock shelves in the warehouse, reefer and freezer. 5. Assist with inventory control. 6. Assist in pick-ups or deliveries when needed. 7. Assist with warehouse sanitation. 8. Supervise warehouse volunteers as needed. 9. Other duties as required by the Warehouse Supervisor. Minimum Qualifications: 1. Ability to work well with the public, other staff, volunteers and community representatives. 2. Ability to work with a minimum of supervision and ability to follow standardized . procedures. 3. Ability to function as a team player. 4. Hawaii's Driver's License. 5. Exert force and/or lift or carry items weighing 20 -100 pounds occasionally and up to 50 pounds frequently. 6. Up to 2/3 of the time: walk, sit, squat, bend, twist, reach at various heights above and below shoulder level. 7. Up to 1/3 of the time: push or pull; lift or carry large, heavy, awkward objects while maneuvering in a confined space, eg: narrow aisles, high density storage areas, inside of a truck box, etc.; ascend or descend flights of stairs; climb in or out of trucks, docks and/or forklifts. 8. Work inside freezers and coolers with a temperature range of 0 degrees F to 38 degrees F. 6/16/95 Mat.. - ReJisEb HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: OFFICE MANAGER Reports to: DIRECTOR and FINANCE OFFICER Supervises: Office Volunteers Purpose of Position: The Office Manager shall be responsible for all office managerment activities including reception. fiscal and secretarial duties and other duties as required by the Director and/or Finance Officer. Duties and Responsibilities: 1. Fiscal Duties: a: Accounts Receivables b: Accounts Payables c: Deposits d: Reconciliations e: Petty Cash f: Filing g: Monthly Statements 2. Inventory: a: Maintain Inventory Records b: Inventory Reports . c: Inventory Control d: Physical Inventories 3. Office Managerment: a: Purchasing Supplies b: Maintain inventory of Supplies c: Maintain Inventory of Fixed Assets d: Equipment Maintenance e: Personnel matters 4. Reports: a: GET b: Invoicing c: Sales Reports d: Audit Reports fe Grant reports as needed 5. Standard operating Procedures: a: Bookkeeping and Accounting b: Office Management c: Reports d: Assist with other SOP's as needed 6. Responsible for getting quotations/bids for all purchases of services and equipment 7. Special Projects as*assigned by Program Director Qualifications: 1. 2 years bookkeeping experience 2. 2 years office managerment and supenison experience 3. Computer experience: Quickbooks, Microsoft Excel,Microsoft Word 4. Demonstrated ability to work well with the public,other staff,volunteers and community representatives 5. Demonstrated organizational skills,ability to work with minimum of supervision and the ability to follow standardized procedures. 6. Ability to clearly explain ideas and instructions verbally or in written form. 7. Ability to function as a team player and establish and maintain good relationships with people representing a wide variety of ethnicity,age and social backgrounds. 8. Degree in Business or Accounting preferrable 9. Ability to use ten key by touch,good typing skills required. HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: OFFICE MANAGER Reports To: DIRECTOR • Supervises: Office volunteers Purpose of the Position: The Office Manager shall be responsible for all office management activities including reception, fiscal and secretarial duties and other duties as required by the Director. Duties and Responsibilities: 1. Fiscal Duties: A. Accounts Receivables B. Prep. of Accounts Payable C. Deposits D. Reconciliation E. Petty Cash F. Filing G. Necessary-materials focbookkeeper to do monthly income statements and balance sheets 2. Office Management: • • A. Purchasing supplies w' ' B. Maintain inventory of supplies C. Maintain inventory of fixed assets (office/warehouse) D. Equipment maintenance: Xerox, postage meter, fax machine, computer E. Personnel: files, monthly time sheets, forms/orientation for new hires, accident reports and other insurance report procedures 3. Reports: A. GET B. County invoices, monthly C. Monthly activity Reports D. Assist with audit preparation E. State of Hawaii invoices for GI A F Monthly agency poundage reports G. Other grant reports as needed 4 Standard Operating Procedures: A. Bookkeeping function B. Office Management function C. Reports D. Assist with warehouse SOPs if needed 5. Responsible for getting quotations/bids for all purchases of services and equipment • 6. Other duties as required by the Food Bank Director. Minimum Qualifications: 1. 2 years bookkeeping experience 2. 2 years office management and supervision experience 3. Experience with computers including the following software: Quickbooks, Microsoft Excel, Microsoft Word, and Works. 4. Demonstrated ability to work well with the public, other staff, volunteers and community representatives. 5. Demonstrated organiational skills, ability to work witha minimum of supervision, and the ability to follow standardized procedures. 6. Ability to clearly explain ideas and instructions verbally or in written form. 7. Ability to function as a team player and establish and maintain good relationships with people representing a wide variety of ethnicity, age and social backgrounds. 8. Bachelor's degree in business preferable 9. Ability to use ten key by touch. Good typing skills also preferred. 6/13/95 1 ' HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: Warehouse Supervisor Reports to: Executive Director Supervises: Driver; VISTA Volunteers: Volunteer Coordinator, Resource Developer; JOBS workers in the warehouse and other warehouse volunteers Purpose of the Position: To provide effective management of the Hawaii Island Food Bank's Hilo warehouse. To ensure an efficient, safe and sanitary system for the collection, storage, distribution, and delivery of donated products, ensuring that the operation meets all state and local government food safety and sanitation standards and regulations. Duties and Responsibilities: 1. Develop standard operating procedures and manage their implementation: A. Supervise and maintain an orderly process for the collection and delivery of donated food and non-food products. B. Ensure that warehouse is in a sanitary condition that meets all Health Department and Second Harvest standards and regulations. C. Dispatch, schedule and supervise all incoming donations and the loading and unloading of product. Oversee storage of same. Work with Resource Developer to maintain a professional donor relationship. D. Supervise a routine inspection program of all vehicles and warehouse equipment. E. Implement and maintain safety policies and programs developed for warehouse operations. F. Prepare monthly reports on warehouse activities, i.e., SMC, food poundage, etc. 2. Oversee the storage and distribution process of purchased and grant food products,such as: Bread on the Water. 3. Ensure reconciliation of inventory records. 4. Manage and help to develop the food inventory system, and ongoing maintenance. • 5. Ensure that monthly food reports that appropriately depict the flow of food products are completed. 6. Manage the development of volunteer projects that facilitate a cost-effective operation. 7. Assist in development of equipment needs/specifications in the warehouse. 8. Other duties as required by the Executive Director. Minimum Qualifications: 1. Demonstrated ability to work well with the public, other staff, volunteers, and community representatives. 2. Demonstrated organizational skills, ability to work with a minimum of supervision, and the ability to follow standardized procedures. 3. Ability to clearly explain ideas and instructions and to provide appropriate documentation. 4. Ability to function as a team player and establish and maintain good relationships with people representing a wide variety of ethnicity, age and social backgrounds. 5. Proven ability to drive cargo vans, operate standard warehouse equipment, and demonstrated ability in maintenance and basic repair of vehicles and equipment. Ability to safely operate all types of warehouse equipment, including, but not limited to, pallet jacks, and forklift. 6. Exert force and/or lift or carry items weighing 20 to 100 pounds occasionally and up to 50 pounds frequently. • 7. Up to 2/3 of the time: walk; sit; squat; bend; twist; reach at various heights above and below shoulder level. 8. Up to 1/3 of the time: push or pull; lift or carry large, heavy, awkward objects while maneuvering in a confined space, eg: narrow aisles, high density storage areas, inside of a truck box, etc.; ascend or descend flights of stairs; climb in or out of trucks, docks and/of forklifts. 9. Work inside freezers and coolers with a temperature range of 0 degrees F to 38 .degrees F. 10. Basic knowledge of food storage, handling, and distribution procedures. 2/8/95 HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: Director Reports To: HICSM Executive Director and HIFB Advisory Boards Supervises: W.H. Deputy Director, E.H. Warehouse Supervisor, Resource Developer, Office Manager/Bookkeeper and other staff as needed Purpose of the Position: To work in concert with the HICSM(Hawaii Island Catholic Social Ministry) Executive Director and HIM Advisory Boards to provide leadership for the Hawaii Island Food Bank(HIFB) in order to carry out its mission in addressing hunger in Hawaii County. The Director is responsible for all aspects of the food bank operations and works to ensure the development of and adherence to sound management procedures throughout the foodbank. Duties and Responsibilities: 1. Carries out the policies of the Food Bank as approved by the HICSM Executive Director and Advisory Boards and the rules and regulations of local, state and federal statutes related to the operations of the Food Bank. 2. Administers and directs the activities of the Food Bank by implementing HICSM and Advisory Board policies, developing procedures, setting direction, and evaluating results. 3, Evaluates the effectiveness of all Food Bank policies, rules and procedures. 4. Ensure adherence to sound hiring, training, supervisory, and disciplinary practices within the agency. S. Recommends to the HICSM Executive Director, the appointment or termination of all Food Bank personnel. 6. Responsible for the implementation of staff work schedules, duties and functions and the general supervision and evaluation of personnel. 7. Develop and maintain a program of health and safety for the protection of staff, volunteers and visitors. S. Responsible for the efficient and economic management of the Food Bank. This includes financial planning, budgeting and reporting, accounting and auditing. --;' �r _ - _ _- -- 9 Supervises the preparation of the annual audit, financial statements and food bank contracts. 10. Manage the application process for United Way, County and other funding as identified including writing grant proposals, reports and coordinating political processes. 11 Supervises the development of Food Bank long-range and short-term resource development including food and funds 12. Represents the Food Bank at meetings and conferences with federal, state and local agenices. (The Director may delegate this responsibility if necessary) 13.The Director is the spokesperson for the Food Bank and will expand public awareness and agency resources by making presentations to community groups. 14. Keeps the HICSM Executive Director and Advisory Board informed of local, state, and federal governmental actions as they relate to the Food Bank. 15. Provides support to the Advisory Boards to foster their responsibilities of effective planning, fundraising and other support for the food bank. This includes securing new membership for the Advisory Boards and its committees striving to have them reflect cultural diversity that exists in the community. 16. Other duties as delegated by the HICSM Executive Director. Minimum Qualifications: 1. Bachelor's Degree or higher, preferably in Business, Management or Public Administration or related field or three years of experience in senior management position, preferably in retailing or foodbankang. 2. Demonstrated organizational and supervisory skills, proven ability to plan, organize and evaluate the work of others. 3. Ability to communicate well, both verbally and in writing. 4. Analyze and synthesize data and make sound judgments. 5. Demonstrate professional and business leadership. 6. Ability to manage time and plan activities in an actively changing environment. 0/25/05 County Grant FY 1996/97 Human Services Form Human Resources 8. Please share information on training opportunities provided to staff and/or volunteers. The Hawaii Island Food Bank over the years have provided the following training opportunities for its staff: * Attending Workshops/Seminars in: - Warehousing, Accounting, - Customer Services, - Volunteer Recruitment, - Donor Resourcing, - Injury Prevention in Warehouse Facilities, and - Food Banking Conferences - Updates - Fund Raising Techniques - Building Successful Boards - Food Prep - Marketing Your Products - Employee Relations * Cross Training/Improving Job Skills/Promotions - In-House Training Programs - Multi-Task Jobs - Distribution of Books or literature to learn other job skills Volunteers: * Conducting orientations to educate the volunteer about the organization. * Specific Job Descriptions and training * Literature or handouts on the tasks or job assigned to * Workshops * One to one training techniques from staff member assigned to train the volunteer 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concerns or challenges. Not applicable at this time. 10. Please provide a description of the minimum requirements for each position. Warehouse Assistant: To assist the Warehouse Supervisor in ensuring an efficient, safe and sanitary warehouse for the collection, storage and distribution of donated products, and that the operation meets all state and local government food safety and sanitation standards and regulations. Office Manager/Bookkeeper. To provide all bookkeeping functions of the Hawaii Island Food Bank as well as office management: purchasing, inventory and other duties as required by the Director. Warehouse Supervisor: To provide effective management of the Hawaii Island Food Bank's Hilo and Kona warehouses. To ensure an efficient, safe and sanitary system for the collection, storage, distribution, and delivery of donated products, ensuring that the operation meets all state and local government food safety and sanitation standards and regulations. Program Director: To work in concert with the HICSM Executive Director and HIFB Advisory Boards to provide leadership for the Hawaii Island Food Bank in order to carry out its mission of addressing hunger in Hawaii County. The Director is responsible for all aspects of the food bank operations and works to ensure the development of and adherence to sound management procedures throughout the foodbank. BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Hagan Islam Food Bark (Page :4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1 Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3 According to the bylaws, how many directors must serve on the board? i 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements(to meet the agency's mission)for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s)in order of importance. Give the number "1" to the most important and dominant service or target population. I educational. 2 victims of crime 2 culture&arts victims of health crises 1 the poor 2 victims of social crises 1 youth 2 the physically disabled 1 the aged 2 the mentally or emotionally disabled 1-- •, 1-10-96 HAWAII ISLAND FOOD BANK EAST HAWAII ADVISORY BOARD FY 95/96 Roland Higashi 714 Kanoelehua Hawaii Printing 1 year tern Chair Hilo, HI 96720 President/Owner 961-6651 Fax 935-0518 Steve Querobin 138 Laula Road Hawaii Firefighters Union 1 Year tern Vice Chair Hilo, HI 96720 Retired 959-6038 Stephanie Salazar 688 Kinoole St. Ste. 214 COH Corp. Counsel 1 year term Secretary Hilo, HI 96720 Family Support Div. 961-8375 Legal Assistant Fax 935-7428 Noel Fujimoto 688 Kinoole St. #104A Office of Hawaiian Affairs 1 Yr tern Treasurer Hilo, HI 96720 Loan Officier 933-474$ Fax 933-4744 Jos Schoemaker 1518 Kilikina St. EH Agency Advisory 1 Year tern Hilo, HI 96720 Committee Chair 935-7364 Debbie Alai P.O. Box 683 Church of the Holy Spirit 1 year term Keaau, HI 96749 EH Agency Advisory 966-8381 Committee Secretary Margaret Koehler P.O. Box 1862 Operation Blessing 1 year term Hilo, HI 96721 EH Agency Advisory 961-0486 Committee Vice Chair Patricia Bergin 75 Aupuni St. Dept. of Education 2 year tern Hilo, HI 96720 District Superintendent 933-4237 Fax 933-4696 • 1-10-96 Toni Granito 101 Holomua St. SBS 2 year tern Hilo, HI 96720 Sales Rep. 935-5401 Fax 961-5522 Timothy Waugh 185 Todd Ave. Wei Fnterpt-ises 2 year tern Hilo, HI 96720 • 935-0763 Marie Fontana 14-4427A Kapoho-Pahoa Rd. Sacred Heart Pahoa 2 year tern Pahoa 96778 936-2718 Nan Hiraoka 450 Waianuenue St. Doe-T i sicn 1J2 year term Hilo, HI 96720 933-4406 Evelyn Sanoria P.O. Box 655 Pahoa Assanbly of God 2 year teen ,Pahoa, HI 96778 965-8901 Carol Ignacio P.O. Box 1373 HLCEI Director no terrradvisarj Honokaa, HI 96727 775-9581 Fax 776-1601 Hawaii Island Food Bank West Hawaii Advisory Board FY 95/96 and FY 96/97 Revised: January 1, 1996 Name Organization Address Term Reggie Morimoto First Hawaiian Bank PO BOX 618 lyr Chair Branch Mgr. KK-HI 96750 Ph: 322-3484/F 322-3150 Donald Sasaki CA-Kona Produce PO BOX 16 lyr Vice Chair Pres. KK-HI 96750 Ph: 322-6033/F 322-6441 Debra Fuller Independent PO BOX 4733 2yr Secretary KK,HI 96740 Ph: 322-7393 David Logan MacFarms HI PO BOX 630 lyr Treasurer Comptroller KK, HI 96750 Ph: 328-2435/F 328-2080 Glenn AbsoKona Village PO BOX 25 1 yr Head Chef KK, HI 96745 Ph: 325-5555/ F 325-5124 Moana Kuma HVB 76-6274 Plumeria Rd. 2yr Secretary KK, HI 96740 Ph: 327-7787/F 326-7563 Heidi Teves PATCH Keauhou Hotel 2yr WH Agency Chair Director KK, HI 96740 Ph: 322-6818/F 326-2155 Ken Clewett Director University of Nations lyr 75-5851 Kuakini Hwy KK, HI 96740 Ph: 326-4447/ F 329-2387 Ross Wilson President Current Events lyr 75-5751 Kualdni Hwy KK, HI 96740 Ph: 326-7820/F 326-5634 Charlene Goo General Manager Keauhou Beach Hotel lyr KK, HI 96740 Ph: 322-3441/F 322-6586 Mamie Bramlett Independent PO BOX 788 2yr Kapaau, HI 96755 P Ph: 899-5833 Keith Hayama Manager KTA-Keauhou 2yr 78-6831 Alii Dr. KK, HI 96740 Ph: 322-2311/F 322-6673 2 County Grant FY 1996/1997 Board of Directors Form Board of Directors 2. List number of board meetings held in the prior year and attendance levels. The Food Bank in FY year 1995/96 holds monthly meetings for its West Hawaii Advisory Board and every other month for its East Hawaii Advisory Board. This was determined by its board members. Estimated: 12 members For FY 95/96 WEST HAWAII 5 meetings 30% attendance For FY 95/96 14 members EAST HAWAII 4 meetings 90% attendance 3. According to the bylaws, how many Board of Directors must serve on the board? In FY 95/96, the Food Bank needed to evaluate the purpose of the Board of Directors. The bylaws that were made in 1992 states that the board can have up 12 members that can serve for a 2 year term. • 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. The Boards on both West and East and Hawaii made major decisions in the area of fund raising. They felt that would like to be more involved in raising money for the Food Bank. Fund Raising Commitees have been organized and they will be planning accordingly for FY 96/97; 97/98; and 98/99, a three year long range plan. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address challenges. In meeting with the various Advisory Boards of the Food Bank, it was clear that these are the major concerns of both boards and Food Bank management: * Mission * Fiscal stability for Food Bank: e.g. Fund Raising * Agency Relations and Customer Service * Volunteer Building and Maintenance * Warehouse Conditions * Resource Developing In assessing all of these concerns, the Advisory Board along with the Program Director, and staff of the Food Bank will have to work in concert in maintaining its mission statement, finding progressive ways of continuing and generating revenue, improving and recruiting member agencies, increasing customer service for its member agencies, building and increasing volunteer base, and developing well-trained volunteers to assist in the operations of the Food Bank, improving warehouse conditions which will bring about efficiency and boost revenues, and continuing to improve, diversify and increase donations from food resources to maintain the distribution of food to those in need. 6. List planned improvements (to meet the agency's mission) for the coming year. In utilizing the Advisory Boards on the East and West sides of Hawaii County this is the list of planned improvements that will help the Food Bank increase or meet the mission for the coming year: * Assessing the current Board members, who, what,where, and how much time can they commit to the Food Bank * Recruitment of new Board members. Finding those in the community that fit the Food Bank and its purpose * Increasing meetings to a monthly schedule * Increasing education about food banking for its board * Utilizing board members and their expertise * Formulating committees to address each aspect of the food bank * Formulating a five-year strategic plan 7. What long range plans does the Board of Directors have for the agency? The Advisory Boards for the Food Bank at this time have no long range plans but is helping to address the critical financial and operations issues that the Food Bank is dealing with during this Fiscal Year 96/97. After the challenges of this fiscal year is addressed and corrected an great impetus from the Board will take place in strategically planning for the Food Bank and its future success. FUNDING NEEDS DIVIDER SHEET AGENCY NAME: Iii Islam Food Bank (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income(subsidy) from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question#7, what is the formula used to determine this amount or percentage? County Grant 1996/97 Funding Needs Form FUNDING NEEDS 1. Briefly explain the purpose of your requests. The Hawaii Island Food Bank requests $35,000 to assist in the moving of 1.6 million pounds of food/grocery products to helping agencies who feed people in need. This will go to pay for part of the Program Director's salary, our Hilo and Kona warehouse rent, utilities, telephone, vehicle gas and maintenance costs. 2. What alternative funding sources were considered and/or applied for? Alternative funding sources that were considered and applied for are: * State Grant-In-Aid * Hawaii Island United Way * Share Maintenance Contributions * Private Contributions 3. What alternatives have you considered if this County requests is not funded or is not fully funded? With the tough economic times our County is suffering through, non-profits like the Food Bank is looking into many types of alternative funding sources to continue it mission and services. If funding from the County grant is cut or restricted in its amount the Food Bank will substantially hit and its operations will tremendously be affected. Hypothetically, if the funding does not come through, the Food Bank will have to scramble and look into a fund raiser or seek-out a private donor. This in effect could cut services, food distribution, warehouse operations, and staffing (which was downsized in FY 95/96). 4. Give a brief explanation for any variances of 15% or greater per line in the current vs. proposed budget. No variances. Questions 5 - 8 is not applicable to the Hawaii Island Food Bank PROGRAM INFORMATION DIVIDER SHEET Agency name. iii. Island Food Bask (Page 6) Distribution of Food Program name: Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative quantitativeterms,where possible)? 4. How do you evaluate program etfbctiveness,and who doestl ev luati`on' =' 5. How does this program's content vary from similar(or same)programsofrere by other agencies in the community'?`:' t {' 6. List specific accomplishments of this program lass y S • 7. Provide information ; fl ed cots*of this pcogr s e ` : d 8. If fees!ils • • are charged,what are the rates fbc each inecific program or service? (Attach a complete rate schedule for this A. When were these rates last reviewed''" B. What-were these rates last changed? County Grant FY 1996/97 Program Information Form PROGRAM INFORMATION 1. How does the program help individuals, groups and/or the community? The Hawaii Island Food Bank provides farmers, grocery retailers, wholesales, hotels and restaurants a convenient and a cost free way to donate surplus or unsaleable wholesome food. It is often the case that potential donors don't have the time or the information to screen charities and most non-profits cannot cope with the quantities of food offered by many large companies. The Hawaii Island Food Bank is equipped to do all the necessary screening of charities; and: to pick-up sort, inventory, store and distribute donated food in amounts that charities need and can use. This saves donors and non-profits both time and money, plus salvage food that goes to hungry people...food that might otherwise be wasted. For every $1 operations, the Hawaii Island Food Bank is able to distribute $6 of food. County funding will thus help multiply by a factor of 6 in the value of food provided. 2. Who is the target population for this program? The target population is private non-profit agencies who serve the poor, children, elderly, homeless, victims of crime, health and social crisis and disabled. 3. What are the specific objectives of the program? The specific objectives of the program which is the distribution of food to 116-118 member agency network is to provide good food to continue their outreach programs or services of feeding the needy and hungry. Also to provide a means of food to empower and uplift people in need during economic hardships so they can continue and maintain their lives. 4. How do you evaluate program effectiveness, and who does the evaluation? The Food Bank measures effectiveness is the number of pounds of food they receive from the food industry and distribute to these agencies each month. The Food Bank also measures effectiveness by providing an on-site evaluation process that is conducted on a yearly basis that goes into the agency's operations and assesses the conditions of how they handling, and distributing out the food to recipients. Also monthly agency reports are submitted by member agencies that reports the amount of people being served from their outreach programs, hot meal programs etc.... This allows the Food Bank to record and report statistics on the geographical area, age, and gender being served. The evaluation is done by the Director, authorized staff, and Member Agency Chair. As for producing the statistically information derived from the Member Agency Monthly Reports, a Volunteer Agency Coordinator under the supervision from the Director in puts and produces a statistically monthly and yearly report. 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community. The Hawaii Island Food Bank is very unique in the Hawaii County, that it is the only kind of non-profit organization entity that has a member agency network that distributes food to people in need islandwide. There is no other county, state and/or federal program or organization that does the three-fold mission of the Food Bank. 6. List specific accomplishments of this program last year. The Food Bank received more than a 1 million pounds of food from local donors, which includes, supermarkets, farmers, and individuals. The Food Bank distributed more than 1 million pounds of food to those people in need, The increase in efficiency in the acquisition of equipment purchases such as: 2 new cargo vans, pallet racks, fork lifts, reefer units (through a CDGB Grant) revolutionized the Food Bank warehouses to accommodate the increase in demand for food. Substantial decrease of wasting of edible foods amongst, retailing, wholesaling and agricultural industries and having them commit and donor their products to the Food Bank. 7. Provided on sheet. S. If fees for program or services are charged, what are the rates for each specific program or service. The Food Bank charges its member agencies .14 per pound for food. This is what the food banking industry calls: Share Maintenance Contribution. Also, there is a $10.00 a year membership dues for member agencies. And a fee of$5.00 per card for each shopper that is of a member agency. a. The last review of the Share Maintenance Contribution was 12/31/95. The SMC was reduced from .18 per pound to .14 per pound. The last review of the $10.00 membership dues was 06/30/95. The last review of the $ 5.00 shopper cards fee was 06/30/95. b. When were these rates last changed? *SMC changed on 12/31/95 *Membership dues rates not been changed *Shoppers Cards Feed rates not been changed. REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a grant, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accredited in accordance with applicable requirements of Federal, State and County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the services provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(a)(l). 5) Have by-laws or policies that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one year's experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity, by addressing educational concerns, culture and the arts,the needs of the poor, youth, the aged, those with physical or emotional disabilities,victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. Conditions for Grantees Page 8 A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by'the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance, the committees of the Council, their staffs, and the legislative auditor access to records, reports, files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the pfoper and effective expenditure of public funds. — 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. Policy limits shall be a minimum of$300,000 for bodily injury and S50,000 for property damage. 7) Purchase motor vehicle liability insurance in the minimum amounts of S100,000 for liability per person, per accident; S25,000 for property damage; and $300,000 comprehensive, per occurrence. 8) Name the County as additional insured and file certificates of insurance or copies of the policies with the Department of Finance. Please refer to the attached Ordinance and the Hawaii County Code regarding grants to non-profit organizations. �y s CS`styla• � ++P�.i,a,'k1f r,#r, -S1 e a" r,�.,}�F.�a.`t-&4gc ,� a ,1'aas;:i,, N"S,z�^�:' ,. w '{;t,}�zf e*c,tF•.!,`� ' '",4des,`'' : �'' R*,:ma'yA�F,s "C x°'E ..K-t•"ri•. �p'F x-'.r,+,,}� "it M_.•.' 4 X(h '',',`511'5,4f A ii• • • 'f r' y "dRd 53+- &` ' ' � '''.4-11*-''', }: may; f - x'+ -' 4, ms°" 9s�' ee�' a--,';',:7,--1,,*, ` .--4-4,!'"--'. 4. " r. ' 3�4,,, 7 } r R ¢` # . 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' N H;H ;:419!4.0:1,40/: Nww H. ; H24:14 ;�, .N N �iHH!�lH1MiNH;Q NP �!N+ N'viN.HlW. iNN'M,AO O ii; 0 po ,p,p o!C 0 :10!O,N $$,�; ;wO N s CO CC O8 '& i. , WNi 1 N0 0` i0 1, o�W' C'" M N N n'cI W � NN 'N ca y► N; 1 i N;H;HiM,N N,y►,H y�i N'N �HiN:N Q�;H' 'H,W:pp.c Io1 'O p O OipiO!Oi0iQ10,0!O O:1;1 ;OiO!O,O O'O O OI io D'0 -' , { 8 �' aI t1. i ' 1 1 VN N' ;' I :Ni !b.": a , '41511 'N.N:a H y� y�iN Hi iN NiN�M!N;N NiWN�N'N WN I10 O Q '00iO1O 0ti0 8 Ot itgi iStt10 O'P,O!O'O'Q1'O 1 v ti3 ,i FOOD BANK Fnnp RANK APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996- June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: Hawaii Island Catholic Social Ministry - HAWAII ISLAND FOOD BANK NAME OF PROGRAM: HAWAII ISLAND FOOD BANK Mailing Address: 140 Holomua Street Hilo, Hawaii 96720 City, State, Zip: Telephone: (808) 935-3050 FAX_ (808) 935-3794 Attach current Internal Revenue tax-exemption certificate 501 (c)3 yes Amount allocated by the Hawaii County in 1995: $35 000.00 8 % of Budget Agency Total Budget in 1995 545(,065.00 Amount requested of Hawaii County in 1996: S 35,000.00 8 % of Budget Agency Total Budget in 1996: $327,098.00 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: 1996/1997 History of funding with the County of Hawaii: New Applicant x Participating agency since 1992 Firm conducting and date of agency's last financial review or audit: NAME: Choo, Osada & Lee, CPAs, Inc. DATE: January 24, 1996 ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Hawaii Island Catholic Social MinistryPage #2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) Hawaii Island Food Bank 1. Agency Name: Geographic Area(a) Served: County of Hawaii (Islandwide) Agency's Mission Statement: ToIxak2gt the vista' °f all 11"441""Pbut god food/gmcery licd-cts in Hawaii County, to allevai to the needs of the huffy ad needy with this surplus ad to eirate the camutity about this 1roblan ad vbat we cal do abaft it. 2. Briefly describe the kinds of programs and services the agency proves 3, How do these services support the agency's mission? 4. Who is eligible for'entices?` � S. Provide as unduplicated of the number orMdhfidala unduplicated - _ List by program tidt 6. What are tate specific objectives of the agency(in quantitative terns*,wliata possible)? ivenMs,and who on? '7. How do you evaiusl�e tsecvnam _ : do to services? $. What other refit, t or 1 Do you contract resits•y verytl sisroaaa sl" offered iii 9. How d� ' � ,,. 1� or cheapen addressed by theagencythis last year 11. Does the agency du& f'�lout current rates b 5l ,(adult, youth,honorary,eta, - 12. Does the agency have a trade afilliados with a national,or atatIWlde ? If so, what is the formula for national and/or state contrioutions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? County Grant FY 1996/97 Organization Information Section Organization Profile 2. Briefly describe the kinds of programs and services the agency provides. The Hawaii Island Food Bank has two warehouse facilities in Hilo and Kona that services and distributes food to its member agencies to feed the needy and the hungry through outreach services and/or programs such as: hot meals, outreach packages, care boxes and snack programs. 3. How do these services support the agency's mission? By distributing food to its 116 member agency network (islandwide), the Food Bank maintains' its mission by working and educating food donors and individuals in reclaiming edible food products that would have been wasted, allowing member agencies to obtain and distribute the food and recipients receiving the food. 4. Who is eligible for the services? Non-Profit organizations that have a 501 c or 501 c 3 tax exempt status, Letters of incorporation, by-laws, a funding source, and a purpose of feeding the needy and the hungry are eligible to receive food from the food bank. As for recipients, there is no requirements except they must fill out an intake sheet with the outreach or pantry that is a member agency of the Food Bank who is providing the distribution of food boxes, hot meals, or snacks. 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. Program Title: Food Distribution through Outreach Programs (total amounts) of snack, food boxes and hot meals programs In Fiscal Year 1995/96 the Food Bank distributed food to its 116-118 member agencies islandwide. Number of requests per month was 8,000. Number of people per month was 4,200. Number of Emergency Food requests per year was 100,000. Number of meals per month was 47,000. Estimated amounts for Fiscal Year 1996/1997 are: Number of requests per month will be 8,500. Number of people per month will be 4,400. Number of Emergency Food requests per year will be 110,000. Number of meals per month will be 51,000. 6. What are the specific objectives of the agency (in quantitative terms)? The Food Bank's specific objectives is to follow its mission statement in rescuing edible foods from being wasted and distributing the food to those in need. Since the mission statement is three-fold, the Food Bank continues to educate and advocate the issues of the wasting of food products, hunger and poverty in Hawaii County through education and awareness. In addition to following its mission, the Food Bank is critically looking at customer relations and satisfaction and also improving its warehouses' conditions in making the warehouse consistently flow and look more like a "supermarket" atmosphere for its member agencies. 7. How do you evaluate programs/services effectiveness, and who does the evaluation? The Food Bank evaluates its member agencies that have pantries or on-site feeding programs by conducting a yearly on-site evaluation. A physical on-site visit and interview is done by reviewing the facility in ensuring that rules and regulations set forth by the Food Bank is upheld. Normally the on-site evaluation is done by the Food Bank Director and/or staff person trained to do an On-site Evaluation and also the Agency Advisory Board Chair (trained by the Director) can conduct the yearly On-site Evaluation. The measure of effectiveness of the food pantry/member agency distributing food to those in need is assessed by the On-site Evaluation intake/questionnaire sheet, its monthly agency reports that reports how many people have been served by the member agency and at the monthly member agency meeting, when each agency updates the Food Bank and others about their outreach programs and reports the numbers of people they are serving and the kinds of services they are providing. 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? None applicable. 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? None applicable. 10. List specific accomplishments or challenges addressed by the agency this last year. In Fiscal Year 1995/96 the Food Bank was faced with major financial crisis that caused a re-organization and streamlining of its budget. Budget cuts were made in expenses and efforts in generating revenue/income was necessary to maintain the operations of its warehouse facilities and also to continue the rescuing and distribution of food to those in need. In addition to the financial challenges, the Food Bank established several other objectives in increasing revenue in its Share Maintenance Contribution by looking into improving and increasing customer service, agency relations, and also implementing warehouse systems to increase efficiency and productivity amongst warehouse staff and volunteers. In addition, great efforts was made in increasing the level accuracy and efficiency in the accounting and bookkeeping systems by upgrading computer accounting hardware and software, improving internal controls, and implementing professional and technical training for its in-house bookkeeper by having a finance officer overseeing the Food Bank's financial "picture" on a day to day basis. 11. Does the agency have membership dues? If so, list current rates by category (adults, youth honorary, etc...) The yearly membership dues that member agencies contribute to the Food Bank is $10.00. This allows for the services to be continued to them. 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national/or state contributions and how often are dues paid? The Food Bank is an affiliate member of Second Harvest which is a national Food Banking Network that governs member Food Banks across the nation. The Hawaii Island Food Bank is only an affiliate and does not pay any membership dues or contributes to the organization. 13. What benefits and/or services are provided to the agency by the national or statewide organization. If though the Hawaii Island Food Bank does not a membership dues to Second Harvest, but belongs to the Hawaii State - Food Bank Network, the benefits or services received are the following: * National Food Corporation Products - e.g. USDA; Kellogs * Food Bank Warehouse Rules and Regulations-Standards * Food Banking Information * Promotional/Fund Raising Information * Invites to National Food Bank Conventions * To "tag on" the national name for public relations HUMAN RESOURCES DIVIDER SHEET Hawaii AGENCY NAME: Islam Food Bank Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? x Yes No Being revised Date last revised: Jun 1995 3. Do your personnel policies contain an equal employment opportunity clause? x Yes No 4. Do you have a written job description? x Yes No Being revised Date last revised: Jule 1995 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) x Yes No Being revised Date last revised: ItmErter 1995 6. Does the agency conduct regular evaluation of employees? x Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide&brief explanation. x No change Increase in staff is projected Decrease in staff is projected (Answer questions 8,9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. f 2 ro rL f✓ = ^..' O -ec. - O. ^1 W C 1 a 1 1 rn i 1 co n 1 MCDCi) (712 <• O n 1 n' Snn P . = c c s E n TCD � o = P o- o �' �• CM C:, Zn' a 0 n �' v' TI d R CD O = 0 a S ir t A d G. " n = .:11 n r O R- 5• O O CA C O C Dr-t a) -I• d n 7d 1 ...< coco 9 o c. aI o , 1 CD 0 1 -s 1 1 x O CD z � CA dd e.•w co °o a) o co N j rn4 *- •, QQ 9 A- ,., �. 0 CO 0 C- t:7,3144711.4. sy .NitodiligwAtevi Hawaii Island Food Bank Hawaii Island Catholic Social Ministry - Hawaii Island Food Bank Current Fiscal Year 1995/96 Salary Ranges Updated: November 1, 1995 Name Position FY 95/96 FY 96/97 Alissa Alcosiba Program Director $30,000 $30,000 Helen Luta WH Warehouse Supervisor $27,040 $24,000 Nani Camacho EH Warehouse Supervisor $25,390 $24,000 Nan Elmer Office Mgr/Bookkeeper $16,802 $16,802 Lau Subica EH Warehouse Ass't $ 4,368 $ 4,368 Andrea Renshaw WH Warehouse Ass't $ 4,032 $ 4,032 Total $107,632.00 $103,202.00 *Subject to change 140 Holomua Street • Hilo,Hawaii 96720 • Ph. (808)935-3050 • Fax(808)935-3794 Box 2125 • Kealakekua,Hawaii 96750 • Ph. (808)322-1418 • Fax(808)322-3812 HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: WAREHOUSE ASSISTANT Reports to: Warehouse Supervisor Supervises: Warehouse volunteers . Purpose of the Position: To assist the Warehouse Supervisor in ensuring an efficient, safe and sanitary warehoue for the collection, storage, and distribution of donated products, and that the operation meets all state and local government food safety and sanitation standards and regulations. Duties and Responsibilities: 1. Scanning duties of reclamation items. 2. Receiving food into warehouse. 3. Assist with distribution of products to member agencies. 4. Stock shelves in the warehouse, reefer and freezer. 5. Assist with inventory control. 6. Assist in pick-ups or deliveries when needed. 7. Assist with warehouse sanitation. 8. Supervise warehouse volunteers as needed. 9. Other duties as required by the Warehouse Supervisor. Minimum Qualifications: 1. Ability to work well with the public, other staff, volunteers and community representatives. 2. Ability to work with a minimum of supervision and ability to follow standardized procedures. 3. Ability to function as a team player. 4. Hawaii's Driver's License. 5. Exert force and/or lift or carry items weighing 20 -100 pounds occasionally and up to 50 pounds frequently. 6. Up to 2/3 of the time: walk, sit, squat, bend, twist, reach at various heights above and below shoulder level. 7. Up to 1/3 of the time: push or pull; lift or carry large, heavy, awkward objects while maneuvering in a confined space, eg: narrow aisles, high density storage areas, inside of a truck box, etc.; ascend or descend flights of stairs; climb in or out of trucks, docks and/or forklifts. 8. Work inside freezers and coolers with a temperature range of 0 degrees F to 38 degrees F. 6/16/95 HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: OFFICE MANAGER Reports to: DIRECTOR and FINANCE OFFICER Supervises: Office Volunteers Purpose of Position: The Office Manager shall be responsible for all office managerment activities including reception. fiscal and secretarial duties and other duties as required by the Director and/or Finance Officer. Duties and Responsibilities: 1. Fiscal Duties: a: Accounts Receivables b: Accounts Payables c: Deposits d: Reconciliations e: Petty Cash f: Filing g: Monthly Statements 2. Inventory: a: Maintain Inventory Records b: Inventory Reports c: Inventory Control d Physical Inventories 3. Office Managerment: a: Purchasing Supplies b: Maintain inventory of Supplies c: Maintain Inventory of Fixed Assets d Equipment Maintenance e: Personnel matters 4. Reports: a: GET b: Invoicing c: Sales Reports d: Audit Reports fe Grant reports as needed • 5. Standard operating Procedures: a: Bookkeeping and Accounting b: Office Management c: Reports d: Assist i‘ith other SOP's as needed 6. Responsible for getting quotations/bids for all purchases of services and equipment 7. Special Projects as4 assigned by Program Director Qualifications: 1. 2 years bookkeeping experience 2. 2 years office managerment and supervison experience 3. Computer experience: Quickbooks,Microsoft Excel,Microsoft Word 4. Demonstrated ability to work well with the public,other staff,volunteers and community representatives 5. Demonstrated organizational skills,ability to work with minimum of supervision and the ability to follow standardized procedures. 6. Ability to clearly explain ideas and instructions verbally or in written form. 7. Ability to function as a team player and establish and maintain good relationships with people representing a wide variety of ethnicity,age and social backgrounds. 8. Degree in Business or Accounting preferrable 9. Ability to use ten key by touch,good typing skills required. HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: OFFICE MANAGER Reports To: DIRECTOR • Supervises: Office volunteers Purpose of the Position: The Office Manager shall be responsible for all office management activities including reception, fiscal and secretarial duties and other duties as required by the Director. Duties and Responsibilities: 1. Fiscal Duties: A. Accounts Receivables B. Prep. of Accounts Payable C. Deposits D. Reconciliation E. Petty Cash F. Filing G. Necessary-materials for-bookkeeper to do monthly income statements and balance sheets 2. Office Management: A. Purchasing supplies B. Maintain inventory of supplies C. Maintain inventory of fixed assets (office/warehouse) D. Equipment maintenance: Xerox, postage meter, fax machine, computer E. Personnel: files, monthly time sheets, forms/orientation for new hires, accident reports and other insurance report procedures 3. Reports: A. GET B. County invoices, monthly C. Monthly activity Reports D. Assist with audit preparation E State of Hawaii invoices for GIA F Monthly agency poundage reports G. Other grant reports as needed r 4 Standard Operating Procedures: A. Bookkeeping function B. Office Management function C. Reports D. Assist with warehouse SOPs if needed 5. Responsible for getting quotations/bids for all purchases of services and equipment 6. Other duties as required by the Food Bank Director. Minimum Qualifications: 1. 2 years bookkeeping experience 2. 2 years office management and supervision experience 3. Experience with computers including the following software: Quickbooks, Microsoft Excel, Microsoft Word, and Works. 4. Demonstrated ability to work well with the public, other staff, volunteers and community representatives. 5. Demonstrated organiational skills, ability to work witha minimum of supervision, and the ability to follow standardized procedures. 6. Ability to clearly explain ideas and instructions verbally or in written form. 7. Ability to function as a team player and establish and maintain good relationships with people representing a wide variety of ethnicity, age and social backgrounds. 8. Bachelor's degree in business preferable 9. Ability to use ten key by touch. Good typing skills also preferred. 6/13/95 HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: Warehouse Supervisor Reports to: Executive Director Supervises: Driver; VISTA Volunteers: Volunteer Coordinator, Resource Developer; JOBS workers in the warehouse and other warehouse volunteers Purpose of the Position: To provide effective management of the Hawaii Island Food Bank's Hilo warehouse. To ensure an efficient, safe and sanitary system for the collection, storage, distribution, and delivery of donated products, ensuring that the operation meets all state and local government food safety and sanitation standards and regulations. Duties and Responsibilities: 1. Develop standard operating procedures and manage their implementation: A. Supervise and maintain an orderly process for the collection and delivery of donated food and non-food products. B. Ensure that warehouse is in a sanitary condition that meets all Health Department and Second Harvest standards and regulations. C. Dispatch, schedule and supervise all incoming donations and the loading and unloading of product. Oversee storage of same. Work with Resource Developer to maintain a professional donor relationship. D. Supervise a routine inspection program of all vehicles and warehouse equipment. E. Implement and maintain safety policies and programs developed for warehouse operations. F. Prepare monthly reports on warehouse activities, i.e., SMC, food poundage, etc. 2. Oversee the storage and distribution process of purchased and grant food products,such as: Bread on the Water. 3. Ensure reconciliation of inventory records. 4. Manage and help to develop the food inventory system, and ongoing maintenance. • 5. Ensure that monthly food reports that appropriately depict the flow of food products are completed. 