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HomeMy WebLinkAboutCOM 0157.000 2006-2008Harry Kim Mayor February 5, 2007 County of Hawaii Finance Department 25 Aupuni Street, Room 118 • Hilo, Hawaii 96720 (808)961-8234 • Fax(808)961-8248 Pete Hoffmann, Chairman and Members of the Hawai'i County Council Hawai'i County Council 25 Aupuni Street Hilo, Hawai'i 96720 RE: NONPROFIT ORGANIZATIONS William Takaba Director Nancy E. Crawford Deputy Director -J 4 T' __ CD U1 -a In compliance with Chapter 2, Article 25 of the Hawai'i County Code, I am submitting the applications from eligible nonprofit organizations for your review and appropriation of funds for the FY2007-08 nonprofit grant program. Also enclosed is a list of these eligible organizations with the name of their program and the amount they are requesting from the County. The list also reflects three (3) organizations that were ruled ineligible for consideration for a grant as they did meet all of the application requirements. We will be contacting these three organizations and inform them of their ineligibility. Should you have any questions, please feel free to call me. William Takabakab Director of Finance Enc. Applications for Nonprofit Grant Funds List of Nonprofit Grant Applicants Note: Attached applications, due to thier size, are not made a part of the duplicated copies of this communication, but are available for viewing upon request in the Office of the County Clerk. Comm. No. 1907 Ref. To _ Ref. Date EB 0 5 2007 Hawaii County is an Equal Opportunity Provider and Employer NONPROFIT GRANT APPLICANTS FOR FY2007-08 ORGANIZATION NAME PROGRAM NAME REQUESTED American Red Cross - Hawaii State Chapter Disaster Service $ 15,000.00 The Arc of Hilo Transition and Outreach Program 40,000.00 The Arc of Kona Adult Day Health/Life Skills Program 20,000.00 Arts & Sciences Center Transportation Support 24,000.00 Big Island Substance Abuse Council East Hawaii Substance Abuse Program 30,000.00 Big Island Substance Abuse Council West Hawaii Substance Abuse Program 30,000.00 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua 50,000.00 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo 100,000.00 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau 50,000.00 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View 50,000.00 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala 50,000.00 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa 50,000.00 Brantley Center, Inc. Employment Rehabilitation Program 25,000.00 Bridge House, Inc. Vocational Skills Building Program 24,000.00 Child and Family Service Family Violence Continuum of Care Programs 10,000.00 East Hawai'i Coalition for the Homeless Hale O Puna 24,000.00 East Hawai'i Coalition for the Homeless Kihei Pua Transitional Housing Program 6,000.00 Family Support Services of West Hawai'i Ka'u and North Kohala Family Centers 65,000.00 Friends of the Children's Justice Center of East Hawaii Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs 20,000.00 Friends of the Children's Justice Center of West Hawaii Enhancement and Basic Needs Program 20,000.00 Goodwill Industries of Hawaii, Inc. Work Experience Program 29,500.00 Grassroots Community Development Group Kupukupu After -School Program 60,000.00 Habitat for Humanity Kona General Operating Support/Staffing 50,000.00 Hale Kipa Hawaii Advocate Program 80,000.00 Hawaii Centers for Independent Living Independent Living Services 15,000.00 Hawaii Island Adult Care, Inc. Hilo Adult Day Center 18,000.00 Hawaii Island HIV/AIDS Foundation Multi -Disciplinary HIV Case Management, Hilo 15,000.00 Hawaii Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawaii County 15,000.00 Hawaii Wildlife Center Hawai'i Wildlife Center Development 25,000.00 The Island of Hawaii YMCA Youth Services 55,000.00 Ka Hale O Na Keiki, Inc. Families -At -Risk Project 7,800.00 Kapi olani Medical Center for Women & Children Kapio'lani Child Protection Center - West Hawaii Title IV -B -West Hli Counseling & Supportive Living Project 10,000.00 Keaukaha One Youth Development Youth Development 10,000.00 Kokua Counseling Services Client Assistance Fund 15,000.00 Kona Adult Day Center, Inc. Adult Day Care 30,000.00 Kona Literacy Council Kailua Learning Center 1,500.00 Ku'ikahi Mediation Center Ku'ikahi Mediation Center 12,000.00 Laupahoehoe Train Museum Museum Sustainability & Outreach 45,000.00 Mental Health Kokua Residential Rehabilitation Services 25,000.00 Neighborhood Place of Puna Building Caring Communities 15,000.00 Office for Social Ministry Beyond Shelter 20,000.00 Office for Social Ministry Care -A -Van Homeless Outreach 35,000.00 Office for Social Ministry Hawaii Island Food Bank 40,000.00 Office for Social Ministry Kihei Pua Emergency Shelter 30,000.00 Office for Social Ministry Mobile Care Health Project 25,000.00 Office for Social Ministry Ponahawai Ola: Community Re -integration Services 30,000.00 The Salvation Army - Family Intervention Services Independent Living Skills Program - West Hawai'i 35,000.00 The Salvation Army - Family Intervention Services Youth Service Center Program - Honokaa 35,000.00 The Salvation Army - Family Intervention Services Youth Service Center Program - Pahoa 35,000.00 NONPROFIT GRANT APPLICANTS FOR FY2007-08 ORGANIZATION NAME PROGRAM NAME REQUESTED Special Olympics Hawaii - East Hawaii Special Olympics Hawaii - East Hawaii 15,000.00 Special Olympics Hawaii - West Hawaii Special Olympics West Hawaii - General Funding 12,000.00 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program 30,000.00 Turning Point for Families, Inc. Violence Intervention Outreach Project of North Hawaii, Keaau, Pahoa, and Ka'L 55,000.00 Turning Point for Families, Inc. West HawaYi Domestic Abuse Shelter 25,000.00 West Hawai'i Mediation Center Mediation Services 10,000.00 YWCA of Hawaii Island Empowering Alternatives60,000.00 YWCA of Hawaii Island Hamakua Youth Center 50,000.00 TOTAL $ 1,778,800.00 Note: The following non -qualifying organizations did not meet the application's requirement(s). North Kohala Community Resource Center Kohala Community Athletic Association 5,000.00 - (No financial audit) Puna Hul'Ohana Pahoa Mentoring Project 98,900.00 - (No proof of IRS 501(c)3 status) 808 MX/ATV Association, Inc. 808 MX/ATV Association 76,500.00 - (Not a 501(c)3 tax exempt organization) American Red Cross Hawaii State Chapter Disaster Services - Hawaii County Agency Director: Coralie Chun Matayoshi, Chief Executive Officer Phone No.: (808)739-8103 Contact Person: Youline Kalima, Hawaii County Director Phone No.: (808)935-8305 Mailing Address: Facility/Site Address: American Red Cross Hawaii County 55 Ululani St., Hilo Hawaii 96720 Site One: Hilo 55 Ululani St., Hilo Hawaii 96720 Site Two: Kona 74-5615 Luhia St., Kailua-Kona, HI. 96714 Fax No.: (808) 969-3673 Email Address: kalimay@hawaiiredcross.org Name of Accountant/CPA (include name of firm if applicable): Detor & Williams Phone No.: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040 Honolulu, HI 96813 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 04-05 05-06 06-07 $2,500 $2,500 $5,000 Agency Mission Statement: The mission of the American Red Cross is as follows: 'The American Red Cross, a humanitarian organization led by volunteers and guided by its Congressional Charter and the fundamental principals of the International Red Cross movement, will provide relief to victims of disaster and help people prevent, prepare for, and respond to emergencies." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 American Red Cross Hawaii State Chapter Disaster Services - Hawaii County Program Description: When disasters or emergencies strike, individuals and families often have no one else to turn to. The Red Cross disaster services program is designed to meet the immediate emergency needs of all persons affected by a disaster. The Red Cross defines a disaster as a natural or manmade event that causes human suffering or creates human needs that the victims cannot alleviate without assistance in addressing their basic emergency needs. The American Red Cross provides support for families in both single family and major disaster events. Volunteers meet with families following a disaster to provide immediate emergency aid and essential services. This immediate emergency needs assistance may include food, clothing, shelter and other services to aid the family in rebuilding their lives. In a larger disaster or tragic event, crisis counseling, sheltering, mass feeding, disaster welfare information, emergency first aid and other support services as appropriate would also be provided to victims. These services would be offered to anyone whose loved ones were directly affected by the event. Crisis counseling services may also be extended to the community for secondary victims. The Disaster Services Program is administered by Red Cross disaster staff who utilize trained disaster volunteers to respond to disaster emergencies throughout our state. Both staff and volunteers are also used to disseminate preparedness materials and speak to community groups on the need to be prepared. The American Red Cross is the only organization mandated by Congress to respond to disasters and provide emergency communication to military families, and the only local nonprofit organization that meets the needs of disaster victims any time of the day, 365 days a year. Because we are an island community and considering the time it takes for assistance from other neighbor islands and the mainland, having the response capacity on island immediately after a disaster is essential. The need for effective disaster response, preparedness and training was clearly demonstrated during the heavy rains of 2006 throughout the state of Hawaii. Since 1917, the Hawaii State Chapter of the American Red Cross has provided food, shelter, clothing and crisis counseling to the people of Hawaii, to help victims get back on their feet after a tragedy. People throughout the islands depend on the Red Cross to be prepared for and respond to everyday disasters and major disasters like Hurricane Katrina. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 With the threat of avian flu, bio -terrorist attacks, and major natural disasters, the American Red Cross is more relevant and necessary than ever before. And with global warming and changing weather patterns, it is not "if' but "when" a major disaster in Hawaii will occur. Big Island Disasters: the Big Island has had more than its share of disasters over the years, including devastating tsunami, lava flows, flooding, heavy rains, high surf, earthquakes, brush fires, air crashes, explosions and hazardous material incidents. Whatever the incident, the Red Cross has always been there, ready to help those in need. A very recent example of Red Cross assistance after a disaster occurred after the earthquake that caused major damage to West Hawaii. Emergency assistance was provided to 524 people during this time period and 622 meals were served in the response ■ Over 10,000 homes were surveyed for residential disaster assessment ■ 217 cases were opened for emergency assistance ■ 160 calls were received statewide via a hotline for requests for immediate aid and for family reunification information. ■ 126 individuals were provided crisis counseling services ■ 8 family reunification requests were fulfilled ■ 110 volunteers and staff participated in the disaster relief operation to include 4 volunteers from the mainland ■ Red Cross partnered with Salvation Army and Hawaii Pacific Baptists to serve over 500 meals at the Disaster Recovery Centers. ■ 100 clean-up kits were donated by Wal-Mart. ■ More than $600,000 was donated to the American Red Cross which well exceeded the costs of the disaster relief operation. Two- thirds of this donation was given to the Hawaii Community Foundation to manage for the Voluntary Organization Active in Disaster's Long -Term Recovery Committee, the Kona Community Hospital and The North Kohala Community Resource Center. The Hawaii Red Cross provides compassionate aid to people in Hawaii who fall victim to natural and man-made disasters that occur on the average of twice a week in Hawaii. The vast majority of them live in low to moderate income areas, and since over half of them do not own their homes and have no property insurance, they are truly destitute after a fire destroys their home. Statewide, we respond to an average of 108 disasters statewide, affecting over 3,300 individuals per year. On the Big Island, we provided 209 families with disaster relief in the past 4 years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 A major portion of the disaster victims we serve have incomes below the Poverty Guidelines set by the U.S. Housing & Urban Development, Federal Register, Volumes 66, 67, 68, 69. Based on family income levels and size, our records show that over half of the Big Island disaster victims we serve live below the poverty level. In FY03, 50% were below poverty level; in FY04, 73% were below poverty level; and in FY05, 39% were below poverty level. The majority of our Big Island disaster clients are the poorest of the poor, living in households ranging from 1 to 13 people. In 2003, 41.6% of our client families made less than $7,500; in 2004, 56.2% made less than $7,500 per year. According to the 2004 State of Hawaii Data Book, the bottom 16.7% of the families in Hawaii make less than $25,000. Our records for the past 3 fiscal years show that an average of 74% of our Big Island disaster clients are within that bottom category making less than $25,000 per year. In 2003, 66.6% were in this bottom category; 2004 was 80.2%; and 2005 was 52.8%. In FY06, 59% of disaster victims on the Big Island were below or within the poverty guidelines (3 did not respond). While 46.5% of Hawaii's population is low to moderate income, a study of the zip codes of our Big Island disaster clients shows that up to 75% of them live in low to moderate income areas as defined by the CRA Wiz program utilized by local financial institutions. Most Big Island disaster victims rent (not own) their apartment or home, and have no property insurance. During times of disaster, the Hawaii Red Cross has been assigned the responsibility of managing shelters by County and State Government. The Big Island has 27 hurricane approved shelters (in public schools or state office buildings) and 8 other shelters in community centers. Total Budget and Position Count Total Program Budget 93,406 Total Program Position Count 1.5 Total Agency Budget 263,141 Total Agency Position Count 10 The $15,000 sought from the County of Hawaii would provide for direct assistance to those affected on the Big Island by disasters for their immediate emergency needs. As of January, 2007, we have already spent over $10,000 in direct assistance to Big Island disaster victims for this fiscal year 2007. All disaster response and training are provided to the public free of charge. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Program Objectives: Overall Goal: To provide 24/7 emergency disaster response and relief to those in need on the Big Island after a disaster (man-made or natural). Objectives: 1. Provide for the immediate emergency needs of Big Island disaster victims (food, clothing, shelter, crisis counseling) 2. Support first responders like firefighters, police, civil defense, and others with food, water, and counseling during brush fires and other challenging incidents that threaten lives and property 3. Increase awareness of disaster preparedness to Big Island residents 4. Train Big Island volunteers in Red Cross disaster skills such as disaster assessment, casework, health services, crisis counseling, shelter management and mass care to increase our capacity to respond to disasters on the Big Island. Program Highlights: From July 1, 2005 through June 30, 2006, the American Red Cross Hawaii County achieved the following: • Responded to 19 disasters on Big Island enabling 43 individuals to recover from their losses and begin rebuilding their lives. Financial assistance in the amount of $18,306 was provided to these families. • Responded and opened 5 shelters due to brushfires. Fortunately, all these shelters were able to close after a few hours and people were able to return to their homes. • Provided training for 60 new disaster volunteers • Distributed 1,110 general disaster preparedness material and brochures, to inform and educate the community on how to be ready and prepared before a disaster strikes • Provided 1,868 Hilo individuals first aid and CPR training, 1,023 individuals with aquatics training and 48 individuals with other health and safety trainings. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 American Red Cross Hawaii State Chapter Disaster Services — Hawaii County Disaster Services - Performance Measures: Disaster Program Expenditures NOTE: Amounts significantly different from FY06 because the Chapter reorganized to better track program expenses. It is important to note that expenses shown for FY07 and FY08 do NOT include significant administrative, technical and programmatic support provided by Headquarters staff on Oahu. FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Disaster Responses 19 25 30 Disaster Assistance Cases 43 114 25 Mass Shelters Opened 5 5 5 # Reached through Presentations in Communities 1,110 900 1400 Trained Individuals in Dis Response 60 40 50 Disaster Drills Conducted 0 2 4 Disaster Program Expenditures NOTE: Amounts significantly different from FY06 because the Chapter reorganized to better track program expenses. It is important to note that expenses shown for FY07 and FY08 do NOT include significant administrative, technical and programmatic support provided by Headquarters staff on Oahu. * $112,046 budgeted for entire state for disaster relief assistance as unknown where disasters will occur. As disasters occur on the Big Island, expenses will increase accordingly. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 FY 2005-06 Actual * FY 2006-07 Budget split FY 2007-08 Estimate Salaries and Wages 92901 48,113 49,556 Operations 32943 21,206 21,842 Equipment 3,527 1,966 2,025 Supplies 9,151 5,960 6,128 Communications 6,430 3,429 3,532 Disaster Relief Assistance * 16,079 0 0 Travel 3,289 10,475 10,789 Other(promo matls, subscriptions, osta e, mist 1,853 2,257 2,163 Total 166,1731 93,406 96,035 * $112,046 budgeted for entire state for disaster relief assistance as unknown where disasters will occur. As disasters occur on the Big Island, expenses will increase accordingly. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 American Red Cross Hawaii State Chapter Disaster Services — Hawaii County Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual' FY2006-07 Budget* FY 2007-08 I Estimate Hawaii County 2,500 5,0001 15,000 Hawaii Island United Way 24,000 24,000 24,000 Contributions Direct Mail & Grants 22,643 25,000 27,000 Hats Off 2,286 3,500 4,000 -Fundraising SUBTOTAL 51,429 57,500 70,000 Amount Hawaii Chapter must subsidize both Hilo & Kona offices to meet expenses for Disaster Services program 114,744 35,739 26,035 Total equal to expenses 166,1731 93,239 96,035 "If applicable NOTE: 1. HIUW. Total given is $48,000 but half for Disaster Services and half for Community Education (health and safety training) 2. Contributions and fundraising amounts subsidize both Disaster Services and our Health and Safety Services Program. Actual Contributions: $45,287 (1/2 to both programs), In addition, amounts do not reflect any administrative or mailing expenses incurred by Financial Development at Headquarters in Honolulu Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The American Red Cross is not a government agency and does not receive any ongoing funding for operations. We rely on the generosity and aloha of our donors: individuals, corporations and foundations to help those in need. We continue to solicit grant requests and other private funding to support this program. Because we cannot anticipate the number of disasters that will occur in Hawaii County or the amount of expenses in relation, we must persist in fundraising to support our disaster response program. To do this, we work on increasing our visibility in the community to increase private individual and corporate donations from Big Island residents and businesses. We continue to look at possible fundraising opportunities on the Big Island such as special events, along with major donor cultivation. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 American Red Cross Hawaii State Chapter Disaster Services — Hawaii County I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. Tertia Freas, Chapter Chair Signature of Board President/Chair 6�� Coralie Chun Matayoshi Signature of Chief Executive Officer 07 Date Date i/a(t/o7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 The Arc of Hilo- Agency Name Transition and Outreach Program- Program Name Agency Director: Mike Gleason Phone No.: 935-8535 x 201 Contact Person: Glen Calvert Phone No.: 935-8535 x 211 Mailing Address: 1099 Waianuenue Ave., Hilo, Hawai'i 96720 Facility/Site Address: Same as above Fax No.: 961-0148 Email Address: mgleason@hiloarc.org Name of Accountant/CPA (include name of firm if applicable): Ann Fukuhara, CPA, MBA, An Accountancy Corporation Phone No.: 961-5532 Mailing Address: 714 Kanoelehua Ave, P.O. Box 6691, Hilo, HI 96720 Amount of Request for County Funds: $40,000 Prior Year(s) Funding: 04-05 05-06 06-07 $29,000 $29,000 $0 Agency Mission Statement: To improve the quality of life for people with developmental disabilities who reside on Hawai'i through Education, Vocational Rehabilitation, Job Training, Job Placement, Life Skills Training and Recreational Programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page I The Arc of Hilo - Agency Name Transition and Outreach Program- Program Name Program Description: The Transition and Outreach Program is designed to assist existing, new and potential clients and their familes to access the social services they need in the State. This is a new program being developed at The Arc of Hilo, which we will become a real asset to the community. Some of these services include but are not limited to: counseling and mediation, circle building, relationship building, communication, community activities, transportation, life skills, HIPAA training for Arc employees and volunteers, Community representation for The Arc of Hilo, and Disability Resource Information. Total Budget and Position Count Total Program Budget $44,200 Total Program Position Count 1 Total Agency Budget $6.2M Total Agency Position Count 149 Program Objectives: 1) Advocate for existing clients and persons in transition in the community to find the services they need, such as job hunting and training, transportation, housing, and medical care. 2) Develop new activities at The Arc of Hilo through research, such as evening social activities, social clubs, and craft workshops. 3) Support The Arc of Hilo programs to develop more comprehensive services offered to Clients. 4) Provide HIPAA training for staff and volunteers at The Arc of Hilo 5) Provide education and resource to students about to enter transition while still in high school regarding vocational training program for Special Needs Students. Program Highlights: 1) This program proposes to assist hundreds of people in transition or in need of information guidance in our community to obtain the services they need. 2) This program proposes to further develop The Arc's ability to serve the community as a information broker for disabled individuals and their caregivers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 The Arc of Hilo - Agency Name Transition and Outreach Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual*_ FY 2006-07 Budget* FY 2007-08 Estimate Mediation and counselling 75 75 Circle Building 24 25 Relationship Building 24 25 Communication 24 25 Community Activities 24 25 Transportation 72 25 Life Skills 24 25 HIPAA 20 21 Community Representative for Are 24 25 Outreach Information Sources 260 268 *If applicable Program Expenditures * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $37,500 $38,625 Professional Fees 200 206 Operations 4,000 4,120 2,500 2,575. -Equipment Other* Total. $44,200 $45,526 * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 The Arc of Hilo - Agency Name Transition and Outreach Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 FY 2006-07 Actual * Budget * FY 2007-08 Estimate The Arc of Hilo - Training Programs $1,800 $2,154 Admission Fees 2,400 2,472 Total $4,200 $4,626 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? As commercial services increase, funding to this program can increase. Also, as participation increases, admission fees should also defray costs. We would hope that in 3 years this program would provide at least 25% of its own funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 The Arc of Hilo - Agency Name Transition and Outreach Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end requests. Signature of Boar resident/Chair Signdture of Executive Director 1-3t-0-7 Date Z ate UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Arc of Kona ADULT DAY HEALTH LIFE SKILLS PROGRAM Agency Director: Contact Person Mailing Address Facility/Site Address Fax No.: Email Address: Gretchen Lawson Phone No.: 808-323-2626 Jeani Navarro Phone No.: 808-323-2626 PO Box 127 Kealakekua, HI 95640 81-1065 Konawaena School Road Kealakekua, HI 95640 808-323-9444 jeani@arcofkona.org Name of Accountant/CPA: Ann N. Fukuhara, CPA MBA An Accountancy Corporation Phone No.: 808-961-5532 Fax: 808-934-8589 Mailing Address: PO Box 6691 Hilo, HI 96720 Amount of Request for County Funds: $20,000.00 Prior Year(s) Funding: 04-05 05-06 06-07 $17,000 $20,000 $18,000 Agency Mission Statement: The Arc of Kona is a private non-profit organization for person with disabilities, their advocates, and families. We believe that people with disabilities are as individual in their needs, abilities and gifts as any other cross section of society. NONPROFIT GRANT APPLICATION 1 FISCAL YEAR 2007-08 Arc of Kona ADULT DAY HEALTH/LIFE SKILLS PROGRAM Program Description: The Arc of Kona operates an Adult Day Health (ADH) standard classroom program that serves 17 participants on a daily basis. Our population is a mix of Native Hawaiian, Asian/Pacific Islander, and Caucasian adults ranging from 21 to 59 years of age with a core group of young adults in their mid 20's. All of the participants in the ADH program have been identified as DD/MR by the State of Hawaii and have cognitive limitations that prevent them from living as independently as individually possible without extensive life skills training and other needed supports. These individuals do not make good judgments and therefore need the types of supports that insure their safety and help with activities of daily living. They require assistance gaining access to community services and activities that will allow them to begin integration into the community where they reside. This population has several risk and protective factors that we consider when designing Life Skills training for them. First, this population is at risk of abuse, both sexual and physical, and need to be taught the skills for saying "NO" and for reporting abuse. They are also at risk for chronic disease and many have a high incidence of diabetes and heart problems related to weight and diet. And lastly they are at risk for being homeless and/or unprepared to prove they can live independently both with daily living skills and finances to prevent homelessness. Protective factors we consider include training in social development, appropriate sexual behaviors, protection from abuse including family members as well as strangers and preparing individuals to find their own housing accommodations and live as independently as possible, with or without other agency supports. With adequate transportation supports 'the community as a classroom' where they can practice these skill sets becomes essential to strengthening the protective factors around this vulnerable population. In turn, our participants have skills that can be shared and will benefit the larger community when provided with community access services for their Life Skills component. It is unfortunate, but the funds received via the Department of Health per participant per day barely covers staff salaries and leaves the Arc of Kona with a $34,000.00 deficit at the end of the fiscal year. Specifically, the $20,000.00 requested would be spent to enhance service delivery by paying costs associated with life skills training to and from home and classroom, and into the community. The dollars would pay for some of the staffing, payroll taxes attached to the salary, and supplies for the Life Skills classes. NONPROFIT GRANT APPLICATION 2 FISCAL YEAR 2007-08 Arc of Kona ADULT DAY HEALTH /LIFE SKILLS PROGRAM Total Budget and Position Count Total Program Budget $258,929 Total Program Position Count 6 Total Agency Budget $3,195,244 Total Agency Position Count 112 Program Objectives: 1) Provide a safe, healthy, and supportive environment for daily living skills in the ADH classroom setting 6 hours per day 268 days per year from July 1, 2007 to June 30, 2008. 2) Provide individualized life skills training programs that allow each participant to develop at his or her own pace in order to live as independently as possible. 3) Insure access to community events and resources that will be a learning laboratory for independent living and reinforce skills taught in the classroom setting at a minimum of three times a week throughout the program year (7/07- 6/08). 4) Provide needed classroom materials to assess, instruct and support life skills, specific health and safety areas relating to abuse, appropriate sexual behavior, hygiene, money management and household safety issues. 5) Provide needed supports for interacting with each other and the public appropriately within the community daily throughout the program year so as to support independent living skills required to function on a day to day basis. Program Highlights: (Adult Day Health Classroom) 1) 15 participants received daily lessons on health and safety as they pertain to daily living and toward independent living (including information on hygiene, appropriate sexual behavior, yoga for stretching and balance, fire safety, and classes on nutrition and weight maintenance). Training positively resulted in a reduced number of behavior outbursts and incident reports. 2) 15 participants have been able to access the community (as required by law) for practicum in independent living skills in real life community settings. This resulted positively in 100% of the participants meeting two or more of their individual objectives toward their personal goals, and 85% of participants actually attaining one of their personalized goals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 3) 15 participants were able to participate in yoga classes, walking and stretching training that has resulted in better balance, and body awareness and therefore more self esteem. 4) 15 participants received training in the nutritional value of foods and were trained to assist in the preparation of healthier lunches and snacks. This has positively resulted in 20% of the participants losing extra pounds and maintaining their goal weight. The remaining 80% maintained their goal weights this year and can make healthy food choices unsupervised. 5) 15 participants and staff were trained by the Kealakekua Fire Department in fire prevention/ fire safety and when and how to use a fire extinguisher for maximum benefit. Performance Measures: Adult Day Health Life Skills FY 2005-06 FY 2006- FY 2007-08 Actual * 07 Budget Estimate * 1. Provide a safe, secure classroom 260 days of ADH 260 days 260 days environment with sufficient staff standard 5 days per 5 days per supervision, 5 days a week, 52 weeks classroom week for 52 week for 52 a year, for 15-17 DD/MR participants. activities with a weeks weeks one staff to four participant ratio. 2. Provide access to the community for 144 transports 144 144 hands-on life skills training experiences into the transports transports including food and clothing shopping, community for provided fire safety, ordering and eating in activities that public, handling money, making promote individual life appointments, nutrition and exercise, skills goals. and appropriate behaviors in public (including sexual behavior). 3. Provide on-going Life Skills 260 days of 260 days of 260 days of assessments and data collection for classroom instruction instruction each individual. This includes areas instruction for Life completed such as recognizing and reporting Skills and daily abuse, health and hygiene, safety, living activities with pre and post socialization and basic cooking skills. testing for assessment of base line skills, data collection and quarterly and year end reporting on achieved results. If applicable NONPROFIT GRANT APPLICATION 4 FISCAL YEAR 2007-08 Program Expenditures * If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 147,580 202,048 208,535 Professional Fees 36,933 40,867 40,867 Operations 49,814 56,881 67,290 Equipment 5000 Other" 197,394 258,929 275,825 Total 197,394 258,929 275,825 * If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County of Hawaii 20,000 18,000 20,000 Hawaii Island United Way 36,933 40,867 40,867 State Medicaid Waiver 140,461 200,062 209,958 Fund Raisin /Donations 5000 Total 197,394 258,929 275,825 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Arc of Kona is celebrating its 40th anniversary this year. We have been working diligently to find new and creative ways to raise unrestricted funds to support our numerous programs. Each year, the week before Thanksgiving, we hold a bazaar and craft sale that is our signature event. In August of this year we held an invitation only musical concert in conjunction with Hawaii Performing Arts, with plans to repeat the event again this year. We also have two upcoming Blue Grass benefit concerts with Grammy award winning artists Laurie Lewis and Tom Rozum scheduled for Kona and Honokaa in February of 2007. Keeping in line with our Marketing Plan, we have developed a relationship with Kupa'a Business Planners which will help the Arc identify and outreach potential donors and assist with fund raisers. We do not anticipate that the ADH program will be self sustaining for another two years. However, the Arc of Kona is working diligently to perfect the art of fund raising and offering events all through the year which will also educate the public about the needs of our population and generate a stronger donors list. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Arc Of Kona ADULT DAY HEALTH/LIFE SKILLS PROGRAM I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, 1 (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. Signature of Board P.eat/Chair �igrihture of �o ..CEO I- a -3 �- Date Date f --z-3 -07- UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Arts & Sciences Center - Agency Name Transportation Support- Program Name Agency Director. Contact Person: Mailing Address: Gail Clarke - pres. Phone No.: 808-938-2933 Facility/Site Address: Fax No.: Email Address: same Phone No.: 965-3730 PO Box 2091 Pahoa, H196778 Homestead Rd. Pahoa - ma'kai off the by-pass 808 965 3733 (HAAS PCS office) asc@aloha.net Name of Accountant/CPA (include name of firm if applicable): John Carbonaro, CPA Phone No.: 808 242 5002 Mailing Address: 1885 Main Street, Wailuku, HI 96793 Amount of Request for County Funds: $24,000 Prior Year(s) Funding: 04-05 05-06 06-07 $0 $0 $0 Agency Mission Statement: To provide support and infrastructure for community based learning. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Arts & Sciences Center - Agency Name Transportation Support- Program Name Program Description: ASC strives to support a community of learners closely associated with the Hawaii Academy of Arts & Science (HAAS) Public Charter School, including k-12 students, their ohana, faculty, staff and interested community members. ASC is developing a campus on 3.7 acres off of the Pahoa by-pass and wants to expand its support of the teaming community by providing funds to support transportation, in the form of funds for fuel and maintenance, to and from the site and out into the community for teaming and service opportunities. Total Budget and Position Count Total Program Budget 1 25200 1 Total Program Position Count .125 Total Agency Budget 1 60000 1 Total Agency Position Count .25 Program Objectives: 1) To provide fuel and maintenace fees (approximately $2000 x 12 months) for HAAS' fleet of 4 vans and 3 small buses to transport students, in our huge district of Puna, to and from campus and off-site teaming and serving opportunities. ASG believes that increasing student opportunities to be active learners and participants in their communities in tum reduces the opportunities to make bad choices (addictive and/or destructive) and transportation is often revealed as the strongest limiting factor in extra- curricular activities and even regular attendance at school. ASC has the unique opportunity to provide support funding to keep the charter school's fleet rolling and serving. Program Highlights: 1) In striving to support community based learning, ASC provides classrooms and administrative space to house a public charter school and extra- curricular activities. Because facilites are limited, transportation is required to allow opportunities in performing arts, physical education, athletics and highly valued community service opportunities. ASC partnered with HAAS in supporting the February 2007 production of Les Miserables at the Palace Theater in Hilo, in which over 60 students from eight (8) East NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Hawaii schools participated. HAAS also provides regular transport for swimming instruction, surfing class, canoe paddling in Hilo, semi-annual school -wide community service weeks (Lifecare visits, Rainbow Sanctuary, Kukui nut picking, Pahoa town & coastal opala pick-ups, pre- school support visits, campus beautification and development, etc.), BIIF volleyball, soccer, wrestling (all partnering with Pahoa High School students), and 4H clubs. ASC's mission, to provide support, includes securing resources to ease the burden of transportation costs. The vans and buses are leased or owned, insured and operated by HAAS (the State) and ASC would contribute funds for fuel and maintenance. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Arts & Sciences Center - Agency Name Transportation Support - Program Name Performance Measures: FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget* Estimate Fuel & Maintenance costs for fleet 0 24000 Program Admin & Accounting 0 0 1200 *If applicable Program Expenditures If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Bud et * FY 2007-08 Estimate Salaries and Wa es 0 0 0 Professional Fees 0 0 1200 O erations 0 0 24000 Equipment Other" Total 01 01 25200 If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Arts & Sciences Center - Agency Name Transportation Support - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County of Hawaii 0 0 24000 Contributions 0 0 1200 Total 0 0 25200 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? HAAS currently pays all student transportation expenses from per pupil allocations received from the state of Hawaii; payroll for faculty and staff, program fees, facilities costs and all student activities are also paid from the same allocation. To the extent ASC is funded, equivalent monies from HAAS would then be available for expanded opportunities for students to become educated, actively contributing members of our community. Exposing students to the wider community in which they live increases their knowing, appreciation and stewardship. Although the state is generally tasked with support of public education, to reach beyond academic standards, non -profits often step up to increase opportunities for students within their communities, a role ASC hopes to play in East Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 200748 Page 5 Arts & Sciences Center - Agency Name Transportation Support - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an haaya'j- Signature of Board President/Chair �F�- C.4 Signature r SulreVr�+:{ . f-3�-o7 Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address Dr. Stephen C. Zuniga Richard Teanio Phone No.: 969-9994 Phone No.: 935-4927 234 Waianuenue Avenue Suite 101, Hilo, HI 96720 297 Waianuenue Avenue Hilo, HI 96720 969-7570 LikekeT@bisac.com Name of Accountant/CPA (include name of firm if applicable): John Carbonaro, Carbonaro CPA's & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $30,000 Prior Year(s) Funding: 04-05 05-06 06-07 $27,000 $30,000 $30,000 Agency Mission Statement: The Big Island Substance Abuse Council strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to the healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Bia Island Substance Abuse Council East Hawaii Substance Abuse Program Program Description: The Big Island Substance Abuse Council's East Hawaii programs provide comprehensive substance abuse treatment services to adults and adolescents through research -based methods and best -practices designed for the area's target population. This population is primarily families to include, adolescents, parents and whole families who are experiencing substance abuse or dependency and require the structure of an institution such as BISAC to begin the process of recovery. BISAC recognizes the significant impact of crystal methamphetamine on this population and has designed programs to intervene in the addictive process and build on an individual's or family's strengths to abstain from the use of drugs and alcohol and increase protective factors and relapse prevention skills to maintain their rehabilitation. The East Hawaii BISAC programs provide outpatient treatment and therapeutic living services to adults and outpatient services (in both outpatient setting and in nineteen (19) school based programs island wide) to adolescents, giving special emphasis to pregnant women, HIV users, and those with co-occurring disorders. Several of the East Hawaii therapeutic living programs are designed to meet specific needs of the target population and include home -like settings for a variety of specialties including; mothers with children ages birth -12 years, fathers with children ages birth - 12 years, women who are transitioning out of the Department of Corrections, single women, and single men. BISAC has also placed a strong emphasis on providing services to persons abusing or addicted to the drug Crystal Methamphetamine or, "Ice". The ice epidemic in East Hawaii is truly evident and requires immediate access to treatment services when the opportunity arises. BISAC is requesting funds to subsidize Outpatient Treatment services to Adolescents and Adults as well subsidizing the necessary infrastructure which supports implementation of an Electronic Health Record which will improve the overall quality and accessibility of services for any client who presents themselves at BISAC and requires immediate and intensive care necessary to recover from addiction. As services continue to grow, it is essential to implement a state of the art Electronic Health Record which is responsive to the service needs of covering a large geographic area, reduces duplication of service efforts, and effectively coordinate services across the many island agencies serving our community. BISAC's mission "strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction." Two goals relating to our mission state that BISAC achieves this through, "...a range of coordinate[d], comprehensive treatment services..." and "individualized treatment modalities..." The planning and integration of an Electronic Health Record, "Guidelines for Executive Management" is based on best practices by a NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 joint task force who published this comprehensive behavioral health and human services automation study in 2006. The task force consisted of Mental Health Corporations of America (MHCA) which is an alliance of select behavioral health organization designed to strengthen members' competitive position, enhance their leadership capabilities and facilitate their strategic networking opportunities. The other task force group, Software and Technology Vendors' Association (SATVA), is a non-profit trade association representing the software companies who serve the behavioral health and human services community. The Task Force's previous work was presented at several national conferences and is uniquely constituted by leaders of treatment provider organizations who implemented and use electronic health record systems (EHRs), and leaders of software companies that supply EHRs and help support their implementation. Information technology (IT) is now considered an essential component of an effective business model to support and improve the delivery of healthcare. Seven key principles facilitate the selection, purchase, implementation and use of an Electronic Health Record. The seventh general principle, "Clinical value is at the heart of the project" supports BISAC's mission to not only enhance but identify BISAC as a leader with respect to the direction of substance abuse services within our state. The impact on financial and human resources is significant and profoundly affects the existing corporate culture according to the paper's authors. "The impact will be extensive, affecting business processes, work responsibilities, time management, methods of reporting, and record keeping. The benefits of centralized electronic data storage will greatly enhance the work of your staff and their ability to fulfill your organization's mission." Information technology increases efficiency in the clinical and billing areas, improves clinical practice, improves patient safety by suggesting courses of action tied to the data entered into clients' files, may be used to track trends, outcomes, can serve to further develop clinical pathways and best practice protocols for BISAC by linking a client's assessment to recommended services or service programs. In evaluating our readiness, BISAC followed a self-assessment matrix published by CSAT (Center for Substance Abuse Treatment) used to evaluate four specific capacities that factor into the development and implementation of a performance management process: Cultural Capacity, Analysis and Management Capacity, Provider Capacity and Data Systems Capacity. Total Budget and Position Count Total Program Budget 3,067,083 Total Program Position Count 59 Total Agency Budget 4,556,605 Total Agency Position Count 84 Program Objectives: 1) Provide immediate access to assessment and treatment services to any individuals who are assessed and diagnosed with any substance related disorders. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 2) Increase the availability of extended outpatient and therapeutic living program treatment services to addicted adults and adolescents who may have no other funding availability for treatment services. 3) Develop a professional IT management structure with the technical skills and facilities necessary to enhance the IT quality, efficiency and management needs of BISAC's programs and services. 4) Document design requirements and IT Project plan to automate/integrate clinical and administrative functions. 5) Select top Behavioral Health Electronic Health Record vendor and negotiate IT Project conversion and maintenance agreement. 6) Identify social support networks and community linkages which support continuity of treatment at time of discharge. 7) Assess current administrative and clinical process functions which support quality service delivery. 8) Implement IT infrastructure which supports adult and adolescent treatment services and best practices throughout the continuum. Program Highlights: • Was able to admit approximately 628 adults into all levels of outpatient substance abuse treatment and Therapeutic Living services. Follow-up data collected on adult consumers who responded to the 6 month post-treatment survey disclosed the following: • Five hundred seventy nine (579) clients (90%) completed treatment program objectives. • Two hundred fifty seven (257) clients (41 %) reduced criminal behavior as evidence by no new arrest at six (6) months post treatment • Two hundred (200) clients (54%) achieved long term abstinence from all drugs and/or alcohol use at six (6) months post discharge from treatment. • Two hundred forty three (243) clients (39%) who were discharged from the Therapeutic Living Programs and/or Outpatient Services reported maintaining clean and sober housing at six (6) months post discharge from treatment. • One hundred sixty seven (167) clients (27%) were either employed, enrolled in school/vocational training or volunteering at the time of discharge and at six (6) months post discharge. • Two hundred seventy four (274) clients (44%) reduced medical services as demonstrated by no emergency room visits or hospital admissions during the first six (6) months post discharge. Proaram Hisrhliahts (Information Technoloav) (1) An IT Baseline Analysis was performed and BISAC's Controller prepared a report detailing the principle hardware, software, local area network, and internet communications comprising BISAC's IT Infrastructure. BISAC management gained tremendous insight into the benefits to BISAC of creating a dedicated resource to maintain, administer, and oversee BISAC's NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 IT infrastructure. The IT Baseline Analysis formed the basis of the Project Manager Consultant's analysis of BISAC's IT and Operational Risks and Mitigation Planning, Business and Technical Requirements Documentation, Financial Requirements (forecast for BISAC's current and anticipated IT environments), BISAC's Vendor Evaluation Criteria, and the RFI/Vendor Survey. Also under the guidance of the Project Manager Consultant, and with the participation of BISAC Human Resources, an IT Manager/Systems Administrator Position was created and approved. The July, 2006 recruitment advertisement generated 36 highly qualified applicants for BISAC's IT Manager/Systems Administrator position, which the IT Project Manager Consultant reviewed and performed screening interviews. Onsite analysis by the IT Manager Consultant of the staff usage of computer resources already deployed throughout BISAC's clinical program and administrative offices revealed an opportunity to improve BISAC's payback from the existing IT infrastructure, by making an investment in staff IT skills training. As a result of this finding, an IT Training Center is in the planning stages with the objective to provide the structured training that will help BISAC achieve a valued upgrade in the staffs IT skills. The IT Training Center work will also serve to support reasonably anticipated needs for training that should be completed by June 2007, such as the State of Hawaii/ADAD WITS project implementation, etc. BISAC's training center will serve as a "Center of Excellence" for proposed WITS training to all Hawaii Island Substance Abuse Providers. (2) Key Behavioral Health Electronic Health Record Systems (BHEHR) were identified and vendor contacts were established to support BISAC's objectives to evaluate the costs and benefits of the vendors' systems features and functions. (3) A Request for Information/Vendor Survey (RFI) was developed and promoted to solicit up-to-date information on the BHEHR vendors' systems features and functions. (4) Business and Technical Requirements were developed and summarized to provide the BHEHR vendors guidance and perspective on BISAC's automation objectives. (5) A High-level IT Project (BHEHR) Financial Requirements Forecast was developed to provide BISAC the financial framework needed to evaluate, compare, and qualify the costs and benefits of automation options in relation to BISAC's clinical and administrative automation objectives. (6) Vendor Evaluation Criteria were developed to provide a consistent business framework required to evaluate BHEHR vendor system offering presented to BISAC. (7) Professional communications were disseminated to key BHEHR system vendors; 7 vendors provided qualifying responses to BISAC's RFI/Vendor Survey. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 (8) Individual vendor system presentations were organized to commence BISAC's vendor evaluation and decision-making process. This process is customized for BISAC's purposes to facilitate selection of BHEHR vendors desired to submit formal business automation proposals during BISAC's IT Project, Phase 2. (9) A preliminary schedule was developed to organize BISAC's resources necessary for the planning and successful completion of BISAC's IT Project, Phase 2. (10) BISAC's IT Baseline, risk analysis, and preliminary BHEHR vendor RFI responses were analyzed and the Project Manager Consultant prepared a proposal to commence BISAC's IT Project, Phase 2. (11) BISAC management and staff participants were identified for BISAC's IT Project, Phase 2, as follows: Dr. Stephen C. Zuniga, Chair; Diana Nelson, Controller and Billing Function Manager; Program Directors Leonard Feliciano, Richard Likeke Teanio, Marilyn McIntosh, and Robert Rohret, Quality Assurance Director Dr. Brian Uldall, and soon to join BISAC IT Manager/Systems Administrator Gary Schwiter. The initial work of BISAC's IT Taskforce will involve review of the vendors RFI responses and participation in the upcoming BHEHR vendor presentations. There were thirty behavioral health client references included by the vendors for BISAC's IT Taskforce to learn how other behavioral health firms are utilizing automation to help improve the quality and efficiency of their clinical programs. The presentations offer BISAC's IT Taskforce an opportunity to meet the vendors, view demonstrations of the vendors' automation capabilities, pose questions about the vendors' RFI responses, and learn how the vendors' clients are utilizing automation that successfully supports many behavioral health programs throughout the U.S. (12) State of Hawaii/ADAD's WITS Project Provider participation requirements were met with the participation of the IT Project Manager Consultant. Quality Assurance Director Dr. Brian Uldall was selected to provide oversight, coordination and to fulfill BISAC's WITS training responsibilities when the system is implemented sometime during Q1or Q2 2007. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Performance Measures: FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Substance Abuse Treatment Units 30,947 31,875 32,566 1,970,635 2,013,989 Professional Fees 61,622 64,058 65,340 Operations 923,699 941,639 960,472 IT Infrastructure 14,509 60,650 62,469 Vehicle 1 21,9121 22,569 *If applicable Program Expenditures " If applicable Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 1,841,803 1,970,635 2,013,989 Professional Fees 61,622 64,058 65,340 Operations 923,699 941,639 960,472 IT Infrastructure 14,509 60,650 62,469 Vehicle 1 21,9121 22,569 Total 1 2,841,6331 3,058,8941 3,124,839 " If applicable Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 FY 2007-08 Budget* Estimate 30,000 30,000 30,000 -County State of Hawaii 1,612,511 1,775,053 1,811,056 Federal 758,523 830,320 830,320 HIUW 25,968 17,500 17,500 Training Fees 7,225 12,0001 12,000 Donations/Fundraising 3,287 4,500 4,635 Private Insurance 342,287 281,420 289,863 Client Fees 153,486 116,290 119,779 Total 2,933,287 3,067,083 3,115,153 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Big Island Substance Abuse Council continues efforts to diversify funding sources and expand services where appropriate throughout the State and Island of Hawaii. BISAC's adolescent treatment services grew by 3% last year and billing to 3rd party payors increased by 1 % to account for 11 % of BISAC's budget. Administrative fees increased by 2% and account for 8% of the revenue reported from July 1, 2004 through June 30, 2005. A conservative fiscal philosophy coupled with a team of skilled and dedicated staff members has enabled BISAC to expand and retain a positive, prominent presence in the community. BISAC's sound fiscal policies are incorporated into decisions related to program expansion or to enter market niches that would expand the behavioral health continuum. Business decisions include enrolling consumers in a Quest plan when eligible and appropriately utilizing benefits to cover treatment services. Administrative staff is scheduled to participate in meetings with HMSA and other substance abuse treatment providers to evaluate ways on increasing community awareness of insurance benefits and working with physicians to appropriately identify and refer consumers who may need treatment services that would be covered by HMSA insurance. The BISAC Board understands the commitment and priority of this project. The CEO is working to obtain commitments for this project and the Board has anticipated the project costs in the approved budget. The $30,000 requested for East Hawaii under this proposal will go towards the supporting this proposal's requests. BISAC plans include exploring available funding that supports capacity building and sustainability efforts, and reduces our reliance on State and County funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Bia Island Substance Abuse Council East Hawaii Substance Abuse Program I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. x«16 1-e4Wt'Z'21 ignature of and President/Chair Patricia Engelhard Signatu a of Exec irettor Dr. Stephen C. Zuniga ,3oJ Date aoo7 ate UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Agency Director: Contact Person Mailing Address: Facility/Site Address Fax No.: Email Address: Dr. Stephen C. Zuniga Marilyn McIntosh Phone No.: 969-9994 Phone No.: 322-3100 234 Waianuenue Avenue Ste 101, Hilo, HI 96720 81-947 Halekii Street, Kealakekua, Hawaii 96750 969-7570 Marilynm@bisac.com Name of Accountant/CPA (include name of firm if applicable): John Carbonaro, Carbonaro CPA's & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $30,000 PriorYear(s) Funding: 04-05 05-06 06-07 $27,000 $30,000 $30,000 Agency Mission Statement: The Big Island Substance Abuse Council strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to the healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Program Description: The Big Island Substance Abuse Council's West Hawaii programs provide comprehensive substance abuse treatment services to adults and adolescents through research -based methods and best -practices designed for the area's target population. This population is primarily youth and young adults who are experiencing substance abuse or dependency and require the structure of an institution such as BISAC to begin the process of recovery. BISAC recognizes the significant impact of crystal methamphetamine on this population and has designed programs to intervene in the addictive process and build on an individual's strengths to abstain from the use of drugs and alcohol and increase protective factors and relapse prevention skills to maintain their rehabilitation. The West Hawaii BISAC programs provide outpatient treatment and therapeutic living services to adults and outpatient services (in both outpatient setting and in nineteen (19) school based programs island wide) to adolescents, giving special emphasis to pregnant women, HIV users, and those with co-occurring disorders. For 2007, BISAC has committed funds to establish a therapeutic living program for males in Kona. BISAC has also placed a strong emphasis on providing services to persons abusing or addicted to the drug Crystal Methamphetamine or, "Ice". The ice epidemic in West Hawaii is truly evident and requires immediate access to treatment services when the opportunity arises. Currently, the East Hawaii therapeutic living programs are designed to meet specific needs of the target population and include home -like settings for a variety of specialties including; mothers with children ages birth -12 years, fathers with children ages birth - 12 years, women who are transitioning out of the Department of Corrections, single women, and single men. Establishing a therapeutic living program in West Hawaii allows clients to transition to communities where they have chosen to live and work. BISAC is requesting funds to subsidize Outpatient Treatment services to Adolescents and Adults as well subsidizing the necessary infrastructure which supports implementation of an Electronic Health Record which will improve the overall quality and accessibility of services for any client who presents themselves at BISAC and requires immediate and intensive care necessary to recover from addiction. As services continue to grow, it is essential to implement a state of the art Electronic Health Record which is responsive to the service needs of covering a large geographic area, reduces duplication of service efforts, and effectively coordinate services across the many island agencies serving our community. BISAC's mission "strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction." NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Two goals relating to our mission state that BISAC achieves this through, "...a range of coordinate[d], comprehensive treatment services..." and "individualized treatment modalities..." The planning and integration of an Electronic Health Record, "Guidelines for Executive Management" is based on best practices by a joint task force who published this comprehensive behavioral health and human services automation study in 2006. The task force consisted of Mental Health Corporations of America (MHCA) which is an alliance of select behavioral health organization designed to strengthen members' competitive position, enhance their leadership capabilities and facilitate their strategic networking opportunities. The other task force group, Software and Technology Vendors' Association (SATVA), is a non-profit trade association representing the software companies who serve the behavioral health and human services community. The Task Force's previous work was presented at several national conferences and is uniquely constituted by leaders of treatment provider organizations who implemented and use electronic health record systems (EHRs), and leaders of software companies that supply EHRs and help support their implementation. Information technology (IT) is now considered an essential component of an effective business model to support and improve the delivery of healthcare. Seven key principles facilitate the selection, purchase, implementation and use of an Electronic Health Record. The seventh general principle, "Clinical value is at the heart of the project" supports BISAC's mission to not only enhance but identify BISAC as a leader with respect to the direction of substance abuse services within our state. The impact on financial and human resources is significant and profoundly affects the existing corporate culture according to the paper's authors. "The impact will be extensive, affecting business processes, work responsibilities, time management, methods of reporting, and record keeping. The benefits of centralized electronic data storage will greatly enhance the work of your staff and their ability to fulfill your organization's mission." Information technology increases efficiency in the clinical and billing areas, improves clinical practice, improves patient safety by suggesting courses of action tied to the data entered into clients' files, may be used to track trends, outcomes, can serve to further develop clinical pathways and best practice protocols for BISAC by linking a client's assessment to recommended services or service programs. In evaluating our readiness, BISAC followed a self-assessment matrix published by CSAT (Center for Substance Abuse Treatment) used to evaluate four specific capacities that factor into the development and implementation of a performance management process: Cultural Capacity, Analysis and Management Capacity, Provider Capacity and Data Systems Capacity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Total Budget and Position Count Total Program Budget 1,489,522 Total Program Position Count 17 Total Agency Budget 4,561,105 Total Agency Position Count 84 Program Objectives: 1) Provide immediate access to assessment and treatment services to any individuals who are assessed and diagnosed with any substance related disorders. 2) Increase the availability of extended outpatient and therapeutic living program treatment services to addicted adults and adolescents who may have no other funding availability for treatment services. 3) Develop a professional IT management structure with the technical skills and facilities necessary to enhance the IT quality, efficiency and management needs of BISAC's programs and services. 4) Document design requirements and IT Project plan to automate/integrate clinical and administrative functions. 5) Select top Behavioral Health Electronic Health Record vendor and negotiate IT Project conversion and maintenance agreement. 6) Identify social support networks and community linkages which support continuity of treatment at time of discharge. 7) Assess current administrative and clinical process functions which support quality service delivery. 8) Implement IT infrastructure which supports adult and adolescent treatment services and best practices throughout the continuum. Program Highlights: Was able to admit approximately 321 adults into all levels of outpatient substance abuse treatment and Therapeutic Living services. Follow-up data collected on adult consumers who responded to the 6 month post-treatment survey disclosed the following: • Ninety-eight (98) clients (43%) completed treatment program objectives with no further substance abuse. • Eighty-one (81) clients (63.32%) reduced criminal behavior as evidence by no new arrest at six (6) months post treatment. • Seventy (70) clients (56.45%) achieved long term abstinence from all drugs and/or alcohol use at six (6) months post discharge from treatment. • Ninety-nine (99) clients (80%) who were discharged from Therapeutic Living Programs and/or Outpatient Services reported maintaining clean and sober housing at six (6) months post discharge from treatment. • Seventy-nine (79) clients (64%) were either employed, enrolled in school/vocational training or volunteering at the time of discharge and at six (6) months post discharge. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Ninety-six (96) clients (77.42%) reduced medical services as demonstrated by no emergency room visits or hospital admissions during the first six (6) months post discharge. Proaram Hiahliahts (Information Technology) (1) An IT Baseline Analysis was performed and BISAC's Controller prepared a report detailing the principle hardware, software, local area network, and internet communications comprising BISAC's IT Infrastructure. BISAC management gained tremendous insight into the benefits to BISAC of creating a dedicated resource to maintain, administer, and oversee BISAC's IT infrastructure. The IT Baseline Analysis formed the basis of the Project Manager Consultant's analysis of BISAC's IT and Operational Risks and Mitigation Planning, Business and Technical Requirements Documentation, Financial Requirements (forecast for BISAC's current and anticipated IT environments), BISAC's Vendor Evaluation Criteria, and the RFI/Vendor Survey. Also under the guidance of the Project Manager Consultant, and with the participation of BISAC Human Resources, an IT Manager/Systems Administrator Position was created and approved. The July, 2006 recruitment advertisement generated 36 highly qualified applicants for BISAC's IT Manager/Systems Administrator position, which the IT Project Manager Consultant reviewed and performed screening interviews. Onsite analysis by the IT Manager Consultant of the staff usage of computer resources already deployed throughout BISAC's clinical program and administrative offices revealed an opportunity to improve BISAC's payback from the existing IT infrastructure, by making an investment in staff IT skills training. As a result of this finding, an IT Training Center is in the planning stages with the objective to provide the structured training that will help BISAC achieve a valued upgrade in the staffs IT skills. The IT Training Center work will also serve to support reasonably anticipated needs for training that should be completed by June 2007, such as the State of Hawaii/ADAD WITS project implementation, etc. BISAC's training center will serve as a "Center of Excellence" for proposed WITS training to all Hawaii Island Substance Abuse Providers. (2) Key Behavioral Health Electronic Health Record Systems (BHEHR) were identified and vendor contacts were established to support BISAC's objectives to evaluate the costs and benefits of the vendors' systems features and functions. (3) A Request for Information/Vendor Survey (RFI) was developed and promoted to solicit up-to-date information on the BHEHR vendors' systems features and functions. (4) Business and Technical Requirements were developed and summarized to provide the BHEHR vendors guidance and perspective on BISAC's automation objectives. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 (5) A High-level IT Project (BHEHR) Financial Requirements Forecast was developed to provide BISAC the financial framework needed to evaluate, compare, and qualify the costs and benefits of automation options in relation to BISAC's clinical and administrative automation objectives. (6) Vendor Evaluation Criteria were developed to provide a consistent business framework required to evaluate BHEHR vendor system offering presented to BISAC. (7) Professional communications were disseminated to key BHEHR system vendors; 7 vendors provided qualifying responses to BISAC's RFI/Vendor Survey. (8) Individual vendor system presentations were organized to commence BISAC's vendor evaluation and decision-making process. This process is customized for BISAC's purposes to facilitate selection of BHEHR vendors desired to submit formal business automation proposals during BISAC's IT Project, Phase 2. (9) A preliminary schedule was developed to organize BISAC's resources necessary for the planning and successful completion of BISAC's IT Project, Phase 2. (10) BISAC's IT Baseline, risk analysis, and preliminary BHEHR vendor RFI responses were analyzed and the Project Manager Consultant prepared a proposal to commence BISAC's IT Project, Phase 2. (11) BISAC management and staff participants were identified for BISAC's IT Project, Phase 2, as follows: Dr. Stephen C. Zuniga, Chair; Diana Nelson, Controller and Billing Function Manager; Program Directors Leonard Feliciano, Richard Likeke Teanio, Marilyn McIntosh, and Robert Rohret, Quality Assurance Director Dr. Brian Uldall, and soon to join BISAC IT Manager/Systems Administrator Gary Schwiter. The initial work of BISAC's IT Taskforce will involve review of the vendors RFI responses and participation in the upcoming BHEHR vendor presentations. There were thirty behavioral health client references included by the vendors for BISAC's IT Taskforce to learn how other behavioral health firms are utilizing automation to help improve the quality and efficiency of their clinical programs. The presentations offer BISAC's IT Taskforce an opportunity to meet the vendors, view demonstrations of the vendors' automation capabilities, pose questions about the vendors' RFI responses, and learn how the vendors' clients are utilizing automation that successfully supports many behavioral health programs'throughout the U.S. (12) State of Hawaii/ADAD's WITS Project Provider participation requirements were met with the participation, of the IT Project Manager Consultant. Quality Assurance Director Dr.' Brian Uldall was selected to provide oversight, coordination and to fulfill BISAC's WITS training responsibilities when the system is implemented Sometime during Q1or Q2 2007. NONPROFIT GRANT APPLICATION FISCAL FEAR 2006-07 Page 6 Performance Measures: FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Substance Abuse Treatment Units 16,428 16,921 17,288 1,018,123 1,043,576 Professional Fees 19,160 17,594 18,034 Operations 355,708 426,683 437,350 IT Infrastructure 11,047 29,384 30,265 Vehicle *If applicable Proaram Expenditures If applicable Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 794,661 1,018,123 1,043,576 Professional Fees 19,160 17,594 18,034 Operations 355,708 426,683 437,350 IT Infrastructure 11,047 29,384 30,265 Vehicle 0 10,428 10,689 Total 1,180, 576 1,502,212 1,539,914 If applicable Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County 30,000 30,000 30,000 State of Hawaii 854,402 1,100,483 1,128,074 Federal 90,977 84,256 84,256 HIUW 4,032 17,500 17,500 Private Foundation 0 0 0 Donations/Fundraising 1,100 3,000 3,090 Private Insurance 175,831 209,500 215,785 Client Fees 59,755 44,783 46,126 Total 1,216,097 1,489,522 1,524,831 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Big Island Substance Abuse Council continues efforts to diversify funding sources and expand services where appropriate throughout the State and Island of Hawaii. BISAC's adolescent treatment services grew by 3% last year and billing to 3rd party payors increased by 1 % to account for 11 % of BISAC's budget. Administrative fees increased by 2% and account for 8% of the revenue reported from July 1, 2004 through June 30, 2005. A conservative fiscal philosophy coupled with a team of skilled and dedicated staff members has enabled BISAC to expand and retain a positive, prominent presence in the community. BISAC's sound fiscal policies are incorporated into decisions related to program expansion or to enter market niches that would expand the behavioral health continuum. Business decisions include enrolling consumers in a Quest plan when eligible and appropriately utilizing benefits to cover treatment services. Administrative staff is scheduled to participate in meetings with HMSA and other substance abuse treatment providers to evaluate ways on increasing community awareness of insurance benefits and working with physicians to appropriately identify and refer consumers who may need treatment services that would be covered by HMSA insurance. The BISAC Board understands the commitment and priority of this project. The CEO is working to obtain commitments for this project and the Board has anticipated the project costs in the approved budget. The $30,000 requested for East Hawaii under this proposal will go towards the supporting this proposal's requests. BISAC plans include exploring available funding that supports capacity building and sustainability efforts, and reduces our reliance on State and County funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 Big Island Substance Abuse Council West Hawaii Substance Abuse Program I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. ignature of Bp/and President/Chair Patricia Engelhard Signatufe of Execyl irector Dr. Stephen C. Zuniga A 07 Date •. ate UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 9 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 43-977 Gym Road, Paauilo, Hawaii 96776 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: 3465 Waialae Avenue, Suite 250 Mailing Address: Honolulu, Hawaii 96816 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 04-05 05-06 06-07 $...0 $...0 $...0 Agency Mission Statement: "To enable all youth, especially youth from disadvantaged circumstances, to realize their full potential as productive, caring and responsible citizens." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua Program Description: Skills Mastery And Resistance Training (SMART) Moves Prevention Program: Helping the young people of the Big Island develop skills to resist tobacco, alcohol, other drugs, and other problem behaviors and enhanced by positive youth development activities through 5 core program areas. The Need Tobacco, alcohol and other drug use are a particularly insidious problem because it rarely remains isolated. It is widely recognized as a major contributing factor in other youth problems including school failure, truancy, runaways, suicide, pregnancy, school dropout, family problems, auto accidents, unemployment and crime. Tobacco is recognized as the ultimate "gateway" drug. Research indicates that the majority of illicit drug users began their substance abuse with tobacco, often at a very young age. Today the United States has the highest rate of illicit drug use of any industrialized nation. Across the country every community, regardless of location and income level, has been touched by drug use. Recent studies have explored the correlation of delinquent and risky sexual behavior with adolescent and teen use/abuse of alcohol, tobacco, and other drugs (ATOD). Adolescents and teens who are "idle" or not involved in positive youth development activities are most likely to engage in activities and social settings that promote behaviors such as drugs and alcohol, gang involvement, delinquency and crime. Youth who use one substance are more likely to use other substances; and these studies showed a strong relationship between substance use and other risk behaviors, including teenage sexual behavior and anti -social behavior. Statistics for the County of Hawaii are alarming: * Hawaii County has the highest rates of crystal methampetamine use in the state and in a recent Alcohol and Drug Addiction Department (ADAD) report for Hawaii District, there is an overwhelming number of youth trying alcohol and marijuana. The percentages for youth drinking and smoking are some of the highest in the State for 8th - 12th grade youth. * Hawaii County has the highest rate of youth at risk due to indicators such as the highest rates of unemployment, highest rates of high school dropouts, highest rates of juvenile delinquency, highest rates of child abuse and out -of - home placement. Youth in Hamakua are faced with a number of challenges. Paauilo is like many of the rural communities on the Big Island where population has been on a rise and youth find themselves with very little positive youth development activities after NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua school and during non -school hours. Combine this factor with a recent statewide student survey of which one half of the adolescents responding in the community reported poor parental supervision as well as a lack of interest in school and adolescents reporting exposure to illicit drugs we see a definite need for positive experiences and activities in the Hamakua District. We have been approached by many of the residents, businesses and organizations in Paauilo Community to provide programs so youth could have positive experiences and reduce the likelihood of the present trend in which youth are showing favorable attitude of alcohol, tobacco and other drugs (ATOD) use among peers. A recent collection of data (Center on the Family) reports that 22.9% of the adolescent in Honoka'a have had exposure to illicit drugs in their school and community which is well above the State rate of 14.5%. Another important factor is a 2002 student survey report that showed that two- thirds of the Honoka'a School seniors reporting no interest in post high school education. This is significantly lower than the State of Hawaii average. These risk factors create a huge challenge for the youth in Paauilo and Hamakua to make a successful transition to adulthood. Despite the overwhelming factors that place youth in Hamakua at risk, the community's strengths and identified protective factors include a low unemployment rate and a high percentage of families that own their own homes. The percentage of youth (0-5) living in poverty is 15.8% and very close to the State's 15.4% rate and quite lower than the County of Hawaii's 24.9%. Too many children today grow up with few, if any, positive role models and little, if any, encouragement to resist tobacco, alcohol, other drugs and sexual activity. The norm and expectation for these young people, whether perceived or real, is that it is almost a "rite of passage" to smoke tobacco, drink alcohol, use other drugs and engage in sex. Not only is this the perception of young people themselves but often the perception of the adults in their lives whose passive resignation encourages rather than discourages these behaviors. While young people are taught skills to prepare them to face educational challenges, at critical stages of psychological, emotional and intellectual development they are often not taught the skills needed to make the transition from childhood to adulthood and to resist tobacco, alcohol, other drugs and premature sexual activity. Furthermore, the effects on families today to keep up with the economy and rising cost of living by working up to three jobs to make ends meet find themselves searching for positive youth activities for their children. We often hear youth today express how they have nothing to do! Our children are growing up in very stressful times, and we need to do more to help them. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua Responding to the Need Until recently, most prevention programs failed, in large part because they were based on faulty assumptions about why young people begin using tobacco, alcohol, and drugs in the first place. Early prevention efforts relied on scare tactics and moral exhortations, expressing prohibitionist views that linked drugs to dangerous criminal influences. Few of these programs were systematically evaluated, but those that were failed to show reduced drug use among participants. Responding to the urgent need for an effective prevention program, Boys & Girls Clubs of America (BGCA) developed and field-tested a comprehensive program to help young people develop skills to resist tobacco, alcohol, other drug use and premature sexual activity. The results were outstanding. Called SMART Moves, the program is based on two rigorously tested curricula: Life Skills Training (Gilbert Botvin, Ph.D., Cornell University) and Project SMART (William Hansen, Ph.D., University of Southern California). SMART Moves is now used successfully in communities across the nation. The program is based on a resistance training/social skills model. Using small group activities, it teaches young people to recognize and resist media influences and peer pressures to engage in tobacco, alcohol, other drug use and early sexual involvement. SMART Moves recognizes that in addition to resistance training and the development of social skills, self esteem is a very important factor in regulating basic human drives and attitudes. When children are made to feel that they matter, that they have a unique contribution to make, and when they are helped to understand their feelings, they are less likely to endanger their own health or that of others by indulging in behaviors that put them at risk. SMART Moves also recognizes that in order for youth to learn and apply prevention principles, prevention programs must include parents and members of the community. SMART Moves uses a team approach to implement the program. The prevention team consists of Club staff, community representatives, parents and older teens. The SMART Moves curriculum is comprised of the following components: SMART Kids Make SMART Moves: A skills development program for boys and girls ages 6 to 9. The program focus is on self awareness, decision-making and interpersonal skills, while communicating age appropriate information about tobacco, alcohol and other drugs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua Start SMART: A resistance skills program for youth ages 9 to 12 that focus on ways to identify and resist peer, social and media pressures to use tobacco, alcohol, other drugs or become sexually involved. It includes age appropriate discussions of puberty and friendships. Stay SMART: A social skills program for adolescents ages 13 to 15 that teaches resistance skills, stress reduction techniques, communication skills, assertiveness training and life planning. It provides accurate information about tobacco use, alcohol use, other drug use and adolescent sexuality. SMART Leaders: A peer mentoring program focused on teens 13-17 years old that plan and facilitate SMART Moves sessions with other youth in one or more of the SMART Moves program. Family Advocacy Network (F.A.N.) Club: A prevention program that targets the families of the SMART Leader participants to encourage family opportunities for positive involvement and reinforcing the concepts of preventing substance abuse amongst the youth participants. Also recognized by the Center for Substance Abuse Prevention and the Western Center for the application of Prevention Technologies as a "Best Practice" prevention program and rated as a model program by Substance Abuse and Mental Health Services Administration. Achievements SMART Moves is: - Recognized as one of 10 exemplary primary prevention programs by the U.S. Office of Substance Abuse Prevention, the National Association of State Alcohol and Drug Abuse Directors, and the National Prevention Network. - Lauded as a premier national prevention program by the White House Conference for a Drug Free America as well as the Children's Defense Fund. - Cited for its parent -training component by the Office of the Inspector General of the U.S. Department of Human Services Administration. - Noted for its effectiveness in a study conducted by the Center for Health Policy Research of The Pennsylvania State University. - Singled out for praise in The Making of a Drug Free America: Programs That Work by Mathea Falco (former Assistant U.S. Secretary of State for Narcotics Affairs). SMART Moves is unique among prevention programs in that: - SMART Moves is the sole national prevention program currently addressing the problems of tobacco, alcohol, other drug use and teen pregnancy in one comprehensive curriculum. - SMART Moves employs a team consisting of staff, parents, community representatives and older Club members to impart the knowledge and teach the NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua skills needed by young people to avoid tobacco, alcohol, other drugs and premature sexual involvement. - SMART Moves actively involves parents in the prevention effort. - SMART Moves uses teen leaders who act as role models to younger people. - SMART Moves is incorporated into all Club activities and programs. Daily positive youth development programs will enhance SMART Moves through activities in a coordinated, comprehensive manner and include the following 5 core program areas. 1) Sports, Fitness & Recreation — Organized Team sports, individual low organized athletic programs, and Smart Moves activities are designed to meet the development needs of a diverse age group of youth participants. Programs are designed to include novice, intermediate and advance levels of skill development to increase youth participation and enhance self-esteem, and promote exercise, good/diet and nutrition. Activities for this program area are conducted at least four times a week, with each session averaging 1-2 hours. On a daily basis two to three sessions are conducted. Program activities also provide opportunities to engage youth in making healthy lifestyle choices and deter involvement in drugs, violence and other risky behaviors. These activities promote physical fitness and positive use of leisure time, and also consist of sports leagues, health and fitness activities, and skill building clinics. To prevent youth engaging in delinquent and risky behaviors, and give opportunities for making new friends, structured and informal recreational and social activities. Activities are conducted in individual, small group and large group formats, with emphasis on positive intra -personal interaction with peers and adults. Examples include drop-in game room activities, instructional clinics and tournaments, club dances, and excursions. Activities for this program area will be conducted at least five days a week with individual session averaging 1 to 1 'Y2 hours. 2) Character and Leadership Development — Youth who participate in Keystone, Torch Clubs, LIT, and Peer Leadership programs provide various community service projects which teaches them civic responsibility. Youth participating in this program area are required to plan and perform a minimum of four community service projects (once every quarter). Youth are engaged and involved in the decision-making and implementation of the projects and activities of the program and community. Youth involved in Keystone & Torch Clubs and the Smart Moves "SMART Leaders" component are given the chance to strengthen intra -personal and decision-making skills through small group focus sessions. As a means of building character & leadership skills, youth plan and implement activities in prevention programs and community service to give back to the Club and community. 3) Education and Career Development — Power Hour program includes educational enhancement activities to increase the opportunities for academic success of youth participants. Power Hour sessions will be held at least four NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua times a week with each session averaging 1 hour. The Career Launch and Job Ready programs available for youth prepares youth for possible employment, post high school education and career development. Youth also have the opportunity to participate in science based programs such as the Ocean Exploration Program "Immersion Presents". This program focuses on the activities that take youth through 5 curriculum -based modules where youth explore expeditions and explorations of scientist. This OJJDP supported program has been implemented at more than 450 Boys & Girls Clubs in 33 different cities and continues to grow in popularity as youth combine science, art, mathematics, career development and law enforcement to learn and increase their educational base. BGCBI also includes programs such as BGCA's Project Learn and Dragonfly Quest to enhance the basics in education. Use of a complete internet accessible computer technology center at the Club also supports a strong education enhancement program. 4) Health & Life Skills — In addition to the proposed SMART Moves curriculum the Boys & Girls Club of the Big Island will conduct other specific SMART Moves component programs to help youth increase their capacity to make successful transition to adulthood, small group and individual programs such as SMART Girls, Passport to Manhood, Act SMART, Street SMART, Quick SMART and SMART Parents. These programs will address issues such as esteem building, planning and personal goals, personal healthy living & practices and development of resistance skills against pre -matured sexual behaviors, drugs, alcohol and other at -risk behaviors. 5) The Arts — Youth will have daily opportunity to engage in arts & craft activities to promote creativity and hands-on experiences through art. Included in art are possible activities in Fine Art, photography, pottery, woodworking and much more to support the need for youth to be involved in creativity and self exploration of the world surrounding them. The art center is often used for all other program components due to the need for hands-on experiences and use of material and supplies used in art. The combination of the proposed SMART Moves and 5 core programs will promote positive youth development and decrease substance use and problem behaviors of youth participants. The standard of our programs will be based on increasing protective factors and reducing risk factors facing our community youth and families. Total Budget and Position Count Total Program Budget $140,806.06 Total Program Position Count 8 Total Agency Budget 1,173,924.56 Total Agency Position Count 127 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua Program Objectives: 1) Increase participants' knowledge about tobacco, alcohol and other drugs and sexuality. 2) Increase participants' ability to identify and resist peer and media pressures to use tobacco, alcohol and other drugs. 3) Increase youth ability to develop and improve skills around making decisions, resisting social and peer pressures, and coping with the stress of growing up. 4) Decrease problem behavior of youth by increasing participant's positive self esteem through participation in positive youth development activities on a daily basis. 5) Increase communication among staff members, parents, guardians and Club members regarding tobacco, alcohol, other drugs and adolescent sexual involvement. Program Highlights: 1) In the Fiscal Year 2005-2006, the Boys & Girls Club of the Big Island completed measurement of impact and collection of data for assessment of risk and protective factors through pre -post surveys and SMART Moves evaluation surveys. Results showed that of the 368 youth completing SMART Moves: 69% showed increased knowledge of the dangers in Tobacco and other drugs and alcohol. 65% of youth showed an increase in not getting involved with ATOD use. 75% showed increase in knowledge of healthy practices that could be used to deal with everyday issues in peer pressures and making better decisions. 90% of teens participating shared that alcohol and tobacco use was in their home. 75% of 10-15 year olds surveyed shared they have tried tobacco.90% of 10-15 year olds shared they have tried alcohol and other drugs. 35% of Stay SMART graduates contributed to SMART Moves by completing the SMART Leaders certification and presently facilitate SMART Moves Programs with younger youth. Further assessment collected shows that parents involved in SMART Moves activities shared how they take for granted tobacco and alcohol use around their kids and learned that second hand smoke and family parties are so much a part of everyday life in our local setting. Parents also shared that other parents would be reluctant to attend these activities as they are ATOD users and would be in denial and not see the need for being told what to do. The breakdown of Club Site completion numbers were 76 youth in Stay SMART in Pahoa, 67 youth in Keaau and 116 youth at the Hilo Club. In addition 109 youth completed a modified Start SMART Abstinence -only program at Keaau, Hilo and Keaau. 2) A SMART Moves Coordinator position was created in 2006 to address a management position to coordinate all SMART Moves training, creative NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua enhancement activities and formal evluative assessments of all SMART Moves program youth. This position has been approved and will be an integral part of our organization as soon as funding is available. 3) The Boys & Girls Club of the Big Island has expanded program services to youth in Pahala, Ka'u in September of 2006. The Pahala Club joins the present Clubs in Hilo, Keaau and Pahoa to provide SMART Moves and core programs to all youth participants. New Club sites in Paauilo, Hamakua and Hawaiian Oceanview Estates, Ka'u will be opening doors for youth in their respective communities on February 1st, 2007. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Bud et * Estimate Youth will complete SMART Moves n/a 38 50 Of the 50 youth :completing the n/a 15 20 SMART Moves Program, Youth ages 6-9 will complete the SMART Kids Program. Of the 50 youth :completing the n/a 15 15 SMART Moves Program, Youth ages 10-12 will complete the Start SMART Program. Of the 50 youth :completing the n/a 8 10 SMART Moves Program, Youth ages 13-15 will complete the Stay SMART Program. Of the 50 youth :completing the n/a 0 5 SMART Moves Program, Youth ages 13-17 will complete the SMART Leaders Program. Youth will participate in 'The Art" n/a 35 50 Program Youth will participate in Character & n/a 10 25 Leadership Program Youth will participate in Education n/a 35 75 and Career Development Program Youth will participate in Health & n/a 35 75 Life Skills Program Youth will participate in Sports n/a 35 100 Fitness and Recreation Program Parents will participate in FAN Club n/a 10 15 activities *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 & Girls Club of the Bie Island SMART Moves & Positive Youth Development Programs: Hamakua Program Expenditures ' If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages n/a $69,221.37 $103,788.27 Professional Fees n/a $850.00 $1250.00 Operations n/a $30,413.46 $34951.19 Equipment n/a $796.50 $776.60 Other (Board Development) n/a $40.00 $40.00 Total n/a $101,321.33 $140,806.06 ' If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Boys & Girls Club of Hawaii/YMCA Rural Youth Program RYP Funds 0 $61,137.44 $19,139.39 Office of Juvenile Justice Delinquency Prevention 0 $ $ Office of Youth Services (OYS): Positive Youth Development 0 $ $55,000.00 County of Hawaii —Non profit Grant 0 $ $50,000.00 County of Hawaii — District 1 Dominic Ya on : Contingency Fund 0 $10,000.00 $ Hawaii Community Foundation: Tobacco Fund 0 $25,000.00 $ Office of Youth Services (OYS) Non -School Hours Grant 0 $ $16,666.67 Fundraising Events $5183.89 $ $ I $ Total $101,321.33 $140,806.06 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 11 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hamakua Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 12 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development: Hamakua FY 2006-07: Line Item: Other — Allocated expenditure for Board of Directors Development: Example: Strategic Planning & Transitional orientation and training with new Chief Professional Officer. FY 2007-2008: Line Item: Other — Estimated Board of Director Development expenses. Boys & Girls Club of the Big Island - Agency Name SMART Moves: Hamakua - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. - *& WU& Signature of Board President/Chair AA Signat a of F�cecutive Director 1-31-01 Date 1 /3I/'0'7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo Agency Director: Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address David (Kawika) Mattos David (Kawika) Mattos Phone No.: 961-5536 Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 100 Kamakahonu Street, Hilo, Hawaii 96720 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: 3465 Waialae Avenue, Suite 250 Mailing Address: Honolulu, Hawaii 96816 Amount of Request for County Funds: Prior Year(s) Funding: 04-05 05-06 06-07 $45,000 $57,000 $0 Agency Mission Statement: $100,000 "To enable all youth, especially youth from disadvantaged circumstances, to realize their full potential as productive, caring and responsible citizens." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo Program Description: Skills Mastery And Resistance Training (SMART) Moves Prevention Program: Helping the young people of the Big Island develop skills to resist tobacco, alcohol, other drugs, and other problem behaviors and enhanced by positive youth development activities through 5 core program areas. The Need Tobacco, alcohol and other drug use are a particularly insidious problem because it rarely remains isolated. It is widely recognized as a major contributing factor in other youth problems including school failure, truancy, runaways, suicide, pregnancy, school dropout, family problems, auto accidents, unemployment and crime. Tobacco is widely recognized as the ultimate "gateway' drug. Research indicates that the majority of illicit drug users began their substance abuse with tobacco, often at a very young age. Today the United States has the highest rate of illicit drug use of any industrialized nation. Across the country every community, regardless of location and income level, has been touched by drug use. Recent studies have explored the correlation of delinquent and risky sexual behavior with adolescent and teen use/abuse of alcohol, tobacco, and other drugs (ATOD). Adolescents and teens who are "idle" or not involved in positive youth development activities are most likely to engage in activities and social settings that promote behaviors such as drugs and alcohol, gang involvement, delinquency and crime.Youth who use one substance are more likely to use other substances; and these studies showed a strong relationship between substance use and other risk behaviors, including teenage sexual behavior and anti -social behavior. Statistics for the County of Hawaii are alarming: ' Hawaii County has the highest rates of crystal methampetamine use in the state and in a recent Alcohol and Drug Addiction Department (ADAD) report for Hawaii District, there is an overwhelming number of youth trying alcohol and marijuana. The percentages for youth drinking and smoking are some of the highest in the State for 8'" - 12th grade youth. Hawaii County has the highest rate of youth at risk due to indicators such as the highest rates of unemployment, highest rates of high school dropouts, highest rates of juvenile delinquency, and highest rates of child abuse and out -of - home placement. Specific Demographic data for the community of Hilo shows that 21.8% of the population in the surrounding community are youth between the ages of 5-19 years old. The eight school complexes that surround our Club site shows a student enrollment totaling 4075 youth in K-12 grade. 60% of student population NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo qualified for free or reduced lunch. The percentage of families with youth living in poverty is 23%. Youth in the central district of Hilo are faced with risk factors such as lack of family supervision and family socioeconomic struggles. Youth lack interest in school, show favorable attitude of alcohol, tobacco and other drugs (ATOD) use among peers and other contributing delinquent behaviors such early sexual activity and unwanted pregnancies, resulting in unhealthy infants born to young mothers. These risk factors affect their ability to make a successful transition to adulthood. Despite the overwhelming factors that place our youth at risk, our community's strengths and identified protective factors include opportunity for positive family involvement and family attachment. Another important factor is the community's graduation rate of high school seniors in the 90 percentile, and more than half of the students in intermediate schools report of their families having positive involvement and close ties into their community. Too many children today grow up with few, if any, positive role models and little, if any, encouragement to resist tobacco, alcohol, other drugs and sexual activity. The norm and expectation for these young people, whether perceived or real, is that it is almost a "rite of passage" to smoke tobacco, drink alcohol, use other drugs and engage in sex. Not only is this the perception of young people themselves but often the perception of the adults in their lives whose passive resignation encourages rather than discourages these behaviors. While young people are taught skills to prepare them to face educational challenges, at critical stages of psychological, emotional and intellectual development they are often not taught the skills needed to make the transition from childhood to adulthood and to resist tobacco, alcohol, other drugs and premature sexual activity. Furthermore, the effects on families today to keep up with the economy and rising cost of living by working up to three jobs to make ends meet find themselves searching for positive youth activities for their children. We often hear youth today express how they have nothing to do! Our children are growing up in very stressful times, and we need to do more to help them. Responding to the Need Until recently, most prevention programs failed, in large part because they were based on faulty assumptions about why young people begin using tobacco, alcohol, and drugs in the first place. Early prevention efforts relied on scare tactics and moral exhortations, expressing prohibitionist views that linked drugs to dangerous criminal influences. Few of these programs were systematically evaluated, but those that were failed to show reduced drug use among participants. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo Responding to the urgent need for an effective prevention program, Boys & Girls Clubs of America (BGCA) developed and field-tested a comprehensive program to help young people develop skills to resist tobacco, alcohol, other drug use and premature sexual activity. The results were outstanding. Called SMART Moves, the program is based on two rigorously tested curricula: Life Skills Training (Gilbert Botvin, Ph.D., Cornell University) and Project SMART (William Hansen, Ph.D., University of Southern California). SMART Moves is now used successfully in communities across the nation. The program is based on a resistance training/social skills model. Using small group activities, it teaches young people to recognize and resist media influences and peer pressures to engage in tobacco, alcohol, other drug use and early sexual involvement. SMART Moves recognizes that in addition to resistance training and the development of social skills, self esteem is a very important factor in regulating basic human drives and attitudes. When children are made to feel that they matter, that they have a unique contribution to make, and when they are helped to understand their feelings, they are less likely to endanger their own health or that of others by indulging in behaviors that put them at risk. SMART Moves also recognizes that in order for youth to learn and apply prevention principles, prevention programs must include parents and members of the community. SMART Moves uses a team approach to implement the program. The prevention team consists of Club staff, community representatives, parents and older teens. The SMART Moves curriculum is comprised of the following components: SMART Kids Make SMART Moves: A skills development program for boys and girls ages 6 to 9. The program focus is on self awareness, decision-making and interpersonal skills, while communicating age appropriate information about tobacco, alcohol and other drugs. Start SMART: A resistance skills program for youth ages 9 to 12 that focus on ways to identify and resist peer, social and media pressures to use tobacco, alcohol, other drugs or become sexually involved. It includes age appropriate discussions of puberty and friendships. Stay SMART: A social skills program for adolescents ages 13 to 15 that teaches resistance skills, stress reduction techniques, communication skills, assertiveness training and life planning. It provides accurate information about tobacco use, alcohol use, other drug use and adolescent sexuality. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo SMART Leaders: A peer mentoring program focused on teens 13-17 years old that plan and facilitate SMART Moves sessions with other youth in one or more of the SMART Moves program. Family Advocacy Network (F.A.N.) Club: A prevention program that targets the families of the SMART Leader participants to encourage family opportunities for positive involvement and reinforcing the concepts of preventing substance abuse amongst the youth participants. Also recognized by the Center for Substance Abuse Prevention and the Western Center for the application of Prevention Technologies as a "Best Practice" prevention program and rated as a model program by Substance Abuse and Mental Health Services Administration. Achievements SMART Moves is: - Recognized as one of 10 exemplary primary prevention programs by the U.S. Office of Substance Abuse Prevention, the National Association of State Alcohol and Drug Abuse Directors, and the National Prevention Network. - Lauded as a premier national prevention program by the White House Conference for a Drug Free America as well as the Children's Defense Fund. - Cited for its parent -training component by the Office of the Inspector General of the U.S. Department of Human Services Administration. - Noted for its effectiveness in a study conducted by the Center for Health Policy Research of The Pennsylvania State University. - Singled out for praise in The Making of a Drug Free America: Programs That Work by Mathea Falco (former Assistant U.S. Secretary of State for Narcotics Affairs). SMART Moves is unique among prevention programs in that: - SMART Moves is the sole national prevention program currently addressing the problems of tobacco, alcohol, other drug use and teen pregnancy in one comprehensive curriculum. - SMART Moves employs a team consisting of staff, parents, community representatives and older Club members to impart the knowledge and teach the skills needed by young people to avoid tobacco, alcohol, other drugs and premature sexual involvement. - SMART Moves actively involves parents in the prevention effort. - SMART Moves uses teen leaders who act as role models to younger people. - SMART Moves is incorporated into all Club activities and programs. Daily positive youth development programs will enhance SMART Moves through activities in a coordinated, comprehensive manner and include the following 5 core program areas. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo 1) Sports, Fitness & Recreation — Organized Team sports, individual low organized athletic programs, and Smart Moves activities are designed to meet the development needs of a diverse age group of youth participants. Programs are designed to include novice, intermediate and advance levels of skill development to increase youth participation and enhance self-esteem, and promote exercise, good/diet and nutrition. Activities for this program area are conducted at least four times. a week, with each session averaging 1-2 hours. On a daily basis two to three sessions are conducted. Program activities also provide opportunity to engage youth in making healthy lifestyle choices and deter involvement in drugs, violence and other risky behaviors. These activities promote physical fitness and positive use of leisure time, and also consist of sports leagues, health and fitness activities, and skill building clinics. To prevent youth engaging in delinquent and risky behaviors, and give opportunities for making new friends, structured and informal recreational and social activities. Activities are conducted in individual, small group and large group formats, with emphasis on positive intra -personal interaction with peers and adults. Examples include drop-in game room activities, instructional clinics and tournaments, club dances, and excursions. Activities for this program area will be conducted at least five days a week with individual session averaging 1 to 1 '/i hours. 2) Character and Leadership Development — Youth who participate in Keystone, Torch Clubs, LIT, and Peer Leadership programs provide various community service projects which teaches them civic responsibility. Youth participating in this program area are required to plan and perform a minimum of four community service projects (once every quarter). Youth are engaged and involved in the decision-making and implementation of the projects and activities of the program and community. Youth involved in Keystone & Torch Clubs and the Smart Moves "SMART Leaders" component are given the chance to strengthen intra -personal and decision-making skills through small group focus sessions. As a means of building character & leadership skills, youth plan and implement activities in prevention programs and community service to give back to the Club and community. 3) Education and Career Development — Power Hour program includes educational enhancement activities to increase the opportunity for academic success of youth participants. Power Hour sessions will be held at least four times a week with each session averaging 1 hour. The Career Launch and Job Ready programs available for youth prepares youth for possible employment, post high school education and career development. Youth also have the opportunity to participate in science based programs such as the Ocean Exploration Program "Immersion Presents". This program focuses on the activities that take youth through 5 curriculum -based modules where youth explore expeditions and explorations of scientist. This OJJDP supported program has been implemented at more than 450 Boys & Girls Clubs in 33 different cities and continues to grow in popularity as youth combine science, art, mathematics, NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo 4) Decrease problem behavior of youth by increasing participant's positive self esteem through participation in positive youth development activities on a daily basis. 5) Increase communication among staff members, parents, guardians and Club members regarding tobacco, alcohol, other drugs and adolescent sexual involvement. Program Highlights: 1) In the Fiscal Year 2005-2006 the Boys & Girls Club of the Big Island completed measurement of impact and collection of data for assessment of risk and protective factors through pre -post surveys and SMART Moves evaluation surveys. Results showed that of the 368 youth completing SMART Moves: 69% showed increased knowledge of the dangers in Tobacco and other drugs and alcohol. 65% of youth showed an increase in not getting involved with ATOD use. 75% showed increase in knowledge of healthy practices that could be used to deal with everyday issues in peer pressures and making better decisions. 90% of teens participating shared that alcohol and tobacco use was in their home. 75% of 10-15 year olds surveyed shared they have tried tobacco.90% of 10-15 year olds shared they have tried alcohol and other drugs. 35% of Stay SMART graduates contributed to SMART Moves by completing the SMART Leaders certification and presently facilitate SMART Moves Programs with younger youth. Further assessment collected shows that parents involved in SMART Moves activities shared how they take for granted tobacco and alcohol use around their kids and learned that second hand smoke and family parties are so much a part of everyday life in our local setting. Parents also shared that other parents would be reluctant to attend these activities as they are ATOD users and would be in denial and not see the need for being told what to do. The breakdown of Club Site completion numbers were 76 youth in Stay SMART in Pahoa, 67 youth in Keaau and 116 youth at the Hilo Club. In addition 109 youth completed a modified Start SMART Abstinence -only program at Keaau, Hilo and Keaau. 2) A SMART Moves Coordinator position was created in 2006 to address a management position to coordinate all SMART Moves training, creative enhancement activities and formal evaluative assessment of all SMART Moves program youth. This position has been approved and will be an integral part of our organization as soon as funding is available. 3) The Boys & Girls Club of the Big Island has expanded program services to youth in Pahala, Ka'u in September of 2006. The Pahala Club joins the present Clubs in Hilo, Keaau and Pahoa to provide SMART Moves and core programs to all youth participants. New Club sites in Paauilo, Hamakua and Hawaiian Oceanview Estates, Ka'u will be opening doors for youth in their respective communities on February 1 st, 2007. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 & Girls Club of the Bit Island SMART Moves & Positive Youth Development Programs: Hilo Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget * Estimate Youth will complete SMART Moves 256 337 537 Of the 537 youth :completing the 32 30 90 SMART Moves Program, Youth ages 6-9 will complete the SMART Kids Program. Of the 537 youth :completing the 86 69 129 SMART Moves Program, Youth ages 10-12 will complete the Start SMART Program. Of the 537 youth :completing the 74 189 229 SMART Moves Program, Youth ages 13-15 will complete the Stay SMART Program. Of the 537 youth :completing the 75 49 89 SMART Moves Program, Youth ages 13-17 will complete the SMART Leaders Program. Youth will participate in 'The Art" 45 150 300 Program Youth will participate in Character & 41 70 145 Leadership Program Youth will participate in Education 94 220 370 and Career Development Program Youth will participate in Health & 368 70 220 Life Skills Program Youth will participate in Sports 128 235 485 Fitness and Recreation Program Parents will participate in FAN Club n/a 30 100 activities *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo Program Expenditure ' If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $392,638.24 $223,520.35 $236,106.20 Professional Fees $8,000.00 $3,400.00 $5,000 -County County of Hawaii District 4 Stacey $226,739.05 $165,801.30 $195,012.17 -Operations $14,738.85 $7,386.00 $7306.40 -Equipment (Board Development) $ $160.00 $160 -Other Total $642,116.14 $400,267.65 $443,584.77 ' If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget* Estimate of Hawaii —Non profit Grant $44,500.00 $ $50,000.00 -County County of Hawaii District 4 Stacey $ $15,000.00 $ Aga Contingency Fund Office of Juvenile Justice $110,000.00 $36,000.00 $ Delinquency Prevention Salvation Army/(OYS) Positive $137,500.00 $ $ Alternative Activities Alcohol Drug Abuse Division $87,500.00 $33,333.33 $ ADAD Boys & Girls Club of Hawaii: $30,099.29 $13,077.41 $2,466.67 Abstinence -Only Grant Hawaii Community Foundation: $56,250.00 $32,000.00 $25,000.00 HCF : Tobacco Fund Hawaii Island United Way $30,000.00 $20,000.00 $13,333.33 YMCA Rural Youth Program (RYP) $43,205.08 $110,133.15 $35,490.03 Grant Center Base YMCA Rural Youth Program (RYP) $32635.79 Grant Outreach Office of Youth Services (OYS): $ $32,965.00 $13,264.65 &Violence Prevention Grant -Drug Office of Youth Services (OYS) $ $ $125,000.00 Positive Youth Development Office of Youth Services (OYS) $ $ $16,666.67 Non -School Hours Grant Athletics (League) Fundraisin s 1 $ $50,000.00 $50,000.00 Intersession Program Fees 1 $70,425.98 1 $40,000.00 $40,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Hilo First Pics / Triple Play OJP Grant $ $30,000.00 $ Fun rraisin Events $ $6,092.09 $12,363.42 Donations $ $30,000.00 $60,000.00 -Community $642,116.14 Total $400,267.65 $443,584.77 'If applicable *** Pertaining to the first column under program funding sources for year 2005- 2006 the total listed reflects total expenses and revenues for our Hilo, Kea'au and Pahoa combined. For the following two years expenses and revenues have been allocated to all Clubs. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 11 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development: Hilo FY 2006-07: Line Item: Other — Allocated expenditure for Board of Directors Development: Example: Strategic Planning & Transitional orientation and training with new Chief Professional Officer. FY 2007-2008: Line Item: Other — Estimated Board of Director Development expenses. Boys & Girls Club of the Big Island - Agency Name SMART Moves: Hilo - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawa!'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. I - 3(-07 Date 1/3 ►,07 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address: David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 16-0565 Pahoa Road, Keaau, Hawaii 96749 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: 3465 Waialae Avenue, Suite 250 Mailing Address: Honolulu, Hawaii 96816 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 04-05 05-06 06-07 $...0 $...0 $...0 Agency Mission Statement: "To enable all youth, especially youth from disadvantaged circumstances, to realize their full potential as productive, caring and responsible citizens." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau Program Description: Skills Mastery And Resistance Training (SMART) Moves Prevention Program: Helping the young people of the Big Island develop skills to resist tobacco, alcohol, other drugs, and other problem behaviors and enhanced by positive youth development activities through 5 core program areas. The Need Tobacco, alcohol and other drug use are a particularly insidious problem because it rarely remains isolated. It is widely recognized as a major contributing factor in other youth problems including school failure, truancy, runaways, suicide, pregnancy, school dropout, family problems, auto accidents, unemployment and crime. Tobacco is recognized as the ultimate "gateway' drug. Research indicates that the majority of illicit drug users began their substance abuse with tobacco, often at a very young age. Today the United States has the highest rate of illicit drug use of any industrialized nation. Across the country every community, regardless of location and income level, has been touched by drug use. Recent studies have explored the correlation of delinquent and risky sexual behavior with adolescent and teen use/abuse of alcohol, tobacco, and other drugs (ATOD). Adolescents and teens who are "idle" or not involved in positive youth development activities are most likely to engage in activities and social settings that promote behaviors such as drugs and alcohol, gang involvement, delinquency and crime. Youth who use one substance are more likely to use other substances; and these studies showed a strong relationship between substance use and other risk behaviors, including teenage sexual behavior and anti -social behavior. Statistics for the County of Hawaii are alarming: Hawaii County has the highest rates of crystal methampetamine use in the state and in a recent Alcohol and Drug Addiction Department (ADAD) report for Hawaii District, there is an overwhelming number of youth trying alcohol and marijuana. The percentages for youth drinking and smoking are some of the highest in the State for 8th - 12th grade youth. ' Hawaii County has the highest rate of youth at risk due to indicators such as the highest rates of unemployment, highest rates of high school dropouts, highest rates of juvenile delinquency, highest rates of child abuse and out -of - home placement. The risk factors and risk behaviors identified as priority concerns for the Keaau community are the early initiation of problem behaviors and the high gang involvement activities; youth reporting feeling unsafe in their communities; interaction with antisocial peers; poor family supervision; low school commitment NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau and poor academic performance. Despite the overwhelming factors that place youth from these areas at risk including high unemployment rate and high percentage of households living in poverty, protective factors show a high percentage of adolescent youth reporting close family and neighborhood ties. Too many children today grow up with few, if any, positive role models and little, if any, encouragement to resist tobacco, alcohol, other drugs and sexual activity. The norm and expectation for these young people, whether perceived or real, is that it is almost a "rite of passage" to smoke tobacco, drink alcohol, use other drugs and engage in sex. Not only is this the perception of young people themselves but often the perception of the adults in their lives whose passive resignation encourages rather than discourages these behaviors. While young people are taught skills to prepare them to face educational challenges, at critical stages of psychological, emotional and intellectual development they are often not taught the skills needed to make the transition from childhood to adulthood and to resist tobacco, alcohol, other drugs and premature sexual activity. Furthermore, the effects on families today to keep up with the economy and rising cost of living by working up to three jobs to make ends meet find themselves searching for positive youth activities for their children. We often hear youth today express how they have nothing to do! Our children are growing up in very stressful times, and we need to do more to help them. Responding to the Need Until recently, most prevention programs failed, in large part because they were based on faulty assumptions about why young people begin using tobacco, alcohol, and drugs in the first place. Early prevention efforts relied on scare tactics and moral exhortations, expressing prohibitionist views that linked drugs to dangerous criminal influences. Few of these programs were systematically evaluated, but those that were failed to show reduced drug use among participants. Responding to the urgent need for an effective prevention program, Boys & Girls Clubs of America (BGCA) developed and field-tested a comprehensive program to help young people develop skills to resist tobacco, alcohol, other drug use and premature sexual activity. The results were outstanding. Called SMART Moves, the program is based on two rigorously tested curricula: Life Skills Training (Gilbert Botvin, Ph.D., Cornell University) and Project SMART (William Hansen, Ph.D., University of Southern California). SMART Moves is now used successfully in communities across the nation. The program is based on a resistance training/social skills model. Using small group activities, it teaches young people to recognize and resist media influences and NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau peer pressures to engage in tobacco, alcohol, other drug use and early sexual involvement. SMART Moves recognizes that in addition to resistance training and the development of social skills, self esteem is a very important factor in regulating basic human drives and attitudes. When children are made to feel that they matter, that they have a unique contribution to make, and when they are helped to understand their feelings, they are less likely to endanger their own health or that of others by indulging in behaviors that put them at risk. SMART Moves also recognizes that in order for youth to learn and apply prevention principles, prevention programs must include parents and members of the community. SMART Moves uses a team approach to implement the program. The prevention team consists of Club staff, community representatives, parents and older teens. The SMART Moves curriculum is comprised of the following components: SMART Kids Make SMART Moves: A skills development program for boys and girls ages 6 to 9. The program focus is on self awareness, decision-making and interpersonal skills, while communicating age appropriate information about tobacco, alcohol and other drugs. Start SMART: A resistance skills program for youth ages 9 to 12 that focus on ways to identify and resist peer, social and media pressures to use tobacco, alcohol, other drugs or become sexually involved. It includes age appropriate discussions of puberty and friendships. Stay SMART: A social skills program for adolescents ages 13 to 15 that teaches resistance skills, stress reduction techniques, communication skills, assertiveness training and life planning. It provides accurate information about tobacco use, alcohol use, other drug use and adolescent sexuality. SMART Leaders: A peer mentoring program focused on teens 13-17 years old that plan and facilitate SMART Moves sessions with other youth in one or more of the SMART Moves program. Family Advocacy Network (F.A.N.) Club: A prevention program that targets the families of the SMART Leader participants to encourage family opportunities for positive involvement and reinforcing the concepts of preventing substance abuse amongst the youth participants. Also recognized by the Center for Substance Abuse Prevention and the Western Center for the application of Prevention Technologies as a 'Best Practice" prevention program and rated as a model program by Substance Abuse and Mental Health Services Administration. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau Achievements SMART Moves is: - Recognized as one of 10 exemplary primary prevention programs by the U.S. Office of Substance Abuse Prevention, the National Association of State Alcohol and Drug Abuse Directors, and the National Prevention Network. - Lauded as a premier national prevention program by the White House Conference for a Drug Free America as well as the Children's Defense Fund. - Cited for its parent -training component by the Office of the Inspector General of the U.S. Department of Human Services Administration. - Noted for its effectiveness in a study conducted by the Center for Health Policy Research of The Pennsylvania State University. - Singled out for praise in The Making of a Drug Free America: Programs That Work by Mathea Falco (former Assistant U.S. Secretary of State for Narcotics Affairs). SMART Moves is unique among prevention programs in that: - SMART Moves is the sole national prevention program currently addressing the problems of tobacco, alcohol, other drug use and teen pregnancy in one comprehensive curriculum. - SMART Moves employs a team consisting of staff, parents, community representatives and older Club members to impart the knowledge and teach the skills needed by young people to avoid tobacco, alcohol, other drugs and premature sexual involvement. - SMART Moves actively involves parents in the prevention effort. - SMART Moves uses teen leaders who act as role models to younger people. - SMART Moves is incorporated into all Club activities and programs. Daily positive youth development programs will enhance SMART Moves through activities in a coordinated, comprehensive manner and include the following 5 core program areas. 1) Sports, Fitness & Recreation — Organized Team sports, individual low organized athletic programs, and Smart Moves activities are designed to meet the development needs of a diverse age group of youth participants. Programs are designed to include novice, intermediate and advance levels of skill development to increase youth participation and enhance self-esteem, and promote exercise, good/diet and nutrition. Activities for this program area are conducted at least four times a week, with each session averaging 1-2 hours. On a daily basis two to three sessions are conducted. Program activities also provide opportunities to engage youth in making healthy lifestyle choices and deter involvement in drugs, violence and other risky behaviors. These activities promote physical fitness and positive use of leisure time, and also consist of sports leagues, health and fitness activities, and skill building clinics. To prevent youth engaging in delinquent and risky behaviors, and give opportunities for NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau making new friends, structured and informal recreational and social activities. Activities are conducted in individual, small group and large group formats, with emphasis on positive intra -personal interaction with peers and adults. Examples include drop-in game room activities, instructional clinics and tournaments, club dances, and excursions. Activities for this program area will be conducted at least five days a week with individual session averaging 1 to 1 '/2 hours. 2) Character and Leadership Development — Youth who participate in Keystone, Torch Clubs, LIT, and Peer Leadership programs provide various community service projects which teaches them civic responsibility. Youth participating in this program area are required to plan and perform a minimum of four community service projects (once every quarter). Youth are engaged and involved in the decision-making and implementation of the projects and activities of the program and community. Youth involved in Keystone & Torch Clubs and the Smart Moves "SMART Leaders" component are given the chance to strengthen intra -personal and decision-making skills through small group focus sessions. As a means of building character & leadership skills, youth plan and implement activities in prevention programs and community service to give back to the Club and community. 3) Education and Career Development — Power Hour program includes educational enhancement activities to increase the opportunities for academic success of youth participants. Power Hour sessions will be held at least four times a week with each session averaging 1 hour. The Career Launch and Job Ready programs available for youth prepares youth for possible employment, post high school education and career development. Youth also have the opportunity to participate in science based programs such as the Ocean Exploration Program "Immersion Presents". This program focuses on the activities that take youth through 5 curriculum -based modules where youth explore expeditions and explorations of scientist. This OJJDP supported program has been implemented at more than 450 Boys & Girls Clubs in 33 different cities and continues to grow in popularity as youth combine science, art, mathematics, career development and law enforcement to learn and increase their educational base. BGCBI also includes programs such as BGCA's Project Learn and Dragonfly Quest to enhance the basics in education. Use of a complete internet accessible computer technology center at the Club also supports a strong education enhancement program. 4) Health & Life Skills — In addition to the proposed SMART Moves curriculum the Boys & Girls Club of the Big Island will conduct other specific SMART Moves component programs to help youth increase their capacity to make successful transition to adulthood, small group and individual programs such as SMART Girls, Passport to Manhood, Act SMART, Street SMART, Quick SMART and SMART Parents. These programs will address issues such as esteem building, planning and personal goals, personal healthy living & practices NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau and development of resistance skills against pre -matured sexual behaviors, drugs, alcohol and other at -risk behaviors. 5) The Arts — Youth will have daily opportunity to engage in arts & craft activities to promote creativity and hands-on experiences through art. Included in art are possible activities in Fine Art, photography, pottery, woodworking and much more to support the need for youth to be involved in creativity and self exploration of the world surrounding them. The art center is often used for all other program components due to the need for hands-on experiences and use of material and supplies used in art. The combination of the proposed SMART Moves and 5 core programs will promote positive youth development and decrease substance use and problem behaviors of youth participants. The standard of our programs will be based on increasing protective factors and reducing risk factors facing our community youth and families. Total Budget and Position Count Total Program Budget $166,742.81 Total Program Position Count 18 Total Agency Budget 1,173,924.56 Total Agency Position Count 127 Program Objectives: 1) Increase participants' knowledge about tobacco, alcohol and other drugs and sexuality. 2) Increase participants' ability to identify and resist peer and media pressures to use tobacco, alcohol and other drugs. 3) Increase youth ability to develop and improve skills around making decisions, resisting social and peer pressures, and coping with the stress of growing up. 4) Decrease problem behavior of youth by increasing participant's positive self esteem through participation in positive youth development activities on a daily basis. 5) Increase communication among staff members, parents, guardians and Club members regarding tobacco, alcohol, other drugs and adolescent sexual involvement. Program Highlights: 1) In the Fiscal Year 2005-2006 the Boys & Girls Club of the Big Island completed measurement of impact and collection of data for assessment of risk and protective factors through pre -post surveys and SMART Moves evaluation surveys. Results showed that of the 368 youth completing SMART Moves: 69% showed increased knowledge of the dangers in Tobacco and other drugs and alcohol. 65% of youth showed an increase NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau in not getting involved with ATOD use. 75% showed increase in knowledge of healthy practices that could be used to deal with everyday issues in peer pressures and making better decisions. 90% of teens participating shared that alcohol and tobacco use was in their home. 75% of 10-15 year olds surveyed shared they have tried tobacco.90% of 10-15 year olds shared they have tried alcohol and other drugs. 35% of Stay SMART graduates contributed to SMART Moves by completing the SMART Leaders certification and presently facilitate SMART Moves Programs with younger youth. Further assessment collected shows that parents involved in SMART Moves activities shared how they take for granted tobacco and alcohol use around their kids and learned that second hand smoke and family parties are so much a part of everyday life in our local setting. Parents also shared that other parents would be reluctant to attend these activities as they are ATOD users and would be in denial and not see the need for being told what to do. The breakdown of Club Site completion numbers were 76 youth in Stay SMART in Pahoa, 67 youth in Keaau and 116 youth at the Hilo Club. In addition,109 youth completed a modified Start SMART Abstinence -only program at Keaau, Hilo and Keaau. 2) A SMART Moves Coordinator position was created in 2006 to address a management position to coordinate all SMART Moves training, creative enhancement activities and formal evaluative assessments of all SMART Moves program youth. This position has been approved and will be an integral part of our organization as soon as funding is available. 3) The Boys & Girls Club of the Big Island has expanded program services to youth in Pahala, Ka'u in September of 2006. The Pahala Club joins the present Clubs in Hilo, Keaau and Pahoa to provide SMART Moves and core programs to all youth participants. New Club sites in Paauilo, Hamakua and Hawaiian Oceanview Estates, Ka'u will be opening doors for youth in their respective communities on February 1st, 2007. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget * Estimate Youth will complete SMART Moves 52 106 206 Of the 206 youth: completing the 25 0 30 SMART Moves Program, Youth ages 6-9 will complete the SMART Kids Program. Of the 206 youth: completing the 16 36 76 SMART Moves Program, Youth ages 10-12 will complete the Start SMART Program. Of the 206 youth: completing the 40 60 SMART Moves Program, Youth 0 ages 13-15 will complete the Stay SMART Program. Of the 206 youth: completing the 30 40 SMART Moves Program, Youth 0 ages 13-17 will complete the SMART Leaders Program. Youth will participate in "The Art" 30 10 75 Program Youth will participate in Character & 25 15 50 Leadership Program Youth will participate in Education 39 55 100 and Career Development Program Youth will participate in Health & 60 131 100 Life Skills Program Youth will participate in Sports 70 75 120 Fitness and Recreation Program Parents will participate in FAN Club n/a 25 40 activities *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau Program Expenditures * If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $40,385.76 $113,136.91 $121,622.09 Professional Fees $ $1,275.00 $1,875.00 Operations $9614.24 $38,902.39 $41,420.82 Equipment $ $1,194.75 $1764.90 Other (Board Development) $ $60.00 $60.00 Total $50000.00 $154,569.05 $166,742.81 * If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Hawaii Community Foundation: Hawaii Island Meth Initiative $ $18,750.00 $18,347.06 Office of Juvenile Justice Delinquency Prevention $ $36,000.00 $ Salvation Army/(OYS) Positive Alternative Activities $12,500.00 $ $ County of Hawaii —Nonprofit Grant $12,500.00 $ $50,000.00 Office of Youth Services (OYS) Non -School Hours Grant $ $ $16,666.67 Hawaii Community Foundation: Tobacco Fund $12,500.00E$3E2OOO.00 $ Office of Youth Services OYS: Gang Prevention $ $ $37,500.00 YMCA Rural Youth Program (RYP) Grant Center Base $ $ $ Boys & Girls Club of Hawaii: Abstinence -Only Grant $ $13,077.41 $2,466.67 Hawaii Island United Way $ $6,666.67 $13,333.33 Alcohol Drug Abuse Division ADAD $12,500.00 $33,333.33 $ Intersession Fees $ $10,000.00 $10,000.00 Club Fundraising $4,741.64 $8,429.08 Total $50,000.00$154,569.05 166,742.81 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Keaau Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 11 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development: Keaau FY 2006-07: Line Item: Other — Allocated expenditure for Board of Directors Development: Example: Strategic Planning & Transitional orientation and training with new Chief Professional Officer. FY 2007-2008: Line Item: Other — Estimated Board of Director Development expenses. Boys & Girls Club of the Big Island - Agency Name SMART Moves: Keaau - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawa!'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and VV l/ ' Signatureo Board President/Chair /A Signature of Executive Director 1-31-D1 Date 1131101 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: David (Kawika) Mattos David (Kawika) Mattos Phone No.: 961-5536 Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 92-8924 Wailani Circle, Ocean View, Hawaii 96737 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): Phone No.: David Chinaka - Chinaka, Sui & Co., CPAs 3465 Waialae Avenue, Suite 250 Mailing Address: Honolulu, Hawaii 96816 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 04-05 $...0 05-06 $...0 Agency Mission Statement: 06-07 $...0 "To enable all youth, especially youth from disadvantaged circumstances, to realize their full potential as productive, caring and responsible citizens." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View Program Description: Skills Mastery And Resistance Training (SMART) Moves Prevention Program: Helping the young people of the Big Island develop skills to resist tobacco, alcohol, other drugs, and other problem behaviors and enhanced by positive youth development activities through 5 core program areas. The Need Tobacco, alcohol and other drug use are a particularly insidious problem because it rarely remains isolated. It is widely recognized as a major contributing factor in other youth problems including school failure, truancy, runaways, suicide, pregnancy, school dropout, family problems, auto accidents, unemployment and crime. Tobacco today is widely recognized as the ultimate "gateway" drug. Research indicates that the majority of illicit drug users began their substance abuse with tobacco, often at a very young age. Today the United States has the highest rate of illicit drug use of any industrialized nation. Across the country every community, regardless of location and income level, has been touched by drug use. Recent studies have explored the correlation of delinquent and risky sexual behavior with adolescent and teen use/abuse of alcohol, tobacco, and other drugs (ATOD). Adolescents and teens who are "idle" or not involved in positive youth development activities are most likely to engage in activities and social settings that promote behaviors such as drugs and alcohol, gang involvement, delinquency and crime. Youth who use one substance are more likely to use other substances; and these studies showed a strong relationship between substance use and other risk behaviors, including teenage sexual behavior and anti -social behavior. Statistics for the County of Hawaii are alarming: " Hawaii County has the highest rates of crystal methampetamine use in the state and in a recent Alcohol and Drug Addiction Department (ADAD) report for Hawaii District, there is an overwhelming number of youth trying alcohol and marijuana. The percentages for youth drinking and smoking are some of the highest in the State for 8th - 12th grade youth. Hawaii County has the highest rate of youth at risk due to indicators such as the highest rates of unemployment, highest rates of high school dropouts, highest rates of juvenile delinquency, highest rates of child abuse and out -of - home placement. Ocean View continues to grow in population and in recent years has seen an increase in youth population. Boys & Girls Club of the Big Island has spent some time visiting this community and meeting with residents. Community needs have focused on a huge need for youth programs. The risk factors and risk behaviors NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View identified as priority concerns for the Ka'u communities include the highest percentage of "idle teens" (Teens not in school and not working), poor family supervision; low school commitment, low school attendance rate and poor academic performance. Despite the overwhelming factors that place youth from these areas at risk including one of the highest unemployment rate and a very high percentage of households living in poverty, protective factors show a high percentage of adolescent youth reporting close family and neighborhood ties as well as many students reporting their desire to attend college or post high school education. The latest school profile report for Na'alehu Elementary, Pahala Elementary and Ka'u Intermediate and High School show a 87.8% and Na'alehu Elementary 88.3% as the daily average of students attending school. These are below the State of Hawaii Standard of 95%. The average daily absences (in days) on the school status profile also showed an alarming 21.7 for Na'alehu Elementary and 20.7 for Pahala Elementary and Ka'u High School. The average daily absence for the State of Hawaii is 9 days. These statistics can be attributed to many of the risk factors surrounding the community and their youth. Our proposed project will increase the protective factors with kids having opportunity for positive involvement and in daily attendance at school. Youth participating in the data collected by the Center on the Family and the Department of Education student surveys live in Ocean View, Na'alehu and Pahala Too many children today grow up with few, if any, positive role models and little, if any, encouragement to resist tobacco, alcohol, other drugs and sexual activity. The norm and expectation for these young people, whether perceived or real, is that it is almost a "rite of passage" to smoke tobacco, drink alcohol, use other drugs and engage in sex. Not only is this the perception of young people themselves but often the perception of the adults in their lives whose passive resignation encourages rather than discourages these behaviors. While young people are taught skills to prepare them to face educational challenges, at critical stages of psychological, emotional and intellectual development they are often not taught the skills needed to make the transition from childhood to adulthood and to resist tobacco, alcohol, other drugs and premature sexual activity. Furthermore, the effects of families today to keep up with the economy and rising cost of living by working up to three jobs to make ends meet find themselves searching for positive youth activities for their children. We often hear youth today express how they have nothing to do! Our children are growing up in very stressful times, and we need to do more to help them. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View Responding to the Need Until recently, most prevention programs failed, in large part because they were based on faulty assumptions about why young people begin using tobacco, alcohol, and drugs in the first place. Early prevention efforts relied on scare tactics and moral exhortations, expressing prohibitionist views that linked drugs to dangerous criminal influences. Few of these programs were systematically evaluated, but those that were failed to show reduced drug use among participants. Responding to the urgent need for an effective prevention program, Boys & Girls Clubs of America (BGCA) developed and field-tested a comprehensive program to help young people develop skills to resist tobacco, alcohol, other drug use and premature sexual activity. The results were outstanding. Called SMART Moves, the program is based on two rigorously tested curricula: Life Skills Training (Gilbert Botvin, Ph.D., Cornell University) and Project SMART (William Hansen, Ph.D., University of Southern California). SMART Moves is now used successfully in communities across the nation. The program is based on a resistance training/social skills model. Using small group activities, it teaches young people to recognize and resist media influences and peer pressures to engage in tobacco, alcohol, other drug use and early sexual involvement. SMART Moves recognizes that in addition to resistance training and the development of social skills, self esteem is a very important factor in regulating basic human drives and attitudes. When children are made to feel that they matter, that they have a unique contribution to make, and when they are helped to understand their feelings, they are less likely to endanger their own health or that of others by indulging in behaviors that put them at risk. SMART Moves also recognizes that in order for youth to learn and apply prevention principles, prevention programs must include parents and members of the community. SMART Moves uses a team approach to implement the program. The prevention team consists of Club staff, community representatives, parents and older teens. The SMART Moves curriculum is comprised of the following components: SMART Kids Make SMART Moves: A skills development program for boys and girls ages 6 to 9. The program focus is on self awareness, decision-making and interpersonal skills, while communicating age appropriate information about tobacco, alcohol and other drugs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View Start SMART: A resistance skills program for youth ages 9 to 12 that focuses on ways to identify and resist peer, social and media pressures to use tobacco, alcohol, other drugs or become sexually involved. It includes age appropriate discussions of puberty and friendships. Stay SMART: A social skills program for adolescents ages 13 to 15 that teaches resistance skills, stress reduction techniques, communication skills, assertiveness training and life planning. It provides accurate information about tobacco use, alcohol use, other drug use and adolescent sexuality. SMART Leaders: A peer mentoring program focused on teens 13-17 years old that plan and facilitate SMART Moves sessions with other youth in one or more of the SMART Moves program. Family Advocacy Network (F.A.N.) Club: A prevention program that targets the families of the SMART Leader participants to encourage family opportunity for positive involvement and reinforcing the concepts of preventing substance abuse amongst the youth participants. Also recognized by the Center for Substance Abuse Prevention and the Western Center for the application of Prevention Technologies as a "Best Practice" prevention program and rated as a model program by Substance Abuse and Mental Health Services Administration. Achievements SMART Moves is: - Recognized as one of 10 exemplary primary prevention programs by the U.S. Office of Substance Abuse Prevention, the National Association of State Alcohol and Drug Abuse Directors, and the National Prevention Network. - Lauded as a premier national prevention program by the White House Conference for a Drug Free America as well as the Children's Defense Fund. - Cited for its parent -training component by the Office of the Inspector General of the U.S. Department of Human Services Administration. - Noted for its effectiveness in a study conducted by the Center for Health Policy Research of The Pennsylvania State University. - Singled out for praise in The Making of a Drug Free America: Programs That Work by Mathea Falco (former Assistant U.S. Secretary of State for Narcotics Affairs). SMART Moves is unique among prevention programs in that: - SMART Moves is the sole national prevention program currently addressing the problems of tobacco, alcohol, other drug use and teen pregnancy in one comprehensive curriculum. - SMART Moves employs a team consisting of staff, parents, community representatives and older Club members to impart the knowledge and teach the NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View skills needed by young people to avoid tobacco, alcohol, other drugs and premature sexual involvement. - SMART Moves actively involves parents in the prevention effort. - SMART Moves uses teen leaders who act as role models to younger people. - SMART Moves is incorporated into all Club activities and programs. Daily positive youth development programs will enhance SMART Moves through activities in a coordinated, comprehensive manner and include the following 5 core program areas. 1) Sports, Fitness & Recreation — Organized Team sports, individual low organized athletic programs, and Smart Moves activities are designed to meet the development needs of a diverse age group of youth participants. Programs are designed to include novice, intermediate and advance levels of skill development to increase youth participation and enhance self-esteem, and promote exercise, good/diet and nutrition. Activities for this program area are conducted at least four times a week, with each session averaging 1-2 hours. On a daily basis two to three sessions are conducted. Program activities also provide opportunities to engage youth in making healthy lifestyle choices and deter involvement in drugs, violence and other risky behaviors. These activities promote physical fitness and positive use of leisure time, and also consist of sports leagues, health and fitness activities, and skill building clinics. To prevent youth engaging in delinquent and risky behaviors, and give opportunities for making new friends, structured and informal recreational and social activities. Activities are conducted in individual, small group and large group formats, with emphasis on positive intra -personal interaction with peers and adults. Examples include drop-in game room activities, instructional clinics and tournaments, club dances, and excursions. Activities for this program area will be conducted at least five a week with individual session averaging 1 to 1 'Y2 hours. 2) Character and Leadership Development— Youth who participate in Keystone, Torch Clubs, LIT, and Peer Leadership programs provide various community service projects which teaches them civic responsibility. Youth participating in this program area are required to plan and perform a minimum of four community service projects (once every quarter). Youth are engaged and involved in the decision-making and implementation of the projects and activities of the program and community. Youth involved in Keystone & Torch Clubs and the Smart Moves "SMART Leaders" component are given the chance to strengthen intra -personal and decision-making skills through small group focus sessions. As a means of building character & leadership skills, youth plan and implement activities in prevention programs and community service to give back to the Club and community. 3) Education and Career Development — Power Hour program includes educational enhancement activities to increase the opportunities for academic success of youth participants. Power Hour sessions will be held at least four NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View times a week with each session averaging 1 hour. The Career Launch and Job Ready programs available for youth prepares youth for possible employment, post high school education and career development. Youth also have the opportunity to participate in science based programs such as the Ocean Exploration Program 'Immersion Presents". This program focuses on the activities that take youth through 5 curriculum -based modules where youth explore expeditions and explorations of scientist. This OJJDP supported program has been implemented at more than 450 Boys & Girls Clubs in 33 different cities and continues to grow in popularity as youth combine science, art, mathematics, career development and law enforcement to learn and increase their educational base. BGCBI also includes programs such as BGCA's Project Learn and Dragonfly Quest to enhance the basics in education. Use of a complete internet accessible computer technology center at the Club also supports a strong education enhancement program. 4) Health & Life Skills — In addition to the proposed SMART Moves curriculum the Boys & Girls Club of the Big Island will conduct other specific SMART Moves component programs to help youth increase their capacity to make successful transition to adulthood, small group and individual programs such as SMART Girls, Passport to Manhood, Act SMART, Street SMART, Quick SMART and SMART Parents. These programs will address issues such as esteem building, planning and personal goals, personal healthy living & practices and development of resistance skills against pre -matured sexual behaviors, drugs, alcohol and other at -risk behaviors. 5) The Arts — Youth will have daily opportunity to engage in arts & craft activities to promote creativity and hands-on experiences through art. Included in art are possible activities in Fine Art, photography, pottery, woodworking and much more to support the need for youth to be involved in creativity and self exploration of the world surrounding them. The art center is often used for all other program components due to the need for hands-on experiences and use of material and supplies used in art. The combination of the proposed SMART Moves and 5 core programs will promote positive youth development and decrease substance use and problem behaviors of youth participants. The standard of our programs will be based on increasing protective factors and reducing risk factors facing our community youth and families. Total Budget and Position Count Total Program Budget $127,864.06 Total Program Position Count 18 Total A enc Bud et $1,173,924.56 Total Agency Position Count 127 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View Program Objectives: 1) Increase participants' knowledge about tobacco, alcohol and other drugs and sexuality. 2) Increase participants' ability to identify and resist peer and media pressures to use tobacco, alcohol and other drugs. 3) Increase youth ability to develop and improve skills around making decisions, resisting social and peer pressures, and coping with the stress of growing up. 4) Decrease problem behavior of youth by increasing participant's positive self esteem through participation in positive youth development activities on a daily basis. 5) Increase communication among staff members, parents, guardians and Club members regarding tobacco, alcohol, other drugs and adolescent sexual involvement. Program Highlights: 1) In the Fiscal Year 2005-2006 the Boys & Girls Club of the Big Island completed measurement of impact and collection of data for assessment of risk and protective factors through pre -post surveys and SMART Moves evaluation surveys. Results showed that of the 368 youth completing SMART Moves: 69% showed increased knowledge of the dangers in Tobacco and other drugs and alcohol. 65% of youth showed an increase in not getting involved with ATOD use. 75% showed increase in knowledge of healthy practices that could be used to deal with everyday issues in peer pressures and making better decisions. 90% of teens participating shared that alcohol and tobacco use was in their home. 75% of 10-15 year olds surveyed shared they have tried tobacco.90% of 10-15 year olds shared they have tried alcohol and other drugs. 35% of Stay SMART graduates contributed to SMART Moves by completing the SMART Leaders certification and presently facilitate SMART Moves Programs with younger youth. Further assessment collected shows that parents involved in SMART Moves activities shared how they take for granted tobacco and alcohol use around their kids and learned that second hand smoke and family parties are so much a part of everyday life in our local setting. Parents also shared that other parents would be reluctant to attend these activities as they are ATOD users and would be in denial and not see the need for being told what to do. The breakdown of Club Site completion numbers were 76 youth in Stay SMART in Pahoa, 67 youth in Keaau and 116 youth at the Hilo Club. In addition 109 youth completed a modified Start SMART Abstinence -only program at Keaau, Hilo and Keaau. 2) A SMART Moves Coordinator position was created in 2006 to address a management position to coordinate all SMART Moves training, creative NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 & Girls Club of the Bie Island SMART Moves & Positive Youth Development Programs: Ocean View enhancement activities and formal evaluative assessment of all SMART Moves program youth. This position has been approved and will be an integral part of our organization as soon as funding is available. 3) The Boys & Girls Club of the Big Island has expanded program services to youth in Pahala, Ka'u in September of 2006. The Pahala Club joins the present Clubs in Hilo, Keaau and Pahoa to provide SMART Moves and core programs to all youth participants. New Club sites in Paauilo, Hamakua and Hawaiian Oceanview Estates, Ka'u will be opening doors for youth in their respective communities on February 1st, 2007. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget* Estimate Youth will complete SMART Moves n/a 38 50 Of the 50 youth completing SMART n/a 15 20 Moves. Youth ages 6-9 will complete the SMART Kids Of the 50 youth :completing the n/a 15 20 SMART Moves Program, Youth ages 10-12 will complete the Start SMART Program. Of the 50 youth :completing the n/a 8 5 SMART Moves Program, Youth ages 13-15 will complete the Stay SMART Program. Of the 50 youth :completing the n/a 0 5 SMART Moves Program, Youth ages 13-17 will complete the Stay SMART Program. Youth will participate in 'The Art" n/a 35 50 Program Youth will participate in Character & n/a 10 35 Leadership Program Youth will participate in Education n/a 35 75 and Career Development Program Youth will participate in Health & n/a 35 75 Life Skills Program Youth will participate in Sports n/a 35 100 Fitness and Recreation Program Parents will participate in FAN Club n/a 10 20 activities *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Ocean View Program Expenditures If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages n/a $64,592.32 $103,896.27 Professional Fees n/a $850.00 $1,250.00 Operations n/a $21,343.57 $21,901.19 Equipment n/a $796.50 $776.60 Other (Board Development) n/a $40.00 1 $40.00 Total n/a $87,622.39 1 $127,864.06 If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Boys & Girls Club of Hawaii/YMCA Rural Youth Program RYP Funds 0 $61,137.40 $19,898.01 Office of Juvenile Justice Prevention 0 $ $ -Delinquency Office of Youth Services (OYS): Prevention 0 $ $5,000.00 -Truancy of Hawaii —Non profit Grant 0 $ $50,000.00 -County County of Hawaii — District 6 Bob Jacobson: Contingency Fund 0 $5,000.00 $ Hawaii Community Foundation: Tobacco Fund 0 $9,500.00 $ Office of Youth Services (OYS) Non -School Hours Grant 0 $ $16,666.67 Events $11,984.99 $11,299.38 -Fundraising Office of Youth Services (OYS) Positive Youth Development $ $25,000.00 $ $ Total $87,622.39 $127,864.06 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 11 & Girls Club of the Biv- Island SMART Moves & Positive Youth Development Programs: Ocean View Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 12 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development: Ocean View FY 2006-07: Line Item: Other — Allocated expenditure for Board of Directors Development: Example: Strategic Planning & Transitional orientation and training with new Chief Professional Officer. FY 2007-2008: Line Item: Other — Estimated Board of Director Development expenses. Boys & Girls Club of the Big Island - Agency Name SMART Moves: Ocean View - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The reportshall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. NW, ,[k Signature of Board President/Chair Signature of Executive Director Date 1/3►/7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 96-2945 Paauau Street, Pahala, Hawaii 96777 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: 3465 Waialae Avenue, Suite 250 Mailing Address: Honolulu, Hawaii 96816 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 04-05 05-06 06-07 $...0 $...0 $...0 Agency Mission Statement: "To enable all youth, especially youth from disadvantaged circumstances, to realize their full potential as productive, caring and responsible citizens." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page I Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala Program Description: Skills Mastery And Resistance Training (SMART) Moves Prevention Program: Helping the young people of the Big Island develop skills to resist tobacco, alcohol, other drugs, and other problem behaviors and enhanced by positive youth development activities through 5 core program areas. The Need Tobacco, alcohol and other drug use are a particularly insidious problem because it rarely remains isolated. It is widely recognized as a major contributing factor in other youth problems including school failure, truancy, runaways, suicide, pregnancy, school dropout, family problems, auto accidents, unemployment and crime.Tobacco is recognized as the ultimate "gateway' drug. Research indicates that the majority of illicit drug users began their substance abuse with tobacco, often at a very young age. Today the United States has the highest rate of illicit drug use of any industrialized nation. Across the country every community, regardless of location and income level, has been touched by drug use. Recent studies have explored the correlation of delinquent and risky sexual behavior with adolescent and teen use/abuse of alcohol, tobacco, and other drugs (ATOD). Adolescents and teens who are "idle" or not involved in positive youth development activities are most likely to engage in activities and social settings that promote behaviors such as drugs and alcohol, gang involvement, delinquency and crime. Youth who use one substance are more likely to use other substances; and these studies showed a strong relationship between substance use and other risk behaviors, including teenage sexual behavior and anti -social behavior. Statistics for the County of Hawaii are alarming: * Hawaii County has the highest rates of crystal methampetamine use in the state and in a recent Alcohol and Drug Addiction Department (ADHD) report for Hawaii District, there is an overwhelming number of youth trying alcohol and marijuana. The percentages for youth drinking and smoking are some of the highest in the State for 8th - 12th grade youth. * Hawaii County has the highest rate of youth at risk due to indicators such as the highest rates of unemployment, highest rates of high school dropouts, highest rates of juvenile delinquency, highest rates of child abuse and out -of - home placement. The risk factors and risk behaviors identified as priority concerns for the Ka'u communities include the highest percentage of "idle teens" (Teens not in school and not working), poor family supervision; low school commitment, low school attendance rate and poor academic performance. Despite the overwhelming NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala factors that place youth from these areas at risk including one of the highest unemployment rate and a very high percentage of households living in poverty, protective factors show a high percentage of adolescent youth reporting close family and neighborhood ties as well as many students reporting their desire to attend college or post high school education. The latest school profile report for Na'alehu Elementary, Pahala Elementary and Ka'u Intermediate and High School show a 87.8% and Na'alehu Elementary 88.3% as the daily average of students attending school. These are below the State of Hawaii Standard of 95%. The average daily absences (in days) on the school status profile also showed an alarming 21.7 for Na'alehu Elementary and 20.7 for Pahala Elementary and Ka'u High School. The average daily absences for the State of Hawaii is 9 days. These statistics can be attributed to many of the risk factors surrounding the community and their youth. Our proposed project will increase the protective factors with kids having opportunity for positive involvement and increasing daily attendance at school. Youth participating in the data collected by the Center on the Family and the Department of Education student surveys live in Ocean View, Na'alehu and Pahala. Too many children today grow up with few, if any, positive role models and little, if any, encouragement to resist tobacco, alcohol, other drugs and sexual activity. The norm and expectation for these young people, whether perceived or real, is that it is almost a "rite of passage" to smoke tobacco, drink alcohol, use other drugs and engage in sex. Not only is this the perception of young people themselves but often the perception of the adults in their lives whose passive resignation encourages rather than discourages these behaviors. While young people are taught skills to prepare them to face educational challenges, at critical stages of psychological, emotional and intellectual development they are often not taught the skills needed to make the transition from childhood to adulthood and to resist tobacco, alcohol, other drugs and premature sexual activity. Furthermore, the effects on families today to keep up with the economy and rising cost of living by working up to three jobs to make ends meet find themselves searching for positive youth activities for their children. We often hear youth today express how they have nothing to do! Our children are growing up in very stressful times, and we need to do more to help them. Responding to the Need Until recently, most prevention programs failed, in large part because they were based on faulty assumptions about why young people begin using tobacco, alcohol, and drugs in the first place. Early prevention efforts relied on scare tactics and moral exhortations, expressing prohibitionist views that linked drugs to dangerous criminal influences. Few of these programs were systematically NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 & Girls Club of the Big- Island SMART Moves & Positive Youth Development Programs: Pahala evaluated, but those that were failed to show reduced drug use among participants. Responding to the urgent need for an effective prevention program, Boys & Girls Clubs of America (BGCA) developed and field-tested a comprehensive program to help young people develop skills to resist tobacco, alcohol, other drug use and premature sexual activity. The results were outstanding. Called SMART Moves, the program is based on two rigorously tested curricula: Life Skills Training (Gilbert Botvin, Ph.D., Cornell University) and Project SMART (William Hansen, Ph.D., University of Southern California). SMART Moves is now used successfully in communities across the nation. The program is based on a resistance training/social skills model. Using small group activities, it teaches young people to recognize and resist media influences and peer pressures to engage in tobacco, alcohol, other drug use and early sexual involvement. SMART Moves recognizes that in addition to resistance training and the development of social skills, self esteem is a very important factor in regulating basic human drives and attitudes. When children are made to feel that they matter, that they have a unique contribution to make, and when they are helped to understand their feelings, they are less likely to endanger their own health or that of others by indulging in behaviors that put them at risk. SMART Moves also recognizes that in order for youth to learn and apply prevention principles, prevention programs must include parents and members of the community. SMART Moves uses a team approach to implement the program. The prevention team consists of Club staff, community representatives, parents and older teens. The SMART Moves curriculum is comprised of the following components SMART Kids Make SMART Moves: A skills development program for boys and girls ages 6 to 9. The program focus is on self awareness, decision-making and interpersonal skills, while communicating age appropriate information about tobacco, alcohol and other drugs. Start SMART: A resistance skills program for youth ages 9 to 12 that focus on ways to identify and resist peer, social and media pressures to use tobacco, alcohol, other drugs or become sexually involved. It includes age appropriate discussions of puberty and friendships. Stay SMART: A social skills program for adolescents ages 13 to 15 that teaches resistance skills, stress reduction techniques, communication skills, NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala assertiveness training and life planning. It provides accurate information about tobacco use, alcohol use, other drug use and adolescent sexuality. SMART Leaders: A peer mentoring program focused on teens 13-17 years old that plan and facilitate SMART Moves sessions with other youth in one or more of the SMART Moves program. Family Advocacy Network (F.A.N.) Club: A prevention program that targets the families of the SMART Leader participants to encourage family opportunities for positive involvement and reinforcing the concepts of preventing substance abuse amongst the youth participants. Also recognized by the Center for Substance Abuse Prevention and the Western Center for the application of Prevention Technologies as a "Best Practice" prevention program and rated as a model program by Substance Abuse and Mental Health Services Administration. Achievements SMART Moves is: - Recognized as one of 10 exemplary primary prevention programs by the U.S. Office of Substance Abuse Prevention, the National Association of State Alcohol and Drug Abuse Directors, and the National Prevention Network. - Lauded as a premier national prevention program by the White House Conference for a Drug Free America as well as the Children's Defense Fund. - Cited for its parent -training component by the Office of the Inspector General of the U.S. Department of Human Services Administration. - Noted for its effectiveness in a study conducted by the Center for Health Policy Research of The Pennsylvania State University. - Singled out for praise in The Making of a Drug Free America: Programs That Work by Mathea Falco (former Assistant U.S. Secretary of State for Narcotics Affairs), SMART Moves is unique among prevention programs in that: - SMART Moves is the sole national prevention program currently addressing the problems of tobacco, alcohol, other drug use and teen pregnancy in one comprehensive curriculum. - SMART Moves employs a team consisting of staff, parents, community representatives and older Club members to impart the knowledge and teach the skills needed by young people to avoid tobacco, alcohol, other drugs and premature sexual involvement. - SMART Moves actively involves parents in the prevention effort. - SMART Moves uses teen leaders who act as role models to younger people. - SMART Moves is incorporated into all Club activities and programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala Daily positive youth development programs will enhance SMART Moves through activities in a coordinated, comprehensive manner and include the following 5 core program areas. 1) Sports, Fitness & Recreation — Organized team sports, individual low organized athletic programs, and Smart Moves activities are designed to meet the developmental needs of a diverse age group of youth participants. Programs are designed to include novice, intermediate and advance levels of skill development to increase youth participation, enhance self-esteem and promote exercise, good/diet and nutrition. Activities for this program area are conducted at least four times a week, with each session averaging 1-2 hours. On a daily basis two to three sessions are conducted. Program activities provide opportunity to engage youth in making healthy lifestyle choices and deter involvement in drugs, violence and other risky behaviors. These activities promote physical fitness and positive use of leisure time, and also consist of sports leagues, health and fitness activities, and skill building clinics. To prevent youth engaging in delinquent and risky behaviors, and give opportunities for making new friends, structured and informal recreational and social activities. Activities are conducted in individual, small group and large group formats, with emphasis on positive intra -personal interaction with peers and adults. Examples include drop-in game room activities, instructional clinics and tournaments, club dances, and excursions. Activities for this program area will be conducted at least five days a week with individual session averaging 1 to 1 'Y2 hours. 2) Character and Leadership Development — Youth who participate in Keystone, Torch Clubs, LIT, and Peer Leadership programs provide various community service projects which teaches them civic responsibility. Youth participating in this program area are required to plan and perform a minimum of four community service projects (once every quarter). Youth are engaged and involved in the decision-making and implementation of the projects and activities of the program and community. Youth involved in Keystone & Torch Clubs and the Smart Moves "SMART Leaders" component are given the chance to strengthen intra -personal and decision-making skills through small group focus sessions. As a means of building character & leadership skills, youth plan and implement activities in prevention programs and community service to give back to the Club and community. 3) Education and Career Development — Power Hour program includes educational enhancement activities to increase the opportunities for academic success of youth participants. Power Hour sessions will be held at least four times a week with each session averaging 1 hour. The Career Launch and Job Ready programs available for youth prepares youth for possible employment, post high school education and career development. Youth also have the opportunity to participate in science based programs such as the Ocean Exploration Program 'Immersion Presents". This program focuses on the activities that take youth through 5 curriculum -based modules where youth NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala explore expeditions and explorations of scientist. This OJJDP supported program has been implemented at more than 450 Boys & Girls Clubs in 33 different cities and continues to grow in popularity as youth combine science, art, mathematics, career development and law enforcement to learn and increase their educational base. BGCBI also includes programs such as BGCA's Project Learn and Dragonfly Quest to enhance the basics in education. Use of a complete internet accessible computer technology center at the Club also supports a strong education enhancement program. 4) Health & Life Skills — In addition to the proposed SMART Moves curriculum the Boys & Girls Club of the Big Island will conduct other specific SMART Moves component programs to help youth increase their capacity to make successful transition to adulthood, small group and individual programs such as SMART Girls, Passport to Manhood, Act SMART, Street SMART, Quick SMART and SMART Parents. These programs will address issues such as esteem building, planning and personal goals, personal healthy living & practices and development of resistance skills against pre -matured sexual behaviors, drugs, alcohol and other at -risk behaviors. 5) The Arts — Youth will have daily opportunity to engage in arts & craft activities to promote creativity and hands-on experiences through art. Included in art are possible activities in Fine Art, photography, pottery, woodworking and much more to support the need for youth to be involved in creativity and self exploration of the world surrounding them. The art center is often used for all other program components due to the need for hands-on experiences and use of material and supplies used in art. The combination of the proposed SMART Moves and 5 core programs will promote positive youth development and decrease substance use and problem behaviors of youth participants. The standard of our programs will be based on increasing protective factors and reducing risk factors facing our community youth and families. Total Budget and Position Count Total Program Budget $127,689.02 Total Program Position Count 8 Total Agency Budget $1,173,924.56 Total Agency Position Count 27 Program Objectives: 1) Increase participants' knowledge about tobacco, alcohol and other drugs and sexuality. 2) Increase participants' ability to identify and resist peer and media pressures to use tobacco, alcohol and other drugs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala 3) Increase youth ability to develop and improve skills around making decisions, resisting social and peer pressures, and coping with the stress of growing up. 4) Decrease problem behavior of youth by increasing participant's positive self esteem through participation in positive youth development activities on a daily basis. 5) Increase communication among staff members, parents, guardians and Club members regarding tobacco, alcohol, other drugs and adolescent sexual involvement. Program Highlights: 1) In the Fiscal Year 2005-2006 the Boys & Girls Club of the Big Island completed measurement of impact and collection of data for assessment of risk and protective factors through pre -post surveys and SMART Moves evaluation surveys. Results showed that of the 368 youth completing SMART Moves: 69% showed increased knowledge of the dangers in Tobacco and other drugs and alcohol. 65% of youth showed an increase in not getting involved with ATOD use. 75% showed increase in knowledge of healthy practices that could be used to deal with everyday issues in peer pressures and making better decisions. 90% of teens participating shared that alcohol and tobacco use was in their home. 75% of 10-15 year olds surveyed shared they have tried tobacco -90% of 10-15 year olds shared they have tried alcohol and other drugs. 35% of Stay SMART graduates contributed to SMART Moves by completing the SMART Leaders certification and presently facilitate SMART Moves Programs with younger youth. Further assessment collected shows that parents involved in SMART Moves activities shared how they take for granted tobacco and alcohol use around their kids and learned that second hand smoke and family parties are so much a part of everyday life in our local setting. Parents also shared that other parents would be reluctant to attend these activities as they are ATOD users and would be in denial and not see the need for being told what to do. The breakdown of Club Site completion numbers were 76 youth in Stay SMART in Pahoa, 67 youth in Keaau and 116 youth at the Hilo Club. In addition 109 youth completed a modified Start SMART Abstinence -only program at Keaau, Hilo and Keaau. 2) A SMART Moves Coordinator position was created in 2006 to address a management position to coordinate all SMART Moves training, creative enhancement activities and formal evaluative assessment of all SMART Moves program youth. This position has been approved and will be an integral part of our organization as soon as funding is available. 3) The Boys & Girls Club of the Big Island has expanded program services to youth in Pahala, Ka'u in September of 2006. The Pahala Club joins the present Clubs in Hilo, Keaau and Pahoa to provide SMART Moves and NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 & Girls Club of the Bie Island SMART Moves & Positive Youth Development Programs: Pahala core programs to all youth participants. New Club sites in Paauilo, Hamakua and Hawaiian Oceanview Estates, Ka'u will be opening doors for youth in their respective communities on February 1st, 2007. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget* Estimate Youth will complete SMART Moves n/a 15 50 Of the 50 youth :completing the n/a 5 25 SMART Moves Program, Youth ages 6-9 will complete the SMART Kids Program. Of the 50 youth :completing the n/a 5 15 SMART Moves Program, Youth ages 10-12 will complete the Start SMART Program. Of the 50 youth :completing the n/a 5 5 SMART Moves Program, Youth ages 13-15 will complete the Stay SMART Program. Of the 50 youth :completing the n/a 2 5 SMART Moves Program, Youth ages 13-17 will complete the Stay SMART Program. Youth will participate in 'The Art" n/a 45 25 Program Youth will participate in Character & n/a 15 20 Leadership Program Youth will participate in Education n/a 45 75 and Career Development Program Youth will participate in Health & n/a 15 50 Life Skills Program Youth will participate in Sports n/a 45 75 Fitness and Recreation Program Parents will participate in FAN Club n/a n/a 25 activities *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahala Program Expenditures " If applicable Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages n/a $74,247.62 $103,771.23 Professional Fees n/a $850.00 $1,250.00 Operations n/a $21,343.57 $21,851.19 Equipment n/a $796.50 $776.60 Other (Board Development) n/a $40.00 1 $40.00 Total n/a $97,277.69 $127,689.02 " If applicable Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Hawaii Community Foundation: Hawaii Island Meth Initiative 0 $50,000.00 $ Office of Juvenile Justice Delinquency Prevention 0 $12,000.00 $ Office of Youth Services Truancy Prevention OYS 0 $ $50,000.00 County of Hawaii —Non profit Grant 0 $ $50,000.00 County of Hawaii — District 6 Bob Jacobson: Contingency Fund 0 $5,000.00 $ Hawaii Community Foundation: Tobacco Fund 0 $9,500.00 $ Office of Youth Services (OYS) Non -School Hours Grant $ $16,666.67 Community Donations $ $ Intersession Program Fees $ $ Fundraiser Events $20,727.69 $11,022.35 $ $ Total $97,277.69 $127,689.02 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 11 & Girls Club of the Bit Island SMART Moves & Positive Youth Development Programs: Pahala Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 12 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development: Pahala FY 2006-07: Line Item: Other — Allocated expenditure for Board of Directors Development: Example: Strategic Planning & Transitional orientation and training with new Chief Professional Officer. FY 2007-2008: Line Item: Other — Estimated Board of Director Development expenses. Boys & Girls Club of the Big Island - Agency Name SMART Moves: Pahala - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and 4k lel C/ Signature of Board President/Chair Signature of Executive Director I -3i -a1 Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa Agency Director: Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address David (Kawika) Mattos David (Kawika) Mattos Phone No.: 961-5536 Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 15-3038 Puna Road, Pahoa, Hawaii 96778 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: 3465 Waialae Avenue, Suite 250 Mailing Address: Honolulu, Hawaii 96816 Amount of Request for County Funds Prior Year(s) Funding: 04-05 $...0 05-06 $...0 Agency Mission Statement: 06-07 $...0 $50,000 "To enable all youth, especially youth from disadvantaged circumstances, to realize their full potential as productive, caring and responsible citizens." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Deve Program Description: Programs: Pahoa Skills Mastery And Resistance Training (SMART) Moves Prevention Program: Helping the young people of the Big Island develop skills to resist tobacco, alcohol, other drugs, and other problem behaviors and enhanced by positive youth development activities through 5 core program areas. The Need Tobacco, alcohol and other drug use are a particularly insidious problem because it rarely remains isolated. It is widely recognized as a major contributing factor in other youth problems including school failure, truancy, runaways, suicide, pregnancy, school dropout, family problems, auto accidents, unemployment and crime.Tobacco is recognized as the ultimate "gateway" drug. Research indicates that the majority of illicit drug users began their substance abuse with tobacco, often at a very young age. Today the United States has the highest rate of illicit drug use of any industrialized nation. Across the country every community, regardless of location and income level, has been touched by drug use. Recent studies have explored the correlation of delinquent and risky sexual behavior with adolescent and teen use/abuse of alcohol, tobacco, and other drugs (ATOD). Adolescents and teens who are "idle" or not involved in positive youth development activities are most likely to engage in activities and social settings that promote behaviors such as drugs and alcohol, gang involvement, delinquency and crime.Youth who use one substance are more likely to use other substances; and these studies showed a strong relationship between substance use and other risk behaviors, including teenage sexual behavior and anti -social behavior. Statistics for the County of Hawaii are alarming: * Hawaii County has the highest rates of crystal methampetamine use in the stateand in a recent Alcohol and Drug Addiction Department (ADAD) report for Hawaii District, there is an overwhelming number of youth trying alcohol and marijuana. The percentages for youth drinking and smoking are some of the highest in the State for 8th - 12th grade youth. * Hawaii County has the highest rate of youth at risk due to indicators such as the highest rates of unemployment, highest rates of high school dropouts, highest rates of juvenile delinquency, highest rates of child abuse and out -of - home placement. The risk factors and risk behaviors identified as priority concerns for the Pahoa community are the early initiation of problem behaviors and the high gang involvement activities; youth reporting feeling unsafe in their communities; NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa interaction with antisocial peers; poor family supervision; low school commitment and poor academic performance. Pahoa reported the highest percentage of youth (23.75%) having involvement in gangs compared to the State average mean % reported at 11.2%. 22.48% of surveyed youth in Pahoa reported attacking someone (State average 10.5%). 2.28% of youth in Pahoa reported taking a handgun to school (State average 0.73%). 18.75% of youth in Pahoa reported being suspended from school compared to the state average of 8.23%. Community demographic data shows Pahoa with a one of the lowest per capita income at $13,120 and a high unemployment rate. Despite the overwhelming factors that place youth from these areas at risk including high unemployment rate and high percentage of households living in poverty, protective factors show a high percentage of adolescent youth reporting close family and neighborhood ties. Too many children today grow up with few, if any, positive role models and little, if any, encouragement to resist tobacco, alcohol, other drugs and sexual activity. The norm and expectation for these young people, whether perceived or real, is that it is almost a "rite of passage" to smoke tobacco, drink alcohol, use other drugs and engage in sex. Not only is this the perception of young people themselves but often the perception of the adults in their lives whose passive resignation encourages rather than discourages these behaviors. While young people are taught skills to prepare them to face educational challenges, at critical stages of psychological, emotional and intellectual development they are often not taught the skills needed to make the transition from childhood to adulthood and to resist tobacco, alcohol, other drugs and premature sexual activity. Furthermore, the effects on families today to keep up with the economy and rising cost of living by working up to three jobs to make ends meet find themselves searching for positive youth activities for their children. We often hear youth today express how they have nothing to do! Our children are growing up in very stressful times, and we need to do more to help them. Responding to the Need Until recently, most prevention programs failed, in large part because they were based on faulty assumptions about why young people begin using tobacco, alcohol, and drugs in the first place. Early prevention efforts relied on scare tactics and moral exhortations, expressing prohibitionist views that linked drugs to dangerous criminal influences. Few of these programs were systematically evaluated, but those that were failed to show reduced drug use among participants. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa Responding to the urgent need for an effective prevention program, Boys & Girls Clubs of America (BGCA) developed and field-tested a comprehensive program to help young people develop skills to resist tobacco, alcohol, other drug use and premature sexual activity. The results were outstanding. Called SMART Moves, the program is based on two rigorously tested curricula: Life Skills Training (Gilbert Botvin, Ph.D., Cornell University) and Project SMART (William Hansen, Ph.D., University of Southern California). SMART Moves is now used successfully in communities across the nation. The program is based on a resistance training/social skills model. Using small group activities, it teaches young people to recognize and resist media influences and peer pressures to engage in tobacco, alcohol, other drug use and early sexual involvement. SMART Moves recognizes that in addition to resistance training and the development of social skills, self esteem is a very important factor in regulating basic human drives and attitudes. When children are made to feel that they matter, that they have a unique contribution to make, and when they are helped to understand their feelings, they are less likely to endanger their own health or that of others by indulging in behaviors that put them at risk. SMART Moves also recognizes that in order for youth to learn and apply prevention principles, prevention programs must include parents and members of the community. SMART Moves uses a team approach to implement the program. The prevention team consists of Club staff, community representatives, parents and older teens. The SMART Moves curriculum is comprised of the following components: SMART Kids Make SMART Moves: A skills development program for boys and girls ages 6 to 9. The program focus is on self awareness, decision-making and interpersonal skills, while communicating age appropriate information about tobacco, alcohol and other drugs. Start SMART: A resistance skills program for youth ages 9 to 12 that focus on ways to identify and resist peer, social and media pressures to use tobacco, alcohol, other drugs or become sexually involved. It includes age appropriate discussions of puberty and friendships. Stay SMART: A social skills program for adolescents ages 13 to 15 that teaches resistance skills, stress reduction techniques, communication skills, assertiveness training and life planning. It provides accurate information about tobacco use, alcohol use, other drug use and adolescent sexuality. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa SMART Leaders: A peer mentoring program focused on teens 13-17 years old that plan and facilitate SMART Moves sessions with other youth in one or more of the SMART Moves program. Family Advocacy Network (F.A.N.) Club: A prevention program that targets the families of the SMART Leader participants to encourage family opportunities for positive involvement and reinforcing the concepts of preventing substance abuse amongst the youth participants. Also recognized by the Center for Substance Abuse Prevention and the Western Center for the application of Prevention Technologies as a "Best Practice" prevention program and rated as a model program by Substance Abuse and Mental Health Services Administration. Achievements SMART Moves is: - Recognized as one of 10 exemplary primary prevention programs by the U.S. Office of Substance Abuse Prevention, the National Association of State Alcohol and Drug Abuse Directors, and the National Prevention Network. - Lauded as a premier national prevention program by the White House Conference for a Drug Free America as well as the Children's Defense Fund. - Cited for its parent -training component by the Office of the Inspector General of the U.S. Department of Human Services Administration. - Noted for its effectiveness in a study conducted by the Center for Health Policy Research of The Pennsylvania State University. - Singled out for praise in The Making of a Drug Free America: Programs That Work by Mathea Falco (former Assistant U.S. Secretary of State for Narcotics Affairs). SMART Moves is unique among prevention programs in that: - SMART Moves is the sole national prevention program currently addressing the problems of tobacco, alcohol, other drug use and teen pregnancy in one comprehensive curriculum. - SMART Moves employs a team consisting of staff, parents, community representatives and older Club members to impart the knowledge and teach the skills needed by young people to avoid tobacco, alcohol, other drugs and premature sexual involvement. - SMART Moves actively involves parents in the prevention effort. - SMART Moves uses teen leaders who act as role models to younger people. - SMART Moves is incorporated into all Club activities and programs. Daily positive youth development programs will enhance SMART Moves through activities in a coordinated, comprehensive manner and include the following 5 core program areas. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa 1) Sports, Fitness & Recreation — Organized Team sports, individual low organized athletic programs, and Smart Moves activities are designed to meet the development needs of a diverse age group of youth participants. Programs are designed to include novice, intermediate and advance levels of skill development to increase youth participation and enhance self-esteem, and promote exercise, good/diet and nutrition. Activities for this program area are conducted at least four times a week, with each session averaging 1-2 hours. On a daily basis two to three sessions are conducted. Program activities also provide opportunities to engage youth in making healthy lifestyle choices and deter involvement in drugs, violence and other risky behaviors.These activities promote physical fitness and positive use of leisure time, and also consist of sports leagues, health and fitness activities, and skill building clinics.To prevent youth engaging in delinquent and risky behaviors, and give opportunities for making new friends, structured and informal recreational and social activities. Activities are conducted in individual, small group and large group formats, with emphasis on positive intra -personal interaction with peers and adults. Examples include drop-in game room activities, instructional clinics and tournaments, club dances, and excursions. Activities for this program area will be conducted at least five days a week with individual session averaging 1 to 1 '/z hours. 2) Character and Leadership Development —Youth who participate in Keystone, Torch Clubs, LIT, and Peer Leadership programs provide various community service projects which teaches them civic responsibility.Youth participating in this program area are required to plan and perform a minimum of four community service projects (once every quarter).Youth are engaged and involved in the decision-making and implementation of the projects and activities of the program and community.Youth involved in Keystone & Torch Clubs and the Smart Moves "SMART Leaders" component are given the chance to strengthen intra -personal and decision-making skills through small group focus sessions. As a means of building character & leadership skills, youth plan and implement activities in prevention programs and community service to give back to the Club and community. 3) Education and Career Development — Power Hour program includes educational enhancement activities to increase the opportunities for academic success of youth participants. Power Hour sessions will be held at least four times a week with each session averaging 1 hour. The Career Launch and Job Ready programs available for youth prepares youth for possible employment, post high school education and career development. Youth also have the opportunity to participate in science based programs such as the Ocean Exploration Program 'Immersion Presents". This program focuses on the activities that take youth through 5 curriculum -based modules as youth explore expeditions and explorations of scientist.This OJJDP supported program has been implemented at more than 450 Boys & Girls Clubs in 33 different cities and continues to grow in popularity as youth combine science, art, mathematics, NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa career development and law enforcement to learn and increase their educational base. BGCBI also includes programs such as BGCA's Project Learn and Dragonfly Quest to enhance the basics in education. Use of a complete internet accessible computer technology center at the Club also supports a strong education enhancement program. 4) Health & Life Skills — In addition to the proposed SMART Moves curriculum the Boys & Girls Club of the Big Island will conduct other specific SMART Moves component programs to help youth increase their capacity to make successful transition to adulthood, small group and individual programs such as SMART Girls, Passport to Manhood, Act SMART, Street SMART, Quick SMART and SMART Parents.These programs will address issues such as esteem building, planning and personal goals, personal healthy living & practices and development of resistance skills against pre -matured sexual behaviors, drugs, alcohol and other at -risk behaviors. 5) The Arts — Youth will have daily opportunity to engage in arts & craft activities to promote creativity and hands-on experiences through art. Included in art are possible activities in Fine Art, photography, pottery, woodworking and much more to support the need for youth to be involved in creativity and self exploration of the world surrounding them. The art center is often used for all other program components due to the need for hands-on experiences and use of material and supplies used in art. The combination of the proposed SMART Moves and 5 core programs will promote positive youth development and decrease substance use and problem behaviors of youth participants. The standard of our programs will be based on increasing protective factors and reducing risk factors facing our community youth and families. Total Budget and Position Count Total Pro ram Budget 1 $167,237.84 Total Program Position Count 8 Total Agenc Bud et $1,173,924.56 1 Total Agency Position Count 27 Program Objectives: 1) Increase participants' knowledge about tobacco, alcohol and other drugs and sexuality. 2) Increase participants' ability to identify and resist peer and media pressures to use tobacco, alcohol and other drugs. 3) Increase youth ability to develop and improve skills around making decisions, resisting social and peer pressures, and coping with the stress of growing up. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa 4) Decrease problem behavior of youth by increasing participant's positive self esteem through participation in positive youth development activities on a daily basis. 5) Increase communication among staff members, parents, guardians and Club members regarding tobacco, alcohol, other drugs and adolescent sexual involvement. Program Highlights: 1) In the Fiscal Year 2005-2006 the Boys & Girls Club of the Big Island completed measurement of impact and collection of data for assessment of risk and protective factors through pre -post surveys and SMART Moves evaluation surveys. Results showed that of the 368 youth completing SMART Moves: 69% showed increased knowledge of the dangers in tobacco, other drugs and alcohol. 65% of youth showed an increase in not getting involved with ATOD use. 75% showed increase in knowledge of healthy practices that could be used to deal with everyday issues in peer pressures and making better decisions. 90% of teens participating shared that alcohol and tobacco use was in their home. 75% of 10-15 year olds surveyed shared they have tried tobacco.90% of 10-15 year olds shared they have tried alcohol and other drugs. 35% of Stay SMART graduates contributed to SMART Moves by completing the SMART Leaders certification and presently facilitate SMART Moves Programs with younger youth. Further assessment collected shows that parents involved in SMART Moves activities shared how they take for granted tobacco and alcohol use around their kids and learned that second hand smoke and family parties are so much a part of everyday life in our local setting. Parents also shared that other parents would be reluctant to attend these activities as they are ATOD users and would be in denial and not see the need for being told what to do. The breakdown of Club Site completion numbers were 76 youth in Stay SMART in Pahoa, 67 youth in Keaau and 116 youth at the Hilo Club. In addition 109 youth completed a modified Start SMART Abstinence -only program at Keaau, Hilo and Keaau. 2) A SMART Moves Coordinator position was created in 2006 to address a management position to coordinate all SMART Moves training, creative enhancement activities and formal evaluative assessment of all SMART Moves program youth.This position has been approved and will be an integral part of our organization as soon as funding is available. 3) The Boys & Girls Club of the Big Island has expanded program services to youth in Pahala, Ka'u in September of 2006. The Pahala Club joins the present Clubs in Hilo, Keaau and Pahoa to provide SMART Moves and core programs to all youth participants. New Club sites in Paauilo, Hamakua and Hawaiian Oceanview Estates, Ka'u will be opening doors for youth in their respective communities on February 1 st, 2007. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 FY 2005-06 FY 200647 FY 2007-08 Actual * Budget * Estimate Youth will complete SMART Moves 60 106 206 Of the 206 youth :completing the 15 0 30 SMART Moves Program, Youth ages 6-9 will complete the SMART Kids Program. Of the 206 youth :completing the 15 36 76 SMART Moves Program, Youth ages 10-12 will complete the Start SMART Program. Of the 206 youth :completing the 20 40 60 SMART Moves Program, Youth ages 13-15 will complete the Stay SMART Program. Of the 206 youth :completing the 10 30 40 SMART Moves Program, Youth ages 13-17 will complete the Stay SMART Program. Youth will participate in 'The Art" 45 70 75 Program Youth will participate in Character & 15 30 40 Leadership Program Youth will participate in Education 57 60 100 and Career Development Program Youth will participate in Health & 60 131 100 Life Skills Program Youth will participate in Sports 78 100 120 Fitness and Recreation Program Parents will participate in FAN Club n/a 30 25 activities *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 & Girls Club of the Bia Island SMART Moves & Positive Youth Development Programs: Pahoa Program Expenditures * If applicable e Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $31,941.00 $112,993.86 $121,467.12 Professional Fees $ $1,275.00 $1,875.00 Operations $7,863.87 $38,902.39 $42,070.82 Equipment $10,195.13 $1,794.75 $1,764.90 Other (Board Developmerk) $ $60.00 $60.00 Total $50,000.00 $155,026.00 $167,237.84 * If applicable e Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Hawaii Community Foundation: Hawaii Island Meth Initiative $50,004.00 $18,750.00 $18,347.06 Office of Juvenile Justice $ $36,000.00 $ -DelinquencyPrevention Salvation Army/(OYS) Positive Alternative Activities $ $ $ of Hawaii —Nonprofit Grant $ $ $50,000.00 -County Office of Youth Services (OYS) Non -School Hours Grant $ $ $16,666.67 Hawaii Community Foundation: Tobacco Fund $ $9,500.00 $ Office of Youth Services OYS: Gang Prevention $ $ $37,500.00 YMCA Rural Youth Outreach RYP Grant $ $6,793.05 $ -Program Boys & Girls Club of Hawaii: Abstinence -Only Grant $ $7,033.34 $2,466.67 Hawaii Island United Way $ $6,666.67 $13,333.33 Alcohol Drug Abuse Division ADAD $ $33,333.33 $ Intersession Program Fees $ $5,000.00 $ Donations/ Fundraising $ -Community County of Hawaii District 5 Emily Naeole Contingency Fund $ $10,000.00 $ Intersession Fees $10,000.00 $ Community Donations $11,949.61 1 $28,924.11 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 & Girls Club of the Big Island SMART Moves & Positive Youth Development Programs: Pahoa Total $50,000.00 $155,026.00 $167,237.84 'If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 11 Boys & Girls Club of the Big Island SMART Moves & Positive Youth Development: Pahoa FY 2006-07: Line Item: Other — Allocated expenditure for Board of Directors Development: Example: Strategic Planning & Transitional orientation and training with new Chief Professional Officer. FY 2007-2008: Line Item: Other — Estimated Board of Director Development expenses. Boys & Girls Club of the Big Island - Agency Name SMART Moves: Pahoa - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and �l e� 1-31,01 President/Chair Date of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Brantley Center, Inc. -Agency Name Employment Rehabilitation Program - Program Name Agency Director: Cami Post Phone No.: 775-7245 Contact Person: Cami Post Phone No.: 775-7245 Mailing Address: P.O. Box 1407, Honokaa, Hawaii 96727 Facility/Site Address: 45-370 Ohelo Road, Honokaa, Hawaii 96727 Fax No.: 775-0211 Email Address: bcenter2Qhawaiiantel.net Name of AccountantlCPA (include name of firm if applicable): Jennifer L. Gossert, CPA Phone No.: (808) 969-3115 Mailing Address: 688 Kinoole Street, Suite 201, Hilo, Hawaii 96720 Amount of Request for County Funds: $25,000 Prior Year(s) Funding: 04-05 05-06 06-07 $ 21,000 $ 23,000 $ 21,000 Agency Mission Statement: To provide quality rehabilitation services in addressing community needs for vocational training and independent living skills training to people with mental, emotional, and /or physical disabilities NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Center, Inc. - A ency Name Rehabilitation Program - P Program Description: Name The Employment Rehabilitation Program provides participants with a variety of services that develop and support the accomplishment of goals leading to meaningful competitive employment. These services include: vocational evaluations, work adjustment training, occupational skills training, job -readiness classes, competitive employment placement services, and follow-up services while on-the-job. Participants receive quality vocational training and at the same time are paid for work performed. Program staff work closely with the community to provide community-based vocational training, and at the same time provide the public with an additional work force. Also included in this program are work transition services for high school students. The Center's staff work with high school counselors to transition students with disabilities from a school environment to a work environment. Total Budget and Position Count Total Program Budget 226,124 Total Program Position 4.1 Total Agency Budget 430,920 Total Agency Position Count 9.0 Program Objectives: 1) Provide vocational evaluations to 30 clients. 2) Provide individualized employment planning services to 20 clients. 3) Provide work adjustment training to 26 clients 4) Provide occupational skills training to 26 clients. 5) Provide job -readiness classes to 20 clients. 6) Provide competitive job placement and follow-up services to 12 clients 7) Provide work transition services to 14 high school students with disabilities. Program Highlights: 1) Provided vocational evaluations to 9 clients. 2) Provided individualized employment planning services to 13 clients. 3) Provided work adjustment training to 14 clients. 4) Provided vocational skills training to 21 clients. 5) Provided job -readiness classes to 12 clients. 6) Placed 9 clients in competitive employment. 7) Provided work transition services to 7 high school students with disabilities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-0$ Page 2 Brantley Center, Inc. -Agency Name Employment Rehabilitation Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 FY 2006-07 FY 2007-08 Salaries and Wages Actual * Budget* Estimate Number of clients who receive 25 30 30 employment rehabilitation services. 56,144 58,500 60,000 Number of clients with improved 14 20 20 scores on the Vocational Evaluation 25,256 26,000 30,000 and Training Report. 206,666 212,250 226,124 Number of clients who increased 13 20 20 their productivity percentages. Number of clients who successfully 11 18 18 completed the job -readiness classes. Number of clients placed in 9 10 10 competitive employment for a minimum of 90 days. Number of high school students who 7 15 15 received work transition services. *If applicable Program Expenditures * If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 112,752 115,750 125,124 Professional Fees 12,000 12,000 11,000 Operations 56,144 58,500 60,000 Equipment 514 Other" 25,256 26,000 30,000 Total 206,666 212,250 226,124 * If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Brantley Center, Inc. -Agency Name Employment Rehabilitation Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County Mass Transit 10,500 10,500 10,500 State of Hawaii 30,000 30,000 30,000 Hawaii Island United Way 26,000 26,000 30,000 County of Hawaii Nonprofit Grant 23,000 21,000 25,000 Sales & Services 117,166 124,750 130,624 Other (fundraising & special events) Total 206,666 212,250 226,124 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? For fiscal year 2007-2008 Brantley Center, Inc. plans to expand our Diversified Agricultural Program by developing a plant nursery. This will provide participants with additional training opportunities and at the same time increase program revenue. In December 2006 Brantley Center received a $1,000 grant from the Rotary Club of North Hawaii to set up the nursery. The Board of Directors and Administrator plan to increase fundraising activities, and large donor contributions through special invitations to the Center to show case our program services. Almost sixty percent of the total cost to provide employment rehabilitation services is funded by the Center's private funds, generated by services made available to the public. The community continues to show their support of Brantley Center through designating their donations to the Center through Hawaii Island United Way, through fundraising activities, and contributions. In order to provide employment training and supports necessary for people with disabilities to become employed, it must be a collaborative effort between Brantley Center, Inc., the State and County, and the community. The funds provided by the State and County of Hawaii are essential to provide quality rehabilitation services. Without this funding, the number of people served would decrease as well as training services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Brantley Center, Inc. -Agency Name Employment Rehabilitation Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. H awarded a grant from the County of Hawaii, l (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board Pres /Chair Signature of Executive Director 1116 0? Date 0//Z --r/07 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Brantley Center, Inc. - Agency Name Employment Rehabilitation Program - Program Name Program Expenditures: The "Other" category is client wages. Clients get paid for the work they produce while they participate in this training program. Bridge House, Inc.- Agency Name Vocational Skills Building Program- Program Name Agency Director: Contact Person Mailing Address: e Mark Schuster, M.A. Phone No.: 808-322-3305 Mark Schuster Phone No.: 808-322-3305 Facility/Site Address: Fax No.: Email Address: PO Box 2489 Kailua-Kona, HI 96745 78-6687 A Mamalahoa Hwy. Holualoa, HI 96725 808-322-0809 mark—bridgehouse@earthlink.net Name of Accountant/CPA (include name of firm if applicable): John Carbonaro/Carbonaro CPA's Phone No.: 808-242-5002 Mailing Address: 1885 Main St., Ste. 408 Wailuku, HI 96793 Amount of Request for County Funds: $24,000.00 Prior Year(s) Funding: 04-05 05-06 06-07 $18000.00 $0.00 $15000.00 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 The Bridge House mission is to assist adults who are in early recovery from drug and alcohol addiction to develop successful living skills through residential and vocational experiences in a safe, structured and supportive environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Bridge House, Inc. - Agency Name Vocational Skills Building Program- Program Name Program Description: The Vocational Skills Building Program is a specialized component of Bridge House that provides assessment, referral and linkages, and training to program residents, that will enable graduating residents to secure and maintain employment upon discharge. Funding of the full amount requested will enable us to continue our current program by fulfilling all the program needs. The Funds will be utilized to obtain all the supplies necessary to mainatin and further develop the grounds for the expanding program (e.g. irrigation pipe and fixtures, soil, containers, tools & equipment, fertilizers, utilities, plant stock, etc.) enabling Bridge House to enhance our'on-site' growing grounds, thus providing for significantly more vocational opportunities within the confines of our property. This should also lead to increased agency self-sufficiency, as what is eventually produced may be sold in the open market. Additionally, Bridge House continues to be the recipient of in-kind support from several community resources (e.g. UofH Agricultural Extension Program; Agro Resources, Inc.) who have expressed a strong commitment to continuing to provide us ongoing support to bring this part of the vocational program to fruition. Total Budget and Position Count Total Program Budget 1 69887.00 Total Program Position Count 1.5 Total Agency Budget 1 423093.00 Total Agency Position Count 5 Program Objectives: 1) All incoming residents to complete an "initial vocational/employment evaluation". 2) A vocational plan is developed that identifies areas of need, e.g. skills building/training, enhancement of attitude and behavior, continuing education, job coaching, resume preparation, mock interviews, job hunting, etc. 3) All residents must contribute a minimum of 15 hours per week, in the manner of practicum, of some form of labor back to the Bridge House 'ohana. This allows for on-site staff evaluation of attitude, commitment and assessment of job readiness. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 4) At approximately 90 days of program participation, staff and resident complete a pre employment evaluation that assesses willingness to participate, punctuality, ability to establish and meet goals, and other items related to employment readiness. 5) Between 100-130 days of residency, individuals are encouraged and assisted to begin a job search for appropriate employment. Staff transports residents to and from resource centers (e.g. WorkForce Development, Department of Vocational Rehabilitation) and job interviews, assists in completion of employment applications, assists in resume preparation, and provides equipment such as computer, fax machine and copy machine to facilitate the job search process. 6) Upon securing a job, Bridge House staff will provide the resident transportation to and from the worksite. Program Highlights: 1) In the 05-06 FY, 91% of the 55 persons admitted were deemed unemployable at the time of admission. 2) 20 individuals successfully completed the program. 3) Three months post -discharge, over 75% of graduates remained employed in full-time positions. 4) Six months post -discharge, 70% of graduates remained employed in full-time positions. 5) 100% of all graduates obtained clean and sober housing prior to discharge. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Bridge House, Inc. - Agency Name Vocational Skills Building Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate 65% of admits will obtain a clinical discharge 41% 43 46% 50% of clinical discharges will be employed, in school, or in a job - training program at 6 months post- discharge 70% 70% 70% Operations 29095.00 16397.00 16787.00 Equipment 3150.00 2400.00 Other" Total 1 63234.00 65787.001 69887.00 *If applicable Program Expenditures If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 29099.00 42500.00 46500.00 Professional Fees 5040.00 3200.00 4200.00 Operations 29095.00 16397.00 16787.00 Equipment 3150.00 2400.00 Other" Total 1 63234.00 65787.001 69887.00 If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Bridge House, Inc. - Agency Name Vocational Skills Building Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Hawaii Island United Way 16,000.00 17,000.00 17,000.00 State of Hawaii/ADAD 37,234.00 16,787.00 15,000.00 State of Hawaii/Judiciary 10,000.00 7,000.00 Program Fees 10,000.00 5,000.00 4,000.00 County 15,000.00 24,000.00 Donations 2,000.001 2,887.00 Total1 63,234.001 65,787.00 69,887.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Bridge House continues to actively seek out and apply for relevant grants (e.g. Atherton Foundation, Weinberg Foundation, U.S Department of Agriculture) which may provide funding opportunities that would allow us to fully develop and utilize our agricultural acreage. If total requested funds were obtained, then it may be reasonable to expect the program to become self-sufficient within two years of start-up. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Bridge House, Inc. - Agency Name Vocational Skills Building Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of.other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an V4/ Signature of Board President/Chair /X Signature of Executive Director 112-11 07 Date 0(- Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Child and Family Service Family Violence Continuum of Care Programs Agency Director: Howard Garval, President and CEO Contact Person: Heidemarie Koop Mailing Address: Child and Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 Phone No.: (808) 681-3500 Phone No.: (808) 323-2664 Facility/Site Address: West Hawaii: 81-6587 Mamalahoa Hwy Kealakekua 96750 East Hawaii: 460 Kilauea Avenue, Suite101 Hilo, Hawaii 96720 Fax No.: (808) 681-5280 Ewa Beach, Executive Office (808) 323-2999 West Hawaii (808) 961-2073 East Hawaii Email Address: h_qarvalC@cfs-hawaii.org h ko op(& cfs-h awa i i. o rg Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPA's, Inc. Phone No.: 808-524-2255 Mailing Address: American Savings Bank Tower, 1001 Bishop Street, Suite 1700, Honolulu, Hawaii 96813-3696 Amount of Request for County Funds: $ 7,500.00 Community and Health Education — West Hawaii $ 2.500.00 Domestic Abuse Shelter — East Hawaii 1 0 Total Prior Year(s) Funding: 04-05 05-06 06-07 $0 $9,000 $9,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Child and Family Service Family Violence Continuum of Care Programs Agency Mission Statement Since 1899, Child and Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child and Family Service programs builds on the strengths of individuals and families to address the many human challenges. The organization's comprehensive array of services has allowed Child and Family Service to develop in many areas and to offer an integrated and comprehensive human service and behavioral health care delivery system throughout the State of Hawaii. Child and Family Service continues to be known in the community for its willingness to work with hard -to -engage individuals and families facing a multitude of difficult problems. As community populations present with increasingly complex problems and situations, Child and Family Service continues to be at the forefront of developing the skills, knowledge, and service models to address these needs. Program Description Funds are requested to support two programs of Child and Family Service that address the family violence continuum of care. These two programs are Community Information and Health Education in West Hawaii and the Domestic Abuse Shelter (DAS) in East Hawaii. These programs educate and serve individuals in the communities of East and West Hawaii, addressing the issues of domestic violence and/or sexual abuse. Funding is being requested to support direct services to the community and to improve the capital investment for the Hilo Domestic Abuse Shelter. Child and Family Service (CFS) has provided Community Health Education since 1994 and has developed a program that has been widely respected in the West Hawaii community. This program provides services, such as educational presentations and referral information to individuals regarding family planning and issues related to sexual violence, domestic violence and safety. Services are provided through direct and indirect contact with individuals, groups and training of paraprofessionals in the community. Direct service includes direct contact with the targeted population/consumer. Indirect service targets relaying information and education to the general public through exhibits such as bulletin board announcements, flyers, public service announcements via radio stations and local cable television broadcasts, and heath fair presentations/booths. In addition, indirect services are also conducted through trainings of other paraprofessionals in the community, who in turn provide direct services to consumers. The program has become unique to the community in West Hawaii since the psycho -educational approach to the general and hard -to -reach population relies on information education without regard for ethnicity, gender, sexual preference, religious, socioeconomic circumstance and physical condition. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Child and Family Service Family Violence Continuum of Care Programs The Community Information and Health Education program is funded through the Department of Health and even though funding received does not fully support the operation of the program, CFS remains committed to providing quality health education to the community. Educational efforts include engaging hard -to -reach populations to include but not limited to adolescents, the homeless, disabled, uninsured or underinsured women, men, substance abusers and the general population. During the presentations, which are conducted in groups or on a one-to-one basis, the Health Educator also provides information on community resources the individual or family can access, including counseling services and medical referrals. Unfortunately, the Department of Health does not cover the rising costs of running this program. At CFS, we believe that we need to continue our work with the hard -to -reach population to ensure that information, resources and support can be provided. This program will utilize funding for the salary of the Health Educator to further the program's goal to provide education in the understanding of the role and cycle of sexual abuse and domestic violence to the hard -to -reach population. CFS is also committed to provide additional training to the community including other professionals. This expertise is greatly needed in the education of the community in understanding the role and cycle of sexual violence. The Domestic Abuse Shelter in East Hawaii is open to victims of domestic violence and their children on a 24-hour basis. Shelter and supportive services are provided to the residents of the shelter to help them break the cycle of violence and to make positive changes in their lives through education, counseling and support. CFS has operated the Domestic Abuse Shelter in East Hawaii since 1995 and constantly tries to find ways to support the women in finding information, resources and support. We are requesting $2,500 for our capital improvement project. The monies would be spent to create a computer lab for the use of clients, their children and staff. With cable, clients can access resources, the children can complete their homework assignments using educational resources, and staff can research information and improve work related tasks. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Child and Family Service Family Violence Continuum of Care Programs Total Budget and Position Count Total Program Budget $349,936 Total Program Position Count 13 Total Agency Budget $5,462,392 Total Agency Position Count 97 Program Objectives Objectives for the Community Health Education specify that: 1) 80% of all participants of a presentation will show an increased knowledge of the information presented regarding sexual violence awareness through pre and post tests. 2) 90% of people participating in the program presentations will complete and indicate a high level of satisfaction of the presentations based on the information provided regarding sexual violence. Objectives for the Domestic Abuse Shelter specify that: 1) 80% of clients will show an increase in self-esteem. 2) 75% of clients will have an increase in knowledge of community resources. 3) 80% of clients will have obtained increased knowledge and understanding of domestic violence and its effect on themselves and their children. 4) 80% of clients in the shelter for at least four weeks will identify at least three skills to cope with verbal abuse and three skills to cope with physical abuse and an understanding of the cycle of violence. 5) 90% of clients in the shelter for four weeks will have completed a personalized safety plan by discharge. 6) 60% of single adults and families will move from the shelter to a non - abusive home environment. 7) 80% of clients will feel supported regarding domestic violence. 8) 80% of returned client satisfaction surveys will show services to be satisfactory. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Child and Family Service Family Violence Continuum of Care Programs Program Highlights Community Information and Health Education — West Hawaii (FY 2006) Child and Family Service in West Hawaii has provided health education services consistently since 1994 and has developed a program that has been widely respected in the West Hawaii community. Services are offered to a hard -to - reach population, youth and families in schools, to clients of other agencies or organizational programs and to families. Over the past three years, indirect contact services have significantly increased and information and education are reaching more and more people. Furthermore, program outcomes have exceeded expectations for community contacts for 11 years. In Fiscal Year 2006, the program provided the following: • 330 Direct Client Services • 8,085 In -Direct Client Services (102% over projected goal) The program also achieved 100% for the following goal: • Participants demonstrated increased knowledge after the presentation based on pre- and post tests Domestic Abuse Shelter — East Hawaii (FY 2006) The target population for services is adults, with or without children, who are physically or emotionally abused or are in imminent danger of abuse by a household member. In Fiscal Year 2006, Hale 'Ghana served 81 women in the 19-59 years age range, five women aged at 60+ years, and 107 children. During this period, our DHS contract requirement was to provide 3647 nights of safety (bed days). Instead, CFS provided 6,180 nights of safety, or 169% of the contract requirement. In addition, the program served 344 individuals accessing the crisis hotline for crisis intervention services and provided 54 adults and 43 children with individual, group, dyad and/or family therapy. The program also achieved 100% of its outcomes for the following goals: Adult participants complete a personalized safety plan Participants have increased knowledge of community resources Returned client satisfaction surveys show that services are satisfactory NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Child and Family Service Family Violence Continuum of Care Programs Performance Measures *If applicable Program Expenditures FY 2005-06 FY 2006-07 FY 2007-08 Salaries and Wages Actual * Budget* Estimate Community Information and Health 0 $315,936 $253,936 Education $4,500.00 $9,000 $2,300 # of Education/Outreach Activities 330 1,000 1,000 # of In -Direct Contact 8085 4,000 4,000 Domestic Abuse Shelter $9,000.00 $9,000 $10,000 # of hotline calls received from 1,349 750 750 public # of persons who were provided 193 225 250 shelter # of psycho -education hours 268 260 260 provided to families residing at the shelter *If applicable Program Expenditures * If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 0 $24,500 $5,600 Professional Fees 0 $315,936 $253,936 Operations $4,500.00 $9,000 $2,300 Equipment $4,500.00 J $349,4361 $2,100 Other* 0 $9,000 Total $9,000.00 $9,000 $10,000 * If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Department of Health (Community Information and Health Education) $24,500 $24,500 $24,500 Department of Human Services Domestic Abuse Shelter $253,436 $315,936 $253,936 Hawaii County $9,000 $9,000 $10,000 Total $286,936 J $349,4361 $288,436 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Child and Family Service Family Violence Continuum of Care Programs Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Child and Family Service strives to achieve sustainability for all its programs. Yet, Child and Family Service is also committed to support critical services in the community despite their budgetary limitations. CFS is active in writing grants for supplemental funding to keep its critical programs operating. Due to shortage of funds, CFS is advocating for higher revenues at contract renewal. The capital improvement project will be sustained by the current budget through monthly expenditures to cover the cable fees. Furthermore, Child and Family will continue their work in providing high quality services to the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Child and Family Service Family Violence Continuum of Care Programs I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 – 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. 9"2 Signatur of aPresident/Chair Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 Child and Family Service Family Violence Continuum of Care Programs Program Expenditures - Other In fiscal year 2006-2007, Child and Family Service was granted $9,000 to provide monies for Kona and Hilo staff to attend best practice training seminars. These trainings are geared to further develop staff expertise and skills so that they may train other professionals in the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 PROGRAM EXPENDITURES Program Expenditures: *Please explain in detail on separate sheet FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $161,833 174,180 163,180 Taxes & Benefits 33,492 38,396 34,396 Airfare 2,378 1,880 1,880 Audit Service 439 648 648 Professional Fees Insurance 1,117 1,978 1,978 Lease/Rental Equip 1,680 1,650 1,650 Lease/Rental Space 26,473 26,280 26,280 Mileage 360 360 Postage Freight & Delivery 538 380 380 Publication & Printing 465 410 410 Repair & Maintenance 2,255 5,820 4,620 Staff Training 772 10,310 5,310 Subsistence/Per Diem 27 10 10 Supplies 8,307 1,950 1,950 Telecommunication 2,185 4,790 4,790 Transportation 586 25 25 Utilities 1,189 3,050 3,050 Admin Support 45,742 53,425 46,425 Auto Expense 1,619 1,700 1,700 Auto Insurance 2,188 1,640 1,640 Client Assistance 158 1,650 1,050 Provisions 4,860 5,000 5,000 Membership 250 250 250 Operations Equipment 20,700 Other* Total $298,553 356,482 306,982 *Please explain in detail on separate sheet East Hawaii Coalition for the Homeless- Agency Name Hale O Puna- Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Steve Bader Steve Bader 142 Kinoole Suite C Hilo, Hawaii 96720 Pahoa Village Center ehchofficel@aol.com Phone No.: 9694848 Phone No.: 969-4848 Name of Accountant/CPA (include name of fine if applicable): Carbonaro CPAs & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408 Wailuku HI 96793 Amount of Request for County Funds: $24,000 Prior Year(s) Funding: 04-05 05-06 06-07 $38,000 $40,000 $40,000 Agency Mission Statement: "Creating Opportunities that enhance the quality of life for homeless families and individuals" EHCH is committed to reducing homelessness in our community through support services, advocacy, education and outreach. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 East Hawaii Coalition for the Homeless - Agency Name Hale O Puna - Program Name Program Description: Hale O Puna is a resource, outreach and advocacy center located in Pahoa that has been serving lower Puna for six years. The homeless and at risk population is able to access food, clothing, school supplies, housing referrals, self- sufficiency Gasses and drop-in services from other agencies. Total Budget and Position Count Total Program Budget 84,616 Total Program Position Count 1 2 Total Agency Budget 344,832 Total Agency Position Count 6 Program Objectives: 1) Provide effective advocacy and referrals to all participants 2) Prepare participants to obtain permanent housing 3) Provide resources (food,dothing, personal hygiene supplies, school supplies) from M -F 4) Provide drop-in space for other agencies to access community Program Highlights: 1) Serve more than 2,500 participants annually 2) Coordinated services with Community Mental Health and Care -a -van 3) Served as primary food pantry in lower Puna NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 East Hawaii Coalition for the Homeless - Agency Name Hale O Puna - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual* FY 2006-07 Budget* FY 2007-08 Estimate Food Packages Distributed 75,000 50,000 50,000 Clothing Bank Contacts 3,500 3,500 3,500 Referrals 2,000 2,000 2,000 Participants Receiving Mental Health Treatment 120 120 120 Participants Receiving Substance Abuse Treatment 30 30 30 Housing Placement Contacts 200 200 1 300 *If applicable Program Expenditures • If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual * FY 2006-07 Bud et * FY 2007-08 Estimate Salaries and Wages 24,960 26,000 33,680 Professional Fees 1000 1000 1000 Operations 20,000 20,000 26,400 Equipment 1000 1000 1000 Other" 18,000 20 000 22,736 Total 64,9601 68,000 84,816 • If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 East Hawaii Coalition for the Homeless - Agency Name Hale O Puna - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate State of Hawaii 20,000 0 0 ESG Grant 13,600 0 0 County Human Services 18,000 18,000 24,000 Other/Grants 1,000 20,000 20,000 Foundation 3,000 10,000 United Way 7,875 10,000 Donations/Fundraising 19,125 20,816 M3,485 Total 64,9601 68,0001 84,816 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? EHCH will be increasing fundraising efforts and will begin charging user fees for agencies accessing our multi -service center to help off -set costs. We will also seek more food donations from churches and service organizations. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 East Hawaii Coalition for the Homeless - Agency Name Kihei Pua/Hale O Puna - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. Signature of Executive Director Z9 lo7 Date /-23-0-7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 East Hawaii Coalition for the Homeless- Agency Name Kihei Pua Transitional Housing- Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.. Email Address: Steve Bader Steve Bader 142 Kinoole Suite C Hilo, Hawaii 96720 Various Sites ehchofficel@aol.com Phone No.: 969-4848 Phone No.: 969-4848 Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408 Wailuku HI 96793 Amount of Request for County Funds: $6,000 Prior Year(s) Funding: 04-05 05-06 06-07 $4,000 $4,000 $4,000 Agency Mission Statement: "Creating Opportunities that enhance the quality of life for homeless families and individuals" EHCH is committed to reducing homelessness in our community through support services, advocacy, education and outreach. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 _East Hawaii Coalition for the Homeless - Agency Name Kihei Pua Transitional Housing- Program Name Program Description: Provide scattered site housing for singles and families for a maximum of two years. The program is designed for financially stable people who need more time to secure permanent housing due to their circumstances (i.e. family size, disability, mental health issues, or in the process of completing a training or educational program. Total Budget and Position Count Total Program Budget 121,500 1 Total Program Position Count 2 Total Agency Budget 344 832 Total A enc Position Count 6 Program Objectives: 1) Help participants secure and maintain permanent housing. 2) Ensure that 75% of those served meet 75% of their goals before exiting the program. 3) Prepare participants to be healthy and productive members of the community. Program Highlights: 1) Transitioned 15% more participants into permanent housing. 2) Increased number of singles served by 20%. 3) Worked with community organizations and area churches to provide meals, clothes, activites and personal items to participants. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 _ East Hawaii Coalition for the Homeless - Agency Name Kihei Pua Transitional Housing - Program Name Performance Measures: If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate # Served 120 110 110 #Life Skills Classes/In-Service 50 50 50 Weal Packages 1200 1500 1500 #Enrolled in education/training classes 5 5 5 #Secured Permanent Housing 13 5 10 #Maintain permanent housing for six months after exiting program. 20 25 25 Transitioned off welfare 5 5 6 If applicable Program Expenditures • If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 82,745 40,000 39,200 Professional Fees 2,000 2,000 2,000 Operations 133,965 70,000 77,600 Equipment 1,000 1,000 1,000 Other" 2,000 2,000 2,000 Total 221,710 115,000 121,800 • If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 East Hawaii Coalition for the Homeless - Agency Name Kihei Pua Transitional Housing - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate State of Hawaii 137,250 0 0 County of Hawaii 4,000 4,000 6,000 United Way 7,500 7,500 10,000 Program Fees 55,000 50,000 54,000 Other/Grants 5,000 20,000 15,000 DonationsFundraisers 12,960 33,500 36,800 Total 221,7101 115,000 121,800 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? EHCH will be increasing program fees and fundraising goals to meet expenses. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 East Hawaii Coalition for the Homeless - Agency Name Kihei PuaTransitional Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Executive Director 1 z9 07 Date Date 1-2-3-07 UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Agency Director: JoAnn Bishop Freed Phone No.: (808) 334-4114 Contact Person: Huellyn Whitford Phone No.: (808) 334-4110 Mailing Address: 75-127 Lunapule Road, Suite 11 Kailua-Kona, HI 96740 Facility/Site Address: Na'alehu and Hawi Fax No.: (808) 326-4063 Email Address: kids@fsswh.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs & Management Group Phone No.: (808) 242-5002 Mailing Address: 1885 Main Street, Suite 408 Wailuku, HI 96793 Amount of Request for County Funds: $65,000 Prior Year(s) Funding: 04-05 05-06 06-07 $49,500 $51,000 $45,000 Agency Mission Statement: Family Support Services of West Hawaii was founded in 1979 as a grassroots organization providing family support in communities throughout West Hawaii. FSSWH incorporated in 1981 as a private, non-profit organization whose mission is "to Support Families and Communities in Providing Love and Care for our Children." This mission statement was chosen carefully as the agency wanted to be sure to target support for both families and the communities in which they lived. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page I Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Program Description: Parenting is harder than it used to be. Not so long ago, families could depend on nearby relatives, neighbors and friends to share in child care; they provided child-rearing advice and encouragement and served as role models. But high rates of divorce and single parenthood, soaring numbers of women in the workforce and increasing geographic mobility have left many families isolated from these traditional informal support networks. Family support programs offer all parents what informal networks once supplied: help in raising healthy, happy children. Family support programs offer a whole new philosophy of community service—one that builds on strengths, focuses on the entire family within its culture and community, and one that gives the family the central role in the planning, design and delivery of carefully planned and implemented services. Family supports are designed to empower parents, build communities and help prevent such problems as child abuse and neglect, low birthweight, teen pregnancy and dropping out of school. Since its inception, Family Support Services of West Hawaii (FSSWH) has been a leader in the field of family support services in the state of Hawaii. The agency opened its first Family Center in Kona in 1990 and has since become a founding member of the state-wide Family Center Alliance. As remote, rural areas of the island of Hawaii, families in both Ka'u and North Kohala faced challenges in accessing child care, health care, employment, housing, substance abuse, financial assistance, counseling and educational resources. The Ka'u and Kohala Family Center are warm and welcoming places where any family member can go, not only in times of need, but as a regular part of day-to-day life. These Family Centers offer parent education classes, child development activities, parent -to -parent support groups, after school and academic enrichment, literacy instruction, health information, referrals and many other programs, activities and services. These services are modified and added to, depending on the needs and desires of local families. More than 500 individuals take advantage of the resources that they provide to children and families each year. FSSWH is seeking funding from Hawaii County to continue the work of the Ka'u and North Kohala Family Centers. Our purpose is to give parents the opportunity to reach out to one another and to learn together. The Family Centers help families prevent crises, define problems, identify strengths and become responsible for determining their own solutions. The Family Centers are the only places in each district that all parents can go to get the help and support they need in a familiar setting. FSSWH Family Center Coordinators not only respond to family needs, but also proactively create and cultivate social networks. For example, the Ka'u Family Center has partnered with the Hawaii County Department of Parks and Recreation to provide an annual Easter Egg Hunt for families. They also partner with Parks and Recreation, the Department of Health's Early Intervention Services and Good Beginnings Alliance by providing play and learn groups and parent support group opportunities for young children, including those with disabilities, and their families. The Family Centers are one of the few places in each district that works with referrals from Hawaii Intake Services to help individuals meet community service requirements. The centers work with homeless families to help minimize the downward spiral that homelessness may bring in areas that lack most social service networks. The centers allow other non-profit organizations and community groups to use the facilities by providing office and meeting space. The Malama Prenatal, Healthy Start, Early Head Start, Youth after-school and summer programs have staff housed in the center and thus families are able to access these services without having to travel NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 long distances. The Family Centers have facilitated community -wide inter -organizational partnerships and have been intimately involved in community-based anti-drug efforts and initiatives. Our North Kohala Family Center Coordinator was one of the founding members of the Community Response to Ice (CRI), and FSSWH has since become a partner in the North Hawaii Drug -Free Coalition—co-sponsoring the "Hugs Not Drugs" Baby Basket Project and helping to bring Dr. Ira Chasnoff to the island to assist with our understanding of and assistance to substance -using prenatal women and drug -exposed infants and their birth as well as foster families. One of the hallmarks of family support is its focus on the ecological perspective—looking at the child within the context of the family within the context of the community. Programs provide child - centered developmental activities and learning opportunities for parents while simultaneously contributing to larger community -building efforts. Funding for the Ka'u and North Kohala Family Centers allows FSSWH and the County of Hawaii to impact outcomes at each of these levels: child, parent, family and community. Total Budget and Position Count Total Program Budget $ 78,520.00 Total Program Position Count 1.0 fte (2x.5) Total Agency Budget $ 3.993,718.00 Total Agency Position Count 76 Program Objectives: 1) Enhance children's development and ability to attain academic and social success. 2) Promote successful transitions throughout a family's major milestones. 3) Assist families in achieving economic independence and self-sufficiency. 4) Mobilize public and private community resources to help children and families in need. 5) Decrease social isolation in rural communities Program Highlights: 1) Information and referral services were provided to two hundred (200) new and five hundred seventy nine (579) returning individuals during the 2005-2006 fiscal year. 2) Provided office and technological support for those without access to one hundred ninety two (192) individuals over the year. 3) Emergency food was distributed to forty nine (49) individuals and their families. 4) Fifteen organizations were able to utilize the facility to provide services to the community. These included: Narcotics Anonymous, Alanon, Kohala Coalition Against Drugs, Teen Court, Salvation Army Family Intervention Services, Alu Like, Bay Clinic's Reach Out, the Ka'u Partnership and the Ka'u Community Action Team. 5) The Family Centers housed programs designed to support families at many different stages of development, such as Healthy Start, Enhanced Healthy Start, Early Head Start, the North Hawaii Child Development Program for infants and toddlers with disabilities and their families, and the Youth Development Program. Together, these programs served well over two hundred and fifty (250) families in the North Kohala and Ka'u districts. 6) There were two community -wide family events in which four hundred sixty-five (465) people participated. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 The Family Centers provide a comprehensive array of family support programs, services and activities. Children's health Education • Health and developmental • After school programs screenings • Tutorial programs • Immunizations • Evening Homework Clubs • Evaluations for dev. delays • Access to GED programs • Access to pediatric care • Literacy programs Adult health care Children's issues • Access to prenatal care • After school care • Access to general medical care • Play and Learn groups • Info on diet, nutrition and health Drug awareness and counseling • Health, medical, & nutritional services • Information • Therapeutic services for infants and • Resource and referral services toddlers with disabilities • Access to mental health services • Child safety in and out of the home • Support groups • Teenage youth councils Domestic issues Social services • Parenting education • Employment opportunities • Financial counseling, planning, and management • Information and referral to other government and community Housing resources NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Education 24 10 20 Employment 13 10 15 Financial 7 10 10 Health 19 20 25 Parenting Information 18 25 25 Office Equip/Computer Use 165 155 165 Food 56 50 60 Substance Abuse Support/Info 10 60 75 76,043.00 $ 75,929.00 $ 78,520.00 *If applicable Program Expenditures See Below Other Program Expenditures, con't FY 2005-06 Actual FY 2006-07 Budget FY 2007-08 Estimate Salaries and Wages $ 42,962.00 $ 40,076.00 $ 44,250.00 Professional Fees $ 4,868.00 Occupancy $ 12,970.00 $ 13,106.00 $ 13,500.00 Operations $ 1,002.00 $ 2,525.00 $ 2,500.00 Equipment $ 1,671.00 $ 2,160.00 $ 2,000.00 Other" $ 30,408.00 $ 31,168.00 $ 29,770.00 Total $ 76,043.00 $ 75,929.00 $ 78,520.00 See Below Other Program Expenditures, con't NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Employee Benefits $ 6,958.00 $ 7,436.00 $ 5,752.06- ,752.00Pa Payroll roll Taxes $ 5,074.00 $ 4,680.00 $ 4,868.00 Occupancy $ 12,970.00 $ 13,106.00 $ 13,500.00 Supplies $ 5,226.00 $ 5,804.00 $ 5,500.00 Travel—mileage $ 180.00 $ 142.00 $ 150.00 Total Other $ 30,408.00 $ 31,168.00 $ 29,770.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Hawaii County $ 51,000.00 $ 45,000.00 $ 65,000.00 Private Donations $ 25,043.00 $ 30,929.00 $ 13,520.00 Total $ 76,043.00 $ 75,929.00 $ 78,520.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Family support is about investing in the promotion of the positive things that families want for their children. In the long term, family support is a societal investment in the creation of happy, healthy, productive citizens. This investment has an impact on the families who participate in services, and on society as a whole. Research shows that by investing in positive outcomes for children and families, family support programs also, over the long term can lead to: • fewer teenage pregnancies • less juvenile delinquency • improved behavior and performance of children at school • fewer incidents of child abuse and neglect • more families moving from welfare to work • increased self-confidence, knowledge of child development and parenting skills among parents • greater educational attainment among parents Through these positive outcomes, family support allows us as a society to invest in the development of citizens rather than putting money into more prisons, foster homes, and public welfare. This investment has a tremendous effect on overall productivity as a society and on the ability of those receiving family support services to contribute to us as a nation. Up until this point, our state legislature has not made the investment in prevention that is necessary to carry out prevention programs such as this, thus continued support from the County is necessary, along with the powerful support given by community members. Donors continue to contribute in order to support our Ka'u and Kohala Family Centers. Collaboration has been a key to the success of the Family Center programs and is recognized as a top priority in the continued growth and service of the Centers. Collaboration among numerous agencies, student organizations, local governments, school systems, departments of health and social services, civic and religious organizations provides on-site programs, services, and activities. Representation on local Advisory Boards, scholarships and financial assistance, volunteers, and in-kind donations such as educational materials, transportation, and Center space are also contributions that will continue to support the programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Family Support Services of West Hawaii - Agency Name Ka'u and North Kohala Family Centers I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Lva,'40_) !o! 9/07 nature of Board President/Chair Date of Executivi DActor Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 'f (°,aP Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name Agency Director: Marcia Prose --Board President Phone No.: 935-8755 Contact Person: Lynnette Uyesato--Program Crd. Phone No.: 935-8755 Mailing Address: 1290 Kinoole Street, Hilo, Hawaii 96720 Facility/Site Address: Fax No.: Email Address: 1290 Kinoole Street, fcjceh@fcjc.org Hilo, Hawaii 96720 Name of Accountant/CPA (include name of firm if applicable): Jennifer Gossert, Jennifer L. Gossert, CPA Phone No.: 808-969-3115 Mailing Address: 600 Kinoole Street, Ste. 201 Hilo, Hawaii 96720 Amount of Request for County Funds Prior Year(s) Funding: 04-05 05-06 $13,000.00 $15,000.00 $20,000.00 06-07 $15,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name Agency Mission Statement: The mission of the Friends of the Children's Justice Center of East Hawaii is to help sexually, physically, emotionally abused and neglected children. We do this in partnership with the Children's Justice Center of East Hawaii, by providing funds and resources to support the needs of these children. The "Friends" offer hope, encouragement, and opportunity for victims of child abuse. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name Program Description: The Friends of the Children's Justice Center of East Hawaii is a private nonprofit organization founded by concerned community members in 1990 whose primary goal was to protect and enhance the physical and psychological safety of abused or neglected children. The Friends are in a unique partnership with the Children's Justice Center (CJC), a State Judiciary Program. The CJC provides a safe, neutral homelike atmosphere where children can be interviewed regarding allegations of abuse, particularly sexual abuse. This Children's Justice Program facilitates and coordinates the system's response to victims of child abuse to reduce their trauma through a multi -disciplinary team approach which involves police, social workers, prosecutors, guardians ad litem, medical professionals, advocates, and others. The Friends support the CJC primarily by helping provide direct services and programs to child victims and their families which are not available through any other public or private source. The Friends accept referrals from state and private agencies working with child abuse victims such as Child Protective Services, Child and Family Services, Hawaii Behavioral Health, Catholic Charities, Parents Inc., etc. and facilitate requested services. The Friends serve children between the ages of 0-18, who are victims of maltreatment (sexual, physical, emotional, mental abuse or neglect) residing in East Hawaii. This includes North Hilo, South Hilo, Hamakua, Puna and parts of Ka'u. Our services are aimed at assisting children in situations of documented cases of abuse and neglect. The Special Needs and Enhnacement Program is designed to help child victims develop positive self-worth. The Friends do this by providing for needs that are not covered by any other public or private source. Funds are used to provide basic essentials (i.e. clothing, diapers, toiletries), special needs (i.e. air/ground transportation, school supplies, correspondence courses) and enhancement support (i.e. sports, music lessons, and tutoring). The Friends have a holiday gift program for children not covered by other programs. The Center Support Program was developed to reduce trauma and ensure the safety and comfort of the children that come to the Children's Justice Center for interviews. One way the Friends maintain the Center's safe, child -friendly and homelike atmosphere is with toys, games, and snacks. This is often made NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name possible by community donations and volunteerism. Also, the Friends maintain the Center's appearance with repairs and refurbishing when it is needed. The Prevention and Education Program is designed to educate the community on child abuse issues. This program plans and implements services and events for the public, promoting awareness and prevention of child abuse. The Training Program helps to sponsor the attendance of various professionals (i.e. social workers, police & therapists) at seminars and conferences. These professionals work with child victims and their families. Training opportunities enhance the quality of services that these victims receive and prevents them from being re -traumatized by the system's response to the allegations of abuse. Total Budget and Position Count Total Program Budget 186,300 Total Program Position Count 1 Total Agency Budget 1 186,300 Total Agency Position Count 1 Program Objectives: 1) Provide clothing, toiletries, bedtfolding mattresses and other necessities for children in emergency or relative foster placement. 2) Cover the costs of tutoring services, correspondence courses, summer school tuition to allow a child to graduate or progress on to the next grade level. 3) Pay for fees, equipment and supplies needed for the extracuricular activity (sports, music, art, drama, dancing lessons, etc.) that a child is involved in. 4) Provide gifts for a special occasion such as Christmas when a child would otherwise not receive a gift. 5) Provide gas coupons to families on a limited budget so children may be able to attend treatment programs. 6) When gaps in funding for child's treatment occur, cover costs, short-term. 7) Provide formula and supplies for infants removed at birth from drug addicted mothers. 8) Give children a chance to participate in school functions by paying for excursion fees, prom dresses, senior pictures, etc. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name 9) Assist police, social workers, and other professionals in keeping up to date with the latest investigative techniques, sensitivity training, forensics and knowledge of resources by helping to sponsor their attendance at training workshops and seminars. 10) Provide privacy, comfort and safety for clients who come to the Center by maintaining its warm environment. 11) Collaborate with community organizations to provide innovative prevention programs targeting schools. 12) Participate with the East Hawaii Coalition for child abuse Prevention in prevention/education activities within the community to spread awareness on issues about child abuse to the general public. Program Highlights: 1) Filled 1,167 appropriate special needs and enhancement requests for abused and neglected children to provide for their specific needs that would otherwise have gone unmet. 2) Helped sponsor 5 professionals to attend trainings on Oahu and the mainland. 3) Increased awareness of the general public by carrying out prevention/education events (ie presentations to Exhange and Rotary Clubs, and participated in the Boy Scouts annual Makahiki Festival). 4) Worked with the Coalition on a proclamation signed by Mayor Harry Kim in April, Child Abuse Prevention month. 5) Planned and participated in the Coalition Family Fun Day event at the Sangha Hall in Hilo. 6) Provided starter school supplies to over 200 children. 7) Brightened the holidays of 170 teens 12-17 years of age (who are not supported by other programs as are young children with Toys for Tots) by providing $25 Christmas gift cards with a stuffed animal attached. 8) Held our signature fundraiser (The Phantom) by distributing over 500 invitations. 9) Sponsored a 2nd Annual Prevent Child Abuse Golf Tournament for FCJCEH. 10) Distributed two newsletters to over 1,500 business and community members. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Special Needs & Enhancement REQUESTS 699 800 900 Winners' Cam 6 4 4 Christmas Gift Program 157 200 200 -Operations 3,036 10,200 18,200 -Equipment Other" 105,477 122,700 134,900 Total 1 129,2681 173,7001 186,300 *If applicable Program Expenditures * If applicable `Program Coordinator became full-time/higher qualifications/expanded responsibilities " Please explain in detail on separate sheet * Breakdown of OTHER (in Program Expenditures) FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 19,018 36,000*** 40,000*** Professional Fees 87,437 7,500 3,600 Facilities 4,773 7,500 7,800 -Operations 3,036 10,200 18,200 -Equipment Other" 105,477 122,700 134,900 Total 1 129,2681 173,7001 186,300 * If applicable `Program Coordinator became full-time/higher qualifications/expanded responsibilities " Please explain in detail on separate sheet * Breakdown of OTHER (in Program Expenditures) NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Center Support 3,362 5,000 5,200 Professional Fees 87,437 92,000 96,000 Facilities 1,671 4,000 4,000 Education/Prevention 3,036 10,200 18,200 Statewide meetings 1,505 2,000 2,000 8,466 9,500 9,500 -Training Total 105,477 122,700 134,900 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget" FY 2007-08 Estimate Donations 5,078 5,000 5,000 Walk 5,000 6,000 5,000 -Charity Ironman 1,000 1,000 1,000 of Hawaii 15,000 15,000 20,000 -County Hawaii Island United Way 15,000 15,000 20,000 Geist Foundation 20,000 40,000 30,000 Teresa Hughes Foundation 31,500 33,000 35,000 Fundraising 19,794 35,300 36,000 Workshop Fees 320 400 400 Interest 691 500 400 John Ross Foundation 5,000 5,000 5,000 Friends of Foster Care 2,528 3,500 3,500 Hi Women's Legal Fund 748 Foundation Proposals 14,000 25,000 Carryover Funds 7,609 Total 129,268 173,700 186,300 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Friends do not collect fees for any of our services. We are continuously researching for additional grant funding, increasing the donors for our Phantom non-event fundraiser and expanding participation in our golf tournament fundraiser. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal Year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature of Board President/Chair Marcia M. Prose Signature of Program Coordinator Lynnette Uyesato ////. � Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 FRIENDS of the CJC-WH- Agency Name Enhancement and Basic Needs Program- Program Name Agency Director: Alice Daniel Phone No.: (808) 331-2425 Contact Person: Alice Daniel Phone No.: (808) 331-2425 Mailing Address: 77-6403 Nalani Street Kailua-Kona, HI 96740 Facility/Site Address: 77-6403 Nalani Street Kailua-Kona, HI 96740 Fax No.: (808) 331-2425 Email Address: fcjcwh@hawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Ann Fukuhara, (auditor) An Accountancy Corporation Denise Hill, Director of Accounting, Hualalai Resort Phone No.: (808) 961-5532 Mailing Address: P.O. Box 6691 Hilo, HI 96720 Amount of Request for County Funds: $20,000.00 Prior Year(s) Funding: 04-05 05-06 06-07 $13,000 $15,000 $12,000 Agency Mission Statement: To provide assistance to children who have been traumatized by sexual assault, physical abuse or neglect, or who are witnesses to violent crime; to promote prevention of child abuse; and to support the Children's Justice Center of West Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 FRIENDS of the Children's Justice Center of West Hawaii - Agency Name Enhancement and Basic Nees Program- Program Name Program Description: The FRIENDS of the Children's Justice Center of West Hawaii (FCJC-WH) was formed in 1989 as the Friends of the Children's Advocacy Center of West Hawaii to provide support to child victims of abuse, neglect and sexual assault. The name changed to the FRIENDS of the Children's Justice Center of West Hawaii in 2001. The program for which we seek funds from the County of Hawaii is our "enhancement and basic needs" program which provides funds for activities, services and items that the child would otherwise go without. All County of Hawaii funds are used to the direct benefit of children and teens in West Hawaii who have experienced abuse or serious neglect. No County of Hawaii funds are used for administrative expenses. Requests for funding are submitted to the FCJC-WH by a professional person working with the child, such as the social worker, therapist or counselor. To be eligible, a child must be a victim of a documented case of abuse or neglect or witness to violent crime. The requests have ranged from $5.00 food coupons used when children are transported to court by social workers to teens attending Winners' Camp on Oahu. Our goal is to "help a victim become a child again." The FCJC-WH is able to help with basic needs and provide emergency assistance in situations where no govemmental or other private agency can meet the need. The "enhancement and basic needs" program is the only program of our agency. It is not a "program" in the traditional sense, in that we are merely funding participation in other programs or supplying basic needs such as clothing and school supplies. Typical requests received are for participation in athletic, music, dance, karate, or summer programs or the Winners' Camp program on Oahu. The only exception to the statements above is that we organize "follow up" activities for the teens who return from Winners' Camp to reinforce the positive lessons and skills they have learned at camp. The majority of these teens are from foster homes and are in need of on-going support. The FCJC-WH also assists the Children's Justice Center by helping to provide a warm, child -friendly atmosphere for the children and their siblings when they are brought to the Center for their forensic interviews. The FCJC-WH also supports training programs provided for professionals by the CJC and participates in child abuse prevention activities in West Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Total Budget and Position Count Total Program Budget 123,074.00 Total Program Position Count 1/2 Total Agency Budget 154,236.00 Total Agency Position Count 1/2 Program Objectives: 1) Assist 20 or more teens to attend Winners' Camp by June 30, 2008; 2) Give holiday gift stockings to 100 teenage youth by the end of December 2007; 3) Give 25 FRIEND boxes to children entering a foster home for the first time, or being suddenly transferred to a new foster home, by June 2008; 4) Assist in planning and carrying out six follow up activities for Winners' camp graduates by June 30, 2008; 5) Assess 600 enhancement/basic needs requests helping 375 individual children, by June 30, 2008; 6) Support one or more training projects in West Hawaii, in collaboration with the Children's Justice Center and other agencies, to provide best practice training to professionals who work with children and families who are victims of abuse and neglect, by June 2008; 7) Participate in building community awarness of child abuse through Family Fun Day in April, attending ten Hui Laulima meetings, presenting one or more talks to service agencies on issues of child abuse in West Hawaii and the work of the CJC-WH and the FCJC-WH by June 30, 2008. Program Highlights: 1) 33 trips to Winners' Camp on Oahu were sponsored during the County of Hawaii fiscal year July 2005 -June 2006. Several have attended camp twice and have become members of the junior staff. 2) 124 holiday gift stockings were distributed to teens in December 2005. 3) 33 FRIEND boxes were distributed during the County's FY 2005-2006. 4) 5 activities were sponsored as follow up activities for teens who attended Winners' Camp during the County FY 2005-2006. 5) Prior to January 2006 we did not have a data base for sorting out duplicate requests for the same child. Consequently, the following numbers reported are for our FY January -December 2006. During that period the FCJC-WH processed 607 requests serving 358 individual children. 77.8 % of the children were in foster care. 14.8% were victims of sexual abuse. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program - Program Name Performance Measures: *If applicable *These numbers are calendar year 2006 since our data base for individual children served was begun January 2006. In the future we will be able to report numbers for the County FY. Program Expenditures FY 2005-06 Actual * FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Children benefitting for CJC-WH interviews 212 225 215 Needs Requests 607* 600 600 Holiday gift bas 124 120 100 FRIEND Boxes 33 35 25 Winners' Camp attendees 33 20 25 Winners'Camp follow up activities 5 2 6 Individual Children served 358* "" 375 *If applicable *These numbers are calendar year 2006 since our data base for individual children served was begun January 2006. In the future we will be able to report numbers for the County FY. Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 0.00 0.00 0.00 Professional Fees 12,970.54 12,800.00 13,624.00 Operations Equipment 0.00 0.00 0.00 Other` 71 336.73 103,301.00 109.450.00 Total 84,307.27 116,101.00 123,074.00 If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FRIENDS of the Children's Justice Center of West Hawaii ITEM 2005-2006 2006 2005 Budget 2006 Budget 2007 Budget actual actual Athletic $ 4,195.38 $ 3,072.91 $ 5,500.00 $ 7500.00 $ 5,000.00 Center Support' $ 6,785.94 $ 6,866.37 $ 8,100.00 $ 13,100.00 $ 14,100.00 Christmas Bags, Teens $ 3,163.49 $ 2,813.41 $ 3,500.00 $ 3,500.00 $ 3,000.00 Clothing $ 2,550.00 $ 37544.12 $ 3,000.00 $ 3,000.00 $ 4,000.00 Counseling $ - $ 1.00 $ 1.00 $ - Dental $ 656.25 $ 4,393.76 $ 4,000.00 $ 4,000.00 $ 5,000.00 Education $ 3,447.62 $ 3,507.22 $ 5,000.00 $ 5,000.00 $ 3,500.00 Enhancement, Basic Needs $ 1,368.71 $ 1,080.34 $ 2,900.00 $ 2,900.00 $ 2,000.00 Enhancement, Miscellaneous $ 2,257.97 $ 991.11 $ 4,250.00 $ 4,250.00 $ 4,000.00 Food Coupons $ 1,060.00 $ 880.00 $ 900.00 $ 900.00 $ 1,000.00 Food Groceries $ - $ - $ - FRIEND Boxes $ 953.22 $ 868.78 $ 2,000.00 $ 2,000.00 $ 1,000.00 Furniture $ 618.70 $ 1,017.09 $ - $ 1,000.00 Gas Coupons $ $ - $ - $ 100.00 Graduation $ 887.88 $ 897.38 $ 1,000.00 Medical $ 1,118.62 $ 1,868.62 $ 100.00 $ 100.00 $ 1,000.00 Music Lessons $ 841.73 $ 325.00 $ 750.00 $ 750.00 $ 500.00 Performing Arts $ 1,514.15 $ 1,699.50 $ 1,000.00 $ 1,000.00 $ 2,000.00 Prevention/Awareness $ 200.077-1 1,500.00 $ 1,000.00 $ 500.00 School Break Programs 2,626.00 $ 5,016.00 $ 5,000.00 $ 2,500.00 $ 5,000.00 School Pictures/Yearbook $ 206.60 $ 355.28 $ 500.00 School Supplies/fees $ 1,518.00 $ 936.00 $ 1,350.00 $ 2,050.00 $ 1,000.00 Summer Camp/Fun $ 2,441.00 $ 2,436.00 $ - $ 2,500.00 Summer School $ 745.00 $ 644.00 $ 1,750.00 $ 1,750.00 $ 1,750.00 Training & Education $ 1,658.21 $ 3,254.49 $ 4,000.00 $ 4,000.00 $ 4,000.00 Travel $ 5,668.26 $ 7,398.77 $ 10,000.00 $ 10,000.00 $ 10,000.00 Winners' Camp $ 20,308.41 $17,430.12 $ 30,000.00 $ 30,000.00 $ 30000.00 Winners' Cam follow u $ 4,545.59 $ 3,372.17 $ 3,150.00 $ 6,000.00 $ 6,000.00 TOTALS: $ 71,336.73 $ 74,668.44 $ 97,751.00 $103,301.00 $ 109,450.00 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program - Program Name Performance Measures: *If applicable *These numbers are calendar year 2006 since our data base for individual children served was begun January 2006. In the future we will be able to report numbers for the County FY. Program Expenditures FY 2005-06 Actual*_ FY 2006-07 Budget* FY 2007-08 Estimate Children benefitting for CJC-WH interviews 212 225 215 Needs Requests 607* 600 600 Holiday gift bas 124 120 100 FRIEND Boxes 33 35 25 Winners' Camp attendees 33 20 25 Winners' Camp follow up activities 5 2 6 Individual Children served 358* *" 375 *If applicable *These numbers are calendar year 2006 since our data base for individual children served was begun January 2006. In the future we will be able to report numbers for the County FY. Program Expenditures If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 0.00 0.00 0.00 Professional Fees 12,970.54 12,800.00 13,624.00 Operations Equipment 0.00 0.00 0.00 Other* 71,336.73 103,301.00 109.450.00 Total 84,307.27 116,101.00 123,074.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate County of Hawaii 15,000.00 15,000.00 13,500.00 Private Foundations 46,470.00 57,001.00 65,750.00 Donations 22,837.27 44,100.00 43,824.00 Total 84,307.27 1 116,101.00 123,074.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The FRIENDS of the Children's Justice Center of West Hawaii's "Enhancement and Basic Needs" program is essentially self-sustaining at the present time. No County of Hawaii funds are used for administrative or staff expenses. Should the County of Hawaii reduce the grant to the FCJC-WH, less money would be available to help the children eligible for our services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 The FRIENDS of the CJC-WH -Agency Name Enhancement and Basic Needs Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. &.' i-2�d7 Si nature of Boa President/Chair D to Signature of Date Program Coordinator UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Goodwill Industries Of Hawaii, Inc.- Agency Name Work Experience Program- Program Name Agency Director: Laura Robertson Phone No.: 808-836-0313 Contact Person: Kathleen Nielsen Phone No.: 808-961-0307 Mailing Address: 500 Kalanianaole Ave, Hilo, HI 96720 Facility/Site Address: 500 Kalanianaole Ave, Hilo, HI 96720 Fax No.: 808-969-3861 Email Address: knielsen@higoodwill.org Name of Accountant/CPA (include name of firm if applicable): Catha Combs, Wikoff Combs & Co., LLC Phone No.: 808-791-1420 Mailing Address: 1001 Bishop Street, Suite 2760, Honolulu, Hi 96813 Amount of Request for County Funds: $29,500 Prior Year(s) Funding: 04-05 05-06 06-07 $10,000 $17,000 $20,000 Agency Mission Statement: Our mission statement is: Goodwill Industries of Hawaii, Inc. helps people with employment barriers to reach their full potential and become self- sufficient. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program- Program Name Goodwill Industries of Hawaii (GIH) has been in business in the State of Hawaii since 1959 providing vocational training and employment services to persons with barriers to employment, including: ■ Individuals with disabilities; ■ Youth who have disabilities or are economically disadvantaged; ■ Disabled veterans; ■ Asian and Pacific Islander immigrants; ■ Older individuals and dislocated workers; and • Adults who are economically disadvantaged, including Welfare -To -Work TANF/TAONF and Food Stamp recipients. With over 50 years of experience operating vocational training programs as well as teaching life skills, Goodwill has developed an expertise in bringing about success to the people we serve. Goodwill Industries of Hawaii in Hilo has been serving our community since 1998. We envision a world where all individuals with disabilities and other barriers will have the opportunity to participate in a full range of life's experiences, including employment. We provide services to empower individuals to be productive and independent, based on their abilities and interests. From July 2005 to June 2006, GIH successfully provided services to 7,990 people statewide, and placed more than 1,460 people into gainful employment. The East Hawaii branch of Goodwill Industries provided services to 1,534 individuals and placed 368 people into employment in 2005-2006. Over the past five years, Goodwill has successfully provided training and employment services to more than 31,000 people with barriers to employment, and placed more than 6,000 people into employment. These numbers reflect that Goodwill has the necessary skills and experience to perform the proposed services. It is our belief that work is a basic right that will assist people to attain other life goals. Moreover, we believe in each individual's right to self-determination, to make their own decisions regarding life choices as a means of promoting independence and self-sufficiency. In previous years, GIH has provided a menu of services to train, place and support individuals with barriers into gainful employment and assist them to overcome their barriers to both employment and job retention. Additionally, Goodwill is committed to providing services to help individuals after they have obtained employment to acquire skills and resources to advance, and improve their economic self-sufficiency through training in basic literacy, computer literacy, GED, ESL, and Earned Income Tax Credit filing. Participants also receive follow-up supports and transitional services once they are employed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Goodwill Industries Of Hawaii, Inc.- Agency Name Work Experience Program- Program Name GIH will coordinate these services with the appropriate agencies and identified networks of support, to better serve the participant on a long-term basis. Examples of agencies and partners with whom we coordinate services include the Department of Health, Division of Vocational Rehabilitation, Workforce Development Department, Department of Human Services, YWCA, Hawaii Literacy, Department of Education, Legal Aid Society, East Hawaii Coalition for the Homeless, Chamber of Commerce, Goodwill Industries International, employers in identified industries with job opportunities corresponding to participants' career goals, and others. When possible natural supports will be developed to enhance the individual experience in the workplace. Collaboration between employer, family, friends, and the program staff will be emphasized to increase the probability of success. Program Description: Funding is requested for a work experience program to provide wage subsidy for individuals with disabilities and other barriers to employment. The program format will allow work training opportunities for individuals that do not have work experience or who need additional supports or training to succeed in their employment goals. The training programs available are Janitorial and/or Textile/Wares processing positions. The Work Experience program will follow guidelines as set forth by the Department of Labor. Goodwill Industries has a subminimum wage certificate that requires the following: e a standard be set for each work station community wage survey be conducted annually, and each paticipant's productivity be measured every six months. Each participant will become familiar with and choose the program that is right for them. When the work experience path has been chosen, the participant will be trained on how to perform the essential job functions needed for the position(s). The benefits of developing these work skills extend beyond the work environment. Through this program participants learn what it is like to earn a paycheck, while being provided valuable work experience and enhancing skills in a real work setting. We recognize the intrinsic value of work and understand the profound effects that meaningful, tangible employment brings to our trainees' lives. More than bringing financial self-sufficiency, work taps the spirit of the individual, provides equal opportunity, and demands commitment and dedication, values that provide the foundation for the community. In 2005-2006, the Work Experience Program served 19 participants that were enrolled in a Goodwill training program. The format allowed work -training NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Goodwill Industries Of Hawaii, Inc.- Agency Name Work Experience Program- Program Name opportunities for individuals to choose a position in our Janitorial program or Textile/Wares Processing program. The Work Experience Program followed guidelines as set forth by the Department of Labor. A standard was set for each workstation, a community wage survey was conducted, and each participant's productivity was measured every six months. Participants developed problem solving skills, motivational skills, an attitude for success, and increased their self- confidence in the workplace. This year Goodwill Industries of Hawaii is requesting an increase in funding to enable expanded services to high school students and other persons with employment barriers. The funding will also permit purchase of assistive devices for persons with disabilities in the program. Proposed equipment purchases include: tables with height adjustment to be used for people in wheelchairs, aprons with pockets to carry tools easily, back supports to assist when lifting, bins with springboard bottoms to raise product toward the person loading or unloading, rubber mats to ease leg fatigue when standing, adaptive chairs and low clothing racks that can be reached easily from a wheelchair. These devices will strengthen the program and increase the comfort, productivity, and success of participants. The increase in the proposed funding will allow us to serve participants that have transportation barriers. East Hawaii communities have challenging transportation needs due to the limited number of transportation resources in the Hilo area. People living in less populous areas, outside of Hilo, have difficulty finding reliable, affordable transportation. Goodwill Industries of Hawaii proposes to assist participants in meeting their transportation needs through existing transportation resources, such as the Mass Transit Shared Ride Program and using the Goodwill van to transport participants to and from the program when necessary. Total Budget and Position Count Total Program Budget $29,500 Total Program Position Count 2 Total Agency Budget* 2,400,000 1 Total Agency Position Count 70 * Total Agency Budget denotes Hilo Branch only NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Goodwill Industries Of Hawaii, Inc.- Agency Name Work Experience Program- Program Name Program Objectives: 1) Enroll 20 participants in the Work Experience Program. 2) Instruct proper work techniques for each workstation to be assigned, by review of the workstation development form during the first week of training. 3) Develop motivational skills and attitudes for success, self-confidence and problem solving skills throughout the training period. 4) Conduct time measurement study for participant during the first 2 weeks of entry into the program. 5) Review outcomes with the participant upon completion of the time study. 6) Continue to instruct and reinforce correct work procedures. 7) Track work hours, daily or as scheduled to work. 8) Pay each participant semi-monthly, according to hours worked. 9) Conduct time study for each participant every six months. 10) Update wages according to productivity level. The emphasis of this program is giving the participants the confidence and tools to maximize their abilities. Our philosophy is to provide an environment for people to believe they can succeed, achieve goals, develop skills and change the barriers they face every day. At Goodwill we believe in the power of work. We create hope, jobs and futures. Through our program, clients learn specific vocational skills and work environment behaviors. Individuals choose the work that matches their abilities and interests and earn wages based on productivity. Clients in the custodial services program perform a variety of cleaning duties in restrooms and offices. Clients in the retail program sort, inspect, hang, and price merchandise. Goodwill supervisors provide appropriate guidance during training that emphasizes safety, quality control, production, proper work behavior, and attendance. Program Highlights: 1) Enrolled 19 participants in the Work Experience Program in 200512006. 2) In a random audit of program participants we found an average 19% increase in productivity for participants since their entry into the program. 3) Instructed participants in proper work techniques for each workstation. 4) Developed motivational skills and attitudes for success, self-confidence and problem solving skills for each participant. 5) Conducted time measurement study for each participant within 2 weeks from date of entry into program. 6) Reviewed outcome of time study with each participant upon completion of study. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Goodwill Industries Of Hawaii, Inc.- Agency Name Work Experience Program- Program Name 7) Instructed and reinforced correct work procedures with each participant. 8) Tracked work hours, daily or as scheduled to work. 9) Paid participants on a semi-monthly basis, according to hours worked. 10) Conducted time study of each participant every six months. 11) Updated wages according to productivity level. 12) Developed workstation for textile processing to accommodate each participant. 13) Placed one individual in competitive employment. 