6. Manage the development of volunteer projects that facilitate a cost-effective operation. 7. Assist in development of equipment needs/specifications in the warehouse. 8. Other duties as required by the Executive Director. Minimum Qualifications: 1. Demonstrated ability to work well with the public, other staff, volunteers, and community representatives. 2. Demonstrated organizational skills, ability to work with a minimum of supervision, and the ability to follow standardized procedures. 3. Ability to clearly explain ideas and instructions and to provide appropriate documentation. 4. Ability to function as a team player and establish and maintain good relationships with people representing a wide variety of ethnicity, age and social backgrounds. 5. Proven ability to drive cargo vans, operate standard warehouse equipment, and demonstrated ability in maintenance and basic repair of vehicles and equipment. Ability to safely operate all types of warehouse equipment, including, but not limited to, pallet jacks, and forklift. 6. Exert force and/or lift or carry items weighing 20 to 100 pounds occasionally and up to 50 pounds frequently. • 7. Up to 2/3 of the time: walk; sit; squat; bend; twist; reach at various heights above and below shoulder level. 8. Up to 1/3 of the time: push or pull; lift or carry large, heavy, awkward objects while maneuvering in a confined space, eg: narrow aisles, high density storage areas, inside of a truck box, etc.; ascend or descend flights of stairs; climb in or out of trucks, docks and/of forklifts. 9. Work inside freezers and coolers with a temperature range of 0 degrees F to 38 degrees F. 10. Basic knowledge of food storage, handling, and distribution procedures. 2/8/95 HAWAII ISLAND FOOD BANK JOB DESCRIPTION Position Title: Director Reports To: HICSM Executive Director and HIFB Advisory Boards Supervises: W.H. Deputy Director, E.H. Warehouse Supervisor, Resource Developer, Office Manager/Bookkeeper and other staff as needed Purpose of the Position: To work in concert with the HICSM(Hawaii Island Catholic Social Ministry) Executive Director and H FB Advisory Boards to provide leadership for the Hawaii Island Food Bank(HIFB) in order to carry out its mission in addressing hunger in Hawaii County. The Director is responsible for all aspects of the food bank operations and works to ensure the development of and adherence to sound management procedures throughout the foodbank. Duties and Responsibilities: 1. Carries out the policies of the Food Bank as approved by the HICSM Executive Director and Advisory Boards and the rules and regulations of local, state and federal statutes related to the operations of the Food Bank. 2. Administers and directs the activities of the Food Bank by implementing HICSM and Advisory Board policies, developing procedures, setting direction, and evaluating results, 3. Evaluates the effectiveness of all Food Bank policies, rules and procedures. 4, Ensure adherence to sound hiring, training, supervisory, and disciplinary practices within the agency. 5. Recommends to the HICSM Executive Director, the appointment or termination of all Food Bank personnel. 6, Responsible for the implementation of staff work schedules, duties and functions and the general supervision and evaluation of personnel. 7. Develop and maintain a program of health and safety for the protection of staff, volunteers and visitors. 8. Responsible for the efficient and economic management of the Food Bank. This includes financial planning. budgeting and reporting, accounting and auditing. - -i 9 Supervises the preparation of the annual audit, financial statements and food bank contracts. 10. Manage the application process for United Way, County and other funding as identified including writing grant proposals, reports and coordinating political processes. 1 1. Supervises the development of Food Bank long-range and short-term resource development including food and funds 12, Represents the Food Bank at meetings and conferences with federal, state and local agenices. (The Director may delegate this responsibility if necessary) 13.T'he Director is the spokesperson for the Food Bank and will expand public awareness and agency resources by making presentations to community groups. 14. Keeps the HICSM Executive Director and Advisory Board informed of local, state, and federal governmental actions as they relate to the Food Bank. 15. Provides support to the Advisory Boards to foster their responsibilities of effective planning, fundraising and other support for the food bank. This includes securing new membership for the Advisory Boards and its committees striving to have them reflect cultural diversity that exists in the community. 16. Other duties as delegated by the HICSM Executive Director. Minimum Qualifications: 1. Bachelor's Degree or higher, preferably in Business, Management or Public Administration or related field or three years of experience in senior management position, preferably in retailing or foodbanking. 2. Demonstrated organizational and supervisory skills, proven ability to plan, organize and evaluate the work of others. 3. Ability to communicate well, both verbally and in writing. 4. Analyze and synthesize data and make sound judgments. 5. Demonstrate professional and business leadership. 6. Ability to manage time and plan activities in an actively changing environment, 4/25105 County Grant FY 1996/97 Human Services Form Human Resources 8. Please share information on training opportunities provided to staff and/or volunteers. The Hawaii Island Food Bank over the years have provided the following training opportunities for its staff: * Attending Workshops/Seminars in: - Warehousing, Accounting, - Customer Services, - Volunteer Recruitment, - Donor Resourcing, - Injury Prevention in Warehouse Facilities, and - Food Banking Conferences - Updates - Fund Raising Techniques - Building Successful Boards - Food Prep - Marketing Your Products - Employee Relations * Cross Training/Improving Job Skills/Promotions - In-House Training Programs - Multi-Task Jobs - Distribution of Books or literature to learn other job skills Volunteers: * Conducting orientations to educate the volunteer about the organization. * Specific Job Descriptions and training * Literature or handouts on the tasks or job assigned to * Workshops * One to one training techniques from staff member assigned to train the volunteer 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concerns or challenges. Not applicable at this time. 10. Please provide a description of the minimum requirements for each position. Warehouse Assistant: To assist the Warehouse Supervisor in ensuring an efficient, safe and sanitary warehouse for the collection, storage and distribution of donated products, and that the operation meets all state and local government food safety and sanitation standards and regulations. Office Manager/Bookkeeper: To provide all bookkeeping functions of the Hawaii Island Food Bank as well as office management: purchasing, inventory and other duties as required by the Director. Warehouse Supervisor: To provide effective management of the Hawaii Island Food Bank's Hilo and Kona warehouses. To ensure an efficient, safe and sanitary system for the collection, storage, distribution, and delivery of donated products, ensuring that the operation meets all state and local government food safety and sanitation standards and regulations. Program Director. To work in concert with the HICSM Executive Director and HIFB Advisory Boards to provide leadership for the Hawaii Island Food Bank in order to carry out its mission of addressing hunger in Hawaii County. The Director is responsible for all aspects of the food bank operations and works to ensure the development of and adherence to sound management procedures throughout the foodbank. BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Haaaid. Island Food Bark (Page 4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) I Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3 According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements(to meet the agency's mission) for the coming year. 7. What long range plans does the Board of Directors have for the agency? D.. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s)in order of importance. Give the number "I" to the most important and dominant service or target population. I educational. - 2 victims of crime culture&arts • 2 victims of health crises 1 the poor 2 victims of social crises 1 youth 2 the physically disabled 1 the aged 2 the mentally or emotionally disabled 1-10-96 HAWAII ISLAND FOOD BANK EAST HAWAII ADVISORY BOARD FY 95/96 Roland Higashi 714 Kanoelehua Hawaii Printing 1 year term Chair Hilo, HI 96720 President/Owner 961-6651 Fax 935-0518 Steve Querobin 138 Laula Road Hawaii Firefighters Union 1 ye.. term Vice Chair ' Hilo, HI 96720 Retired 959-6038 Stephanie Salazar 688 Kinoole St. Ste. 214 COH Corp. Counsel 1 year tern Secretary Hilo, HI 96720 Family Support Div. 961-8375 Legal Assistant Fax 935-7428 Noel Fujimoto 688 Kinoole St. #104A Office of Hawaiian Affairs 1 year tin Treasurer Hilo, HI 96720 Loan Officier 933-474$ Fax 933-4744 Jos Schoemaker 1518 Kilikina St. EH Agency Advisory 1 Year tarn Hilo, HI 96720 Committee Chair 935-7364 Debbie Alani P.O. Box 683 Church of the Holy Spirit 1 year term Keaau, HI 96749 EH Agency Advisory 966-8381 Committee Secretary Margaret Koehler P.O. Box 1862 Operation Blessing 1 year tan lido, HI 96721 EH Agency Advisory 961-0486 Committee Vice Chair Patricia Bergin 75 Aupuni St. Dept. of Education 2 year tern Hilo, HI 96720 District Superintendent 933-4237 Fax 933-4696 1-10-96 Toni Granito 101 Holomua St. SBS 2 year tern Hilo, HI 96720 Sales Rep. 935-5401 Fax 961-5522 Timothy Waugh 185 Todd Ave. L Enterprises 2 year team Hilo, HI 96720 • 935-0763 Marie Fontana 14-4427A Kapoho-Pahoa Rd. SacxeI Heart Fame 2 year teen Pahoa,96778 936-2718 Nan Hiraoka 450 Waianuenue St. Doe-1i ai siren 1/2 year term Hilo, HI 96720 933-4406 Evelyn Sanoria P.O. Box 655 Rima Assethly of God 2 year temp ,Pahoa, HI 96778 965-8901 Carol Ignacio P.O. Box 1373 1IIC21 Director no teen-advisory Honokaa, HI 96727 775-9581 Fax 776-1601 Hawaii Island Food Bank West Hawaii Advisory Board FY 95/96 and FY 96/97 Revised: January 1, 1996 Name Organization Address Term Reggie Morimoto First Hawaiian Bank PO BOX 618 lyr Chair Branch Mgr. KK-HI 96750 Ph: 322-3484/F 322-3150 Donald Sasaki Cal-Kona Produce PO BOX 16 lyr Vice Chair Pres. KK-HI 96750 Ph: 322-6033/F 322-6441 Debra Fuller Independent PO BOX 4733 2yr Secretary KK,HI 96740 Ph: 322-7393 David Logan MacFarms HI PO BOX 630 lyr Treasurer Comptroller KK, HI 96750 Ph: 328-2435/F 328-2080 Glenn AbsoKona Village PO BOX 25 1 yr Head Chef KK, HI 96745 Ph: 325-5555/ F 325-5124 Moana Kuma HVB 76-6274 Plumeria Rd. 2yr Secretary KK, HI 96740 Ph: 327-77871F 326-7563 Heidi Teves PATCH Keauhou Hotel 2yr WH Agency Chair Director KK, HI 96740 Ph: 322-6818/F 326-2155 Ken Clewett Director University of Nations lyr 75-5851 Kuakini Hwy KK, HI 96740 • Ph: 326-4447/ F 329-2387 Ross Wilson President Current Events 1 yr 75-5751 Kuakini Hwy KK, HI 96740 Ph: 326-7820/F 326-5634 Charlene Goo General Manager Keauhou Beach Hotel lyr KK, HI 96740 Ph: 322-3441/F 322-6586 Mamie Bramlett Independent PO BOX 788 2yr Kapaau, HI 96755 Ph: 899-5833 Keith Hayama Manager KTA-Keauhou 2yr 78-6831 Alii Dr. KK, HI 96740 Ph: 322-2311/F 322-6673 2 County Grant FY 1996/1997 Board of Directors Form Board of Directors 2. List number of board meetings held in the prior year and attendance levels. The Food Bank in FY year 1995/96 holds monthly meetings for its West Hawaii Advisory Board and every other month for its East Hawaii Advisory Board. This was determined by its board members. Estimated: 12 members For FY 95/96 WEST HAWAII 5 meetings 30% attendance For FY 95/96 14 members EAST HAWAII 4 meetings 90% attendance 3. According to the bylaws, how many Board of Directors must serve on the board? In FY 95/96, the Food Bank needed to evaluate the purpose of the Board of Directors. The bylaws that were made in 1992 states that the board can have up 12 members that can serve for a 2 year term. 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. The Boards on both West and East and Hawaii made major decisions in the area of fund raising. They felt that would like to be more involved in raising money for the Food Bank. Fund Raising Commitees have been organized and they will be planning accordingly for FY 96/97; 97/98; and 98/99, a three year long range plan. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address challenges. In meeting with the various Advisory Boards of the Food Bank, it was clear that these are the major concerns of both boards and Food Bank management: * Mission * Fiscal stability for Food Bank: e.g. Fund Raising * Agency Relations and Customer Service * Volunteer Building and Maintenance * Warehouse Conditions * Resource Developing In assessing all of these concerns, the Advisory Board along with the Program Director, and staff of the Food Bank will have to work in concert in maintaining its mission statement, finding progressive ways of continuing and generating revenue, improving and recruiting member agencies, increasing customer service for its member agencies, building and increasing volunteer base, and developing well-trained volunteers to assist in the operations of the Food Bank, improving warehouse conditions which will bring about efficiency and boost revenues, and continuing to improve, diversify and increase donations from food resources to maintain the distribution of food to those in need. 6. List planned improvements (to meet the agency's mission) for the coming year. In utilizing the Advisory Boards on the East and West sides of Hawaii County this is the list of planned improvements that will help the Food Bank increase or meet the mission for the coming year. * Assessing the current Board members, who, what,where, and how much time can they commit to the Food Bank * Recruitment of new Board members. Finding those in the community that fit the Food Bank and its purpose * Increasing meetings to a monthly schedule * Increasing education about food banking for its board * Utilizing board members and their expertise * Formubthng committees to address each aspect of the food bank * Formulating a five-year strategic plan 7. What long range plans does the Board of Directors have for the agency? The Advisory Boards for the Food Bank at this time have no long range plans but is helping to address the critical financial and operations issues that the Food Bank is dealing with during this Fiscal Year 96197. After the challenges of this fiscal year is addressed and corrected an great impetus from the Board will take place in strategically planning for the Food Bank and its future success. FUNDING NEEDS DIVIDER SHEET AGENCY NAME: " ' Island Food Bek (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3 What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question#7, what is the formula used to determine this amount or percentage? County Grant 1996/97 Funding Needs Form FUNDING NEEDS 1. Briefly explain the purpose of your requests. The Hawaii Island Food Bank requests $35,000 to assist in the moving of 1.6 million pounds of food/grocery products to helping agencies who feed people in need. This will go to pay for part of the Program Director's salary, our Hilo and Kona warehouse rent, utilities, telephone, vehicle gas and maintenance costs. 2. What alternative funding sources were considered and/or applied for? Alternative funding sources that were considered and applied for are: * State Grant-In-Aid * Hawaii Island United Way * Share Maintenance Contributions * Private Contributions 3. What alternatives have you considered if this County requests is not funded or is not fully funded? With the tough economic times our County is suffering through, non-profits like the Food Bank is looking into many types of alternative funding sources to continue it mission and services. If funding from the County grant is cut or restricted in its amount the Food Bank will substantially hit and its operations will tremendously be affected. Hypothetically, if the funding does not come through, the Food Bank will have to scramble and look into a fund raiser or seek-out a private donor. This in effect could cut services, food distribution, warehouse operations, and staffing (which was downsized in FY 95/96). 4. Give a brief explanation for any variances of 15% or greater per line in the current vs. proposed budget. No variances. Questions 5 - 8 is not applicable to the Hawaii Island Food Bank PROGRAM INFORMATION DIVIDER SHEET Agency name: Edi Isla i Foo3 Balk (Page 6) Distribution of Fccd Program name: Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer questions 14 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the progran(in quantitativOssins,where possible)? 4. How do you evaluate program effectiveness,and who does-tube`ev ati '-° 5. How does this program's content vary from similar(or same)programeoflbrec#by other agencies in the commwaty '' 6. List specific accomplishments of this l rogran%taxi yam'` ` } F ' • a µ 7. Provide information _ . ed count ofthis ei • • iodinate S CCC 8. If fees ft* 1.} . are s what are the rates.Oaf geed specific program or service? (Attach a campy rate schedule for this ) A. When were these rates last reviewed? B. Whes.were these rates last changed? County Grant FY 1996/97 Program Information Form PROGRAM INFORMATION 1. How does the program help individuals, groups and/or the community? The Hawaii Island Food Bank provides farmers, grocery retailers, wholesales, hotels and restaurants a convenient and a cost free way to donate surplus or unsaleable wholesome food. It is often the case that potential donors don't have the time or the information to screen charities and most non-profits cannot cope with the quantities of food offered by many large companies. The Hawaii Island Food Bank is equipped to do all the necessary screening of charities; and: to pick-up sort, inventory, store and distribute donated food in amounts that charities need and can use. This saves donors and non-profits both time and money, plus salvage food that goes to hungry people...food that might otherwise be wasted. For every $1 operations, the Hawaii Island Food Bank is able to distribute $6 of food. County funding will thus help multiply by a factor of 6 in the value of food provided. 2. Who is the target population for this program? The target population is private non-profit agencies who serve the poor, children, elderly, homeless, victims of crime, health and social crisis and disabled. 3. What are the specific objectives of the program? The specific objectives of the program which is the distribution of food to 116-118 member agency network is to provide good food to continue their outreach programs or services of feeding the needy and hungry. Also to provide a means of food to empower and uplift people in need during economic hardships so they can continue and maintain their lives. 4. How do you evaluate program effectiveness, and who does the evaluation? The Food Bank measures effectiveness is the number of pounds of food they receive from the food industry and distribute to these agencies each month. The Food Bank also measures effectiveness by providing an on-site evaluation process that is conducted on a yearly basis that goes into the agency's operations and assesses the conditions of how they handling, and distributing out the food to recipients. Also monthly agency reports are submitted by member agencies that reports the amount of people being served from their outreach programs, hot meal programs etc.... This allows the Food Bank to record and report statistics on the geographical area, age, and gender being served. The evaluation is done by the Director, authorized staff, and Member Agency Chair. As for producing the statistically information derived from the Member Agency Monthly Reports, a Volunteer Agency Coordinator under the supervision from the Director in puts and produces a statistically monthly and yearly report. 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community. The Hawaii Island Food Bank is very unique in the Hawaii County, that it is the only kind of non-profit organization entity that has a member agency network that distributes food to people in need islandwide. There is no other county, state and/or federal program or organization that does the three-fold mission of the Food Bank. 6. List specific accomplishments of this program last year. The Food Bank received more than a 1 million pounds of food from local donors, which includes, supermarkets, farmers, and individuals. The Food Bank distributed more than 1 million pounds of food to those people in need, The increase in efficiency in the acquisition of equipment purchases such as: 2 new cargo vans, pallet racks, fork lifts, reefer units (through a CDGB Grant) revolutionized the Food Bank warehouses to accommodate the increase in demand for food. Substantial decrease of wasting of edible foods amongst, retailing, wholesaling and agricultural industries and having them commit and donor their products to the Food Bank. 7. Provided on sheet. 8. If fees for program or services are charged, what are the rates for each specific program or service. The Food Bank charges its member agencies .14 per pound for food. This is what the food banking industry calls: Share Maintenance Contribution. Also, there is a $10.00 a year membership dues for member agencies. And a fee of$5.00 per card for each shopper that is of a member agency. a. The last review of the Share Maintenance Contribution was 12/31/95. The SMC was reduced from .18 per pound to .14 per pound. The last review of the $10.00 membership dues was 06/30/95. The last review of the $ 5.00 shopper cards fee was 06/30/95. b. When were these rates last changed? *SMC changed on 12/31/95 *Membership dues rates not been changed *Shoppers Cards Feed rates not been changed. REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a grant, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accredited in accordance with applicable requirements of Federal, State and County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the services provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(ax 1). 5) Have by-laws or policies that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one year's experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity, by addressing educational concerns,culture and the arts,the needs of the poor,youth,the aged, those with physical or emotional disabilities,victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. Conditions for Grantees Page 8 A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance, the committees of the Council, their staffs, and the legislative auditor access to records, reports, files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. Policy limits shall be a minimum of$300,000 for bodily injury and $50,000 for property damage. 7) Purchase motor vehicle liability insurance in the minimum amounts of S 100,000 for liability per person, per accident; S25,000 for property damage; and $300,000 comprehensive, per occurrence. 8) Name the County as additional insured and file certificates of insurance or copies of the policies with the Department of Finance. Please refer to the attached Ordinance and the Hawaii County Code regarding grants to non-profit organizations. •'r ft ,,.h.'Y ..`�� �' * } ,r.y=.,...,-,,-;,•,_-_-,---,-,•,::;11-4.4,:',' ,# '6Y F '4'. 4 N .+n; - a. `€#'� `'' .* .�e x ^. >- a. ',71:4,4,'''-:.;: f � a t sH. -';'1",;'''' � v .a', -o4;!' p. 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IiMu! ! p 40 O poa i O ti M yb iov NV/,M Miy 4w y► W M IP 40!4/'40'F'40 40 � 40 • . X, " , O O Oi0!0i0,0t0!0 O'�0•OIO O O�,O,0:0 O.O,O 0:Q10.0 O , a - 1 �► '0 I - , IMaOi�� w '0,40.0,.4p.0,4014,4140140.• ; d/1M'N !Ni40 H'WN,N;M W � 42 1 0 p O O! . 010,00 & ;010.00!O O!0O!OO! ,O'O O Q •O Au •,Ci : $ N3$ I •I I � . , a T HILO HAMAKUA SUPPORT PROGRAM Application for Non-Profit Funds COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1-8) Organization Summary Organization Name: Hawaii Island Catholic Social Ministry Name of Program: Hilo-Hamakua Support Program Mailing Address: P.O. Box 1373 City, State, Zip: Honoka'a, Hawaii 96727 Contact Person: Carol R. Ignacio, Executive Director Valerie T. Ahuna, Program Director Telephone: (808) 775-9538 Fax: (808)775-8163 Attach current internal Revenue Tax-exemption certificate 501(c)3: Yes Amount allocated by the Hawaii County in 1995: N/A Agency Total Budget in 1995: N/A Amount requested of Hawaii County in 1996: $44,958 100% of Budget Agency Total Budget in 1996: $44,958 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February , 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year. July 1 -June 30 History of funding with the County of Hawaii: New Applicant X Participating agency since 1991 Firm conducting and date of agency's last financial review or audit NAME Choo, Osada and Lee, CPA's,Inc. DATE: June 30, 1994 An Audit was conducted in June of 1995 by the same firm, but we have not received the final report yet. We will forward a copy of the final report on to you as soon as we receive it. 1994 Audit is enclosed. 1 ORGANIZATION INFORMATION SECTION(pages 2-8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Hawaii Island Catholic Social Ministry Hilo-Hamakua Support Program Geographic Area(s) Served: HICSM - Hawaii County in its entirety. Hilo-Hamakua Support Program - Hamakua through Hilo Coast Agency's Mission Statement: The overall mission of Hawaii Island Catholic Social Ministry, hereinafter HICSM, is to research, plan and implement specific programs and projects to meet the needs of the poor and marginalized in Hawaii County and to advocate on their behalf. Our goals are: 1) To provide services to sustain the human dignity of all persons; 2) To foster social justice; and 3) To call others to do the same. In carrying out this mission HICSM relies on a four-sided model which incorporates the following: 1) Direct Service 2) Community Development; 3) Social Concerns Education; 4) Social Action Hilo-Hamakua Support Program: The Hilo-Hamakua Support Program works to strengthen community by bringing people together to facilitate community planning and development. Close partnerships between the program,agencies and the community results in addressing immediate and long-term needs through case-management. 2. Briefly describe the kinds of programs and services the agency provides. HICSM is a non-profit organization on the island of Hawaii. HICSM is a unit within the Office for Social Ministry of the Catholic Diocese of Honolulu. HICSM was established on July 15,1986 as part of the Catholic Diocese's plan to develop strong local island communities which would reflect the shared experience of responsible decision-making in building communities of social service and action. • Hilo-Hamakua Support Program: The Hilo-Hamakua Support Program was developed in 1993 in response to the recent closings of the Hamakua Sugar and the Hilo Coast Processing Companies. The program works with displaced workers and their families. Outreach staff reach out to individuals in the community as well as to be available through self and other kinds of referrals. Staff conducts assessments of situations of the "participants" identifying strengths as well as barriers. Information about resources and referrals are made as appropriate. Outreach staff provides non-clinical counseling such as life skills counseling and advocacy as needed. Two(2) resource centers(located in Hamakua and Rural South Hilo) network with human service and educational programs to provide assistance to the community in this time of transition. Through outreach services,the interest of the community is identified. Other providers are encouraged to extend and adapt their resources to be acceptable and of use to develop the strengths of the community and its'people. 2 • Care-A-Van: Care-A-Van is a mobile health care and social service program serving the homeless people on the island of Hawaii. It was established by HICSM on this island in March of 1991. Care-A-Van is in its' fourth year of operation and is the only outreach program for the homeless in Hawaii County. • Hale Kokua: The Hale Kokua Program is a new program of HICSM. It is a program designed to increase the housing availability for homeless families and individuals through a construction grant program to owners willing to build a new unit or add on to an existing unit . The units house homeless families. Our staff provides case management to these families and help them work toward self-sufficiency. This program is a partnership with Hawaii Housing Authority, County of Hawaii and HICSM. • Hawaii Island Food Bank(HIFB): HIFB has been a project of HICSM since 1989. The food bank provides over 118 agencies with food each month. Thousands of pounds of food were salvaged and distributed this past year through HIFB and participating agencies. HIFB operates food banks on both the East and West sides of the island projecting to salvage 2 million pounds of food this year and getting this much needed food to participating agencies. • Emergency Assistance Program: The Emergency Assistance Program has been in operation for 9 years. Emergency Assistance Programs provides a number of emergency financial assistance programs to the community. These programs have eligibility requirements and assist individuals with emergency food, housing and utility assistance, health care and other life supports. • Parish Social Ministry Programs: HICSM has oversight for parish outreach programs in the 13 parishes on the Big Island. These outreach centers serve the entire community in which they are situated, providing food, clothing, and financial aid. The outreach centers are also the "pulse" of the community and are a way to identify needs so that appropriate programs can be developed. Quarterly network meetings are held to network, in-service volunteers, and to support the volunteers. HICSM plans and coordinates these gatherings. 3. How do these services support the agency's mission? All services support the agency mission by serving the poor and marginalized. 4. Who is eligible for services? HICSM's programs target different populations i.e. Care-A-Van - homeless . . . according to contract requirements or program focus. In all programs no person is discriminated against on the basis of race,color, national origin, religion,creed, sex,age, sexual orientation,or physical handicap. For the purpose of this proposal the Hilo-Hamakua Support Program targets dislocated workers and families of the former Hamakua Sugar and Hilo Coast Processing Companies. 5. Provide an unduplicated count of the number of individuals served by the agency? HICSM provides services through various programs. An annual report is attached hereto The Hilo-Hamakua Support Program served 641 unduplicated persons for the period September 1994 through November 15, 1995. Funds to operate the Hilo-Hamakua Support Program during this period came through a grant from Office of Community Services and private donations. 3 6. What are the specific objectives of the agency ( in quantitative terms, where possible)? The specific objectives of each HICSM program varies. The annual report is attached hereto. The following are the specific objectives of the Hilo-Hamakua Support for the contract period January 1, 1996 to June 30, 1996. • 2 Resource Centers will be established, one in Rural South Hilo, and one in Hamakua. • 2 Resource Centers will oversee, and conduct training events, which include workshops, and technical assistance for skill building, problem solving and goal setting. • At least 150 families/individuals will receive outreach services. • At least 150 families/individuals will receive assessment, information and referral services. • At least 75 families/Individuals to receive non-clinical counseling services with at least 3 encounters each. • At least 30 Individuals to develop assets and resources to increase community's capacity for social support to do peer counseling and develop network of trained helpers. • At least 1 team to be comprised of staff,employment service specialists and former unemployed or under-employed sugar workers who will develop strategies to assist unemployed persons. • At least 15 Participants to develop a career plan and create a personal plan of action. 7. How do you evaluate programs/services effectiveness, and who does the evaluation? HICSM's programs are evaluated in a number of ways: A. Monitoring is done quarterly by government funders. Office of Community Services will begin monthly reviews of the Hilo-Hamakua Support Program contract effective 2/96. These reviews include on-site visits,client file reviews,and financial reviews. B. On-going evaluation by staff at our monthly staff meetings and weekly, if necessary, are done. C. A yearly financial audit is carried out by an independent auditor of all HICSM activities. D. Internally,quality assurance monitoring activities are conducted to ensure that goals and objectives of the program are being met and that the program is in compliance with our contracts. These quality assurance activities are conducted by the Executive Director. S. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? A. We do not contract within any monetary manner with other agencies. We do have memorandum of agreements with a few agencies to ensure responsible follow- through by both parties. 4 B. HICSM coordinates with many private and public agencies to ensure that the people we serve receive the maximum service possible. This coordination also eliminates duplication wherever possible. Agencies like Salvation Army,700 Club, churches,Alu Like, Family Support Services, are groups we work with on a fairly regular basis The Hilo-Hamakua Support Program, through the past year, worked with the following: • State Employment Services • Hamakua Health Center • YWCA • Various Task Forces • RSVP • Senior Centers • University of Hawaii, Hilo • DBEDT • Schools - Honokaa, Laupahoehoe,Kalanianaole, etc. • State Unemployment Office • VISTA 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? The Hawaii Island Catholic Social Ministry is based on a four sided model which facilitates our ability to respond to social needs in all areas. • Direct Assistance: Addressing the immediate needs of the poor. Direct Assistance addresses the effects of social problems. • Education/Foundation for Social Concerns: To teach people about social justice and to give people the tools to understand and able to read the signs of the times. • Community Development: Developing leadership and organization to solve community problems. It can mean setting up alternative institutions. • Social Action: Initiating action by presenting the problem to the organization causing the problem,or to the organization responsible for solving the problem. Social Action addresses the causes of social problems. Analogy of the four-sided model: The Bridge The bridge is washed out,people are falling into the river Direct Assistance: Pulling the drowning victims out of the water. Education: Explaining that people don't have to fall into the river. Community Development: Gathering neighbors to organize carpentry crews to repair the bridge. Social Action: Working together to get the Office of Bridges to do right by the people, by demanding the repair or replacement of the bridge. 10. List specific accomplishments or challenges addressed by the agency this last year. The Hilo-Hamakua Support Program was developed as a direct response to the needs of the displaced worker/families. The Hilo-Hamakua Support Program was developed from "scratch". The accomplishments for a "new" program has been phenomenal. During 5 evaluations,conducted by Office of Community Services at two public meetings, recipients & community members who received/worked with the Hilo-Hamakua Support Program gave the program high marks. A resolution by the County Council as well as 800+ signatures and numerous letters were sent to the State testifying to Hilo-Hamakua Support Program's accomplishment and effective work(available upon request from Office of Community Services.) More specifically, the accomplishments this past year have been: 1. During the year the objectives of the contract were exceeded in all areas except in the number of newsletters published. With instructions from our funders to discontinue activities related to the operations of the newsletter, the final issue with condensed versions of four special editions were completed without the use of contract funds (Last issue of the newsletter attached hereto). 2. Staff met weekly with employment service counselors to coordinate services and to network. The outreach workers disseminated updated information about jobs to dislocated sugar workers. 3. With unemployment running out and the beginning of school in September, the staff recognized a need - many families were not able to purchase school supplies for the children. Staff got together in an effort to canvas the local businesses, as well outside businesses for donations. The effort was a success and no child went without supplies. 4. Staff have worked with dislocated workers who are beginning farmers to identify what they perceive to be obstacles to their moving forward. This included working with Sr. Rosita Aranita who is a community resource developer. Together staff assisted farmers to become more active in taking initiative to problem solve what were obstacles versus depending on others or awaiting "permission" to move forward on their own behalf. Challenges: There have been challenges. These have mainly been working through political challenges which Hilo-Hamakua Support Program had to work through to ensure that displaced workers/families received services/resources due them. The paternalism that has prevailed in these plantation communities has also been a challenge to work with. Ensuring people that they have what it takes, critical thinking and self- motivation still remain the greatest challenges our work entails. Strides are being made. FINAL REPORT STATISTICAL REPORT ATTACHED HERETO 11. Does the agency have membership dues? If so, list current rates by category (adult, youth, honorary, etc . ..). There are no membership dues. 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? The agency does not have a trade affiliation with a national or statewide organization 13. What benefits and/or services are provided to the agency by the national or statewide organization? Not applicable. 6 HAWAII ISLAND CATHOLIC SOCIAL MINISTRY AGENCY PROFILE: The Catholic Church has been providing services to the world community for the past 2000 years. These services include working with the poor and marginated through the provision of basic life's needs, to opening up schools and hospitals, drug treatment centers, immigration services, aiding the lepers on Molokai, and the list goes on. In most corners of the world, you will find the Catholic Church working in areas of charity and justice. Our work includes operating food kitchens and shelters, to collaborating to develop a social order where the poor and marginal are able to become active participants in economic life and where all persons are actors in community, shaping their world together. The Catholic Church has a long and rich history in providing needed services to communities as well as working for a more just society. Bishop Joseph Ferrario created the Office for Social Ministry (in the Diocese of Honolulu) on August 1984, assigning to it three major responsibilities: 1) Identify and facilitate action on important social issues facing the people in Hawaii; 2) Plan and coordinate the social ministries of the Diocese; and 3) Review the organization and operations of Catholic Social Services (now reorganized). HICSM was established on July 15, 1986 as part of the Catholic Diocese's plan to develop strong local island communities which would reflect the shared experience of responsible decision- making in building communities of social service and action on the island of Hawaii. Carol Ignacio was hired by the Diocese to develop and implement this initiative and has served as its director up to the present. In 1994 Carol was appointed as Executive Director of the Office for Social Ministry as well. Hawaii Island Catholic Social Ministry is a department within the Office for Social Ministry of the Roman Catholic Church in the State of Hawaii,Diocese of Honolulu. 7 HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: Hawaii Island Catholic Social Ministry Hilo-Hamakua Support Program Page 3# B. HUMAN RESOURCES: 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? Yes - Date last revised:6/95 3. Do your personnel policies contain an equal employment opportunity clause? Yes 4. Do you have a written job description? Yes - Date last revised: 1/96 5. Do you have written salary ranges for each Job description? (If yes, attach salary ranges.) Yes 6. Does the agency conduct regular evaluation of employees? Yes 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. No change Increase in staff is projected X Decrease in staff is projected The agency, Hawaii Island Catholic Social Ministry, has received County funds for its programs. This is the first year that the Hilo-Hamakua Support Program is seeking funds. 8. Please share information on training opportunities provided to staff and/or volunteers. Most of the Hilo-Hamakua Support Program staff were dislocated workers and have had to learn many new skills in a short time. They have spent almost 200 hours in workshops and seminars organized specifically to address the problems of the dislocated workers and their families. These sessions have increased the ability of each worker to assess the problems and needs and therefore better assist their former fellow workers. This was necessary due to the nature of those hired to do the job. i.e. mechanics became outreach staff. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. More people in the State are economically scrapped. As the need for services increases, availability of funds to provide these services are being drastically curtailed. 8 Organizations like HICSM are expected to do more with much less, putting tremendous demands on staff and management. The constant demand to solicit funds, work smarter and more effectively put strain on groups working in the Human Services area. 10. Please provide a description of the minimum qualifications for each position. Job Title: Outreach Worker/Site Coordinator Qualifications: Bachelor's Degree in social services preferred; relevant experiences may be substituted with 18 months work experience per year of education. At least one year experience in health/human services program. Knowledge of case planning, implementation, and case management. Effective interpersonal skills and group skills. Experience working in a community or field setting. Knowledgeable of community and outside resources, and knowledge of its' accessibility. Current Hawaii State Drivers license with good driving record. Has personal vehicle with adequate insurance. Salary Range: $18,000 - $20,000 Job Title: Counselor/Trainer Qualifications: Masters Degree or PHD in health and human service or related field preferred. Relevant experience may be substituted with 18 months work experience per year of education. Five years minimum clinical and/or public health experience. Knowledge of case planning, implementation, and case management. Excellent interpersonal skills and group skills. Experience working with the target population. Knowledge of community and outside resources and knowledge of its' accessibility. Positive attitude, good team skills, and good organizational skills. Current Hawaii State Drivers license with good driving record. Has personal vehicle with adequate insurance. Salary Range: $35„000-$42,000 Job Title: Program Director Qualifications: BA in human services preferred. Relevant experiences may be substituted with 18 months work experience per year of education. Five years experience in health and human services field. Supervisory experience necessary. Grant-writing experience, program development and management experience necessary. Knowledge of case planning, implementation, and case management. Excellent interpersonal skills and group skills. Experience working with the target population. Knowledge of community and outside resources and knowledge of its' accessibility. Positive attitude, good team skills, and good organizational skills. Current Hawaii State Drivers license with good driving record. Has personal vehicle with adequate insurance. Salary Range: $28,000 -$30,000 9 BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Hawaii Island Catholic Social Ministry Hilo-Hamakua Support Program Page 4# C. BOARD OF DIRECTORS: 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. There are various levels of accountability and responsibility with the Diocese of Honolulu. The Diocese is a 501 c.3 non-profit charitable organization. The Board of Trustees are the Policy making arm of the Diocese. See attached. The HICSM Leadership Team oversees the work of HICSM. The members are from the island of Hawaii. The different programs of HICSM have Advisory Boards. 2. List number of board meetings held in the prior year and attendance levels. The Board of Trustees meet monthly. Attendance is 98- 100% The HICSM Leadership Team meets monthly. Attendance is 95-100% Advisory Boards attendance, i.e. Care-A-Van, HIFB are usually high,90-95%. 3. According to the bylaws, how many directors must serve on the board? The Board of Trustees -6 Leadership Team -9 Advisory Board- Varies for each program 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. • Revision of personnel policies. • Changing from cash to accrual accounting for HICSM program. • Budget cuts within the Diocese by$500,000. Downsizing of Diocesan departments. Two departments were closed. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. Providing quality service to the people we serve while at the same time operating under sound,accounting principles(balanced budgets)are challenges facing most non-profits at this time. Utilizing the volunteer sector is an initiative we are strengthening as well as exploring untapped private funding in the County, State and nationally. 10 6. List planned improvements (to meet the agency's mission) for the coming year. All HICSM programs are working toward incorporating the ASSETS BASED program development as the motus operandi. Assets Model: In the helping professions, clients and communities are characterized by the their problems and needs, or by their deficits. Usually the evaluation focuses on what is not there, what is wrong or broken. Solutions in the form of services aim to fix people. An assets frame of reference is different. The approach begins with an assessment of the strengths , resources capacities of the person or situation. Assistance begins with assisting people to know their strengths and to build upon them. The service provider or helper acts as a consultant to people to identify their goals and work to achieving them. The Hawaii Community Services Council will be tapped to provide technical assistance in Assets Based program for HICSM. 7. What long range plans does the Board of Directors have for the agency. Long range plans include use of church owned lands for economic development projects for I displaced workers and poor in the area of Hamakua, Onomea, Puna and Kau. 11 FUNDING NEEDS DIVIDER SHEET AGENCY NAME: Hawaii Island Catholic Social Ministry Hilo-Hamakua Support Program Page 5# E. FUNDING NEEDS: 1. Briefly explain the purpose of your request. The Hilo-Hamakua Support Program has been in operation through a State contract for the period of September 1994- to present,ending June 30, 1996. This project will most likely not be funded next year. This 6 month contact has been designed to be a "transition" time focusing on strengthening community groups and individuals to take on many of the services the Hilo-Hamakua Support Program now provides. However, the many challenges and obstacles which the displaced workers and their families are experiencing will not end on June 30, 1996. The purpose of this request for funding is to ensure continuity of support in Hamakua. We are requesting $37,245 specifically to fund a position for a community worker who will coordinate services with other human service providers in the Hamakua District. i.e. Hamakua Health Center. 2. What alternative funding sources were considered and/or applied for? We continue to write grants to the local trust and foundations for additional supplemental funds to keep the resource center and program functional in meeting the needs of the community . Once this is successful, the community will be able to take leadership of the resource center and will start planning on funding sources and fund-raisers for the following fiscal year. 3. What alternatives have you considered if this County request is not funded or is not fully funded? If this request is not funded by the County, the position of community worker will not be filled. The community will need to develop another strategy and take into consideration start-up costs for technical support, equipment purchases, phone, rent, office supplies, etc. in which HICSM will be able to offer very limited staff support. 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. The current budget is based on a 6 month contract providing more extensive services. The proposed budget is scaled down and personnel is limited to one. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income (subsidy) from neighbor island or a parent organization? If so,how much? N/A 12 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? N/A 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? N/A 8. If you answered Yes to question #7, what is the formula used to determine this amount or percentage? N/A • 13 issue of the newsletter attached hereto). 2. Staff met weekly with employment service counselors to coordinate services and to network. The outreach workers disseminated updated information about jobs to dislocated sugar workers. 3. With unemployment running out and the beginning of school in September, the staff recognized a need - many families were not able to purchase school supplies for the children. Staff got together in an effort to canvas the local businesses, as well outside businesses for donations. The effort was a success and no child went without supplies. 4. Staff have worked with dislocated workers who are beginning farmers to identify what they perceive to be obstacles to their moving forward. This included working with Sr. Rosita Aranita who is a community resource developer. Together staff assisted farmers to become more active in taking initiative to problem solve what were obstacles versus depending on others or awaiting "permission" to move forward on their own behalf. Challenges: There have been challenges. These have mainly been working through political challenges which Hilo-Hamakua Support Program had to work through to ensure that displaced workers/families received services/resources due them. The paternalism that has prevailed in these plantation communities has also been a challenge to work with. Ensuring people that they have what it takes,critical thinking and self- motivation still remain the greatest challenges our work entails. Strides are being made. FINAL REPORT STATISTICAL REPORT ATTACHED HERETO 7. Provide information on the unduplicated count of this program's beneficiaries. last year actual 641 this year estimate 200 next year estimate 200 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program) Our services are free of charge to all of our participants. A. When were these rates last reviewed? N/A B. When were these rates last changed? N/A 17 A. CLIENT AND OUTPUT INFORMATION Final 10/15/95 - 12/15/95 ---- AS'1995 ANNUAL TOTAL PERCENT PERSONS SERVED AND ACTIVITIES PLANNED YEAR OBJECTIVE PROVIDED OBJECTIVE TO DATE ACCOMPLISHED PERFORMANCE LEVELS Process Objectives FAM. IND. FAM. IND. FAM. IND. Family Dev./Case Mgmnt. Unduplicated 200 465 305 641 153% 138% Assessment/Evaluation 465 641 138% Outreach 465 2592 557% Service Planning 465 641 138% Follow Up 1363 Collaboration/Liaison 393 Information/Referral 1038 Non-Clinical Counseling 50 165 596 771 1192% 467% Advocacy 597 Transportation 91 Acculturation 282 Survey Camp/Communities 650 715 110% Publish Newsletter 18 15 83% # of People Receiving 4000 5300 133% Community Problems # of Events 30 299 997% # of people Served 350 1987 568% # Receiving Training/Ed 100 161 161% Youth Programs # of Events 39 247 633% # of Families served 40 137 343% # of Individuals served 180 1975 1097% Training/Orientation Workshops # of Hrs for Outreach Wrkrs 36 344 956% Volunteer Recruitment 45 294 653% Rural South Hilo RC 15 72 480% Youth Program/Laupahoehoe 15 151 1007% Honokaa Resource Center 15 71 473% Events sponsored by each Resource Center 117 263 225% Rural South Hilo RC 36 40 111% Youth Program/Laupahoehoe 36 71 197% Honokaa Resource Center 36 166 461% Community Support Mtgs/Pgms 12hrs wk per center=36 hrs wk) 1872 3598 192% Rural South Hilo 624 1255 201% Youth Program 624 946 152% Honokaa Resource Center 6241 1402 225% OCS 07/89 CI Lu 14 O `° as ... w O o >i ° C, E. 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C, o z o i I- ..1 vt 2 F O O z o cd ts.1 F cn 2 0 I- 0 F Accountability Structure Hawaii Island Catholic Social Ministry Bishop Diocese of Honolulu Officers and Directors Roman Catholic Church in the State of Hawaii Hawaii Island Catholic Social Ministry Leadership Team A) w 11) 0 = ?'. 7N- cD c 1.. oro = =. cn o -1 C23 c. P 0 _< CI rte; 1 Z ao -. 7• c s I I sz a- o CD 1 V Gb 1 O 0 = I '�' f C7 CD < o z, •, -; Oo p- on 0 ^S cD -• O O =, = -s nv ^, UQ a = _ = 'z vn • = = � • ., 7) 0.. 0 2.' = I O t9 ►-+ Qom. -"�• CPO b0 , ' MI co E6 CA CDD Q., p.! v 0. CSD 7• S CD //�� y CD " > 1 V cn ry G n C O CD C P 5 02/28/95 10:14 1,808 521 8428 DIOCESE OF HNL la00ii001 -/.." \. ROMAN CATHOLIC CHURCH IN THE STATE OF HAWAII Chancery Office of the Roman Catholic Diocese of Honolulu • 1184 Bishop St.,Honchufu.Hawaii 968134858 • Phorc(808)533.1991 / Fax:(808)52:-8428 r� • . FAX MEMORANDUM To: Carol Ignacio Hawaii Island Social Ministry From: Nona Kamal Date: February 28, 1995 Subject Officers The officers and directors of the ROMAN CATHOLIC CHURCH IN THE STATE OF HAWAII are: President The Most Reverend Francis X. DiLorenzo Vice-President Reverend John J. Bolin, S.J. Secretary Reverend John J. Bolin, S.J. Treasurer Reverend Msgr. Alan Nagai Director Reverend Msgr. Daniel Dever Director Reverend Joseph Bukoski, III, SS.CC. Director Reverend Marc Alexander Effective cater January 17, 1995. Call at any time if I can be of any assistance to you. Aloha! 05/19/95 11:19 'x'808 521 8428 DIOCESE OF ENL ®001 001 Post-It'Fax Note 7671 Da.1 fq ipaa► I - To vat4,,,,,_,...., Fromecit /r i CoJCaot Co. Til r Clot GIacGe Phone a Pone a 6,7—/7�,/• / Fsa s l—VT'y�1 5.O'/7— Faz a l.�bf l—z et-.1'Q DOMESTIC t4OTIPAOFIT CORPORATION STATE Or r1H Vr tut (y :2"ter r± u- MRUNG TIM SUM AiQ is urrawca PAVAaaa Ta DEPARTMENT OP COMMERCE AND CONSUMER AFFAIRS ostctwa.-nrnioi eV "NC" BUSINESS REGISTRATION DIVISION 'o'a'+LTY RSA LATE PILE I.n t 010Street Xour cancelled cheek is your receipt � Mailing Address; Annual Piling,Richards StrP.O. Box 40, Honolulu, I3:. 96610 DOMESTIC NONPROPIT CORPORATION ANNUAL, REPORT FOR THE YEAR ENDED DECEMBER 31, 1994 CORPORATE NAME AND MAILING ADDRESS: it/111•. ID T SEii. F:L6. TR-+H$ R MAN CATHOLIC CHURCH RCH IN THE STATE OF HAWAII ','!:;11.-.1-•:11.t, F.1? t i(I:, -LINE 4-373 ` yli�HHHSTREr ATM. ryriiH;hiT t. ,,j)NOLULU lb,:rii? If the above mailing address has changed, line out address and type or print the new address on the following line. Give Number, Street, City. Stale. and Zip Code: If address of nrinrmat orfice differs frn!rt ;he nbnve mailing sdrtraes. rlr.!e the address of the principal r ?- Number, Street, City, 5'atc, and Zip Code: priocir_, of.e GES: 1. The fol;cwing is a brief statement of the character of the affairs which the corporation is actually conducting. NATURE OF AFFAIRS: 1RELIvI3U8 PURPOSES (To cermet line out sod print corrections below.If inactive during the period.state INACTIVE.) 2. OFFICERS:DIRECTORS:(List all o!fleers/direeiors.Every corporation muss hent a minimum of rem individuals as ofucers.There muss be a minimum or three direetots and st least one muse he a resident of Hawaii.) occica MELD/ NAaa! of Fu.t inisicaracia Ancaassorio Nor UST u rsaESS ADDRESS' DIRECT OR CODE (INCLUDE NUMBER a STREET. APT. NO.. CITY. STATE 4 ZIP CODE? gyp• d--tt4-?MOPrS-1---- •HON HI-aei 13 •-t V sP•• 'As/o -pp4.p -P . . . V/?F8 Bal ;i•, 34401''17—^ --1.1$4p-S e-r--- •Hrr1=968t-3 . . Hnl•:-- 9681-3 f! 4stro•r-51----....--- Hn 1;-96813-I , D---- DuAvsA -� ; , Jos ?, :11 11-8i-8--shro.s51`-- — -__.__.Hnl 9681,3 1 e xlrAdnce-r-, ,d-c------1164 9i shop St.-•-- • Hnl 96813,.' P/0 OiLORENZO, Francis X. 6301 Pali Hwy Kaneohe, Hi 96744 V/S/D 9011n, John J. 3140 uaialae Ave, Hnl , 96816 T/D Nagai , Alan 920 Keolu Dr. , Kailas, H1 96734 D Jerer, Caniel 6301 nets Hoy. <anoot,c, Hi 96744 0 .9ukosp-a Joseph III P.O. 9ox 797 o Al exaro�r, fear- Kaneohe, M; 96744 6331 Pal , Hley Kaneche, !ii 96744 :....-st..;-.) ic- • • • . CERTIFICATION a1t _ I certify under Tie penalties of SFrtion 4158-131. Hawaii Revised SMAIut'S. that 1 nave read thOib 'e and: : CHECK ONLY ONE OF THE FOLLOWING STATEIvfENTS ';`~ I l The above information is true and correct and no changes aro necessary. v-. I The above information is true a and correct with changes o noted. DATE / / /��4 C Pr es4ent SIGNATIj.g OF A oRIZEO FRCER, OFFICE HELD) FILE N0.0001667D2 `t Attorney-in-fact signs, attach power of attorneyl ILE NO.0 (Pile this-original copy. Photo copywill not be accepted. Keep photo copy for your records.) Rev. la ',iI � (See reverse side for Instructions) I N I B11I 1U 822 Hawaii Island Catholic Social Ministry Roman Catholic Church in the State of Hawaii Leadership Team Chairperson: Don Aanavi Professor, University of Hawaii - Hilo P.O. Box 165 Ninole, Hawaii 96773 Vice-Chairperson: Marge Fujimoto Pastoral Associate, St. Benedict - Honaunau P.O. Box 209 Honaunau, Hawaii 96726 Secretary: William McPeek Deacon, Sacred Heart - Hawi P.O. Box 278 Retired Principal, Kohala High School Kapaau, Hawaii 96755 Treasurer: Rev. George DeCosta Pastor, Malia Puka O'Kalani - Keaukaha 326 Desha Avenue Vicar, Hawaii Island Vicariate Hilo, Hawaii 96720 Member: Steve Querobin Retired Fire Captain 138 Laula Road Hilo, Hawaii 96720 Member: Marge Bartelt Social Worker, Child Protective Services P.O. Box 425 Kurtistown, Hawaii 96760 Member: Maureen Saturnio Secretary, University of Hawaii - Hilo 113 Uhaloa Place Chairperson, Bishop's Advisory Board for Hilo, Hawaii 96720 Persons with Disabilities Member: Rev. Alapaki Kim, CSP Campus Minister, University of Hawaii - Hilo 430 W. Kawili St., Apt. 12B Hilo, Hawaii 96720 Member: Josh Schoemaker Deacon, Immaculate Heart of Mary - Papaikou 1518 Kilikina Street Hilo, Hawaii 96720 Member: Ehukai Sako Counselor, Big Island Substance Abuse Council 543 Kupulau Road Hilo, Hawaii 96720 Dated: June 6, 1995 JEHOVAi-i k)Ebug APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996- June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: �/ • fD ORGANIZATION NAME: KO rA ;" � )v l I�� 46,4:71/1.40- Mailing /l.� NAME OF PROGRAM: �k0�/�,�/` � ��� �� ��1� 1 Mailing Address: P'A /ft/ City, State, Zip: /e/40'4•44,.. V.rwl f4 77f Telephone: ( ) 7Gs`80 0 D FAX: ( ) Attach current Internal Revenue tax-exemption certificate 501 (c) 3 Amount allocated by the Hawaii County in 1995: $ D O % of Budget Agency Total Budget in 1995 $ ' • -,• o F 4i'!•2 12 ill/OK Amount requested of Hawaii County in 1996: $ ,'• • • • o o /s�0 % of Budget Agency Total Budget in 1996: $ /0)0s0, Is O $'//0, 0p0• (oa Xt.e,kti) This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year:194 t. 1 �I tia*/V42 •a /LV c "4' w 114441144141 4IW /doe tine ��� MIK T l� Ta,A t c .3°. History of funding with the County of Hawaii: o _New Applicant Participating agency since 19 Firm conducting and date of agency's last financial review or audit: T NAME: 4-1/101/4/6 V 1144 te. ' IN*, "16. DATE: dotib N Je a and Jesus' Kingdom . • 0#40,/ 1'ff404 SUrrd War 1 (toad •39 Honolulu. HI ! USA JK 96819.2277 1-(803) 845-4567 "AO7#30,111 ii t'4 YeA101 /t 9 31 Wirt, 7rt l� �/}sff l ft'.pE. iR t c 7d lt . --di hio, VT )1 i4t.4.44: t C447044 24 i t tfies:t owsfitt dua a 0 2 677 P‘`• . i `iv/147 esi r 04". ot*t", leo; 1.) sot 1) ig lepAdeu-6) 0447-4044.A f 4f 711:1 . "f 1 •7%;ffi Afgazice5, ( (z .). 7SFE C a.,�:7. ;>,T ramp!) wA 41 74i. e ct )44p s7;/, i,X1). ataiAt � 14-*61 4 ctitodi.)6 K. 04.1•414610.44.44, ON. -di t,It 0 .,....,.,, ,. •.a/S t Rd;yiNATrx.AA alteafs( 4 /` E, 44 24: #4a1 2.2). V'. 1 alt.'? a i:� �1-.'-" ItE� rH� _ c. •p�mss, A0.-tibaii. j.?..dite,rfur/ ' ft-ter C t s9 Selo•-( 'Id g 0(u tett �t•41.✓Zeal 4 04.N, ,J`Rfro 0 01 402 Cor moi--"ft,. pf o 444tc, _F/ 06ria4 CP%�Leio�t .7 g?f{o✓4H, ; 44.4- `;, T ./g q1 Cogs 7°- � 7Zet • .3,Amict 1Syti, ,,,�, ��fo1 ,�4t h«,a ase ,, at; /"� S to-1044= ' ' "Wein, �I. Xtickka)lik 44?#,S.r41441; dito t t E - i1'it jj *Ji..,( so./ 5`qt- J.NDNE / ' 0 ur 5Ec7 -%t(A'. : 77zat zr-Katels•A,¢,c%441• 611/s • • •d 4/0A AO £f fit;4rw#* a/Fr • p '477i i A. 774:•,,,A,. C-0' As - 6 taen-*/' kottir,./e. o itatioa go 0/0 Attfaie %,3414,1,74hAtiir7- 11 CIA ,,g, ;44..4044-0.4./ 114414.6. A$t af• 01- gc.drwitsive."4 ore,.,,i i g e4 jp4? SOnt mg 1440e4 !o fp �,•si. rte) Jehovah.. & Jesus' Kingdom 4.54.COV 3 pi ' •`A �Lfr 4 Dock T. Lee, Ketchmark c 04 Health & Weight Counselor ALOHA!FROM HAmark 70e�' �� 61 1-808-845-4567 Hon. HI Dock T.Lee Ketchmark POB 1991 Kslapana•Pahc�a 1 1-808-965-8000 Hilo, HI H1-US-JJK•JK96778.1991 1-808-965-8000 X, IGC l ORGANIZATION INFORMATION SECTION (pages 2 - 8) zia,cal 4/400 ORGANIZATION PROFILE 00*$60.4„ DIVIDER SHEET 7 , S�/y • ORGANIZATION NAME: t lii 5 r 11° iw A�! Page #2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Geographic Area(s) Served: Agency's Mission Statement: 2. Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency(in quantitative terms, where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? Jetoag(and Jesus' Kingdom 4 Sand Island Road '39 Ho4noluau, HI ! USA JK 96819-2277 1•(818) 845.4567 ,A*1 /4 /9,9 4). ,x..),‘„,, , . se.k.ve (44 ff...,. A Niv-tio-yi k-- ,04 r•w 1 71.144#"4°4 1 4 /6440-1 • 7 3 .� ,mss. G4� it-41..)t4 7 / IIit t"t4 g tt'€HF/ f �..ls� ( 4' ,4? . tilt Of , a ,7pd, u .I�• eat t7 2 uI44at m4.v i 4 t/! S e co,C e#444T . Of Pitpimj 'jxic146 ,t v 4o 1/W , -SA/ , ' Mf /af,.7; A 3 t4 in t k A4 t d ,j)(14.4. iril 1440#10 4 a e • S 44'4.414dt Z, f k g.7;N. m Mti.( 4 ,e41 J s •pA • I„LC �Z,t :. 3. Q -7141, L a ca- /a.. tie.: 4,...c .'61i, f Alf fao rIre4. �. pal"' �li4"A A04/ /sem aid fdLdi/, . t c,t.•ff , i. 41,,i4,00 .4 . dith,4.4", TA,. >,...we,..-, (,..4# # . 47, dit, ' t 4/41 4-01r44., i7fb pit!l J. k• ,,,D I /tl y , ir 4; 1,1 ± . -fjsA1 ; S k pax. 4% • Pity I' )44. a! ..i/ K, $, mt407a4. 41445 #744 a 4ig4trl tit Ito Coag fv �1 ra � 9. • -gdol t o i �J.. 1 tit a�� 0' Q iai/n °� /D %0 ..1, b 7 Cm• :7`' ' Non o c/e(tit s,4 '4 d= 04044-, o75 t#k- ti #414 #kid•fst j ,x 4/ ad, 72001, ma 0004, - ?aL *Is "Xo A tyZIAry.'"Ikir 4.41141,a60 1,760 2/i o� if, No 3„,.. a, 44 A 1,44„• .4441:"j. '1*1741,% ,;:r.74.:.'?i.4,i1.10WIri.i.-1.1.z,: .;- . . / 4,.‘.,4.„it.t.v.-t . . ;,..‘vi',' :;.-1::. ‘i '.;!. ; le c.,- ..". A71, 4 Is.,frtk*, fg-145,4-t 4,„,t„,, ,dr., fitt"t ,.c. .,6-_ .'t :*.-.' `..'.' . 2 40 item (VA akpit, 44,..,..m...4 IL ....1 -- '6...•*-Tivii ::!.:..=4: . t-li ?"4:44174 4..444Q/�s �o' 1. i' „.4;: (4;,.::JrS1: A y[ M .ac HUMAN RESOURCES Jehovah&Jesus' IVnyooii' DIVIDER SHEET ALOHA FROM HAWAII! Doric T.Lee Ketc hmark POB 1991 Pahoa, HII 96778 AGENCY NAME: Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.)1. Please attach a copy of the organizational chart. p(A, 1*--C1-4'172 2. Do you have written, up-to-date personnel policies? Ic Yes No Being revised Date last revised: /f 15 /9f4. 3. Do your personnel policies contain an equal employment opportunity clause? Yes No 4. Do you have a written job description? i m.lilitoo44 0 Yes No Being revised Date last revised: .f.�I y.40. R 0110.11148:4 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) Yes No Being revised Date last revised: ire. svt • 6. Does the agency conduct regular evaluation of employees? 7D'et% Yes . No In the process of being developed N. f�.`► Y o 7. What is the staffing pattern in County funded programs for thisyear com ared o next year? Please provide a brief explanation. mak- A4 f C� `s"• �`�' f4)14)(4'Qiniiti .r ► # n. c Rfj s �o..� ,Sacat,7T . c f . No change % Increase in staff is projected Decrease in staff is projected K (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. /.. -0 s.K ': TRi t ,.$,.BL - ifisToky 9'rd'eS, 9. Please share concerns or challenges within the H esources area and what steps have been taken to address the concern or challenges. L.hr--K or ABLE hurt y c%e d. 4 DrsLi%- - ,Z , 6c, lmmia.7-7o+v a/aa,,.r 'a/a/e- Htsro.9 c/aao� 10. Please provide a description of the minimum qualifications for each position. 54. tT 477/oma; r dt 1/ 44 i de 6 -i and Jesus' Kingdom . . 4 Sand IsLir,d :"oad /39 Honolulu, HI ! USA JK 96819.2277 1•(6O8) 845.4567 ) t pitesiaL h0-1","1, 2km", rify ,.., P -a3 S ftc� fid' l� S 74, tilitrie-144#4. 1 tV14-44tri k".044 I 64, oat le-01"-r tL 4,1r4.41 i( g t A e'4:1 thr t 4- "i)6 74ftA . i . 5A 1 ta r 7 iftig"ti4J 44.j( til ITS4.°444° .5774 drAw . • 1. %-'4°7. 4.) . ' (3 La* s Ga toefc t. tait ./• -r X t 4.541.it 044-0(711 41144 I f d4g44°tAl. 10i 0,1,1 ��r. erftsed � �-� , Si‘'‘`11 , � Ili*" f .S Jt yA4A4 lcvi.�.�� • I d i 40)IV Aftr 70 _crvir 71 C 40142_040,4 5 do•I 1 )1I ea". an / , .� Di "-4 A ivy 114,#A . iet`‘ , s7;- 1/ - 0 38/0, u�� f i c �,� • i"1 ,,/ (/d l tD P Jehovah. & Jesus Klnadom i11 41A� H G 4. el y� E0( WAfor 144>P ( 1 Dock T. Lee, Ketchmark yi 4 7 $ A S6%/,tT� i z4 Health & Weight Counselor b? 1-808-845-4567 Hon. HI ALOHA! FROM HAWAII! Dock T.Lee Ketchmark � 1-808-965-8000 Hllo, I it POB 1991 Kalapan7-Pahoa 1 -808-965-800 HI-L'S-JJK•JK 967784991 t-4`i BOARD OF DIRECTORS ,/,-. &Jesus'Kingdom ,k•• - -• HAWAII! DIVIDER SHEET AGENCY NAME: (Page:4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a current listing of the Board of Directors with board terms and positions, �,Cg 161 addresses, phone numbers and current occupations. £. t e.4 � 'rq 2. List number of board meetings held in the prior year and attendance levels. iipAcut1wA. ' 3. According to the bylaws, how many directors must serve on the board?.1 , 4. List major decisions made by the Board of Directors last year and actions taken or plans _ made to implement the decisions. eor#.1 mar"`"' ? C ? 7 14` 5. Discuss foreseeable challenges in the coming year and anticipated actions the ency will take to address such challenges. irtlitIVI Fed..-4-4j /ANZ11'j "/"'`,�if' 7s/Ve( , 6. List planned improvements (to meet the agency's mission) for the coming year. ' S. • 7. What long range plans does the Board of Directors have for the agency? /o-on 3.ta.A4 w 0 "j ?lam f C D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the number "1" to the most important and dominant service or target population. educational 3 victims of crime L culture& arts Ki i y a victims of health crises Zthe poor 3 victims of social crises /% youth 3 the physically disabled A• the aged J the mentally or emotionally disabled Jel-i -i and Jesus' Kingdom . 4 Sand Island noad #39 Hono!u1u, HI ! USA JK 96819.2277 1-(808) 845-4567 ad, t.7e. jtLt GMS AX ' d0'L. /•36 -d'3s- $0 0 2s5 Vir440/te Ri ��fu �!, 7c1gsNsf7t 914 1/ f, -Trt to....tit 3„.„4.„0,4,,,L-77-,,,. Z r ,� d 67PCs� 7'grdior 4)/ , /1 CU4AwD/Z � s 1 ` • 4 T( l pew - 74st 7f,.•tn pt7ini.e, sN- , 3 307414; t f ., mimiet• a�craK tm- . • • 7.-riost, Q,..cC oo� � '711s AS fR�f a�R �• av "At �,7t0JaR�(fwI N E ft nie f 45o3 /lf 83` ?Mgg Co_ AfSagMI• ,Boarsd -217 f rR .Ad a+it T : 2�/,d Ef h., • s s ( $ d t m L 4a. /'� -7 t t. fA4s Tw 4) 4 *fvf 90.8/ff/ 4/4• oarsd o f.�74ttro4 Go-pAts74 (J 4.414 4/4/AZ 904 ,8 , Low:! 71N : zrNat/'c.cT Niidatt c-44,tifi47 ,�A&✓/'4i 0;1401 04, Sva4;6714"al 4 I Apo h a"`rE G.t , G 4 w; Jehovah. & Jesus' Kingdom Dock T. Lee, Ketchmark Health & Weight Counselor ALOHA! FROM HAWAII! 1-808-845-4567 Hon. HI Dock T.Lee Ketchmark FOB 1991 Kaiapana-Pahoa HI-US-JJK-JK 967784991 1 -808-965-8000 3 1-808-965-8000 Hilo, HI It • FUNDING NEEDSJehovah&JAMB, n ALOHA FROM HAWaII DIVIDER SHEET P081 1 PPaahoa. IIHICeld�7 AGENCY NAME: (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) • 1. Briefly explain the purpose of your request. £1 i 2. What alternative funding sourcesre considered and/or applied for? to-0 11 f y t 4. pi.A zLL Ci. .4'd tit me*... d..e.ra )1.-t 9 (�M f a.....T+t p. og.M. o 4- Of 1 ME S"4_ I t I.j. %..3. What alternatives have you considered if this County request is not funded or is not fully. funded?.1) lotow to me a! Ti�tr� 04,-4 W e AA is a..•f �I ,c7owy L�s s, Z 4/At t U c*m.• 4 Ivo T 13904,6s' 2>f ir re o� .D eV* W e�i No >� Ts�,�!N f-f•+�0 . to ,T t( tel �A 1,44J6T•••.f f 1 °o or greater r line item in the v J4. Grv�a bneflanation for any variances o 5 current vs. proposed budget. srdx ' I er'Ts ane 41-.4 043 *Aft If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. •Do you receive any income (subsidy) from a neighbor island or a parent organization? If . so, how much?a)46, 1/4 042,•o 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? Air 50/0 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much?15;00, 0'I/ NO, DE 8. If you answered Yes to question#7, what is the formula used to determine this amount or percentage? 57/5-0 7. foo t lyp f. $c .x Sif Et i P tywPf.4 `/r .Care/ 1 hecArN(and Jesus' Kingdom . . 4 Sand Island Road 139 I-o-olulu, HI ! USA JK 96819.2277 1-(SO-8) 845-4567 7/ta'ssø , d4iA A, 7,440 .S4.41 Mt. gc.,l• t,4ividj;entl� l � �, B.M.aL efts a , / , .,/ ,,,.,,,, to1(1 ter . j‘i, -1640g, eg f-r/idfi, 'mom 7t*Ir Xi/at flon6Nd6 4 eciki 1 a 0 aAtewa4lIwi4 W t ,T¢. �y TR>ud 04.-61 Qt 4k Sowf ot Ja with Abs, Zehet TA t s!y '2i ss 30.04,4 ; i ea t ji4-141fo0,51", c�a �-,8,.4.. 4--#t / el 7144 inti 0 E rid, 447- - 2/.0 C•4i40 4. /) /( 140. 4 'Vuailia40 440 77 71i 1%4(444‘0i4 ♦ ,..I , 1(ailti iths-,Ato 0' oA ya ( ifs0 Y `k At'- "" ,f t au-si tAILI Tia 444 . / r ,K 1401 4 mot #04/ei feIitct / at ,ST'tit 04- —ooh°, Q o �. � .O a 7 ?s; Dov. 00/1(4009, �Iy iOd,(/( T S t t.: ,t/kit t o et 4ry:T Sa....4( IJtI'4 B a e, i 4-: *'u' ,; �uu 'AWd(t) fl4Ha4 o ,r" enc �. ��g j ,imiA—'/Cil yyde•44/ tag i�' Jehovah.. & Jesus' Kingdom 4., Dock T. Lee, Ketchmark Health & Weight Counselor ALOHA! FROM HAWAII! ha -808-845-4567 Hon. HI Dock T.Lee Ketchmark POB 1991 Kalapana•Pahoa dei 1-808-965-8000 Hilo, HI HI.US-JJK•JK96778.1991 1 -808-965-800 1 4‘) PROGRAM INFORMATION Jehovah&Jesus'Kingdom DIVIDER SHEET ALOHA FROM HAWAII! Dock T.Lee Ketch nark P061991 Pahoa,HO 96778 Agency name: ,ems&Jesus' n (Page 6) ALOHA FROM HAWAII Dock T.Lee Kstchmwl POB 1991 Pahoa,HIl 96778 Program name: Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? tfis gas. oo/L ?» bs Nti; al tt ��'l 2. Who is the target population for thi program? p �dl Pi 1� (t t�, R 1 c fel ofo l✓if, Tv Pi fc fief nK• S oft, 3. What are the specific objectives of the program(in quantitative terms, where possible)? Loc• +3 tigo Lv His ioR , 7'�'lw' *444-1 IC•44o rr 14460 gopp 4.441, _ 4. How do you evaluate pram effectiveness, and who does the evaluation? Lad*. 7'ftaE � 5. How does this program's content from similar(or same) programs o red b other01 s T c agencies in the community? 5/01/04, t X ,( Ste.•• Ieo _a 9���=1•r/1�-fo�t t P.t I[ P' •�3 S f ka�io7t • Kis �p.� •T.a�► m t f P ttruld en.orpi. AL 6. List specificciaccomplishments of this program last year. a � x ,� Cep E! 04...o( T,e..�.7`w ,� . k Qi✓ h/iTo f , �r l , 7. Provide inforlflation on the unduplicated count of this prograt�'s beneficiaries: last year actual a ‘44.061‘41( X /DV this year estimate - , A a $ /eV next year estimate 6,s a E. AleAsaiciI X /°D 8. If fees for programs or services are charged, what are the rates for each specific program or i . service? (Attach a complete rate schedule for this program.) C fit.tfidabAlt-s go Ilext, Xiceivt• A. When were these rates last reviewed? 401 B. When-were these rates last changed? 0/A blf(Arl'eand Jesus' Kingdom WeiIlimlit 4 Sand Island Road #39 Hono10.u, HI ! USA JK 96319-2277 1•(803) 845-4567 I I. L 7447 #0,0, 54vi.7...., 4 4. cy4•4441, o/d IxaA(*54; .s• z0CA 40. 3'3 L t, 1;7112 1 miotit,04.1 ailp'sr 1 aSlaird• 7 4,474c9/,ix , / .61 a., ' )(14::140ft CPAS tthvadi- 1114i4out4A4/ ,30At. T,1*4 E ,..& :AwsAX, S. VAA t air t 44.0• 7"444`4. .1 ?it/(O,4 n r / 4./i4e;e "1*--d--C 7!) Sao, /No 5 /6011 k//YzL 7-Ltd' (41 -Jr ,oitr 7 f 71 Oc/S1 • QO/Nfs 4. ‘,...4 JR4'? WGILntf " 1 •44 s 7,44 ` 7>� /p Xafro ' z 't ao x ia 0 i ' t : T $ c 0,74 ‘6 dingo 7,7?on 4.7 ",,4, 7 fys ex t Rt 4*/tit 4k.• A.- 3 h% = 0 I exq G1jJehovah. & Jesus' Kingdom Dock 1. Lee. Ketchr►ucrk Health & Weight Counselor ALOHA! FROM HAWAII! ? 1-808-845-4567 Hon. HI Dock T.Lee Ketchmark 1-808-965-8000 Hilo, HI POB 1991 Kalapana•Pahoa HI -JJ K J K 96778-1991 1 -808-965-8000 �C' Conditions for Grantees Page 8 A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance, the committees of the Council, their staffs, and the legislative auditor access to records, reports, files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. Policy limits shall be a minimum of$300,000 for bodily injury and $50,000 for property damage. 7) Purchase motor vehicle liability insurance in the minimum amounts of$100,000 for liability per person, per accident; $25,000 for property damage; and $300,000 comprehensive, per occurrence. 8) Name the County as additional insured and file certificates of insurance or copies of the policies with the Department of Finance. Please refer to the attached Ordinance and the Hawaii County Code regarding grants to non-profit organizations. REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a grant, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accredited in accordance with applicable requirements of Federal, State and County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the services provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(a)(1). 5) Have by-laws or policies that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one year's experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity, by addressing educational concerns, culture and the arts, the needs of the poor, youth, the aged, those with physical or emotional disabilities, victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. .� • o • a y • i. 5 3 eE a e j ;! e�� V � R ▪ e • :•c. .11 E 5 k Ss 3 5 M 11; ' r.• liGil a e ', a 5- p a ^ ; 1 e k ;�• U H •$ H 4 y e + . 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QW C i j c u n 2 .. ., a ` ' a r .aleriovan, gnu Jesus rto .Lu,,, 4 Sand' Island Road 039 Honolulu. HI ! USA JK 96819.2277 1-(848) 845-4567 .z.cG. z9- fT79' iff k-b• m 4.sx14 i %4 7�4,,off Charitable ,�,c Dear President and Board of Directors , T—: Contributions €.o P. .►..._....41 Aloha ! Mabuhay ! and Seasons Greetings Aloha ! from Hawaii ! ! How ! are you? I hope and pray you are fine . forts We are 1 ock i rg for sponsors rltso-s and brottrers to help '-' T - in ui ni s t7y. Arra dirg to US.IRS. 6 26 you & Iz�" .p.....•..�min bilwnim.. ma donate/ Ca-rtribute up to $250.00 `"m Yom" �Y Y ►.,_..�.....^......... . without a re eipt. We are a tax deictible non-profit .�-W��. —. organinticn as listed telae. Can you help rcretarily ��. .. .-.. or in services? Toe anonwry�,sl;, a , porm.i We give free Bible studies . .fto r'j b..w.rte\ May we Bless JEHOVAH , Jesus , The Holy Spirit & All the Good Angels , & may they Bless Us . Thanks ! and Mahalo Nui _oa ! - it' t 4- '-r; Ltt 4-7-‘41,474?,Jc AKA eti4ARAA p.v. it it t. 4747 'fiZitoid,i kiko Hadi lifr f A, et It.g1 G ; Jehovah. & Jesus' Kingdom 4w, Dock T. Lee. Ketchmark .-4: Health & Weight Counselor cE 1 1-808-845-4567 Hon. HI •G—eii 1-808-965-8000 Hilo, HI ILS, JER3M-1, The Holy Bible; My Boor; of Bible Stories; Evolution or Creation? Yai Can Live Fcre',e In Paradise On Earth; Fevelaticn: It's (rand Clirrax Naar at Hard. +ttzlitales. Publishing Co.- David tbrvell W. Page 1. 1991-1995 A.D. by Dods T.LTD-t AF K- AC TDtrAJ (I H JD-CWA1, The Fbly Bible, All translations Allan Cott, M.D., Fasting As A Way Of Life,A Bantam Book/May 1977:115-116 Bragg, Paul and Patricia., The Miracle of Fastirg. Health Sciences Ketd-rrAPK, Dock T. Lee.,Jrtm3n's Travels, Tribulatiau,Fastirg,Diet,& Exercise. - ALOHA! FROM HAWAII! _:57' t F.t =' Dock T.Lee Ketchmark : C'UFu^:x C'FC" POB 1991 Kalapana•Pahoa n:$T•-_'•EY F:3.Y. 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' ...:-_' '6 ^� - .` ...y : Ni.......irt.441111,ilk `; "' `�`, >< GG Jehovah, Jesus' Kingdom .Ichn,uh s.Jccu'' Kingdom i .. ...4 ' • a. '- `VJ/ ALMA! FROM 11.1%144,11! - - �j Doth T. Lee, Ketchmark I)oc6'F. Lee Kcichnmurk . ,4}'�r ''. !AF- `� * �J 1'01)1991 Palma, H1; 96778 " P �4 Health Weight Counsels ALOHA! FROM HAWAII!- ,� �%j;> i �`f` b4 Dock T. Lee Ket-hmark 1-808-845-4567 Hon. H POB 1991 Kalapana-Pahoa Kr�" ,v.... -a '; s c�4 1-808-965-8000 Hilo. H H1-L'S-JJK-JK 96778-1991 `` t1, .,1, Cd"-1" •�,416 - pC`, r Cr 'V n w n> -- p .0 00 c. L/ A w i`' .•-• Rz7 "CC Q = 4t mo O Cin ;=7 M *t- O 00z C -3 ,- ,, ^ c -- 6 m H CT n O - a I- O Sz f z z , z -G O Qo m rd C z R.i.t 9: 4. 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V 1 q Oli N • O v a I O O ft i\tIt 1 O vt 4;Apio -i n * b C" rri xJ z 0 H o. ., -< t• -t% t 17,..t• ..4\ la LIIt nco 72' rii It‘ 14 6, H ... © t y . z ci) O h • V �' H 9ti, p z V )k) ° CYz ril ° rn • H • L La N A . , O Z.:;: 17 1 It � . w n fij %a% P k ".? -Ns, ,, ., ♦ y:1 C' y , z e ,,,'aa• (..t ,,,,. \ ;•, hp•ti. 1. ,s7-1I 11 aL0 , " P ' /I f' rip' z tmO z 70 00 60 3 z -c n � • fiN TRANSITION NETWORK APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996- June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: // �/ L ORGANIZATION NAME: ,}N Si,tlMi /V P t,/o�t� NAME OF PROGRAM: Vi o --€ c , N R V AJ 4-r4-)V P4 An') Mailing Address: p. 0. Box 10 o(o $ City, State, Zip: IA Lo µ; g L 7 a I Telephone: (80g) qSq 04 0 3 FAX: ( ) SRin l; Attach current Internal Revenue tax-exemption certificate 501 (c) 3 Amount allocated by the Hawaii County in 1995: $ , % of Budget Agency Total Budget in 1995 $ 9S) 96 3, Da Amount requested of Hawaii County in 1996: S r.s o00,oh /4.7y% of Budget Agency Total Budget in 1996: $ 3o I 47.7. OD This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: /Nfl /2/3//9/ History of funding with the County of Hawaii: New Applicant Participating agency since 19 Firm conducting and date of agency's last financial review or audit: NAME: DATE: ORGANIZATION [ FORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Thi 1/J .d /Uk/ "'1'f -ING . Page 2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet ) 1 Agency Name: Geographic Area(s) Served: Agency's Mission Statement: 2 Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4 Who is eligible for services? 5 Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6 What are the specific objectives of the agency(in quantitative terms, where possible)? 7 How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category (adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? TNI CofH Non-Profit Funds Grant Proposal Transition Network, Inc. County of Hawaii Non-Profit Funds Grant Proposal Organization Information Section ORGANIZATION PROFILE A. AGENCY PROFILE: 1. Agency Name: Transition Network, Inc. Geographic Area(s) Served: Hamakua, Kau, Hilo, and Puna Districts of the Big Island. Agency's Mission Statement: To promote community and domestic harmony by seeking the end of emotional and physical abuse on the Big Island through educational efforts in the areas of human services anti community development. 2. Briefly describe the kinds of progrtuns and services the agency provides. Transition Network Inc. currently administers the Sex Offender Treatment Program at Kulani Correctional Facility. We also contract with various agencies and health providers for staff training in Domestic Violence and intervention techniques. In the rural Hamakua and Puna districts we are developing community based Domestic Violence programs designed to be self supporting in the community within a two year period. TNI's Violence Intervention Project's goal is to provide Domestic Violence awareness education to community members, organizations and service groups; design and facilitate implementation of victim support services and batterers programs; and provide training and technical support to communities in victim advocacy, group facilitation, program management, and administrative skill. The victims' support services will include Temporary Restraining Order assistance, court advocacy services, victim support group, and information and resource options. The batterers program will be based on the Duluth model of Alternatives to Violence. 3. How do these services support the agency's mission? The above services support TNI's mission by breaking the cycle of violence within the family and the community. TNI CofH Non-Profit Funds Grant Proposal 4. Who is eligible for the services? All members of the community, specifically adult and youth victims and perpetrators of domestic violence. Any group or agency which is working with victims and perpetrators or affected by domestic violence may utilize our training and information. 5. Provide an unduplicated count of the number of individuals served by the agency. List by program title. Sex Offender Treatment Program: inmates 51 Parolees 1 Community/agency Training: 20-25 6. What are the specific objectives of the agency (in quantitative terms, where possible)? a. To make Domestic Violence services locally available to individuals and families in rural Big Island communities. b. To provide training to community members of rural districts in the development, implementation and execution of Domestic Violence services. c. To reduce isolation from services, and increase accessibility. d. To increase and enhance multi-cultural leadership and administrative skills among the local community members. e. To facilitate the ability of families to identify signs of abuse and improve the ways in which they address and resolve abuse concerns. f. To provide for continuity of services through coordination of necessary, related services and programs. 7. How do you evaluate programs/services effectiveness, and who does the evaluation? The evaluation of this project will be built largely on the effectiveness in accomplishing program goals, including: a. Defining each project objective in operational terms, susceptible to measurement. b. Collecting data on number of clients served. c. Collecting data on number of personnel trained. page 3 TNI CofH Non-Profit Funds Grant Proposal d. Tracking rate of recidivism. e. Tracking the #of participants who complete program and show increased awareness and knowledge of domestic violence. f. Providing quarterly and yearly reports to judiciary as required of court ordered participants in batterers program. 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? In the Puna district we coordinate with the YWCA Family Support Services to use their facility, and provide training to Healthy Start providers. We also work with the Bay Clinic to provide training and in-services to their personnel and will be utilizing their meeting space. We are currently negotiating a contract with The Family Crisis Shelter Inc., to provide training. TNI is collaborating with Hawaii Island Catholic Social Ministry's Hilo Hamakua Support Program in attempting to develop much needed domestic violence services and education in Hamakua. In addition, we are members of the County's Domestic Violence Interagency Team and work with the various organizations and agencies involved in that body. We are in limited partnership with Wireless Cable TV, Ltd., waiting for a FCC license. 9.How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? TNI's services and programs are different in that they provide services in rural areas of the Big Island where lack of public transportation isolates people from the services in Hilo and Kona. 10. List specific accomplishments or challenges addressed by the agency this last year. TNI has only recently begun operating. Our primary accomplishments and challenges have involved becoming operational, acquiring insurance, and our non-profit status and all it that entails. We procured a state contract and are now providing services for sex offender treatment. We are currently securing funding and coordinating a major fundraiser in the community. 11. Does the agency have membership dues? If so, list current rates by category (adult, youth, honorary, etc.). Yes, we have membership dues. page 4 TNI Cotes Non-Profit Funds Grant Proposal Individual Membership $20.00/yr Organization Membership 50.00/yr 12. Does the Agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and or state contributions and how often are dues paid? No. 13. What benefits and/or services are provided to the agency by the national or statewide organization? N/A t • page 5 HUMAN RESOURCES DIVIDER SHEET 't,'ENCY NAME: /A/W,C.//ivN /1/ -� -i11c . Page 3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) I Please attach a copy of the organizational chart. 2 Do you have written, up-to-date personnel policies? Yes No _Being revised Date last revised: 6/c/95"-- 3 Do your personnel policies contain an equal employment opportunity clause? Yes No 4 Do you have a written job description? ,% Yes No Being revised Date last revised: /i'c,ks Do you have written salary ranges for each job description? (If yes, attach salary ranges.) ti,, Yes No Being revised Date last revised: �a � 9S 6 Does the agency conduct regular evaluation of employees?eg Yes No ✓ In the process of being developed 7 What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. /No change Increase in staff is projected Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9 Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10 Please provide a description of the minimum qualifications for each position. TNI CofH Non-Profit Funds Grant Proposal HUMAN RESOURCES 8. Please share information on training opportunities provided to staff and/or volunteers. TNI maintains constant communication with other agencies statewide to update and increase our information and skills. All staff and board members are encouraged to attend various workshops, conferences and trainings as funding allows. We are also a member of the Domestic Violence Interagency Team and collaborate to bring in national and state experts in all levels of social and legal services. At this time TNI is applying for membership with the State Coalition on Family Violence. 9. Please share concerns or challenges within the Human Resource area and what steps have been taken to address the concern or challenges. We have observed that there often appears to be a lack of culturally appropriate materials, presented by experienced and trained personnel who are familiar with the geographic and cultural factors of the rural areas. We are concerned about the lack of accessibility to families in isolated communities. TNI intends to address these concerns by identifying and training local community leaders in domestic violence while also using the expertise of the communities to identify effective intervention strategies. 10. Please provide description of the minimum qualifications for each position. Executive Director: B.A. or equivalent combination of education and experience in administrative/managerial positions with emphasis on fundraising, fiscal responsibility and have knowledge of feminist philosophy of violence against women, and the dynamics and scope of family violence. Must have experience or willingness to work in a team environment. Knowledge of consensus. Accountable to Board of Directors. Good communication and supervisory skills a must. C she Manager, Men's Program: Training and Experience; B.A. or equivalent combination of education and experience in situations requiring communication skills and group facilitator techniques. Knowledge of feminist philosophy of violence against women, the dynamics and scope of family violence, power and control issues, and working with men who batter. Case.Manager, Wom n's Program: Training and Experience; B.A. or equivalent combination of education and experience in situations requiring communication skills and group facilitator techniques. Familiarity with Court procedures. Knowledge of page 6 TNI CofH Non-Profit Funds Grant Proposal feminist philosophy of violence against women, the dynamics and scope of family violence, power and control issues, and working with battered women. Group Facilitators: Training and experience in communication skills and group facilitator techniques. Knowledge of feminist philosophy of violence against women, the dynamics and scope of family violence, power and control issues, and working with battered women and/or men who batter. Office Manages_Education or experience in organizational/administrative management. Knowledge of bookkeeping, policies and procedures. Computer literate. Good communication skills. Understanding of feminist philosophy of violence against women. Training Coordinator: B.A. or equivalent training and/or experience in public speaking, coordinating and developing workshops. Excellent communication and writing skills, extensive knowledge of feminist philosophy of violence against women and power and control issues. Experience or willing to work in team environment. page 7 d a og 1.1 .... ..p / i: Clg • 8 g 0 44 5 04 en o1 Ix w \ g H U H i cn d 0 R ddb 0 P 1 / 0 5 vompetombar z,...:4 g (4 d E ; t a o v w5t% r� a 0 A i 6cg TS mimcog CIS o • a g z �_ w co 0 g .. \ IIIIIIMMIIMIL5 o cg i 0i g g 0 1a Q w TNI CofH Non-Profit Funds Grant Proposal Attachment: Human Resources #5 Salary Ranges Executive Director $35-38,000 Administrative Staff 22-25,000 Training Coordinator 25-27,000 Victim Support Case Manager 22-25,000 Men's Case Manager 22-25,000 Facilitator $35-60.00/session Sex Offender Treatment Case Manager 32-35,000 Assistant Case Manager 22-24,500 page 16 BOARD OF DIRECTORS DIVIDER SHEET .AGENCY NAME: TRRNSifjiA) /'YETtdiM/< 1"--A)C- (Page 44) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1 Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3 According to the bylaws, how many directors must serve on the board? 4 List major decisions made by the Board of Directors last year and actions taken or plans made to implement,the decisions. 5 Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the agency's mission) for the coming year. 7. What long range plans does the Board of Directors have for the agency? D FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the number "1" to the most important and dominant service or target population. 3 educational J victims of crime culture& arts victims of health crises S the poor a victims of social crises Li youth the physically disabled the aged the mentally or emotionally disabled TNI CofH Non-Profit Funds Grant Proposal BOARD OF DIRECTORS 1. Provide a current listing of the Board of Directors with board terns and positions, addresses, phone numbers and current occupations. All terms are 1 year Transition Network, Inc. was founded in 1981 under the name of Shanti Nilaya Maui. The original purpose of the organization was to provide support services to terminally ill patients and their loved ones. At that time we were in collaboration with the Elisabeth Kubler-Ross Center, and served as a liaison between the public and the EKR Center activities. We also coordinated speaking engagements, lectures and workshops on behalf of the EKR Center. In addition to direct services to patients, we facilitated regularly scheduled support groups to the public and to inmates at the Maui and Oahu Community Correctional Centers on issues of grief and loss. By 1986, as both the Hospice movement and the Therapeutic Community model for prisons came in to place, our services in this field were no longer needed. From 1987 to1995 the4organization was inactive, although we maintained our required, annual filing to retain our non-profit status. In June of this year we re-organized with the new name of Transition Network, Inc. with our focus on Domestic Violence education and technical support, and community development. Currently, we are administering the Sex Offender Treatment Program at Kulani Correctional facility, here on the Big Island. We also are contracting with various agencies and health service providers for staff training in Domestic Violence awareness and intervention techniques. Although the organization is new in the community, our staff and Board of Directors have a wide range and many years of expertise in the field of Domestic Violence, community development, grant management, and represent many of the interests of our diverse, island community. The following is a list of our Board of Directors: President and Exec. Director, Community College, Michigan Roberta(Bobbi ) Leone License for Mental Health Associates 1545 Ainaola Dr. degree- Oakland, Social Worker Technician Hilo, HI 96720 - Wayne State U; Staff member and trainer 959-0603 for the Elisabeth Kubler-Ross Center Site Coordinator Hilo/Hamakua Support Services (17 yrs.). Coordinator of Substance Abuse Catholic Social Ministries Counseling Services and Community Development Specialist for the State of Alaska, and various Alaska Native Corporations(5 yrs.) Staff Trainer and group facilitator in Domestic Violence work since 1981. President and/or Director of this organization since 1981. Vice President and staff, M.S.W. -University of Hawaii, Manoa, B.S. Jana Hill, M.S.W.: University of Idaho ( Specializing in Human page 8 TNI Cotes Non-Profit Funds Grant Proposal PO Box 4012 Services), Private Practice Therapist, Hilo, HI 96720 Human Service conference planning, 969-7748 Domestic Violence direct service provider and trainer(8 yrs.), and Program Director, Sex Offender Treatment Program(6 yrs.) Treasurer and staff, Carl Swett: Combination of education and experience PO Box 33 in Women's Issues, Domestic Violence, Mt. View, HI 96771 Feminist philosophy, Youth at risk, sexual 968-8056 assault, and curriculum development for Assistant Case Manager, Batterers Program(5 yrs.). Co- Sex Offender Treatment Program Facilitator, Sex offender Treatment Program (4 yrs.) Secretary, Diane Blanchard: Domestic Violence'direct service provider PO Box 877 (13 yrs.)and Community Education, Mt. View, HI 96771 Program Director(6 yrs.)Designed and 968-8674 implemented Sex Offender Treatment Community Trainer/UHH Student Program(4 yrs.), Substance Abuse Treatment, Group Facilitator(1 yr.), Member of Domestic Violence Inter-Agency Team(DVIAT), Chaired numerous Task Force and Caucus groups. Former Director for Shanti Nilaya. Director, Ron Byrum: Domestic Violence direct service PO Box 225 provider, Batterers Program Facilitator Kurtistown, HI 96760 (5 yrs), revised and developed curriculum, 966-7719 homework, and related program materials Men's Case Manager Batterers Program Alternatives to Violence Director, Cathy Dumond: Office management and related support PO Box 6580 services(17 yrs.) Domestic Violence work Hilo, HI 96720 (3 yrs.) 982-8352 Director, Mary Furlong: B.A. -University of Minnesota, Human PO 'Box 1141 Services and administration(15 yrs.),Video Kurtistown, HI 96760 production(20 yrs.), Domestic Violence, 966-9217 Men's and Youth programs(5 yrs.), page 9 TNI Con Non-Profit Funds Grant Proposal Social Worker Professional Musician, performance and Catholic Services to Families recording(20 yrs.), Hospice worker(5 yrs.), Production Assistant member DVIAT. Jones Spacelink Director, Lonnie Large: Domestic Violence work includes PO Box 673 administrative, program development, Kurtistown, HI96760 evaluated Duluth Alternatives to Violence 966-7096 in East Hawaii;trained and experienced in Sex Offender Treatment, agency liaison(9 yrs.) Director, Theodora Bell: B.A. -University of Minnesota, Affirmative 533A Manono St. Officer(11 yrs.), Sex Education Instructor Hilo, Hi 96720 (2 yrs.),Action Literacy Project 961-2521 Coordinator (2 yrs,),Board of Directors (member& officer)Bay Clinic(4 yrs.) 2. List number of board meetings held in the prior year and attendance levels. Six Meetings, 100% attendance. 3. According to the by-laws, how many directors must serve on the board.? Ten directors 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. Decisions and actions made by our Board include; developing and implementing the Violence Intervention Project; operating the Sex Offender Treatment Program in Kulani Correctional Facility; creating culturally appropriate standardized training programs and materials. In order to implement plans we have created time-lines, held fundraising events and applied for private funding. We decided to go into limited partnership with Wireless Cable TV Ltd., in order to develop educational and informational programming for rural Hawaii. Our application for FCC licensing is pending. S. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. page 10 TNI CofH Non-Profit Funds Grant Proposal Challenges and anticipated actions include building community awareness of domestic violence and its effect on our community, creating a broad base of funding support in order to become self sufficient; providing immediate services to women in need of TRO assistance. Anticipated action TNI will take include continuing to follow our long range plan, increasing our funding base with fundraising and foundation grants; providing standardized training to all service providers in areas related to Domestic Violence, especially in the Hamakua and Puna districts. 6. List planned improvements (to meet TNT's mission)for the coming year. Planned improvements include: continuing to provide training and education to the community and agencies to help facilitate a coordinated community response to Domestic Violence; increasing agency membership; increasing TNI's funding base; increasing our agency membership in National and statewide coalitions and committees. We are coordinating a fundraising/educational event to raise public awareness as well as increase our name recognition in the community 7. What long range plans does the Board of Directors have for the agency? Long range plans include becoming self sufficient and ensuring that all areas of the Big Island have access to information and services regarding Domestic Violence. We are, in particular, interested in increasing accessibility and improving services in the impoverished rural areas of the Big Island. Once our FCC license is approved we anticipate the development of our own programing through contract with wireless TV. Develop training materials (videos, manuals, etc.) and utilize media to increase community development and social awareness. Our long range scope includes seeking innovative environmental/agricultural support as a means for community development in rural areas . page 11 FUNDING NEEDS DIVIDER SHEET AGENCY NAME: 1-45/1/S777,421/ /I/ 7- /D/i)k /1/6 . r' r E. FUNDING NEEDS: (Answer on separate paper and attach.) 