14) Placed three individuals in volunteer positions Through participation in the work experience program, four participants have gained valuable job skills and have transitioned to competitive or volunteer employment. In the work experience program they learned how to take direction, follow through on their work and how to work as a team. As they progressed in the program they demonstrated strong work ethic, attention to detail and positive attitude. One trainee who started in textile/wares this past year, is doing very well. Through her increased self-confidence and pride in work, she has requested assistance to learn other skills. Currently she is adding office skills to her resume with the hope of transitioning to an office position. Another trainee volunteers at a local museum. She enhanced her self-esteem, teamwork abilities, confidence and skills required to perform her volunteer duties with ease All of the participants in the Work Experience Program look forward to receiving a paycheck. Earning a paycheck provides them with opportunities to budget, save and make decisions on where and how to spend their money. The power of work allows participants to gain self-esteem and develop the following qualities that are important for job retention. Qualities such as confidence, initiative, willingness to learn, desire to work, cooperation, attendance, communication skills, team play, flexibility, honesty, and respect for coworkers, workplace, and equipment Performance Measures: Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete a follow-up survey used to evaluate the satisfaction and effectiveness of services. Upon NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Work Experience Program $17,000 $20,000 $29,500 Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete a follow-up survey used to evaluate the satisfaction and effectiveness of services. Upon NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program - Program Name program exit, each participant, employer and referring counselor will be asked to complete a satisfaction survey. Parties are asked to respond to questions in several areas including the quality of services received, the service outcomes, level of satisfaction regarding the program, and suggestions for changes. Satisfaction surveys are compiled and analyzed on an annual basis. The results are shared with funding sources and Goodwill's Board of Directors. Recommendations for needed changes are analyzed. Plans for improvements are then developed and implemented as a result of this feedback. For the most recent year 2005-06, the Work Experience Program participants that were also enrolled in the Home & Community Based Services Program indicated a participant and advocate satisfaction rate of 97% in the categories of "Very Good" to "Excellent". Participant's comments included: (1) like working doing janitorial. • 1 am able to work and get a paycheck Program Expenditures " If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $14,355 $18,000 $25,500 Professional Fees 2,000 2,000 2,000 Operations 368,210 391,000 408,000 Equipment $3,000 Other (Payroll Processing Charges)" $2,645 $2,000 $1,000 Total 1 $17,000 $20,000 $29,500 " If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate County of Hawaii Non -Profit Grant $ 17,000 $ 20,000 $ 29,500 Goodwill Industries of Hawaii 2,000 2,000 2,000 State of Hawaii 368,210 391,000 408,000 Total $387,210 $413,000 $439,500 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program - Program Name Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Work Experience Training Program is a component of a much larger service provided to persons with disabilities, through the State of Hawaii. The money provided by the county allows trainees to earn money while gaining valuable work experience in a structured learning environment. As they gain the necessary experience they transition out of the program. While this funding pays the direct salary, it does not cover overhead, supervision, and case management. We leverage the County funding to provide a full -range of services for the trainees. Although we do not have alternative funding for the program at this time, we are looking into expanding the program for trainees who possibly qualify for Federal funds and using the County grant for trainees who have no other sources of funding. County grant serves as funding of last resort for our trainees, who have no other options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'i, 1(we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. ---- D� o Wh4rf Bo resident/Chair Date Signature of Executive Director (m (o-7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Grassroots Community Development Group- Agency Name Kupukupu After -School Program- Program Name Agency Director: Trina Nahm-Mijo Phone No.: Contact Person: same Phone No.: 966-7154 Mailing Address: P.O. Box 1772, Kea'au, HI 96749 Facility/Site Address: 15-0565 Kea'au-Pahoa Highway, Bdng. G Fax No.: 974-7757 Email Address: nahmmijo@hawaii.edu Name of Accountant/CPA (include name of firm if applicable): Peralto and Co. CPA Inc.Joel Phone No.: 961-3462 Mailing Address: 180 Kinoole St., Ste. 302, Hilo, HI 96720 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 04-05 05-06 06-07 $0 $ $0 $ $42,500 Agency Mission Statement: To strengthen our communities through the cooperative development of programs and services for all of Puna. To provide a quality After -School Program for area youth, family strengthening, health and wellness, cultural diversity and economic development activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Grassroots Community Development Group - Agency Name Kupukupu After -School and Summer Program- Program Name Program Description: This free after-school program was first started through a HI Island Meth. Initiative grant in 2004 in response to the ice epidemic on the Big Island. The target population is 6", 7a', and 8" graders from Kea'au Middle School. The program teaches drug refusal skills, pro -social and communication skills and healthy holistic development through physical activities, tutoring and homework assistance, cooking and nutrition, agricultural skills and sustainability values, and arts and crafts. Special workshops are also offered in expressive activities like music, video, circus arts, and hiphop. The program runs M -F, 1-5 p.m. and this past summer, a six-week, all day program was successfully started. Total Budget and Position Count Total Program Budget 60,000 Total Program Position Count 4 part- time Total Agency Budget 72,000 Total Agency Position Count 4 part- time Program Objectives: 1) Prevent drug use and other anti -social behaviors in Kea'au area youth; 2) Increase academic performance of Kea'au Middle School youth; 3) Provide skill development in physical, social, communication, LifeSkills; 4) Provide family strengthening and community bonding activities; 5) Provide Youth Leadership opportunities through high school and college mentors Program Highlights: 1) Participation of 3 Ola'a youth and 1 staff member in the "Strengthening Communities" Conference in Honolulu in spring 2006 sponsored by the Prosecutor's office and Kamehameha Schools. They led the other Ola'a youth in deciding on a anti-drug slogan "Don't Get Lost in the Frost" for a T-shirt campaign as part of their Project Action Plan. They also manned a NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 booth publicizing Ola'a Community Center's activities at the HawCC Earth Day Fair on April 21, 2006; 2) "Fight Right Pizza Night" was a collaboration with HawCC students who planned a presentation for families about positive communication tips, family bonding, and dealing with conflict in Nov. 2005; 3) Successful piloting of all -day summer program starting in June which included a visit to Mayor Harry Kim's office; hosting 30 Japanese middle school students from Kitoshima Japan. Ola'a youth taught them block printing and the Kitoshima youth taught them a contemporary folk dance. 4) Project Kupukupu youth increased the number of participants reaching the criterion score for pro -social and assertiveness skill competence by 17% from pre-test in the fall to post-test in the spring. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 - Agency Name - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Youth achieve pro -social and communication skills competency 63% 65% 70% Youth report being drug-free 100% 100% 100% Youth lead group interventions which increase problem -solving and leadership skills 16% 33% 50% Youth participate in community activities which teach active citizenry 40% 50% 60% Families of youth participate in family strengthening events 20% 30% 40% Total 56,601 1 76,000 77,000 *If applicable Program Expenditures * If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 43,273 55,000 60,000 Professional Fees 1,000 3,000 3,000 Operations 11,942 7,000 7,000 Equipment 386 11,000 7,000 Other* Total 56,601 1 76,000 77,000 * If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Grassroots Community Development Group - Agency Name Kupukupu After -School Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual" FY 2006-07 Budget * FY 2007-08 Estimate HI Island Meth Initiative Grant 50,000 20,000 0 KuKi'o Grant 5,000 5,000 Healing Our Island Grant 2,000 2,000 County of Hawai'i 42,500 60,000 Research & Development 10,800 1,200 5,000 Donations 4,283 5,000 5,000 Fundraising 3,000 Other Grants 2,300 2,000 Total 72,083 76,0001 77,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? This program plans to increase revenues through the following activities: 1) Grant writing to foundations, government, and other entities; 2) Becoming a HI Island United Way recipient; 3) Fundraising events. The goal is to be self-sustaining in five years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Grassroots Community Development Group - Agency Name Kupukupu After -School Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature of Board President/ hair ,Sig ature of Executi Director D 0 Dat l 3� o Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Habitat for Humanity Kona- Agency Name General Operating Support/Staffing- Program Name Agency Director: 8010 Contact Person: 8010 Mailing Address: Facility/Site Address: Fax No.: Email Address: Susan Sewell Susan Sewell P.O. Box 4619 Kailua Kona, HI 96740 74-5622 Alapa St. Suite 201 Kailua Kona, HI 96740 331-8020 ssseweil@earthlink.net Phone No.: 331 - Phone No.: 331 - Name of Accountant/CPA (include name of firm if applicable): Alex Smith, CPA Phone No.: 877-257-6484 Mailing Address: 1403 Frank Street, Honolulu, 111 96816 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 04-05 05-06 06-07 $ 0 $ 0 $ 15,000 Agency Mission Statement: Our mission is to empower families, build community and hope through home ownership for low income partner families. We partner with these families to build NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page I affordable homes and then "sell' the homes to the families with 0% interest, reasonable monthly mortgage payments. Habitat for Humanity is a "hand up," not a "hand out," since families contribute at least 300 hours or more to helping us build there own home and the homes of others. We not only build the homes, we make sure that the families are going to be successful homeowners through counseling and family support. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Habitat for Humanity Kona - Agency Name General Operating Support/Staffing- Program Name Program Description: Our affiliate was started in 2001 and was granted affiliation with Habitat for Humanity International in 2002. We follow the Habitat for Humanity International model that has been very successful for the past 30 years in eradicating poverty housing. We renovate and build douses for families eaming between 40-60% of the median income for West Hawaii. Our priorities currently include families with children and elderly people in need of safe and decent housing. Partner families are selected on basis of need, ability to pay the mortgage, willingness to partner and contribute sweat equity to the building of their home We also require residency in West Hawaii for a minimum of one year. After completion, homes are sold to families on a no profit !basis with a I% down payment with no interest loans and 20 year mortgages. Monthly mortgage payments usually run about $300 a month, or no more than 21 % of a family's monthly income. Since we rely entirely on volunteer labor, homes built by our affiliate cost between $65,000 to $100,000. We are seeking funding to support staffing and general operations of our affiliate. Last year, the County assisted in! funding our Volunteer Coordinator/Office manager. We recently went from one part time employee to three, acquiring an Interim Financial Director, InterimExecutive Director and a VISTA volunteer. We have hired a new full-time Execive Director who will start with us effective February 1, 2007. Our affiliate is in a transitional stage, and we are working to expand our output of houses from two per year to five to seven per year. To support this level of activity, the affiliate will need to hire a professional part-time Construction Site Supervisor. As a fund-raising device, Habitat permanent Restore, a retail loca household furnishings. ReStores locations on the U.S. mainland, < generating funds for the Habitat opportunities and "recycles" mat County's landfills. Habitat for Hui sales. We have received a grant for a permanent ReStore and he Community Development Block 1 Restore manager and to pay sta established. for Humanity Kona is planning to establish a ion selling donated building materials and have been successfully established at many s well as on Kauai and Maui. In addition to affiliate, the ReStore provides employment :rials that would otherwise be designated for the sanity Kona has had several one -day ReStore Df $5,000 to be used towards start-up expenses re applied for additional funds from the County's 3rant allocation. Funding is needed to hire a t -up expenses until the permanent location is NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Total Budget and Position Count Total Program Budget 188,200 Total Program Position Count 3 Total Agency Budget 550,000 Total Agency Position Count 5 Program Objectives: 1) Grow and maintain staff and operations support to coincide with the needs of our growing output of houses and growing operations. This will also allow us to provide the structure we need to continue construction of affordable housing in West Hawaii. The core office staff (Office ManagerNolunteer Coordinator, Executive Director, VISTA volunteer) recruit volunteers, secure cash and in-kind donations, maintain our database of volunteers and donors, manage affiliate financial transactions and reporting and work with our volunteer Board of Directors to manage the agency. We have several partnerships with the potential for many home builds on the horizon, and our staff and operations will need to grow accordingly in order to make these projects successful. 2) Ensure the effective use of volunteers and professional labor at the construction site. The part-time Construction Supervisor will be responsible for this, as well as securing permits, overseeing the construction process, ensuring site safety, and providing a "quality experience" for participants in the construction program. 3) Secure a site for the permanent ReStore, establish policies and procedures for Restore operation, purchase or lease warehouse and sales equipment, secure and train volunteer and paid staff and begin marketing for the ReStore.This will be done during the pre -opening period expected to last approximately six months, by the ReStore Manager. When the store is up and running, the ReStore Manager will oversee the operation of the store. Program Highlights: 1) Habitat Kona has gained revenues in excess of $17,000 from three quarterly Restore sales. 2) Extensive research has been done and a long-range plan developed for ReStore operation and finances. 3) An interim Financial Director and Executive Director and a fund development VISTA have been acquired, and a permanent full-time Executive Director has been hired to start on February 1, 2007. 4) A database of corporate and private donors has been established. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Habitat for Humanity Kona - Agency Name General Operating Support/Staffing - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Number of Homes completed 0 2 5-7 Number of people directly benefitting from house builds/renovations 0 6 15-30 Active volunteers 60 175 350-400 Number of part-time HFHK employees 1 3 5 Other" Total 54,563 124,6001 188,200 *If applicable Program Expenditures If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 18,852 39,750 145,000 Professional Fees 24,806 65,100 15,000 Operations 10,905 19,750 28,200 Equipment Other" Total 54,563 124,6001 188,200 If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Habitat for Humanity Kona - Agency Name General Operating Support/Staffing - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual* FY 2007-08 Estimate Countyof Hawaii 0 50,000 Private Contributions 44,346 45,000 Grants 25,000 FundraisingEvents 9,3441 20,000 Interest Income 543 1,100 1,200 Hawaii Island United Way 11,0001 13,000 Habitat for Humanity International 20,000 34,000 Total 54,2331 124,600 188,200 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Our forthcoming home builds and projects will be funded through grants for which we have applied and will continue to apply for, as well as through our continued fundraising efforts. We are also in the process of setting up a Restore which will supply us with a steady source of income. A Restore is a store that sells new or gently used, donated building materials to the general public. The Habitat for Humanity model is designed so that all mortgage payments collected from our partner families will go into a revolving "Fund for Humanity," which is used to build more houses. Therefore, the more houses we build, the larger our Fund for Humanity will be, allowing us more income to create more affordable housing. As our affiliate grows and is able to build more houses, our income will stabilize and allow us to become sustainable. We hope to increase our output from two houses a year, to five to seven within the next two years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Habitat for Humanity Kona - Agency Name General Operating Support/Staffing - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an i Signature of Board President/Chair JxAe an` Je'WW Signature of Executive Director 1-C2 r. (51 Date /-2s-4 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Hale Kipa - Agency Name Hawaii Advocate Program- Program Name Agency Director: Contact Person Mailing Address: Facility/Site Address: Fax No.: Email Address Punky Pletan-Cross Steven Pavao Phone No.: 589-1829 Phone No.: 969-1935 615 Pi'ikoi Street Suite 203 Honolulu, Hawaii 96814 357 Waianunue Avenue Hilo, Hawaii 96720 969-3276 spavao@halekipa.org Name of Accountant/CPA (include name of firm if applicable): Maria Gozzip, Controller Phone No.: 589-1829 Mailing Address: 615 Pi'ikoi Street, Suite 203 Amount of Request for County Funds Prior Year(s) Funding: 04-05 $0 05-06 $0 Agency Mission Statement: 06-07 $0 Hale Kipa's mission is: to provide opportunities and environments that strengthen and encourage youth, their families and communities to actualize their potential and social responsibility. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 • Page I *Hale Kipa - Agency Name Hawaii Advocate Program- Program Name Program Description: The Hawaii Advocate Program is for children and families known to the child welfare and juvenile justice systems — or at -risk of becoming known to these systems — the Hawai'i Advocate Program (HAP) provides comprehensive, community-based care. This statewide program strives to prevent out -of -home placements of youth. Hale Kipa began providing the Hawaii Advocate program both on the Big Island as well as statewide in July of 2004. The major funding source for the program is the State of Hawaii's Department of Human Services. The Hawaii Advocate Program services, which are a replication of the nationally successful Youth Advocate Program model, are based on an intensive, individualized, strengths -based approach that focuses on the youth's and family's needs and goals. The Youth Advocate Program model is a scientifically proven model that prevents out -of -home placement of youth and involvement in substance abuse and other high risk behaviors. Once admitted to HAP, each family is assigned a Community Advocate. The Advocate helps the family identify and cultivate relationships with persons and associations within the community that can provide support. Families receive an average of 13 hours of advocacy service per week. Services are flexible, creative and determined by the family's needs, and are guided by a "No Reject, No Eject" policy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 $� Hale Kipa - Agency Name Hawaii Advocate Program - Program Name SERVICES Individual and group counseling Advocacy and referrals Comprehensive assessments Individualized Service Plan development Competency Development for Youth and Parents Youth and Family Supports Development of Child/Family Teams Resource Development In -school Assistance Linkages to Community Resources Group Activities (recreational, skill building, cultural, tutoring, etc.) Supported Work Option 24 -Hour Staff Accessibility/Crisis/Emergency Interventions POPULATION & ADMISSION CRITERIA Youth ages 5-18 (or up to 20 if youth is on parole) Families referred to Child Welfare Services (CWS) that have been assessed to require supportive services, but not accepted for child protection services Families assessed and confirmed for child abuse or neglect by CWS that need NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 *Hale Kipa - Agency Name Hawaii Advocate Program - Program Name services to prevent out -of -home placement of a child; or to support reunification of a child who has been returned home Youth in PINS status with Family Court or in DHS system Youth being diverted from or transitioning back into the community from Hawai'i Youth Correctional Facility (HYCF) YOUTH RESPONSIBILITIES Participation in the development of an individualized Service Plan and personal goals Participation in program activities, at a specified number of hours per week Attend school or maintain another appropriate educational or vocational plan DISCHARGE CRITERIA Youth/Family achieves goals of the program Youth ages out or otherwise becomes ineligible for services Placement agency removes youth from the program Prevention/Intervention Services NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Hale Kipa - Agency Name Hawaii Advocate Program - Program Name Total Budget and Position Count Total Program Budget 1 $672,064.00 Total Program Position Count 25 Total Agency Budget 1 $15,188,620.00 Total Agency Position Count 326 Program Objectives: 1) 95% of participant youth not placed out -of -home for safety 2) 95% of participant youth not placed out -of -home due to his/her behavior 3) 99% of youth avoided pregnancy 4) 80% of youth sought employment actively or maintained employment. 5) 90% of youth participants attend school regularly 6) 95% of youth participants remain arrest free 7) 95% of youth participants remain free from reports of abuse/neglect. Program Highlights: 1) Independently contracted research contractor, Catalyst Group conducted follow-up with all cleints over the past two years and conducted surveys of all youth and families 2) The above percentages were consistently attained, clearly displaying the successful impact of this program NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 *1 Hale Kipa - Agency Name Hawaii Advocate Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Number of at -risk youth served n/a n/a 288 Number of DHS referrals n/a n/a 156 Number of Family Court referrals n/a n/a 132 Number of advocate hours n/a n/a 18,256 Number of groups held n/a n/a 121 Number of youths transported n/a n/a 279 Numbers of total mileage n/a n/a 25,656 Numbers of families financially assisted n/a n/a 166 Number of referrals made for other services needed b families n/a n/a212 n/a n/a n/a n/a n/a n/a *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 407,456 Professional Fees 84,429 Operations 171,270 E ui ment 8,909 Other' 0 Total 672,064 * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 *Hale Kipa - Agency Name Hawaii Advocate Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 FY 2006-07 Actual * Budget* FY 2007-08 Estimate State of Hawaii/DHS 592,064 County of Hawaii(projected) 80,000 Total 672,064 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Hale Kipa has a long history of being a successful fundraiser and will begin an aggressive fundraising effort statewide. The current emphasis is on a $30 million capital campaign to build its core facility on Oahu. Hale Kipa will also seek community partnerships both with the local business sector as well as with the Hawaii Island United Way. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Hale Kipa - Agency am ge cy N e Hawaii Advocate Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, 1(we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Executive Director �yr.3fr206' Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Hawaii Centers for Independent Living- Agency Name Independent Living Services- Program Name Agency Director: 5400 Contact Person: 5400 Mailing Address: Facility/Site Address: Fax No.: Email Address: Patricia Lockwood Nathan Holmes Phone No.: 522 - Phone No.: 522 - 414 Kuwili Street, Suite 102, Honolulu, HI 96817 400 Hualani Street, Suite 16D, Hilo, HI 96720 522-5427 nathanh@pacificil.org Name of Accountant/CPA (include name of firm if applicable): Fred Hattori, Hattori & Co. CPA Inc. Phone No.: 808-949-2656 Mailing Address: 1750 Kalakaua Ave, Suite 1904, Honolulu, HI 96815 Amount of Request for County Funds: $15000 Prior Year(s) Funding: 04-05 05-06 06-07 $15000 $15000 $15000 Agency Mission Statement: Hawaii Center for Independent Living, people with disabilities, building access, independence, and choice. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 THIS PAGE INTENTIONALLY LEFT BLANK NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Hawaii Centers for Independent Living - Agency Name Independent Living Services- Program Name Program Description: The Hawaii Centers for Independent Living (HCIL) is a non-profit organization operated by and for people with disabilities to ensure their rights to live independently and fully integrated in the community of their choice, outside of institutional care settings. As a non-profit, county wide resource, HCIL serves people of any age with any type of disability. HCIL was founded on the historical constitutional beliefs of civil rights and the empowerment of people with disabilities to have equal access, opportunities, and choices in life, no matter how severe their disability. To accomplish this, HCIL actively seeks systems change and promotes self - advocacy. The Philosophy That Guides HCIL Is Three -Fold: 1. HCIL's objective is to present information on a wide array of options, from full independence to other forms of community-based living, from which individuals with disabilities can make their own personal choices. 2. The needs of people with disabilities can be met effectively by comprehensive programs encompassing personal care, housing, transportation, work, recreation -- the list is almost endless. This is what drives HCIL's response to consumer requests. 3. Those who know best the needs of people with disabilities, and how to meet those needs, are people with disabilities themselves. It is the strong belief in this peer relationship that distinguishes HCIL and its services. Total Budget and Position Count Total Program Budget 291,480 Total Program Position Count 6 Total Agency Budget 1,457,402 Total Agency Position Count 30 Program Objectives: 1) Provide landlord / tenant rights training, how to complete a housing application, how to locate housing and how to maintain their housing situation. This will reduce risk of being homeless and dependent on others. This service will be provided to 20 individuals. Timeline: 7/1/07 6/30/08 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 2) Provide consumers with personal care attenandant regerrals whom we have screened and interviewed to assist them with their personal care, chores, etc. Provide consumer training on how to interview, hire and fire an attenent. This prevents institutionalization and dependence on family, friends, and neigbors. This service will be provided to 30 separate individuals. ( Should a person require the service more than one time in the two year period they will be counted as one individual) Timeline: 7/1/07 - 6/30/08 3) Provide one--on-one independent living skills to assist consumers in carring out their everyday living activities such as housekeeping, shopping, laundry, cooking, etc. This will reduce dependence on others. This service wll be provided to 8 individuals. Timeline 7/1/07 - 6/30/08 4) Provide consumer with information on their legal rights, how to access consumers to empower self -advocacy. This service will be provided to 30 individuals. Timeline 7/1/07 - 6/30/08 5) Provide one-on-one training with consumers to acquire problem -solving and decision-making skills. This will provide the consumer to make informed choices. This service will be provided to 20 individuals. Timeline: 7/1/07 - 6/30/08 6) Provide one -on- one training on video relay service for the deaf. Serve as the location where consumers can file complaints if they have problems with the 711 service. This service will be provided to 20 consumers. Timeline: 7/1/07 - 6/30/08 7) Provide consumers with housing referrals to acquire a place to live. This will increase their independence and decrease dependency on family and/or friends. 15 people with locate and move into housing. Timeline 7/1/07 - 6/30/08 8) Provide consumers with information and referral services to increase their options of various resources in the community. This will increase their independence. Timeline 7/1/07 - 6/30/08 Program Highlights: 1) During the past year HCIL- Hawaii provided services to 297 persons with disabilities in the County of Hawaii. 2) HCIL- Hawaii staff attended the legislative informational briefing in Honolulu and gave testimony to the committee on the impact of the earthquake on persons with disabilities. HCIL developed an emeregency preparedness educational packet to distribute to our customers. 3) HCIL - Hawaii providing housing information and assistance to 53 person in the county and helped people get into housing in 2006. 4) HCIL - Hawaii helped 26 individuals get personal assistants in 2006. 5) HCIL-Hawaii taught 15 individuals independent livings skills in 2006. (Please note this is an unduplicated count of persons not the number of classes provided) NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 6) HCIL - Hawaii provided classes and technical assistance to 13 individuals on public benefits such as Social Security Disability and how returning to work would impact not only Social Security but Medicaid, Section 8 Housing Vouchers, etc. 7) CIL-Hawaii has initiated the outreach staff working from their homes in different districts of Hawaii County. CIL-Hawaii has a staff person in the North & South Kona District, Kau District, North & South Kohala District and Puna District. The Hilo office will assist with the North & South Hilo District and Hamakua District. 8) 108 of our customer, who received services were over age 60. 9) 30 were below age 20. 10) 22 had cognitive disabilities 11) 21 had mental emotional disabilities 12) 46 had physical disabilities 13) 1 had a hearing disability 14) 10 were blind or had low vision 15) 186 had more than one disability. 16) 10 had other kinds of disabilities such as cancer, heart problems, etc. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Hawaii Centers for Independent Living - Agency Name Independent Living Services - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate 11 Pieces of adaptive equipment 201.71 201.71 201.71 161 Housing and Shelter Services 2,952.74 2,952.74 2,952.74 151 Independent Living Skills srvcs. 2,769.34 2,769.34 2,769.34 227 Self-care Services 4,163.18 4,163.18 4,163.18 36 Recreational Services 660.24 660.24 660.24 11 Vocational Services 201.74 201.74 201.74 21 Transportation Services 385.14 385.14 385.14 11 Communication Services 201.74 201.74 201.74 50 Personal Resource Management 917.00 917.00 917.00 43 Self-Avocacy Services 788.62 788.62 788.62 21 Avocacy Services 385.14 385.14 385.14 75 Access the community/social participation 20 1,375.50 1,375.50 1,375.50 *If applicable Program Expenditures * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 443.22 10,500 10,500 Professional Fees 2,700.25 750 750 7,941.42 2,000 2,000 -Operations 1,459.52 500 500 -Equipment Other* 2,455.59 1,250 1250 Total 15,000 1 15,000 15,000 * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Hawaii Centers for Independent Living - Agency Name Independent Living Services - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Hawaii County 15,000 15,000 15,000 State of Hawaii 518,632 518,632 518,632 Federal Funds 884,179 875,370 875,370 Private Fountations 15,570 3,000 25,000 Untied Way Funds 48,400 48,400 48,400 Donations 6,879 1,675 2,000 Interest Income 129 260 300 Total 1,474,7891 1,462,337 1,484,702 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Over the past several years HCIL has worked on leveling the playing field for all of its offices in the state. We have worked on insuring that all offices have parity in terms of staff, equipment, and services. At this time HCIL is hoping to be able to increase its full program of deaf services throughout the state. For the past several years HCIL has had a deaf program which was only funded in Oahu. At this time we are seeking increased funding to take this program statewide. HCIL hopes to be self sufficient by 2010. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Hawaii Centers for Independent Living - Agency Name Independent Living Services - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature, of Board President/Chair C:h0.rleen 06o - Signature of Executive Director /-, 0-0`1 _ Date /--da -0 7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center - Program Name Agency Director: Contact Person: Mailing Address Facility/Site Address: Fax No.: Email Address: Carolyn Cabreira Carolyn Cabreira 34 Rainbow Drive Hilo, HI 96720 same as above 961-3740 adltcare@hawaiiantel.net Phone No.: 961-3747 Phone No.: 961-3747 Name of Accountant/CPA (include name of firm if applicable): Jennifer L. Gossert, CPA Phone No.: 969-3115 Mailing Address: 688 Kinoole St., Suite 201, Hilo, HI 96720 Amount of Request for County Funds: $18,000.00 Prior Year(s) Funding: 04-05 05-06 06-07 $15,500.00 $18,000.00 $16,000.00 Agency Mission Statement: To advocate for the rights of frail elderly and disabled adults, and to assist them and their caregivers in maintaining their independence and dignity as active members in the life of the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center- Program Name Program Description: Hilo Adult Day Center provides a safe, socially active, quality adult day program for frail elders and mentally/physically challenged adults needing supervised daytime care. Total Budget and Position Count Total Program Budget 1 941,148.00 Total Program Position Count 22 Total Agency Budget 1 1,192,000.00 Total Agency Position Count 33 Program Objectives: 1) Provide a safe, caring daytime environment for frail elders and mentally/physically challenged adults including those with Alzheimer's disease; all of whom can no longer take full care of themselves, many are under doctor's orders for supervised care. 2) Provide interaction/socialization with others, hands-on activities, singing, arts/crafts, games, bingo, excursions, entertainment and more. These individuals are generally inactive at home, having old -age depression; the day center is geared to give them enjoyment of life, something to look forward every day. 3) Provide the opportunity for elders to continue living in their own homes as long as possible and deter pre -mature institionalization into long term care facilities. 4) Provide respite for caregivers and deter "caregiver burnout". 5) Allow working families to continue their employment while attending to their frail loved ones in the evenings and weekends. 6) Provide adult day care to all individuals needing supervised daytime care, regardless of their ability to pay by utilizing federal, state, county and private foundation tuition -assistance funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Program Highlights: 1) Provided day care services to 127 individuals having varied physical and/or mental challenges. June 2006 had 84 participants enrolled. 2) For the fiscal year ending June 30, 2006, new participants enrolled: 29; discharged, 43, attending the full year, 62. Five clients passed away while attendees of the center and still living at home (this is the real goal for our clients, to move on from this life while still living at home). 3) Maintained professional level of client services with the state of Hawaii, Department of Human Services (DHS) Adult Day Services program and the Nursing Home w/o Walls (NHWW) program. The day center was re - licensed by the state of Hawaii DHS in January 2006 for two years. The DHS Purchase of services application and renewal occurred in 2005 for a six year term, it provides adult day services for 20 poverty level — Medicaid eligible (DHS) clients per month. 4) Continued working with numerous agencies including the Interdisciplinary team(IDT) organized by the state Department of Health to provide client specific care, other agencies included are NHWW, DHS, Services for Seniors, Kokua Nurses, Care Resources, and others). 5) Continued submitting grants and receiving private foundation support for tuition/fee assistance, received adequate support for all clients needing to attend but who could not afford full costs. 6) Continued the Caregiver support group, and received a HMSA grant to provide caregiver training classes to the community at large, at least two classes per month including Saturdays. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 FY 2006-07 FY 2007-08 Salaries and Wages Actual * Budget* Estimate Average monthly attendance 87 90 92 All figures are totals for the year: 127 135 140 Participants enjoyment of life, 124 132 137 maintain or improve personal 171,864.00 173,300.00 175,000.00 hygiene/self-care 831,858.00 914,648.00 941,148.00 Participants continue to live in own 103 111 116 homes in care homes Families/caregivers able to continue 76 82 85 employment Families/caregivers receiving 101 104 106 respite Participants continue to attend after 100 102 104 6 months Participants continuing after 1 year 79 80 80 Participants continuing after 2 years 58 59 59 Participants continuing after 5 years 21 21 21 Medicaid monies saved on $534,240.00 763,200.00 763,200.00 participants attending day care (7 persons (10 persons) (10 persons) versus those living in long term care were institutions (based on clients discharged discharged into long term care into long during the ear) term care *If applicable Program Expenditures * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 485,487.00 548,061.00 568,000.00 Professional Fees 10,719.00 10,000.00 12,000.00 Operations 158,860.00 177,287.00 180,148.00 Equipment 4928.00 6,000.00 6,000.00 Other" 171,864.00 173,300.00 175,000.00 Total 1 831,858.00 914,648.00 941,148.00 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Tuition/Fees 446,077.00 483,000.00 504,000.00 State - DHS and Nursing Home without Walls 117,628.00 152,648.00 154,148.00 Federal - Nursing Home without Walls and Kupuna Care 43,327.00 32,500.00 35,000.00 Count of Hawaii 18,000.00 18,000.00 18,000.00 Hawaii Island United Way 20,750.00 25,000.00 25000.00 May Templeton Hopper Fund 76,566.00 75,000.00 75,000.00 Mclnerny/ Gwenfread Allen/HHA Charity Walk/Friends of Hawaii Charities/other grants 58,548.00 54,000.00 55,000.00 Donations 9,302.00 11, 500.00 12, 000.00 USDA Lunch reimbursement Program 27,895.00 30,000.00 30,000.00 PIN grant management 8,875.00 8,500.00 8,000.00 Fundraising/interest/vending machines/misc. sales 4,220.00 24,500.00 25,000.00 Total 831,188.00 914,798.00 941,148.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Day Center tuition rates were raised in Fiscal Year'06 (21% after no increases for four years) to increase pay rates (no increases for three years) and to retain staff. The Board of Directors held a first annual golf tournament in July, 2006, which was very successful, and will assist each year with operating costs. The adult day center program can only be self-sustaining if the federal and/or state government would recognize the importance of adult day care and being able to live at home, versus long term care institutionalization and the large tax savings noted above. Government funding for those low income individuals above poverty level needs to be in place, then we would not be dependent on applying to other sources to assist with tuition costs. Some individuals have purchased long term care insurance, but this only helps those who can afford to purchase this insurance. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signat re of Boa d Presi ent/Chair Signature o xecutive Director I ti� Date 119 (0"1 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Hawaii Island HIV/AIDS Foundation- Agency Name Multi -Disciplinary HIV Case Management, Hilo- Program Name Agency Director: 8177 Contact Person: 8177 Mailing Address: Facility/Site Address Fax No.: Email Address: Georgie Kennedy Georgie Kennedy Phone No.: 331 - Phone No.: 331 - 75-240 Nani Kailua Drive #5, Kailua-Kona, HI 96740 16-204 Melekahiwa Place #1, Kea'au HI 96749 808-331-0762 or 808-982-8802 georgie@hihaf.org Name of Accountant/CPA (include name of firm if applicable): James D. Jennings, CPS, Inc. Phone No.: 808-942-8813 Mailing Address: 1600 Kapiolani Blvd., Suite 730, Honolulu, HI 96814 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 04-05 05-06 06-07 $10,000 $10,000 $15,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Agency Mission Statement: The Hawai'i Island HIV/AIDS Foundation is a non-profit organization dedicated to assisting those affected by HIV/AIDS to maximize their quality of life, and to ending the spread of HIV. We also utilize the lessons learned in the HIV epidemic to care and advocate for others in the fight against HIV and related diseases. Our vision is to build a healthier, stronger, and more sustainable community that supports all its members with a focus on HIV issues. It is an IRS -designated 501(c)(3) tax-exempt non-profit organization which provides care and services for people living with HIV/AIDS (PLWHA), and we provide HIV prevention and education to the residents of Hawai'i County. Because most of the clients served at the Kea'au office live in the Hilo area, we refer to the Kea'au office as "HIV Foundation - Hilo." Required checklist forms are attached at the end of this proposal. HIHAF has been providing services to people at risk for, infected with, and affected by HIV/AIDS since 1986. Our Foundation is an efficient and effective system to provide a comprehensive continuum of prevention, care, and support services with regard to HIV/AIDS for the entire Big Island. As treatment and medical care for HIV-infected individuals continues to dwindle, HIHAF's role in helping our clients manage HIV and AIDS becomes increasingly crucial. As reported by the Hawai'i State Department of Health, Hawai'i County has a higher rate of AIDS cases than the state overall, with a reported rate of 10.5 AIDS cases per 100,000 population in the years from July of 2001 through June of 2006. In contrast, the state overall has 9.1 cases per 100,000 population for that time period. A total of 13% of all AIDS cases reported in the state since the beginning of the epidemic come from the Island of Hawaii. Only Oah'u has a higher percentage. The number of people living with HIV/AIDS continues to climb steadily with each passing year of the epidemic. Presently, HIV Foundation - Hilo provides multi- disciplinary team HIV case management, advocacy, information and referral, food pantry, client financial assistance, and other support services for more than 110 PLWHA and affected persons in East Hawaii. Over the course of the year of December, 2005 through November, 2006, a total of 186 clients have been cared for in Hilo. Case Managers support client independence and self-determination by providing a range of supportive services. These include knowledge and assistance in accessing a variety of public and private benefit programs, medical and nursing services, housing, food, emergency financial assistance, transportation, employment counseling, and other forms of assistance as appropriate to help and support a client's retention and active participation in primary medical care. The services received by each client are monitored regularly to determine the effectiveness of the service plan, identiry emergent needs, and measure the outcome(s) of service delivery. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 HIV Foundation - Hilo proposes to continue its provision of high quality multi- disciplinary team HIV case management and primary prevention services, including anonymous HIV-antibody testing and counseling services, for at least one hundred and ninety (190) people living with HIV/ AIDS during FY 2007-2008. Like last year, we continue to experience cuts in State of Hawai'i Department of Health funding allocated to HIV/AIDS case management services on all islands. This is reflected in our Program Expenditures and Program Funding Sources tables. Regardless, we will continue to do our very best, as always, to provide the highest quality of services to all our clients, despite the decreases in funding available to us. Perhaps the greatest challenge that case management has had to face in the last year is the island -wide loss of primary HIV -treating physicians. All doctors seeing HIV-positive individuals in West Hawaii have left private practice in the last year, and East Hawaii clients face similar shortages in medical care of their HIV. The absence of primary physicians who understand the complicated nature of clinically treating HIV, often alongside other health issues, adds to the complexities of HIHAF case managers' work. They not only educate doctors on resources for the treatment of HIV, they act as a liaison between clients and their health care providers, and advocates for comprehensive treatment of the medical and psycho -social needs of our clients. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Hawaii Island HIV/AIDS Foundation - Agency Name Multi -Disciplinary HIV Case Management, Hilo- Program Name Program Description: HIV and AIDS still carry a debilitating stigma in our society. Because of this, many of those who are infected with, affected by, and at -risk for HIV hide their challenges concerning the disease and managing it in their lives. HIHAF is one organization at which HIV-positive individuals do not have to hide, and where all their needs can at least be addressed, if not fully resolved. A multidisciplinary team composed of two full-time (2.0 FTE) case managers, one half-time (0.5 FTE) housing specialist and one half-time (0.5 FTE) client services facilitator provide the direct care services for PLWHA residing in East Hawai'i. (The housing specialist also serves the Kona side clients.) The monthly average active caseload for the East Side office of the agency this year is one hundred and ten (110) clients. Twenty-eight percent (28%) of the HIV Foundation - Hilo's clients are homeless, multiply diagnosed, drug misusers and/or mentally ill. Eighty-six percent (86%) fall into two or more special population categories as defined by the federal Ryan White CARE Act Title II. Addressing clients' HIV and AIDS needs often begins and ends in completely different arenas. HIHAF's case managers negotiate and juggle relationships with clients and their families, social service agencies and state and federal agencies and programs. They reach across Hawai'i and other states to build relationships with previous advocates, to find medical and benefits records, and to establish client histories and needs. For example, in order to begin addressing the clinical needs of a recently - returned Hawaiian man, HIHAF advocates searched for and found his medical records and benefits in Nevada state agencies and then helped him establish his residence locally. The treatment advocates worked closely with this young man and his parents to find a doctor to treat him, although he lives in a remote part of the island. Staff developed a strong relationship with the doctor closest to him to proactively begin understanding his HIV status and level of disease. These multiple steps were necessary in order to help him access treatment for his HIV as well as begin seeking diagnosis and care for other health issues. Due to the complex nature of treating HIV most effectively, HIHAF advocates will now continue to work with this client's doctor, guiding him as he works with one of his first HIV-positive clients. Maintaining strong relationships with professionals and agencies that serve a myriad of social and other needs is only one small part of our advocates' jobs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Our case managers' holistic care for and dedication to working with all needs our clients face is motivated by HIHAF's mission of serving people who are living with HIV. For many people living with HIV, the financial and logistic difficulties of managing their disease are still complicated by fear and stigma. Several of our older, female, Hawaiian clients feel that HIHAF is the only safe place for them to let down their walls. In our office, they can show the depth of their feelings, they can find necessary, life-saving, and disease -monitoring clinical care and drugs. They find a shoulder to lean on, resources for themselves and their families: One woman's teenage daughter was expecting a baby. Recently, phone cards and food coupons were made available to clients and beneficiaries of HIHAF programs. Advocates spent time calling all clients to ensure they all received what was needed. At holiday time, advocates call each of our 186 clients to see if they can help during the holiday season by providing holiday appropriate food. One woman's living situation was putting her at risk for drug abuse. HIHAF case managers discovered that, because of a previous, unrelated error, she was receiving disability benefits greatly below what she was due. HIHAF then was able to find assisted housing for her through a lottery system that went in the client's favor. Through HIHAF's efforts, this client was able to access more benefits (thereby significantly raising her monthly income), move into a safe and secure home (one she had not had previously), live in town (where she could better access medical treatment and care for her other life needs), and begin a steady relationship with a doctor who has been able to address her medical needs. Two challenges of this last year have greatly changed the scope of services that our case managers provide our clients. The number of physicians on the Big Island who are knowledgable about HIV and how to best treat it has drastically declined in the last year. When physicians have been found who are willing to work with HIV-positive patients and are accepting new patients, HIHAF case managers have stepped in to educate and guide these physicians through proactive treatment of HIV. The other great challenge of this year has been for our case managers to adapt to new federal prescription drug plan legislation that greatly complicates accessing necessary medicines through multiple layers of complex eligibility criteria, changes to plan structures and services covered. Many of our clients face multiple health issues and need medications to suppress HIV, need other drugs to address side effects of HIV drugs, need additional drugs to treat opportunistic infections related to HIV. Most clients who are taking medications take from 6 to 10 drugs on a regular basis, and some of our clients take up to 25 medications. In order to enable clients to best treat these medical issues at the lowest possible cost through this new plan, case managers must understand the client's current income and drug coverage plan, know what drugs the client needs and which plans cover it, have knowledge of the client's other medical needs, understand which pharmacies will accept which drug coverage program, and have an understanding of HIV and other pharmaceuticals to compare pricing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 HIHAF's case managers are compassionate and talented; For them, treating someone's HIV incorporates all aspects of life, as HIV affects and complicates all areas of experience. For our clients, who often live with fear and stigma, deal with other medical and social issues, and face declining access to medical services in Hawai'i, HIHAF is the only place to come for support in any area of their lives. HIHAF's case managers are often the only people that HIV-positive individuals on this island know and trust; They are sensitive professionals who navigate the complications that HIV brings to the body and soul. In order to best serve the needs of our clients, a written service plan is developed cooperatively by the case manager with the client. The service plan identifies client needs, defines the specific goals and objectives that address identified needs, and lists the action steps required to accomplish the client's stated goals and objectives. The service plan is developed and implemented within two weeks following the intake of a new client and then updated quarterly or more frequently, if necessary, until the client is discharged. Between service plan updates, clients are contacted at least once a month to monitor their health status and identify new emergent needs. Acute clients in need of more frequent contact receive telephone calls and/ or office or home visits three to four times per week. A minimum of one hundred and fifty (150) service plans will be developed or revised during the upcoming FY 2007-2008 grant period. Case management is ensured through schedules that make service delivery possible, consistent, and amenable to clients' needs. The agency's doors are always open to clients, Monday through Friday, 8:00 a.m. to 4:00 p.m. Staff frequently visit clients in their homes, in hospital, and outside of both home and office, if that is what is necessary to help clients engage in their own care. The Client Service Facilitator is responsible solely for the delivery of support services, including food bank, food deliveries, transportation, volunteers, and clerical support. The Executive Director provides program administrative oversight and program supervision for care staff, quarterly reports for all funders, job counseling, staff training, and crisis intervention. Volunteers assist clients with online searches, distribution of food, clerical assistance, and helping clients shop in the food pantry. HIHAF provides invaluable support to HIV-infected individuals in keeping their loved ones free of HIV. Primary HIV prevention is based upon a culturally appropriate harm reduction methodology. When a new client begins their relationship with HIHAF, we take care to assess the relationships they have and activities they undertake that might put others at risk for HIV infection. Case managers either provide such interventions themselves or make referrals to the HIV Foundation - Hilo's prevention department. Case managers also offer anonymous HIV-antibody counseling and testing for family members and significant others. Evaluation: Quantitative evaluation measures for multi -disciplinary team case management services include the collection, tabulation and entry of service data into a computer tracking system provided by the State of Hawaii (The Reggie System). NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Data routinely tracked include: number of clients, types of service provided, and the number of services provided by service category. Planning estimations for service delivery during the FY2007-2008 currently project that a total of twenty- six (26) separate case management services will be individually provided for 150 to 190 clients living with HIV/AIDS. Services include, but are not limited to, intake, assessment, treatment advocacy, benefits counseling, volunteer referrals, hospital and home visits, medical liaison, crisis intervention, emergency financial assistance, housing assistance, home care and transportation. Quantitative Analysis: Data collection consists of counting the number of written service plans that are developed or revised each quarter. Computer reports indicating number and kinds of services delivered by each case manager are generated on a monthly basis. If projections are met or exceeded, service delivery is considered successful. The service component is also considered successful if ninety percent (90%) of clients have a medical care provider and adhere to their treatment routine. Qualitative Analysis: A client satisfaction survey is mailed to all clients annually. Completed surveys are returned anonymously and tallied survey results are distributed to the HIV Foundation's Board of Directors, staff, clients and state and federal granting organizations. Total Budget and Position Count Total Program Budget 349,436 Total Program Position Count 3.0 Total A enc Bud et 1,279,987 Total A enc Position Count 18 Program Objectives: 1) Objective One: By June 30, 2008, and within twenty-five (25) days following a determination of need, identify and secure appropriate financial resources to pay health insurance premiums for no less than ninety percent (90%) of all PLWHA whose access to high quality primary care, ancillary health care and specialty medical care would otherwise be in jeopardy. 2) Objective Two: By June 30, 2008 and within twenty-five days following a determination of need, assist no less than ninety percent (90%) of all eligible PLWHA who request or demonstrate a need for substance misuse treatment, mental health counseling, oral health care, HIV-related medication, food and/or transportation assistance to obtain such goods and services through appropriate referrals and practical support. 3) Objective Three: By June 30, 2008 and within twenty-five days following a determination of need, forestall homelessness by providing financial support and/or housing relocation assistance for no less than ninety percent (90%) of all eligible PLWHA requesting or demonstrating a need NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 for emergency shelter, or either short-term or long-term shelter or housing assistance. 4) Objective Four: By June 30, 2008 offer HIV preventive education and/or anonymous HIV-antibody counseling and testing services to seventy-five (75) at -risk individuals. In addition, the HIV Foundation - Hilo shall provide the types and levels of case management related supportive services for its consumers, listed below. Benefits assessment/counseling Progressive case notes Health care assessment/counseling Medical treatment referrals Housing assessments Legal document assistance Funeral/estate coordination Client family counseling Crisis intervention Field /office visits Home visits Intake/assessments Financial benefits Generic assistance/counseling Housing assistance Health care benefits Legal advocacy assistance Client monitoring/assessment Nutritional assessment/counseling Risk assessment/counseling Mental health assessment/counseling Service coordination Mental health counseling referrals Transport activities Substance abuse assessment Substance abuse treatment referrals (as available) Total number of service categories: 26 Timeline: Service plans are developed within two weeks of the initial intake session and reviewed quarterly. Service delivery will be on-going during FY 2007-2008. The services listed above represent baseline service projections. Client -centered Outcome(s): A mimimum of one hundred fifty (150) clients and their families will access critical services including medical, financial, social, care givers, legal, nutritional, etc. through the HIV Foundation - Hilo's case management and volunteer team. At least ninety percent (90%) of clients will secure a primary care physician and remain in medical treatment. Program Highlights: 1) To date during FY 2005-2006, medical case management services included one hundred eighty-six (186) clients receiving medical assessment, patient education, treatment advice, nutrition, medical liaison, dental liaison. 2) Over the past ten years, eight (8) HIV positive families have birthed nine children. All but one are over the age of three, and not one of these is HIV NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 positive. The youngest child is almost 2 years old. The HIV Foundation - Hilo is extremely proud of this fact and immensely happy for the parents. 3) As of December 2006, all except three clients are receiving the highest quality primary medical care; those three are accessing the best available medical care through public health clinics. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Hawai'i Island HIV/AIDS Foundation - Agency Name Multi -Disciplinary HIV Case Management, Hilo - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual*_ FY 2006-07 Budget* FY 2007-08 Estimate Number of types of case management services provided 26 26 26 Number of clients receiving case management services 100 110 150 Risk Behavior Assessment, Counseling and Education 250 250 285 HIV Counseling and Testing 65 150 150 Other" 0 0 0 Total $291,546.00 $364,816.00 $349,436.00 *If applicable Program Expenditures " If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $163,538.00 $140,181.00 $130,264.00 Professional Fees $3,000.00 $3,500.00 $3000.00 $125,008.00 $221,135.00 $216,172.00 -Operations Equipment 0 0 0 Other" 0 0 0 Total $291,546.00 $364,816.00 $349,436.00 " If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 Hawai'i Island HIV/AIDS Foundation - Agency Name Multi -Disciplinary HIV Case Management, Hilo - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate County of Hawai'i $10,000.00 $15000.00 $15,000.00 Department of Health (**We have been informed that this amount may be reduced by 5% in March 2007 $170808.00 $201,000.00 $192,830.00 ** AIDS Community Care Team (***The federal government has restricted some of these funds and we may experience a cut in these funds as well. $52230.00 $63,000.00 $66,606.00* ** Medicaid Waiver $13293.00 $11000.00 0 United Way $8000.00 $5000.00 $15,000.00 Housing - Special Projects of National Significance $6000.00 $8800.00 $7,000.00 Private Foundations $20000.00 $20000 $3,000.00 Donations/ Fundraising $11215.00 $48000.00 $50,000.00 Total $291,546 $371,800 $349,436.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Unfortunately, the HIV/AIDS epidemic shows no sign of ending, and indeed continues to grow. There is often a misrepresentation of facts about the epidemic in the media, indicating a lessening of urgency in dealing with this epidemic. The fact is, there are still a minimum of 40,000 new cases in the US each year. Each newly infected individual presents with a myriad of challenges to be met and overcome. Because the epidemic continues to grow, we do not see a specific point at which our program might become self-sustaining. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 11 We have received level or decreasing funding from our main revenue source, the State of Hawaii Department of Health, for the last 14 years. During this time, the number of people we are caring for has more than doubled, and may well double again over the next 14 years. In addition, our clients live longer now because of the availability of new drug treatments. This is wonderful in that it allows those who are infected to continue as productive members of society. Simultaneously, it also raises challenges for us as a foundation to continue to support their productivity. We are the only HIV/AIDS services organization in Hawaii County providing these vital care and prevention services. We are currently still working to develop an affiliated for-profit business, whose profits would help sustain our foundation. For now, we are very grateful that we have this support from the County, and we want to thank you for this opportunity to apply to you for funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 12 Hawai'i Island HIV/AIDS Foundation - Agency Name Multi -Disciplinary HIV Case Management, Hilo - Program Name 1 (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. / /� P /0 1? Date i i�o� Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 13 Hawai'i Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawai'i County Agency Director: Georgie Kennedy Phone No.: 331-8177 Contact Person: Georgie Kennedy Phone No.: 331-8177 Mailing Address: 75-240 Nani Kailua Dr., # 5, Kailua-Kona, HI 96740 Facility/Site Address: 75-240 Nani Kailua Dr., # 5, Kailua-Kona, HI 96740 Fax No.: 331-0762 Email Address: georgie@hihaf.org Name of Accountant/CPA (include name of firm if applicable): James D. Jennings, CPA, Inc. Phone No.: 808-942-8813 Mailing Address: 1600 Kapiolani Blvd., Suite 730 Honolulu, HI 96814 Amount of Request for County funds: $15,000.00 Prior Year Funding: 02-03 03-04 04-05 $15,000.00 $15,000.00 $15,000.00 Agency Mission Statement: The Hawaii Island HIV/AIDS Foundation is a non-profit organization dedicated to assisting those affected by HIV/AIDS to maximize their quality of life, and to ending the spread of HIV. We also utilize the lessons learned in the HIV epidemic to care and advocate for others in the fight against related diseases. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 1 Our vision is to build a healthier, stronger, and more sustainable community that supports all its members with a focus on HIV issues. We are an IRS -designated 501(c)(3) tax-exempt non-profit organization that provides care services for People Living With HIV/AIDS (PLWHA), and provides HIV prevention and education of the residents of Hawai'i County. HIHAF has been providing services to people at risk for, infected with, and affected by HIV/AIDS, since 1986. Our Foundation has an efficient and effective system to provide a comprehensive continuum of prevention, care, and support services with regard to HIV/AIDS for the entire Big Island. We refer to the Kona office as "HIV Foundation - Kona". As reported by the Hawaii State Department of Health, Hawai'i County has a higher rate of AIDS cases than the State overall, with a reporting rate of 10.5 per 100,000 population in the years from July of 2000 through June of 2006. In contrast, the state overall has 9.1 cases per 100,000 population for that time period. A total of 13% of all AIDS cases reported in the state since the beginning of the epidemic come from the Island of Hawaii. Only Oahu has a higher percentage. The number of people with HIV/AIDS climbs steadily upward every year of the epidemic. In the US alone, there are 40,000 new cases of HIV every year. Additionally, the proportion of cases diagnosed in women has been increasing over time. According to the State of Hawaii Department of Health, for the first twenty-one years of the epidemic women represented 7.5% of all cases reported in the state. But for the five years from 2000 through 2004, a total of 12% of newly reported AIDS cases in the state were women. This is a distressing increase in infection among women. The female population in other US and global communities continue to bear the brunt of new HIV infections. Women's rights are often compromised within relationships and, due to gender imbalances within relationships, women continue to be more vulnerable to HIV infection than men. Our foundation believes in upholding a strong focus on prevention programming, and specifically targeting women and populations vulnerable to HIV infection. Through working with HIV-positive women and addressing their behaviors, and empowering them through education and prevention activities, we plan to continue contributing strongly to stopping the spread of HIV and AIDS. We continue to experience cuts in the State of Hawaii Department of Health funding allocated to HIV/AIDS prevention services on all islands. This is reflected in our Program Expenditures and Program Funding Sources tables. We also continue to do our very best, as ever, to provide the highest quality of services to our clients, regardless of the decreases in funding available to us. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 2 Program Description, The Hawai'i Island HIV/AIDS Foundation - Kona is proposing to continue funding for the HIV transmission prevention programs for all HIV+ women in West Hawaii County, including individual and group protocols and counseling and testing of women at risk. This program is designed to STOP HIV at the source, with individuals who can transmit the disease to others. This program also provides early treatment for newly diagnosed HIV positive women, maintenance of stable health and well being for all HIV+ women in West Hawai'i County, long term planning for health maintenance, and transmission prevention interactions. A recent addition to women's prevention services this year is the SISTA Project, "Sisters Informing Sisters about Topics on AIDS". This program is aimed at local women at high risk for infection and transmission of HIV, and is an in-depth behavioral change program. Our Women's Outreach Worker leads a social skills training intervention, aimed at reducing HIV sexual risk behavior among minority women who are at highest risk for HIV and other sexually transmitted diseases. This includes women who experience poverty, drug addiction, violence and sexual abuse. The project consists of five once -a -week two-hour sessions, and includes a sixth, "booster" session a month after the women graduate at the fifth session. Most of the women participating are referred to the program from other local agencies and organizations serving community needs. We include the SISTA Project in this application because it will be instrumental in helping us reach women who may already be HIV positive to get them tested and into care services, as well as providing the type of behavior change training that has been accepted by the U.S. Centers for Disease Control and Prevention as the most effective. Total Budget and Position Count Total Program Budget 1 $70,250.00 Total Program Position Count 3.0 Total Agency Budget 1 `$1,279,987.00 Total Agency Position Count 18 " Total Agency Budget now reflects combined Kona and Hilo budgets. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 3 Hawai'i Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawai'i County Program Objectives: 1) Review each HIV+ woman's transmission prevention service plan in first month of program, and/or initiate new transmission prevention plan for newly infected women. (Estimated 28 women, 1-2 hours per client.) 2) Refer women to appropriate providers if needed, i.e. mental health providers, substance abuse providers, etc. within the first month. These providers can deal with some of the behaviors which place these women at risk of transmitting this disease. These professional counseling sessions are paid for by other funding sources. 3) Initiate transmission prevention protocol (estimated 28 clients, 1 hour each) in the first session, then quarterly, as needed when problems arise. 4) Document progress and adherence to transmission prevention protocol with input from client each quarter (28). 5) Monthly support group for HIV+ women dealing with self-esteem, negotiation, sexual issues, transmission prevention. 6) Referral by participants of other women who may be at risk of contracting or transmitting HIV to others. Referral to result in HIV counseling and testing by prevention outreach staff and screening for possible referral for participation in the SISTA project. Program Highlights: 1) Achieved a review of care prevention service plans for fourteen (22) women (meeting goal) during first half of funding year 2006-2007. 2) Referred women to specialized care for health and/or prevention issues during first half of the funding year. 3) Reviewed and updated health plans for all participants quarterly. 4) Initiated in-depth transmission protocols with all participants, and met with each participant on a one-to-one basis quarterly. 5) More than seventy-five (75%) percent of participants have reported 100% compliance with prevention protocols by second session (i.e., use of condoms or other protection during all sexual encounters.) 6) Twenty-five (25%) percent of participants have reported compliance 90% of the time to date, with the goal of 100% compliance by the end of the year. 7) Ninety (90%) percent of participants are documented to have benefited from the program by maintenance of good health, increased self-esteem, and ability to interact with sexual partners in a safe manner, thereby decreasing the probability of sexual transmission. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 4 8) As of month seven (January 2006), zero transmission of HIV by any participants in the program. No hospitalizations, stable health, and maintenance of employment. 9) A total of 87 women of unknown HIV infection status have participated in the SISTA Project training sessions. Performance Measures: In addition to the numbers listed below, the savings to the community of eliminating just one new case of HIV is between $25,000 and $35,000 annually. This is the cost of medical care, support, housing, and disability benefits for a single individual who is affected by this disease. Additionally, the only people who can transmit this disease are those who are infected with it. By working at the source we can STOP this disease, and do it in a humane and loving manner, which benefits both the individual and the community. For purposes of this chart, the individual transmission prevention session count includes all counseling sessions, for both males and females. *If applicable ** Numbers include the new SISTA project. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 5 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget* Estimate Individual transmission prevention 252 150 175** session assessment session Health/prevention plan review 36 42 50 -quarterly Quarterly individual transmission 36 42 50 sessions 1 hr. each -prevention Review and documentation of 36 42 50 quarterly -program SISTA Project participation 0 13 50-60 *If applicable ** Numbers include the new SISTA project. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 5 Hawai'i Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawai'i County Program Expenditures *Other: Program expenses include costs for HIV testing kits, literature, condoms, incentives, and other miscellaneous items specific to prevention programs. **Includes new SISTA program. Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages $20,000.00 $20,000.00 $33,000.00 Professional Fees 0 0 0 $15,192.00 $15,192.00 $27,000.00 -Operations Equipment 0 0 0 Other* Program Ex enses $4,000.00 $4,000.00 $10,000.00 Total $39,192.00 $39,192.00 $87,000.00** *Other: Program expenses include costs for HIV testing kits, literature, condoms, incentives, and other miscellaneous items specific to prevention programs. **Includes new SISTA program. Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Bud et * FY 2007-08 Estimate State of Hawai'i Prevention, 33% Women only 1/2 for Kona $15,192.00 $12,500.00 $12,500.00 Hawai'i Island United Way 0 0 $5000.00 $4,308.00 $9,692.00 $8,000.00 -Fundraising of Hawai'I $15,000.00 $15,000.00 $15,000.00 -County 0 $2,000.00 $3,750.00 -Macy's Life Foundation/CDC SISTA $22,000.00 Elizabeth Taylor Foundation $3750.00 Total $34,500.00 $39,192.00 $70,000.