1 Briefly explain the purpose of your request. 2 What alternative funding sources were considered and/or applied for? 3 What alternatives have you considered if this County request is not funded or is not r l Funded? -t Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5 Do you receive any income (subsidy) from a neighbor island or a parent organization) if so, how much? 6 If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7 Do you expense any portion of income to a neighbor island or parent organization to snare in operational expenses? If yes, how much? 8 If you answered Yes to question #7, what is the formula used to determine this amount or percentage? TNI CofH Non-Profit Funds Grant Proposal FUNDING NEEDS 1. Briefly explain the purpose of your request. This grant, when awarded will be used to partially fund the Violence Intervention Project in rural Hawaii for one year. 2. What alternative funding sources were considered and/or applied for? Other funding sources considered and applied for include several private foundations, contracts with related agencies to provide training to their staff, continual fundraising, and a sliding scale of fees to batterers program participants. 3. What alternatives have you considered if this County request is not funded or is not fully funded? Alternatives we have considered include continuing to pursue private foundation money, charging for direct services provided, fundraising, and contracts to provide training to other agencies. 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. There are no variances in our budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: TNI is not part of a larger organization. page 12 PROGRAM INFORMATION DIVIDER SHEET .:._::ncv name 7/� /9//S1TTeW /1/ 7---W/r/ . .Pay_e Piog,ram name: V 10 LNC_ - —r—A)-VER (A.,NTLeA) l le Ott aim Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc.. ) Answer questions 1-8 on separate paper and attach. l How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3 What are the specific objectives of the program(in quantitative terms, where possible)? 4 How do you evaluate program effectiveness, and who does the evaluation? 5 How does this program's content vary from similar (or same) programs offered by other agencies in the community? o List specific accomplishments of this program last year. 7 Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate 4.2 next year estimate g'S—O S. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When-were these rates last changed? TNI CofH Non-Profit Funds Grant Proposal PROGRAM INFORMATION 1. How does the program help individuals, groups and/or the community? TNI's Violence Intervention Project benefits individuals by giving them the tools to address and stop violence in their relationships, and by having local access to services. Due to rural isolation, and lack of public transportation, current services in Hilo and Kona are not easily accessible and are often not seen as appropriate in design for the various ethnic groups found in rural Hawaii. Building community involvement through collaborative efforts provides a basis for positive change. The community would play a critical role in shaping their surroundings while promoting individual empowerment and fostering social cohesion. 2. The target population for this project is: -Women and children who live in the geographically isolated districts of Puna and Hamakua are in need of TRO assistance and court advocacy services, victim support groups and information and resource options. -Men who batter who are court ordered to attend, or self referred to a batterers program and live in the Puna, Hamakua or surrounding districts. - Individuals, community organizations, or social service agencies requesting training or information on Domestic Violence. 3. The specific objectives of the Violence Intervention Program are: a. To make Domestic Violence services locally available to individuals and families in the Hamakua and Puna districts b. To provide training to community members of the Hamakua and Puna districts in the development, implementation, and execution of rural Domestic Violence services c. To reduce isolation from services, and increase accessibility d. To increase and enhance multi-cultural leadership and administrative skills among the local community members e. To facilitate the ability of families to identify signs of abuse f. To improve the ways in which families address and resolve family abuse concerns page 13 TNI CofH Non-Profit Funds Grant Proposal g. To provide for continuity of services through coordination of necessary, related services and programs 4. How do we evaluate program effectiveness, and who does the evaluation? Evaluation, reporting and dissemination The evaluation of this project will be built largely on the effectiveness in accomplishing the program objectives, and a major preparatory activity during the first month or two after funding will be to prepare a complete evaluation design that will be submitted to our funding sources . Preparatory tasks would include: a. Defining each project objective in operational terms, susceptible to measurement b. Developing the measurements that would be used as indicators of achievement of objectives and impact c. Identifying variables that influence program performance and outcome d. Specifying data requirements and identifying the source for each type of required data e. Describing the data-collection methods f. Describing the content of the final report g. Describing the staffing and managing of the evaluation h. Developing a timetable for the evaluation S. How does this program's content vary from similar or same programs offered by other agencies in the community? No other agency or organization is providing these services in Puna or Hamakua. 6. List specific accomplishments of this program last year. First year of program. 7. Provide information on the unduplicated count of this programs beneficiaries: page 14 TNI CofH Non-Profit Funds Grant Proposal last year actual: 4 this year estimate: 6211 Next year estimate: $.5.0. 9. If fees for programs or services are charged, what are the rates for each specific program or service? (attach a complete rate schedule for this program) A. When were these rates last reviewed? B. When were these rates last changed? Services for victims are free. There is a sliding scale for the batterers program based on income. It ranges from $5.00-20.00 per two hour group. 4 page 15 Q 4 O cg Q p `° 4 -*--4. �. o - � 4 4g � , w a w Q O 0 a~ Gz, i— a04 i— a z A U 4 es k � IU A ill A O v x 0 oo 0 a F- c aH • \ Z k". 1 r.. z oo U o0 Q r 0 Q � � � � O N c 5 x r Cn a Q -.--' 00 U z N t; O`o :)...1 `i zz� °� owa. c a w O Q 8 v a o R 0 W w z a0 F Q c4 FZ~- E— oc c Oz w 0 w w U 5 v i o E ZW0 a t p z G:: 0 w `F" v 3 >- z A F" ° t < t, 8 2 a o H a o zw z � x ttW r a Q a4 Q•+ en .-, N M tt til vp I— oo ON cv U Cl - w _ S N OLi- cr. 9_ S el w c - cr 2. 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IS\ o k. 0 R o o� Lr ��-co e- r w , C7 A az iti '* -i- i• o \sN c4 <s' tz 9 N .3 •'g oo � ztiN o .� y 8 � _ S§ § §g U VH a0 w $ $ $ 8 i9 ° -. �o_ Z_ _ o_0 c_A Q 0 ,0 ..*n < 0\ U y 2 —______14tt- W .2 ZO . , - , . . . �' N zo ,4 u ,c2. , -z , , ).- 61 s [-L. 2 0 U a ° _ _ W g 0 H 4 i 1 r4 ,� - VD Fe ul t r Uiflfl ,_ o HILO ARC APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996- June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: The Arc of Hilo NAME OF PROGRAM: Residential and Suaaort Services; Vocational Rehabilitation; Adult Day Program Mailing Address: 1 n 4 9 I ila i a.i l a ma Axj a ai la City, State, Zip: Hilo, Hawaii 96720 Telephone: (808) 935-8534 FAX: (808) 961-0148 Attach current Internal Revenue tax-exemption certificate 501 (c)3 see attached Amount allocated by the Hawaii County in 1995: S 25,00a 2 % of Budget Agency Total Budget in 1995 S Amount requested of Hawaii County in 1996: $ 75,000 4 % of Budget Agency Total Budget in 1996: S This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996• BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year; June 30th ending History of fines with the County of Hawaii: New Applicant x Participating agency since 19 89 Firm conducting and date of agency's last financial review or audit: NAME: William Ronald Dolan CPA Inc. DATE: June 30, 1995 ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SFIEET ORGANIZATION NAME: The Arc of Hilo Page #2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) I. Agency Name: The Arc of Hilo Geographic Area(s) Served: County of Hawaii Agency's Mission Statement: see #2A 2. Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency(in quantitative terms,where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? The Arc of Hilo Page #2 (a) A. AGENCY PROFILE: 1. Agency Name: The Arc of Hilo Geographic Area Served: County of Hawaii Agency's Mission Statement: The mission of the Arc of Hilo is to improve the quality of life for people with mental retardation and developmental disabilities in the County of Hawaii. The Arc of Hilo's beliefs and philosophy regarding the mentally retarded and developmentally disable are based on the recognition of individual human rights, normalization principles and on the developmental model. Based on these beliefs, the Arc of Hilo acknowledges the following: Individuals have the right to live, work and play in the least restrictive individually appropriate environment; Individuals have the right to a comprehensive and integrated individualized habilitation program and services designed to maximize development; and Families play a central role in the lives of persons with mental retardation and developmental (MR/DD). 2. Briefly describe the kinds of programs and services the agency provides. Vocational Rehabilitation Services providing vocational evaluation and training, rehabilitation services, sheltered work employment, competitive employment placement and supported employment services in the County of Hawaii. An Adult Day Program provides training to increase levels of functioning in the areas of self-care, hygiene, communication, personal and social skills, use of leisure time, transportation, home management, vocational skills, and employment. The Arc of Hilo Page #2 (b) 2. (continued) The Arc of Hilo provides employment opportunities for the severely handicapped. The Arc of Hilo is qualified as a producing agency for people with severe disabilities under the provisions of Public Law 92-28, the Javits- Wagner-O'Day Act. Workers at the Center perform contract work including nursery, laundry and ironing. Mobile work crews perform janitorial and grounds maintenance duties at Hilo Post Office, the Federal building, University of Hawaii at Hilo, and other locations under private, County, State and Federal contracts. A domiciliary licensed home provide independent and supported living options for persons with mental retardation and developmental disabilities. Each individual in the home receives basic care, positive behavioral supports, and training to develop the living skills necessary for more permanent placements in the community. The Hale Ulu Hoi apartment complex provide HUD subsidized housing for economically disadvantaged elderly and handicapped individuals as well as case management for individuals where none currently exists. The Partnerships in Community Living Program, (PICL) provides family support and community outreach services for individuals with mental retardation and developmental disabilities. We provide direct services as determined by the family and consumer, and the purchase of service items that cannot be obtained through Medicare and other sources. The Transitional Residential Services Program (TRS) provides behavioral intervention and training services to individuals with mental retardation and developmental disabilities who exhibit challenging behaviors or who are medically fragile. 3. How do these services support the agency's mission? These programs and services provide the disabled person with options for learning, personal care, housing, leisure activities, employment and transportation. Individuals are encouraged to choose among options in order to realized their goals of when, how, and where they will learn, live, work and play. The Arc of Hilo Page #2 (c) 3. (continue) Choice is fundamental for maintaining a positive quality of life, individual dignity and self worth. Providing these services and empowering consumers to make their own choices support our mission by enabling persons with mental retardation and developmental disabilities to achieve normalization and realize their individual human rights and full potential. 4. Who is eligible for services? All persons with bonafide disabilities - physical or mental - over the age of 16 years are eligible for referral by the Department of Human Services Vocational Rehabilitation and Services to the Blind Division to our vocational rehabilitation programs. Persons who are developmentally disabled adults as defined under sections 333F-2 of the Hawaii Revised Statutes as determined to be eligible for program participation in the Adult Day Program by referral from the Services Intake Offices established by the Community Services for the Developmentally Disabled Branch, State of Hawaii Department of Health. • Adults and children with disabilities and their families are eligible for community support services under the TRS and PICL Program by referral from the Service Intake Offices as established by the community Services for the Developmentally Disabled Branch, State of Hawaii Department of Health. Economically disadvantaged disabled and elderly individuals are eligible for federal housing assistance under HUD Section 202 Housing for the Elderly or Handicapped. Individuals with mental retardation, developmental disabilities, other handicapping conditions and the elderly receive Equal Housing Opportunity in accordance with the Federal Fair Housing Act. The Arc of Hilo Page #2 (d) 5. Provide an unduplicated count of the number of individuals served by the agency. List by program title. Vocational Evaluation and Training 95 Adult Day Program 50 Domiciliary Homes and Support Services 45 Partnerships in Community Living 56 Transitional Residential Services Program 5 Total served 251 6. What are the specific objectives of the agency (in quantitative terms where possible.) To build, maintain and improve facilities for the education, recreation and care of mentally retarded citizens within our geographical area. 7. How do you evaluated program service effectiveness, and who does the evaluation? Each client, consumer and their family has an Individual Program Plan. Client are monitored daily. Staff reviews and reports on individual's progress monthly or quarterly using established behavioral models acceptable to our funder sources. Results are transmitted to the agencies we serve monthly or quarterly. Program monitors have on site review of program effectiveness. Consumer and family provide feedback directly to us and through evaluation surveys submitted directly to our funders. Progress toward client goals within the programs, are recorded on an Individualized Program Plan. Nationally recognized models such as the West Virginia Pyramid Scale or the Goodwill Accessment Tools are then used to quantifiably evaluate client progress toward the achievement of their goals. The Arc of Hilo Page #2 (e) 8. What other resources or providers do you coordinate with to deliver agency service? Do you contract with these resources or providers? Service contract with: State of Hawaii Department of Health Developmental Disabilities Division Community Service for the Developmentally Disabled Branch State of Hawaii Department of Human Services Vocational Rehabilitation Services for the Blind State of Hawaii Department of Transportation in cooperation with the Federal Transit Administration for Transportation of the Elderly and Handicapped. NISH Commission Creating Employment Opportunities for People with Sever Disabilities acting under provisions of Public Law 92-28 The Javits-Wagner O'Day Act U.S. Department of Housing and Urban Development Coordination with other community agencies: East Hawaii Special Olympics Big Island Center for Independent Living • Mayor's Commission for Persons with Disabilities Hawaii County Economic Opportunity Council County of Hawaii Office of Aging State of Hawaii Department of Labor and Industrial Relations State of Hawaii Department of Human Services Family and Adult Services Division Social Security Administration The Arc of Hilo Page #2 (f) 9. How does this agency's services and programs vary from similar services and programs offered by other agencies in the community? Experienced service provider since 1954 for the Mentally Retarded and Developmentally Disabled population. The largest provider of vocational rehabilitation services for persons with mental retardation and developmental disabilities on the Island of Hawaii. The only agency in East Hawaii providing residential and support services specifically to the mentally retarded and developmentally disable an their families. 10. List specific accomplishments or challenges addressed by the agency this last year. Supported an active Human Rights committee to insure that clients rights are protected. formerly an agency advisory committee, this committee has reorganized independently to serve on a multi-agency basis to monitor client rights throughout East Hawaii. Improved accounting system function to institute a complete in-house general ledger accounting system. Upgraded our laundry facility to meet State Department of Health licensing requirements. Started licensed cooking program. Began the process to become Medicaid Home and Community Based Waiver Service provider which matches State and Federal money. 11. Does the agency have membership dues? No. 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? A $500 affiliation fee is paid annually to The Arc, a national organization on mental retardation. The Arc of Hilo Page #2 (g) 13. What benefits and/or services are provided to the agency by the national or statewide organizations? Education, research, advocacy and support for persons with mental retardation and development disabilities, their families, friends and community. Guidance to those who need or want help. Monitor national progress in the area of inclusion, such as education, employment, community living and recreation. Public awareness of needs, rights and abilities of people with mental retardation, including Fetal Alcohol Syndrome and alcohol-related birth defects. The Arc Today is a national newspaper with up-to-date information on the organization and mental retardation. HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: The Arc of Hilo Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? x Yes No Being revised Date last revised: Feb, 1994 3. Do your personnel policies contain an equal employment opportunity clause? x yes No 4. Do you have a written job description? X yes No Being revised Date last revised: as needed 5. Do you have written salary ranges for each job description?(If yes, attach salary ranges.) Yes No x Being revised Date last revised: 6. Does the agency conduct regular evaluation of employees? X Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. x No change Increase in staff is projected Decrease in staff is projected (Answer questions 8,9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. • Hilo Association For Retarded Citizens Organizational Flow Chart r — -' — — — — — — - Board of Directors• - _— — -- I � I , Cr.ief Exeutive Office= I 1 l f IRC Advisory i RSS Advisc-y Cornittee Cbr r-dttef I E & T AppRSS Director Director Co.vtroiler Administrator i Admin Sec Erployment Education Coordinator �Instructori � Acc Clerk N_'H sb I • Admin Clerk I ,� ed Supervisors sors e rl „_ E LSI � I I Effective as of: 4/94 The Arc of Hilo Page #3 (a) B. HUMAN RESOURCES (Question 1-6 answered on Divider Sheet) 8. Please share information on training opportunities provided to staff and or volunteers. CPR; First Aid Training Mandt Training - Counseling and non obtrusive behavioral management program Visions Domiciliary Training - 40 hours of class work and hands on training covering topics from philosophy to medication delivery Nutritionist training AIDS Training Team-building and Professional Conduct 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenge. New employee policies and procedures manual. Downsizing of administrative staff. Adjusted staff salaries. Advocating Systems Delivery Change Education and advocacy for expanded funding and alternative funding sources 10. Please provide a description of the minimum qualifications for each position. (see attachment 3B) The Arc of Hilo Page #3 (b) 10. (continued) a. Chief Executive Officer: B.A. in Business and Human services with 3 years experience in administration. b. Controller: B.A. or equivalent in accounting with 2 years experience. c. Residential and Support Service Administrator: BA in Human services with 1 years experience working with mental retarded and developmentally disabled population. d. Adult Day Program Instructor: BA in Education or equivalent and 2 years experience working with mental retarded and developmentally disabled population. e. Vocation Rehabilitation Evaluator/Trainer: BA or equivalent with 1 year experience with mental retarded and the developmentally disabled population. f. Job Coach: High School graduate with 1 year experience in Human Services. g. Living Skills Instructor (LSI): High School graduate with 1 year experience in Human services and work with mental retarded and developmentally disable population. h. Partemer in Community Living (PICL) Program Director: BA in Human services with 1 years experience working with persons with mental retarded and developmental disabilities population. The Arc of Hilo Page #3 (c) 10. (continued) Richard Santos, Chief Executive Officer, has a B.A. in psychology from the University of Hawaii; he is a retired Police Captain and has worked in the MR/DD field since 1960. Susan Beth Simonsen CPA CMA, Controller, has a B. A. in Business Administration, and has 1 year experience in the MR/DD population. Allen Dillon, Residential and Support Services Administrator; has a B.A. in Philosophy from the University of Hawaii and post graduate work in clinical psychology; the last 8 years he has administered service to the MR/DD population. Michelle Averil, Living Skills Instructor, has an A. A. degree and has been a teachers aide and LSI for 4 years. Colleen Madeira, Living Skills Instructor, has an A. A degree and has been a teachers aid for 11 years. Seonaid Nakata, Adult Day Program Instructor, has a B. A. in psychology from the University of Hawaii and has 7 years experience working with the MR/DD population. Shelagh Yoon, Job Coach, has a A. A. degree and has 5 years experience working with the MR/DD population. Bevlyn Costa, Vocational Rehabilitation Evaluator and Training, has been a teacher, Evaluator and Trainer for the Arc of Hilo for 19 years. Wendy Norton, PICL Program Director, has a B.A. in Sociology and has 3 years experience working with the MR/DD population. BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: The Arc of Hilo (Page *4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1 Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements(to meet the agency's mission) for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s)in order of importance. Give the number "1" to the most important and dominant service or target population. educational victims of crime cut***sits 3 victims of health crises 5 the pacer victims of social crises youth 2 the physically disabled 4 the aged i the mentally or emotionally disabled HILO ASSOCIATION FOR RETARDED CITIZENS BOARD OF DIRECTORS 1995 - 96 Board Member/Address Occupation Office Term/Phone # LOUIS H. PAVAO Retired Businessman President 6/98 632-B Kaumana Drive Volunteer 935-3511 (h) Hilo, Hawaii 96720 SS# 576-10-5572 GLENN HIRATA Businessman, Volunteer Vice Pres. 6/98 15-2712 Moi Street SS# 575-62-0448 965-9023 (h) Pahoa, Hawaii 96778 935-4821 (w) HAL SMITH Retired & parent of a Treasurer 6/97 2817 Maiko Street disabled adult, Volunteer 965-9503 Pahoa, Hawaii 96778 SS# 515-07-3080 DORIS IWAOKA Businesswoman & parent of a Secretary 6/98 799 Komomala Street disabled adult, Volunteer 959-6761 (h) Hilo, Hawaii 96720 SS# 575-42-9029 967-8425 (w) ELLEN AOKI Volunteer & Realtor Term exp. 6/98 1444 Mona Loop SS# 575-30-7298 959-9098 (h) Hilo, Hawaii 96720 935-0399 (w) VELMA BURGADO Parent of a disabled adult Term exp.6/96 1506 Waianuenue Avenue Volunteer 935-3087 (h) Hilo, Hawaii 96720 SS# 576-10-5572 WINSTON CHING Businessman, parent of a Term exp. 6/97 25 Hanohano Street disabled adult, Volunteer 959-9291 (h) Hilo, Hawaii 96720 SS# 575-38-9972 935-1171 (w) PHYLLIS HAYAMA Volunteer Term exp.6/98 345 Anela Street 959-8789 (h) Hilo, Hawaii 96720 LARAINE KAWASAKI Volunteer Term exp. 6/98 480 Mohouli Street 935-5366 (h) Hilo, Hawaii 96720 934-8181 (w) Page Two (2) $oard Member/Address Occuoatlon Office Term/Phone # FLORENCE KUBOTA Volunteer Term exp. 6/98 33 Manulele Street 935-1259 (h) Hilo, Hawaii 96720 HAROLD MIMAKI Retired, Hilo Hospital Term exp. 6/96 145 Lukia Street Parent of a disabled adult, 935-2462 (h) Hilo, Hawaii 96720 Volunteer SS# 575-34-7550 LOUISE NORTHWOOD Retired, Volunteer Term exp. 6/97 700 Akolea Street SS# 575-30-3621 934-0954 (h) Hilo, Hawaii 96720 TAKASHI SASAKI Retired businessman Term exp. 6/97 76 A Huaalani Street Volunteer 935-0647 (h) Hilo, Hawaii 96720 SS# 575-36-3409 PETER TADAKI CPA, Parent of a disabled Term exp. 6/97 101 Aupuni Street adult, Volunteer 935-8826 (w) Hilo, Hawaii 96720 SS# 575-52-0542 935-0059 (fax) CAREY UCHIDA Parent of a disabled adult Term exp. 7/97 138 Kaikuono Place Volunteer 935-0537 (h) Hilo, Hawaii 96720 SS# 575-56-2349 969-1051 (w) The Arc of Hilo Page #4 (a) C. BOARD OF DIRECTORS 1. Provide a current listing of the Board of Directors with board terms and position, addresses, phone numbers and current occupations. Attached. 2. List number of board meetings held in the prior year and attendance levels. Full Board - 12 meetings one per month 75 % attendance. Executive Board - 3 meetings as requires 100% attendance. 3. According the the bylaws, how many directors must serve on the board? Article 5 Section 1 of the bylaws was amended at the Board of Directors Meeting held July 14, 1992 to read "Board of Directors shall consist of no less than seven (7) or more then seventeen (17). Currently there are 14 board directors. 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decision. Actively addressed past budgetary deficits by passing a balanced budget. Established endowment fund to provide matching monies for future grant requests. Implemented active fund raising plan - 1995 informational letter mailout campaign. Downsized administrative staff in response to budgetary shortfall. Developed and adopted new update personnel policies and procedures. The Arc of Hilo Page #4 (b) 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. Budgetary cutbacks decreased service commitment from State agencies. Look for new sources of funding to cover anticipated budgetary shortfall. Obtaining more private and governmental job contracts. Expand in-house training for staff to improve performance and productivity on contracts. 6. List planned improvements (to meet agency's mission) for the coming year. Seek alternate sources of funding which will allow us to provide a greater array of services for consumers with mental retardation and developmental disabilities. Apply to receive Home and Community Based Waiver federal and state matching funds which would allow us to provide a greater array of services which include resourcing alternative living options in the community, and an Adult Day Health program targeting those consumers with challenging behaviors and the medically fragile. 7. What long range plans does the Board of Directors have for the agency? Expand residential options for community living. Set up after school program for junior high and high school consumers with mental retardation and developmental disabilities. Implement after school, evening and weekend respite services. Expand employment options including job placements, supported employment and in house training programs. FUNDING NEEDS DIVIDER SHEET AGENCY NAME: The Arc of Hilo (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income(subsidy)from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question#7,what is the formula used to determine this amount or percentage? The Arc of Hilo Page #5 (a) D. FUNDING NEEDS: 1. Briefly explain the purpose of your request. State grant monies and existing sources of funding are not keeping pace with the increasing demand for our program services and Department of Health funding to provide was cut, and an average or 20% per contract. The vocational training program grant monies do not begin to cover the cost to serve the 95 clients referred to us by the Department of Vocational Rehabilitation. Currently we are serving 19 unfunded clients for vocational rehabilitation services. The Department of Vocational Rehabilitation moneis were cut 20%. In the Adult Day Program, increased spending restrictions associated with grant revenues require that a higher staff to client ratio be maintained, which means that, unless we can afford to hire more staff we may be forced to discharge clients. We are currently serving 20 unfunded clients under the program who may be turned back into the community without day care. Costs of running the domiciliary home which was formerly funded by the Partnerships in Community Living Programs (PICL) grant, must now be funded from other sources due to new grantor restrictions on the PICL funds. The costs to maintain appropriate staffing levels are currently unsubsidized. Without this home 5 individuals - medically fragile and with challenging behaviors - will be released to the community where there are no other known living alternatives currently available for such individuals. Grant revenues for the PICL Program require an increase in service from the Hilo area to Island-wide service. Our use of the grant monies is further restricted by a contact stipulation requiring 75%of the grant amount to be allocated for direct assistance to individuals. The remaining 25%of contract amount is insufficient to cover staffing, administrations, insurance, office, supplies and other costs associated with the service delivery. The PICL contract monies were cut 20%. The Arc of Hilo Page #5 (b) 2. What alternative funding sources were considered and/or applied for? Combined Federal Campaign Fund Private Foundations (5) County of Hawaii Wilcox Foundation Home and Community Based Waiver Federal and State matching funds. Department of Labor Purchase of Service Grant 3. What alternatives have you considered if the County Grant request is not funded or is not fully funded? Fees for services. Independent fund drive effort and solicitation of private donation. Setting up for-profit companies which profits would be used to fund our non- profit services. 4. Give a brief explanation for any variances of 15%or greater per line item in the current vs. proposed budget. There are no variances of 15%. The Arc of Hilo Page #5 (c) 5. Do you receive any income (subsidy) from a neighbor island or parent organization? No. 6. Not applicable. 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? No. 8. Not applicable. PROGRAM INFORMATION DIVIDER SHEET Agency name. The Arc of Hilo (Page 6) Program name: Vocational Rehabilitation Evaluation and Training Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6,etc...) Answer questions 14 on separate paper and attack. 1. How does the program help individuals, groups and/or the community? { 2. Who is the target population for this program? 3. What are the specific objectives of the progtam(in qui `where possible)? 4. How do you evaluate program effectiveness,and who doextist n? 5. How does this program's content vary from similar(or same)prima offered by other agencies in the community?. 6. List specific accompl' s of this grogrWnn'Caet year. K k v r 7. Provide i ,. • • count owt eer-' : 9 95 100 8. If fees fist peat - are charged,what are the rates breach specific program or service? (Attach a:completer rate schedule fbr this prove ,.� A. When were these rates last reviewed' No fees are charged for program services. B. WheeEwere these rates last changed? The Arc of Hilo Page #6 (a) 1. The Evaluation & Training Program helps individuals with disabilities to train in a hands on program to prepare for eventual placement in meaningful employment. This helps the community at large by turning tax users into tax payers. It also provides training to enrich and improve the quality of life for the persons it serves. 2. The target population is all persons over the age of 16 years of age who have a disability that prohibits them from obtaining meaningful employment. 3. The specific objectives are to successfully rehabilitate as many clients as possible by placing them in competitive employment within one year of service to them. So far this program has placed almost one hundred persons with disabilities in employment since 1991. 4. The program is evaluated by the numbers of placements which are set by the Department of Vocational Rehabilitation (DVR). The effectiveness is based on the results which have been consistently on target with the requisites of the DVR contract for the past four years. 5. There may be similar programs in the community, but none are solely targeted for the population we serve nor are they able to offer the variety of hands on training that we provide. The most important ingredient is the aggressiveness of the employment program. 6. Specific accomplishments of the DVR program last year are: Effective placement of twenty five clients into gainful employment, exceeding the eighteen required placements. Other outstanding accomplishments for last year: One client, suffered from sever brain damage, and could not remember where the restroom was at the Center. Now, he works for a famous fast food chain, resides in Kamuela, drives a car again and just became the DVR Employee of the Year. Another client, completed one year of service at the USDA Tropical Fruit Fly Lab and now earns$10.87 per hour as a gardener. Two other clients with mental retardation now own and operate vehicles, bought property and got promoted. One client is now the trainer at the job and just completed three years of employment. These are just some of the special accomplishments of our clients last year. The Arc of Hilo Page #6 (b) 7. We plan to serve 100 clients. 8. There are no fees for services. PROGRAM INFORMATION DIVIDER SHEET Agency name The Arc of Hilo • (Page 6) Program name: Adult Day Program (see 6c) Complete on program information for every program with County funding (please paginate starting with page I , page 6, etc ..) Answer questions 1-8 on separatepaper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar(or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual 50 this year estimate 50 next year estimate 54 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? • No fees are charged for program services. B. When-were these rates last changed? The Arc of Hilo Page #6 (d) ADULT DAY PROGRAM 1. How does the program help individuals, groups and /or the community? The Arc of Hilo's Adult Day Program assists individuals indeveloping skills for them to achieve their maximum level of independence in the following major life activities: 1. Self-care 5. Self direction 2. Receptive & Expressive Language 6. Capacity for Independent Living 3. Learning 7. Economic Self-sufficiency 4. Mobility This is accomplished through working with the individual, their family, case management, human services, community businesses and any other community agency or organization utilized by the individual. 2. Who is the target population for this program? Individuals are considered eligible for our program through the Central Intake Office, CSDDB, Department of Health. The individual must be developmentally disabled which is defined as: "A level of disability that occurs before the age of 22 which has a severe and chronic effect on achieving individual independence. It is recognized that the level of impairment is attributable to a mutual or physical impairment or combination which can include autism, cerebral palsy, mental retardation and other disabilities that impair substantially the functional ability of the individual in their major life activities. 3. What are the specific objectives of the program (in quantitative terms, where possible)? An Individual Program Plan (IPP) is developed annually and reviewed quarterly for each client funded under the Adult Day Program. It is based on assessments, evaluations, professional reports and input from the Clients Program Planning Team (CPPT). The cppt includes the individual, parents and/or care giver, case manager, program staff and any other relevant people. The Arc of Hilo Page #6 (e) ADULT DAY PROGRAM 3. (continued) The IPP has goals and objective that relate to the following areas: 1. Making choices 6. Self-Care 2. Mobility 7. Communication 3. Use of leisure time 8. Social Skills 4. Use of transportation 9. Home Management 5. Pre-Vocational 10. Long-term supported employment The overall goal of the program is to train the individual in all necessary areas to reach the highest level of independence. 4. How do you evaluate program effectiveness, and who does the evaluation? The program is evaluated annually when it is monitored by the Department of Health, CSDDB monitor. At that time, a survey, generated by the Department, is sent to all of the families of individuals funded under the Adult Day Program. The results of the survey are returned to CSDDB in Honolulu. We, in turn, receive a summary from the Department based on the results. As an agency, we, ourselves, are in constant contact with our consumers and their families receiving feedback daily on an informal basis regarding the operation of the program. 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community. Our program is similar to one offered by the Department of Health, Hilo Day Activity Center. They service the same population as we do. The difference, however, between the two programs is that they are a State agency and we are a nonprofit organization contracted by the State. Both programs follow similar goals and objectives. Other agencies in the community service the developmentally disabled population. Though, no other private, non-profit organization offers the broad range of activities and training areas comparable to the Arc of Hilo. The Arc of Hilo Page #6 (f) ADULT DAY PROGRAM 6. List specific accomplishments of this program last year. *Developed an educational training center which includes items to assist individuals in developing their motor skills, their education level, building communication skills (which includes accessing computers). *Developed a cooking class that trains individuals in their home management skills (ie: developing menus and shopping lists, grocery shopping, money management, food prep, cooking, presentation of food and clean up). *Formed a more structured program to assure that the consumers are being served the most effective ways possible. *Included weekly outings to the program schedule to introduce and integrate our consumers to the community. *Placed eight individuals on a mobile, supported employment crew at a local hotel assisting in housekeeping and grounds keeping. *Continued to maintain a supported employment crew at the local hospital assisting in their Central Supply area. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual 50 this year estimate 50 next year estimate 54 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When were these rates last change? There are no fees charged under the Adult Day Program. PROGRAM INFORMATION DIVIDER SHEET Agency name. The Arc of Hilo (Page 6) Program name: Residential and Support Services (see 6g) Complete on program information for every program with County funding (please paginate starting with page 1 , page 6, etc ..) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4 How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar(or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual 49 this year estimate 46 next year estimate 46 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) • A. When were these rates last reviewed? HUD subsidized rents adjusted by tenants income level. B. When-were these rates last changed? Rates are charged quarterly depending on income level based on HUD formulas. The Arc of Hilo Page #6 (h) DOMICILIARY HOME AND RESIDENTIAL AND SUPPORT SERVICES 1. Our Agency has a licensed Domiciliary Home and a thirty-six unit independent living appartment complex that provides homes for the MR/DD population in East Hawaii. In the Dom homes we provide personal care, living skills instruction and individual habilitation training to our clients. We also provide positive behavioral supports sevices to individuals with challenging behaviors. These services are not offered in Foster or Care homes. 2. Our target population is persons with mental retardation and or developmental disabilities. 3. We provide a home environment to our tenants. The Mission of our agency is to improve the quality of life of persons with MR/DD and this includes their right to live, work and play in the restrictive, individually appropriate environment in the community of their choice. Our specific objectives are to increase mobility, training, communication, personal and social skills, use of leisure time, independently use transportation and home management. We also do positive behavioral supports training to those individuals that have challenging behaviors; those that have acting-out behaviors that may cause harm to themselves or people in the community. 4. We evaluate our effectiveness by having an individual habilitation plan for each client that quantivitvely delineates a particular domain to be addressed, task analysis for each domain, training in the particular area are taught by a Living Skills Instructor with time frames to accomplish the objective and this is monitored daily, reviewed by an Interdisciplinary team quarterly and annually reviewed, changes made as needs after, and these programs are monitored by the Department of Health DD Division. 5. We are the only Agency in East Hawaii that had a contract with the Department of Health DD Division (DOH/DD) to provide these particular services; we continue to provide these sevices without DOH/DD funding which was out, as of July 1, 1995 for our Dom Home. 6. The accomplishments this year are: We moved a long time resident from one of our homes with a history of acting-out and violent behaviors to a less restrictive environment. This resident was moved to a Foster Home and currently the resident does not require any positive behavioral supports. Because of the lack of funding by the DOH/DD we were forced to close one of our homes. This home was used essentially to provide habilitation and behavioral supports training for persons with challenging behaviors. The Arc of Hilo Page #6 (i) DOMICILIARY HOME RESIDENTIAL AND SUPPORT SERVICES 6. (continued) We were able, after a year of working with these individuals, to place 2 of them in Foster homes with minimal supports and the other individual was placed in a home in Kona; this individual still requires a complicated support system. We have only one 5 bedroom home left which is partically subsidized by HUD. 7. Program beneficiaries: last year we served 8 clients in our two Dom homes. This year we will serve 5 clients depending on program accomplishments and the transitional nature of resident needs. Next year again 5 clients will be served. These numbers do not include the unfunded assistance that we find we must provide to our Hale Ulu Hoi, 36 unit independent apartment complex. This comoplex is a HUD project we began 12 years ago for the MR/DD population. HUD does not fund support services and so in order for many of our apartment tenants to continue living independently our Agency provides many needed support services that are not available in our community. 8. The Agency does not charge service fees for our Dom home or Hale Ulu Hoi. Tenants pay rent based on their individual income levels subsidized by federal and state funds. Rent rates are reviewed annually and more often if necessary. PROGRAM INFORMATION DIVIDER SHEET Agency name. The Arc of Hilo (Page 6) Program name. Partnerships in Community Living Programs (PICL) (see 6j) Complete on program information for every program with County funding (please paginate starting with page 1 , page 6, etc ..) Answer questions 1-8 on separate paler and attach. 1 How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)' 4 How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar(or same)programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual 46 this year estimate 60 next year estimate 62 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? ' No fees are charged for program services B. When-were these rates last changed? The Arc of Hilo Page #6 (k) PARTNERSHIPS IN COMMUNITY LIVING PROGRAM (PICLP) 1. The PICL Program is a non-traditional model of providing services for persons with developmental disabilities that fosters consumer choice and decision- making; provides individuals with the fundamental right to choose how, where and with whom they want to live, work and play in natural community settings; assists individuals to be integrated into all aspects of living in the community; is individualized and flexible to address the goals and needs of the person; encourages interdependence between the participant and a community network of support. 2. Children and adults with mental retardation or developmental disabilities and their care givers are the target population for this program. 3. The objective of the PICLP are to plan services with rather fgi the consumer; provide opportunities for consumers to make their own choices and decisions regarding their everyday life; provide opportunites for consumers to participate in, and contribute to, community life through work, volunteer activities, and community association; integrate the consumer into community recreational, social, and cultural events and activities; assist the consumer to build natural, informal support networks; design service delivery from the consumer's perspective and emphasize person-centered service. 4. To evaluate program effectiveness, each consumer's Individual Supported Living Plan (ISLP) is reviewed quarterly by PICLP staff for consumer/family satisfaction. In addition, the PICLP is monitored annually by DOH-CSDDB; and they also send out surveys to evaluate consumer/family satisfaction. 5. This program's content is not offered by any other agency in the County of Hawaii. 6. Last year, this program was successful in coordinating and funding personal care/respite service and independent living skills training; developing a resource of personal care/respite providers; funding in full or in part for therapeutic an adaptive equipment and communication devices; community coordination for teens with disabilities who have aged out of the A+ Program to be included in after school programs; community training for Hawaii's Visions for Persons with Developmental Disabilities. 7. last year actual 46 this year estimate 60 next year estimate 62 8. No fees are charged for program service. PROGRAM INFORMATION DIVIDER SHEET Agency name The Arc of Hilo (Page 6) Program name: Transitional Residential Services Program (IRS) (see 61) Complete on program information for every program with County funding (please paginate starting with page 1 , page 6, etc ..) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4 How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar(or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual o this year estimate 5 next year estimate 5 - 10 8. If fees for programs or services are charged,what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) • A. When were these rates last reviewed? ' No fees are charged for program services. B. When-were these rates last changed? The Arc of Hilo Page #6 (m) TRANSITIONAL RESIDENTIAL SERVICES PROGRAM (TRS) 1. The Transitional Residential Service Program (TRS) provides skills training and behavior support to adults, particularly those persons with challenging behaviors, who live in residences licensed or certified by a State of Hawaii or in their own homes. The training is functional and practical to meet the individual needs and preferences and is provided in the residence and various community settings exclusive of day programs or employment settings. Thereby persons with MR/DD are able to live independently in the community with support. 2. Adults with mental retardation or developmental disabilities who have challenging behaviors who reside in the County of Hawaii. 3. The objectives of the TRS Program is to provide particular behavioral supports to persons with challenging behaviors. An individual is referred to this program and a psychiatrist or a psychologist assess them. A program is implemented to intervene an provide various training to decrease the challenging behaviors. The behavioral intervention program is evaluated, as needed, but minimally each month; task analysis and staff monitor qualitive goals and objectives and they are revised as needed. The overall goal is to reduce these inappropriate behaviors so that the individual can live independently in our community. 