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Unfortunately, the HIV/AIDS epidemic shows no sign of ending, and indeed continues to grow. Often, there is a misrepresentation of facts about the epidemic in the media. The fact is, there are still people becoming infected, regardless of the rate at which that happens. And each newly infected individual NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 6 presents with a myriad of challenges to be met and overcome. Because the epidemic continues to grow, we do not see a specific point at which our program for prevention might become self-sustaining. The more people who become infected, the greater the possibility of new cases of the disease. We have received level or decreasing funding from our main revenue source, the State of Hawaii Department of Health, for the last 14 years. During this time, the number of people we are testing and counseling and are caring for has more than doubled, and may well double again over the next 14 years. In addition, our clients live longer now because of the availability of new drug treatments. This is wonderful in that it allows those who are infected to continue as productive members of society. But it also raises additional challenges for us as a foundation to continue to support them in their productivity. We are the only HIV/AIDS services organization in Hawaii County providing these vital care and prevention services. We are currently working to develop an affiliated for-profit business, whose profits would help sustain our foundation. But this will happen at some unknown and perhaps distant point in the future. For now, we are very grateful that we have this support from the County, and we want to thank you for this opportunity to apply to you for funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 7 Hawai'i Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawai'i County I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that i (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'l grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, anc agency's future funding requests. I Board ident/Chair Date xecutiu& Director I Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-2008 Page 8 HAWAII WILDLIFE CENTER- Agency Name HAWAII WILDLIFE CENTER DEVELOPMENT- Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Linda Elliott Linda Elliott P.O. Box 506 Hawi, HI 96719 53-496 lole Rd. Kapa'au, HI 96755 Phone No.: 889-5180 Phone No.: 889-5180 hawaiiwildlifecenter@mac.com Name of Accountant/CPA (include name of firm if applicable): In the process of hiring a new accountant Phone No.: Mailing Address: Amount of Request for County Funds: $25,000 PriorYear(s) Funding: 04-05 05-06 06-07 $ $10,000 R&D $ Agency Mission Statement: The HAWAII WILDLIFE CENTER is a 501 (c) (3) nonprofit, dedicated to the care and conservation of Hawai'i's threatened wildlife through hands-on treatment, research, training and education & cultural programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 PARP 1 HAWAII WILDLIFE CENTER - Agency Name HAWAII WILDLIFE CENTER DEVELOPMENT- Program Name Program Description: To construct and develop the HAWAII WILDLIFE CENTER, a wildlife recovery facility, and an important conservation tool and the first of its kind in Hawaii, The Center will operate seven days a week year round. It will treat HawaiTs sick, injured, orphaned native wildlife, and benefit their threatened populations by returning rescued animals to the wild. The Center will provide three conservation functions simultaneously: 1. The wildlife care and response facility, 2. The public interpretive and outreach courtyard, and 3. The education pavilion. This County grant will provide for the set up of electric utilitiy service vital to the functioning of the Center. Specifically, 85% of this requested County grant will provide the funds for the HELCO power -line to the Center. 15% will go to the project management costs. Total Budget and Position Count Total Program Budget 2,965,238 I Total Program Position Count 1 Total Agency Bud et 123,488 Total A enc Position Count 1 Program Objectives: We will break ground for the HAWAII WILDLIFE CENTER by March 2007. To open the Center, we will complete the following steps: 1.) Arrange for funding from both the local and statewide community and a wide range of funding sources, Ongoing 2007. 2.) Build a facility for the Center on the already secured 2 acres of land. March 2007 -Dec. 2008. 3.) Acquire materials and equipment through donations and purchases, Feb. 2007 -Dec. 2007. 4.) Hire qualified staff, including a Center Director, Center Manager, and contract positions for Veterinarian service, public information and accounting. Completion target: March -Dec 2007. 5.) Acquire the requisite federal and state permits. April 2007. 6.) Establish a volunteer work program, May 2007, and develop our training and educational programs, Ongoing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Program Highlights: 1) Hawai'i holds the unfortunate distinction as the endangered species capital of the United States, and there are more endangered species per square mile on these islands than anywhere else on the planet. 2) The island of Hawai'i has the largest population of endemic birds in the State. 3) Availability of a qualified facility to care for HawaiTs sick, injured, and orphaned endemic and indigenous wildlife is an important resource tool towards reversing trends in these declining populations. While there are centers available in all regions of the U.S. mainland, there is no facility that can provide suitable care for Hawai'i's sick, injured, and orphaned native wildlife. 4) The new Center will receive more than 300 native birds per year from the vast wildlife areas in the county of Hawaii such as Volcano and Kaloko- Honokohau National Parks, Hakalau & Kona Forest National Wildlife Refuges and major DLNR wildlife areas such as Manuka, Pu'u O'umi and Pu'u Wa'a Wa'a and from the many public areas that wildlife share. Also, large numbers are expected when there is a natural or man-made disaster. The Center will meet the needs of the threatened wildlife and the County, State and Federal Wildlife Agencies that protect these public resources, and provide a benefit through unique conservation, cultural and educational opportunities currently not available in the state. 5) The HAWAII WILDLIFE CENTER will benefit the Big Island community through revitalization of the former Halaula Camp, North Kohala and create a place for volunteerism in conservation education, cultural, mentor and training programs. The Center will provide educational resources for the entire island for both private and public groups, including visitors to the island. The Center will provide the County with a public out -reach and emergency response resource for natural and man-made disasters. 6) Surety Kohala Corporation, the largest landowner in North Kohala, is supporting this project by providing use of a 2 -acre site for the Center, valued at $1,080,000. The New Moon Foundation has donated the development office valued at $18,000, JS Bedingfield Construction Management is donating time to manage the construction. William T. Ruhl, AIA and Rhoady Lee, AIA are donating architectural services. Tinguley Development, Inc. is providing general contracting services. Thomas Pattison has provided the site survey. Steve Groves and William Blakeney are providing engineering services. Gregg Todd has provided schematic drawings and Earthworks Construction is donating site clearing and preparation consultation services. West Hawaii concrete is also donating materials and services. 7) The Center has raised close to 58% of the program funds to date. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 HAWAII WILDLIFE CENTER - Agency Name HAWAII WILDLIFE CENTER DEVELOPMENT - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Construction complete & Center is operational Begin treatment of injured wildlife 100-300 birds Begin conservation & education 5,000 visitors -programs in disaster preparedness -Participate 2,965,238 Exhibit -A Total *If applicable Program Expenditures If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages Professional Fees -Operations -Equipment Other" 2,965,238 Exhibit -A Total If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 HAWAII WILDLIFE CENTER - Agency Name HAWAII WILDLIFE CENTER DEVELOPMENT - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual* FY 2006-07 FY 2007-08 Bud et * Estimate County of Hawaii Non roifit grant 21,250 State of Hawaii rant -in -aid 500,000 Federal Matching rant 100,000 Capital grants 450,000 In-kind Project Management 37,500 In-kind Proffessional Services 92,342 250,000 In-kind Donation Property 1,080,000 In-kind Donation Building Supplies 300,000 Inkind Donations Equipment & sup. 136,000 Total 1 1,209 842 1,257,250 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? We have obtained $1,709,842 of the $2,965,238 total start up capital needed that includes a $500,000 grant from the State of Hawai'i (refer to attached Exhibit A). To obtain the remaining startup capital and operational funds we plan on several sources: in kind donations of supplies, equipment and services from local and statewide businesses and wildlife agencies, grants from both Hawai'i and national grantmakers and matching government funds. Ultimately, we will attempt to create an endowment fund large enough to cover the remaining of the Center's operating costs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 HAWAII WILDLIFE CENTER - Agency Name HAWAN WILDLIFE CENTER DEVELOPMENT - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizatims. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Board President/Chair/c"D Signature 6f E*eeuiive Diisste ice tom/ o /a6eo7 Date I zt.u 7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 EXHIBIT A: Program Expenditures Capital Budget Capital Budget Summary Capital Detail Project Timeline VD $$$ �\k 7 ) )k2 a § 000 0 ouo «" k kkk § k2 a22 | E m ƒ k8 e §r k\OOL0Ovi 0 t§ rl I§�O§§k 2�)�§LIk VZ C � ci K 00 88 88 o§§§§ kkAs \■(M6� f e$ "M f \ k k � $ Ms 800 0 }// LO LO 0 Lo co r- / ° IZ � 2 [ � v 2aa 9i). b _ _ kifk )7{# ■a § § Aa. E��, f }${ % �. 2J� £��� osV- 2 § §*�aakk)k- ^��2: a £ %�/kk222CL i�)+ o� o L $22 a§E 7� § #$$»afG7a)©a§aJ -22]$ v / �/%///_� 00 RƒCLa22 )/J2 § ! z w ■ ■ I- q Z § 0 § O §03 � § z■� 0�g LU Lu �\ � � IL � $d CL fix§ S � ■a !2! k 22� k ;£a ! KKk K§Ki§§ k§ R§§7K ■ A§�i m _ ,_- k k --- ------ - -- ----- - ---- - - - 888 m#a�e8 § KAg *\�\7\ $v \[$}- k G©, ® \\` ®-- ------ -- ----- ®- MMM AMM M - § i._ „A_�. _4 ( i ° K K k e o % ■ ! § - § f!$aC § § r -a! |d § /f!! E C2 Of k U. ��kL b ■! $$ CO ° !.!& § § !alfa_■E f| m vi . ) ■#°!� k§ -6 § !)k)! k $ 8$ $g $g F C Y8.8 $8888588 ,88, $8 88888888888 w888$8 Y88 w88 $ 88$ UNIONN888888IRMA 99 ._Egg ^ERAR 2. eiv.gs.... j..=. � 9 SEA NNYNYY...N ..... MYMwN.............NNNww Mw ww N NYw 88 888888 $$, $$$$$x$88$8$8 s$s$8 $$ 88 $s 'A IN MIN Nsswa.Nww vagal vagal � wN a8 N»NNNN »NY 88$q$8 88, NN NwwNaYYNnNw 8888888888$8880 wwwwN 88888 88 Nw $8 g8 % 4g 3A SAaIiA$3�$8� alNo Val 'w iN Ae N 8 aaa wNNNN MNM Nw YN.NN 181 888 III � �6N aQ a QsQNNN88 Y8Y yaypps qQs 88 88 8 '8 88 s €i€€@@S@:€ ���sts :sE EEza�s issssEE n:sax o: as ss s t O 292221-2 -R 8R$'4- W w F= Lb a z 0 V N ZO Up W �U0 lu mil go Ja 8Jilllit 8 $ 8 8 w » ww » ra«Nw wYr» wY Nw w w w Yw wx w r x ww Np Nx NNM »»www N 8$y89 8984848 $ 8y88g8q p8p J 8d b xxwxpwN 888$888 M xx n « w wa « $ $ $8 $ y8q Si i5 iL SK �XEf q$q$Q8 3CN 8 8 8 M MwwM w N N 8$y89 8984848 $ 8y88g8q p8p `palm 88q xxwxpwN 888$888 w w 8 8 $q$q8 $$q �rvNn:d8 8$z$88y8 8 8y88g8q 88q $q8q 88 $q$q8 $$q �rvNn:d8 N �F{ea q$q bi y8q Si i5 iL SK �XEf q$q$Q8 3CN Q$ Q$ N6a 8 MYMNNw M MwwM w N N Np NN NMN NNN .NNNN '$��88 8 $888 $ 8 8 88 88 888 S88 8$8$8 awYYwr » rrrN N w Y »N »N www »»a NN»»» id :Q4%=s=: _ ===C29 VA.: f%V ::Sass: j%UUMV.x :Y]2Y:9 :$::1d 4 g94ya�� S q ?O gil X' 8R8Cz i�2tx K!f �otOZ�»N Y.N�$N� x�N Y 8'if iS a Q f 8� Jill fill AM IM �| | t � 2,■E � 0 f §§§ LU Z k k B'$� X - || ) W) |! !|! | |§ | t | f 2 | ..■■�, ..■-.■ � • §|■■■■ ■ ■ |§#§!§! ` ...... _\/\\\ ..■ . ■ .� :� ; ;; ;; §\§ \ ! |§ §§ , \� .. | ....,. .. ... .�..�.� ■ ! � ! ` h|h��■■��| |i R i I r I i I I �. ....... ........ ii I E F E F E 8 F E E 8 F EF E E E E F A E E E E E 4 3 $ { § ¢ SS g?S g S$ �3 +f i i" 3iE iRF7S EEiEeS€a2 A� ¢�l1�l�ltj=$#Eta{�3tlfttEt�ttltt3flt3 saa ! tttttttttttttttfttttittttttttttfFttttttttttttt S R S A A f e p R -. ___ The Island of Hawaii YMCA- Agency Name Youth Services- Program Name Agency Director: Contact Person: 3721 Mailing Address: Billy Dannals Bobby Stivers P.O. Box 7067 Kamuela, HI 96743 Phone No.: 885-5034 Phone No.: 935- Facility/Site Address: Hilo - Waiakea Settlement YMCA 300 West Lanikaula Hilo, HI 96720 Kona - Kona Family YMCA 74-5605 Pawai Place Kona, HI 96740 Waimea - Waimea Family YMCA P.O. Box 2998 Kamuela, Hl 96743 Fax No.: 887-1861 Email Address: ymca-stivers@hawaii.rr.com Name of AccountantlCPA (include name of firm if applicable): Ann Fukuhara, An Accountancy Corporation Phone No.: 961-5532 Mailing Address: 714 Kanoelehua Ave, P.O. Box 6691, Hilo, HI 96721 Amount of Request for County Funds: $55,000 Prior Year(s) Funding: 04-05 05-06 06-07 $55,000 $0 $35,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Agency Mission Statement: "Aloha Ke Akua - God is Love. The mission of the Island of Hawaii YMCA is: To bring God's Love to children, adults and families of all races and faiths by putting Christian principles into practices through programs that build healthy spirit, mind and body for all." NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 The Island of Hawaii YMCA - Agency Name Youth Services- Program Name Program Description: The Island of Hawaii YMCA Youth Services program is designed to provide a spectrum of positive, safe, child centered, developmentally appropriate activities in Puna, Kona and Waimea as a basis to prevent youth from being involved in high risk behaviors such as drugs, alcohol, sex and violence. The YMCA since its beginning in 1844 has always developed character in its members. Today, the YMCA teaches and demonstrates its core values of caring, respect, responsiiblity and honesty in all its programs. Adult volunteers and staff are screened and recruited with these values in mind and serve as positive role models for the youth they serve. The YMCA will extend its services to communities that have high risk factors. In Hilo, the Waiakea Settlement YMCA will begin to serve the Puna community. In Kona, the Kona Family YMCA will service North Kona and the Waimea Family YMCA will serve Norht Kohala. Puna has the largest number of TRO violations and domestic violence arrests. Puna has the highest duplicated count of child abuse and neglect in 2005. It has the highest rate of school age children living beneath 200% of poverty. Puna has the second highrest risk factors for substance abuse among teens, but also ranks high in protective factors. Puna has the lowest 8th grade reading and math scores on the island. North Kona has the highest rate of confimed child abuse and neglect for high school students. Kona has seen a rapid rate of growth, 30%, and has the highest rate of growth for children under 5. North Kohala has the third highest rate of growth. While North Kohala has the lowest number of drug assests in 2002 and the lowest rate of children living beneath 200% of poverty and lowest 5 of those children attending subsidized preschool, this is a community still need to positive experiences to reduce such risk factors that are in other communities. 'Date from Hawaii United Way and DHS Child Abuse and Neglect. YMCA programs are tools used to develop the fullest potential of each youth. Programs directed by trained, caring and nurturing adult role models will be implemented in these communities. Program activities are offered throughout the year, including intersession breaks, summer and weekends. Leadership development including decision-making, communications, leadership skills are just some of the on-going learning experiences. Team games, youth sports, NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 clutural music and dances, arts & crafts, filed trips are just additional activities for the youth. Total Budget and Position Count Total Program Budget 1,450,000 Total Program Position Count 61 Total A enc Bud et 3,002,000 Total Agency Position Count 160 Program Objectives: 1) The objectives of YMCA Youth Services include: 2) *Self-awareness, confidence, and feelings of self-worth; 3) *Interpersonal relationships; 4) Values development - accepting and demonstrating caring, respect, responsibility and honesty; 5) Academic achirevement; 6) Physica skills; and 7) Health and nutritiion. 8) Program Highlights: 1) To deliver youth services program in the respecitive communities in a positive YMCA environment of safety, support, and care, focusing on: 2) *Having all youth be safe and happy; 3) *Broading the community, national, and world understanding of youth and parents; and 4) *Conducting the program in accordance with the YMCA philosophies, operating principles, and program standards. 5) General curriculum framework to include: 6) *Character development 7) *Homework Support; 8) *Arts & Humanities; 9) *Health, Wellnes, and Fitness; 10) *Service learning 11) *Participant surveys, parent surveys. 12) PROGRAM FOCUS: 13) Community of Puna: Establish a school year YMCA after school program for school age youth; establishe a Saturday morning youth sports program. During the summer, establish a summer day camp program. 14) Community of Norht Kona: Establish a school year youth sports afterschool program and Saturday mornings youth sports program at NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Kahakai Elementary School Integrate summer with the YMCA's summer day camp program. 15) Community of North Kohala. Establish an arts & humanities school year after school and weekend program. To include drama, dance and music. 16) YMCA and communities facilities will be utilized, YMCA van transportation as needed will be available. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 The Island of Hawaii YMCA - Agency Name Youth Services - Program Name Performance Measures: FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget* Estimate *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 883,740 901,268 830,000 Professional Fees 72,842 34,936 5,000 Operations 773,791 662,507 600,000 Eui ment 13,440 15,705 15,000 Other" Total 1,743,8131 1,614,416 1,450,000 * If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 The Island of Hawaii YMCA - Agency Name Youth Services - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual* FY 2006-07 Budget * FY 2007-08 Estimate County of HI Partners with Youth 0 35,000 55,000 Hawaii Island United Way 58,000 42,207 50,000 Donations 140,578 310,000 350,000 Fundraising 127,532 20,000 50,000 Service/Program Fees 585,325 550,000 550,000 Judiciary FVC Grant 64,753 72,500 68,000 Safe Haven FVC Grant 83,006 87,200 174,432 PAR Federal Grant 152,456 148,319 155,768 Weed & Seed 91,155 42,625 0 HI Community Foundation Diabetes Grant 3,000 HI County Resource Center Teen Dance 2,000 HI Community Foundation Kona Teens in Action 5,000 Sale of Property 300,000 Total 1,305,805 614,851 1,453,200 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The YMCA will need continued funding to provide outreach services to high risk communities as being proposed in this grant request. While the YMCA receives funding from various sources including United Way, grants and foundations and community donations, these funds are generally designated thus making the YMCA hard pressed to self -sustain new initiates in the first three to five years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 While The Island of Hawaii YMCA - Agency Name Partners with Youth Services - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'! grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair � � l Signature of Exec ive Director /`--�,//07 Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Ka Hale O Na Keiki, Inc.- Agency Name Families -At -Risk Project- Program Name Agency Director: Lorna Lorenzo Phone No.: 775-9870 Contact Person: Kathy Oshiro Phone No.: 775-9473 Mailing Address: 45-3668 Honokaa-Waipio Rd Honokaa, HI 96727 Facility/Site Address: same Fax No.: 775-9870 Email Address: gso@kona.net Name of Accountant/CPA (include name of firm if applicable): Hoolaea Andrade Phone No.: 775-1319 Mailing Address: 46-1068 Kinimaka Street Honokaa, HI 96727 Amount of Request for County Funds: $7800 Prior Year(s) Funding: 04-05 05-06 06-07 $2500 $ 3000 $3000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Agency Mission Statement: At Ka Hale O Na Keiki it is our mission to help children develop a lifelong love of learning through a program that encourages freedom, individualism, and creativity. Our carefully prepared environment provides children with an opportunity to explore their surroundings, challenge their thoughts, and enjoy and love the people and world around them. Through a positive interaction among the children's developmental characteristics, their school, practices, family, and community, children will be ready to have successful learning experiences that will last throughout their lifetime. Above all, our children come first. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Ka Hale O Na Keiki, Inc - Agency Name Families -At -Risk Project- Program Name Program Description: The Families -At -Risk Project allows our school to remain open between 2:30 and 5:30 pm daily, year round (including Summers and holidays), providing a safe, stimulating, and caring environment for children ages 24 months to 6 years. This frees young parents to work at their jobs, and allows the unemployed to seek work and pursue training and educational opportunities, particularly working parents transitioning from welfare assistance. We serve the working poor. These families are likely to be cut off from the mainstream community because of poverty, racism, lack of education, unemployment, and/or the inability to timely access community and human services. They are therefore at risk of being unable to take care of their basic needs and those of their nuclear family. It is important to understand that our school's positive stimulation of children's brains during these critical first years lays the foundation for the child's future ability to learn, develop language skills, and interact with others. While under our trained, caring, and gentle care, children at risk learn self confidence, initiative, self-worth, and independent thinking. Our teachers, all trained in Early Childhood Education (ECE), understand child development and excite our children about learning, as well as provide them, and their families, with basic health and nutritional information and referrals. We promote positive social behavior and conflict resolution, as well as actively engage parents in their children's care and education. Drug abuse is our worst nightmare here on the Hamakua Coast. We are the anti-drug. Numerous studies have shown that participation in a quality ECE program can actually prevent illegal drug usage in the future, because we teach these children, at a very early age, how to appropriately handle conflict resolution as well as help them attain good self esteem. If we are to break the cycle of drug abuse in our community, we must begin taking preventative action now, and intervene at the preschool -age level. Our community, our island, and our state also benefit, as it is estimated that for every $1 invested in high-quality ECE programs the public will save $7 in costs like remedial education, welfare, and incarceration. Children who attend high quality ECE programs are more successful in later life and more productive than their peers who did not attend. Studies are showing that children with access to quality programs demonstrate higher I.Q.'s, High School graduation rates, and success than their peers. Most preschools are not open more than eight hours per day because a second qualified teaching staff is required; and, such a service is just not economically feasible. Ka Hale O Na keiki is not "just another preschool", but a community organization that serves and meets multiple needs for the people of the entire area. With literally no other preschool available in our isolated area, parents would have no where to place their child, except perhaps, in front of a neighbor's NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 TV, if our Families -At -Risk Project was not available. And, obviously, our Families -At -Risk Project benefits our parents, as well as our children. Our low- income parents, leaving welfare rolls and entering the workforce, become more economically self-sufficient because they have been given access to reliable, quality care for their children. It is imperative, therefore, that we remain open at least 10 hours a day, and operate year round; otherwise, parents would have no where to send their young children for quality care and education. We agree that private funds are a key to our success, but those funds are very limited. Therefore, we also need additional public support in order to help these young children and their families towards a successful, productive future. We need the County's continuing financial support until financial stability is realized. Our community understands and acknowledges the scarcity of County funds to non -profits, and we sympathize with the Council's difficult budgetary task. We are very grateful to the financial support we have received in the past from our County and truly believe that the County's continuing investment now in the Families -At -Risk Project will save the County ten -fold in future rehabilitation costs. Total Budget and Position Count Total Program Budget 45,950 Total Program Position Count 5 Total Agency Budget 1 243,000 Total.Agency Position Count 8 Program Objectives: 1) Make care and educational services available to at -risk families and their children between the hours of 2:30 and 5:30 pm daily. 2) Provide high-quality care and educational services to children of at -risk families of the under -serviced Hamakua Coast. 3) Provide monthly scholarship/tuition assistance to at -risk families. 4) Pursue other funding sources for the Families -At -Risk Project, to insure that the Project, and the school, will prevail. 5) Maintain a developmentally appropriate learning environment among all students, ensuring progress in social, emotional, cognitive, language, and physical development. 6) Increase the parenting skills, and the understanding of the developmental and educational needs of children of the at -risk parents we serve. 7) Recognize the need for, and provide referral services for children of at -risk families who may need treatment for known or suspected health, psychological or developmental problems. 8) Have the Families -At -Risk Program become financially self-sufficient, no longer a financial drain on the Day Program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Program Highlights: 1) Remained open for the at -risk families until 5:30 pm daily, including during monthly holidays, holiday breaks, and Summer. This was the first year that we remained open during monthly holidays. 2) Provided a developmentally appropriate, high-quality childcare and educational facility to the working poor of the Hamakua Coast. 3) Obtained National Accreditation, insuring that we are providing the best available care and education to our at -risk children, plus allowing us to obtain additional income from the State. 4) Provided five jobs in our local community, in order to operate the Families - At -Risk Project. 5) Referred three at -risk children, and their families, to special services counseling, to meet their special needs, as identified by our teaching staff. 6) Offered scholarship/tuition assistance to twenty six families using the Families -At -Risk Project, an increase by eight from 2004-2005. 7) Succeeded in keeping our budget for the Project low, within reason, and affordable to the families we serve while being able to increase our services to them. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Ka Hale O Na Keiki, Inc - Agency Name Families -At -Risk Project - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Total Enrollment 36 37 37 Students Enrolled 2:30-5:30 Families -At -Risk Project 26 27 29 Families receiving financial assistance from Ka Hale O Na Keiki for the Families -At -Risk Project 26 27 29 -operations 2300.00 3100.00 3500.00 -Equipment Other" Total 29, 500.00 1 45,55o nn 45, 950.00 *If applicable Program Expenditures *If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wa es 18,800.00 28,750.00 31,500.00 Professional Fees 900.00 5900.00 2450.00 7500.00 7800.00 8500.00 -operations 2300.00 3100.00 3500.00 -Equipment Other" Total 29, 500.00 1 45,55o nn 45, 950.00 *If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Ka Hale O Na Keiki, Inc - Agency Name Families -At -Risk Project - Program Name Program Funding Sources: Identify all funding sources (speck to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Payment from families for Families- At -Risk program 13,000 16,200 16800 Donation/Fundraisers 500 500 500 County of Hawaii Grant 3000 3000 7800 Young Bros. Grant 1000 1000 1000 Friends of Hawaii Charities 1500 1500 1500 Wilcox Foundation 0 1000 1000 Frear Trust 0 1500 1500 Mclnerny Foundation 0 1000 0 State of Hawaii Poverty ECE Program 0 9,000 10,000 Day Program payment from families, portion allocated to Families -At -Risk Project 9500 9350 4350 Hard Foundation 1000 1500 1500 Total 29, 500 45,550 45, 950 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Our past budgets have taken funds away from our Day Program in order to help support the Families -At -Risk extended day program, putting our entire operation at risk. This practice simply cannot continue. Our Families -At -Risk Project MUST become self-sufficient. Additionally, the requirement by the County for an audit has put a great financial strain on our entire operational budget this year. We were awarded National Accreditation in September, 2006, not only insuring that we are providing the best quality care and education to our children, but also enabling our parents to receive slightly higher State Supplement payments. We were thus able to raise our monthly tuition rates to help meet our budgetary demands. Additionally, National Accreditation is now allowing our school to NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 receive a higher payment per month from the State from their Poverty ECE Program. National Accreditation, however, places on our budget financial demands, as our staffing qualifications are now higher, requiring a budget for increased wages and benefits, playground safety measures, etc. Our absolute goal is to be financially independent of annual grants. With optimism, and with our State government's continued interest in providing funds for Early Childhood Education, we hope to be financially solvent, and without need for continued County grant funds, within the next two to four years. It must be remembered that our program is one that we were told "could not be done". We were told that our isolated community did not have the economic base to afford an early childhood center, and that our area could not provide the qualified teaching staff to run such a program. With a preschool closing in Waimea, and two day care centers closing in Honokaa, all within the last six months, it is an obvious indication that what we are trying to do (provide quality care and education to our youngest citizens) is not a financial windfall. But, the need, and the desire was there, and we did it. We are simply asking the County for their continued support for a few more years to help these children who are in desperate need. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Ka Hale O Na Keiki, Inc - Agency Name Families -At -Risk Project - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawal'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Board President/Chair 1 , r .S' _. = r'_.. /l7 3A 7 Date /f L3 / Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project Agency Director: Willow Morton - KMCWC Vice President Dr. Steven Choy — KCPC Program Director Phone No.: 1-888-535-7790 Contact Person: Steven J. Choy, Ph.D. Phone No.: 1-888-535-7790 Mailing Address: Hawaii Pacific Health Research Institute Attn. Allison Lopes 55 Merchant Street — 26th Floor Honolulu, HI 96813 Facility/Site Address: 74-5599 Luhia Street - #E7 Kailua-Kona, HI 96740 Fax No.: 329-8628 (Kona) 1-888-535-8820 (Honolulu) Email Address: stevenc(cilkapiolani.org Name of Accountant/CPA (include name of firm if applicable) Ernst & Young, LLP Phone No: (808) 531-2037 Mailing Address: 2400 Pauahi Tower 1001 Bishop Street Honolulu, Hawaii 96813-3429 Amount of Request for County funds: $10,000 Prior Year Funding: 04-05 05-06 06-07 $20,000 $5,000 $5,000 Agency Mission Statement: The mission of the Kapi'olani Child Protection Center is to protect children and strengthen families. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project Program Description: The Title IV -B Counseling and Supportive Living Project provides assessment, counseling, service linkage and coordination, educational and supportive services to assist West Hawaii families at risk of child abuse and neglect. This program is part of the Kapi'olani Child Protection Center — a Statewide Center whose mission is to protect children and strengthen families. Priority for services is given to families at risk due to substance abuse (85% of referrals). Special priority is given to families who have or are in the process of adopting or otherwise providing a permanent home for children who have been harmed. Services are provided by KCPC-WH staff and by staff of other organizations through subcontracts with KCPC. The array of services includes, crisis intervention, individual, couple and family counseling, anger management counseling and classes, substance abuse counseling, parenting and life skills education, assistance with supportive living and other adjunct supportive services as needed by family members. The program is funded through a Federal Grant and requires matching funds from the State and from the provider. New Programs In Development For FY07-08: During the 2006-2007 Fiscal Year, KCPC embarked on a collaborative training program with UC -Davis Medical Center to provide the KCPC-WH Therapists with the capacity to provide Parent -Child Interactive Therapy (PCIT) to its client population. KCPC is now the only provider of this empirically -supported practice in the State of Hawaii. This form of therapy has been shown to have a dramatic, long-lasting positive effect on families struggling with changing the behaviors and relational styles that led to their neglectful and abusive parenting. Staff began providing this service to a small group of West Hawaii families in FY06-07 and is now looking to make this service available to a greater number of families in FY07-08 providing KCPC receives adequate funding from the Hawaii County Grant, and HIUW. About 8 years ago, KCPC initiated a Foster Care Mentoring program for youth in foster care on the island of Oahu. This program provides training for older youth in the foster care system so that they can become peer mentors to younger youth who are just beginning their foster care experience. The mentors and mentees participate in monthly recreational and service activities in their community. It has been a phenomenally successful program that now serves some 15 mentor- mentee pairs. KCPC has formalized its mentor training program and is now NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project ready to replicate this program for foster youth on the Big Island providing there is adequate funding from the Hawaii County Grant, and HIUW. KCPC will also begin a new adult mentoring program to support individuals who have successfully completed residential treatment or an independent living program and are then ready to transition back into community life. This can be a precarious time for these clients, as their treatment demands often don't allow them to maintain stable employment and housing. As they come out of such treatment settings, they need to obtain housing, employment and still tend to their recovery and outpatient treatment goals. They can benefit greatly at such times from peer support. The mentor understands and has successfully navigated the exact challenges the mentee has to face. The mentors, in both the Transitional Living Mentoring Program and the previously mentioned Foster Care Mentoring Program, also gain a sense of enhanced self-worth as they contribute positively to others lives. This additional service will be available providing there is adequate funding from the Hawaii County Grant and HIUW. Total Budaet and Position Count Total Program Budget $380,000Total Program Position Count 7 Total Agency Budget $1,940,288* Total Agency Position Count 21 *Statewide Services Program Objectives: 1) Improve child safety by reducing child abuse/neglect risk factors 2) Improve child safety by increasing child protective factors Program Highlights: During FY2006 the following performance measures were obtained: 1) Provided services to 151 families, 251 adults and 327 children. 2) Provided services to 9 permanency families. 3) Completed all services - 62% of individuals served. 4) Reduced CA/N risks — 87% of caregivers who completed services. 5) Had no new CPS report within 6 months after case closure — 100% of families who completed services. 6) Had no new CPS report within 1 year after case closure —100% of families who completed services NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget * Estimate 62% 80% 80% Individuals Completing Service Plan Individuals completing service plan who have established and implemented a 87% 95% 95% child safety plan at closure. Families completing Service Plan who have no new confirmed report of child abuse or 100% 90% 90% neglect at 6 -month follow-up Families completing Service Plan who have no new confirmed report of child abuse or 100% 90% 90% neglect at I year follow-up Families participating in the Parent -Child Interaction Therapy will achieve CDI N/A N/A 75% relational skill mastery. Mentor-Mentee Pairs Trained and participated in Recreational/Service N/A N/A 90% activities. *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project Proaram Exoend'itures *Mentoring Activities Costs Proaram Fundina Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages $243,563 $276,446 279,661 Professional Fees 16,540 $10,000 9,000$ ChariWalk 92,410 $94,554 97,339$ -Operations Equipment 3,242 $3,000 $2,000 Other* 1 $2,0001 $3,000 Total $355,7551 $386,0001 $391,000 *Mentoring Activities Costs Proaram Fundina Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Title IV -13 Federal Grant $360,000 $360,000 $360,000 HIUW $10,000 $5,000 $5,000 ChariWalk $0 $0 $0 HI County Grant $5,000 $5,000 $10,000 KMCWC Matching Indirect Write-off) 16,000 16,000 16,000 Total $391,000 $386,000 $391,000 *If applicable Explain what plan, If any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to be self- sustaining? KCPC-West Hawaii will continue to seek donations and grants to provide the necessary matching funds to obtain the federal grant to continue to provide these very vital services for West Hawaii residents. The County grant has provided some of the matching funds that allow our program to obtain the federal funds. Without the matching funds, we will be unable to obtain the federal funds that are the major support for the program's services. KCPC-WH will need to continue to obtain matching funds and will need to continue to seek grants and donations to support this program. The IVB program can't be fully self-sustaining due to the requirements of matching funds. The KMCWC Matching Indirect write-off is In - Kind matching that doesn't actually reduce direct expenditures and thus is not real revenues but required to obtain federal funds. Donations, HIUW and the Hawaii County Grants will be need to fund other KCPC West Hawaii Programs that did not receive full funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. or �.�zopt' Willow Morton KMCWC Vice President gy � Or/ Steven J. Choy, Ph.[Y. KCPC Director 1A31,J7 Date ��� Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 KEAUKAHA ONE YOUTH DEVELOPMENT- Agency Name Youth Development- Program Name Agency Director: Stanley H. Roehrig Contact Person: Michael F. Divinski Mailing Address: Facility/Site Address: Fax No.: Email Address: Phone No.: 969-1441 Phone No.: 935-5866 101 Aupuni St., #124 Hilo, HI 96720 Bayfront Hilo, HI 935-3945 shroehrig@hawaiiantel.net Name of Accountant/CPA (include name of firm if applicable): Brian M. Iwata Taketa, Iwata, Hara & Associates, LLC Phone No.: 935-5404 Mailing Address: 101 Aupuni St., # 139, Hilo, HI 96720 Amount of Request for County Funds: $10,000.00 Prior Year(s) Funding: 04-05 05-06 06-07 $0 $ 0 $0 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Agency Mission Statement: General scope of the Public Charity activities for Keaukaha One Youth Development is to provide native cultural opportunities for local youth to reconnect with the historic ocean experiences here in Hawaii. The purpose of this reconnection is to provide healthy alternatives to local youth in order to steer them away from potential increasing drug use and other unhealthy lifestyle activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development- Program Name Program Description: The specific purpose is to reconnect children in the County of Hawaii with Hawaiian cultural heritage related to ocean activities. Total Budget and Position Count Total Program Budget $30,000.00 Total Program Position Count 0 Total Agency Budget $30,000.00 Total Agency Position Count 0 Program Objectives: 1) Entails: (1) stress physical fitness; (2) instructional use and maintenance of canoes; (3) perfection of swimming skills; (4) training Hawaiian youth as qualified crew for Hokualakai'i double hulled sailing canoes. The use of Hawaiian canoes and volunteer coaching will be provided free of charge to minor children. The charity will strive to coordinate these activities with local schools. Program Highlights: The date of inception of this program was August 23, 2006. Highlights to date include the acquistion of five one man canoes which are currently being used for training/paddling by those involved with the charity. Footnote 1 : At present we have six volunteer directors helping with this public charity. There are no paid staff. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 1 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development - Program Name Performance Measures: If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Acquition of youth canoes $10,500.00 $30,000.00 $40,000.00 Professional Fees $800.00 0 0 Operations N/A 0 0 Equipment $10,500.00 $62,500.00 $60,000.00 Other* $2,500.00 0 0 Total $13,800.00 $62,500.00 $60,000.00 If applicable Program Expenditures If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages N/A 0 6 - Professional Fees $800.00 0 0 Operations N/A 0 0 Equipment $10,500.00 $62,500.00 $60,000.00 Other* $2,500.00 0 0 Total $13,800.00 $62,500.00 $60,000.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Contributions $19,500.00 $30,000.00 $40,000.00 Total $19,500.00 $30,000.00 $40,000.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? This program will rely on contributions from the public and private sector in conjunction with fund raising activity. We will strive for community support, to spread the word of the accomplishments of the youth, to gamer interest from the community at large and benefactors to subsidize our cause of cultural development and physical well being. Our aspiration is to become a self- sustaining program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The reportshall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Program Expenditures : ( Other ) : - Roofing material donated $2,500.00 Kokua Counseling Services — Agency Name Client Assistance Fund — Program Name Agency Director: Jerry Merrill Phone No.: 934-0940 (home) Contact Name: Pat Merrill Phone No.: 935-0222 (office) Mailing Address: Hilo Lagoon Centre 101 Aupuni Street, Suite 114 Hilo, Hawaii 96720 Facility/Site Address: Hilo Lagoon Centre 101 Aupuni Street, Suite 114 Hilo, Hawaii 96720 Fax No.: 935-0222 Email Address: kcs(a-)hawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Janet W. Hara, CPA, MBA Taketa, Iwata & Associates, LLC Phone No.: 935-5404 Mailing Address: 101 Aupuni St., Suite 139, Hilo, HI 96720 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 04-05 05-06 06-07 $0.00 $0.00 $0.00 Agency Mission Statement: Kokua Counseling Services provides affordable professional counseling, therapy and education for East Hawaii residents who face difficult life situations including conflicts in family and marriage life, employment and job dissatisfaction, depression, anxiety, substance abuse, financial distress, loss and grief, major life decisions and anger management. Our services integrate the insights from behavioral sciences with the wisdom of religious traditions to understand and work with persons seeking wholeness of body, mind, and spirit. All services are sensitive to the particular beliefs and cultures of clients. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Kokua Counseling Services — Agency Name Client Assistance Fund — Program Name Program Description: The Client Assistance Fund provides subsidized low-cost or no -cost counseling services to individuals, couples and families who have no health insurance, restrictive health insurance, and/or limited financial resources. The Assistance Fund enables Kokua Counseling Services (KCS) to provide low-cost, affordable counseling services for clients in need while adequately compensating its professional staff. KCS staff clinicians — two clinical social workers and one marriage and family therapist — are certified by the National Association of Social Workers and the American Association for Marriage and Family Therapy, respectively, and are licensed by the State of Hawaii. Approximately 30-40% of all clients served by KCS require "gap group" subsidized services. Total Budget and Position Count: Total Program Budget $4,550.00 Total Program Position Count 3 Total Agency Budget $37,000.00 Total Agency Position Count 4 Program Objectives: 1) Insure that no client in need of professional counseling services is turned away due to an inability to pay fees. KCS fee schedules begin as low as $25 per session, a considerable savings over standard professional rates. When clients cannot pay even reduced rates, the Client Assistance Fund is used to subsidize services. Unlike many publicly funded nonprofit agencies that require specific admission criteria for mental health services, KCS has no admission criteria. Its services are available to anyone who believes they can benefit from counseling. Its Client Assistance Fund assures that no one "falls through the cracks" due to eligibility criteria or inability to pay. 2) Provide services to clients with limited or inadequate health insurance to assure that successful therapeutic and life outcomes are achieved. Where health insurance policies limit eligibility for mental health services and/or the number of sessions reimbursed by insurance is insufficient to fulfill healthy outcomes, the Client Assistance Fund is used to supplement insurance coverage. 3) Expand service delivery to clients referred by other area agencies — e.g., YMCA, Salvation Army, Care Hawaii — and expand outreach, networking and collaborative partnerships with other behavioral health agencies in East Hawaii. 4) Establish performance measures to (1) record the actual number of clients requiring assistance from the Client Assistance Fund; (2) calculate the number of financially assisted clients as a percentage of the total number of KCS clients; and (3) administer pre- and post- counseling surveys to assess the ability of clients to function well within his/her family and community. Program Highlights: 1) During its first year of operation (January -December, 2006), the Client Assistance Fund partially or fully subsidized counseling services for 34% of all KCS clients. 2) The Client Assistance Fund enabled many clients to achieve personal health goals and improve their marriage and family relationships. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Kokua Counseling Services — Agency Name Client Assistance Fund — Program Name Performance Measures: 'Budget year is January 1— December 31 Program Expenditures: FY 2005-06 FY2006-07 FY2007-08 Salaries and Wages Actual* Bud et* Estimate No. of clients 0 0 Provide professional clinical and family/marriage served by KCS 10 40-50 counseling to 8-10 clients who require subsidized Assistance Fund 0 0 services through the Client Assistance Fund No. of underinsured 0 0 Provide professional counseling to 10-15 clients clients served by 4 15-20 who lack sufficient health insurance benefits to Assistance Fund fulfill treatment modalities and healthy outcomes No. of new KCS Expand outreach, networking and referral to public clients served via 41 70-80 and nonprofit agencies to provide services to 30+ outreach and new clients annually in need of mental health and referral behavioral counseling Total no. of clients Record the number of clients needing assistance served by KCS 14 40-50 from the Client Assistance Fund and calculate the Assistance Fund number of such financially assisted clients as a percentage of the total number of KCS clients Pre- and post- Administer pre- and post- counseling surveys to counseling surveys 60 140-160 assess the ability of clients to function well within all clients his/her family and community No. of hours of Expand staffing hours of marriage & family operation and 0 156 therapist and, through an interagency working establishment of agreement, add a second location to the KCS satellite office Aupuni Street office where personal and family counseling sessions may be conducted 'Budget year is January 1— December 31 Program Expenditures: Budget year is January 1— December 31 # Please explain in detail on separate sheet NOTE: ' KCS counselors are contract (not salaried) employees; accordingly, client services subsidized by the Client Assistance Fund are shown as "Operations" expenditures. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual FY2006-07 Budget* FY2007-08 Estimate Salaries and Wages 0 0 0 Professional Fees 0 0 0 Operations' 0 $4,550.00 $30,000.00 Equipment 0 0 0 Other# 0 0 0 TOTAL 0 $4,550.00 $30,000.00 Budget year is January 1— December 31 # Please explain in detail on separate sheet NOTE: ' KCS counselors are contract (not salaried) employees; accordingly, client services subsidized by the Client Assistance Fund are shown as "Operations" expenditures. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Kokua Counseling Services — Agency Name Client Assistance Fund — Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual* FY2006-07 Budget* FY2007-08 Estimate KTASuperstores contribution 0 $1,000.00 Big Island Toyota contribution 0 $ 250.00 Corporate Contributions $2,000.00 Church of the Holy Apostles contribution 0 $ 500.00 Christ Lutheran Church contribution 0 $ 500.00 Puna Congregational Christian Church contribution 0 $ 300.00 Church/Temple Contributions $2,000.00 Jerry & Pat Merrill 0 $2,000.00 $1,000.00 Other Contributions/Grants 0 0 $10,000.00 County of Hawaii Grant 0 0 $15,000.00 TOTAL 0 $4,550.00 $30,000.00 * Budget year is January 1— December 31, 2006 Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? Kokua Counseling Services received its advance ruling IRS Letter of Determination establishing its 501(c)(3) tax -exemption in December, 2006. Prior to receipt of this notification, it was difficult for KCS to apply for grants or seek donations as a qualified tax-exempt charitable organization. Consequently, the majority of contributions placed in the Client Assistance Fund came from the personal resources of KCS founders Jerry and Pat Merrill. For the first year of operations, Mr. & Mrs. Merrill gave $2,000.00 to the Client Assistance Fund and $25,000.00 to support the overall operational budget of the agency. In spite of the limitations imposed by pending 501(c)(3) status during 2006, KCS undertook several key initiatives to become self-sustaining. KCS successfully applied for inclusion in the Compassion Capital Fellows Program (CCFP) jointly administered by the UH Manoa Center on the Family, Hawaii Community Foundation and Hawaii Islands Ministries. Through the CCFP, KCS received two organizational "capacity -building" grants totaling $30,000. These grants provided a one-year training program for two KCS board members and funded the preparation of an 'Infrastructure Assessment in Preparation for Major Gift Development' by Solid Concepts, Inc. in Honolulu on behalf of KCS. It should be noted that no funds from the CCFP grants could be applied to the KCS operating budget or Client Assistance Fund. In 2007, KCS will implement its fund development/marketing plan to generate income streams from public and corporate donations, foundation grants, and special events. A percentage of any income received will be placed in the Client Assistance Fund. Award of a County human services grant will provide critical "bridge" funding in support of our services to low-income citizens in East Hawaii while we undertake these steps to become self-sustaining. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Kokua Counselina Services - Aaency Name Client Assistance Fund - Program Name I (we) have read and understood all of the eligibility requirements, grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92-F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative Auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Sig ure f Boa resident/Chair Date N/A Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 • KONA ADULT DAY CENTER, INC- Agency Name ADULT DAY CARE- Program Nape Agency Director: Contact Persona: Mailing Address: Facility/Site Address: Fax No.. Email Address: Rowena L Tiqui Rowena L. Tiqui P. O. Box 1350 Kealakekua HI 96750 81-989 Halekii St Kealakekua ill 95750 808 322-0514 Phone No.: 322-7977 Phone leo.: 322-7977 kadcrowena@hawaii.rr.com Name of Accountant/CPA (include name of firer if applicable): Ronald G. Hawkes, CPA Phone No.: 808 939-7392 Mailing Address: P. O. Box 2030 Kealakekua Hl 95750 Amount of Request for County Funds: $30,000 Prior Year(s) Funding: 04-05 05-06 06-07 $15,000 $15,000 $15,000 Agency Mission Statement-. "Our mission is to provide health, social and recreational programs and activities that enable impaired adults to experience feelings of well being, friendship, acceptance, accomplishment and independence in a caring and secure environment." NONPROFIT GRANT APPLICATION In ESCA L ITR AR 2007-08 'age I KONA ADULT DAY CENTER, INC. - Agency Name Accu t Day Care- Program Name Program Description: Adult Day Care is viewed as a promising long-term care option because it provides regular and reliable respite to informal caregivers, while it fosters their continued participation in the workforce. Persons eligible for Kona Adult Day Center services are those adults 18 years and older, but particularly those 60 years and older, having either a physical or a cognitive disability, requiring supportive care. These are persons with Alzheimer's disease, dementia or Parkinson's disease, multiple sclerosis and those who are socially isolated. Day care provides a less restictive setting and a more cost effective program than other types of care, such as home nursing or institutionalization. Total Budget and Position Count Total Program Budget 295,504.39 Total Program Position Count 6 Total Agency Budget 295,504.39 Total Agency Position Count 6 Programa Objectives: Program Goals fo Individuals a. Avoid premature or inappropriate institutionalization. b. The client will be able to associate with a place and a group corresponding with his/her own sense of identity. C. isolation and prejudice often associted with frail and disabled adults will be reduced. d. Health monitoring as well as protective and supportive care for the frail and disabled adults will be included in care planning and services. e. The clients maximum level of independence will be assessed through the individual program planning. f. Socializing, peer interaction and continued relationship with the community will be ensured. g. Mentally and physically impaired adults will be maintained at their highest level of functioning, thus preventing or delaying further deterioation. h. the caregivers' knowledge of, and access to elderly services available in the community. NONPROFIT GRANT A,PPLICA') EON FISCAL YEAR 2007 -GO Page 2 Program Coals for families and Other Caregivers a. Famaiies that desire to keep elderly members in the home will be given relief for full-time care of an impaired adult. b. Families and other caregivers will be assured that elders dependent upon them are being cared for appropriately during the day. C. Family members will be enabled to continue productive careers Instead of being homebound with an elderly, disabled spouse, parent or other family member. Program Coals for the Community a. The medical community and other resources state wide will be provided a liaison in geriatrics, especially Alzheinler;s disease and other related disorders. Program HiighUghtrs: 1) Surveyed caregivers, who responded, expressed satisfaction with Bona Adult Day Center. 2) Maintained participants at home for a minimum of 6 months with adult day care services. 3) Had intergenerational interaction activities. 4) Maintained or improved hygiene/self-care of participants. 5) Maintained or improved socialization/infraction skiffs of participants. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-09 Page 3 KONA ADULT DAY CENTER, INC. - Agency Name Aduft Day Care - Program Nape Performance Measures: Program apenditures If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 FY 2007-08 Budget* Estimate Salaries and Wages 164,640.00 169,728.00 180,000.00 Professional Fees 3,756.00 8,878.00 4,000.00 Operations 127,108.39 142,375.00 148,000.00 E ui went .00 .1,000.00 1,500.00 Other' Total 295,504.39 1 321,981.00 333,500.00 If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 KONA ADULT DAY CENTER, INC - Agency Name Adult Day Care - Program Name Program Funding Sources: lidentify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual ° FY 2006-07 Budget* FY 2007-08 Estimate DHS POS Program 28,849.64 28,800.00 30,000.00 DHS NHWW 50,715.00 51,600.00 55,000.00 HCOA - Services For Seniors 2,501.66 2,592.00 2,800.00 County of Hawaii 15,000.00 15,000.00 25,000.00 May Templeton Hopper 28,218.00 28,800.00 30,000.00 Hawaii Island United Way 15,000.00 15,000.00 20,000.00 Other Grants 5,000.00 5,000.00 8,000.00 Carter Grant 0 4,992.00 0 Tuition 109,943.34 111,000.00 112,000.00 Tuition Assistance 0 0 0 Transportation Fees 11,385.00 11,700.00 12,000.00 Bathing Fees 14,005.00 13,560.00 14,000.00 Feeding Fees 0 0 1,500.00 Intake Fees 640.00 480.00 800.00 Adult Food Program 1 10,559.87 10,380.00 11,000.00 Fundraising Donations 1 34,905.37 5,260.00 6,000.00 Fundraising Membership 4,535.00 5,000.00 5,000.00 Fundraising Special Events 4,563.50 1,290.001 2,200.00 Fundraising Sales 12,290.00 12,000.001 13,000.00 Administration Fees 1,875.00 2,750.00 j 1,900.00 Interest Income 1,361.26 1,404.00 1,450.00 Unrealized Gain Loss 772.22 .00 .00 Medical Supplies 11.54 .00 .00 Total 1 352,131.40 326,608.00 351,650.00 *If applicable Explain what pians, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? We pian to increase client census to maximum 60. Tuition revenue will increase but so will staffing. Rates will increase. We will continue to seek out grants. We will better promote our annual fundraising campaign and our annual membership drive. Becoming self-sustaining is a constant goal. Reaching maximum client census will help to attain that goal. We will also depend on the continued support of our community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-09 Page 5 KONA ADULT DAY CENTER, INC - Agency Name Adult Day Care - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Particle 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 32F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai"i, I (we) understand andwill comply wvti� the requirement to submit a year-end report to the Legislative aud`otor within 60 days after June 30 of the fiscal year. The report shalf include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawal`i grant funds, and a listing of other funding sources and amounts obtained during the award period. Faflure to submit a timal r, compllete, an apency's future fundinci requests. Signature of Board President/Chair �CXA,%_ as Date l'T / _c�:> -7 Dat UNSIGNED PROPOSALS 4krl'L.L HOT BE ACCEPTED! N®NTRf FIT GRANT APPLICATION FISCAL YFAR 2007-08 Page 6 Kona Literacy Council- Agency Name Kailua Learning Cbnter- Program Name Agency Director: 1180 Contact Person: 1180 Mailing Address: Facility/Site Address: Fax No.: Email Address: Brenda Natina Brenda Natina Phone No.: 329 - Phone No.: 329 - 75-5766 Kuakini Highway Suite 106A Kailua-Kona, HI 96740 75-5766 Kuakini Highway Suite 106A Kailua-Kona, HI 96740 329-1180 konalit@msn.com Name of Accountant/CPA (include name of firm if applicable): NA Phone No.: Mailing Address: Amount of Request for County Funds: $1,500 Prior Year(s) Funding: 04-05 05-06 06-07 $1,000 $1,500 $1,500 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 The Kona Literacy Council's trained volunteer tutors help any adult increase their basic reading, writing, math, and communication skills to enable the learners to become better family members, workers, community members and lifelong learners. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Kona Literacy Council - Agency Name Kailua Learning Cdnter- Program Name Program Description: The Kona Literacy Council's trained volunteer tutors provide free, one-to-one, small group, and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing, computation skills and computer literacy. Special programs designed to meet the specific needs of the learners are offered, such as: English as a Second Language, preparation for passing the GED or Competency Based High School Diploma, Citizenship preparation, keyboarding and computer literacy. All tutoring is at no cost to the student. All of the 572 students, who have had lessons at the Kailua Learning Center since it opened in September 1992, have made remarkable progress in their basic skills; some have gained their High School Equivalency Diploma, passed the Citizenship exam, and have gotten better jobs. Reading improves the adults' self-esteem, thereby improving their lives and becoming better family members, workers and community members. Total Budget and Position Count Total Program Budget $6,000 Total Program Position Count 8 Total Agency Budget $6,000 1 Total Agency Position Count 8 Program Objectives: 1) Continue to provide free one-to-one, small group and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing, computation and computer literacy skills. 2) Register, schedual, match learner with tutor, and prepare programs for 15 new students for the year. 3) Continue recruiting and training new tutors. 4) Continue networking with community agencies to provide free literacy assistance to their clients, i.e. Department of Human Services, Department of Labor & Industrial Relations, Kona Community School for Adults, various Vocational Rehabilitation Programs, Bridgehouse, Alternatiaves to Violence, court ordered participants, Family Support Services of West Hawaii, Head Start, Hawaii Community College and the public libraries. 5) Offer pre-employment skills, help in filling out application forms, resume writing and interview skills to enable our learners to get and hold jobs. 6) Improve family literacy services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 7) Help foreign born learners with their communication skills and assist them in ,passing their citizenship test. , 8) Empower adults to become contributing members of our community by ensuring that everyone increases their literacy skills and becomes lifelong learners. 9) Publish a quarterly newsletter. 10) Hold general membership and public meetings quarterly. 11) Continue writing grants, pursuing fund raising functions, and seeking donations to keep open the doors of the Kailua Learning Center. Program Highlights: 1) Tutored 9 basic literacy students. (includes reading, math & computer literacy) 2) Tutored 12 English as a Second Language students. 3) Left the program and attained employment: 4 students. 4) Retained employment: 3 student. 5) Studying for the citizenship test: 2 students. 6) Entered other educational programs: 2 student. 7) Increased involvement with children's education: 3 student 8) Met goals: 8 students. 9) Utilized 2 volunteer tutors plus the Program Director. 10) Tutored 519 hours of actual tutoring. , 11) Contributed aproximately 500 hours by volunteers in other areas. 12) Trained 2 new tutors. NONPRWT GRANS' AP ,Pjj1bATION FISCAL WSW -W 8 Paye 4 Kona Literacy Council - Agency Name Kailua Learning Center - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Tutored Basic Literacy Students 7 12 10 Tutored ESL Students 10 15 12 Trained new tutors 1 4 3 Published Newsletter 3 3 3 Board & General Public Meetings 3 0 3 Total Tutodng Hours 533 550 550 Total Non -Tutoring Hours 450 550 500 *If applicable Program Expenditures * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 0 0 6- Professional Fees 0 0 0 4,779 5,600 5,100 -Operations Equipment 238 400 400 Other n 500 400 500 Total 5,5171 6,5001 6,000 * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Kona Literacy Council - Agency Name Kailua Learning Center - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Grant 1,500 1,500 1,500 -County Dues 30 50 50 -Membership Wal-Mart 0 1,250 250 Donations 100 2,500 2,000 Fundraising 0 500 1 500 Federal Campaign 642 7001 700 Brothers Tug &Bare 0 0 1,000 -Young Rebate 20 0 0 Total 2,292 6,5001 6,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Kona Literacy Council plans to particapate in more fundraising and grant proposal writing. Since we do not charge our clients for our literacy services, we will have to continue to rely on the generosity of our community supporters. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 _ Kona Literacy Council - Agency Name Kailua Learning C2nter - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. .. .: 0MI romp, �, . &4, . e4 � _ SioMure of-Exeeative-Director 1�gU"Ipl- as o� Dat //G o Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Ku'ikahi Mediation Center, Inc.- Agency Name Ku'ikahi Mediation Center- Program Name Agency Director: Libby Pulelehua Oshiyama, Ed. D Phone No.: 935-7844 Contact Person: Libby Pulelehua Oshiyama, Ed. D. Phone No.: 935-7844 Mailing Address: 614 Kilauea Ave. Ste 4, Hilo, 96720 Facility/Site Address: 614 Kilauea Ave. Ste 4, Hilo 96720 Fax No.: 961-9727 Email Address: kuikahi_mediation@hawaiiantel.net Name of Accountant/CPA (include name of firm if applicable): Ron Dolan Phone No.: 935-5433 Mailing Address: 16A Railroad Avenue, Hilo Hawai'i 96720 Amount of Request for County Funds: $12,000 Prior Year(s) Funding: 04-05 05-06 06-07 $4,000 $5,000 $4,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 To provide a safe environment, an impartial process, and skilled,trained personnel for the delivery of affordable dispute prevention and resolution services to the East Hawai'i community, on a non-profit basis. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Ku'ikahi Mediation Center, Inc. - Agency Name Ku'ikahi Mediation Center- Program Name Program Description: Ku'ikahi Mediation Center (KkMC) has served the Hawai'i Island community from 1983 to 2005 under the auspices of the YMCA. The Center obtained it's 501 c 3 status on December 22, 2005 and has grown appreciably from that time. Obsticles, especially funding, were surmounted thru the generous efforts of the staff andf the Board of Directors Presently, Ku'ikahi provides quality, and expedient mediation services, to individual and organizations in the East Hawai'i community. Our approach to mediation is sensitive to the multicultural ways of co -existing, communicating, and problem solving. These low cost -to -free services are offered on a sliding scale according to income which makes them available to many who are identified as low income. KkMC utilizes professionally trained and very dedicated community volunteers to mediate disputes involving neighbor -neighbor, family (including divorce and intergenerational issues), work place, community, business, Special Education, and civil rights. Aside from individuals seeking services, referrals come from the Prosecuting Attorney's Office, the County Police Department, many local attorneys, as well as the District and Family Courts of the 3rd Circuit. the center has increased services to individuals and families involved in requests for restraining orders. the sucessful resolution ;of these cases reduces the number of calls requiring police response, as well as the decreasing the threat of violence on school campuses, in the work place, and in neighborhoods. KkMC is committed to providing information, and encouraging participation in mediation to all members of the community. Our outreach includes individuals who are without resources, live outside of the mainstream, or feel culturally alienated. Some may not be prepared to express themselves or their issues in a mediation setting, and will need additional education about the opportunities that our mediation process provides.The Center refers potential and existing clients to various resourses in the community that will help them address some of their issues, and help them understand and participate more effectively in the arena of the laws and the courts. KkMC also provides facilitation services to community groups, outreach and education to persons and groups that might utilize mediation services, Mediation Skills Training for businesses, condominium boards, and the Department of Education, agencies, attorneys, and other community members. BasicMediation Training, on-going refresher training, and Advanced Mediation Training in various specialized areas are provided to maintain a high level of competency among the Center's 50 plus volunteer mediators. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Total Budget and Position Count Total Program Budget $132,032. Total Program Position Count 3 Total A enc Budget $132,032 Total Agency Position Count 3 Program Objectives: 1) Advance training for mediators in Facilitation 2) Enlarge Outreach and Education in Mediation efforts in Puna communities, to reduce the Temporary Restraining Order load on the courts 3) Collaboration with Proscutors office to build Restorative Justice program, 4) Increase staff with one new part time person 5) Increased number of self referred mediations 6) Update all documents used in divorce/co-parenting mediations 7) Extend Mediator Skills training opportunities in the community 8) Enhance awareness and opportunities for parent/student mediations in schools 9) Explore with the DOE means by which mediation training can occur in public schools. 10) Increase funding through grants, fundraisers, and Mediation Skills Seminars for the business community, Program Highlights: 1) Executive Director hired. 2) Refresher training held for 25 existing mediators 3) Monthly newsletter to mediators established 4) 30 new participants in Mediator Basic Training 5) 20 more active mediators, added to the pool of 30 6) 7 mediators trained in Mediating Condominium board disputes 7) Divorce/Co-parenting Training scheduled 8) Increased percent of mediations reaching agreement from 58% to 65% 9) Created one part time staff specializing in scheduling timely mediations 10) Turn around time for mediations to occur after intake has been reduced by half. 11) Focus on outreach and education has increased number of opened cases who choose to participate in mediation 12) 610 clients served in a safe, neutral environment 13) Board of Directors fund raising were effective, thus enabling the Center to reach the end of the year with a small posiive bottom line. 14) Moved to new office with more appropriate, space and ADA capacity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 THIS PAGE INTENTIONALLY LEFT BLANK NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Ku'ikahi Mediation Center, Inc. - Agency Name Ku'ikahi Mediation Center - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Number of Cases opened 282 310 340 Number of mediators 30 050 65 Number of mediations held 151 180 215 Percent of mediations reaching agreement] 62% 65% 70% Number of domestic/divorce cases 45 60 75 Number of court referrals 200 215 230 Number of self referrals 37 45 58 Percentage of satisfied clients in self report 81% 88%% 93% Percent clients would refer others to mediation 83% 90% 95% Percent clients earning less than $20,000 a year 50% 50% 50% Percent Native Hawaiians served 23.2% 25% 28% *If applicable Program Expenditures If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 25,062 77,000 87,600 Professional Fees 00 9600 8,800 7,927 28,700. 35,600 -operations 00 00 -Equipment Other* 00 00 Total 32,9891 115,300 132,032 If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Ku'ikahi Mediation Center, Inc. - Agency Name Ku'ikahi Mediation Center - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County of Hawai'i *2500* 4000 10,000 Judiciary, State of Hawai'i *21,604 51,850 53,000 Justice Foundation Grant * 2000 6,000 10,000 Atherton Foundation Grant 00 2000 2000 Fees for services *6035 18,500 23,000 Contributions & fundraising 1-6,06 *1255 14000 17,000 Training revenue 00 9000 10,000 YMCA funds transfer of remaining rant funds from 2005 *3903 00 00 Other Grants 8100 *Note: We opened our doors as a non-profit on January 3, 2006 so our income for that contract year is for only 6 months Total 1 32,937 115250 132,100 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining/ Ku'ikahi has come a long way in it's first year as a non-profit agency (since December 22, 2005). We have raised funds through contributions and events, as well as collecting small fees via our sliding scale, which is dictated by the Judiciary --so it cannot be changed. As our case load continues to increase, the fees collected will increase. We have conducted mediator trainings with top notch trainers, and the 30 attendees paid from their own pocket or were covered by their employment situation to attend 36 hours of training to become volunteer mediators. The Bar Association helped subsidize five prosecuting attorneys to attend that training, and then contributed $1300 more to support the event. Soon, eWe will be offering training throughout the community which will provide income for the Center. However, we will always be concerned that our services NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 JP,4J-39-2007 21:41 From: To:9353945 Paee:819 Ku'ikahi Mediation Center, Inc. -Agency Name Ku'ikahi Mediation Center - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. J��. 3 ( )-o o-7 Date a, 31, zooT Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Pagc 8 Laupahoehoe Train Museum - Agency Name Museum Sustainability & Outreach - Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Lisa Barton Lisa Barton P.O. Box 358 Laupahoehoe,H196764 Phone No.: 962-6300 Phone No.: 962-6300 36-2377 Mamalahoa Highway Laupahoehoe,H196764 962-6957 laupahoehoetrainmuseuni@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Natalie Iwasa, CPA, Inc. Phone No.: (808) 395-3233 Mailing Address: 7267 Naohe St, Honolulu 96825 Amount of Request for County Funds: $45,000 $39,500 is for labor and $15,500 is for operational costs. Labor cost includes for 120 hours/month for 2 part time docents, 50 hours/month for a curator/marketer, 40 hours/month for maintenance. Operations include $5,000 for accounting (audit cost), $6,000 for displays, $2,500 for advertising, and $2,000 for printing and postage. The $45,000 is a decrease from our 2006-07 funding request of $59,400. Prior Year(s) Funding: 04-05 05-06 06-07 $ $35,000 $35,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Agency Mission Statement: Our purpose is to preserve, promote, and protect the historic, cultural, educational, social, civic and economic interests of the North Hilo and Hamakua districts, while highlighting the history of railroads on the island of Hawaii. Our mission is to preserve Hawaii Island's railroad history for posterity and prosperity. Through our broad purpose and in keeping with our mission, we provide many services and programs that are not funded by the community or government agencies alone. We have been working towards the sustainability of the museum since its inception by completing objectives outlined when we were established.; 1) provide a quality museum experience; sharing information on railroads, plantations, local history and natural attractions as part of the Hilo/Hamakua Heritage Coast, 2) assist in the development and completion of projects in the community that enhance the area for its residents and 3) provide a market via our giftshop and jobs to stimulate the community's economic development. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Laupahoehoe Train Museum - Agency Name Museum Sustainability & Outreach - Program Name Program Description: The goal of this program is to continue to work towards the museum's original goals. Specifically, to make the best use of our facility as an sustainable educational resource and highlight in the community. As part of the'Hilo- Hamakua Heritage Coast' we preserve and protecte our islands railroad, plantation and local histories and assiste the community by providing social and economic stimulation in the area. This program will focus on our continuing efforts of outreach, providing activities for youth while continuing our work towards sustainablity of the museum and its staff. We will continue to expand the museum's interior and exterior displays to provide a quality experience to our visitors, tour groups and for those in our outreach programs. These expansion efforts include adding technology, translations and new displays as information, photos and memorabilia are donated and or researched. The use of technology will allow more photos, history and personal stories to be shared in a limited time and physical space. (i.e., videos, slide shows and power point presentations.) Maintaining our paid staff enables us to ensure; consistant business hours, updated displays, active programming and museum growth. Use of staff also provides a museum representative for outreach programs to those on limited transportation or time budgets including schools, senior centers and Hilo cruise ship visitors. Staff also assists in the expansion of our membership and gift shop, where many local crafters find a market, which assists in local economics and encourages the museums sustainability. Providing jobs within the community stimulates the community's economic development. Providing more information with new and improved displays enhances visitor experience and increases word of mouth advertising, increasing visitor count and gift shop sales, improving revenues and improving sustainability. As a young growing community endeavor these components work towards our goal of presenting a quality museum experience. Total Budget and Position Count Total Program qojeLtt 177,000 1 Total Program Position Count 1 4 Total Agency Budget 1 235,000 1 Total Agency Position Count 1 16 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Program Objectives: 1) 2) 3) 4) 5) 6) 7) 8) Provide tours and educational programs to Hawaii Island Youth. Research to provide more displays regarding railroads, plantations and local history. Maintain, update and rotate displays, memorabilia and photos in our files. Maintain grounds, buildings and displays. Provide tours and educational programs to Cruise Ship arrivals and work towards eventually providing transportaton to and from Hilo Harbor. Increase visitor count, membership recruitment, expansion of our gift shop, and creative marketing to support sustainability. Research and apply for private, State and Federal funding sources to meet our operational and future expansion needs. Maintain paid staff to provide programing, tours and outreach. Program Highlights: 1) Provided 1.5 FTE jobs to Hawaii Island youth for museum operations. 2) Healing Our Island Grant 2007 providing youth activities toward healthy living & creating youth baseball teams in two communities along the coast. 3) Completion of the interior of our Caboose as additional display space (Feb 2007) includes seating and movie projection as well as photo displays. 4) Completion of our unique railroad locomotive 'Rusty' as our mascot and advertising icon -Feb. 2007 includes cab restoration and finish paint coat. 5) Open daily operation with the exclusion of major holidays by a mostly volunteer staff, augmented by paid staff funded by County Grant. 6) Museum Tours and out reach tours for school, and community groups coming from as far away as Hilo and Waimea with varying age groups. 7) Train Room Completion funded by HELCO including new interior model railroad displays, photos and memorabilia. 8) Laupahoehoe Walking Trail - clearing completed 2002. County reclaimed roadway in 2006 and is providing geotechnical survey to be considered for alternative access. 9) Ookala Community Forest Stewardship grant (7th year of a 10 year program) maintaining 40 acre tropical hardwood demonstration forest including two native lowland forest restoration areas. 10) Museum Assessment Program awarded by Institute of Museums and Libraries Services 2003 reviewed our museum practices and gave positive critical review that is a guide for creating a quality museum. 11) State Incentive Grant (SIG) provide substance abuse prevention education programs to youth with four programs. (3 year program) 12) Keiki Car Seat Program provides car seat fitting station & island training. 13) Senior Safety Kits provide first aid kits, smoke detectors, emergency lights and emergent' medical cards to community seniors (500 kits). NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Laupahoehoe Train Museum - Agency Name Museum Sustainability & Outreach - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual* FY 2006-07 Budget* FY 2007-08 Estimate Increase visitor count by 15% 7,000 8,050 9,100 Increase school and community tours by 20% 30 36 42 number of displays 2 2 2 -Expand Increase paid staff FTE .5 1 2.5 Increase gift shop sales $7,676 $11,000 $15,000 Total 119,791 121,600 1 177,000 *If applicable Program Expenditures • If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 18,234 36,400 86,400 Professional Fees 2,406 0 5,000 operations 41,943 25,200 46,400 0 5,000 0 -Equipment Other' 57,208 55,000 39,000 Total 119,791 121,600 1 177,000 • If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Laupahoehoe Train Museum -Agency Name Museum Sustainability & Outreach - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Bud et * FY 2007-08 Estimate Admissions/donations 12,937 20,000 20,000 dues 6,970 3,600 8,000 -Membership Sales net 7,676 8,000 15,000 Grants IMLS - federal 0 0 50,000 Docent in-kind) 31,208 36,0001 20,000 Management in-kind 26,000 19,0001 19,000 Appropriation 35,000 35,000 45,000 -County Total 119,791 1 121,6001 177,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? LTM applied for a three year, $150,000 program grant through the Institute for Museum and Library Services. These are operational funds that would help sustain the museum, while building toward self-sufficiency. These funds are to be used to increase public awareness and educational programming. Staffing the museum will allow for outreach programs to increase visitor count and revenue. With grant assistance to increase visitor awareness and extend our outreach programs, we project visitor count to be near 10,000 by 2010 and we will be near self -sustainable with a full paid staff. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Explanation of Program Expenditures In regard to the column marked "Other": LTM recorded $57,208 for in-kind volunteer time for FY 2005-06. While in FY 2006-07, we estimated estimated $55,000 for our in-kind volunteer hours . In FY 2007-08 our in-kind volunteer hours are estimated at $39,000. This reduction of volunteer hours is a reflection of being able to pay for some volunteer staff time. Paying key staff positions have been very important to the museum in terms of maintaining museum hours, researching information for new displays, display creation and maintenance of the facility. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Laupahoehoe Train Museum - Agency Name Museum Sustainability & Outreach - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Atticle 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, l (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. /L r". Signatur of Executive Director Date�i0 I LLq A7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Mental Health Kokua Residential Rehabilitation Services Agency Director: Joanne Lundstrom Phone No.: 737-2523 Contact Person: Gary Michell Phone No.: 331-1468 Mailing Address: 1221 Kapiolani Blvd., Ste 345, Honolulu, HI 96814 Facility/Site Address: 75-5752 & 75-5750 Alanoe PI., Kailua-Kona, HI 96740 140 Wainaku Avenue, Hilo, HI 96720 139 Amau Road, Hilo, HI 96720 Fax No.: 331-1468 Email Address: konamhk(a mentalhealthkokua.org Name of Accountant/CPA (include name of firm if applicable): Summer B. Such, CPA Phone No.: (808)737-2523 ext 1107 Mailing Address: Mental Health Kokua 1221 Kapiolani Ave, Suite 345 Honolulu, Hawaii 96814 Amount of Request for County funds: $25,000 Prior Year Funding: 04-05 05-06 06-07 $15,000 $20,000 $20,000 Agency Mission Statement: We believe that all citizens should have an opportunity to live and participate in and contribute to their communities. Through specially designed services, Mental Health Kokua helps those in Hawaii who are in mental distress, emotional crisis or recovering from serious mental illness achieve their optimum level of recovery and ability to function in the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Mental Health Kokua Residential Rehabilitation Services Program Description: Funding is requested for our transitional residential services, including PATCH (Psychosocial and Transitional Community Housing) Place and Hale Amau in Hilo, and Hale Alanoe and Kealahou in Kailua-Kona. The acquisition of Hale Amau in February 2006 allowed for a needed expansion of transitional housing for people in recovery from mental illness in Hawaii County, Mental Health Kokua offers 18 beds in Hilo, and 12 beds in Kailua-Kona, (a total of 30 beds) from which recovery in the community can occur. Mental Health Kokua staff provide 24-hour supervision and rehabilitation services with the goal to enable clients to move on to more independent housing. While in placement, clients are assisted in acquiring personal and social survival skills necessary for sustained community living. Staff provide training and support in daily living skills and medication management while facilitating social, educational and recreational activities in the community. Clients are assisted in making connections to community resources including mental health centers, vocational training programs, and community housing agencies, as well as assistance with long-term community placement. These projects provide cost effective, humane, recovery oriented alternatives to institutional care and/or homelessness. Transitional bed day costs for FY 2006 are estimated at $94. Comparative bed day costs in a psychiatric hospital range from $600 to $800 a day. Total Budget and Position Count Total Program Budget 1,029,789 Total Program Position Count 26 Total Agency Budget 8,195,422 Total Agency Position Count 170 Program Objectives: 1) Provide residential and social rehabilitation services to 85 unduplicated persons with serious mental illness. 2) Show completion of identified treatment plan goals upon discharge by at least 80% of clients served. 3) Reduce consumer psychiatric hospitalization by at least 90% 4) Ensure 100% compliance of Commission on Accreditation of Rehabilitation Facilities (CARF) and other monitoring recommendations. 5) Show evidence of satisfaction with services received at 95% of consumers served NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Mental Health Kokua Residential Rehabilitation Services 6) Show improvement in daily living skill scores upon discharge in at least 90% of consumers served. 7) Place at least 70% of consumers served in more independent living settings following planned discharge. Program Highlights: 1) Provided transitional residential rehabilitation services in FY 2006 to forty- three (43) unduplicated clients at PATCH Place and Hale Amau in Hilo and twenty-four (24) unduplicated clients at Hale Alanoe and Kealahou in Kailua-Kona. 2) Discharged 57% of clients to more independent living in the community. All clients showed improvement in daily living skills. 3) Provided a total of 8,392 bed days and 16,784 meals in our transitional residential programs during FY 2006. 4) In February 2006, opened Hale Amau, a five (5) bedroom home in the upper Kaumana area of Hilo, allowing for expansion of the number of beds available in Hilo for transitional services from twelve (12) to eighteen (18). Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual* FY 2006-07 Budget* FY 2007-08 Estimate Number of unduplicated consumers served 67 75 85 Percentage of consumers served who were discharged to more independent living settings 57% 65% 70% Number of consumers served requiring hospitalization 7 4 3 Percentage of consumer satisfied with services 97% 95% 95% *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Mental Health Kokua Residential Rehabilitation Services Program Expenditures: * If applicable #Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 552,623 619,847 638,442 Professional Fees 18,072 20,000 20,600 Operations 314,464 323,898 333,615 Equipment 6,729 0 0 Other#: 0 0 0 Total 891,888 963,745 992,657 * If applicable #Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual FY 2006-07 Budget* FY 2007-08 Estimate County of Hawaii 20,000 20,000 25,000 State of Hawaii - Department of Health 665,948 742,305 764,574 United Way 27,500 27,500 30,000 Program Service Fee 103,312 106,207 106,200 CCS Fees 15,662 16,132 16,616 Donation/other 42,737 18,000 18,000 Other: MHK Support 16,729 33,601 32,267 Total 891,888 963,745 992,657 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Mental Health Kokua has demonstrated notable ability and success in obtaining funding from private sources such as trusts and foundations. We have been NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Mental Health Kokua Residential Rehabilitation Services providing services to people with mental illness in Hawaii for over 30 years and have built strong relationships with many foundations and trusts. For example, in 2001 MHK started a capital campaign to raise $1.5 million to purchase properties on the Big Island and in Maui. This objective was achieved in 2003 through support from various foundations, trusts, individual donors, Board member donations, the County of Maui, and Housing and Community Development Corporation of Hawaii (HCDCH). In 2005, funding from the State of Hawaii and the U.S. Department of Housing and Urban Development (HUD) was granted to MHK for the acquisition of Hale Alanoe in Kona and another property in Hilo. We continue to explore ways for the agency to become fully self-sustaining. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Mental Health Kokua Residential Rehabilitation Services I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report may impact the evaluation of your program's or agency's future funding requests. Signature B ird President/Chair dhature of Executive Director I Jai )07 Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Neighborhood Place of Puna - Agency Name Building Caring Communities- Program Name Agency Director: Mary Hyslop Phone No.: 965-5550 Contact Person: Mary Hyslop Phone No.: 965-5550 Mailing Address: PO Box 2020 Pahoa Hawaii 96778 Facility/Site Address: 15-3039 Pahoa Village Rd. Pahoa HI 96778 Fax No.: 965-5109 Email Address: npp2020@hawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Katherine Marachese Aloha Accounting Phone No.: 965-7564 Mailing Address: PO Box 1907 Pahoa HI 96778 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 04-05 05-06 06-07 $0 $ 0 $ 0 Agency Mission Statement: The goal of the Neighborhood Place of Puna is to prevent child abuse and neglect. The vision: "To Nurture, Strengthen and Celebrate'Ohana" The mission: "Empowering families and communities in Puna by building strong foundations through healthy relationships that value each person's uniqueness. "E malama pono kakou". NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Neighborhood Place of Puna - Agency Name Building Caring Communities- Program Name Program Description: Child abuse and neglect is a serious problem in Hawaii. Based on statistics, the incidence of child abuse and neglect has grown despite continuing efforts by both the government and the private sector. In East Hawaii, the two most alarming statistics are the high rate of abuse (34 children per 1000) and the rate of removal of children, which is higher than any other area in the state. In an effort to try to build a strong and safe community, Neighborhood Place of Puna (NPP) proposes to bring to East Hawaii an integrated approach to child abuse prevention using a multi -sectored and multi -disciplinary concept based on the Consuelo CAIPU Model. This model does a number of different things including: 1. Bringing together the key players in the community that provide services to families and children at risk of child abuse and neglect. 2. Introducing integrated systems that address a targeted approach to the prevention of child abuse and neglect. 3. Promoting resource sharing and strengthening capacities of direct service providers. 4. Allowing for the identification of gaps in service delivery. 5. Introducing best practices and program evaluation. This model has been formally documented to help with program replication. The project undertaken by Neighborhood Place of Puna, while holding to the CAIPU model will be reflective of the uniqueness of East Hawaii. Neighborhood Place of Puna will convene service providers and other key stakeholders appropriate for East Hawaii to improve outcomes for families at risk for child abuse in Hawaii through improved service coordination, access and increased public engagement. Just as a strong, positive community produces healthy children, a lack of connection or support has a very real effect on the community and on an individual family's quality of life and ability to cope. Promoting the development of a Caring Community is an important way of preventing child maltreatment. Total Budget and Position Count Total Program Budget $25,000 Total Program Position Count .5 Total Agency Budget $214,000 Total Agency Position Count 3.5 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Program Objectives: 1. Identify, assemble and organize the key players in child abuse prevention. 2. Set up regular coordination and communication mechanisms (monthly meetings, newsletters, minutes, etc.) 3. Assess the extent of child abuse and neglect in East Hawaii through data analysis and key informants. 4. Develop a community plan to address the reduction of child abuse and neglect. Outcomes of the plan would include: (a) Increased public awareness of children's rights and issues (i.e. medical, housing, etc.) (b) Generate resource sharing and exchange among participants (c) Strengthen programs and services for target groups (d) Improve service provider outcomes through improved access to training and utilization of evidence based practices 5. Oversee the implementation of the community's child abuse prevention plan Other outcomes: • Individuals in the community will understand that community involvement can reduce the likeliness of child maltreatment • Individuals in the community are actively involved in activities that can reduce the likeliness of child maltreatment. Program Highlights: Since opening its doors in August 2002, three hundred families at risk for child abuse and neglect have received home based services, advocacy and support. Ninety-nine percent (99%) of families have not been confirmed for child abuse or neglect while in the program. Ninety-five percent (95%) of families have not been confirmed for child abuse or neglect six months after case closure. Neighborhood Place provides community activities to coordinate resources for families and professionals. Some of the activities in 2006 included: "Celebrate Your Family" event, "Sexual Exploitation of Youth" training, "Ready to Learn" school supply distribution, interagency Roundtable meetings, Blue Ribbon Campaign, Information Booths, Calendar of Events for Child Abuse Prevention Month, chairing of East Hawaii Coalition for the Prevention of Child Abuse and Neglect, etc. Additionally Neighborhood Place of Puna provides information and referrals to over 400 callers each year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Neighborhood Place of Puna - Agency Name Building Caring Communities - Program Name Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget * Estimate Assemble key players in child N/A N/A 12 meetings abuse and neglect prevention. 12 Convene the meeting, provide stakeholders minutes, reminders, etc. Assemble social service providers N/A N/A 12 meetings not working directly with families at 30 social risk for child abuse or neglect. service Convene the meeting, provide providers minutes, reminders, etc. Assess resources and gaps in N/A N/A 25 service. participants within project year Assess extent of of abuse and N/A N/A 20 key neglect. informants/5 data collection tools Develop a community plan to N/A N/A 1 written strengthen the community and draft reduce child abuse and neglect. Provide trainings for families and NA NA 2 trainings - professionals to increase 60 knowledge of child abuse and participants neglect dynamics. Provide community activites to NA NA 10 activities disseminate information to families including and professionals about the service resource model and other community fairs, media resources. *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Program Expenditures If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget * Estimate Salaries and Wages 0 0 $21,282 Professional Fees 0 0 0 Operations 0 0 3,606 Equipment 0 0 Other* 0 0 112 Total 0 0 $25,000 SEE BUDGET DETAIL ON ATTACHED SHEET If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Neighborhood Place of Puna Building Caring Communities BUDGET EXPLANATION ITEM COUNTY OTHER TOTAL Salary and Wages $16.75 an hr. x 20 hrs./wk 11,300 6,120 17,420 Taxes 16% Health Insurance 1,808 550 980 524 2,788 1,074 Operations: Mileage 2340 miles x 462 474 936 .40 a mile Rent 505 1,595 2,100 Telecommunications 300 270 570 Other: Office supplies 75 37 112 TOTAL 15,000 10,000 25,000 50v Neighborhood Place of Puna - Agency Name Building Caring Communities - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 FY 2007-08 Budget* Estimate Consuelo Foundation confirmed -0 0 $ 8,500 Blueprint for Chane confirmed 0 0 $ 1,500 County of Hawaii not confirmed 15,000 Total $25,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Plan to reduce child abuse and neglect to be developed within 18 months of convening key providers. Implementation of plan may be ongoing. Funding will be sought through United Way and Hawaii Children's Trust Fund NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Neighborhood Place of Puna - Agency Name Building Caring Communities - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawal'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!`i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature oar President/Chair Signature of cutiv it ctor clh-7--P�' 7 t Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Brandee Menino, Program Administrator Phone No.: 808-935-3050 X 113 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: carolrianCa7aol.com, bcochola(cDrcchawaii.org Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Choo, Osada & Lee, CPAs, Inc. — Auditor Phone Number: (808) 734-1921 Mailing Address: 3536 Harding Ave., Room 605, Honolulu, HI 96816 Amount of Request for County Funds: $20,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $30,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. Program Description: The Office for Social Ministry began a transitional housing program, Beyond Shelter, on June 1, 2006 at 110 Ululani Street, Hilo, HI. Private apartments for eight (8) families are available at Beyond NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter Shelter in the form of six (6) — 2 bedroom units with 2 baths, one (1) — 1 bedroom unit with 1 bath and one (1) — studio with 1 bath. 58 beds will be available at our emergency housing. Families are expected to participate in organized program classes, pay program fees on time, be good neighbors, and commit to seeking employment or explore educational opportunities. This transitional program is based on a seamless continuum of care model as advocated by Department of Housing and Urban Development (HUD). Our target aroug for Beyond Shelter Transitional Housing Program consists of family units with at least one minor child experiencing homelessness, including the unsheltered homeless, those living in emergency and transitional housing programs/shelters. Families must have no record of domestic violence issues for four months or substance use for six months. Our selection criteria also depends on participants possessing personal motivation towards making positive changes in their lives and agreeing to pay program fees on time and follow House Rules. Services available to participants build on extensive linkages to agencies throughout our community as well as the experience and knowledge of our own on-site staff, and consist of: transitional housing; case management, including intake, assessment, and access to services; educational and vocational training; job placement; transportation support; a mentor program; linkages to substance abuse and mental health treatment; assistance with family unification; life skills and financial skills training; culturally appropriate activities; housing placement assistance; and one year of aftercare after placement in permanent housing. Total Budget and Position Count Total Program Budget 3,425,352.00 Total Program Position Count 1ft Total Agency Budget 5,703,283.00 Total Agency Position Count 63ft,25pt Program Objectives: For FY -07-08: 1. Maintain clean and sober housing for 100% of program participants; 2. Provide monthly classes on life skills, continuing education, health, family, and community; 3. Assist in obtaining employment and education placement for 9 participants; 4. Link one-third of participants to community service and/or community activities; 5. Provide advocacy as needed for a minimum of one-third of participants. Program Highlights for FY 05-06: 1. OSM assumed of the Beyond Shelter transitional housing s in July 2006 at 110 Ululani Street, providing housing for up to eight (8) families. 2. 35 homeless individuals making up six families entered our transitional housing program. 3. Renovated (repainted interior, renovated bedroom walls, renovated bathrooms and replaced shower stalls, buffed floors) and furnished (including three new Energy Saver refrigerators) 7 apartments. 4. Established on-going, regular on-site classes and resident meetings 5. Extensive exterior renovations including repairing and painting roof, painting the exterior of units NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter 6. Eliminated some of the pest problems with feral cats by cleaning area in front of units and removing trash cans from front of units 7. Rented dumpster to be located on property to cut down on trash building up in front of units 8. Purchased and built playground equipment for children residing at shelter program 9. Provided safe play area for children by fencing off a portion of the parking lot for children 10. Registered 30 individuals (10 adults, 20 children) with the YWCA and provided swimming passes for 5 families 11. Decreased altercations with neighbors and possible criminal activity by evicting non- compliant families from program Performance Measures: *If applicable Program Expenditures FY 2005- FY 2006-07 FY 2007-08 Salaries and Wages 06Actual * Budget* Estimate Number of persons placed in emergency or - 35 44 transitional housing 85,127 93,844 Number of persons placed in permanent housing - 3 3 Number of persons placed into drug treatment or - 2 2 alcohol treatment 118,800 138,780 Number of persons who retained employment for - 9 9 a minimum of six months Number of persons who participated in long-term - 35 35 case management services Number of persons accessing mental health - 10 10 services *If applicable Program Expenditures * If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual* FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 33,673 44,936 Professional Fees Operations 85,127 93,844 Equipment Other(rent/deposit subsidies)# Total 118,800 138,780 * If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual FY 2006-07Budget * FY 2007-08 Estimate County of Hawaii 20,000 HPHA — Beyond Shelter - 60,000 61,800 HIUW 7,000 Program Fees 1,788 58,800 49,980 Total 1,788 118,800 138,780 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? OSM's Beyond Shelter Transitional Housing program has received extensive support from State and County agencies such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); the Hawaii Island United Way; the Hawaii Community Foundation (HCF); and the County of Hawaii (CoH). We are pursuing additional grant opportunities with the Hawaii Community Foundation and the Kellogg Foundation. Program fees generated from the transitional housing program provides an additional revenue stream for operational costs once the units are fully occupied. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Howai'! Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Howai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Sire of oard �rresidenl/Chair Signature of Executive 16tor I/00(01 Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Brandee Menino, Program Administrator Phone No.: 808-935-3050 X 113 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: carolrign(d)aol.com. bcacholaercchowaii.ora Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Choo, Osada & Lee, CPAs, Inc. — Auditor Phone Number: (808) 734-1921 Mailing Address: 3536 Harding Ave., Room 605, Honolulu, HI 96816 Amount of Request for County Funds: $35,000 Prior Year(s) Funding: 05-06 06-07 07-08 $30,000 $30,000 $35,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. Program Description: Care -A -Van (CAV) is a mobile, homeless outreach program serving the unsheltered homeless of Hawaii County; it is the only such program on the island. Operating since 1991, CAV has engaged NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach with over 15,000 homeless individuals. The ultimate goal of CAV is to help the unsheltered homeless progress towards healthier, more stable living conditions and ultimately move out of homelessness, and into permanent housing. We believe that in order to achieve this goal, we must establish a trusting relationship and rapport with each individual so that they are more receptive to addressing internal barriers. Outreach and engagement takes unique people to deal with multiple complex factors at persons experiencing homelessness face. Our mobility allows staff to outreach and engage with the homeless where they are, whether they are on remote beaches, the woods, lava -covered areas (lava tubes) where they live in tents and under tarps, or in town. We currently utilize nine (9) program cars, with seven (7) of them having 4 -wheel drive capabilities. We've begun to see an increase of homeless in the town -areas as well as in the outlying rural areas of the island. According to a 2005 Homeless -Point -in -time Count (raw data), homelessness is on a rise. Hawaii County is in a unique situation with larger geographical areas to cover compared to other Counties in Hawaii. Rental costs are still out of reach for most households living on fixed incomes. Without their rent being supplemented in some government form, housing options for most are slim. Care -A -Van also facilitates empowerment groups as a creative avenue to engage the chronic homeless to participate in activities in a safe, healthy, and clean environment. These activities encourage and promote participation in meaningful activities on a regular basis; involves consumers in groups to enhance self-confidence and stimulate appropriate interpersonal interaction; facilitate an open dialogue about establishing and maintaining relationships/intimacy; provide and promote opportunities to practice using their social skills; share information about systems and community resources; and promote awareness of resources available in our community. The "Friendly Place," a drop-in day center for homeless services opened in the summer of 2006 in Kailua-Kona, on the west coast of Hawaii. This drop-in center will operate between 6am to 6pm daily. OSM works closely with the County of Hawaii's Office of Housing and Community Development to create this center. Stanford Carr, a major developer in Hawaii, has donated the building to the County, with a layout similar to a modest 3-bedroom/2-bath HPM kit home with modifications. This facility houses lockers, showers, bathrooms, mailing services, meeting/interview rooms and other supportive services such as community bulletin boards, employment opportunity boards, feeding programs and specialized services coordinated with existing resources in the community. We are engaging with the community to bring their services to the "Friendly Place" for the homeless to receive all in a single location. This year, CAV also added a specialized outreach position, a "Benefits Specialist" to help individuals experiencing homelessness apply for social security benefits. The State Interagency Council on Homelessness was awarded a federal grant for technical assistance in implanting this initiative. Despite the benefits to individuals and communities, many homeless adults, particularly those who are chronically homeless and have mental illnesses or other disabilities, do not receive SSA disability benefits. Estimates are that two-thirds of people who are chronically homeless have one or more serious health or behavioral health problems. Many likely would be eligible for SSA benefits; however, only 11 percent of the homeless population is estimated to receive SSI. The work does not stop here. Promising Practices indicate that Case Managers need to focus on initial applications, become an applicant's representative, avoid the need for consultative examinations work closely with NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach health care providers, reach out to medical records departments, establish ongoing communication with SSA and DDS and create a comprehensive summary report to illustrate the story of each disabled applicant. Consultative examinations only provide a "snap shot" of the individual, especially if they are performed by someone other than the consumer's physician. Thus the "Benefits Specialist" will be charged with focusing on the initial SSA application. Total Budget and Position Count Total Program Budget 3,425,352.00 Total Program Position Count 28h, 2pt Total Agency Budget 5,703,283.00 Total Agency Position Count 6311,25pt Program Objectives: For FY -07-08: 1. Residential Stability: -- 80% of program participants to remain in housing for at least 6 months; 80% of program participants to remain in housing for at least one year; and 75% of program participants to maintain their housing for at least two years. 2. Increased Skills/Income: -- Of those who reported no income, 80% of program participants to be referred to mainstream programs (DHS, TANF, SSA, Veteran benefits, etc.) for which they are eligible -- 50% of program participants to enroll in some type of higher/further educational opportunity including college courses, continuing education classes, vocational training or job-readiness/employment programs. 3. Self -Determination -- 50% of program participants will engage with case management services by implementing real budget planning, and seeking out community programs for which participants may be eligible. Program Highlights from FY 05-06: 1. Served 1,664 unduplicated homeless persons in Hawaii County, including 422 unduplicated families with children (635 individuals in families); 607 unduplicated single persons; and 1,009 new program participants. 2. Awarded $50,000 in September 2005 through the State's Housing and Community Development Corporation of Hawaii (now the Hawaiian Public Housing Authority) office to assist individuals and families with financial assistance to prevent homelessness, including rental deposits, rent assistance, utility costs, transportation, including major car repair, and temporary shelter. 3. Awarded $91,000 in September 2005 from the Hawaii Community Foundation, Meth Initiative to increase the number of Certified Substance Abuse Counselors (CSAC) in Hawaii County. Offering these scholarships to existing community providers developed an open relationship with scholarship recipients including the Psychiatric Unit staff at the Hilo Medical Center (HMC). NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach 4. 2005 was CAV's second year of implementing the Kukui Program, our local version of the U.S. Department of Housing and Urban Development's (HUD) Supportive Housing Program, Shelter Plus Care. CAV housed forty-eight (48) unsheltered homeless persons into twenty-nine (29) rental units, including thirty-eight (38) adults and ten (10) children. Participants must meet eligibility criteria including homelessness and a disability including severe mental illnesses, chronic substance abuse, dual -diagnoses, HIV/AIDS and developmental disabilities. Kukui participants pay up to 30% of their monthly income towards rent while CAV pays for the remainder of their total rent due to the landlord. 5. Care -A -Van's staff nearly doubled by September 2005 due to an increase of TANF funds (from $178,000 to $500,000) to help TANF-eligible families' transition from the streets/shelter to permanent supportive housing. This assistance allowed us to financially assist families with their rental deposits, rental costs, and utility deposits. Performance Measures: *If applicable Program Expenditures FY 2005- FY 2006-07 FY 2007-08 Salaries and Wages 06Actual * Budget* Estimate Number of persons placed in emergency or 86 125 125 transitional housing 727,428.78 858,428.00 780,233.00 Number of persons placed in permanent housing 235 300 300 Number of persons placed into drug treatment or 38 55 55 alcohol treatment 1,519,951.85 2,142,832.00 2,142,152.00 Number of persons provided or referred for 3,972 1,590 1,590 medical or dental services (duplicated) Number of persons who participated in long-term 1,492 800 800 case management services Number of persons accessing mental health 437 600 600 services *If applicable Program Expenditures * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 792,523.07 1,284,404.00 1,361,919.00 Professional Fees 0 0 0 Operations 727,428.78 858,428.00 780,233.00 Equipment Other(rent/deposit subsidies)4 Total 1,519,951.85 2,142,832.00 2,142,152.00 * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006- 07Budget * FY 2007-08 Estimate Adult Mental Health -Rep Payee 91,440 120,000 136,320 Adult Mental Health -Outreach 192,716.47 275,000 310,000 HPHA — Federal Shelter Plus 102,185.89 125,832 125,832 HPHA — Outreach 426,000 750,000 750,000 HPHA — SHEG 47,500 180,000 1 180,000 HPHA — TANF 342,31 1.54 600,000 600,000 HPHA — non TANF 10,060.88 52,000 - HCF — Federal Meth CSAC Grant 83,067.49 Hawaii Hotel Industry 5,000 County of Hawaii 30,000 30,000 35,000 HIUW 7,500.04 10,000 10,000 Donations 3,240 - - Interest Income 538.29 - Total 1,341,560.60 2,142,832 2,152,152 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? OSM's CAV program has received extensive support from State and County agencies such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); the Department of Health, Adult Mental Health Division (AMHD); the Hawaii Community Foundation (HCF); Hawaii Island United Way; the County of Hawaii (CoH), and the SuperNOFA through the U.S. Department of Housing and Urban Development (HUD), and TANF funding from the Department of Human Services. We are pursuing additional grant opportunities with the Hawaii Community Foundation and the Kellogg Foundation. Finally, CAV receives donations each year from community members, and will begin to solicit additional unrestricted funds through direct mailings and fundraising campaigns. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Roman Catholic Church in the State of Hawaii, _ Office for Social Ministry Care -A -Van Homeless Outreach I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete and accurate year-end report will impact the evaluation of your program's or agency future funding requests. Signature of Boa rCCCCCC!!!!!!/President/Chair Signature of Executive IIM0(01 Date Dalle UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Hawaii Island Food Bank (a Not for Profit Organization and a subsidiary of the Diocesan Offices of the Roman Catholic Church in the State of Hawaii) Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: 140 B. Holomua Street, Hilo, HI 96720 79-1016 Honalo Street, Kealakekua, Hi 96750 Fax No.: (808) 935-3794 Email Address: carolrign(Waol.com or cignacio@rcchawaii.org Name of Accountant: Nancy Lee, MBA Phone Number: (808) 935-3050 Mailing Address: 140 B Holomua Street, Hilo, HI 96720 Name of CPA: Independent Audit Firm: Ann Fukuhara, CPA Phone Number: 808-961-5532 Mailing Address: 714 Kanoelehua Ave., Hilo, Hawaii 96720 Amount of Request for County Funds: $40,000 Prior Year(s) Funding: 04-05 05-06 06-07 $32,500 $32,500 $35,000 NONPROFIT GRANT APLICATION FISCAL YEAR 2007-08 Page 1 Hawaii Island Food Bank (a Not for Profit Organization and a subsidiary of the Diocesan Offices of the Roman Catholic Church in the State of Hawaii) Agency Mission Statement: The mission of Hawaii Island Food Bank (hereinafter "HIFB) is to feed the hungry in Hawaii County while attending to the root causes of this critical social problem. Hawaii Island Food Bank will accomplish its mission by 1) preventing the waste of all edible food in Hawaii County 2) feeding the hungry with this food, 3) educating the community about local hunger and what can be done to solve this social problem; and 4) collaborating with organizations of partnering missions to eradicate the root of hunger and other social ills: poverty. Program Description: The Hawaii Island Food Bank is a clearinghouse for food and non-food items that retailers, wholesalers, and farmers would normally discard, and for food donated by the community through food drives. Reasons for discarding food include food surplus, discontinued products, near pull -date products, damaged labeling, off -grade produce, etc. HIFB also receives food from the Hawaii Foodbank on Oahu for a small fee and shipping costs. USDA foods are now being shipped directly to HIFB for distribution as well. On a daily basis, HIFB staff members drive to donor sites to receive these items. All goods are delivered to warehouses, one in East Hawaii and one in West Hawaii, where HIFB staff and volunteers will weigh the incoming poundage and salvage usable products. Once items are salvaged, they are stocked on warehouse shelves for distribution to nonprofit member agencies. This past year, over 1.7 million pounds of food were distributed via the HIFB network of approved nonprofit member agencies. 106 nonprofits are involved in the HIFB member agency network, and sere approximately 3,000 individuals each month, unduplicated. Requests for food amount to 12,000 to 14,000 per month. These agencies distribute goods directly to the public either by serving meals, providing food boxes, or providing snacks to adults and children in daycare. The largest segment of these agencies provides emergency food pantries to the hungry in their respective communities. Agencies also include those that serve hot meals, child and adult daycare programs, programs that sere the chronically ill, homeless and abuse shelters and substance abuse recovery programs. Additionally, the HIFB operates its own Senior Brown Bag Program that provides items for low-income seniors at nine sites on a weekly basis. Equally important to the HIFB is its educational component. Throughout the year the HIFB participates in community forums and gives presentations to civic groups, schools, businesses and other interested parties about hunger on the island and steps we all can take to help make a difference in the life of a hungry person for family. General information brochures and statistics are distributed at the forums and presentations. The HIFB currently has a FTE. staff of 6 and 2 part-timers. Staff members include two warehouse/drivers in Kona, two warehouse/drivers in Hilo, and 1 part-time warehouse helper in both Hilo and Kona along with 1 FTE. Program assistant and 1 FTE. Accountant. The executive director oversees the food bank and does not receive compensation from the program. A pro- rated amount is charged each of OSM's programs for other supportive services, i.e. receptionist. NONPROFIT GRANT APLICATION FISCAL YEAR 2007-08 Page 2 Hawaii Island Food Bank (a Not for Profit Organization and a subsidiary of the Diocesan Offices of the Roman Catholic Church in the State of Hawaii) Total Budget and Position Count Total Program Budget $976,345.00 Total Program Position Count 9 FT-3PT Total Aen Budget $5,740,743.00 Total Agency Position Count 63FT-25PT Program Objectives for FY07-08: Expand Food Supply and Distribution: • Increase core food distribution by 10% from 1.7 million pounds in FY 06 to 1.87 million pounds of food. • Decrease the number of pounds of waste from food collected. • Facilitate the development of two new food pantries which is currently in negotiation: Sacred Heart Catholic Church in Pahoa (Puna area) and St. Jude Episcopal ChUrch in Oceanview. • Apply for a minimum of $350,000 grant for Senior Fresh Produce Program that would run for approximately for 22 weeks, providing a minimum of 1850 low income seniors with weekly locally grown, fresh fruits and vegetables. • Implement "Pantry Express" produce and perishables distribution in 5 locations. 2. Support Member Agency Development by assisting in building capacity where needed (including equipment, logistics, fund development and management): • Coordinate 3 workshops on each side of the island for member agencies with the goal of having member agencies optimize their resources and meet the Basic Agreement standards for: a) Optimal use of Food Bank's product offerings, etc. b) food safety , storage and handling of food c) quality of service to consumers and accountability d) promotion of the food stamp program 3. Strengthen and Manage Food Bank's Organizational Capacity; Grow and maintain the Hawaii Island Food Bank's organizational, human resource and financial capacity to develop and sustain Food Bank programs to achieve strategic objectives and five- year goals in furtherance of the mission of feeding the hungry on the Big Island: Complete transition of Hawaii Island Food Bank (currently program of Catholic Diocese) to separate 501c.3 with local board of directors. Implement Major Giving Opportunities, raising $400,000 annually by increasing contributions from individual and corporate major donors. Create a baseline index and measurement of the Food Bank's internal organizational performance including indicators such as: o Staff development/training hours o Cost/benefit and efficiency measures o Board activity/participation and governance NONPROFIT GRANT APLICATION FISCAL YEAR 2007-08 Page 3 Hawaii Island Food Bank (a Not for Profit Organization and a subsidiary of the Diocesan Offices of the Roman Catholic Church in the State of Hawaii) Program Highlights for FY 05-06: (1) Expanding and developing the supply of more nutritious foods and distribution efforts: • Hawaii Island Food Bank (HIFB) distributed 1.7 million pounds of via our 106 member agencies valued at $2,550,000 (based on $1.50 per pound used by America's Second Harvest for IRS purposes). • HIFB served 27,650 (unduplicated) individuals or 16,000+ households through the network of member agencies with the food collected and distributed. • HIFB responded to an average of 12,000 requests for food per month from the public through the network of member agencies. • HIFB secured 50% more USDA product (nutritious food) and made this food available for distribution to needy people in the community with no charge. ' • HIFB delivered 190,304 pounds of food to the Oceanview community for distribution through a network of volunteers since there is no established food pantry in the area. Approximately 300 people receive food weekly through these efforts. • HIFB was awarded a $5,000 West Hawaii Fund grant to help defray the costs of delivering the food to the Oceanview community. • HIFB secured three new food donors this fiscal year expanding the supply of food coming into the food bank. • HIFB distributed 78,608 pounds of food to low income seniors in housing projects through our Senior Brown Bag Program during this fiscal year. We expect to expand the number of housing projects we serve by 20% in FY 2006-2007. • HIFB began receiving USDA product directly and not through the Hawaii Foodbank on Oahu. This allows us to receive more food and secure the Administrative fees which were being paid to the Hawaii Food bank for storage, etc. • HIFB serves as a storage site for HCEOC's USDA products which are distributed quarterly in the community. • HIFB continued to do our part for the environment by salvaging over 2.1 million pounds of food which would otherwise have gone to the county dumpsites. The salvaged food that was not optimum for human consumption was used by pig farmers both in Hilo and Kona who pick up these products a bi-weekly (or more often if necessary). • HIFB distributed 190,000 pounds of locally grown, grade A produce to 1700 low income seniors through the USDA sponsored Senior Fresh Produce Grant program. This initiative is in partnership with the Hawaii County Office of Aging, Nutrition Program and County Coordinated Services for Seniors. (2) Strengthening the movement to end hunger (education) on the Big Island (benefits the public) through the following activities: • HIFB made 12 presentations at schools regarding hunger and poverty on the Big Island. • HIFB hosted 5 schools at the warehouses with tours of the facility and mini -educational sessions regarding hunger and how the food bank operates. NONPROFIT GRANT APLICATION FISCAL YEAR 2007-08 Page 4 Hawaii Island Food Bank (a Not for Profit Organization and a subsidiary of the Diocesan Offices of the Roman Catholic Church in the State of Hawaii) • HIFB published two press releases were in the local newspapers regarding Hunger Awareness Day on June 3. • HIFB made 4 presentations to businesses in the community regarding hunger and related issues. • HIFB solicited and was awarded a grant from USDA to provide 1800 low income seniors on the Big Island with fresh locally grown, grade A fruits and vegetables weekly for a period of 15 weeks. The total grant amount is $253,412. The program runs from August 7 to November 17, 2006. The awareness that low income seniors do not have access to fresh fruits and vegetables due to their low incomes continues to be heightened through this program. • HIFB had two major community food drives - Spring and Fall - The community raises the food and money which confirms the awareness that there are hungry people in the community. Awareness is the first step to ending hunger. • HIFB received over 32,000 pounds of food from the National Letter carriers Food Drive in May 2006. (3) Creating/Developing the best efficiency and effectiveness for HIFB's delivery of services to the Big Island community including but not limited to governance, operations and fund development: • Infrastructure Assessment and Feasibility Study was completed by Solid Concepts, Inc. in February 2006 providing HIFB with critical information for strategic planning efforts. • Case for Support Document was completed on July 24, 2006. • Strategic Planning Document was completed in August 2006. • Creation of a separate community based 501 c.3 not for profit with locally based board of directors (in process). • Founding Board of Directors for the new not-for-profit entity has been established with key community members. The Board meets monthly. Performance Measures: FY 2005-06 FY 2006-07 FY 2007-08 Actual " Budget * Estimate 1. Increase core food distribution to 1.7 million 1.87 million hungry and food insecure individuals pounds Pounds and families in county by 10%. 2. Increase the number of low-income 1500 seniors 1750 seniors 1850 seniors seniors receiving fresh produce through USDA Fresh Produce program. 3. Implement "Pantry Express"produce 5 low income & perishables distribution to 5 locations housing sites providing produce and perishables to low-income households (minimizing waste) 4. Decrease "pig waste" by 30% - 30% (average 30% or 250,000pounds) 75,000 pounds NONPROFIT GRANT APLICATION FISCAL YEAR 2007-08 Page 5 Hawaii Island Food Bank (a Not for Profit Organization and a subsidiary of the Diocesan Offices of the Roman Catholic Church in the State of Hawaii) 4. Coordinate a minimum of 3 capacity FY 2005-06 Actual * FY 2006-07 Budget * 3 workshops building workshops for emergency food 240,620.47 244,666.00 45 pantry reps. pantry member agencies with 70% 415,336.06 453,850.00 attending attendance 15,849.00 14,490.00 14,490.00 5. Complete transition of organization 2,191,703.59 2,550,000.00 12/31/07 (HIFB) to separate 501c.3 with local 2,847,660.12 3,248,516.00 3,676,345.00 Board of Directors increasing 23,050.00 65,000.00 27,100.00 effectiveness and efficiency of 257,554.09 260,000.00 100,000.00 organization 65,841.31 Program Expenditures *Please explain in detail on separate sheet Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 240,620.47 244,666.00 409,715.00 Operations 415,336.06 453,850.00 566,630.00 Equipment 15,849.00 14,490.00 14,490.00 Other* donated food 2,191,703.59 2,550,000.00 2,700,000.00 Total 2,847,660.12 3,248,516.00 3,676,345.00 *Please explain in detail on separate sheet Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate County of Hawaii 32,500.00 35,000.00 40,000.00 Senior Produce Program 18,060 250,000.00 State of Hawaii via Hawaii Foodbank 15,849.00 14,490.00 14,490.00 TEFAP 2,030.00 Hawaii Island United Way 13,000.00 15,000.00 12,000.00 Various Small Grants 23,050.00 65,000.00 27,100.00 Fundraising Events 257,554.09 260,000.00 100,000.00 CDBG 65,841.31 Donations 118,657.58 184,576.00 401,715.00 Program Service Fees 112,463.92 115,100.00 121,200.00 Interest Income 1,263.54 1,250.00 1,000.00 Gain on sales of assets 4,000.00 Patriot's Dinner 5,000.00 5,000.00 5,000.00 Return, Inc. 2,813.37 3,000.00 3,000.00 Miscellaneous 218.47 100.00 840.00 Donated Food value 2,138,000.00 2,550,000.00 2,700,000.00 Total 1 2,810,301.28 3,248,516.00 13,676,345.00 NONPROFIT GRANT APLICATION FISCAL YEAR 2007-08 Page 6 Hawaii Island Food Bank (a Not for Profit Organization and a subsidiary of the Diocesan Offices of the Roman Catholic Church in the State of Hawaii) Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Hawaii Island Food Bank is in the process of becoming a separate 501c.3 organization. This will provide access to more resources (financial) than it is currently as a program of the Roman Catholic Church. The reason for this is many trusts and foundations will give a not-for- profit one grant per year. Competing with other RCC programs minimizes the ability to apply for certain kinds of funding. An example of this is the Harry and Jeanette Weinberg Foundation. They provided an endowment to RCC some years ago. The HIFB has not been able to apply for funding from this foundation. HIFB has never launched a major gift campaign but instead focused on events which ars labor and resource intensive and unpredictable. It is our goal to have on-going major gifts as well as direct mail solicitations as the mainstay of our fundraising efforts. Foodbanking, unlike other programs that are contracted services by government, will always need support from both the public and private sectors. It is our hope that the County of Hawaii will support this work as it has done in the past and into the future. Food is basic to life. The Hawaii Island Food Bank is the safety-netto our struggling Ohana in our county. NONPROFIT GRANT APLICATION FISCAL YEAR 2007-08 Page 7 Roman Catholic Church in the State of Hawaii Office for Social Ministry, Hawaii Island Food Bank I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an accurate year-end report will impact the evaluation of your program's or agency's future funding requests. �ignature of BoarenUChair �9vo�ol Date 1 L3010-7 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 Email Address: carolrign(a-)aol.com. bcachola(a)rcchowaii.org Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Choo, Osada & Lee, CPAs, Inc. — Auditor Phone Number: (808) 734-1921 Mailing Address: 3536 Harding Ave., Room 605, Honolulu, HI 96816 Amount of Request for County Funds: Prior Year(s) Funding: $30,000 05-06 06-07 07-08 $0 $20,000 $35,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. Program Description: ON January 1, 2007, OSM assumed fiscal and operational responsibilities for the Kihei Pua Emergency Shelter, previously operated by the East Hawaii Coalition for the Homeless, which NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Brandee Menino, Program Administrator Phone No.: 808-935-3050 X 113 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: carolrign(a-)aol.com. bcachola(a)rcchowaii.org Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Choo, Osada & Lee, CPAs, Inc. — Auditor Phone Number: (808) 734-1921 Mailing Address: 3536 Harding Ave., Room 605, Honolulu, HI 96816 Amount of Request for County Funds: Prior Year(s) Funding: $30,000 05-06 06-07 07-08 $0 $20,000 $35,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. Program Description: ON January 1, 2007, OSM assumed fiscal and operational responsibilities for the Kihei Pua Emergency Shelter, previously operated by the East Hawaii Coalition for the Homeless, which NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter provides emergency housing for up to 58 individuals for 90 days. This program is a vital components of our organization's ability to provide a systematic and seamless continuum of care to our consumers, to better assist them in obtaining and retaining permanent housing and maintaining long-term economic independence and self-sufficiency. Our target aroup for the Kihei Pua Emergency Shelter consists of individuals and families who are experiencing homelessness, including the unsheltered homeless, those living in emergency and transitional housing programs/shelters, and those at -risk of homelessness. Additionally, preference is given to families, with space provided for individuals as available. Services available to participants build on extensive linkages to agencies throughout our community as well as the experience and knowledge of our own on-site staff, and consist of: transitional housing; case management, including intake, assessment, and access to services; educational and vocational training; job placement; transportation support; a mentor program; linkages to substance abuse and mental health treatment; assistance with family unification; life skills and financial skills training; culturally appropriate activities; housing placement assistance; and one year of aftercare after placement in transitional or permanent housing. Total Budget and Position Count Total Program Budget 3,425,352.00 Total Program Position Count 5ft,3pt Total Agency Budget 5,703,283.00 Total Agency Position Count 6149L Program Program Objectives: For FY -07-08: 1. Provide 610 program participants with emergency housing and case management; 2. Maintain clean and sober housing for 100% of program participants; 3. Assist 55% of program participants in obtaining transitional or permanent housing; 4. Assist in obtaining employment and education placement for 90 participants; 5. Assist with increased mental health and substance use treatment for 150 participants. Program Highlights thus for in 06-07: Program Highlights for FY 05-06: 1. OSM assumed administration of the Kihei Pua Emergency Shelter in January 2007 at 110 Ululani Street, providing emergency housing for 58 individuals for up to 90 days. 2. Hired three (3) full-time and two (2) part-time employees to provide case management, life skills training, and supervision to program participants. We are currently interviewing to fill the remaining positions. 3. We have partnered with Hale Nani Work Furlough for free labor, along with program participants from Ponahawai Ola, to paint the interior of our administrative building and refinish the flooring. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter 4. We are working with the Mayor's Office for renovation funds totaling $67,000 in materials; we also have commitments from the Hawaii Public Housing Authority for Emergency Shelter Grant monies totaling $50,000, and stipend monies totaling $170,000. Performance Measures: *If applicable Program Expenditures FY 2005- FY 2006-07 FY 2007-08 Salaries and Wages 06Actual * Budget * Estimate Number of persons placed in emergency or - 650 650 transitional housing - 247,104.00 137,777.00 Number of persons placed in permanent housing - 300 300 Number of persons placed into drug treatment or - 100 100 alcohol treatment 346,167.00 467,000.00 Number of persons obtained employment - 50 50 Number of persons who participated in long-term - 610 610 case management services Number of persons accessing mental health - 50 50 services *If applicable Program Expenditures * If applicable u Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages - 99,063.00 329,223.00 Professional Fees 0 0 0 Operations - 247,104.00 137,777.00 Equipment 0 8,500 Other(rent/deposit subsidies)# 0 208,766 Total 346,167.00 467,000.00 * If applicable u Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 FY 2006- Actual * 07Budget * FY 2007-08 Estimate ESG 50,100 50,000 County of Hawaii 20,000 35,000 Mayor 67,000 H I U W 9,917 14,000 Program Fees 29,150 68,000 HPHA Emergency Shelter 170,000 275,000 Other Grants & Foundations 25,000 Total 346,1671 467,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? OSM's Kihei Pua Emergency Shelter has received extensive support from State and County agencies such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); and the County of Hawaii (CoH)). Additionally, we are applying for annual support from the Hawaii Island United Way. We are pursuing additional grant opportunities with the Kellogg Foundation, Hawaii Community Foundation and the Office of Hawaiian Affairs. Program fees generated from our emergency shelter provide an additional revenue stream for operational costs once we are operating at full capacity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Howai'!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signotur�President/Chair Signature of Executive I/910-7 Date //3 a 01 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Office for Social Ministry Mobile Care Health Project Agency Director: Carol R. Ignacio, Executive Director Phone No.: (808) 935-3050, x105 Contact Person: Kaye Lundburg, Program Director Phone No.: (808) 987-8904 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: Carolrign@aol.com, mikela@aloha.net Name of Accountant/CPA Phone Number: Mailing Address: Amount of Request for County funds: $25,000 Prior Year Funding: 04_05 05-06 06-07 $20,000 $20,000 $20,000 Agency Mission Statement: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. Program Description: Funds are being requested for continuing support of the Mobile Care Health Project (hereinafter MCHP). The MCHP is a joint partnership between the Office for Social Ministry (hereinafter OSM), St. Francis Community Health Services and the community of the Big Island. The project provides primary dental care in the rural areas of West and North Hawaii and in Kona and Honokaa. Services are delivered to the low-income uninsured and underinsured people through two (2) Winnebago vans that are fully equipped for dental services. Each of the two Winnebago vans is a self-contained, fully equipped dental office including digital x-ray units and secure web -based Electronic Medical Record Systems. Additional services include oral health education in schools and at community health fairs and oral health assessments in long-term care facilities. The project partners with many different agencies to achieve the goals and objectives of meeting the dental needs of the Big Island rural poor. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Office for Social Ministry Mobile Care Health Project Currently, the MCHP has established outreach sites at the following five (5) locations: West Hawaii: Ocean View, Honaunau, Kailua-Kona North Hawaii: Honoka'a, Kapa'au With the opening of the Keaau Family Health Center Dental Clinic in March 2003, the Mobile Care Health Project suspended services in East Hawaii. The Keaau Family Health Center Dental Clinic is now established and providing dental services for the target underserved population in East Hawaii. Mobile Care continues to advocate for the target population and provides dental services for East Hawaii patients at scheduled clinic sites. The Mobile Care Health Project focuses its efforts in North Hawaii and West Hawaii providing direct services in scheduled clinics and working collaboratively with Hawaii Healthcare Systems Corporation (HHSC) and community health centers to expand dental services. Under a Memorandum of Agreement between the Hamakua Health Center and the Mobile Care Health Project dental services are provided to the underserved population in Hamakua and North Hawaii in clinics 2 days each week. Mobile Care provides dental services at sites in Kailua, Honaunau, OceanView 3 days per week. West Hawaii Community Health Center (WHCHC) opened in Kona in January 2005 with medical services. Federal funding for the WHCHC was secured in May 2005. MobilevCare and the WHCHC have an informal agreement that includes cross - referrals.. A contract between Hawaii Hospital Systems Corporation (HHSC) and St. Francis Community Health Services enables Mobile Care to provide dental assessments for the long-term care patients in Honokaa, Kapa'au and Pahala. Total Budget and Position Count Total Program Bud et $535,002.00 Total Program Position Count 4ft-5pt Total Agency Budget $5,740,743.00 Total Agency Position Count 63ft-25pt Program Objectives - FY 2007-08 MobilewCare seeks to continue to meet the project's two -fold goals: • To provide direct dental services to the low-income uninsured and Medicaid insured population of Hawaii Island. • To advocate for systemic change that will bring long-term solutions, contributing to the continuum of healthcare and access to dental care for the underserved population. The Mobile Care Health Health Project proposes to meet these goals through the following objectives: NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Objective #1: The MCHP will provide direct dental care and health education in at least 1,248 patient visits to people to the underserved population. This is based on a current average of four clinics per week with an average of six patients treated at each clinic for a period of 52 weeks. Objective 02: The MCHP will partner with Hawai'i Health Systems Corporation (HHSC) to provide annual dental assessment to all long-term care patients in HHSC facilities in Honokaa, Kapaau and Pahala. (approximately 100 patients) Objective #3: MCHP will provide dental education and preventive treatment to the community at large. • The MCHP will provide health education, fluoride treatments, and distribute health aids (ex. Toothbrushes, toothpaste, floss) and information about maintaining good oral health in at least 4 community health fairs around the island. Some fairs will be geared toward children; some will be geared specifically to seniors. (Approximately 100 people served a year) • A MobilevCare staff person will provide dental education to students (pre -K -5 t' grade) at private and public schools upon request. (Approximately 200 students a year). Objective # 4 OSM and MobilevCare administration will continue to attend Hawaiian Island and Tri -County Oral Health Task Force monthly meetings to advocate for change in the local healthcare system, trying to secure more State funding and support for the neighbor islands. As an advocate, one of our primary goals has been to work with existing Community Health Centers (CHCS) to help them open their federally mandated dental clinics as our entire island is a federally designated dental Health Professional Shortage Area. Program Highlights — FY 2005-06: 1. Provided 237 clinic days — 20/month avg. in Honokaa, Kapa'au, Kailua, Honaunau, OceanView 2. Served patients in 1575 clinic encounters 0 7 patients/ day avg. 0 52% Acute Care 0 67% - Medicaid o 33% Low-income Uninsured for Dental Services o 4465 Clinic Dental Procedures Palliative, Restorative, Preventive 3. Provided 87 dental assessments in long-term care facilities in Honokaa, Kapa'au, and Pahala. 