4. To evaluate the program; each individual has an individual habilitation plan and a behavioral intervention plan. A interdisciplinary team made up of the consumer, family members, a case manager, a psychologist and any other concerned party meet monthly to evaluate program objectives. These plans are reviewed quarterly by the DOH/DD. The consumer and family have constant input into the process along with formalized tools of evaluation and a consumer satisfaction survey. The DOH/DD monitors the program annually.regarding over all program stipulations and the general implementation of the program. 5. This program is not offered by any other Agency in the State. 6. This is the first year for this program. This year we will serve 5 individuals. 7. Last year actual: Not applicable 8. No fees are charged for program service. REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a grant, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accredited in accordance with applicable requirements of Federal, State and County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the services provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(ax1). 5) Have by-laws or policies that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one year's experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity, by addressing educational concerns, culture and the arts, the needs of the poor, youth, the aged, those with physical or emotional disabilities,victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. Conditions for Grantees Page 8 A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance, the committees of the Council, their staffs, and the legislative auditor access to records, reports, files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. Policy limits shall be a minimum of$300,000 for bodily injury and $50,000 for property damage. 7) Purchase motor vehicle liability insurance in the minimum amounts of$100,000 for liability per person, per accident; $25,000 for property damage; and $300,000 comprehensive, per occurrence. 8) Name the County as additional insured and file certificates of insurance or copies of the policies with the Department of Finance. Please refer to the attached Ordinance and the Hawaii County Code regarding grants to non-profit organizations. • W N O vD 00 J Ch v, d w N r i ^v O x = > 4t -0 o • n n O z < S ° = z Cy s c z 0 z Po "< m z . .. 0 �• _ G n trj n 52 w < H ° °Zmz rl L. 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W0 01 1/40 01 0 0 y-I H+ 1-, 1-, 1 , N W NJ Hr .4i .P W .A .P CI0 CO Q1 U7 • W CO U1 0 UI J 001 001 Ui O 0 J 1/40 10 H-' U1 J J 10 O 0 .< 03C b cn —3 z 91 O 1 10 r z 70 i U1 1-+ NJ I--' F-+ NJ N 1-, CO W F✓ NJ N N N U1 01 J 1.... N 01 W 0 J 1/40 01 U1 l0 W 0 NJ W itil 3 . • • • y C1 0 U1 NJ .A NJ .A O 10 .P .A .D .P CO J .A O 1/40 0 NJ J 0 1/40 .4 CO 0 CO 1/40 .A W 0 1/40 '.O -J O 0 n -t T MENTAL HELP-THE HOUSE C-) C_ APPLICATION FOR NONPROFIT FUNDS � • Fiscal Year July 1, 1996 -June 30, 1997 ►—� COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1-8, etc..) ORGANIZATION SUMMARY: ~ c-, 0 ORGANIZATION NAME: Mental Help Hawaii NAME OF PROGRAM: Hawaii Island Services/Hilo Hale Mailing Address: 1122 11th Avenue. First Floor City, State, Zip: Honolulu. Hawaii 96816 Telephone: (808) 737-2523 FAX (808) 734-1208 Attach current Internal Revenue tax-exemption certificate 501 (c) 3 99-0154505 Amount allocated by the Hawaii County in 1995: $ 12.000 1 % of Budget Agency Total Budget in 1995: $ 1.460.500 Amount requested of Hawaii County in 1996: $ 15.000 1 % of Budget Agency Total Budget in 1996: $ 1.573.500 This application for County of Hawaii non-profit funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Please Print) Council Chairperson Agency's Fiscal Year. July 1 - June 30 History of funding with the County of Hawaii: New Applicant X Participating agency since 19 93 Firm conducting and date of agency's last financial review or audit: NAME: Wilcoff. Combs & Co.. CPAs DATE: August 291 1995 —I Focus of Program: 'The mentally or emotionally disabled. Documents Submitted: The following documents, certified as correct and complete by John Hoshino, a duly authorized official of the organization were submitted in February 1995, and are still in force without revisions: • Articles of Incorporation • By-Laws • IRS Exemption Certificate Certification: I hereby certify the above documents are correct and complete, as submitted, and that requirements and conditions as listed on page 7 and 8 of the County of Hawaii application for non-profit grant funds have been reviewed, and we herein certify that the organization agrees to comply with all of the conditions stipulated. l/ ZS/ (0gat),„.. Date Xhn Hoshino Chair, Board of Directors hocartltr ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Mental Help Hawaii, formerly The House. Inc. Page#2 A. AGENCY PROFILE: (Answer on separate paper and attach to divider sheet.) 1. Agency Name: _ Geographic Area(s) Served: Statewide Agency's Mission Statement: Attached 2. Briefly describe the kinds of programs and services the agency provides. 3. How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency. list by program title. 6. What are the specific objectives of the agency(in quantitative terms,where possible)? 7. How do you evaluate program/service effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. list specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so,list current rates by category (adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so,what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? Wein) MENTAL HELP HAWAII AGENCY PROFILE Page 2a 1. AGENCY'S MISSION The purpose of Mental Help Hawaii is to provide residential facilities, and rehabilitation services to enable persons with psychiatric disabilities to achieve their optimum level of self-maintenance in the community, sustain placement in the least restrictive setting appropriate to them, and enjoy a quality of life in keeping with community norms. 2. AGENCY PROGRAMS AND SERVICES Mental Help Hawaii provides social restoration and rehabilitation services through facilities and programs specially designed to meet the physical, social and psychological needs of persons recovering from serious mental illnesses. On Hawaii, residential and rehabilitation services are provided through Hilo Hale, Hale Lehua and Ke Waena. On Oahu projects include: Sierra House, the Duplex Project, the Housing Assistance Project, the Clubhouse, Ho`opaepae, Project of Assisted Living, Respite, and the Safe Haven. 3. HOW SERVICES SUPPORT AGENCY'S MISSION All agency services are designed to enable and empower persons with mental illness to better care for themselves and contribute to the community. 4. WHO IS ELIGIBLE FOR SERVICES Mental Help Hawaii focuses services on adults with serious mental illness, who number up to 15,000 in the State of Hawaii, with 1562 as an estimated eligible base for the Island of Hawaii. (Department of Health Report 11/95) 5. UNDUPLICATED COUNT OF NUMBER SERVED BY THE AGENCY In Hawaii County, fiscal 1995, the number of persons receiving residential services was 24. In the first half of this fiscal year we have already served 30 in our residential projects as well as 38 in our activity center. 6. OBJECTIVE OF THE AGENCY Each agency project has quantifiable annual objectives, relating to numbers to be served and outcomes of clients services. Generally, the goal of all services is to enable clients to better care for themselves and to live as independently as possible in the community. MENTAL HELP HAWAII AGENCY PROFILE Page 2b 7. PROGRAM/SERVICED EVALUATION For Hawaii Island, program service evaluation occurs as follows: Bi-weekly service review meetings with all project staff. Monthly quality assurance reviews with Project Director. Quarterly service review and planning meetings with the Hawaii Island Advisory Board. Annual on-site monitoring by the Department of Health, Mental Health Division. Client Satisfaction Surveys. All other agency program services go through similar review and evaluation processes. 8. OTHER RESOURCES COORDINATING WITH THE AGENCY Mental Help Hawaii is an integral part of Hawaii's resources for mentally ill persons, and the agency works in close collaboration with a number of public and private human service organizations, including the regional community mental health centers of the Department of Health, The Queen's Medical Center, Hilo Hospital, Hawaii Community Services Council, Mental Health Association, Hawaii Island Health and Human Services Coalition, United Way, and Community Care Services. Mental Help Hawaii is a direct service provider, and is not currently contracting with other agencies. 9. HOW AGENCY SERVICES VARY FROM SIMILAR SERVICES Mental Help Hawaii is the only not-for-profit agency providing residential and social rehabilitation services exclusively to adults with serious mental illness. Services are complementary to other services in the community. 10. SPECIFIC ACCOMPLISHMENTS ADDRESSED THIS LAST YEAR Mental Help Hawaii * changed the agency name to encompass the range of services * negotiated with the Department of Health to include supportive housing in the request for proposal for East Hawaii MENTAL HELP HAWAII AGENCY PROFILE Page 2c * rented a house next to Hilo Hale as a supportive housing resource for clients transitioning from Hilo Hale * developed working agreements with Community Care Services to provide case management and other services on a fee-for-service basis * successfully applied for Federal funding to set up a Safe Haven in urban Honolulu * began preparing for agency accreditation by the Commission on Accreditation of Rehabilitation Facilities. * successfully applied for foundation funding to begin Hale Lehua supportive living services in Hilo HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: Mental Help Hawaii. formerly The House. Inc. Page #3 B. HUMAN RESOURCES: (Answer questions 2 - 6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? X Yes _No _ Being revised Date last revised: 7/95 3. Do your personnel policies contain an equal employment opportunity clause? X Yes _ No 4. Do you have a written job descriptions? X Yes _No _ Being revised Date last revised: 7/95 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) X Yes _No _Being revised Date last revised: 1/1/95 6. Does the agency conduct regular evaluation of employees? X Yes _No _In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. ,X.No change _Increase in staff is projected_Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenge. 10. - Please provide a description of the minimum qualifications for each position. Ebbe] MENTAL HELP HAWAII HUMAN RESOURCES Page 3a 1. ORGANIZATIONAL CHART SIERRA HOUSING PROJECT OF RESPITE HILO DUPLEX ASSISTANCE ASSISTED HO'OPAEPAE CLUBHOUSE PROGRAM HALE Hour Annex PROGRAM LIVING LEHUA MANAGEIENT SUPPORT SERVICES PROGRAM DIRECTOR BUSINESS DIRECTOR DEVELOPMENT DIRECTOR EXECUTIVE DIRECTOR ASSOCIATE BOARD OF DIRECTORS HAWAII ISLMD BOARD GOVERNANCE AFFILIATE BOARD HAWAII ISLAND RESIDENTIAL SERVICE 1995-96 HILO HALE HILO HALE HALE LEHUA Night Manager (2) Residential Assistant (1) Office Manager (.50) Project 0_rector (1) Adninistrat Ive Services MENTAL HELP HAWAII Effective Date 1/1/95 Page 3b JOB CLASSIFICATION & TITLE ANNUAL SALARY RANGE Min Exp. Exp. Job Rate AGENCY ADMINISTRATIVE SERVICES Chief Executive Officer Overall agency administration $45,000 $52,500 $60,000 Business Director Overall agency accounting, clerical staff oversight, administrative support $33,000 $37,500 $42,000 Program Administrator Project monitoring, quality review, project staff oversight, project/staff development $37,000 $41,500 $46,000 Development Director Fund raising, marketing $30,000 $35,000 $40,000 PROJECT SUPPORT SERVICES Program Directors/Managers Direct, manage program services, oversee staff; monitor expenses, proved direct client services, project staff supervision $30,000 $34,000 $38,000 Rehabilitation Specialists, Program Coordinators Professional staff, provide direct client services, project staff supervision $24,000 $27,000 $30,000 Rehabilitation Assistant Paraprofessional, provide direct client services $18,000 $22,000 $24,000 CLERICAL SUPPORT SERVICES Office Manager/Clerical Assistant Clerical, bookkeeping specific to project $18,000 $22,000 $24,000 MENTAL HELP HAWAII HUMAN RESOURCES Page 3c 7. STAFFING PATTERN IN COUNTY FUNDED PROGRAMS Hawaii Island staff has been increased by 1.5 full time employee, with expansion of services. No County funding is being used for personnel costs. 8. TRAINING OPPORTUNITIES PROVIDED STAFF AND VOLUNTEERS Residential staff will be certified in CPR and first aid training, at agency expense, in compliance with agency expectations. All residential staff will have experience in working with SDMI individuals and will reflect and be culturally consistent with, and understanding of, multi-ethnic populations. All direct service staff and volunteers will be expected to understand what serious mental illness is, how it is treated, and what community resources are available in Hawaii for treatment. Further, staff will be expected to understand and adopt the philosophy and principles of a bio-psychosocial rehabilitation approach to treatment. Finally, professional staff will be expected to learn how to do functional assessments, individualized service plans, and client care management. Wherever possible, existing Hawaii Island resources will be used for training. In the absence of Hawaii Island training resources, Mental Help Hawaii management will arrange for training of Hilo based staff and volunteers in all of the above areas, no less than on an annual basis. 9. HUMAN RESOURCE CONCERNS OR CHALLENGES Recruiting and retaining employees who understand the needs of this special population is a challenge, and Mental Help Hawaii has addressed this by offering competitive salaries, and providing four weeks equivalent vacation leave per year for full time employees. Staff are also encouraged to pursue educational and staff development opportunities. MENTAL HELP HAWAII HUMAN RESOURCES Page 3d 10. MINIMUM QUALIFICATIONS DESCRIPTION HAWAII ISLAND SERVICE PROJECT TITLE/DESCRIPTION PERSONNEL INFORMATION Project Director Michele James Job Duties: Under the general supervision of the Director Education: Master's Degree in Social Work of Programs plan,operate and manage project services on behalf of clients served. Responsibilities include:oversight Experience: 7 years with mentally ill population; 5 years of daily operations, supervision of project staff ensure with Hilo Hale (Mental Help Hawaii) in management services are in compliance with contractual obligations, position develop and maintain professional relationships, ensure safety and security of clients,develop and maintain quality standards of client services. Education Requirements: Bachelor's Degree in human services, Master's degree preferred Experience Required: 2 years of experience working in related job including supervisory experience Residential/Rehabilitation Assistant Paul K.Carboni Job Duties: Under direct supervision of professional staff, Education: High school graduate, Certified Nurses Aide assist in providing supportive services to clients. Responsibilities include: carrying out day to day activities Experience: 1 year working with alzheimers patients and of program, teach daily living skills, supervise client 22 years with Hilo Coast Processing Company activities to ensure safety and security, plan and implement social, recreational activities. Frauds L'Orange Education Requirements: High school equivalent, A.A. degree preferred Education: B.A., Philosophy, course study and thesis completed for Master's degree in Theology Experience Required: 1 year in related field Experience: 3 years with mentally ill population; 1 year with Mental Help Hawaii William Dean Education: Nigh school graduate, 3 years college Experience: 4 years residential services; 2 years crisis intervention services Jerome Janto Education: 1 year college Experience: 12 years in human services MENTAL HELP HAWAII HUMAN RESOURCES Page 3e 10. MINIMUM QUALIFICATIONS DESCRIPTION HAWAII ISLAND SERVICE PROJECT TITLE/DESCRIPTION PERSONNEL INFORMATION Clerical Assistant Lynn Kealoha Job Duties: Under the general supervision of the Director Education: High School Graduate with 1 year college of Business Services,perform clerical,accounting,project related duties which are essential to project management Experience: 15 years in general office; 2 years as and accountabilities. Responsibilities include:project data rehabilitation assistant at Hilo Hale(Mental Help Hawaii) collection and entry;personnel files,management of petty cash,maintenance of project bookkeeping systems. Education Requirements: Business school graduate or equivalent work experience as secretary/bookkeeper Experience Required: 1 year in related position and evidence of computer experience Care Coordinators Victoria Clark Job Duties: Provide case management and care Education: B.A.,Business Administration coordination services to eligible community care service members in order to facilitate members to better care for Experience: 13 years working with mentally ill populations themselves. Education: Bachelor's Degree preferred Larry Stevens Experience: 2 years working with special needs Education: B.A.,Sociology population. Experience: 5 years working with special needs population MENTAL HELP HAWAII HUMAN RESOURCES Page 3f 10. MINIMUM QUALIFICATIONS DESCRIPTION (Cont.) ADMINISTRATION MANAGEMENT PROJECT TITLE/DESCRIPTION PERSONNEL INFORMATION Executive Director/CEO Joanne Lundstrom Job Duties: Responsible for all aspects of agency Education: MSW, MPH management and administration, including agency planning, development, and implementation, fiscal Experience: Social Worker - State of Hawaii, 10 years; planning, development, and monitoring, and personnel management and administration, 20 years Agency from planning, development and oversight. 1979 to present Education Requirements: Master's Degree in Human Other. Weinberg Fellow (Executive Director Training); Services or Business Administration Multiple community leadership positions Experience Required: 3 years of Administration Director of Program Services Jim Carter Job Duties: Responsible for monitoring quality Education: B.A.,Psychology plus Continuing Education review/assurance of all service programs,project planning and development, program staff oversight, staff Experience: US Navy; Self-employed business Agency development,liaison with Department of Health regarding professional positions from 1979 to present client services. Education Requirements: B.A.,Human Services Experience Required: 4 years in job related to position, including supervisory experience Director of Development Rowland Donk Job Duties: Responsible for agency fund development Education: B.S.,Engineering Graduate Study,Personnel activities, including fund-raising. capital and endowment Administration campaigns and special events. Experience: Fund development, 15 years;engineering,30 Education Requirements: Bachelor's Degree years Experience Required: Evidence of successful, related Other. 20 years of community volunteer experience experience Director of Business Lin Joseph Job Duties: Responsible for developing and maintaining Education: 3.5 years college,plus professional training in all business management information systems; accounting coordinating all agency clerical and bookkeeping functions; supervising clerical assistant positions. Experience: Secretary/sales - 10 years;bookkeeping - 11 years; Agency Business Manager from 1989 Education Requirements: Specialized training in principles of accounting,office practices, and procedures Experience Required: 5 years bookkeeping/accounting experience MENTAL HELP HAWAII HUMAN RESOURCES Page 3g 10. MINIMUM QUALIFICATIONS DESCRIPTION (Cont.) ADMINISTRATION MANAGEMENT PROJECT TITLE/DESCRIPTION Clerical/Accountina Assistant Joy Sutherland Job Duties: Maintaining agency files, provide office Education: A.A. degrees, Liberal Arts, Marketing coverage, inventory, purchasing and maintaining office equipment, word processing for management, routine Experience: 4 years sales,fashion design,4 years clerical, agency bookkeeping procedures. accounting Education Requirements: Business school graduate or 2 years experience as secretary, bookkeeper Experience Required: 1 year secretarial and bookkeeping work, computer-friendly BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Mental Help Hawaii. formerly The House. Inc. Page #4 C. BOARD OF DIRECTORS: (Answer on separate paper, staple to this divider sheet.) 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the agency's mission) for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the numbe?1"to the most important and dominant service or target population. _educational victims of crime _culture & arts _victims of health crises _the poor _victims of social crises youth _the physically disabled _the aged 1 the mentally or emotionally disabled [eel MENTAL HELP HAWAII BOARD OF DIRECTORS Page 4a 1. CURRENT BOARD OF DIRECTORS LISTING NAMEATTLETTERM ADDRESS OCCUPATION PHONE# FAX# John Hoshino 2658 Pacific Hts. Road Vice Pres./Controller Bus. 538-4682 538-4940 Clair Honolulu, HI 96813 1997 Walter Ozawa Dept. Public Safety Deputy Dir. Bus. 587-1251 587-2549 Vice Clair 919 Ala Moana Blvd.,4th Fl. Dept. Parks &Rec. Res. 373-2415 1997 Honolulu, HI 96814 Carol Eblen 1310 Heulu St. #2101 Attorney at Law Bus. 547-5600 547-5880 Vice Chair/1997 Honolulu, HI 96822 Res. 538-1819 Charles Hardy 1350 Ala Moana Blvd. #2903 Health Information Res.596-8703 596-8703 Secretary/1996 Honolulu, HI 96814 Management Consultant 320 Via Casitas #109 (415) 461-5140 Greenbrae, CA 94904 Pat Duarte 616 Hamakua Place Sr. Vice President Bus. 521-1431 538-3733 Treasurer/1998 Kailua, HI 96734 Hawaii Dental Service Jim Boersema 1001 Bishop St. President Bus. 528-3159 523-7443 1995 Pacific Tower, 19th Floor Pro Comm Adv.Agency Res. 623-0707 Honolulu, HI 96813 Rodney Y. Fukuya 1580 Makaloa St. #890 CPA/Sharehldr. Bus. 945-3111 949-1376 1998 Honolulu, HI 96814 Matsuno, Fukuya &Co. CPAs Res. 735-5135 Randolph Hack 1117 12th Ave. #8 Consumer Advocacy Bus.926-0466 1997 Honolulu, HI 96816 Specialist Res. 734-8487 1 Dennis Lind 1441 Kapiolani Blvd. #1306 Psychiatrist Bus.949-6418 949-6420 1997 Honolulu, HI 96814 Private Practice Res. 373-1224 Chuck McLemore 98-503 Kipaepae St. Creative Fundraising Bus. 487-8821 487-8821 1997 Aiea, HI 96701 Associates Res. 488-7115 Robert L Rodin 925 Bethel Street, 5th Fl. Director,Bldg.Diagnostics Bus. 523-5866 523-5874 1998 Honolulu, HI 96813-4307 Group 70 International Res. 261-0538 Father T.Watanabe St. Philomena Parish Monsignor Bus. 839-1876 1996 3300 Ala Laulani Street Honolulu, HI 96818 Janice Wolf Davies Pacific Center Attorney at Law Bus. 532-0900 532-0909 1997 841 Bishop St.,#2000 Private Practice Res. 247-6201 Honolulu, HI 96813 Geri Wong 1104 Pueo St. Realtor Bus. 735-2411 1997 Honolulu, HI 96816 Res. 737-4020 -- MENTAL HELP HAWAII BOARD OF DIRECTORS Page 4b MENTAL HELP HAWAII HAWAII ISLAND AFFILIATE BOARD NAME ADDRESS OCCUPATION PHONE # FAX # Emmett Cahill P.O. Box 807 Writer &Community Volunteer Res. 967-7413 1997 Volcano, HI 96785 Beverley Grogan 1230 Waianuenue Ave. Dir.Hawaii County Res. 966-8736 1997 Hilo, HI 96720 Mental Health Assoc. Bus. 935-6706 Ruby Wilson 45A Amauulu Rd. Big Island Alliance Res. 961-6647 1996 Hilo, HI 96720 For The Mentally Ill Bus. 935-1206 Russell Kokubun 252 Kamehameha Ave. Project Manager Res. 938-8850 1998 Hilo, HI 96720 Hilo Main Street MENTAL HELP HAWAII BOARD OF DIRECTORS Page 4c 2. BOARD MEETINGS AND ATTENDANCE LEVELS Seven Board meetings were held on Oahu in calendar year 1995, with attendance averaging 70%. The Hawaii Island Affiliate Board held four meetings in 1995, with an average of 75% attendance. 3. NUMBER OF DIRECTORS Agency By-Laws state that the Board of Directors shall consist of not less than six, nor more than twenty-four persons. There are four members on the Hawaii Island Affiliate Board, with representatives from health and human services, professional mental health services, and Hawaii Island business and consumer advocates. 4. MAJOR DECISIONS * Supporting the development of a continuum of services on the Island of Hawaii has been a special achievement, as the Governing Board, and the Affiliate Hawaii Island Board members endorsed the start up of a second residential program in Hilo, and Care Coordinator services island wide, and an activity center in downtown Hilo. * The leap forward into the managed care world of mental health was supported by the Board of Directors, as Mental Help Hawaii entered into service provider agreements with Community Care Services (CCS), the winning bidder for Behavioral Health Services in Hawaii. * Maintaining the delicate balance between insuring funding for the present while securing funding for the future was prioritized, with the active support of the Board Fund Development Committee. * The continued collaboration of Mental Help Hawaii with other not-for-profit agencies in the development of a Safe Haven for the homeless mentally ill in Honolulu was endorsed, as what had been a distant vision in 1994, has become a viable project. * The importance of providing safe and consumer friendly settings was supported, as City HOME loan funds were secured to renovate Sierra House, and the decision was made to relocate the Clubhouse at Palama Settlement. MENTAL HELP HAWAII BOARD OF DIRECTORS Page 4d * The Hawaii Island Affiliate Board decided to obtain another house to meet the increasing need for residential programs for the seriously mentally dl on the Big Island. A lease was obtained on an adjoining property, and Hale Lehua is being developed as a semi-independent living facility. The Board participated in obtaining donations for our new house. 5. FORESEEABLE CHALLENGES Uncertainty about the amounts for, and methods of, funding for mental health services in future years makes planning difficult. Managed Care is imminent, and we are working actively with Biodyne, dba Community Care Services, to ensure inclusion of agency services in the Quest Behavioral Health Services Plan. Concurrently, we are preparing for accreditation of our rehabilitation facilities through an extensive internal review process, with the goal of meeting the National Standards established by the Commission on Accreditation of Residential Facilities (CARF) by years end. Challenges for the Hawaii Island Affiliate Board are to continue to maintain and develop quality services in a time of diminishing state funding. 6. PLANNED IMPROVEMENTS As noted above, Mental Help Hawaii will further diversify funding opportunities for service provision on behalf of clients, and will set up accounting and accountability systems to manage such systems. On the Big Island, the Affiliate Board is active in planning the renovation of the Wainaku Avenue property, and expanding services through Hale Lehua and Ke Waena, our new activity center. 7. LONG RANGE PLANS The Hawaii Island Affiliate Board plans include continuing to modify and adapt Mental Help Hawaii's services to further meet the psychosocial rehabilitation needs of the Big Island's seriously mentally ill population. The Board of Directors is committed to providing high quality, cost effective treatment and rehabilitation services on behalf of persons with mental illness. Securing adequate financial and community support resources toward that end is the Board priority. FUNDING NEEDS DIVIDER SHEET AGENCY NAME: Mental Help Hawaii. formerly The House. Inc. Page #5 E. FUNDING NEEDS: (Answer on separate paper, staple to this divider sheet.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization please answer the following questions: 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? 8. If you answered Yes to question #7, what is the formula used to determine this amount or percentage? roil MENTAL HELP HAWAII FUNDING NEEDS Page 5a 1. PURPOSE OF REQUEST This request is for County funding at $15,000 to supplement State and Hawaii Island United Way funding for residential placement and rehabilitation services at Hilo Hale. Funds received will be applied to program supplies and occupancy costs for Hilo Hale services. Projected fiscal year 1996 bed day cost for Hilo Hale is $60. Comparatively, a bed day in a psychiatric ward costs over $600, per the Department of Health. County funding at $15,000 would cover 250 bed days in this cost effective, rehabilitation oriented setting. 2. ALTERNATIVE FUNDING SOURCES All known potential funding sources have been tapped, including Department of Health, Hawaii Island United Way, Foundations, Charity Walk event, and purchase of service arrangements with Community Care Services (Biodyne). 3. ALTERNATIVES IF NOT COUNTY FUNDED If Hawaii County is unable to fully fund Hilo Hale at the requested level, we will return to the above noted sources. This is not a promising scenario given the current economic climate. 4. 15% VARIANCE EXPLANATION Expense variations are related to program expansion, particularly in Hawaii County, with the addition of: Hale Lehua, a second residential program; Ka Waena, the day activity center in Hilo; and the extensive Care Coordinator/Case Management island- wide. The $15,000 requested for Hilo Hale will be applied as follows: Occupancy $9,000 Supplies $6,000 PROGRAM INFORMATION DIVIDER SHEET Agency name: Mental Help Hawaii. formerly The House, Inc. Page #6 Program name: Hilo Hale Complete on program information for every program with County funding. (please paginate starting with page 1, page 6, etc....) Answer Questions 1-8 on separate paper and attach 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program (in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate nest year estimate 8. If fees for programs or services are charged,what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When were these rates last changed? [awl MENTAL HELP HAWAII PROGRAM INFORMATION Page 6a HILO HALE 1. HOW THE PROGRAM HELPS Hilo Hale opened in August 1991 to fill a critical gap in Hawaii County mental health services created by the dissolution of Hilo Transitional Services. Hilo Hale provides 24 hour transitional residential care and rehabilitation services for adults in Hawaii who are recovering from serious mental illnesses. As a community resource, it provides a cost effective, humane alternative to institutional care and/or homelessness. Hilo Hale bed day costs for 1996 are estimated at $60. Comparatively, a bed day in a psychiatric hospital, such as Hilo Hospital, costs $600. 2. TARGET POPULATION The target population of this program are adults from Hawaii County with a serious mental illness whose numbers are estimated at 1562. (Department of Health Report, 11/95) The specific problems and needs of this population include difficulty in accessing affordable, appropriate housing, limited social skills, lack of experience in self-care and independent living, and inadequate and/or inconsistent follow through with mental health services. 3. SPECIFIC OBJECTIVES OF PROGRAM The goal of Hilo Hale services is to enable clients to become more self-sufficient Changes in assessment of independent living scores are used to determine level of improvement in self-care. Additionally, evidence of sustained independent living capability is obtained through follow-up three months past discharge from Hilo Hale. Finally, client feedback is solicited through client satisfaction survey forms. 4. EVALUATION OF PROGRAM EFFECTIVENESS Client progress at Hilo Hale is assessed through Department of Health approved measurement tools, and client follow up after discharge. The Mental Health Division of the Department of Health - monitors the quality of care, as well as achievement of outcome objectives at annual site visits. Quality assurance reviews occur throughout the year at the project site. 5. HOW PROGRAM CONTENT VARIES FROM SIMILAR PROGRAMS Hilo Hale provides transitional residential placement for persons with serious mental illness who might otherwise be in jail, in Hilo Hospital, and/or on the streets. Staff work collaboratively with Hawaii County Community Mental Health Center staff prior to, and during placement, to ensure treatment goals are met and clients have follow-up placement and support after leaving Hilo Hale. This is the only such resource targeted for this population on Hawaii. MENTAL HELP HAWAII PROGRAM INFORMATION Page 6b HILO HALE 6. SPECIFIC PROGRAM ACCOMPLISHMENTS LAST YEAR In fiscal year 95, Hilo Hale provided transitional housing to 24 persons, of whom 90% showed significant improvement in their daily living skill scores after three or more months of services. Of 17 clients discharged during the year, 100% moved to more independent living settings. Hilo Hale has established itself as a vital community resource serving Hilo's mentally ill persons. 7. UNDUPLICATED INFORMATION ON PROGRAM'S BENEFICIARIES last year actual 24 this year estimate 35 next year estimate 35 8. RATE SCHEDULE HILO HALE RATE SCHEDULE Fee policy, effective January 1, 1995 for Hilo Hale is as follows: $230.00 Monthly Rent - to cover basic shelter expenses. $120.00 Monthly Basic Needs - to cover food and household supplies. $ 50.00 Monthly Program Service Fee - supplementing rehabilitation and support services provided by residential staff. Rates were last changed on January 1, 1995. PROGRAM INFORMATION DIVIDER SHEET Agency name: Mental Help Hawaii. formerly The House. Inc. Page #7 Program name: Hale Lehua Complete on program information for every program with County funding. (please paginate starting with page 1, page 6, etc....) Answer Questions 1-8 on separate paper and attach 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program (in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. list specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged,what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When were these rates last changed? [pees) MENTAL HELP HAWAII PROGRAM INFORMATION Page 7a HALE LEHUA 1. HOW THE PROGRAM HELPS Hale Lehua is a housing component of a comprehensive residential system; and serves as a more humane, cost effective alternative to homelessness and/or extended care home placement for persons with serious mental illness. The proposed services are designed to enable persons to sustain community living through staff support, on site and off site. 2. TARGET POPULATION The target population for Hale Lehua are adults from Hawaii County with a serious mental illness ho can live semi-independently with support services. Hale Lehua is a resource for persons graduating from Hilo Hale, as well as persons needing a supportive placement resource for stabilization. 3. SPECIFIC OBJECTIVES OF PROGRAM The goal of Hale Lehua services is to enable clients to become more self-sufficient. Changes in assessment of independent living scores will be used to determine the level of improvement in self-care. Additionally, evidence of sustained independent living capability will be obtained through follow-up three months post discharge from Hale Lehua. Finally, client feedback will be sought through client satisfaction survey forms. 4. EVALUATION OF PROGRAM EFFECTIVENESS Client progress at Hale Lehua will be assessed through Department of Health approved measurement tools, and client follow up after discharge. The Mental Health Division of the Department of Health monitors the quality of care, as well as achievement of outcome objectives at annual site visits. Quality assurance reviews occur throughout the year at the project site. MENTAL HELP HAWAII PROGRAM INFORMATION Page 7b HALE LEHUA 5. HOW PROGRAM CONTENT VARIES FROM SIMILAR PROGRAMS Hale Lehua is designed to complement Hilo Hale transitional residential services. Staff work collaboratively with Hawaii County Community Mental Health Center staff prior to, and during placement, to ensure treatment goals are met and clients are able to sustain community living. Hale Lehua is part of a continuum of residential care. 6. SPECIFIC PROGRAM ACCOMPLISHMENTS LAST YEAR Not Applicable 7. UNDUPLICATED INFORMATION ON PROGRAM'S BENEFICIARIES last year actual N/A this year estimate 10 next year estimate 10 8. RATE SCHEDULE Fee policy, effective January 1, 1995 for Hale Lehua is as follows: $250.00 Monthly Rent - to cover basic shelter expenses. $ 50.00 Monthly Program Service Fee - supplementing rehabilitation and support services provided by residential staff. Rates established January 1, 1995 PROGRAM INFORMATION DIVIDER SHEET Agency name: Mental Help Hawaii. formerly The House. Inc. Page #8 Program name: Care Coordination Complete on program information for every program with County funding. (please paginate starting with page 1, page 6, etc....) Answer Questions 1-8 on separate paper and attach 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program (in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged,what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When were these rates last changed? ['seal MENTAL HELP HAWAII PROGRAM INFORMATION Page 8a CARE COORDINATION 1. HOW THE PROGRAM HELPS Eligible clients from Hawaii Island Community Care Services (CCS) receive case management services through this project. The Care Coordinators provide outreach and referral to other resources, as needed, to assist clients in their recovery from mental illness. 2. TARGET POPULATION The target population are adults with serious mental illness who receive Quest (Community Care) services. 3. SPECIFIC OBJECTIVES OF PROGRAM The objective is to provide individualized services to the persons in their community environment. Thereby diverting or reducing the need for hospitalization. 4. EVALUATION OF PROGRAM EFFECTIVENESS Community Care Services provide a Utilization Review monthly. 5. HOW PROGRAM CONTENT VARIES FROM SIMILAR PROGRAMS Care coordination services are provided specifically to Community Care clients who do not receive State case management services. 6. SPECIFIC PROGRAM ACCOMPLISHMENTS LAST YEAR Not Applicable 7. UNDUPLICATED INFORMATION ON PROGRAM'S BENEFICIARIES last year actual N/A this year estimate 65 next year estimate 8. RATE SCHEDULE Not Applicable PROGRAM INFORMATION DIVIDER SHEET Agency name: Mental Help Hawaii. formerly The House. Inc. Page #9 Program name: Ke Waena Complete on program information for every program with County funding. (please paginate starting with page 1, page 6, etc....) Answer Questions 1-8 on separate paper and attach 1. How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program (in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged,what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When were these rates last changed? tams) MENTAL HELP HAWAII PROGRAM INFORMATION Page 9a KE WAENA 1. HOW THE PROGRAM HELPS Many seriously mentally ill adults experience continuing social handicaps. Rehabilitation services help these individuals learn the social skills and acquire the supports needed for survival and acceptance in the community. 2. TARGET POPULATION Our target populations are persons in community placements who have no place to go during the day and the highly visible population of indigent individuals who have an obvious mental illness and who have become a community concern. The situation has become serious enough for the Downtown Improvement Association to schedule special meetings to find out which agency, private or public, is responsible. The answer continues to be that unless these persons are a danger to self or others, no one can force them to accept help. 3. SPECIFIC OBJECTIVES OF PROGRAM This activity center was opened in August, 1995 in Hilo, to address the need for a place for persons with mental illness to go during the day for social, recreational and educational activities. Community Care Services provided start up funds for Ke Waena. 4. EVALUATION OF PROGRAM EFFECTIVENESS Client progress is evaluated quarterly. 5. HOW PROGRAM CONTENT VARIES FROM SIMILAR PROGRAMS Ke Waena is the only day program for persons with mental illness accessibly located in the downtown area. 6. SPECIFIC PROGRAM ACCOMPLISHMENTS LAST YEAR Not Applicable 7. UNDUPLICATED INFORMATION ON PROGRAM'S BENEFICIARIES last year actual N/A this year estimate 38 next year estimate 40 MENTAL HELP HAWAII PROGRAM INFORMATION Page 9b KE WAENA 8. RATE SCHEDULE Not Applicable I t'. 1.0 t� 0 Oo •v Ch W t-� '�' a w Alk 016 �y R 2 i - - Q " ?v �r!!JJ C M . Re 'M '' "-t IUi.:t P C " r. ~ P5n. ; O C a (D O n C b e mn gOGr+ Q ;n y 5; = g Et. R ,r, - P, . i •4; 1 - il, r0 pa rn (I) — t12 g E V a. N "� Z Ft n e. v rp' 0 n.a A a 0 ,] -4 o•-' 0 c 00 _ �O — UiN 4.. 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Crs 51 _ 1 C Z Cl) az R°t..) N Cv, 00 -4 000 O CIN V � Iv O cn '1 00 CO0 vO Oo ON ‘.0V, 00 cr, v, w c) Qdooe� 0000d r� �{ 0 o 0 o d 0 0 0 0 d O O 0 t a 4 , . OW ci p ; )-i ,,, ... C A N w ;-.1 O .... r-. �... t., 1 tt w py �' i � tai, 0 0 C © LA © OL C C) 0 t" 2 ,a N •O w ... wv0N oo d �.l ISM 1.' o0oo 0) 00000 C w 0 v, 0 1 . . - to z �" " 4. w v, U o � W00a, A � -80oo00 pA p _ T SALVATION ARMY APPLICATION FOR NONPROFIT FUNDS REC'='.',''7-^ "�ge Fiscal Year July 1, 1996 - June 30, 1997 COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: The Salvation Army-Hilo Interim Home NAME OF PROGRAM: Keaau Youth Service Center Outreach Program Mailing Address: P.O. Box 5085 City, State, Zip: Hilo, Hawaii 96720-1085 Telephone: (808) 959-5855 FAX: (808) 959-7980 Attach current Internal Revenue tax-exemption certificate 501 (c) 3 Amount allocated by the Hawaii County in 1995: S 32,000 3.42 % of Budget Agency Total Budget in 1995 $937,732 Amount requested of Hawaii County in 1996: $ 53,891 5'47 % of Budget Agency Total Budget in 1996: $ 984,842 This application for County of Hawaii non-profit grant funding in 1996 was considered and approved for submission at the Council meeting held on February 1996. BY: (Signature) (Print) Council Chairperson Agency's Fiscal Year: History of funding with the County of Hawaii: New Applicant Participating agency since 19 Firm conducting and date of agency's last financial review or audit: NAME: Chinaka, Siu & Co. , CPAs DATE: 9/1/95 for FY1994-95 ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: The Salvation Arany-Hilo Interim Home Page 42 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet.) 1. Agency Name: Geographic Area(s) Served: Agency's Mission Statement: 2. Briefly describe the kinds of programs and services the agency provides. 3, How do these services support the agency's mission? 4. Who is eligible for services? • 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency(in quantitative terms, where possible)? 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 8. What other resources or providers do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency this last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth, honorary, etc...). 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? ORGANIZATION PROFILE ORGANIZATION NAME: THE SALVATION ARMY-HILO INTERIM HOME A. AGENCY PROFILE: 1. Agency Name: The Salvation Army-Hilo Interim Home Geographic Area Served: East Hawaii Agency Mission Statement: To provide a safe, nurturing environment for youths ages 10 to 17 which provides them the opportunity to sort out their problems, develop a sense of self- confidence and positive values, and the potential to become productive individuals in the community. 2. Briefly describe the kinds of programs and services the agency provides. The Salvation Army established the Hilo Interim Home(SA-HIH) in December 1970, to provide an emergency shelter for youth requiring protective services. SA-HIH currently operates two(2) licensed child caring homes for youth, ages 12 through 17. The Emergency Shelter(ESH) is for youth requiring placement from 24 hours to 90 days, and the Group Home(GH) is a residential facility where youth may stay for 6 months or longer. Referrals accepted for placement include abused and/or neglected youth; those requiring respite care; status offenders; minor law violators. The following services are provided: individual, family, group, counseling; pro-social activities; instruction on personal care, housekeeping; social skill development; educational follow-up or at-home tutoring. Referrals are made as indicated to other community resources to assist the youth and their families. Youth discharged from residential care are returned to their families, placed in foster care or other alternative placements. As part of SA-HIH's continuum of care for youth and families, non-residential outreach preventative counseling and activity-based intervention services are provided to youth ages 10 to 17 in East Hawaii. Outreach counselors provide the following services: development of self- esteem; opportunities for positive peer and family relationships through use of recreational, cultural activities; family strengthening activities. In September 1994, through funding from the State Office of Youth Services, a Youth Service Center for the Keaau-Puna area was established. It's major objective is to provide a school-based in community center to provide afterschool activities. Collaboration with the Keaau Elementary 1 and Intermediate School principal and Puna police indicated the lack of organized sports/recreational after school activities for youth residing in the Keaau-Puna area. The County of Hawaii is providing funding for an outreach counselor to provide outreach services to youth in the Keaau-Puna area through the Youth Service Center(YSC). In addition, the YSC assists Keaau Elementary and Intermediate School in supervising an In-School Suspension(ISS) program to provide an alternative for students would otherwise be without adult supervision if placed on normal suspension status. 3. How do these services support the agency's mission? The residential, outreach and services through the YSC support the agencies mission by providing a safe, nurturing environment in assisting youth by providing positive alternative activities, counseling to youth and their families to assist in reducing or preventing a youth's involvement in the juvenile justice system. 4. Who is eligible for services? Any youth residing in East Hawaii ages 10 to 17 who is considered at-risk and requires residential or outreach services. 5. Provide an unduplicated count of the number of individuals served by the agency. The following numbers are for FY95: 407 Emergency Shelter 19 Group Home 544 Outreach 162 Youth Service Center After School Program 114 Youth Service Center In-School Suspension Program 6. What are the specific objectives of the agency? The objectives of the agency are to assure protection of youth by providing them with a quality shelter care program; to provide a support system to youth and their families which will increase the assurance of a successful return to their family or into alternative placement; to provide intervention and prevention services to at-risk youth to assist them in keeping out of the juvenile justice system; and to provide an afterschool program for youth in the Keaau-Puna area. 7. How do you evaluate programs/services effectiveness, and who does the evaluation? 2 Evaluations are secured from youth and parent/legal guardians upon discharge from residential programs. State funding agencies require all programs under contract to submit quarterly progress reports which must address such areas the number of youth served in the target population; number of youth involved in various program activities as required by contract; and progress which are designed to measure effectiveness of services provided. Program monitoring is done biannually by State funding agencies and licensing agents. Also, fiscal audit is performed annually by an independent certified public accountant. 8. What other resources or providers do you coordinate with to deliver agency services? SA-HIH, along with the Office of the Prosecuting Attorney, Police Department, Department of Parks and Recreation, is a member of the State and County Youth Gang Response System providing prevention activities to you youth residing in East Hawaii. Through Project Ho'okala, a diversionary program for youth, SA-HIH provides intake/assessment services to the Police Department for youth not known to Family Court or Child Protective Services. SA-HIH is also a co-sponsor of the Big Island Crisis Teen Line program. In partnership with the Volcano Community Association, an action plan for a youth gang drug prevention program for the Volcano area was developed involving a year of community planning activities. Project Ho'okala and all outreach programs requires us to work closely with all of the community resources providing support services to youth and their families to assist them in accessing services which are necessary to provide family stability. We do not contract with any of these providers. 9. How does this agency's services/programs vary from similar services/programs. offered by other agencies in the community? To our knowledge, there is no other agency which provides shelter/residential, outreach, and services through a YSC concept to at-risk youth in East Hawaii. 10. List specific accomplishments or challenges addressed by the agency this last year. One accomplishment during the past year has been the establishment of the Keaau Youth Service Center providing afterschool programs and In-School Suspension program for Keaau Elementary and Intermediate School. This is only one of three such programs funded by the State Office of Youth Services in the entire State. Other programs are in Honolulu and Lihue. 3 Another is the completion of a community-based planning project to develop youth gang drug prevention program in the Volcano area. Through a $100,000 planning grant by the Federal office of Administration for Children and Families awarded to SA-HIH through the Office of Youth Services, a five year action plan was recently completed. Unfortunately, the number of grants originally intended to be awarded was reduced significantly because of budget cuts by Congress, and Hawaii was not successful in obtaining funding. Nevertheless, the action plan is an excellent one, and in part will be used to request funding through this application. 11. Does the agency have membership dues? SA-HIH does not have any membership dues. 12. Does the agency have a trade affiliation with a national or statewide organization? Is so, what is the formula for national and/or state contributions and how often are dues paid? No. 13. What benefits and/services are provided to the agency by the national or statewide organization? See attached. 4 ✓`� RATE AGREEMENT NONPROFIT ORGANIZ4TIONS SALVATION ARMY WESTERN TERRITORY DATE : 03/08/93 )840 HAWTHORNE BLVD. FILING REF. : The preced- ,.ANCHO PALOS VERDES , CA 90274 ing agreement was dated ; 10/04/89 N20077 . 88 The rates approved in this agreement are for use on grants , contracts and other agreements with the Federal Government, subject to the conditions contained in Section II . • SECTION I : RATES Effective Period Type . From To Rate Location Applicable to INDIRECT COST RATES* Pred. 10/01/92 09/30/93 23 . 00% ALL ALL PROGRAMS Prov. 10/01/93 09/30/94 23 . 00% ALL ALL PROGRAMS *BASE: Total direct costs excluding capital expenditures (buildings , individual items of equipment, and alterations and renovations ) and that portion of each subaward in excess of $25 , 000 . TREATMENT OF PAID ABSENCES \cation, holiday, sick leave pay and other paid absences are included in ..alaries' and wages and are charged to Federal projects as part of the normal charge for salaries and wages . Separate charges for the cost of these absences are not made. TREATMENT OF OTHER FRINGE BENEFITS This organization charges the actual cost of each fringe benefit direct to Federal projects . However, it uses a fringe benefit rate which is applied to salaries and wages in budgeting fringe benefit cost under project proposals . The following fringe benefits are treated as direct costs : RETIREMENT, FICA TAXES, HEALTH INSURANCE, WORKER' S COMPENSATION AND UNEMPLOYMENT INSURANCE. t Support>ort Services oI' rihlie• Salvation Artily 1 1 die Salvation Army is a religious and charitable organization which is international in scope and has a quasi- ar y structure. Local units ;ue the front line operations of The Salvation Armytl e and are augmented t byof tl►c :tamilitary ty ;uray of support services which are necessary for sound management Ul g,lll i,..,"m's mission and objectives.'these local units ate not autonomous,but are part of the whole fabric of The ,,alvation Army. Each local operation must be fully self-supporting and is icqulted tolaallocate ten percent of its operating revenues for essential internal support services it receives. These PI'Ugrtllll Personnel Business Administration • Recruitment Audits ConsultationBudgetsEvaluation Education Monitoring Planning Information In-service training Reports Property & insurance Evaluation Legal services Agency referral Deployment Record keeping Agency relations Statewide services Reports Yemeni reviews Conferences & councils Policy development b Program materials Government liaison Planned giving Divisional 1kitdquarters (1)11Q) provides direct guidance and support to each local unit. In addition, r divisional headquarters is responsible for operating statewide services (camps, inti i institutional nd piog ams, met emergency disaster services, correctional services, ir etc.), viding training hrogi;tJts,and reviewing all property, audits and program evaluations for each vcalproviding at least personnel and legal matters throughout the division. Each divisional operation has work vlteh twenty officers e and professionals backed by support personnel, all of whom ars available local Salvation Army unit. Territorial headquarters ('11IQ) in Rancho Palos Verdes, ('A. is the corporate headquarters for The Salvation Army in the 13 western states and the Marshall Island:, 1,500iullher headquarters quailetsenters has tespouration sibwith ility for overseeing the operations of the eight divisions, 192 corps and more than 6,200 officers and employees.Territorial headquarters also operates s ar school for officers f fi ers training, property, a supplies and purchasing department, and other departments rest business, community relations and other organizational functions. rt Lvlvrc than 120 years of operations marked by continued expansion, accountability vC�Ito Salvation Army's slrucllUre aand a strong record of effective and timely services attest to the success and policies. In effect, the organization's strength and resilience rests its el ll-coIles ncvestructure d e cture ann the its ability to allocate its resources to achieve the greatest benefit and success. interdependence of the local unit,with its responsiveness to the unique heeds of tcclativ e munit management eAs ITanninpublic support system includes a broad ;uray of financial, legal, planning, • experience and resources. I IX . SUPPORT SERVICE The most basic financial structure of the Army is the payment of Support Service. The term Support Service has had other titles over the years, the most recent being Field Service. Support Service is the payment of 10% of all income received from Corps and Unit commands to their supervising Divisional Headquarters, and the subsequent payment of 10% of all income received at the Divisional Headquarters to the Territorial Headquarters . The payment of these funds from one level to another and ultimately, to National and International Headquarters provide for the operation of the supervising headquarters. The various headquarters provide numerous services from the receipt of these funds as follows : 1 . Internal Auditing and financial reporting for those units under their control . 2 . Investment Services for all Salvation Army funds held on deposit . 3 . Program Consultation and Annual inspections of Salvation Army Programs . 4 . Property Inspections of all owned facilities, and recommendations for maintenance and repair of same. 5 . Risk Management Program and maintenance of an internal self insurance program for all operations . 6 . Legal services that relate to the organization as a whole. 7 . Consultation to all units for fund raising programs, and research and development of innovative fund raising techniques. 8 . Program consultation, evaluation, monitoring, conferences and councils, and program materials. 9 . Personnel recruitment, education, evaluation, and policy development. 10 . Estate planning and planned giving programs. 8 I HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: The Salvation Army-Hilo Interim Home Page #3 B. HUMAN RESOURCES: (Answer question 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? X Yes No Being revised Date last revised: 7/95 3. Do your personnel policies contain an equal employment opportunity clause? X Yes No • 4. Do you have a written job description? X Yes No Being revised Date last revised: 795 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) Yes X No Being revised Date last revised: NOPE: starting salary plus 3% annual increase. 6. Does the agency conduct regular evaluation of employees? X Yes No In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. No change X Increase in staff is projected Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenges. 10. Please provide a description of the minimum qualifications for each position. HUMAN RESOURCES AGENCY NAME: Salvation Army - Hilo Interim Home 8. Please share information on training opportunities provided to staff and/or volunteers. All staff are encouraged and allowed to attend training offered by various human service and educational organizations. During the past year, staff attended the following training: Creating Safe Relationships with Un-safe Adolescents Working with Violent Kids in a Non-Violent Way Drugs: Are They a Problem on the Big Island Understanding the Sexually Abused Child Creating Collaborations Communicating as Partners Anger Management In February 1996, five staff will attend a 40 hour psycho-educational training program to develop skills in assisting adolescents in coping with the major emotional demands of their developmental stages of life. 9. Please share concerns or challenges with the Human Resources area and what steps have been taken to address the concern or challenges. Our primary concern is that all staff be provided with the necessary skills to appropriately and effective work with the youth and families we serve. In order to accomplish this, the following steps have been taken: a. Psychologist Christopher Barthel,Ph.D., is contracted to provide regular training to staff on issues relating to the youth we serve. b. A private consultant with a Master's Degree in Social Work and twenty-five years of human service experience has been contracted to work with staff in areas such as personal growth, roles of staff, development of mission statement and core values, and development of staff development plan for each individual and program. c. The Program Coordinator for Outreach services joined the agency in January 1995 after 30 years as a professionally trained social worker with the State of Hawaii. He has identified training 5 needs with staff and provides case consultation and inservice training on a monthly basis. He also works with management and staff in identifying staff development needs. 10. Please provide a description of the minimum qualifications for each position. Attached are position descriptions for the Outreach Counselor and Youth Service Worker. Ms. Denise Vasconcelles, the Outreach Counselor for the Keaau-Puna area graduated from the University of Hawaii-Hilo with a Bachelor's degree in Sociology. She has one year experience as a Youth Service Worker in the Keaau Youth Service Center. The minimum qualification for this position in a Bachelor's degree in a human service field and one year experience working with at- risk youth and their families. Mr. Alvin Jitchaku is the Program Coordinator who supervises this position. He has a Bachelor's degree in Sociology and Master of Social Work Degree from the University of Hawaii-Manoa. He has 30 years experience as a social worker in various human services State agencies as a worker, supervisor and administrator, and has been a Program Coordinator with SA-HIH since January 1995. 6 F H W _1 Fi ..'7w _ ., d8 1 R . 0 Js M d fV P- 04 aH w di -y N/0 W p 0 O U q N a43 v 4t )) ik okg WA zUuz, E , z p6 §- 0 ° 0 pUg oBa a � g1O a � 601 . op 6 ,, 3 .9. ,,, 8wo 0 --itl N P, N . glm P. li;k Ai 2c 40 I ' I 1y a r W 1 a , o Jig og o, to i ,"- § UQ r z a w P N • C' JOB DESCRIPTION POSITION TITLE: 0UIREAC1f COUNSELOR RESPONSIBLE TO: COUNSELING SERVICES COORDINATOR QUALIFICATIONS: A. Knowledge and experience: 1. I high school graduals. 2. Bachelor's degree in human services field with one year experience working with at-risk youth and his/her family or Master's degree in social work. 3. Valid Slate of I lawaii driver's license with use of personal auto with valid no-fault insurance. 4. Valid First Aid and CPR training certificate. B. Skills and personal qualities: 1. Willingness to accept and implement The Salvation Army philosophy and goals. 2. Ability and skill in communicating with people of diverse social, economic and multi- ethnic backgrounds. 3. Ability and skill in relating to a wide range of people and situations: at-risk youth and families/guardians, law enforcement personnel, school personnel, social workers, corrections personnel supervisors. • 4. Ability and skill to work within an inter-disciplinary team concept and participate in staff training and growth groups. 5. Personal attributes: good/sound judgment, dependability, initiate understanding, firmness, caring, organizational skills, high energy level, speak/read/write comprehensibly, ability to work cooperatively and productively under conditions of stress and change. 6. Be on call 24 hours a day to respond to emergencies. 7. Have the willingness to take on reasonable responsibilities as necessary when directed by administration. C. Responsibilities and duties: 1. Receive all referrals from community. a. Perform intake/assessment, service planning, follow-up services. b. Develop/refer youth and/or family to community resources. c. Provide face-to-face contact with youth and family for counseling (individual/family) as oflen as necessary. d. Monitor youth school/work attendance and progress and youth/family involvement in community activities and other supportive programs. 2. Serve as a role model and mentor to youth and family. 3. Provide aflercare services (up to 3 months minimum) to youth and family afler discharge from services. 4. Provide individual, family, group counseling for all youth and families as needed or requested. 5. Provide crisis intervention services for all youth and families as needed. Must be able to handle crisis on phone or in person. 6. Maintain complete individual case records of each youth and family: documentation of all contacts, case consultations, counseling services, referral sources used, etc. 7. Prepare and submit monthly and quarterly reports on activities/data to the supervisor and to the Slate funding agency. 8. Attend all staff meetings, training's, conferences, workshops, etc. as requested/scheduled. 9. Maintain professional worker-client relationship. I I l I 10. Duties may be required to be performed in Clic emergency shelter facility located on the . 2nd floor. 11. Duties will require restraints of children involved in physical confrontations. 12. Duties will require ability to lift up to 25 lb. (a backguard provided at company expense must be worn when doing any substantial filling or moving. 1). Individual Services: 1. Dcvclop a service plan to outline the individualized treatment of youth and/or family. 2. use other community agencies involved to develop the service plan. 3. May request the assistance of other community agencies to develop an attainable service plan for the youth/family. 4. Develop short term and long term plans involving youth/family. 5. Service plan to be reviewed by those involved as needed to check on progress towards treatment goals. E. Eligibility Criteria: 1. Male or female youth ages 10 through 17 years old. 2. Youth/family residing in north/south Hilo or Puna districts. 3. Youth not endangering self and/or others. 4. Youth not in need of residential substance treatment. 5. Youth and/or family shows willingness to cooperate according to program policies during initial intake and assessment. F. Exclusion Criteria: .1. Youth has met the necessary service plan goals. 2. Youth/family leave the geographical service arca. 3. Youth no longer meets admission criteria, therefore, youth will be referred to other community resources. 4. Youth and/or family shows unwillingness to cooperate. G. Form and reports: 1. Ilave youth/family sign the necessary forms: consent for counseling services and program activities. 2. Add youth to Youth Register. 3. Prepare a client file with the necessary forms. 4. Carry youth on monthly and quarterly reports. 5. Prepare and submit monthly and quarterly activities/data reports to the supervisors and state funding agency. IL Forms used by ORC Hilo/Puna: 1. CSC Form 1100 Case Notes 2. CSC Form 1300 Client Treatment Plan 3. CSC Form 1500 Monthly Program Summary Report 4. CSC Form 1511 End of the Month Report 5. CSC Form 1512 Weekly Progress Report 6. ORC Foran 2100 Assessment and Referral Form 7. ORC Form 2101 Consent for Outreach Counseling Services 111 I JOB DESCRIPTION POSITION TITLE: YOUTH SERVICE WORKER RESPONSIBLE TO: PROGRAM COORDINATOR QUALIFICATIONS: A. Knowledge & Experience: 1. High school graduate. 2. Bachelor's degree in human services filed; or two years college level studies in human services or recreational field and three years experience working with at-risk youth and families. 3. Valid Hawaii Driver's License. 4. Valid TB Clearance and Physical Exam. 5. Valid First Aid and CPR Certification. B. Skills and Personal Qualities: 1. Willingness to accept and implement The Salvation Army philosophy. 2. Ability and skill in communicating with people of different cultures/ethnicity. 3. Ability to write and speak comprehensibly. 4. Ability and skill in relating to a wide range of people and situations: youth parents, agency workers, school personnel, law enforcement personnel, supervisors, etc. 5. Ability to train/orientate volunteer personnel. 6. Ability and skill to work within an interdisciplinary team concept and participate in staff training and growth groups. 7. Personal attributes: Good/sound judgment, dependability, initiate understanding, firmness, caring, organizational skills, high energy level and ability work under conditions of stress and change without verbal or active expression, able to perform job with minimal supervision. 8. Be available to work days, evenings, weekends, holidays and maintain a flexible work schedule. 9. Be willing to take on job responsibilities outside job description, if need arises. C. Responsibilities: 1. Develop, organize, schedule and supervise group program recreational/craft activities for youth during after school, evenings, weekends, holidays, vacations. 2. Maintain consistcnecy in program rules and procedures with youth. 3. Monitor and ensure all program, youth and family needs arc met on a continuing basis. Reporting to Program Coordinator problems encountered, action to be taken. 4. Orientate, train, supervise volunteer staff. 5. Transport youth to/from activities. 6. Complete required daily reports on youth. 7. Monitor phones, visitors, parents, and handle emergencies and crisis calls as needed or required. 8. Do intake/discharge interviews. Orientate new youth into program. 9. Model behavior, including communciation process, decision making, problem solving, discipline, organizational skills, cleanliness, respect for property or others, work and education. 10. Maintain professional worker/client and staff relationship at all times. 1 I. Participate in individual,group, family counseling sessions when appropriate, and upon request. 12. Maintain all required documentation relating to youth and provide monthly program summary and statistical data to Program Coordinator. 13. Be involved in public information campaign and assist in representing the Center in the community. 14. Attend meetings, workshops, retreats, conferences, as scheduled or required. 15. Duties will require safe restraints of children involved in physical confrontation as needed in time of crisis. 16. Duties will require ability to lift up to 25 lbs. (a backguard, provided at agency expense, must be work when doing any substantial lifting or moving). BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: The Salvation Army-Hilo Interim Home (Page 44) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) I. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements (to meet the agency's mission) for the coming year. • 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s) in order of importance. Give the number "l" to the most important and dominant service or target population. 6 educational 3 victims of crime culture & arts victims of health crises 5the poor 2 victims of social crises 1 youth the physically disabled 4 aged a ed the mentally or emotionally disabled C. BOARD OF DIRECTORS 1. Provide a current listing of the Board of Directors with board terms and positions, address, phone numbers and current occupations. THE SALVATION ARMY A CALIFORNIA CORPORATION BOARD OF DIRECTORS Robert A. Watson - Chairman of the Board of Directors Peter H. Chang - President and Director Dennis Phillips - Vice President and Director Albert A. Avery - Treasurer and Director Evelyn J. Hunter - Secretary and Director Bill D. Luttrell - Director Joe Noland - Director Sharon Robertson - Assistance Secretary HILO ADVISORY BOARD (attached) 2. List number of board meetings held in the prior year and attendance levels. In 1995, the Hilo Temple Advisory Board held 9 Board meetings. Our average attendance for 1995 was 13. In addition to these full board meetings, 7 committee meetings were held during 1995 with an average attendance of 6 members at each committee meeting. 3. According to the bylaws, how many directors must serve on the board? The Salvation Army Manual of Advisory Organizations gives us the guidelines for Advisory Board membership. It states that an Advisory Board is to be made up of"not less than nine and not more than twenty-four" members. Presently The Salvation Army Hilo Temple Corps Advisory Board has 15 members. ATTACHMENT A-2 Dan Holmes, Member 1-1/2 P.O. Box 11332 Hilo, Hawaii 96720 Student Al ldemoto, Member 6 1622 Akolea Road Hilo, Hawaii 96720 • Retired - Asst. Vice-President Bank of Hawaii Lorraine Inouye, Member 6 215 Paukaa Drive Hilo, Hawaii 96720 Former Mayor - County of Hawaii Larry Lau, Member 13 562 Mohouli Street Hilo, Hawaii 96720 Retired Owner - LK Radio & Appliance Aileen Lum, Member 7 P.O. Box 1007 Hilo, Hawaii 96720 ' Director - Family Court Ilerman Sensano, Member 25 P.O. Box 35 Pepeekeo, Hawaii 96783 Retired - Industrial Relations Supervisor Suellen Tanaka, Member 1-1/2 1259 Haihai Street Hilo, Hawaii 96720 Vice-President, T&T Electric Inc. Ivan Torigoe, Member 5 168 Alu Street Hilo, Hawaii 96720 Attorney Dr. Marlin Werner, Member 6 400 Hualani Street, Suite 191-A Hilo, Hawaii 96720 Audiologist 4. List major decisions made by the Advisory Board last year and actions taken or plans made to implement the decisions. a. The Advisory Board Property Committee presented a long-range plan for the use of our existing facilities and the newly purchased adjacent property. ACTION TAKEN: Plan was approved by the entire Advisory Board. b. The Advisory Board approved the Interim Home proposal to rent part of the Hilo Temple Corps property which adjoins their facility. ACTION TAKEN: The property on Kinoole Street was leased for one year to the Interim Home for us in their programs. c. The Advisory Board approved the 1997 United Way proposal. ACTION TAKEN: The 1997 Budget proposal was submitted to United Way for approval. d. The Advisory Board recommended that it's regular monthly meeting times be changed from 4:00pm to 4:30pm to accommodate the members work schedules. ACTION TAKEN: The Advisory Board approved the change and will notify all members. e. The Advisory Board recommended that a attorney be contacted to help us with the condemnation proceeding against our property which will be taken for use in the canal construction. ACTION TAKEN: Fred Deetman will contact both the county and a attorney to work out the details so that The Salvation Army will receive a fair settlement for it's condemned land. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. In 1997, the Advisory Board will continue to work on projects in the following areas: PROPERTY: The Board will need to continue to develop plans for the property which we purchased in 1994. These plans will need to include proposals for property us and fund raising to cover improvements. The Board will also need to address the need to upgrade and restore our present facility so that programming will not be jeopardized. This will be quite challenge with the state of our economy and the very increasing need for our services. FINANCE: This past year we have seen considerable stabilization of our financial situation. The Board needs to continue to monitor this area closely and add their expertise where needed. PROGRAM: Presently The Salvation Army provides valuable programming to low-income youth & families in our community. We believe this need is going to increase due to significant trends and problems in our community. These include: the unemployment rate for our Island is one the highest in the state and it has risen more that 50 percent since 1994; the Big Island has twice the child abuse rate of Oahu and the state's highest rate of non marital births; there are more attempted suicides and suicides here particularly among teens than anywhere in the st have the worst schools in the State as rated by the State. ate, and we To help curb these problems, we have increased our staff by hiring a full-time who is in charge of developing additional programs which would help to address Assistant ens th listed above. The Advisory Board will need to continue their involvement e proulems help develop adequate ongoing funding for this position and guidance as to the specific helping problems tod objectives as we further develop this position. goals and 6. List planned improvements (to meet the agency's mission) for the coming year. The upgrading of our facility, the overall greater financial stability and the ad Assistant staff member will all help us to more adequately serve our mission which is stated Corps desire to meet the practical "needs of humanity". This is expressed by a spiritual stated , the purpose of which are to "supply basic human necessities, provide personal counseling ministry, the undertake the spiritual and moral regeneration and physical rehabilitation of allpersons and who come within (our) spiritual sphere of influence regardless of race, color, creed, in needs sex or age." 7. What long rang plans does the Advisory Board have for the agency? The most significant long-range plan that the Advisory Board is working on is the de the property which we purchased in 1994. The plan includes the planning and con development of a new facility which would enable The Salvation Army to place all of it operations w construction a exception of the Interim Home on one site. It also includes the development of a financial l the which would be used to finance the future construction. cial base FUNDING NEEDS DIVIDER SHEET AGENCY NAME: The Salvation Army—Hilo Interim Haile (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1 Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternatives have you considered if this County request is not funded or is not fully funded? 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income (subsidy) from a neighbor island or a parent organization? If so, how much? iio 6. If you answered Yes to question #5, what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes, how much? no 8. If you answered Yes to question #7, what is the formula used to determine this amount or percentage? FUNDING NEEDS AGENCY NAME: Salvation Army - Hilo Interim Home 1. Briefly explain the purpose of your request. This is a two-part request. First is to request continuing funding for the Keaau-Puna Outreach Counselor. For FY 95, the Outreach Counselor provided services to a total of 60 youth, ages 10 to 17 in the Keaau Puna area, with the major focus of providing intervention and counseling services to the youth and family to prevent unnecessary breakdown of the family unit. Intake, assessment and crisis counseling was offered to the community. In January 1995, the University of Hawaii Center for Youth Research published a Report to the Eighteenth Hawaii Legislature entitled "Evaluation of Hawaii's Youth Gang System."The report indicates the arrests of youth climbed 78.7% in Hawaii from 1983 - 1993, which was markedly higher than the 17.4% increase seen in the nation as a whole during a comparable period. Virtually all of the increase seen in Hawaii's juvenile arrest rates can be explained by arrests of youth for non-criminal status offenses(curfew violations, running away from home), which increased 249.9% between 1983 - 1993. The report further states that youth at risk for delinquency and gang memberships are frequently experiencing failure in school. In examining schools statewide, half of the state's top ten schools dealing with the greatest number of challenges (and reporting the most problem behavior among their students) are located in Hawaii County. Of the 71 schools included in the study, 13 were on the Big Island. Five of these 13 schools, however, were ranked among the 10 most troubled schools in the state, with Keaau Elementary and Intermediate School ranked 6th. This information is corroborated by the number of students referred to the In-School Suspension program initiated as part of the Youth Service Center program in October 1994 through funding from the State Office of Youth Services. From October to June 1995, a total of 114 students were referred to ISS. In an attempt to assist these students make a more positive adjustment to school, and to provide services to these youth and their families, the outreach program funded by the County of Hawaii has focused on working with these students referred to ISS in FY 96 9 The second part of this request is to fund a half-time Youth Service Worker at a total personnel cost of$12,123 to provide after school activities for youth in the Volcano area and work out of the Cooper Center. A recently completed youth gang drug prevention planning project for Volcano was recently completed and five year action plan developed, which is attached. In part, a major problem is that students attending Keaau Elementary and Intermediate School must take the bus to and from school, preventing them from participating in after school activities or in the Keaau Youth Service Center. Youth returning to the Volcano area have little activities available to them. Many who are bored or without adequate supervision are responsible for burglaries in the area according to the Puna police. If approved for funding, this position will provide after school activities, solicit volunteers to assist in the development and supervision of activities, and work with the Volcano Community Association in assisting to implement as much of the attached action plan as possible. 2. What alternative funding sources were considered and/or applied for? Funding for both the Outreach Counselor and Youth Service Worker positions have included an internal review of current program funding to determine whether such increased staffing is possible. In view of the State's budget shortfall, all current contracts have been reduced, and this is not a viable option at this time. Applications have been obtained from private trusts and foundations, but their level of funding at the current time does not allow for a proposal of this nature. At the completion of the Volcano planning project, an application was submitted to the Federal government for funding. However, due to budget cuts by Congress, grant funds were reduced by nearly 70%, and Hawaii did not receive funding for our request. 3. What alternatives have you considered if this County request is not funded or is not fully funded? Unfortunately, the alternatives available should funding not be approved is very limited. The State and federal government, who have supported such programs in the past are not resources at this time. Such services as described in this request will not be available to the Keaau-Volcano communities, significantly impacting an already underserved population. 4. Give a brief explanation for any variances of 15% or greater per line item,in the current vs. proposed budget. 10 Each line item on Budget Form 2 dealing with personnel costs are greater than 15% due to the request for a half-time Youth Service Worker position at a salary of$9,360 per year and total personnel cost of $12,123. Travel and transportation: This line item is above 15% to cover the cost of mileage in providing service in the Puna area at 3,000 miles per year at $.29 per mile. The current budget includes $85 for this expense which does not adequately allow for outreach services. Line 52, Others: This cost represents the 10% indirect cost to the Salvation Army for all contracts awarded to the SA-HH-I for support services they provide. This item is over 15% as the total budget request is $21,891 more than the current level of funding. • 11 VOLCANO FIVE YEAR ACTION PLAN 1996 - 2021 The following action plan for Volcano youth was developed by a committed group of volunteers, who contributed countless hours of data collection and plan development. Although the following plan did not receive federal funding in 1995, volunteers continue their commitment to the Volcano community as a sub committee of the Cooper Center Council. The Team's mission and vision remain alive in Volcano's long range plan. VISION 2020. TEAM MEMBERS Buck Esposito Dee Griep Hugh Griep Phillip Jenkins, Chair Betsy Kohler Bill Luttrell Nana Manuel • Lloyd Matsunami Ting Ortiz Roberta Peahu Paul Peahu Kanani Reed Ron Reilly Mary Hyslop, Project Coordinator, Hilo Interim Home Alvin Jitchaku, Project Director, Hilo Interim Home SPECIAL THANKS Betsy Mitchell, Maurice Thomas - Garden Exchange, Cooper Center Council, Volcano Community Association, Staff of Hilo Interim Home, William Smith, Family Preservation Act Committee Members, Lt. Dale Fergestrom HPD, Department of Education, Mountain View School, Keaau Elementary and Intermediate School, Waiakea High School, Department of Social Services - Child Protective Services, Office of Youth Services, Sheri Siegel - photogra- pher, and all the people who assisted TEAM members with data collection, analysis,programming ideas and encouragement. VOLCANO YOUTH D.R.E.A.M.• TEAM FIVE YEAR ACTION PLAN 1996 - 2Q21 (#Development, Resources, Education, Assessment, Motivation) MISSION: The Volcano Youth Dream Team's vision for our community is a safe and supportive environment of family, community and school, where children are given the opportunities to lead healthy lives. RISKS ADDRESSED IN THE PLAN: A. Availability of Drugs Indicators: Survey of drug availability Amount of drugs seized B. Academic Failure Indicators: Test scores Reading scores Math scores C. Alienation and Rebelliousness Indicators: Movement in and out of school • Suicides Vandalism Graffiti Runaways Suspensions Adolescents in the Juvenile Justice System CONTRIBUTING FACTORS: The greatest concern of the community is economic. In Volcano, twenty-one percent of families and thirty-seven percent of children are living below poverty level. (see graphs). Hawaii's high cost of living often makes it necessary for both parents to work outside of the home, leaving little time for children. Pakalolo is entrenched in the area's economic base and economic stressors push people to grow and sell. Moreover, pakalolo and alcohol are socially acceptable. Two other major concerns of Volcano residents are: lack of transportation and lack of activities for youth. All services and most activities are twenty- six miles from Volcano. There is little for children to do once they leave the school bus. Bored youth are responsible for most of the burglaries in the area. (Puna police reports) COMMUNITY STRENGTHS: The community defined a number of strengths in its long range planning meetings and in the Family Preservation Act task force meeting. These strengths include: the natural environment of the ocean, mountains, rain forest and National Park areas; cultural diversity and cultural heritage; the smallness of the community and the communication networks inherent in small communities; the spirit of volunteerism that has resulted in the building of the Cooper Center and the fire station. STRATEGIES FOR ACTION: The scope of this plan cannot address the economic and transportation concerns of the community. The goals and objectives will address the risks of drug availability, academic failure and alienation and rebelliousness. GOAL: TO PROMOTE AND IMPLEMENT EDUCATION AND AWARENESS OF SUBSTANCE ABUSE EFFECTS AND TO PROVIDE POSITIVE INTERACTIONS THAT DEVELOP SELF ESTEEM AND SELF CONTROL IN ORDER TO IMPROVE YOUNG PEOPLE'S ABILITY TO RESIST ANTI-SOCIAL AND ILLEGAL ACTIVITIES. • RISK ADDRESSED: AVAILABILITY OF DRUGS OBJECTIVE: To promote education and awareness of substance abuse by providing bi-monthly drug programs in the after-school tutorial program to forty (40) participants monthly. IMPLEMENTATION: Project Coordinator will be responsible for contacting and scheduling programs by substance abuse service providers including but not limited to BISAC, Awareness House, Baby Safe, Hilo Interim Home, Health Department, STAND. YWCA, YMCA, Castle Medical, American Cancer Society, American Heart Association, etc. Participants will be surveyed at the end of each program session and at six month intervals to determine program effectiveness. Programs will take place bi-monthly after regular tutoring sessions. Programs will be open to the public and parents will be strongly encouraged to attend. In the second year of this project a program will be phased in that will actively involve parents and other members of the community in group discussions on drug refusal skills, family management techniques, conflict resolution and family bonding skills. OBJECTIVE: To provide positive interactions that develop self esteem. IMPLEMENTATION: This will be achieved by implementing a model based on the Big Brothers\Big Sisters model ('Aha Kua'ana). Matches of participants and adults will be made by using University of Hawaii students in early education and human services curriculums and community members, including senior citizens. The priority for matches will be single parent families. Once priority matches have been made the program will be expanded to include other youth at risk. The 'Aha Kua'ana Project Coordinator will be responsible for screening and training of volunteers. Training will include empathic listening skills, decision making skills, self esteem skills, conflict resolution and child development ) issues. The 'Aha Kua'ana Coordinator will meet with each volunteer, participants and participant's parent to define the perimeters of the program, explore parent and participant's expectations and formalize the contract. Volunteers will be expected to spend minimally two hours a week with each youth and one weekend day a month. Quality of time spent and not extravagant outings will be stressed. Volunteers will report monthly to the 'Aha Kua'ana Coordinator. Parents of youth in the program will be contacted monthly to discuss concerns. Contracts will be reviewed bi-annually by the 'Aha Kua'ana Coordinator. Projected matches in the first year will be ten with a five to ten percent increase each year. Records will be kept confidential and will include the contract, number of hours spent with participants by volunteers and number of parent contacts. A signed release by the custodial parent will be needed to share information except in cases of child abuse and neglect. A recycled bicycle program for skills development will be phased in during the third year. This program uses the bicycle to teach equipment repair, physics, nutrition, wellness, etc. GOAL: TO RAISE THE TEST SCORES AND INCREASE ATTENDANCE OF ELEMENTARY AND MIDDLE SCHOOL CHILDREN BY PROMOTING ACADEMIC AND COGNITIVE SKILLS AI4b BONDING TO SCHOOL. RISK ADDRESSED: ACADEMIC FAILURE OBJECTIVE: To improve the reading and math skills of elementary and middle school children and to increase school attendance by providing tutorial services four afternoons a week. IMPLEMENTATION: Tutorial services will be provided to any child needing academic assistance in reading, math and homework assignments in an effort to improve participant's self esteem especially as related to academic success. Tutors must be culturally sensitive to participant's needs and learning styles. The Community Family School Liaison will recruit tutors trough the high school, community, University of Hawaii, and Hawaii Community College. The Liaison will provide training to tutors and be responsible for contracts between parent, participant and school. Contracts will include the days of the week child will be attending tutoring sessions, parent and youth commitment to tutorial policies, teacher's progress reports, homework assignments, school attendance and tutoring session attendance. Tutoring will take place after school, Monday through Thursday from 3:00 to 4:00 with interactive programs from 4:00 to 5:00. Participants will provide input on types of interactive programs they would like to participate in and a calendar of these activities will be developed. Drug and health awareness programs will be included on the calendar. Fridays will be "bonus" days and will be set aside for parent/child activities. A tutor will be available for every three children. First year projections: Twenty percent of high risk youth increasing by ten percent each year. Success in the program will be evaluated using pre and post standardized reading and math tests. During the first year an expected five percent increase in math and reading scores will occur. Participants will evaluate the program and their tutors by anonymous check lists on a monthly basis Confidential records will be kept on each student. Records will include: the contract, attendance at sessions, pre and post test scores, evaluations and progress notes. Records will be the responsibility of the Community Family School Liaison. All records must have a signed release by the parent before information can be shared. A release to the school will be a permanent part of each participant's file. Students will receive certificates of accomplishment at the end of each marking period. Honors Night will be held at the end of each school year. GOAL: TO INCREASE COMMUNITY CONNECTION BY HELPING CHILDREN AND THEIR FAMILIES BOND TO THE COMMUNITY AND SCHOOL THEREBY REDUCING ALIENATION AND REULLIOUSNESS. RISK ADDRESSED: ALIENATION AND REBELLIOUSNESS OBJECTIVE: To involve twenty youth and their families in the community by providing activities to decrease social isolation and increase participant awareness of the larger community. IMPLEMENTATION: Participants will be able to choose from a number of community involvement activities. All activities require volunteer labor and include but are not limited to: picking up litter in the Adopt a Highway Program; staffing the booth or picking vegetables for the Volcano Farmer's Market; working as a Senior Aide to help seniors with errands, yard work or house work; becoming a Friend of Ainaloe Ranch at the National Park. Participants will design their own contracts for the activity of their choosing. Their parents and the Program Coordinator will assist with the development of the contract. Participants will set up a system to keep track of their volunteer hours. When a participant has worked twenty hours, recognition will be provided. Recognition will consist of certificates, participant names in the Volcano Community Association Newsletter and a family, group or individual activity chosen by the participant. Supervision of volunteer activities will be the responsibility of the adult sponsor. Parents will be encouraged to provide assistance in the recognition activities. A ten percent growth of the total elementary and middle school population is expected annually. Evaluation of the project will be based on number of youths involved, number of volunteer hours worked and number of youths and parents attending recognition activities. QUARTERLY EVENTS: Youth involved in the tutoring program, the volunteer program or the 'Aha Kua'ana program will be invited to participate in special quarterly events. The events will involve an activity designed to expand the horizons of socially isolated youth. Events will include but will not be limited to: cultural and ethnic activities, movies in town, Hilo swimming pool, National Park activities, musicals, plays, shopping at the mall, bowling, etc. Youth and parents will provide input in the planning of these quarterly activities. NOTE: Although this plan was originally developed for nine to twelve year old youth, as mandated by the Youth Gang and Drug Prevention Planning Grant, the plan has been expanded to serve all elementary and middle school children. As money, time and volunteers permit, the plan will again be expanded to serve pre-school and high school students. Because funding was not received, the TEAM prioritized the tutoring project as described under the second goal: To raise the test scores-and increase attendance of elementary and middle school children. The other components of the plan will be implemented as money becomes available for the project. • c . 4 v e* 4 --- . . 42g,::,': t„: „N..�iT'�:• ,-•.1 to •r . . .i 0, ` ',s ' . 'j 4 t. , M �......._.; t r ter . r i. I ; ;� L ' . . a t. v• N. T ys \)v . • .4'..4:-. `'• •I',• . . sar. a {,, s44•y .°41:it 1.0*V.i:..\':':,j V ill 141‘ • :� 2 .. �4 Ct+ •. ''.1irv: "•••*: of 'a a • 4 a . „. . .,.. . .. , :,... z.... . , ..... •• . . i ". .. • .......... . filt‘aa... .;Oil I. .. 5 .,' ,„,V.I. I i..4-4 _3,, .i ,..„ ,,...0. e:, f 5/( . '.• •. ..4101!!p -4. r .•X .-1. Youth clearing the Volcano Cooper Center's forest for a covered court. Photograph by Sheri Siegel EXTREME ECONOMIC AND SOCIAL DEPRIVATION: PERSONS LIVING BELOW POVERTY LEVEL 40 P E 36 R C 32 E N 28 T A 24 G E 20 16 12 1II!l li ;;;1 „ 8 il.l.ii II;I;;; 11111111 I: 0 1990 U.S . 1 li;i:•:::M':lli;iMMWb;:::1::;; 13 . 5 IN 1990 E VOLCANO 26 . 7 IN 1990 SOURCES : U. S . CENSUS EXTREME ECONOMIC AND SOCIAL DEPRIVATION: FAMILIES LIVING BELOW POVERTY LEVEL PERCENTAGES OF FAMILIES BELOW POVERTY: 40 . 5-- 36 . 0-- 31 . 5-- 27 . 0-- 22 . 5-- 18 . 0-- 0 . 5-36 . 0-31 . 5-27 . 0-22 . 5-18 . 0— :1�:III{iii 13 . 5— Heil 9 . 0 �- 11111!; Mmh 1it;t.. 4. 5-- IIIllll! 0 . 0 1990 U. S . 10 . 7% in 1990 VOLCANO iii79""Pi'• 21 . 3% in 1990 HAWAII STATE 11,1111 6 . 0% in 1990 Sources : U.S . Census EXTREME ECONOMIC AND SOCIAL DEPRIVATION: CHILDREN LIVING BELOW POVERTY LEVEL P 50 E 45 R 40 C 35 E 30 N 25 T 20 A 15 4111 G 10 E 5 III "nun" 1990 United States - all races ffMMM 19 . 8% Hawaii County 1111 15 . 6% Hawaii State NNIN 16 . 7% Volcano ® 36 . 9% Source : U. S . Census *In Volcano in 1990, 161 children out of 436 were living in poverty EXTREME ECONOMIC AND SOCIAL DEPRIVATION: PUBLIC AID RECIPIENTS AS PERCENT OF POPULATION 40 P E 35 R C 30 E N 25 N T EN A 20 N INN G E 15 11111 10 s imo 5 HIMmm III 111111 lull 0 89/90 91/92 United States Hawaii State [Hi1fiII1!I!�j Keaau School District • • • Mt . View School District DATA 89/90 91/92 US 6 . 5 7 . 9 Hawaii State 5 . 2 5 . 9 Keaau 25 . 0 24 . 0 Mt . View 31 . 9 35 . 2 EXTREME ECONOMIC AND SOCIAL DEPRIVATION: FREE AND REDUCED LUNCHES P E 100-- R C 90 E N 80 T A 70G E 60 O 50 ** 1 F ** 1 ■ ) 40 ** 1 S ** I ; ++ T 30 ** • ■ ++ U ** ■ ++ D 20 ** ■ ++ E ** ■ ++ N T 10 ** I I ■ ++ S 0 89/90 91/92 • 90/91 91/92 Keaau illillllIMtillliiiidi`HilhIIIIIIIiII!Ii 55 . 8 60 . 1 Mt . View 65 . 9 65 . 2 Waiakea limillum 14 . 1 13 . 0 Hawaii Countymomm 48. 8 Hawaii State +++++++++ 38. 0 +++++++++ USA ************ (53% in 1989) Sources : School Profiles Hawaii County Data Book Statistical Abstract VOLCANO STUDENTS REPORTING DRUGS WOULD BE EASY TO GET: DRUG AGE EASY VERY EASY * of PERCENT surveys MARIJ- 14 2 3 5 100% UANA 15 8 8 18 88 16 2 4 7 85 . 7 17 & 18 6 4 10 100 LSD 14 na na 5 0 15 1 na 18 5 . 5 16 na na 7 0 17 & 18 5 na 10 50 COCAINE 14 na 1 5 20 15 3 1 18 22 16 1 1 7 28 17 & 18 1 2 10 30 HEROIN 14 na na 5 0 15 2 na 18 11 . 1 16 na na 7 0 17 & 18 1 0 10 10 CRACK 14 na na 5 0 15 2 0 18 11 . 1 16 0 1 7 14. 2 17 & 18 1 2 10 30 • ICE 14 na na 5 0 15 na 1 18 5 . 5 16 na na 7 0 17 & 18 1 2 10 30 NICOTINE 14 1 3 5 80 15 2 12 18 77. 7 16 1 4 7 57. 1 17 & 18 2 7 10 90 BEER OR 14 2 3 5 100% WINE 15 5 2 18 88 16 na 5 7 71 .4 17 & 18 3 5 10 80 WHISKEY 14 2 3 5 100% OR 15 2 11 18 72 OTHER 16 na 4 7 57 . 1 HARD 17 $ 18 2 6 10 80 ALCOHOL SOURCE: Volcano Drug Survey - 1995 INDICATOR: LIFETIME PREVALENCE: DRUG USE PERCENTAGE OF STUDENTS REPORTING DRUG WOULD BE "EASY TO GET" 100 90 p 80 NH 1111 11111' E 111111 1111111111111�1 Ii R 70 �11 s E 6 0 11111 111111 14 I 1 , I'I hill 1.111 �l,s' it II� A 1.... 1111 401111 1111 111E 1111 1111liii 30 1 1111111 111111 1111 20 D 11111 lttI 'ills di s 11111 1111 �� 11111110 11111i ,11 Hiss 111111 WI 0 Cocaine Marijuana Cigarettes Alcohol and Hash ,',;: ;,,, ',A U. S . 12th graders , 1992 Volcano 12th graders, 1995 U.S. 12th graders Volcano 12th graders Cocaine 48. 0 30 . 0 Marij/Hash 82 .7 100 . 0 Cigarettes 87. 8 90 . 0 Alcohol 82 . 5 80 . 0 • Source : Volcano Drug Survey, 1995 National Source : National Institute on Drug Abuse RISK: COMMUNITY LAWS AND NORMS FAVORABLE TO DRUG USE INDICATOR: QUANTITY OF DRUGS SEIZED Total weight of marijuana seized in tons* 625 T 5000 N 375 S 250 125 I 11 0 11 Ia 11 Ii 1989 1990 1991 UNITED STATES HAWAII COUNTY 1989 1990 1991 United States 322 . 9 111 . 2 143. 8 Hawaii County 242 69 109 SOURCES : County Data Book Hawaii County Police Department Puna Police Department Communities That Care * One plant - one pound [DEA) READING SCORES GRADE 6 MOUNTAIN VIEW ELEMENTARY PERCENTAGES 7 - 9 ABOVE AVERAGE STANINE 4 - 7 AVERAGE STANINE 1 - 3 BELOW AVERAGE STANINE 88/89 89/90 90/91 91/92 92/93 93/94 ABOVE 19 19 _ 13 16 ND 16 ' AVERAGE 60 _ 51 50 59 ND 58 BELOW 21 30 37 25 ND 26 MATH SCORES GRADE 6 MOUNTAIN VIEW ELEMENTARY PERCENTAGES (Math Stanines same as Reading Stanines) 88/89 89/90 90/91 91/92 92/93 , 93/94 ABOVE 23 29 22 21 ND 8 AVERAGE 47 39 45 55 ND 54 BELOW 30 32 33 23 ND 38 Source : School Profile READING SCORES GRADE 8 KEAAU INTERMEDIATE PERCENTAGES 7 - 9 ABOVE AVERAGE STANINE 4 - 7 AVERAGE STANINE 1 - 3 BELOW AVERAGE STANINE 86/87 87/88 88/89 89/90 90/91 _ 91/92 ABOVE 21 20 30 18 21 19 AVERAGE 58 49 49 55 _ 57 45 BELOW 21 30 21 27 22 36 MATH SCORES GRADE 8 KEAAU INTERMEDIATE PERCENTAGES (Math Stanines same as Reading Stanines) 86/87 87/88 88/89 89/90 90/91 91/92 ABOVE 30 , 15 17 22 _ 15 13 AVERAGE 44 49 54 49 51 50 BELOW 26 36 29 29 34 37 Source : School Profile ACADEMIC FAILURE: ACT SCORES 36 . 0 32 . 4 28 . 8 25 . 2 21 . 6 18 . 0 _s 14.4 10 . 3 7 . 2 5 . 6 0 . 0 1993 UNITED STATES 20 .7 WAIAKEA H. S. 18 . 7 Sources : Statistical Abstract School Profiles ACADEMIC FAILURE: SAT TEST SCORES (800 points possible) 800 750 700 650 600 550 500 ■ ■ 450 m • m ■ ■ ■ 400 ■ ■ m ■ E ■350 ■ m■ ■ 300 1991 1992 1993 US VERBAL US MATH WAIAKEA VERBAL WAIAKEA MATH Imm o ■ ■ 1991 1992 1993 US/VERBAL 422 424 424 WAIAKEA/VERBAL 399 404 398 US/MATH 474 478 478 WAIAKEA/MATH 455 447 456 Sources : Statistical Abstract . School Profiles EDUCATIONAL ATTAINMENT (ADULTS 25 YEARS OR OLDER) LESS THAN 12 YEARS OF HIGH SCHOOL 22 20 1i11111I 111111 18 I�llt R 16 Ill I nit: E 14 11IPH IIII!II? T N Ilf,�,fl A 12 'II1E11.I �I!HhI E 10 l'•l lifflili 8 ilil}l :.nI: 6 IIRI=I 4 II I;1! I,1 2 0— Itis??:?1111111 1990 ,,,:,,:,:„:,,,,,::,::,:,,,,,, 22 . 4% United States I?Efi?:::sEI???i???::?:::E?E?} Hawaii County 22 . 3% Volcano milimm, 20 . 0% Source : US Census EARLY AND PERSISTANT ANTI—SOCIAL BEHAVIOR ELEMENTARY SCHOOL DISCIPLINE PROBLEMS : CLASS A (most serious— assault, burglary, weapons, drugs, etc . ) 111111111 9 . 2% IIIIIIol R 5 . 5-- A . 5— ::::::::: 1!1!11111 iil:!!!!. A nil1W T 5 1i1l4i111 1::1111. E ,,,,1,,,, 111111111 4. 5— lll !hili! P I,.11111i l ll 111111111 E 4 li1fi11i1 11111X111 O i!=i:i1 R rriiiil 11111/1111 3 . 5 – ilili111 111111111 1 1111111 0 3 1}I 11 5— im 11 1!1111 2 11111 111111 111111 11112 I111111 . 5- 111111ll 1111111 1 111111 UVUL111!_.1 111 111=,• ii lill!;lli . 1111111 1111{lll' 11111I1'11 111!11! 1:!:1.1:1111.: 88/89 89/90 90/91 91/92 MOUNTAIN VIEW ELEMENTARY II CLASS A OFFENSES KEAAU ELEMENTARY 131111 CLASS A OFFENSES 88/89 89/90 90/91 91/92 I � Mt . View: Number 18 5 5 13 Rate 2 .4 . 7 . 6 1 . 7 Keaau: Number 7 40 21 113 Rate . 8 4 . 46 1 . 8 9 . 2 Source : School Profiles EARLY AND PERSISTANT ANTI—SOCIAL BEHAVIOR CLASS B SUSPENSIONS : Disorderly conduct , rendering false alarms , gambling, theft, harassment, trespassing. 45 40 R A 35 T E 30 P 25 E R 20 1 15 0 0 10 At. 1111 iii 1111 88/89 89/90 90/91 91/92 Mountain View Class B 'IIH Keaau Class B III 88/89 89/90 90/91 91/92 Mountain View Number 94 . 0 9 . 0 5 . 0 20 . 0 Rate 3 . 3 2 . 3 . 7 2 . 6 Keaau Number 60 . 0 159 . 0 146 . 0 448. 0 Rate 7 . 3 17 . 7 12 . 5 36 . 7 Source : School Profiles * In 93/94 Keaau Suspension Rate : 27 . 1 was second highest in state RISK: ALIENATION AND REBELLIOUSNESS STUDENTS IN AND OUT OF SCHOOL — TRANSIENCY Percentage of students moving in and out of school 1989/1990 1990/1991 1991/1992 Mt . View Elem. 70 . 1% 66 . 7% 60 . 9% Keaau 57 . 6% 64 . 2% 67% Intermed. Waiakea li. S . 34 . 0% 33 . 6% 32 . 2% Source : School Profiles PROPERTY CRIMES REPORTED IN THE VOLCANO AREA Year 1991 1992 1993 1994 1995 first 6 months Burglary 75 35 54 66 18 Theft 27 24 28 35 3 Property 15 9 11 18 6 Damage Auto 3 5 0 3 no data Theft Source : Puna Police Department JUVENILE ARRESTS OR FAMILY COURT REFERRALS FOR VOLCANO AREA r- -r -r -r -r -r -1 Year 1991 1992 1993 1994 1995 FIRST 6 ♦ ♦ ♦MONTHS —� F— —4.— + I-- 1 a r�—+ 3 +— 0 + 10 + 13 4 0 -A i 1 1 I 6 1 2 1 0 i Theft 0 1 1 Drums 1 4 I 1 1 2 I 0 1 3 I-- ♦ + —♦-- ----♦ ♦ —A Hunting 1 0 4 0 0 0 1 IFirearms + +------♦ 4— i Curfew ' no data : no data ' 1 ' 1 1 1 ♦ ♦— ♦— —i Auto -1--- 0 f-- 0 i 0 o 5 1 0 1 Theft 4--- + 4-- ♦— -1--------I i 11 1 6 0 Runaway 1 7 1 7 1 I Pins 4— +--------_ --- --- • ---i iProperty 0 i 0 1 0 I10 10 Damage4.—.....4...........---4-----+—___A 1Total 1 12 1 13 i 29 1 38 s 4 1 Arrests i .i. 1.---.---......11.--.----1.--...-..----.....i 1A Source : Puna Police Reports ALIENATION AND REBELLIOUSNESS : VANDALISM (JUVENILE) REPORTED P 3 . 5 E R 3 C E 2 . 5 N T 2 A G 1 . 5 E 1 . 5 1994 Hawaii Count FIRM • Volcano: r_ HAWAII COUNTY .41% Based on 64 incidents in 1994 VOLCANO 3 . 00% Based on 10 incidents in 1994 Source : Hawaii County Data Book Puna Police Department RISK: ALIENATION AND REBELLIOUSNESS ADOLESCENTS IN JUVENILE JUSTICE SYSTEM 1985 1987 1989 United States RATE 313 354 367 Volcano : 1995 14 youth on status * Rate = 5000 Source : Statistical Abstract Hawaii Juvenile Court RISK: ALIENATION AND REBELLIOUSNESS SUICIDE 1988 1992 1994 United States 12 .4% 11 . 7% no data Hawaii County 14 . 5% 16 . 1% 12 . 5% Volcano no data no data 1 successful 2 attempts** * Rate is statistically not reliable ** These are numbers - percentage not statistically reliable Source : Statistical Abstract Hawaii County Data Book Puna Police Reports RISK: FAMILY MANAGEMENT: NUMBER OF RUNAWAYS 90 80 R A 80 11111111 T IiI E 70 11111111 P 6 0 i'{111 111{1 E 50 11'1111 42 . 8 42 . 5 ��ii8 1110 1 40 32 . 1 1•,1,•: p 11111q1{ 0 3011''•11 0 IIii iii i{111M 20 {{11{111{ 10 111111111 0 1I1II1III „ 1993 1994 VOLCANO PUNA MI HAWAII STATE 111"•1111'•11111:,1iim Volcano Runaways : 1993 1994 Number 7 12 Rate per 1000 32 . 1 42 . 8 PROGRAM INFORMATION DIVIDER SHEET Agency name The Salvation Army-Hilo Interim Home (Page 6) Keaau-Puna Outreach Program Program name: Complete on program information for every program with County funding. (please paginate starting with page 1 , page 6, etc...) Answer questions 1-8 on separate paper and attach. 1 How does the program help individuals, groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms, where possible)? 4. How do you evaluate program effectiveness, and who does the evaluation? 5. How does this program's content vary from similar (or same) programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual 162 this year estimate 150 next year estimate 150 8. If fees for programs or services are charged, what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) no fees A. When were these rates last reviewed? B. When-were these rates last changed? PROGRAM INFORMATION Agency Name: Salvation Army -Hilo Interim Home Program Name: Keaau-Puna Outreach Program 1. How does the program help individuals, groups and/or the community? The Keaau-Puna outreach program through the Keaau Youth Service Center currently provides intervention and counseling services to students referred to the In-School Suspension program at Keaau Elementary and Intermediate School. In a January 1995 report entitled "Evaluation of Hawaii's Youth Gang System"to the Eighteenth Hawaii Legislature by the Hawaii Center for Youth Research at the University of Hawaii,juvenile arrests for non-criminal status offenses increased 249.9%between 1983 - 1993 in Hawaii. The report further states that youth at risk for delinquency and gang memberships are frequently experiencing failure in school. Data received from Keaau Elementary and Intermediate School in 1994 indicated that of the approximately 1300 students enrolled in Kindergarten through 8th grade, approximately 323 suspensions were recorded during the past school year. Such action created other problems as many of these student were without adult supervision during these suspensions. The ISS program was established to assist the school with this problem to provide the school and students with an alternative to regular suspension. During regular suspensions, students do not receive any homework or assistance with classroom requirements. The ISS allows students to receive class work from teachers with assistance provided by YSC staff. During the initial year of ISS ending June 30, 1995, 114 students were referred to this program.. From September to December 1995, 116 students were referred to ISS, or increase of 207% over the same period a year prior. Of the 116 students, 45 or 38%were referred two or more times, while 18 or 15% were referred three or more times Principal Lloyd Matsunami also expounded on the need fro a school-based prevention activities program for youth residing in the Keaau-Puna areas as there are no organized sports/recreational activities for youth after school hours and during school vacations. Police also concur that activities/services for youth is a basic need that is severely lacking in the area. Approximately a third of the student enrollment are from families who have recently moved into 1 the community from Oahu or the mainland. A number of youth moving into the area have been involved in the juvenile system, while some are sent to live with relatives in Puna to start anew. During the past few decades, dramatic social changes have profoundly affected the daily lives of young adolescents. In September 1994, The Carnegie Council on Adolescent Development published a report on afterschool programs The report indicates that instead of safety in their neighborhoods, adolescents often face physical danger; instead of economic security, they face uncertainty; instead of intellectual stimulation, they face boredom; in place of respect, they are neglected; lacking clear and consistent adult expectations from them, they feel alienated from the mainstream society. The adolescents in Hawaii face these same problems The report further states that families and communities have generally become less able to support adolescents. Lacking constructive activities to engage them during their out-of-school hours, many adolescents turn into another course of development. Some use tobacco, alcohol and other drugs, while some engage in premature, unprotected sexual activity, and many commit acts of crime. Families, schools and community organizations need to expand opportunities for young adolescents during after school hours. The Youth Service Center and outreach program, therefore, meets a vital need in the Keaau- Puna area It provides a supportive, non-threatening approach to intervention and counseling services to youth and their families. We believe the community will benefit from these services as outreach services will have an impact on potential delinquent behavior and assist in minimizing school failure. Students who attend Keaau Elementary and Intermediate School need to take the bus home immediately after school, and are unable to participate in activities offered in the Keaau community of the Youth Service Center. Upon returning to the Volcano area, there are no organized activities available to these youth. Funding the half-time Youth Service Worker position will assist this Volcano community, which is severely underserved, to provide after school activities and to work with the Volcano Community Association in developing appropriate programs discussed in the attached five year action. 2. Who is the target population for this program? 2 The target population is youth 10 to 17 years of age residing in the Keaau-Puna area including the Volcano community. 3. What are the specific objectives of the program? The major objective of the Youth Service Center is to provide a school-based community center at Keaau Elementary and Intermediate School for an after school program for youth ages 10 to 17 residing in the Keaau-Puna area. Other objectives include: Provide structured programs that focus on the development of social skills and constructive alternatives to gang involvement or involvement in the juvenile justice system. Provide a safe environment for youth. Teach such skills as goal setting, decision making, communicating, problem solving, and negotiating conflicts. Design and implement community service programs and activities. Provide intake and assessment services to determine appropriate intervention and counseling services to youth and their families, and possible referral to community agencies Develop services to youth ages 10 to 17 and their families which include: development of self- esteem and social skills; opportunities for positive peer and family relationships through use of recreational and arts/crafts activities; organized sports, cultural activities; involvement of parent(s) and/or legal guardians in family strengthening activities; parent and youth support groups; educational assistance and support; and individual, family and group counseling. 4. How do you evaluate program effectiveness, and who does the evaluation? State funding agencies require all programs under contract to submit quarterly progress reports which must address such as the number of youth served in the target population; number of youth involved in various program activities as required by contract; and activities which are designed to measure effectiveness of services provided. Program monitoring is done bi-annually by State funding agencies and licensing agents. Also, fiscal audit is performed annually by an independent certified public accountant. 3 The Youth Service Center also has a Youth Advisory Committee which assists in planning programs as well as evaluating ongoing activities. Future plans call for the establishment of a parent advisory committee. 5. How does this program's content vary from similar programs offered by other agencies in the community? To our knowledge, there is no other agency which provides afterschool programs for middle school students and outreach services through a Youth Service Center concept to at-risk youth in the Keaau-Puna area. 6. List specific accomplishments of this program last year. Accomplishments include: Establishment of the Keaau Youth Service Center providing afterschool and In-School Suspension program for Keaau Elementary and Intermediate School. This is only one of three such programs funded by the State Office of Youth Services in the entire State. Provision of outreach services to youth experiencing school adjustment, family or personal problems requiring intervention and counseling services. Sixty adolescents and their families were assisted for the one year period ending June 30, 1995. A special Hawaiiana summer program was held during the morning of each week day for youth interested in learning more about Hawaiian culture and arts. 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Fiscal Year July 1, 1996 -,J,une 30,1997 r 2 bJL L� ' V+ COUNTY OF HAWAII NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: Hawaii Island YWCA NAME OF PROGRAM: Family Support Services, Early Childhood Support Team Mailing Address: 165 Keawe Street City, State, Zip: Hilo, Hawaii 96720 Telephone: (808) 961-3877 FAX: (808) 961-9140 Attach current Internal Revenue tax-exemption certificate 501 (c) 3 attached Amount allocated by Hawaii County in 1995: $ 20,000 .7%of Agency Budget Program Total Budget in 1995: $ 139,436 14.3%of Program Budget Agency Total Budget in 1995: $2,970,311 Amount requested of Hawaii County in 1996: $ 39,500 1.3%of Agency Budget Program Total Budget in 1996: $ 158,936 24.9%of Program Budget Agency Total Budget in 1996: $3,138,132 This application for County of Hawaii non-profit funding in 1996 was considered and approved for submission at the Council meeting held on February , I996. BY: , (Signature) (Print) Council Chairperson Agency Fiscal Year. July 1 -June 30 History of funding with the County of Hawaii: New Applicant X Participating agency since 1987 Firm conducting and date of agency's last financial review or audit: NAME: Taketa, Iwata, Hara and Associates DATE: June 1994 (The June 1995 audit will be completed by mid-March) ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Hawaii Island YWCA Page#2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet) 1. Agency Name: Hawaii Island YWCA Geographic Area(s)Served: The Island of Hawaii Agency's Mission Statement: 2. Briefly describe the kinds of programs and services the agency provides. 3 How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency(in quantitative terms,where possible)? 7. How do you evaluate programs/services effectiveness,and who does the evaluation? 8. What other resources or provider do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth,honorary,etc...) 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? Agency Name: Hawaii Island YWCA Page #2a Geographic Area(s) Served: Hawaii County, primarily East Hawaii, although Sexual Assault Support Service and Teen Court serve the entire island. Agency's Mission Statement: The mission of the Hawaii Island YWCA is to provide services to meet community needs, drawing together people with diverse experiences and relationships, so that together they_may join in the struggle for peace, justice, freedom and dignity for all people. OUR PURPOSE The Young Women's Christian Association of the United States of America is a women's membership movement nourished by its roots in the Christian faith and sustained by the richness of many beliefs and values. Strengthened by diversity, the Association draws together members who strive to create opportunities for growth, leadership and power in order to attain a common vision: Peace, justice, freedom and dignity for all people. OUR ONE IMPERATIVE To thrust our collective power toward the elimination of racism wherever it exists and by any means necessary. 2. Describe programs. Currently the Hawaii Island YWCA has the following seven (7) main program service areas: 1. The Aquatics program offers a full spectrum of therapeutic and instructional swimming classes, as well as recreational swimming. 2. Child and Family Program Services offers licensed pre-school, after school, summer, school break and holiday fun programs that provide quality child care and educational program for children ages 2-12. 3. Ekahi addresses the needs of youth and families through a community based coalition in Hamakua, with the goal of reducing substance abuse by increasing drug free activities for our youth. 4. Family Support Services provides early identification of families at risk for child abuse and neglect and a range of interventions to successfully reduce that risk. 5. Fitness Education Services offers a variety of structured activities and support for all ages. The program includes fitness, dance, and adult education classes, along with martial arts and special interest classes. 6. Sexual Assault Support Services provides the Island of Hawaii with a comprehensive range of services designed to support, assist and educate victims of sexual assault and the communities in which they live. 7. Teen Court involves the creation of a teen (peer) jury system which brings together first time juvenile offenders, their peers and community volunteers to determine logical and natural consequences for the offenses. Agency Name: Hawaii Island YWCA Page #2b How services support the agency's mission. Each service offered increases the participants' ability to live out our mission. The Hawaii Island YWCA is a tradition that provides our members an opportunity to give back to the community, to help others reach their goals and to both give and receive support and advocacy at different times in their lives. Times change and so do the needs, interests and problems in our community and the Hawaii Island YWCA will continue to be an association dedicated to leadership and empowerment for our members and for peace, justice, freedom and dignity for all people. 4. Eligibility. YWCA programs and classes, with the exception of programs targeted for specific groups, are open to everyone, regardless of race, religion, socio-economic background, age or sex. Membership or registration fees may be waived or reduced if they create a barrier to participation or place financial hardship upon the participant. 5. Unduplicated count of the number of individuals served. 1. Aquatics - 1,500 2. Child and Family - 521 3. Ekahi - 2,000 4. Family Support - 1,164 5. Fitness Education - 1,200 6. Sexual Assault Support Services - 3,410 7. Teen Court - 400 .6. Agency Objectives. The Hawaii Island YWCA uses the five core themes adopted at the YWCA national convention as its general objectives. These Core themes are: Empowerment, Health Promotion, Family Life, Youth Development and Community and Leadership. The 1993 - 1998 Strategic Plan further identifies specific objectives including expansion of existing programs, improvement of service quality, expansion of program type and location, diversification of funding base and preparation of physical facilities plan. Each program has specific measurable objectives. 7. Evaluation. Effectiveness in meeting community needs is evaluated via our clients' evaluation of programs and services they receive. The elected Board of Directors Program Planning and Evaluation Committee reviews programs quarterly. They identify relevant outcome measures for each program using resources such as the Oregon Benchmarks and Kids Count. Each program is monitored by its funding source. Since we receive federal funds, an A 133 audit is performed. As part of it, our external auditors also conduct a program audit to confirm we are doing what we are funded to do. 8. Coordination. The Hawaii Island YWCA strives to work with all existing agencies and service providers on the Big Island of Hawaii. We specifically work with agencies providing like services or collaborating services. 1A1e also work with the business community in East Hawaii through our association with the Main Street Program, and The Hawaii Chamber of Commerce. We are active participants in the East Hawaii Health & Human Services Council, various statewide coalitions representing the needs of our diverse target populations and task forces, commissions and advisory groups planning for improved service delivery. Agency Name: Hawaii Island YWCA Page #2c 9. Uniqueness. The Hawaii Island YWCA has developed an excellent reputation in the local community, on the Big Island and in the State. It is highly respected for its quality services and leadership role in the human services. Its management philosophy also reflects this commitment to excellence. The Hawaii Island YWCA is unique in the county as a women's membership organization with program services addressing empowerment, health promotion, family life, youth development and community leadership. Other agencies may offer similar services in different geographic areas or to different target populations, but none duplicates our services. 10. List specific accomplishments or challenges addressed by the agency this last year. The major challenge this year was implementing a reduction in force, when the state retroactively cut our purchase of service contracts by more than $600,000. Program directors quickly submitted applications to trusts and foundations to obtain interim funding for some of the programs. We continue to respond to federal grant requests, especially when requested by the community. Given the challenges, our continued provision of high quality service is more of an accomplishment than ever. 11. Membership dues. Hawaii Island YWCA is a membership organization. Its membership dues are: Voting (Women 18-59 yrs.)----$25.00 Associate (Men 18-59 yrs.)----$25.00 Teen/Youth (12-17 yrs.) $12.50 Seniors (60+ yrs.) $12.50 12. National and Statewide Association We are accredited by the YWCA of the USA and pay 2.2% of adjusted gross receipts (gross receipts less government grants and interest earnings). We pay dues monthly and reconcile annually after our audit is complete. There are no dues paid to our State YWCA Council. 13. Benefits provided by YWCA of the U.S.A. The YWCA of the U.S.A. serves in an advisory and consultative capacity to the local Associations. Regional workshops are conducted in executive management, program development, budgeting and financial administration, leadership development, and personnel training. Communications (newsletters, public affairs bulletins, staff news, etc.) are received regularly. They provide management consultation on request and can identify successful programs operated by other YWCAs around the country. The Board President and Executive Director will be attending an intensive management course in February. The YWCA of the U.S.A. has also identified cosponsors of events like Encore, Women and Girls In Sports Day, the Week without Violence, and the New Face of Fitness. Sponsors include Avon, Nike and other large corporations. HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: Hawaii Island YWCA Page#3 B. HUMAN RESOURCES: (Answer questions 2- 6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? X Yes _No _Being revised Date last revised: 1994 Printed: 2/95 3. Do your personnel polices contain an equal employment opportunity clause? X Yes No 4. Do you have a written job descriptions? X Yes _No X Being revised Date last revised: 1992 5. Do you have written salary ranges for each job description? (If yes, attach salary ranges.) X Yes _No X Being revised Date last revised: 1992 6. Does the agency conduct regular evaluation of employees? X Yes _No _In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. No change X Increase in staff is projected Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenge. 10. Please provide a description of the minimum qualifications for each position. , a) > w tO d c, o a) c N c (0co C N U O ill C C co N N ,7-.) 7 N O N y N C LL D Q) (9 47 C a1 Q Q a Q > 13 — E c _ a� _ E a� _ . a, . Q E in m E m N — (/) U J () co Q J 17 _ O N i ° S ) 0 .c NTA IL o 0) w r c a) m o as m m (n m m E 713 0 12 c E p — N v ,- OS Uco o U cs NCO in- O L N c Q t O a. U = Q• U - O' 0 O U a o O -,,F, .>'. ° Q1 2• U N .c CO 1 co C .> ` N C Nj„ co U 'Z N a) Y 12 O C 1- 7 .c C O `1 U c _ O W '- o >- Q c > a m O U (° O § I - M•11111 CO t t O - t O - ` - E o m o `° ° m .3 .3 a) m E v y v m U c m U ,, as cu m W 63 3 d _ c C c _ c _ = c = ' c 'c y 45 0 d Y VN H U ul aoi o 3 j • e w aa'i O' U 0 3 L H U a co V o i 0C c o N _ o © 0i fa a - 0 a VI > w ;p 7 c c c 0 O > t E t a' cu :: W V c co) H c m y o E o o e3C tx W 03 wT o y .� d •a t uNi '� c H : AGENCY NAME: Hawaii Island YWCA Page # 3a 8. Training Opportunities New employees receive an appropriate, systematic and uniform orientation to Hawaii Island YWCA and the specific program for which they have been hired. In addition to specialized training related to their program, regular group or program staff development sessions are held on topics of interest to the work group. YWCA-wide safety training is conducted periodically. All staff responsible for the safety of others receive certification training, that includes Basic Water Safety through wilderness emergency responder training. Staff attend various workshops offered within the state. In some instances, they have attended mainland conferences, when special funding earmarked for that purpose has been available. The training for the Early Childhood Support Team focuses on child development, family functioning, parent-child bonding and other crucial areas for working with this population. The Family Support Services program also employees a full-time Education Coordinator, who plans and implements the training agenda. All employees have access to the coordinator to make requests and provide suggestions. A running list of training received are kept in each staff person's personnel file. The training for the Sexual Assault Support Service staff includes a mandatory minimum 35 hour orientation training. This focuses on the legal, medical and emotional aspects of rape. It also includes advocacy protocol, team expectations, and role playing responses to a variety of typical and atypical requests for assistance. Staff attend community training such as the recent S.A.N.E. training for forensic examiners. 9. Challenges within the Human Resources area. Budget cuts in state funded contracts in the first quarter of this fiscal year forced the termination of a number of staff, including the Human Resources Director. This reduction in force has necessitated all staff to become more generalists. Since the previous Human Resource Director's duties have been passed to remaining administrative staff, Hawaii Island YWCA is in the process of revising several procedures to address such things as the insurance of more consistent information passing during orientation periods, better tracking of training and quality assurance. A Human Resource computer program linked to our payroll program will be installed in February 1996. This will improve accuracy and streamline reporting. We are a large (110-130) staff with diverse skills and job assignments. Designing an equitable pay scale and job evaluation system to cover life guards, preschool aides, outreach workers and professional social workers is a nightmare challenge. We have borrowed tools from other YWCAs and have joined Hawaii Employers Council so that they can assist with this rating process. AGENCY NAME: Hawaii Island YWCA Page # 3b We have broad concerns in the area of safety. We are responsible for children in high risk areas. Our employees are exposed to a variety of hazards. We have developed a Safety handbook that is in the final review stages. All program heads are responsible for ongoing safety training for their program. We have hosted several training sessions about back care and the ergonomics of office work. Appropriate safety equipment is purchased for each program. All staff who drive on company business and especially using company vehicles must pass an in-house defensive driver class. The cost of worker's compensation insurance continues to climb. We had been most concerned about the contagious nature of worker's compensation claims especially for back injuries and stress. Our prior insurance carrier actively investigated all claims and the frivolous claims were denied.' Our new carrier has an aggressive loss prevention program that we will be implementing. 1 We continue to use Hawaii Employers Council as Human Resource consultants and regularly attend pertinent training sessions offered by them. They reviewed our framework for determining layoffs, our responses to disgruntled employees and their family members, and various issues confronting the organization. In conjunction with legal advice, Hawaii Employers Council has assisted the management team in making better and more consistent difficult decisions. Like a Puna substandard subdivision that is experiencing growth, we at the YWCA also have some serious infrastructure needs that we are addressing between running programs and handling crises. Our focus for this year is: Re-organization of management staff due to the vacancies created by the departure of senior management staff. Pay range and job rating tool developed and implemented. Unifying staff and insuring an identification with the larger organization. Safety standards and training. Workers Compensation. In the future we need to address: Job descriptions. Safety awareness. Salary parity. Salary increases. AGENCY NAME: Hawaii Island YWCA Page # 3c 10. Description of minimum qualifications. ECST Manager: Minimum qualifications for this position include either a Bachelor's degree in social work, psychology or related field or five years experience and/or training in human services. Also required are two years experience in management/supervision. Jim Borden has 15 years of human service experience and 5 years of management/supervisory experience, along with considerable experience in working with troubled families. ECST Family therapist: Minimum qualifications for the position include a Master's degree in social work, psychology or related field and two years of individual or family counseling, including at least one year in child abuse and neglect. Horace Black is the Family Therapist. He possesses a Ph.D. in psychology and has experience in counseling individuals and families with multiple problems. Additionally, he has extensive knowledge of child development and parenting skills. Health Educator: Minimum qualifications require an A.A. in a nursing field, education or public health and two years experience providing health education to families. Terry Kahele is an experienced dental assistant and has worked with families in the area of health and hygiene education for many years. Outreach Workers: Minimum qualifications are a high school diploma and three years human service or child rearing experience. Yvonne Tavares and Cherry Edullantes are specially trained para-professionals with parenting experience and intensive training in child abuse, family functioning, parent-child interaction and other significant areas. • Nurse: Requirements for this position are a Bachelor's degree in Nursing and two years experience in working with families or in child abuse and neglect. The Nurse is required to have a current Hawaii license as a Registered Professional Nurse. This position is currently vacant. All persons filling the positions exceed the minimum qualifications. Agency Name: Hawaii Island YWCA Page 3d Hawaii Island YWCA Charts fcr Grades and Rates - 5-% / Step Increase Points 100- 255- 460- 555- 905- 1090- 1205- 1305- 1405- 250 455 550 900 1085 1200 1300 1400 1500 Grades 1 2 3 4 5 6 7 8 9 Start 6 .00 6 . 48 7.06 7 . 77 8 . 47 9 . 88 11.29 12 . 70 14. 61 6 mos 6 .30 6 . 80 7. 41 8 . 16 8 . 89 10. 37 11 .85 13 . 34 15 . 34 1 6 . 62 7 . 14 7. 78 8 . 57 9 . 33 10 . 89 12.44 14 . 01 16 . 11 2 6 .95 7 . 50 8 . 17 9 .00 9 . 80 11 . 43 13 .06 14 . 71 15 . 92 3 7.30 7 . 88 8 . 58 9 . 45 10 . 29 12 . 00 13 .71 15 . 45 17. 77 4 7 . 67 8 . 27 9.01 9 . 92 10 . 80 12 . 60 14.40 16 . 22 18 . 66 5 8 .05 8 . 68 9 . 46 10 . 42 11 . 34 13 . 23 15.12 17 . 03 19 .•59 6 8 . 45 9 . 11 9 . 93 10 . 94 11 . 91 13 . 89 15 .88 17 . 88 20 . 57 7 8 . 87 9 . 57 10. 43 11 .49 12 . 51 14. 58 16 .67 18 . 77 21 . 60 8 9 .31 10 . 05 10.95 12 .06 13 . 14 15 .31 17.50 19 . 71 22. 68 9 9 .78 10 . 55 11. 50 12 . 66 13 . 80 16 .08 18.38 20 . 70 23 . 81 10 10 .27 11 . 08 12.08 13 .29 14.49 16 . 88 19 .30 21 . 74 25 .00 BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Hawaii Island YWCA (Page#4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements(to meet the agency's mission)for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s)in order of importance. Give the number"1" to the most important and dominant service or target population. 4 educational 2 victims of crime culture&arts 5 victims of health crises the poor 1 victims of social crises 3 youth the physically disabled the aged the mentally or emotionally disabled Revised January 1996 11111 YWCA Page#4a Hawaii Island 145 Ululani Street Hilo, Hawaii 96720 BOARD OF DIRECTORS Phone (808) 935-7141 1995-1996 Fax (808) 935-5150 NAME OCCUPATION ADDRESS BUSJHM. ZIP FAX TERM POS. BUGADO,Amy Private Secretary 1116 W. Kawailani St., Hilo 961-8233/959449 96720 '97 CAMBLOR,Arabel Optician 2368 Kalanianaole Ave., Hilo 935-1111/969-7016 96720 '98 CROMEY, Margo QA Manager 1428 Pukana PI., Hilo 966-8648/959-9758 96720 966-8410 '96 Pres./Exec. DAWRS,Jill Chiropractor 210 Kamehameha Ave., Hilo 935-0004/9347919 96720 '96 Treas./Exec. ESCRITOR, Priscilla Dietitian 270 Mohala PI, #109, Hilo /935-5655 96720 '96 FENG, Nina Student 757 Nou St., Hilo /959-3088 96720 '96 HAYASHI, Karla UHH Instructor 710 Iwalani St., Hilo 933-3545/959-6066 96720 '96 2ndV.P./Exec. KUWAYE,Amy Social Worker 931 Komomala Dr, Hilo 933-4401/959-7709 96720 '98 MAEDA,Annette HCC Instructor P.O. 133, Mt.View 933-3514/968-8129 96771 '97 1st V.P./Exec. NISHIDA, Lois Business Banking Officer 116 Puhili St., Hilo 933-7038/935-7481 96720 '98 OKUMA, Ellen HCC Librarian P.O. Box 1575, Hilo 933-3483/964-1408 96721 '98 PERRIN, Shirley 543 Ka'anini Cr., Hilo /961-6165 96720 '97 SAVAGE,Jill HCC Instructor 1656 Waianuenue Ave., Hilo 933-3581/969-3444 96720 '97 STUART, Mary Retired Educator 159 Halai St., Hilo /9347808 96720 '98 NOMINATING COMMITTEE CAMBLOR,Arabel 2368 Kalanianaole Ave.,Hilo 935-1111/969-7016 96720 '96 DARR,Penny 15 Kaapur>i PI.,Hio 935-5559 96720 '96 DAWRS,Jill 210 Kamehameha Ave.,Hilo 935-0004/934-7919 96720 '96 LAUNIU,Stephanie 311 Kalanianaole Ave.,Hilo 969-1427 '96 NORRIS,Anita 514 Ka'anini Cr.,Hilo 966-7461/935-3060 96720 '96 ADVISORY BOARD FERGERSTROM,Flossie 1593 Wailuku Dr.,Hilo 935-6528 96720 '96 FUERTES,David Halaula 889-5391 96719 '96 HALE,Helene 262 Anela St,Hio 935-2891/959-7423 96720 '96 HASEGAWA,Raymond 688 Kinoole St.#203,Hio 935-5732/961-5031 96720 '96 HENDERSON,Richard 345 Kekuanaoa St,Hilo 961-5252 96720 '96 KIDANI,Sue 26 Waianuenue Ave.,Hilo 935-2961/959-7625 96720 '96 ODA,Russell Box 4848,Hilo 935-9358/959-9770 96720 '96 0A United Way Agency Agency Name: Hawaii Island YWCA Page#4b C. BOARD OF DIRECTORS: 1. A current listing of the Board of Directors is attached to this application. 2. List number board meetings held in the prior year and attendance levels: 1 Annual meeting 40 members 10 Business meetings 66% attendance on average 1 Orientation 9 board members 1 Board recruitment meeting 10 potential, current and nominating committee members- 3. How many on board per Bylaws: Between 4. Major decisions by12 Boardand25 of Directors and actions taken: At the end of fiscal year 95, several programs had sufficient funds to pay budgeted salary increases as one time bonuses. The Board approved the distribution of bonuses based on funding availability. In September 1995, the Board adopted a balanced budget that required the lay off of two senior management staff. The Action Audit for Change committee audited the membership and staff to determine how well we represent the community. Our membership and staff generally reflect the larger community. 5. Foreseeable challenges: Most challenges were discussed under Human Resources. Raising funds in a failing economy is our primary challenge. To make matters worse the demand for our services is often inversely related to the amount of funding available to provide it. We will maintain core services so that we are positioned to grow when the economy recovers. A related challenge is the retention of our identity as a human service agency. The pressure to be more business like causes us to look at break even points and to increase fees. This makes it less likely that the people we are created to serve will be unable to use our services and we will simply become another business in town. Agency Name: Hawaii Island YWCA Page#4c 6. Planned improvements to meet agency's mission: We believe the Hawaiian Sovereignty issue is directly related to our One Imperative. We have begun an education process with our Board, staff and membership to help the non-Hawaiian community understand the issue. We are also working toward a YWCA of the U.S.A. resolution to be adopted at convention in either 1996 or 1998. The planning and evaluation committee is reviewing the Oregon Benchmarks and seeing which might apply to our core themes and finally how these both apply to our programs. The Kids Count indicators will also.be used. This will enable us to begin to look at community expected outcomes and how our programs move our community toward those outcomes. North Kohala Intergenerational center partnership will help us increase our services to youth and geographically expand. We are also responding to requests from the community such as Lanakila and Pahoa High School. 7. Long range plan for agency: As stated in our Strategic Plan 1993-1998: Expand programs Geographically Maintain and improve Quality of current programs Expand Child Care, Youth and Teen Programs Improve/Acquire Physical Facilities Diversify funding base Promote continual organizational development FUNDING NEEDS DIVIDER SHEET AGENCY NAME: Hawaii Island YWCA (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. • 2. What alternative funding sources were considered and/or applied for? 3. What alternative have you considered if this County request is not funded or is not full funded? 4. Give a brief explanation for any variances of 15%or greater per line item in the current vs.proposed budget. If the agency is a part/branch of a larger multi-island organization, please answer the following questions: 5. Do you receive any income(subsidy)from a neighbor island or a parent organization?If so,how much? 6. If you answered Yes to question#5,what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes,how much? 8. If you answered Yes to question#7,what is the formula used to determine this amount or percentage? FUNDING NEEDS (Page 5a) 1. Briefly explain the purpose of your request. Currently, the County of Hawaii provides funding for the Early Childhood Support Team's staff personnel along with some operating expenses for the Unit. Due to funding shortfalls and a steady participant caseload, we are respectfully requesting that the County of Hawaii continue funding a portion of the Unit's personnel and a portion of the necessary operating expenses. 2. What alternative funding sources were considered and/or applied for? The ECST unit is largely funded through Hawaii Department of Human Services. The County of Hawaii has generously provided supplemental funds in previous years. In searching for private funding, it was discovered the most private grants are awarded only to new programs or components. While the program has demonstrated repeated success, it is generally not considered by private funding sources. 3. What alternatives have you considered if this County request is not funded or is not fully funded? Should the County of Hawaii choose not to contribute,the Family Support Services ECST Unit would not be able to serve all at-risk families in East Hawaii and, potentially, young children may suffer extreme abuse or death. The impact of not funding this project would be that the incidence rate of confirmed abuse would continue to increase now and for the future generations of these families. There will also be a continuing escalation of violence in the community with accompanying social and economic costs. 4. Give a brief explanation for any variances of 15% or greater per line item in the current vs. proposed budget. Line Item #1: Salaries: The projected staffing pattern for the Early Childhood Support Team remains similar to the current year. The one significant change is in the payment of the Nurse position. Previously, it has been paid primarily from DHS funds. However,after DHS budget cuts in August, 1995, that position was eliminated. The loss of this position has created a hardship on the team. Originally, ECST believed that it would be able to access public health nurses to provide nursing assessments and developmental testing, but public health, because of its own staffing shortage has not been able to respond in a timely manner to their requests. Reinstatement of that position with funding entirely from the County is being requested. Line Items#2 through#13: These changes are all proportionate to#1 as related taxes and benefits. 5. Do you receive any income(subsidy) from a neighbor island or a parent organization? If so,how much? No 6. If you answered Yes to question#5,what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes,how much? No 8. If you answered Yes to question#7,what is the formula used to determine this amount or percentage? PROGRAM INFORMATION DIVIDER SHEET Agency name: Hawaii Island YWCA (Page 6) Program name: Family Support Services,Early Childhood Support Team Complete on program information for every program with County funding. (please paginate starting with page 1,page 6,etc...) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals,groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms,where possible)? 4. How do you evaluate program effectiveness,and who does the evaluation? 5. How does this program's content vary from similar(or same)programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual • this year estimate next year estimate 8. If fees for programs or services are charged,what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When were these rates last changed? PROGRAM INFORMATION (Page 6a) 1. How does the program help individuals,groups and/or the community? Family Support Services Early Childhood Support Team(ECST)provides important long term home visiting and counseling services to families confirmed for child abuse or neglect and referred by Child Protective Services(CPS). By providing home visiting and other comprehensive services to families involved in the CPS system, the issues surrounding abuse and neglect will be addressed. Furthermore, providing home visiting and other professional services to CPS families will allow for consistent and continual intervention to high risk families, thereby further unburdening and supporting an already over- worked child protective system. One of the goals of the ECST Unit continues to be the empowerment of families by providing education which gives parents the necessary skills to take responsibility for their families' health and well-being. Upon referral from CPS to ECST, the family will be enrolled in the ECST program, which utilizes a team approach in service delivery. In this program, a home visitor(outreach worker)will visit the parents' home on a regular basis to strengthen family functioning, enhance parent-child interaction and positive parenting by teaching and role modeling, promote optimal child development, refer to community resources to meet family needs, and most importantly, prevent further child abuse and neglect. All families enrolled in services will have access to the Family Therapist,who will provide individual and family counseling. The team will continually assess parent-child interaction to monitor progress. Services will be provided by staff who are culturally sensitive to non-western values and behavior, able to interpret client problems within a cultural context, and able to develop culturally appropriate intervention. 2. Who is the target population for this program? The target group for the Hawaii Island YWCA Early Childhood Support Team will be those families,with infants under one year of age, in East Hawaii who meet the criteria of"imminent harm" or who have been • confirmed for abuse or neglect by Child Protective Services. Services are intended to benefit parents/caregivers with newborns. Services continue through the infant's first year of life, or at the time of reduction of risk factors if that occurs before the first birthday. These target clients will usually be parents with specific problems including psychosocial and economic problems, such as substance abuse,emotional/mental illness, inadequate personal support systems, severe financial or marital discord, violence in the homes and other dysfunctions. Parents referred to ECST are, in many cases, abused or neglected themselves as children. 3. What are the specific objectives of the program (in quantitative terms,where possible)? The goal of Hawaii Island YWCA Family Support Services Early Childhood Support Team is to prevent abuse, neglect or exploitation of infants by providing limited-term emergency crisis intervention, case management or treatment/counseling services as demonstrated by increased bonding quality between parents and infants. a. Serve 32"at risk"or abused neglected infants and families referred to ECST b. Provide 1325 home visits to model behavior and provide parenting education and support c. Provide 32 child development assessments and 32 health assessments d. Provide 182 counseling sessions for referred family members e. Provide 47 ECST conferences and 24 conferences with CPS f. Provide 82 written client progress reports to DHS g. Provide 14 follow up contacts with families within 3 months after termination from ECST services. PROGRAM INFORMATION (Page 6b) In doing so, the outcomes for ECST are as follows: a. 95%of referred infants will not be abused or neglected while receiving ECST services. b. 95%of referred families will attain ECST case objectives while receiving ECST services. c. 95%of referred families will demonstrate an increase in parenting skills. d. 95%of referred families will show a decrease in stress factors at the time of discharge based upon mutual agreement between client, ECST and CPS staff. e. 95%of referred families will use at least one other community resource at case closure. f. 95%of referred families with services completed will be satisfied with ECST services received. g. 95%of referred families will be assessed as adequately functioning at 3 month follow-up visit after DHS closure. h. 95%of referred families will display improved bonding between mother and infant as measured by an assessment tool. 4. How do you evaluate program effectiveness,and who does the evaluation? ECST is subject to annual evaluations provided by the Department of Human Services. Also, the Hawaii Island YWCA Board of Directors' Planning and Evaluation Committee reviews programs quarterly. They identify relevant outcome measures for each program using resources such as the Oregon Benchmarks and Kids Count. Finally,the ECST unit conducts participant satisfaction surveys used to gauge the program's responsiveness to the needs of the community and the families it serves. 5. How does this program's content vary from similar(or same) programs offered by other agencies in the community? ECST provides important long term home visiting and counseling services to families confirmed for child abuse or neglect and referred by Child Protective Services. This program is the only one of its type in East Hawaii. 6. List specific accomplishments of this program last year. The program met and exceeded its goals. In a population that has demonstrated abuse and imminent harm with an infant, repeated abuse would be expected. However, for those families who received ECST services, abuse and neglect did not occur. Families demonstrated significant increases in parenting skills, as demonstrated in a pre and post parenting education inventory. Parents were taught effective disciplinary techniques and healthy coping skills. Frequently,the parents with whom the team works have poor cognitive abilities. The challenge of teaching those parents was met in an exciting method last year by the Outreach Workers. The Outreach Worker takes a video camera into the home to tape the parents during interaction with their children. During the taping,the Outreach Worker instructs the parent on when and how to respond appropriately to the child's behaviors. After a series of tapings occur,the parent is given the tapes to view at home. This has proven to be a less threatening method of"modeling"as well as an educational reinforcement. Additional to the pre and post parenting education survey, a stress questionnaire was developed to determine effectiveness of service. Finally the team was successfully restructured due to funding shortfalls and provided quality services throughout the restructuring. PROGRAM INFORMATION (Page 6c) 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual 35 families this year estimate 32 families next year estimate 32 families 8. If fees for programs or services are charged,what are the rates for each specific program or service? Fees have never been charged for ECST services. REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a grant, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accredited in accordance with applicable requirements of Federal, State and , County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the services provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(a)(1). 5) Have by-laws or policies that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one year's experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity, by addressing educational concerns, culture and the arts, the needs of the poor, youth, the aged, those with physical or emotional disabilities,victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. Conditions for Grantees Page 8 A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance, the committees of the Council, their staffs, and the legislative auditor access to records, reports, files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. Policy limits shall be a minimum of$300,000 for bodily injury and $50,000 for property damage. 7) Purchase motor vehicle liability insurance in the minimum amounts of$100,000 for liability • per person, per accident; $25,000 for property damage; and $300,000 comprehensive, per occurrence. 8) Name the County as additional insured and file certificates of insurance or copies of the policies with the Department of Finance. 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O U U O U _ co U F- U a U L O O -m r 2 LU LL WWWWWWWWWH IZza ?`WA=N } MCNT'-'LY FINANCIAL 6EPC: T 4331 ACT1_AL ,r5 ANNUAL BUDGET WITH VARIANCE F':R HE '',,NTH ENDING NUVE BER 30. 1995 PER OD TO DATE lEAR TO OATF ANN'A_ SUDGE T ACTUAL L'LL E_L'-_ :ARIANC_ SUPPORT AND ^.E =NU : Contributions (General) 572 663 25.920 7,252 =o_c1a1 events 2.076 9.203 22. 142 15. 932 ^?°Bests, ;'}:'n-Endowlent 0 0 0 0 P,ssociated ,organizations 2 2 0 8 Fees/Grants --rig't. Aoe- :e 761,333 1.33. 21_ 1, 120. 123 nc. � 116.754 .,embership Ls; - ind 1.0.20 3.444 :7.000 16,556 Program service fees 35.032 251.874 605. 113 353,244 Eales to public 0 100 0 (100) Investment income 80 1.343 3.60 1.552 Other 0 13 00 447 Trusts and foundations 14,411 23.663 252.310 223. 147 Allocation from rt1UW 5.833 23. 16 ' 65.200 35.834 Income From Other Sources 16. 144 76.330 .20. 124 243.794 Total Cash Income 176,008 1, 106,073 2.357,500 1.781.427 Total All Income 192,152 1, 182.403 3,207.624 2.025,221 , EXPENSES: Personnel 129,225 333.778 2,364.497 1,480,719 Professional fees 11.620 67.417'4203.766 136.349 6upol ies 1,835 18,046 55.662 37.616 Telephone 395 3.302 31.676 22.374 Postage & shin^Ino 625 2.888 5.62/ 2,759 Occupancy 66.666 161.550 326.418 164.439 _ouicient 584 24.049 55.551 31.302 Printing 0 1.327 ?.260 733 Publications & subscriptions 22 1. 161 4.390 3.829 Travel & transportation 2.172 25. 112 66.543 61.437 Conf, conv, and ieetinas 595 6,937 12,285 5.348 Specific assist to ind 0 0 1.650 1.650 iembershio dues 0 1,420 3.725 2,305 Awards & °rants 0 0 1.180 1. 100 Other 630 5.375 13. 175 8,100 . Total functional exoerses 214.869 1,203.492 3. 163.592 1.960. 180 Payments to affiliated 337 3.762 15.337 12. 175 Weinberg Expenses 170 916 0 (916) Total exo all activities 215,876 1.213. 170 3. 184.529 1,971.359 Total expenses - Restricted 134.668 417.036 2. 117.433 1.345.457 Total Expenses - Unrestricted 81.208 394. 134 1.017.036 622.902 Excess (deficit) of total support and revenue over expenses (23.724) (30,767) 23,095 53,862 T YWCA-SEXUAL ASSAULT I' APPLICATION FOR NONPROFIT FUNDS Fiscal Year July 1, 1996 -June 30, 1997 - COUNTY OF HAWAII 31 Hi 3 04 NARRATIVE REPORTING FORMS (Pages 1 - 8) ORGANIZATION SUMMARY: ORGANIZATION NAME: Hawaii Island YWCA NAME OF PROGRAM: Sexual Assault Support Service Mailing Address: 145 Ululani Street City, State, Zip: Hilo, Hawaii 96720 Telephone: (808) 935-7141 FAX: (808) 935-5150 Attach current Internal Revenue tax-exemption certificate 501 (c) 3 attached Amount allocated by Hawaii County in 1995: $ 51,000 1.7%of Agency Budget Program Total Budget in 1995: $ 273,810 18.6%of Program Budget Agency Total Budget in 1995: $2,975,541 Amount requested of Hawaii County in 1996: $ 60,000 1.9%of Agency Budget Program Total Budget in 1996: $ 287,735 20.9%of Program Budget Agency Total Budget in 1996: $3,137,520 This application for County of Hawaii non-profrt funding in 1996 was considered and approved for submission at the Council meeting held on February , 1996. BY: (Signature) (Print) Council Chairperson Agency Fiscal Year. July 1 -June 30 History of funding with the County of Hawaii: _New Applicant X Participating agency since 1984 Firm conducting and date of agency's last financial review or audit: NAME: Taketa, lwata, Hara and Associates DATE: June 1994 (The June 1995 audit will be completed by mid-March) ORGANIZATION INFORMATION SECTION (pages 2 - 8) ORGANIZATION PROFILE DIVIDER SHEET ORGANIZATION NAME: Hawaii Island YWCA Page#2 A. AGENCY PROFILE: (Answer on separate paper and attach to this divider sheet) 1. Agency Name: Hawaii Island YWCA Geographic Area(s)Served: The Island of Hawaii Agency's Mission Statement: 2. Briefly describe the kinds of programs and services the agency provides. 3 How do these services support the agency's mission? 4. Who is eligible for services? 5. Provide an unduplicated count of the number of individuals served by the agency? List by program title. 6. What are the specific objectives of the agency(in quantitative terms,where possible)? 7. How do you evaluate programs/services effectiveness,and who does the evaluation? 8. What other resources or provider do you coordinate with to deliver agency services? Do you contract with these resources or providers? 9. How does this agency's services/programs vary from similar services/programs offered by other agencies in the community? 10. List specific accomplishments or challenges addressed by the agency last year. 11. Does the agency have membership dues? If so, list current rates by category(adult, youth,honorary,etc...) 12. Does the agency have a trade affiliation with a national or statewide organization? If so, what is the formula for national and/or state contributions and how often are dues paid? 13. What benefits and/or services are provided to the agency by the national or statewide organization? Agency Name: Hawaii Island YWCA Page #2a Geographic Area(s) Served: Hawaii County, primarily East Hawaii, although Sexual Assault Support Service and Teen Court serve the entire island. Agency's Mission Statement: The mission of the Hawaii Island YWCA is to provide services to meet community needs, drawing together people with diverse experiences and relationships, so that together they may join in the struggle for peace, justice, freedom and dignity for all people. OUR PURPOSE The Young Women's Christian Association of the United States of America is a women's membership movement nourished by its roots in the Christian faith and sustained by the richness of many beliefs and values. Strengthened by diversity, the Association draws together members who strive to create opportunities for growth, leadership and power in order to attain a common vision: Peace, justice, freedom and dignity for all people. OUR ONE IMPERATIVE To thrust our collective power toward the elimination of racism wherever it exists and by any means necessary. 2. Describe programs. Currently the Hawaii Island YWCA has the following seven (7) main program service areas: 1. The Aquatics program offers a full spectrum of therapeutic and instructional swimming classes, as well as recreational swimming. 2. Child and Family Program Services offers licensed pre-school, after school, summer, school break and holiday fun programs that provide quality child care and educational program for children ages 2-12. 3. Ekahi addresses the needs of youth and families through a community based coalition in Hamakua, with the goal of reducing substance abuse by increasing drug free activities for our youth. 4. Family Support Services provides early identification of families at risk for child abuse and neglect and a range of interventions to successfully reduce that risk. 5. Fitness Education Services offers a variety of structured activities and support for all ages. The program includes fitness, dance, and adult education classes, along with martial arts and special interest classes. 6. Sexual Assault Support Services provides the Island of Hawaii with a comprehensive range of services designed to support, assist and educate victims of sexual assault and the communities in which they live. 7. Teen Court involves the creation of a teen (peer) jury system which brings together first time juvenile offenders, their peers and community volunteers to determine logical and natural consequences for the offenses. Agency Name: Hawaii Island YWCA Page #2b ). How services support the agency's mission. Each service offered increases the participants' ability to live out our mission. The Hawaii Island YWCA is a tradition that provides our members an opportunity to give back to the community, to help others reach their goals and to both give and receive support and advocacy at different times in their lives. Times change and so do the needs, interests and problems in our community and the Hawaii Island YWCA will continue to be an association dedicated to leadership and empowerment for our members and for peace, justice, freedom and dignity for all people. 4. Eligibility. YWCA programs and classes, with the exception of programs targeted for specific groups, are open to everyone, regardless of race, religion, socio-economic background, age or sex. Membership or registration fees may be waived or reduced if they create a barrier to participation or place financial hardship upon the participant. 5. Unduplicated count of the number of individuals served. 1. Aquatics - 1,500 2. Child and Family - 521 3. Ekahi - 2,000 4. Family Support - 1,164 5. Fitness Education - 1,200 6. Sexual Assault Support Services - 3,410 7. Teen Court - 400 6. Agency Objectives. The Hawaii Island YWCA uses the five core themes adopted at the YWCA national convention as its general objectives. These Core themes are: Empowerment, Health Promotion, Family Life, Youth Development and Community and Leadership. The 1993 - 1998 Strategic Plan further identifies specific objectives including expansion of existing programs, improvement of service quality, expansion of program type and location, diversification of funding base and preparation of physical facilities plan. Each program has specific measurable objectives. 7. Evaluation. Effectiveness in meeting community needs is evaluated via our clients' evaluation of programs and services they receive. The elected Board of Directors Program Planning and Evaluation Committee reviews programs quarterly. They identify relevant outcome measures for each program using resources such as the Oregon Benchmarks and Kids Count. Each program is monitored by its funding source. Since we receive federal funds, an A 133 audit is performed. As part of it, our external auditors also conduct a program audit to confirm we are doing what we are funded to do. 8. Coordination. The Hawaii Island YWCA strives to work with all existing agencies and service providers on the Big Island of Hawaii. We specifically work with agencies providing like services or collaborating services. We also work with the business community in East Hawaii through our association with the Main Street Program, and The Hawaii Chamber of Commerce. We are active participants in the East Hawaii Health & Human Services Council, various statewide coalitions representing the needs of our diverse target populations and task forces, commissions and advisory groups planning for improved service delivery. Agency Name: Hawaii Island YWCA Page #2c 1. Uniqueness. The Hawaii Island YWCA has developed an excellent reputation in the local community, on the Big Island and in the State. It is highly respected for its quality services and leadership role in the human services. Its management philosophy also reflects this commitment to excellence. The Hawaii Island YWCA is unique in the county as a women's membership organization with program services addressing empowerment, health promotion, family life, youth development and community leadership. Other agencies may offer similar services in different geographic areas or to different target populations, but none duplicates our services. 10. List specific accomplishments or challenges addressed by the agency this last year. The major challenge this year was implementing a reduction in force, when the state retroactively cut our purchase of service contracts by more than $600,000. Program directors quickly submitted applications to trusts and foundations to obtain interim funding for some of the programs. We continue to respond to federal grant requests, especially when requested by the community. Given the challenges, our continued provision of high quality service is more of an accomplishment than ever. '1. Membership dues. Hawaii Island YWCA is a membership organization. Its membership dues are: Voting (Women 18-59 yrs.)----$25.00 Associate (Men 18-59 yrs.)----$25.00 Teen/Youth (12-17 yrs.) $12.50 Seniors (60+ yrs.) $12.50 12. National and Statewide Association We are accredited by the YWCA of the USA and pay 2.2% of adjusted gross receipts (gross receipts less government grants and interest earnings). We pay dues monthly and reconcile annually after our audit is complete. There are no dues paid to our State YWCA Council. 13. Benefits provided by YWCA of the U.S.A. The YWCA of the U.S.A. serves in an advisory and consultative capacity to the local Associations. Regional workshops are conducted in executive management, program development, budgeting and financial administration, leadership development, and personnel training. Communications (newsletters, public affairs bulletins, staff news, etc.) are received regularly. They provide management consultation on request and can identify successful programs operated by other YWCAs around the country. The Board President and Executive Director will be attending an intensive management course in February. The YWCA of the U.S.A. has also identified cosponsors of events like Encore, Women and Girls In Sports Day, the Week without Violence, and the New Face of Fitness. Sponsors include Avon, Nike and other large corporations. HUMAN RESOURCES DIVIDER SHEET AGENCY NAME: Hawaii Island YWCA Page#3 B. HUMAN RESOURCES: (Answer questions 2-6 on this sheet.) 1. Please attach a copy of the organizational chart. 2. Do you have written, up-to-date personnel policies? X Yes No Being revised Date last revised: 1994 Printed: 2/95 3. Do your personnel polices contain an equal employment opportunity clause? X Yes No 4. Do you have a written job descriptions? X Yes —No X Being revised Date last revised: 1992 5. Do you have written salary ranges for each job description? (If yes,attach salary ranges.) X Yes _No X Being revised Date last revised: 1992 6. Does the agency conduct regular evaluation of employees? X Yes _No —In the process of being developed 7. What is the staffing pattern in County funded programs for this year compared to next year? Please provide a brief explanation. No change X Increase in staff is projected Decrease in staff is projected (Answer questions 8, 9, and 10 on separate paper and attach.) 8. Please share information on training opportunities provided to staff and/or volunteers. 9. Please share concerns or challenges within the Human Resources area and what steps have been taken to address the concern or challenge. 10. Please provide a description of the minimum qualifications for each position. CD CO 4) O N y Co _N C V _ :° �_ c c6 ai CZ C U •C_ C L C N .N N 'y j •E lL a N O N O N Ca) m CN N C ` `) LL Q Q d Q _ C C ^_ 0 cu E O O 0 7 T Q -p —r CO 'O 1 .. C 7 O 0 7 y N m 7 (n U J &) ...1 < J ammi O E O m 11 - I II 7 >, a m m as co y Y >. � - —r W .� 0 CO ti 0 O o .. y 0 Ln F c m > `O E co _ ... m E �' ID N L C . m L L m c cn c _ C W N C N f' ^ U O U �. U y 7 t N -� �� C < N a .. C ey y 11 , 6 o o a )- a : ! 0 o _ r O O .0 N C 7 > U '0-' co U m V N co 0 w L r� O C — 7 .c N .c ....7. E) = U r a > a y O V to 07 co a) 70 0 m t m �mm '� L O L N U m V c m U c m CD m m aa)i 3 W 0 u w m `0 c m 2 . 2 x H 2 as U > > i O U OC.) R U uc N L 3 V L T o el im y O e I2 Q �- ' d cs • C mom ( .00. Ca .0 d C 0 'C 2 C CC > = 3 L Co o c c c " ' N w+ LL a O C > Co a) a) I .r 0 W cocoN N C m N O EHI Cv U CC d —� Ny mcn O — mQ U �• mQ .L) U) N N N = = y S a) Y 7 Y u.. C) C p '2 o m = m C7 m U m a) C c c co Cl)_ 2 cr) s7 T ._ O C J > INIIIIIMINI V1 41) CD ITH ' Jill -. N - N a •m 3 C N• Mr .68 RI co ato o I > O Cm ' (,),- 2U Q O_ U Cl.) •-' E ¢ 0 V �� N co iD 7 CO _ RI L _ N 1— m r c 8 UJ 43 a1 o y .m a) .m 0 < N m U0 m N c cn t C 7 U = . = N X O' _ .. .-. .0 0 L x O. N a. w > w to = = 0 U N 7 O 0 Q co U) = E cmv - rn ipto 7 N ^O U = =a .. 1 > a) m a) U 7 0 CL at X • n ' U N y W co 0CD AGENCY NAME: Hawaii Island YWCA Page # 3a 8. Training Opportunities New employees receive an appropriate, systematic and uniform orientation to Hawaii Island YWCA and the specific program for which they have been hired. In addition to specialized training related to their program, regular group or program staff development sessions are held on topics of interest to the work group. YWCA-wide safety training is conducted periodically. All staff responsible for the safety of others receive certification training, that includes Basic Water Safety through wilderness emergency responder training. Staff attend various workshops offered within the state. In some instances, they have attended mainland conferences, when special funding earmarked for that purpose has been available. • The training for the Early Childhood Support Team focuses on child development, family functioning, parent-child bonding and other crucial areas for working with this population. The Family Support Services program also employees a full-time Education Coordinator, who plans and implements the training agenda. All employees have access to the coordinator to make requests and provide suggestions. A running list of training received are kept in each staff person's personnel file. The training for the Sexual Assault Support Service staff includes a mandatory minimum 35 hour orientation training. This focuses on the legal, medical and emotional aspects of rape. It also includes advocacy protocol, team expectations, and role playing responses to a variety of typical and atypical requests for assistance. Staff attend community training such as the recent S.A.N.E. training for forensic examiners. 9. Challenges within the Human Resources area. Budget cuts in state funded contracts in the first quarter of this fiscal year forced the termination of a number of staff, including the Human Resources Director. This reduction in force has necessitated all staff to become more generalists. Since the previous Human Resource Director's duties have been passed to remaining administrative staff, Hawaii Island YWCA is in the process of revising several procedures to address such things as the insurance of more consistent information passing during orientation periods, better tracking of training and quality assurance. A Human Resource computer program linked to our payroll program will be installed in February 1996. This will improve accuracy and streamline reporting. We are a large (110-130) staff with diverse skills and job assignments. Designing an equitable pay scale and job evaluation system to cover life guards, preschool - aides, outreach workers and professional social workers is a nightmare challenge. We have borrowed tools from other YWCAs and have joined Hawaii Employers Council so that they can assist with this rating process. AGENCY NAME: Hawaii Island YWCA Page # 3b We have broad concerns in the area of safety. We are responsible for children in high risk areas. Our employees are exposed to a variety of hazards. We have developed a Safety handbook that is in the final review stages. All program heads are responsible for ongoing safety training for their program. We have hosted several training sessions about back care and the ergonomics of office work. Appropriate safety equipment is purchased for each program. All staff who drive on company business and especially using company vehicles must pass an in-house defensive driver class. The cost of worker's compensation insurance continues to climb. We had been most concerned about the contagious nature of worker's compensation claims especially for back injuries and stress. Our prior insurance carrier actively investigated all claims and the frivolous claims were denied.- Our new carrier has an aggressive loss prevention program that we will be implementing. We continue to use Hawaii Employers Council as Human Resource consultants and regularly attend pertinent training sessions offered by them. They reviewed our framework for determining layoffs, our responses to disgruntled employees and their family members, and various issues confronting the organization. In conjunction with legal advice, Hawaii Employers Council has assisted the management team in making better and more consistent difficult decisions. Like a Puna substandard subdivision that is experiencing growth, we at the YWCA also have some serious infrastructure needs that we are addressing between running programs and handling crises. Our focus for this year is: Re-organization of management staff due to the vacancies created by the departure of senior management staff. Pay range and job rating tool developed and implemented. Unifying staff and insuring an identification with the larger organization. Safety standards and training. Workers Compensation. In the future we need to address: Job descriptions. Safety awareness. Salary parity. Salary increases. AGENCY NAME: Hawaii Island YWCA Page# 3c 10. Description of minimum qualifications. SASS Program Director: Minimum qualifications for this position include either a Master's degree or equivalent in social sciences, health care, education or related field; plus five years experience in human services, including work with women, children and/or families; plus three years supervisory experience; or equivalent combination of education and experience. This position was recently vacated by Nancy Moser and is being temporarily covered by Patti Ramsey-Scott who possesses a Master's degree in Social Work and many years of supervisory experience. SASS Clinical Supervisor: Minimum qualifications for the position include a Master's degree in social work, psychology or related field, two years experience counseling crime victims, and one year's experience in clinical supervision; or equivalent combination of education and experience. Ahnalira Koan is the Clinical Supervisor. She possesses a Master's degree in Clinical Psychology and has twenty-five years work experience with sexual assault survivors, perpetrators and other clients. Prevention Specialist: Minimum qualifications require a B.A. in social sciences, nursing, humanities or education; or one to two years related experience and/or training; or equivalent combination of education and experience. Renee Echavez has B.A. in Speech communications and has worked with Hawaii Island YWCA SASS in urgent care to survivors since 1991. She has extensive experience in theater arts production and in working with educationally disadvantaged youth in rural Hawaii Island communities. Support Specialists: Minimum qualifications are a bachelor's degree or equivalent in education plus experience. Patricia Pabro has college credits in psychology and liberal studies. She has extensive experience and continuing education in sexual assault victim services at Hawaii Island YWCA SASS since 1982. Cindy Schrader-Masterjohn has a BA in sociology, is a certified substance abuse counselor and has many years of work experience in mind/body therapies, treatment of batterers and chemical dependency. Care Team: Graduation from high school, one year's experience working in human services and qualification as a sexual assault victim counselor, as defined in HRS 626-1. Our seventeen care team members have varying educational backgrounds, from some college work through an earned graduate degree. They have from three months to five years experience with SASS. All persons filling the positions exceed the minimum qualifications. Agency Name: Hawaii Island YWCA Page 3d Hawaii Island YWCA Charts for Grades and Rates - 5% / Step Increase Points 100- 255- 460- 555- 905- 1090- 1205- 1305- 1405- 250 455 550 900 1085 1200 1300 1400 1500 Grades 1 2 3 4 5 6 7 8 9 Start 6 .00 6 . 48 7.06 7 . 77 8 . 47 9 . 88 11.29 12 . 70 14 . 61 6 mos 6 .30 6 . 80 7. 41 8 . 16 8 . 89 10 . 37 11 . 85 13 . 34 15 .34 I 6 . 62 7 . 14 7. 78 8 . 57 9 . 33 10. 89 12.44 14 . 01 16 . 11 2 6 . 95 7 . 50 8 . 17 9 . 00 9 . 80 11 . 43 13 .06 14 . 71 16 . 92 3 7. 30 7 . 88 8. 58 9 . 45 10 . 29 12 . 00 13 .71 15 . 45 17.77 4 7. 67 8 . 27 9 .01 9 . 92 10 . 80 12 . 60 14.40 16 . 22 18 . 66 5 8 .05 8 . 68 9 . 46 •10 .42 11 .34 13 . 23 15 .12 17 . 03 19 . 59 6 8 . 45 9 . 11 9 . 93 10 . 94 11 . 91 13 . 89 15 .88 17 . 88 20. 57 7 8 . 87 9 . 57 10. 43 11 .49 12 . 51 14. 58 16 . 67 18 . 77 21 . 60 8 9 .31 10 . 05 10.95 12.06 13 . 14 15.31 17.50 19 . 71 22 . 68 9 9 .78 10 . 55 11. 50 12 . 66 13 . 80 16 .08 18.38 20 . 70 23 . 81 10 10 .27 11 . 08 12.08 13 .29 14.49 16 . 88 19 .30 21 . 74 25.00 BOARD OF DIRECTORS DIVIDER SHEET AGENCY NAME: Hawaii Island YWCA (Page#4) C. BOARD OF DIRECTORS: (Answer on separate paper and attach.) 1. Provide a current listing of the Board of Directors with board terms and positions, addresses, phone numbers and current occupations. 2. List number of board meetings held in the prior year and attendance levels. 3. According to the bylaws, how many directors must serve on the board? 4. List major decisions made by the Board of Directors last year and actions taken or plans made to implement the decisions. 5. Discuss foreseeable challenges in the coming year and anticipated actions the agency will take to address such challenges. 6. List planned improvements(to meet the agency's mission)for the coming year. 7. What long range plans does the Board of Directors have for the agency? D. FOCUS OF PROGRAM FOR WHICH COUNTY GRANT WILL BE REQUESTED Indicate the most applicable classification(s)in order of importance. Give the number"1" to the most important and dominant service or target population. 5 educational 1 victims of crime culture&arts 2 victims of health crises 8 the poor 3 victims of social crises 4 youth 7 the physically disabled 9 the aged 6 the mentally or emotionally disabled Revised January 1996 \11111% Page#4a YWCA Hawaii Island 145 Ululani Street Hilo, Hawaii 96720 BOARD OF DIRECTORS Phone (808) 935-7141 Fax (808) 935-5150 1995-1996 NAME OCCUPATION ADDRESS BUSJHM. ZIP FAX TERM POS. BUGADO,Amy Private Secretary 1116 W. Kawailani St., Hilo 961-8233/959-6449 96720 '97 CAMBLOR,Arabel Optician 2368 Kalanianaole Ave., Hilo 935-1111/969-7016 96720 '98 CROMEY, Margo QA Manager 1428 Pukana PI., Hilo 966-8648/959-9758 96720 966-8410 '96 Pres./Exec. r'`NRS,Jill Chiropractor 210 Kamehameha Ave., Hilo 935-0004/934-7919 96720 '96 Treas./Exec. RITOR, Priscilla Dietitian 270 Mohala PI, #109, Hilo /935-5655 96720 '96 FbNG, Nina Student 757 Nou St., Hilo /959-3088 96720 '96 HAYASHI, Karla UHH Instructor 710 Iwalani St., Hilo 933-3545/959-6066 96720 '96 2ndV.P./Exec. KUWAYE,Amy Social Worker 931 Komomala Dr, Hilo 933-4401/959-7709 96720 '98 MAEDA,Annette HCC Instructor P.O. 133, Mt.View 933-3514/968-8129 96771 '97 1st V.P./Exec. NISHIDA, Lois Business Banking Officer 116 Puhili St., Hilo 933-7038/935-7481 96720 '98 OKUMA, Ellen HCC Librarian P.O. Box 1575, Hilo 933-3483/964-1408 96721 '98 PERRIN, Shirley 543 Ka'anini Cr., Hilo /961-6165 96720 '97 SAVAGE, Jill HCC Instructor 1656 Waianuenue Ave., Hilo 933-3581/969-3444 96720 '97 STUART, Mary Retired Educator 159 Halai St., Hilo /934-7808 96720 '98 NOMINATING COMMITTEE CAMBLOR,Arabel 2368 Kalanianaole Ave.,Hilo 935-1111/969-7016 96720 '96 DARR,Penny 15 Kaapuni PI.,Hilo 935-5559 96720 '96 DAWRS,Jill 210 Kamehameha Ave.,Hilo 935-0004/934-7919 96720 '96 LAUNIU,Stephanie 311 Kalanianaole Ave.,Hilo 969-1427 '96 NORRIS,Anita 514 Ka'anini Cr.,Hilo 966-7461/935-3060 96720 '96 ADVISORY BOARD FERGERSTROM,Flossie 1593 Wailuku Dr.,Hilo 935-6528 96720 '96 FUERTES,David Halaula 889-5391 96719 '96 HALE,Helene 262 Anela St,Hilo 935-2891/959-7423 96720 '96 HASEGAWA,Raymond 688 Kinoole St.#203,Hilo 935-5732/961-5031 96720 '96 HENDERSON,Richard 345 Kekuanaoa St,Hilo 961-5252 96720 '96 KIDANI,Sue 26 Waianuenue Ave.,Hdo 935-2961/959-7625 96720 '96 ODA,Russell Box 4848,Hilo 935-9358/959-9770 96720 '96 0A1✓,� United Way Agency Agency Name: Hawaii Island YWCA Page#4b C. BOARD OF DIRECTORS: 1. A current listing of the Board of Directors is attached to this application. 2. List number board meetings held in the prior year and attendance levels: - 1 Annual meeting 40 members 10 Business meetings 66% attendance on average 1 Orientation 9 board members 1 Board recruitment meeting 10 potential, current and nominating committee members. 3. How many on board per Bylaws: Between 12 and 25 4. Major decisions by Board of Directors and actions taken: At the end of fiscal year 95, several programs had sufficient funds to pay budgeted salary increases as one time bonuses. The Board approved the distribution of bonuses based on funding availability. In September 1995, the Board adopted a balanced budget that required the lay off of two senior management staff. The Action Audit for Change committee audited the membership and staff to determine how well we represent the community. Our membership and staff generally reflect the larger community. 5. Foreseeable challenges: Most challenges were discussed under Human Resources. Raising funds in a failing economy is our primary challenge. To make matters worse the demand for our services is often inversely related to the amount of funding available to provide it. We will maintain core services so that we are positioned to grow when the economy recovers. A related challenge is the retention of our identity as a human service agency. The pressure to be more business like causes us to look at break even points and to increase fees. This makes it less likely that the people we are created to serve will be unable to use our services and we will simply become another business in town. Agency Name: Hawaii Island YWCA Page#4c 6. Planned improvements to meet agency's mission: We believe the Hawaiian Sovereignty issue is directly related to our One Imperative. We have begun an education process with our Board, staff and membership to help the non-Hawaiian community understand the issue. We are also working toward a YWCA of the U.S.A. resolution to be adopted at convention in either 1996 or 1998. The planning and evaluation committee is reviewing the Oregon Benchmarks and seeing which might apply to our core themes and finally how these both apply to our programs. The Kids Count indicators will also be used. This will enable us to begin to look at community expected outcomes and how our programs move our community toward those outcomes. North Kohala Intergenerational center partnership will help us increase our services to youth and geographically expand. We are also responding to requests from the community such as Lanakila and Pahoa High School. 7. Long range plan for agency: As stated in our Strategic Plan 1993-1998: Expand programs Geographically Maintain and improve Quality of current programs Expand Child Care, Youth and Teen Programs Improve/Acquire Physical Facilities Diversify funding base Promote continual organizational development FUNDING NEEDS DIVIDER SHEET AGENCY NAME: Hawaii Island YWCA (Page 5) E. FUNDING NEEDS: (Answer on separate paper and attach.) 1. Briefly explain the purpose of your request. 2. What alternative funding sources were considered and/or applied for? 3. What alternative have you considered if this County request is not funded or is not full funded? 4. Give a brief explanation for any variances of 15%or greater per line item in the current vs.proposed budget. If the agency is a part/branch of a larger multi-island organization,please answer the following questions: 5. Do you receive any income(subsidy)from a neighbor island or a parent organization? If so,how much? 6. If you answered Yes to question#5,what is the formula used to determine the amount or percentage? 7. Do you expense any portion of income to a neighbor island or parent organization to share in operational expenses? If yes,how much? 8. If you answered Yes to question#7,what is the formula used to determine this amount or percentage? ATTACHMENT TO PAGE 5 HAWAII ISLAND YWCA SEXUAL ASSAULT SUPPORT SERVICE E. FUNDING NEEDS 1. The purpose of this request is to maintain this community program which continues for its 18th year to provide immediate caring and skilled support to sexual assault victims of all ages and both genders throughout the county. Whenever a victim comes forward after a sexual assault, in need of medical care or intending to participate in a crime investigation, staff of the program respond in person immediately, in coordination with police officers and nurse examiners as members of the community Sexual Assault Response Team. They provide the victim and family members with needed comfort and support to sustain them through rigorous procedures of investigation. This program then provides follow up care and mental health promotion while the victim and family recover from the crime, renew self esteem, reorganize normal life routines and perhaps endure the difficulties of the legal system. Telephone contact is also available 24 hours a day for help to victims who will not come forward but need to get to safety and to manage feelings of fear and trauma. On-call staff give information and comfort to encourage those who are anxious about making a crime report of child abuse or adult sexual assault. Finally, the program provides sexual assault prevention and safety education to children and adults in presentations which are offered to all schools throughout the island. Professionals in allied fields also receive consultation and education about sex assault related issues. 2. Purchase of service funding through the State Department of Health is contracted for the current and proposed fiscal years (FY 1995-97). In fall of 1995 the program was informed by DOH that, retroactive to 7/1/95, State POS funds to this service were cut by 25%. That source represents 73% of the total program revenue. In response to this reduction, one position was eliminated and another job offer was rescinded, leaving a position unfilled. This program has been included in the YWCA's request to Hawaii Island United Way. Recent history shows that HIUW has allocated funding less than the amount requested and then reduced actual revenue transferred, due to failure to collect funds sufficient to meet their goal amount. 3. If this County request is not funded, the program will have to eliminate services categorically and/or by geographic areas. For instance, no face to face support may be offered to victims during medical-legal examination. Services could be limited to telephone contact only. Services could be limited to the Hilo vicinity only. ATTACHMENT TO PAGE 5 - continued 4. Increases in the proposed versus the current budget reflect continuing effort to meet the ballooning demand for service as more children and adults come forward to report sex assault crimes. The program has maintained its course toward reducing staff time in administrative positions in favor of increasing direct service staff time. The addition to this direct service time, a part time clerical staff and increases in the payroll taxes account for variances of greater than 15%. 5. through 8. These questions do not apply. PROGRAM INFORMATION DIVIDER SHEET Agency name: Hawaii Island YWCA (Page 6) Program name: Sexual Assault Support Services Complete on program information for every program with County funding. (please paginate starting with page 1,page 6,etc...) Answer questions 1-8 on separate paper and attach. 1. How does the program help individuals,groups and/or the community? 2. Who is the target population for this program? 3. What are the specific objectives of the program(in quantitative terms,where possible)? 4. How do you evaluate program effectiveness,and who does the evaluation? 5. How does this program's content vary from similar(or same)programs offered by other agencies in the community? 6. List specific accomplishments of this program last year. 7. Provide information on the unduplicated count of this program's beneficiaries: last year actual this year estimate next year estimate 8. If fees for programs or services are charged,what are the rates for each specific program or service? (Attach a complete rate schedule for this program.) A. When were these rates last reviewed? B. When were these rates last changed? ATTACHMENT TO PAGE 6 HAWAII ISLAND YWCA SEXUAL ASSAULT SUPPORT SERVICE 1. The program supports the strengths of individuals and families to recover from the stress and trauma of a sexual assault. This benefits the community because the functional capacity of citizens to work, parent, play, learn and care for each other is maximized. The risk of victims becoming ill, resorting to chemical abuse, becoming dependent or homeless, committing suicide or homicide are all reduced by the program. Educational services have helped adults and children avoid being victimized. The program delivers professional in-service education which is used by the police department, school faculty and many other human service workers. 2. The target population consists of adults and children, males and females throughout the county. Victims of sexual assault are the target group, as well as anyone who has a question or concern about sexual assault and anyone at risk to be assaulted. That includes all citizens. 3. The program objectives are to provide: -support services to 260 persons effected by sexual assault -prevention education to 2,000 children and adults -consultation or education to at least 50 professionals -sex assault urgent response services by phone or face-to-face 24 hours a day in East and West Hawaii In addition, -80% of program participants will complete a satisfaction survey indicating that they found the program services to be good and helpful -80% will demonstrate a reduction in anxiety and an increase in self-esteem -education students will show an increase in knowledge about sexual assault and safety (75%) -classroom teachers who observe their students receiving a program presentation will complete an evaluation indicating that the service was helpful and appropriate to their students (90%). 4. Clients and education participants evaluate the program by completing a satisfaction survey. Staff assist clients to measure their own progress in reference to each client's treatment plan goals. Education participants complete pre and post tests to determine an increase in their knowledge. Aggregate data from these sources and program statistics are evaluated at least quarterly by the program manager, YWCA Board of Directors and representatives of program funders. ATTACHMENT TO PAGE 6 - continued HAWAII ISLAND YWCA SEXUAL ASSAULT SUPPORT SERVICE 5. This program is the only rape crisis center in the county and is fully coordinated with the services of the police department, forensic examiners, prosecutor and Child Protective Service, who jointly function as this island's Sexual Assault Response Team. The program differs from generic crisis response services in at least four ways: - a) the program and staff have extensive specialized expertise in the dynamics of sexual assault trauma and the justice system, developed over 18 years of operation, b) the program continues follow up services beyond the first 72 hours after crisis, c) the program structure and staff expertise make it the only urgent response provider in the county which qualifies to give its clients privacy and confidentiality in their direct mental health services, under the sex assault victim/counselor privilege enacted in HRS 626, d) the program takes responsibility to address prevention of sexual assault crimes - at the individual and group level through educational sessions, and at the community level through public events and by continuously working with allied agencies to improve the system. 6. The program again met the high service demand from this community by surpassing its objectives for numbers of persons served. Last year the program helped: -345 adults and children from all areas of the island requesting support services. -2,833 prevention education participants -232 human service professionals who received in-service education or consultation Staff of the state Department of Health, the program's largest f under, made a site visit and declared the program healthy and in compliance with all particulars of its purchase of service contract. The prevention staff organized, rehearsed and delivered a highly successful presentation to the Big Island Annual Youth Conference. This live dramatic performance and audience discussion about date rape was performed by volunteer young adult actors. The adolescent audience was very enthusiastic in praise of this session. Third grade students around the island received classroom sessions and met the program goals of increased knowledge about sexual assault and safety. Several seventh and tenth grade groups also received education. Counseling groups were initiated in the West Hawaii office. The program initiated fee for service activities to meet the needs of some clients for more extensive treatment than is afforded by the purchase of service funds. We applied for and received third party reimbursement from the Criminal Injuries Compensation Commission for a few eligible clients. This was the program's first effort at third party reimbursement for client care. ATTACHMENT TO PAGE 6 - continued HAWAII ISLAND YWCA SEXUAL ASSAULT SUPPORT SERVICE The program's Sex Assault Support Specialist was qualified before an administrative board as an expert witness on sex assault. She was assisting her client who had been a victim of patient abuse. The perpetrator was convicted in criminal court and was relieved of a professional license prior to the administrative hearing by this board which decided the institution's level of culpability. This was the first time the program was called upon to assist a client with such an administrative board. The client was very appreciative as the specialist accompanied her through a grueling process which took several hours. 7. Unduplicated count of the program's beneficiaries: last year actual = 3,410 this year estimate = 3,000 next year estimate = 3,000 8. Clients receive urgent response, crisis stabilization, support, follow up and education services without cost to the individual, thanks to the county, state, federal and charitable funds which have purchased these services on behalf of the public. Clients who complete the no cost services for which they are eligible but wish to continue receiving additional group sessions may do so by paying $10 per two hour group session. Those clients who are assessed to need specific focused professional therapy are offered treatment with the program's Master's level therapist at a cost of $75 per individual treatment hour. The program assists the client to apply for appropriate reimbursement if eligible (such as Criminal Injuries Compensation funds or restitution), or the client may pay out of pocket. Alternatively, clients may be referred out to the few privately practicing therapists who work with issues of sexual assault. Rates for those therapists may range from $75 to $130 per hour. A & B. These rates were last reviewed in September 1995 and have not changed since they were first introduced in December 1994. REQUIREMENTS AND CONDITIONS FOR NON-PROFIT GRANTS COUNTY OF HAWAII For Fiscal Year July 1, 1996 to June 30, 1997 Eligibility Requirements Page 7 To be considered for a grant, a non-profit organization must meet the following requirements. 1) Be chartered or otherwise authorized to do business in the State for charitable purposes. 2) Be exempt from paying Federal income taxes per 501 (c) 3. 3) Be licensed and accredited in accordance with applicable requirements of Federal, State and , County laws. 4) Have a governing board whose members have no conflict of interest between their regular occupations and the services provide by the applicant. For definition of conflict of interest, see Hawaii County Code, Section 2-136(ax1). 5) Have by-laws or policies that describe management policies, audit policies, fiscal policies and procedures, and policies on management of potential conflict of interest. 6) Have at least one year's experience with the service or activity for which the appropriation is sought, or otherwise demonstrate sufficient expertise to carry it out successfully. 7) Provide direct benefits to the people of Hawaii County through that service or activity, by addressing educational concerns, culture and the arts, the needs of the poor, youth, the aged, those with physical or emotional disabilities,victims of crime, or victims of health or social crises, as determined by the County. 8) Provide benefits to the people of Hawaii County. Conditions for Grantees Page 8 A non-profit organization to which a grant has been made must comply with the following conditions in order to receive the grant funds. 1) Employ and appoint persons on the basis of merit and ability. 2) Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race, color, national origin, religion, creed, sex, age, or handicap. 3) Agree not to use any public funds for purposes of entertainment or perquisites. 4) Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the non-profit organization with Federal, State and County laws, and established standards for fiscal and program management. 5) Allow the Director of Finance, the committees of the Council, their staffs, and the legislative auditor access to records, reports, files, and other related documents in order that the program, management, and fiscal practices of the non-profit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds. 6) Purchase a comprehensive general liability insurance policy covering the activity funded by the county under this grant and maintain such policy throughout the fiscal year of this grant. 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MONTHLY FINANCIAL REPORT *331 ACTUAL CS ANNUAL BUDGET WITH VARIANCE • FOR THE MONTH ENDING NOVEMBER 30. 1935 PER OD TO FATE 1Er4( .O BUT: ANNUL BUDGET ACTUAL ACTUAL BUDGET ARIANCE SUPPORT AND FEVENU_: Contributions (General) 572 18.663 25.320 7.252 oecial events 2.076 =.208 22.140 13.332 Bequests, Non-Endowment 0 0 0 0 Associated _roanizations 0 0 0 0 FeesiGrants Gov't Agencies 116,784 761,039 1.381.212 1.20,123 Membership dues - ir,d 1.020 8.444 27.000 18.556 Program service fees 35,032 251,374 605. 118 353.244 Sales to public 0 100 0 (100) Investment income 80 1,348 3,800 1.952 Other 0 13 3040 487 Trusts and foundations 14,611 28.643 254.810 228.147 Allocation from HIUW 5.833 29,166 65.000 35,834 Income From Other Sources 16.144 76.330 320. 124 243,754 Total Cash income 176,008 1, 106,073 2,887,500 1.781.427 Total A11 Income 192,152 1, 182.403 3,207,624 2.025,221 EXPENSES: Personnel - 129,225 383,778 2,364,497 1,480,719 Professional fees 11.620 67.417 203.766 136.349 Supplies 1,835 18,046 3�:,.662 37,616 Telephone Postage 895 9.302 31.676 22.374 shipping 625 2.866 5,627 2,7:9 Occupancy 66.666 161.960 326,475 164,499 Eouioment 584 24,049 55.351 31,302 Printing 0 1.327 2.060 733 Publications & subscriptions 22 1, 161 4,930 3.829 Travel & transportation 2,172 25. 112 86.543 61.437 Conf, cony, and meetinos 595 6,537 12,285 5.348 Specific assist to ind 0 0 1,650 1.650 Membership dues 0 1.420 3.725 2,305 Awards & grants 0 0 1.100 1.100 Other 630 5.075 13.175 8,100 Total functional exoerses 214,869 1,208,492 3,168.592 1,960. 100 Payments tc affiliated 837 3.762 15.937 12.175 Weinberg Expenses 170 916 0 (916) Total exp all activities 215,876 1.213.170 3,184.529 1,971.359 Total excenses - Restricted 134,668 413.036 2.167.493 1.348.457 Total Expenses - Unrestricted 81,208 394. 134 1.017,036 622,902 Excess (deficit) of total support and revenue over expenses (23,724) (30.767) 23,095 53,862