4. Provided 102 dental assessments and fluoride treatments in Community Health Fairs 5. Served 126 participants in Oral Health Education in local schools and transitional shelters 6. Provided $167,854. Uncompensated Dental Services. 7. Participated as a member of the Hawaii Island Oral Health Task Force and the Tri - County (Hawaii, Maui, Kauai) Oral Health Task Force to address the oral health needs of Hawaii County as stated in the Hawaii Island Oral Health Strategic Plan and to pursue collaborative funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Performance Measures: Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget FY 2007-08 Estimate # of people accessin services 1890 2000 2000 Program Expenditures *Please explain in detail on separate sheet (see page 6) *If applicable Program Funding Sources: Revenue Source FY 2005-06 Actual * FY 2006-07 Budget FY 2007-08 Estimate * Salaries and Wages $ 199,405.49 $205,342.00 $ 281,800.00 Professional Fees $ 108,812.50 $120,000.00 $ 120,000.00 Operations $ 116,940.62 $142,202.00 $ 133,202.00 Equipment $ 90,000.00 Humanitas Foundation $ Other* $ 20,000.00 $ 20 000.00 G. N. Wilcox Grant Total $ 425,158.61 $467,544.00 $ 535,002.00 *Please explain in detail on separate sheet (see page 6) *If applicable Program Funding Sources: Revenue Source FY2005-06 Actual* FY2006-07 Budget* FY2007-08 Estimate County of Hawaii $ 20,000.00 $ 20,000.00 $ 25,000.00 State of Hawaii $ 192 000.00 $200,000.00 $ 200 000.00 OHA Grant $ 2,500.00 $40,000.00 $ 90,000.00 Humanitas Foundation $ 20,000.00 $ 20,000.00 $ 20 000.00 G. N. Wilcox Grant $ 10,000.00 $ 10,000.00 $ 10 000.00 HIUW $ 10,000.00 $ 10,000.00 $ 20,000.00 HMSA $ 50,000.00 $ 50,000.00 $ 50,000.00 Thomas J. Long Foundation $ 20,000.00 $ 10,000.00 $ 10,000.00 Hawaii Hotel Association $ 5,000.00 $ 3,000.00 $ 3,000.00 Bank of Hawaii $ 5,000.00 $ 10,000.00 $ 10,000.00 Misc small grants $ 2,000.00 $ 1,000.00 $ 6,000.00 fees $ 22,439.55 $ 20,000.00 $ 20,000.00 -Program Donations $ 29,254.35 $ 23,544.00 $ 21,002.00 3rd Party Payments $ 66 313.95 $ 50,000.00 $ 50,000.00 Dental fees $ 1,500.00 Miscellaneous $ 71.94 Total $ 456,079.79 $467,544.00 $ 535,002.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Future Program Support The MCHP is a short-term project/solution. As an advocate for the underserved, we will continue to collaborate with local and state government, foundations, service providers and the community to ensure oral health access for the low- income population. The long-term solution for expanded dental access includes stationary dental clinics within the array of services of Federally Qualified Health Centers (FQHC). Bay Clinic (FQHC) opened the first dental clinic on the island of Hawaii in Keaau in 2003). The MCHP currently collaborates with Hamakua Health Center (FQHC) in Honokaa and the West Hawaii Community Health Center (FQHC) in Kona to provide interim dental services. We anticipate these Community Health Centers will be providing dental services in North and West Hawaii by 2010. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Office for Social Ministry Mobile Care Health Project I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. /signature of Board President/Chair OA� Illy - Signature of Exec tive 0 for I 0(01 Date 30 �sl Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawai Ola: Community Re -integration Services Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Brandee Menino, Program Administrator Phone No.: 808-935-3050 X 113 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: carol rign .ciol.com, bcachola(C)rcchawaii.org Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Choo, Osado & Lee, CPAs, Inc. — Auditor Phone Number: (808) 734-1921 Mailing Address: 3536 Harding Ave., Room 605, Honolulu, HI 96816 Amount of Request for County Funds: Prior Year(s) Funding: 05-06 $0 06-07 $0 Agency Mission Statement: $30,000 07-08 $30,000 The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawai Ola: Community Re -integration Services Program Description: The mission of Ponahawai Ola, a "prison -reentry" program, is to reduce barriers for men and women previously incarcerated in Hawaii County. A report published by the Hawaii Island Corrections Advisory Committee in 2003, "E Malama Kekohi I Kekahi/Taking Care of Our Own," advocates a "seamless reintegration program" as the best approach to reducing these barriers. Working from this model, OSM acts collectively with the State's correctional and judiciary agencies to identify offenders at -risk of homelessness for placement in our transitional housing program prior to the offenders' release. Special needs and diagnoses are assessed during the initial application and interview process. Preparatory actions are then made to create an individualized support network for each exited man and woman, including necessary linkages to treatment facilities for those diagnosed with substance use disorders and/or mental illnesses. Private and shared rooms are available for 28 program participants in "downtown" Hilo, Hawaii. In preparing for our pilot year of the "reentry" program, we looked at other successful community- based reentry programs which provide for those needing drug abuse treatment; to name a few, AIDS Housing of Washington, TASC (Treatment Alternatives for Safe Communities), Inc. in Illinois, the Fortune Society in New York City, and, a bit closer to home, the Maui BEST program and the Good Beginnings Alliance SKIP (Supporting Keiki of Incarcerated Parents) program, with which we are partnering to establish a Big Island site. Following their excellent examples, we strive for a diverse number of targeted services to offer at Ponahawai Ola. Services available to program participants are built on extensive linkages to agencies throughout our community as well as the experience and knowledge of our own on-site staff. Services include a safe, clean and supportive environment, transitional housing; case management, referrals to community programs skilled in educational and vocational training; direct job placement; transportation; mentorship services; linkages to substance abuse and mental health treatment; assistance with family unification; life skills and financial skills training; culturally appropriate activities; housing placement assistance; and one year of aftercare after placement in permanent housing. Total Budget and Position Count (need to adjust as per Nancy) Total Program Budget 3,425,352.00 Total Program Position Count 80, 6pt Total Agency Budget 5,703,283.00 Total Agency Position Count 63ft,25pt Program Objectives: For FY -07-08: 1. Maintain clean and sober housing for 100% of program participants; 2. Decrease violations of conditions of supervised release for 65% of program participants; 3. Increase participation in substance use disorder and mental health services for 70% of program participants; A. Assist in obtaining employment and education placement for 65% of participants; 5. Assist with increased child support and general family contact for 70% of participants. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawai Ola: Community Re -integration Services Program Highlights for FY 05-06: 1. Ponahawai Ola opened its doors in August 2006 at 479, 481 and 483 Kinoole Street, providing furnished housing for up to 28 men and women reintegrating back into the County of Hawaii. This property is located across the street from Hilo's Central Fire Station, near Salvation Army and Lincoln Park. The entire facility consists of (20) studios, (2) two-bedroom units, and (2) commercial spaces for office space and storage. 2. 21 offenders entered our transitional housing program. 3. Hired (7) seven full-time and (3) three part-time employees to provide case management, life skills training, and 24/7 supervision to program participants. 4. For its initial year of operation, OSM received $300,000.00 from the State of Hawaii, Hawaii Public Housing Authority, $95,000.00 from the Hawaii Community Foundation, $5,000.00 from the Bank of Hawaii Charitable Foundation and $5,000.00 from the Hawaii Visitor's Industry Charity Walk to initiate and operate program services for Ponahawai Ola participants. 5. Six (6) Drug Court participants placed in transitional supportive housing units. 6. 71 % program participants remained drug-free since entering Ponahawai Ola. 7. Eight (8) program participants have obtained employment since entering our program. Performance Measures: *If applicable Program Expenditures FY 2005- FY 2006-07 FY 2007-08 384,358.00 06Actual * Budget* Estimate Number of persons placed in transitional housing N/A 28 28 Number of persons placed in permanent housing N/A 1 Other(rent deposit Number of persons in employment N/A 28 28 Number of persons placed into drug treatment or N/A 15 15 alcohol treatment Number of persons receiving education/job N/A 28 28 training assistance Number of persons accessing health services N/A 28 28 (nutrition, medical, gerontology, therapeutic massage, aerobic) Number of persons accessing mental health N/A 10 10 services *If applicable Program Expenditures NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 FY 2006-07 Actual * Budget * FY 2007-08 Estimate Salaries and Wages 384,358.00 418,042.00 Professional Fees 0 0 0 Operations - 275,442.00 291,838.00 Equipment Other(rent deposit NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawai Ola: Community Re -integration Services * If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 FY 2007-08 Budget* Estimate subsidies)# HCF — Federal Meth Total 609,880.00 709,880.00 * If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006- 07Budget * FY 2007-08 Estimate HCF — Federal Meth 95,000 HCF — Federal Living Skills 75,000 75,000 County of Hawaii - 30,000 HPHA — Ponahawai Ola 300,000 500,000 HIUW - 20,000 Hawaii Hotel Industry 5,000 5,000 Program Fees 84,800 74,880 Other Grants & Foundations 100,000 5,000 Total 659,800 709,880 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? OSM's Ponahawai Ola program has received extensive support from State agencies and foundations such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); the Hawaii Community Foundation (HCF); and the Bank of Hawaii Charitable Foundation. Additionally, we have received support the Hawaii Visitor Industry Charity Walk. We are pursuing additional grant opportunities with funding sources including the Kellogg Foundation and Hawaii Community Foundation. Program fees generated from this program provide an additional revenue stream for operational costs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawai Ola: Community Re -integration Services I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the programs) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Bo�Presidentt/C kv0vi Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 The Salvation Army Family Intervention Services Independent Living Skills Program- West Hawaii Agency Director: Pauline Pavao Phone No.: 935-4411 Contact Person: Denise Pacheco Phone No.: 959-5855 ext. 14 Mailing Address: P.O. Box 5085 Hilo, HI 96720 Facility/Site Address: 1786 Kinoole St. Hilo, HI 96720 Fax No.: 933-9810 Email Address: pauline_pavao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Name: Carole Nagamine(TSA-FIS)/ Donna Lum (Divisional Director of Finance) Phone: (808) 935-44111(808) 988-2136 Mailing: P.O. Box 5085 Hilo, HI 96720/ P.O. Box 620 Honolulu, HI 96809 Amount of Request for County funds: $ 35,000 Prior Year Funding: 04-05 05-06 06-07 $29,000 $ 32,000 $ 28,000 Agency Mission Statement: To provide youth with skills for a healthy life, and instill purpose, hope, and vision to youth and their families. Our agency's goals are to provide youth with a safe, caring, and nurturing environment; and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: The Salvation Army Family Intervention Services- Independent Living Skills Program helps foster youth ages 12-21 prepare for and manage the transition to productive, self-sufficient NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 adults with a base of independent living skills. The curriculum emphasizes career education and job -skills development, utilizing a school-based skills format (recognized by DOE for elective credits) as a framework for implementing an array of independent living/transition curriculums that can be tailored to fit the respective participants relative to age, level of education and psychosocial developmental levels. The focus of this training is to draw a connection between academic success, job skills and positive social skills development in order to attain a higher quality of life in the high need areas of Health, Housing, and Economic Self -Sufficiency. The curriculum is divided by components or themes that highlight sessions connected to self- sufficiency. In following with the school year, each component represents a month. These components include: *Orientation/Personal Development (Sept) *Educational Success & Planning (Oct) *Social and Community Awareness (Nov) *Vocational/Job Skills Training (Dec) *Post -High Options/Financial Aide (Jan) *Career Exploration & Employment (Feb) *Life Planning & Money Management (Mar) *Self Care & Positive Relationship Bldg (Apr) *Daily Living & Comm. Involvement (May) *Evaluation, Youth Recognition (June) Group sessions are held at Konawaena High School on Mondays, and Kealakehe Intermediate School on Wednesdays. Each youth is required to attend one 2 -hour session per week. Aside from the group activities, we integrate homework, study hall, computer knowledge and extra curricular activities. They include: College Fairs, Job Fairs, Housing Fairs, World of Work Tours sponsored by the Hawaii Community College, University of Hawaii at Hilo, West Hawaii Community College, Hawaii National Park Service, National Energy Laboratory Hawaii Authority, Sheraton Keauhou Beach Resort and Spa and many others. The purpose of homework and extra curricular activities is to foster a connection between what is learned in class and the working world. We also believe that exposing foster youth to post -secondary educational opportunities is vital to their successful transition to adulthood. Total Budget and Position Count Total Program Budget 129,000 Total Program Position Count 2.0 Total Agency Budget 3,541,042 Total Agency Position Count 1 74 Program Objectives: The objective of the program is to accomplish the following for 25 foster youth in West Hawaii each year: ➢ Of the 25 foster youth, ages 12 to 15 participating in the program, 75% will demonstrate increased Independent living skills, as identified in their IL Plan. ➢ Of the 25 foster youth, ages 16 plus participating in the program, 75% will successfully complete their Independent Living Skills Program and attain at least a "fair prognosis" of achieving goals of independence upon exiting the Program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 ➢ Of the youth ages 18 plus, participating in the program, 80% will participate in Higher education, Vocational Training, Employment andfor Military. ➢ 75% of youth will avoid non -marital childbirth, incarceration and homelessness during program participation. Program Highlights: In our 2005-2006 fiscal year, The Independent Living Skills Program in West Hawaii provided over 2000 direct service hours to over forty foster youth, providing case management and outreach services. Below are some of the highlights. ➢ 80% of foster youth, ages 16 plus successfully completed their independent living skills program and attained a "fair prognosis of achieving goals of independence ➢ 100% of youth avoided non marital childbirth, incarceration and homelessness during program ➢ 80% of youth ages 12-15 demonstrated increased independent living skills, as identified in their IL plan. Services were provided to foster youth in West Hawaii, which consisted of North and South Kohala, North and South Kona, and parts of Hawaii Ocean View Estates. 2. The Independent Living Skills Program provided school based classes at Konawaena and Kealakehe High Schools and covered the following components: Personal and Social Development, Budgeting and Money Management, Health and Nutrition, Employment and Career options, self care & Positive Relationship building, and Daily Living Skills & Community Involvement. 3. The program provided several workshops on financial aid, resume writing, meal planning, and housing. 4. The program provided the following excursions: World of Work tour at Hawaii Volcano's National Park, with Kilauea Military Camp, U.S. Geological Service Park Observatory, the Nene Emergency Project Program and the Turtle Hatching program, career fairs, job fairs, and college fairs and visits to local credit unions and banks. 5. We have collaborated with West Hawaii Community College, Konawaena High School, Kealakehe High School, Kealakehe Intermediate School, Work Force Development Division -West Hawaii, and various hotel and businesses in West Hawaii Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget * Estimate Completion of ILSP 25 Participates in IL Activities 25 Participates in IL Plan 25 Follow up and Monitoring 25 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 *If applicable Note: This is the first time proposing county funds for the Independent Living Skills Program. Hence, no numbers are reported for the FY 2004-05 and FY 2005-06. Program Expenditures *Please explain in detail on separate sheet Please note that for the past few years, the County grant has funded the Adolescent Diversion Program. Since Office of Youth Services (OYS) is not funding that program effective September 1, 2007, we humbly ask to be considered for the Independent Living Skills Program. Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 98,016 95,780 103,864 Professional Fees 624 660 0 Operations 40,395 37,385 25,136 Equipment 740 50 0 Other* 0 0 0 Total 139,775 133,875 129,000 *Please explain in detail on separate sheet Please note that for the past few years, the County grant has funded the Adolescent Diversion Program. Since Office of Youth Services (OYS) is not funding that program effective September 1, 2007, we humbly ask to be considered for the Independent Living Skills Program. Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Hawaii County 32,000 28,000 35,000 Office of Youth Service 105,875 105,875 0 Department of Human Services 94,000 Total 137,875 133,875 129,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army -Family Intervention Services is required to seek its own funding for program services. As such, TSA -FIS relies primarily on funding from government at the federal, state and county levels to continue our program services to at -risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs. We do rely heavily on funding from all levels of government. As such, we do not anticipate being self-sufficient in providing Independent Living Skills services to the foster youth residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. ff awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature of Board President/Chair ,Sign ature of Exec tiv Qirector FISCAL YEAR 2007-08 /-03- 07 Date Date The Salvation Army Family Intervention Services Youth Service Center Program-Honokaa Agency Director: Pauline Pavao Phone No.: 935-4411 Contact Person: Raymond Dangaran Phone No.: 935-9777 ext.200 Mailing Address: P.O. Box 5085 Hilo, HI 96720 Facility/Site Address: 21 W. Ohea St. Hilo, HI 96720 Fax No.: 933-9810 Email Address: pauline_pavao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Name: Carole Nagamine(TSA-FIS)/ Donna Lum (Divisional Director of Finance) Phone: (808) 935-4411/ (808) 988-2136 Mailing: P.O. Box 5085 Hilo, HI 967201 P.O. Box 620 Honolulu, HI 96809 Amount of Request for County funds: $ 35,000 Prior Year Funding: 04-05 05-06 06-07 $ 0 $ 0 $28,000 Agency Mission Statement: To provide youth with skills for a healthy life, and instill purpose, hope, and vision to youth and their families. Our agency's goals are to provide youth with a safe, caring, and nurturing environment; and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: The Salvation Army Family Intervention Services -Youth Service Center (TSA-FIS-YSC) Program provides a safe and nurturing environment along with access to opportunities, experiences, and services to support positive youth development. We utilize a prevention approach to decrease the use and abuse of alcohol, tobacco, and other illicit drugs (ICE, ecstacy, and etc.), involvement in gangs and violence, delinquent behaviors, early sexual behaviors, and to improve academic performance and school NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 attendance. This will be accomplished by implementing a Leadership Development Program and Positive Alternative Activities to youth ages 7-18 years old and their families, residing in the Honokaa district. ➢ Leadership Development Program -The L.E.A.D. Team (Learning Experience in Assisting and Directing) provides development of leadership skills and training in areas of personal and social skills, teamwork, decision making, goal setting, and action planning to conduct community service and learning projects. Leadership activities will allow youth to experience leadership, group dynamics and problem solving opportunities such as youth planning committees and youth representative on community collaboration efforts. ➢ Positive Alternative Activities consist of: Recreational, Perform ingNisual Arts and Humanities, Educational, Cultural, and Youth Leadership Activities. Other prevention activities consist of Community Service and Learning Projects, Drug- free dances, and Excursions. These activities will provide yout with opportunities to develop an understanding of self and one's culture and a sense of identity and belonging, and promote the development of competencies (social well-being, knowledge, and social responsibility. All services will be part of the Prevention Programs (Teenage Pregnancy Prevention & Family Strengthening Program and Drug and Violence Prevention Program), currently funded by the Department of Defense and Office of Youth Services respectively. All program services and activities will be conducted at the Salvation Army facility in Honokaa. We propose to implement program services during after-school and occasionally weekend hours. The proposed funding would support and provide for 2 part-time staff (Youth Service Workers) @ 15 hrs per week, with full time hours during school intercessions (summer, winter, spring). Total Budget and Position Count Total Program Budget 173,614 Total Pro ram Position Count 3.5 Total Agency Budget 3,541,042 Total Agency Position Count 74 Program Objectives: 1) Of the 60 youth targeted to participate in the Youth Service Center Program, at least 80% will register for Outreach Services (L. E.A. D. Team, Positive Alternative Activities) and maintain participation with the program to completion or for 6 months beyond the registration date. 2) Of the 60 youth participating in the Youth Service Center activities throughout the year, at least 80% will participate in Positive Alternative Activities (Community Service and Learning Projects, Recreation, Tutoring, and Community Events), demonstrate an increase in competencies (social well-being, knowledge, and social responsibility) for the first 6 months, and continue that gain for an additional 6 months or completion of the program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Program Highlights: 2006-07 1) In the Honokaa Community, we are currently providing a Teenage Prevention and Family Strengthening Program (TPP&FS), funding by the Department of Health and the Department of Defense under the TANF funding. The program includes in -school presentations/group sessions on -campus at Honokaa Intermediate and after school group sessions at the Youth Service Center in Honokaa. We utilize an evidence -based curriculum (Making Choices Program) that consists of skill building activities in personal development, decision-making, sexuality, STD/STI, and other related topics. 2) We also provide Positive Alternative Activities (Recreational, Educational, and Leadership Activities) at the Youth Service Center during after school hours. We have seen an increased interest in our after-school component with youth participating regularly. We discuss any issues they need to talk about, assist with homework and other activities such as gardening, cooking, and learning to DJ. We have also collaborated with Honokaa Parks and Recreation Department to assist with a girl's basketball team. 3) We have implemented an Anger Management class, targeting 18 youth in the Intermediate School. It has been effective in terms of curbing the number of fights on the intermediate campus as stated by the administration. All selected youth referred to the class was either from the school Vice- Principal and/or teachers. Youth have also participated in Community Service Projects such as Halloween and Christmas activities with the Elementary youth. 4) We have established a close relationship with Honokaa High and Intermediate Schools. They continue to give us tremendous support for our program such as, a place to provide our services, additional staff support, and an open invitation and request for services throughout the year. Also, we have participated in the Power of Choice-Hamakua, which is a community entity that provides networking with other service providers and community members, plans and collaborates community events and activities focused on a Healthy and Drug Free Community. Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 FY 2005-06 FY 2006-07 Actual * Budget * FY 2007-08 Estimate Participates in L.E.A.D. Team 45 60 Participates in Pos. Alter. Activities 45 60 Participates in Comm. Srv. Projects 45 60 Follow up and Monitoring 45 60 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Pro ram Ex enditures FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wa es 124,676 135,989 Professional Fees 550 860 Operations 27,774 36,165 Equipment 0 600 Other* 0 0 Total 153,000 173,614 *Please explain in detail on separate sheet Program Funding Sources Revenue Source FY 2005-06 FY 2006-07 Actual * Budget * FY 2007-08 Estimate County of Hawaii 28,000 35,000 Department of Defense* 125,000 125,000 Office of Youth Services** 13,614 Total 1 1 153,0001 173,614 *Teenage Pregnancy Prevention & Family Strengthening Program funded under DOD. **Drug and Violence Prevention Program funded under OYS, effective until Sept. 30, 2007. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army -Family Intervention Services, while part of The Salvation Army, is required to seek its own funding for program services. As such, TSA -FIS relies primarily on funding from government at the federal, state and county levels to continue our prevention and intervention programs to assist at -risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Very limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs. However, in view of the nature of our mission in developing healthy lifestyles for youths and their families, we do rely heavily on funding from all levels of government. As such, we do not anticipate being self-sufficient in providing prevention services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 • w tHonokaa Youth Service Center - Program Name I (we) have read and understood ail of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii' County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that t (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, 1(we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an &fes- P. md� Signature of Board President/Chair Sig`rtAture of Executive Director /-03-07 Date Date ��W&M' 11141711111111111 • a NONPROFIT GRANT APPLICATION FISC_kI, YEAR 2007-08 Page 5 The Salvation Army Family Intervention Services Youth Service Center Program-Pahoa Agency Director: Pauline Pavao Phone No.: 93514411 Contact Person: Raymond Dangaran Phone No.: 935-9777 ext.200 Mailing Address: P.O. Box 5085 Hilo, HI 96720 Facility/Site Address: 21 W. Ohea St. Hilo, HI 96720 Fax No.: 933-9810 Email Address: pauline_pavao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Name: Carole Nagamine(TSA-FIS)/ Donna Lum (Divisional Director of Finance) Phone: (808) 935-4411/ (808) 988-2136 Mailing: P.O. Box 5085 Hilo, HI 96720/ P.O. Box 620 Honolulu, HI 96809 Amount of Request for County funds: $ 35,000 Prior Year Funding: 04-05 $ 35,000 05-06 $ 38,000 06-07 $ 32,000 Agency Mission Statement: To provide youth with skills for a healthy life, and instill purpose, hope, and vision to youth and their families. Our agency's goals are to provide youth with a safe, caring, and nurturing environment; and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: The Salvation Army Family Intervention Services -Youth Service Center (TSA-FIS-YSC) Program provides a safe and nurturing environment along with access to opportunities, experiences, and services to support positive youth development. We utilize a prevention approach to decrease the use and abuse of alcohol, tobacco, and other illicit drugs (ICE, ecstacy, and etc.), involvement in gangs and violence, delinquent behaviors, early sexual behaviors, and to improve academic performance and school NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page I attendance. This will be accomplished by implementing Community -Based Outreach Services and Positive Alternative Activities to youth ages 7-18 years old and their families, residing in the Pahoa district. Outreach services consist of: ➢ Leadership Development Program -The L.E.A.D. Team (Learning Experience in Assisting and Directing) provides development of leadership skills and training in areas of personal and social skills, teamwork, decision making, goal setting, and action planning to conduct community service and learning projects. ➢ TSA -FIS has developed a program called "Project Family" to build relationships between agency, youth, parents, and community. Project Family Activities provide parent support and family strengthening activities to promote family cohesion and positive relationships within diverse family structures. Youth and their families along with agency staff participate in regularly scheduled "Family Days" which are activity -based and fun. The Objectives are to: Reduce potential problem family situations, such as miscommunications, and harmful conflicts; Increase communication between youth and their families; Decrease youth's at - risk behaviors such as involvement with the juvenile justice system, poor school performance, family conflicts, and other problem behaviors; Increase parent's involvement with their child by attending school activities, participating in TSA - FIS sponsored or other activity that requires parent involvement; and Increase family's ability to network with other families and support systems. ➢ Positive Alternative Activities consist of: Recreational, Educational, Cultural, and Youth Leadership Activities. Other prevention activities consist of Community Service and Learning Projects, Drug-free dances, and Excursions. All services will be part of the Youth Service Center Program, currently funded by the Office of Youth Services, funding effective until July 1, 2007. Program services will be provided at Pahoa School Districts and at the Nanawale Community Center. We propose to implement program services during in -school, after-school, and occasionally weekend hours. The proposed funding would support and provide for 0.30 FTE Youth Development Specialist and 1 -Youth Service Worker @ 19 hours per week. Funding from the Teenage Pregnancy Prevention & Family Strengthening Program and Tobacco Prevention Program will help support and establish a 1.00 FTE Youth Development Specialist for Prevention Services in Pahoa. Total Budget and Position Count Total Program Budget 260,000 Total Program Position Count 3.175 Total Agency Budget 3,235,039 Total Agency Position Count 74 Program Objectives: 1) Of the 60 youth targeted to participate in the Youth Service Center Program, at least 80% will register for Outreach Services (L.E.A.D. Team, Project Family, Positive Alternative Activities) and maintain participation with the program to completion or for 6 months beyond the registration date. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 2) Of the 60 youth participating in the Youth Service Center activities throughout the year, at least 80% will participate in Positive Alternative Activities (Community Service and Learning Projects, Recreation, Tutoring, Community Events, and Family Days), demonstrate an increase in competencies (social well-being, knowledge, and social responsibility) for the first 3 months, and continue that gain for an additional 6 months or completion of the program. Program Highlights: FY 2005-06 In -school Presentations: TSA -FIS worked with Mr. Gardner, Mr. Heidelk, and the ALC classes at Pahoa High and Intermediate Schools, providing in -school presentations. The presentations consist of the L.E.A.D. curriculum (skill-buildin%activities, leadership skills, and ATOD issues). The target population ranged from 7 Graders to 12th Graders. There were over 75 youth that completed the in -school L.E.A.D. Team Program. We have established a good relationship with the school personnel, and they have shown interest in continuing our services for the next school year. LEADer's and Little LEADer's Group: Every third and fourth quarters of the year, these groups met to discuss, plan, and organize activities THEY were interested in conducting such as community service projects, drug free dances, and other daily activities. The LEADer's group was from 6-8 grades and the Little LEADer's group was 2-5 grades. Water Awareness Program: Youth participated in a Water Awareness Program that consisted of skills training in First Aid/CPR, water rescue and survival skills, canoe paddling, and recreational activities. We collaborated with Palekana Kai, Hawaii County lifeguards, American Red Cross, and the Kamehameha Canoe Club. Family Days: We invited youth and their families to come down to the Pahoa Pool and just have a day of fun, food, and fellowship. We have also conducted Family days during the Holidays: Halloween, Christmas, and Easter at Nanawale Longhouse. We encouraged family participation and involvement with fun, team building, and family focused activities. Community Collaborations: Referrals to the Youth Service Center were coordinated through the In -School Services at Pahoa Elementary, Intermediate and High Schools, and Keonepoko Elementary. TSA -FIS has also worked cooperatively in coordinating services for youth and families with the following programs: Big Island Substance Abuse Council; Workforce Investment Youth Employment Services; Hawaii County Community Policing Officers; Bay Clinic; Queen Liliuokalani Children's Center; Neighborhood Place of Puna; Weed and Seed Committee; Boys and Girls Club of the Big Island; Alulike Inc; and Nanawale Community Center. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Performance Measures: Proqram Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Completion of L.E.A.D. Team 81 60 60 Participates in Pos. Alter. Activities 90 60 60 Participates in Project Family 68 60 60 Follow up and Monitoring 90 60 60 Proqram Expenditures *Sub -Contracted with Boys and Girls Club -Big Island to provide Positive Alternative Activities at the Pahoa Youth Service Center, effective July 1, 2006, sub -contract was terminated. Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 101,843 140,516 160,371 Professional Fees 4,806 1,000 0 Operations 56,684 65,384 99,629 Equipment 84 100 0 Other* 50,000* 0 0 Total 1 213,417 207,0001 260,000 *Sub -Contracted with Boys and Girls Club -Big Island to provide Positive Alternative Activities at the Pahoa Youth Service Center, effective July 1, 2006, sub -contract was terminated. Program Funding Sources Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County of Hawaii 38,000 32,000 35,000 Office Of Youth Services* 175,000 175,000 0 Dept. of Human Services** 125,000 Hawaii Community Foundation*** 100,000 Total 1 213,0001 207,0001 260,000 *Youth Service Center Programs for Pahoa, funding ending June 30, 2007. **Teenage Pregnancy Prevention & Family Strengthening program, funded in Dec. 2006. ***Tobacco Prevention Program in Pahoa recently funded January 2007. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army -Family Intervention Services, while part of The Salvation Army, is required to seek its own funding for program services. As such, TSA -FIS relies primarily on funding from government at the federal, state and county levels to continue our prevention and intervention programs to assist at -risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Very limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs. However, in view of the nature of our mission in developing healthy lifestyles for youths and their families, we do rely heavily on funding from all levels of government. As such, we do not anticipate being self-sufficient in providing prevention services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Pahoa Youth Program -.. I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawai't County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including ail supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. M, Signature of Board President/Chair Signature of Executive Director Date 1-:3--11-r.% Date NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Pao.- 5 Special Olympics Hawaii- Agency Name COPY Special Olympics Hawaii -East Hawaii- Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Nancy Bottelo Carey Uchida Post Office Box 7265 Hilo, HI 96720 135 Kaikuono Place Hilo, HI 96720 (808) 935-1968 careyuchida@hotmail.com Phone No.: (808) 943-8808 Ext.22 Phone No.: (808) Name of Accountant/CPA (include name of firm if applicable): Akamine, Oyadomari & Kosaki Phone No.: (808) 941-0500 Mailing Address: 1440 Kapiolani Blvd. Suite 900 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 04-05 05-06 06-07 $5,500 $12,000 $12,000 Agency Mission Statement: 935-0537 Honolulu, HI 96814 The mission of Special Olympics is to provide year round sports training and athletic competition in a variety of Olympic -type sports for children and adults NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 with intellectual disabilities, giving them continuing opportunities to develop physical fitness, demonstrate courage, experience joy and participate in the sharing of gifts, skills and friendship with their families, other Special Olympics athletes and the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Special Olympics Hawaii - Agency Name Special Olympics Hawaii -East Hawaii- Program Name Program Description: People who are isolated from life experience by a disability have little chance for the development growth and acquisition of important skills that they will need to gain employment, maintain relationships and function disability the necessary skills to achieve that independence. We believe that all people regardless of their disability deserve to lead full, active lives, enriched with social and recreational opportunities that most of us take for granted. Unfortunately, appropriate physical education programs in the public schools and social service programs that realistically address the special needs of this population are virtually non- existent. Special Olympics Hawaii believes that we address a very real issue for all communities throughout the world, which is how to take care of the people within their community that have disabilities; how to employ them, how to take care of their health issues, or just plain how to interact with them. We help the communities that we are involved in with those issues. Our 6,000 volunteers interact with our athletes and their family members on a weekly basis, our medical volunteers throughout the state have been proficient at interacting with our athletes within their own practices, and an impact study done in 2004 states that 52% of the adult Special Olympics athletes in the United States are employed, over half of those are in competitive employment. The general disabled population only has 10% employed. This is a significant impact within the communities that we are involved with. Special Olympics East Hawaii continues our Unified Sports Program. We feel this is a vital program where our special needs individuals interact with their non - handicapped peers on a weekly basis. Unified Sports is a program that combines equal numbers of athletes with intellectual disabilities and special partners without disabilities. All participants are of similar age and athletic ability. This program dramatically increases inclusion of our athletes into the community by helping break down barriers that have historically kept people with and without disabilities apart. Special Olympics East Hawaii now has a softball team and several bowling teams that participant in the Unified Sports Program. They all train and compete together here in East Hawaii and they travel to Maui and Oahu for regional and state competitions. The benefits for our athletes continue to be: improved physical fitness and motor skills, greater self-confidence, a more postitive self-image, friendships, and increased family support. Special Olympics athletes carry these benefits with them into their daily lives at home, in the classroom, on the job, and in the community. Families play a significant role in the East Hawaii program. We believe the families who participate with us become stronger as they learn a greater appreciation for their child's talents. They play significant roles in our organization from a enthusiastic spectator in the stands to coaching their child's NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 team. Our program could not continue without the help from our community volunteers. Our volunteers learns more about the capabilities of people with intellectual disabilities and take that into their own homes. The need for Special Olympics East Hawaii program to continue here on this island is extremely high. Special Olympics provides year round training for all the volunteers involved in running our program, from the Area Director to our weekend chaperone. These training are essential due to the unique services that we provide. These services are not available anywhere else but with our program. Our program is free of cost to all our athletes, special partners, and coaches. This has been the policy of our organization since its inception, making it a very unique sports program. Special Olympics Hawaii receive no money from the Kennedy Foundation or the Federal Government. All of the money raised for the East Hawaii program stays here to support our program. Due to the aspect of our program, a volunteer committee under the leadership of our Area Director must raise all the funds needed for this unique program. Those funds will pay for all aspects of the Special Olympics program, which includes, equipment, uniforms, transportation costs, training of the coaching staff, family activities and trainings, our Athlete Leadership Program (ALPS). In the ALPS program athletes are trained to become coaches, public speakers, members of the Board of Directors, officials, and technology experts using PowerPoint. Special Olympics East Hawaii believes that our athletes are the Voice of our program. In February 2007 we will have three athletes representing our program at the Athlete Congress. Athletes come together to vote on issues concerning our Special Olympics program. The results will be shared with our CEO/President and Board of Directors. We are a program that believes that we are working WITH the people that we are serving. As always, Special Olympics East Hawaii's largest expense for 2007 is transportation. It is an essential part of our program that Special Olympics athletes are provided an opportunity to interact and compete against people of smiliar athletic ability. Unfortunately our area program is too small to be able to provide quality competition, therefore our athletes must travel to other islands to achieve that goal. The state competitions that are held on Oahu 3 times per year provide many activities that our athletes never have a chance to experience. They include; dances, Opening and Closing Ceremonies, entertainment and games, and being exposed to a Healthy Athlete Village. This village provides a free dental screening, vision screening, hearing screening, Fun Fitness (flexibility & strength) screening, nutrition screening and podiatric screening for our athletes. As you know, these services are sometimes not available to individuals with disabilities due to financial difficulty or lack of professionals who are trained to treat people with disabilities. Each athlete who participated in the vision screening at the Summer 2007 games and who required glasses, were given free glasses that were mailed to each athlete. Special Olympics East Hawaii wishes to continue to provide these fantastic opportunities to all the athletes that are currently involved. In order to continue NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 to provide the current services that we do, continue to outreach to new family members and volunteers, continue to train our coaching staff, and to send our Athlete Delegates to Oahu we will need funding from the County of Hawaii. Special Olympics Hawaii -East Hawaii Area is asking for $15,000 from the County of Hawaii to help fund our Special Olympics East Hawaii program activities. Total Budget and Position Count Total Program Budget $112,285 Total Program Position Count 1 Total Agency Budget 1,801,578 Total Agency Position Count 20 Program Objectives: 1) To provide quality sports training and Olympic type competitions for 195 athletes and special partners within our program by June 2008. 2) To establish a new delegation at Keaau High School, therefore providing the opportunities for more students with intellectual disabilities to become more physically fit through sports training and competition by June 2008. 3) To provide sports specific coaches training to 15 coaches in various Olympic type sports and at various athletic ability levels so that they may provide appropriate training to the athletes within their delegations by June 2008. 4) To provide our families, coaches, volunteers and athletes with 2 family activities throughout the year, that will be conducted by our familiy committee by June 2008. 5) To provide transportation to 125 athletes, coaches & special partners 3 times per year so that they may travel to state competitions to compete with their peers by June 2008. 6) To provide an opportunity for our three Athlete Delegates to represent Special Olympics East Hawaii at the Statewide Athlete Congress by July 2007. 7) To provide an opportunity for over 400 community volunteers to interact with our Special Olympics athletes throughout the year, providing them the chance to "change the world". Program Highlights: 1) Conducted 3 major athletic competitions for our athletes & Special Partners: In April -area track & Field competition with West Hawaii athletes and the Hawaii County Police Department & First Hawaiian Bank's Annual Troy Barboza Law Enforcement Torch Run / October - a 2 day bowling tournament for singles bowling with West Hawaii athletes and unified team NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 bowling / November - a Weinberg area Basketball Tournament with West Hawaii & Maui athletes. 2) Established a weightlifting program in East Hawaii that will allow athletes an additional sport to begin training towards physical fitness. 3) We provided sports training, competition and transportation to 26 soccer athletes, 13 bocce athletes & 9 bocce special partners during the Aukake Season / 52 athletes for singles bowling & 18 special partners for unified bowling during the Winter season / 36 athletes who trained & competed in basketball during the Winter Season / 62 track & field athletes and 45 softball athletes with 6 softball special partners who trained & competed during the Summer Season. 4) Provided our families, coaches, volunteers & athletes 2 family events. In August 2006 we held the 2nd annual Ohana End of Summer Bash which was attended by over 80 athletes & family members / December 2006 we held our Christmas Party with over 90 athletes & family members attending. 5) We established our annual area awards and winners were presented with trophies at the December Christmas party. 6) Positions on our area management team, which helps to coordinate all activities for the Special Olympics East Hawaii program, has been filled and meet monthly to discuss the operations of the area program. 7) Our fundraising team has been established with 7 members who meet monthly to plan and coordinate all fundraisers for our area program. 8) Tip A Cop was added as a new fundraiser this year and was successful in raising over $4,000 with the cooperation of the Hawaii County Police Department's Police Officers and local restaurants. 9) Athletes, coaches, volunteers and family members conducted 5 separate fundraisers; selling chili, bentos & candies throughout the year and were sucessful in raising a net profit of $23,500 10) Outreached to teachers at the Teachers Institute Day held at Keaau High School on October 10, 2006. 11) Increased the number of certified coaches by 8. 12) Provided a community service project at Hale Anuenue by singing Christmas carols to the residents there. 13) In July 2006, 8 basketball athletes & 3 coaches were selected from the East Hawaii area program to represent the State of Hawaii in Iowa at the 15` Special Olympics National Games. They spent a week meeting, competing and making new friends with other intellectually disabled athletes from across the United States sharing and showing what the spirit of Aloha is about. Bonds with other athletes were formed and a lifetime of wonderful memories were created - all because they particiapted in Special Olympics. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Special Olympics Hawaii - Agency Name Special Olympics Hawaii -East Hawaii - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Athlete & Unified Partner participants Volunteers 184 394 185 400 195 410 Family members 78 75 80 Management team members 14 15 16 Community Service Projects 0 1 2 State Competitions on Oahu attended 3 3 3 Area Regional Competitions attended 5 6 7 Delegations within the school system 4 4 5 Number of Family Events 1 2 2 Number of Volunteer Hours provided by volunteers for training & com etiton 9,021 9,500 *If applicable Program Expenditures If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages $2,986.00 $3,000.00 $2,200.00 Professional Fees $2,650.00 0 0 Operations $82,239.00 $71,200.00 $108,085.00 Equipment $1,750.00 $1,700.00 $2,000.00 Other" Total $89,625.00 $75,900.00 $112,285.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Special Olympics Hawaii - Agency Name Special Olympics Hawaii -East Hawaii - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County of Hawaii Grant $12,000 $12,000 $15,000 Foundations $14,000 $9,000 8,000 Individual Contributions $5,000 $5,000 $5,000 Corporate Contributions $6,400 $5,000 $6,000 Special Events $49,200 $31,300 $23,000 HSO Co -Op Monies $2,925 $3,000 $4,300 Interest Income $100 $10 $25 Merchandise Sales -East Hawaii 0 $590 0 Merchandising -other sales 0 $10,000 $33,960 New Fundraiser _ $17,000 Total $89,625 1 $75,900 $112,285 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? 2007 Plans to increase revenues to support our programs: 1) We have a new fundraiser planned, called "Red Carpet Event -Fashion on the Bay" which we will be coordinating with local fashion designer Zig Zane. We anticipate to gross $17,000 and it will be held towards the ending of 2007. 2) We are planning our Tip A Cop fundraiser to be held at restaurants that have high customer turn over and fast service that will allow us to reach more clients and therefore collect more tips. 3) We are planning to increase our donations for Cop on Top by coordinating with a local retail store to sell Cop on Top icons to raise funds. 4) We are planning to increase our Fueling Dreams fundraiser with the help of the County of Hawaii Police Department's officers and Tesoro, by doing more advertising and promotions. Special Olympics East Hawaii is very diverse in how we raise money to support the athletes, families and volunteers. However as we continue to meet our mission of continuing to outreach to new athletes, family members and NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 8 volunteers within our community, our budget continues to grow, so even as we get better at raising money, it continues to be difficult to reach our budget without the support of the County of Hawaii. Becoming self sufficient is the ultimate goal of our program, however we do know that if any of our events/grants fail to raise the expected amount of money, our program would change drastically. We would have to cut back on some services that we currently provide and/or we would have to cut back on our outreach goals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 9 _ Special Olympics Hawaii - Agency Name Special Olympics Hawaii -East Hawaii - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 – 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. �w Sign Y �•. • PresidentlChair (7 Sign ure of ecutive Director //9/07 Date 1'0'-07 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 10 w Special Olympics - West Hawaii- Agency Name SOWH General Funding - Program Name Agency Director: Nancy Bottelo Phone No.: 943 - Contact Person: Ted Spitaleri Phone No.: 217-9324 Mailing Address: P.O. Box 390358, Keauhou, HI 96739 Facility/Site Address: 77-187 Mahiehie Street, Kailua-Kona, HI 96740 Fax No.: 322-6698 Email Address: ted@tccomputer.net Name of Accountant/CPA (include name of firm if applicable): Akamine, Oyadomari, and Kosaki CPAs, Inc Phone No.: 941-0500 Mailing Address: 440-Kapiolani Blvd, Suite 900, Honolulu, HI 96814 Amount of Request for County Funds: $12,000 Prior Year(s) Funding: 04-05 05-06 06-07 $5,5000 $10,000 $10,000 Agency Mission Statement: The mission of Special Olympics is to provide year-round sports training and athletic competition in a variety of Olympic -type sports for all children and adults with intellectual disabilities, giving them continuing opportunities to develop physical fitness, demonstrate courage, experience joy and participate in a NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 sharing of gifts, skills and friendships with their families, other Special Olympics athletes and the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Special Olympics Hawaii - West Hawaii - Agency Name SOWH General Funding- Program Name Program Description: Thanks to the Hawaii County grant, Special Olympics West Hawaii is able to continue to provide so many opportunities for the special needs individuals in our community to become productive citizens of our community. We provide them the opportunity to live "normal" lives within the community in which they live. Special Olympics conducts local competitions and training, we provide Holiday parties, hold local dances and picnics, and travel together to neighbor islands for competitions where dances and banquets are held. We have many athletes who have never traveled away from Kona until joining Special Olympics. We provide these individuals with a much larger view upon the world. Special Olympics West Hawaii helps more than the Special Olympics athlete, we reach out to the families, teachers, care givers, and communities. In Special Olympics, we are all 'Ghana. We provide an opportunity for parents to share their experiences with other families that desperately need to find encouragement and hope for their disabled child. We provide an opportunity for the care givers and teachers to see their clients active and accepted by their peers, and maybe most importantly, we provide an opportunity for the community of West Hawaii to experience the unique gift of sharing time and experiences with another member of their community, that is usually forgotten through our Volunteer program. Our Athlete Leadership Program helps to train our Special Olympics athletes to become leaders within our organization. This is a project that Special Olympics West Hawaii believes in strongly. We have athletes speaking to the Kona community all the time. It is a wonderful way for the community to get to know our athletes and accept them for who they are! Very unique individuals! In order for Special Olympics West Hawaii to provide this much needed service to the families and their special needs children, there are many expensive needs to be covered. As you know, the cost of the equipment for these athletes to train and compete in their given sport can be quite costly. Additional needs include ground transportation to practices and competition, air transportation to State competitions, uniforms, meals and awards. There are also mandatory training's for coaches and volunteers to attend in order to receive certification to work with Special Olympics athletes. The additional funds from the grant made possible travel to not only Oahu for State Games, but also to Maui and Hilo for Regional Competitions as well. Many of the uniforms and equipment are outdated and we were able to start replacing old uniforms and unsafe equipment as well. Special Olympics provides much needed life skills for our athetes and our ALPS (Athlete Leadership Program) participants have taken the initiative to plan social outtings by planning, polling their peers, creating invitations and learning NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 responsibility by following through with these tasks. Funding that is realized this year will continue this program as well as branch into the field of technology with our athletes learning basic hardware and software computer skills. Special Olympics Hawaii has been an accredited program of Special Olympics Incorporated since 1968. The West Hawaii Area Director, who will make contact through the school systems, newspaper, radio, television, adult facilities, etc., will coordinate the Outreach Project along with the Outreach Chairperson. Total Budget and Position Count Total Program Budget 1 $62,064.00 Total Program Position Count 1 Total Agency Budget 1 $1,554,009.71 Total Agency Position Count 18 Program Objectives: • Increase school participation in Kona District by adding delegations • Increase participation in South Kona/Kau area by adding delegation • Increase athlete count by 10% total in the West Hawaii program. • Continue Unified Sports programs to involve more family members and general public. • Train new delegations on ways to maintain current and recruit new athletes, coaches, and volunteers. • Provide financial support for new delegations • Provide quality activities for families and siblings • Continue to increase Athlete Leadership by training more Global Messengers (athletes trained in public speaking) • Continue providing high quality training and competition to the intellectually disabled individuals in the West Hawaii region • Continue to provide athletes an opportunity to be involved with planning and attending social events • Provide athletes with additional opportunities of learning (i.e. technology) to broaden their awareness and understanding of model citizenship • Increase the fund raising opportunities for SOWH • Diversify management team to include outside members of the community Program Highlights: 1. Increased number of certified coaches in our program by 6. 2) Our program is almost completely coordinated by family members. This includes management team, coaches, and volunteers NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 3) Have family specific events and booths at competitions 4) Outreached to teachers at Teacher Institute Day. 5) Increased number of regional competitions that were held in West Hawaii to 3 - powerlifting, soccer and bocce 6) Continued working with AYSO VIP program 7) Extended the knowledge of what Special Olympics is all about through press releases, newspaper articles, newsletters and other printed materials. 8) Trained and competed in 9 Special Olympics official sports. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Special Olympics - West Hawaii - Agency Name SOWH General Funding - Program Name Performance Measures: *If applicable Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Community Service projects - Aid Stations 8 8 8 State Competitions in Oahu 3 3 3 Area/Regional Competitions 8 8 8 Regional Competitions Held in WH 1 3 3 Delegations within school 3 3 3 Number of athletes within program 50 52 52 Number of Special Partners 20 25 27 Number of Unified Bowling Teams 4 6 7 Number of Unified Softball Team 1 0 1 Number of Families actively involved 35 40 45 Number of Family Events 8 8 8 *If applicable Program Expenditures If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 9600.00 9600.00 11,600.00 Professional Fees 0 0 0 Operations 16000.00 17000.00 17589.00 6000.00 5540.00 7350.00 -Equipment Other" 23400.00 24900.00 25525.00 Total 55000.00 5704.00 62064.00 If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Special Olympics Hawaii - West Hawaii - Agency Name SOWN General Funding - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County of Hawaii Non -Profit Grant 10000.00 10000.00 12000.00 Larry Mitchell Mrmorial Fund 2000.00 2000.00 2000.00 Aid Stations 1500.00 1500.00 1500.00 Ironman Foundation 1000 1000 0 Private Donations 1739.40 2000 2008.00 Merchandise Sales 1227.57 1500.001 438.00 Fire Truck Pull 0 7000.00 0 Cop on Top 24000.00 25000.00 27568.00 Silent Auction 00 1000.00 0 Corporate Contributions 3001.00 3500.00 4000.00 Underpants Run 2500.00 3500.00 10000.00 Interest Income 40.39 40.00 50.00 SOHI Co -Op Money 2500.00 2500.00 2500.00 Total $49,508.40 $60,540.00 $62,064.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Special Olympics West Hawaii is constantly increasing our database for fundraising purposes. We anticipate instituting a stong marketing plan to increase our visibility within the community to attract potential donors, as well as to attract more athletes. Due to the fact that it is our hope to grow our program so that more deserving individuals may benefit, becoming self-sustaining would be at least 5-10 years. It would be our hope that more corporate and individual contributions would help as well as additional fundraising/awareness events. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 7 Special Olympics Hawaii - West Hawaii - Agency Name SOWH General Funding - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawal'i, l (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shah include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawal`i grant funds, and a listing of odw funding sources and amounts obtained during the award period. Failure to submit a timehr, complete. am 6-Kol, 1-06-'"' i 12yio� Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program Agency Director: Steve Zodrow Phone No.: 935-8229 Contact Person: Claudia Wilcox-BoucherPhone No.: 935-8229 Mailing Address: P.O. Box 612 Hilo, Hawaii 96720 Facility/Site Address: 1266 Kamehameha Ave. Suite A-5 Hilo, Hawaii 96720 Fax No.: 808-935-2573 Email Address: stevetpff@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Sandy Moses, Fiscal Officer Phone No.: 808-935-8229 Mailing Address: P.O. Box 612, Hilo Hawaii 96720 Amount of Request for County Funds Prior Year(s) Funding: 04-05 $0 05-06 $0 Agency Mission Statement: $30,000. 06-07 $15,000. Turning Point for Families, Inc. is a domestic violence agency that provides Shelter, Counseling, Education and Advocacy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program Program Description: Perpetrators of domestic violence isolate their victims from family, friends, and community. These same perpetrators control the income, the household, and eliminate self-esteem, not only from their partners but their children as well. Many victims of domestic violence have no idea how to manage funds and often time are afraid of independence. 92% of the homeless women and children in the nation are homeless as a direct result of domestic violence (Office on Violence Against Women). Women that have become homeless and have assets as a result of the marriage (even of they have no access to the assets) are ineligible for transitional housing designed for the homeless. In addition, they are ineligible for financial assistance for the same reason. Because of contract restrictions victims of domestic violence are limited to a 90 -day stay at an abuse shelter. When they leave the shelter they are left with few options: to stay with family or friends, return to their perpetrator, or become homeless. Hale Kahua Pa'a (house on a stable foundation) is a 12 -month transitional housing program designed to assist victims of domestic violence and their children rebuild their lives. The program goal is to assist victims and their children in gaining stability and independence while transitioning into a violence -free life style. Victims will transition from emergency shelters such West Hawaii Domestic Abuse Shelter, Hale Ohana (located in East Hawaii) and East Hawaii Coalition for the homeless shelter. Priority is given in that order if the participant is eligible and willing to participate in the program. The program encourages and seeks victims with little or no resources or support system. Victims receive support services through case management services to address barriers in establishing income, housing, and independence. Children in the program are included in the family's safety plan and Family Goal plan. Services that are addressed for the children are: health, school success, after school activities, and tutoring. Total Budget and Position Count Total Program Budget 145,505.00 Total Pro ram Position Count 1 1.54 Total Agency Budget 1,732,531.03 1 Total Agency Position Count 1 36.45 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 Program Objectives: 1) Maintain 6 homes for the transition housing program 2) Make available 12 -months of affordable and safe transitional housing with extensions granted on a case-by-case basis. 3) Develop individual safety plans with participants. 4) Provide individual weekly case management meetings. 5) Offer weekly life skill classes and support groups. 6) Conduct individual safety planning for both adults and children within seven days of intake. 7) Provide 3-6 month follow-up services (aftercare is voluntary). 8) Network with rental management businesses to seek out additional homes and apartments for future expansion to accommodate more families. Program Highlights: 1) The program staff has worked hard to develop a comprehensive program that supports families that have entered the domestic violence array of social services and is ready to begin a violence free life and maintain self sufficiency from their batterer. This support enables them to be contributing members of society. 2) All six units are occupied and there is a wait list of other families. 3) Three families entered the program and successfully transitioned into permanent housing within six months. Note that by June 30, 2007, three additional families will have successfully completed the program and will be in permanent housing. 4) The three families that completed the program have demonstrated an increased knowledge of safety necessities, financial life skills and increased their support systems and knowledge of resources in the community that will assist them in maintaining their newly established independence. 5) Due to the success of participants in the program and community presentations, the coordination with social service agencies, community organizations and rental management and retail business have been developed to encourage the possible expansion of the program. 6) Six participants have been accepted into the vocational training and job employment services which will enhance their job market skills and increase their economic stability. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program Performance Measures: *Note: these are the figures for the first six months of the program This is a 12 -month program for participants. Some participants will transition more quickly than others and some may require more than the 12 months offered. Program Expenditures FY 2006-07 Actual* FY 2006-07 Budget* FY 2007-08 Estimate Short-term 20,466.75 54,507.50 58,454.13 # of families provided housing 9* 14 18 # of service plans developed 9* 14 18 # provided case management 9* 14 18 # of safe plans developed 9* 14 18 # of life skill classes 26* 52 52 # of support groups 26* 52 52 Long-term # w/secured income 9* 6 10 # enrolled in education program 1* 3 7 # w/secured employment 3* 3 7 # obtained permanent housing 2* 4 5 *Note: these are the figures for the first six months of the program This is a 12 -month program for participants. Some participants will transition more quickly than others and some may require more than the 12 months offered. Program Expenditures * If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate Salaries and Wages 20,466.75 54,507.50 58,454.13 Professional Fees 1,100.00 5,387.00 5,329.17 Operations 18,358.52 85,610.50 96,721.70 Equipment 742.14 0.00 0.00 Other' 0.00 0.00 0.00 Total 40,667.14 145,505.00 160,505.00 * If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Bud et * FY 2007-08 Estimate Office of Violence Against Women 40,667.41 126,505.00 126,505.00 Count of Hawaii 0.00 15,000.00 30,000.00 Fees 0.00 4,000.00 4,000.00 -Program Total 40,667.41 145,505.00 160,505.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Turning Point for Families, Inc. is seeking opportunities to purchase transitional housing units. In doing so it would eliminate much of the overhead costs associated with rent, deposits, etc. As a non-profit agency serving one of our most vulnerable population groups with income that is non-existent or below the 30% median income it is difficult to generate revenue from client program service fees. Turning Point for Families will seek support from the Hawaii Community Development Corporation of Hawaii (HCDCH) homeless stipend program and the Emergency Shelter Grant Program (ESG). Funding through these programs however will not be available until fiscal year 2008-09. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. 4natureward President/Chair �. CZV- Signature cWExecutive 9i ector 1 im Dale I -- 31- 6'4 -- Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Turning Point for Families, Inc. Violence Intervention Outreach Project North Hawaii, Keaau, Pahoa, and Ka'u Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Steve Zodrow Phone No.: 935-8229 Claudia Wilcox -Boucher Phone No.: 935-8229 P.O. Box 612 Hilo, Hawaii 96720 1266 Kamehameha Ave. Suite A5 (Main Office) Hilo, Hawaii 96720 808-935-2573 stevetpff@yahoo.com Name of Accountant/CPA: Sandy Moses, Fiscal Officer Phone No.: 808-935-8229 Mailing Address: P.O. Box 612, Hilo Hawaii 96720 Amount of Request for County Funds: $55,000.00 Prior Year(s) Funding: 04-05 05-06 06-07 $30,000 $25,000 $45,000* *This figure is a combination of Bay Clinic's VIP program with Turning Point For Families ATV North Hawaii and Puna Groups. Agency Mission Statement: Turning Point for Families Inc. is a domestic violence agency that provides Shelter, Counseling, Education and Advocacy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Turning Point for Families, Inc. Violence Intervention Outreach Program North Hawaii, Keaau, Pahoa, & Ka'u Program Description: Turning Point for Families, Inc. (TPFFI) is seeking continued funding for domestic violence intervention and education outreach services in rural locations throughout the County of Hawaii through our Alternatives to Violence Program (ATV). The Alternatives to Violence program provides support, education, TRO assistance and referrals for victims and batterers of domestic violence. TPFFI has received funding to service North HawaiiMaimea and the Puna/Keaau ATV batterers groups since 2003. The Bay Clinic's Violence Intervention Program has received funds for similar services in Ka'u and Pahoa. Bay Clinic and TPFFI staff met in January 2007 to coordinate services resulting in TPFFI agreeing to provide domestic violence services in Pahoa and Kau. The Violence Intervention Outreach Program under Turning Point for Families, Inc. combines the domestic violence outreach services that Bay Clinic offered with the services of TPPFI's Alternatives to Violence. The Violence Intervention Outreach Project (VIOP) provides domestic violence services to rural Waimea, Kea'au, Ka'u and Pahoa, by offering psycho- educational groups to court ordered men who batter, community education and awareness presentations that promote community and family safety, as well as classroom presentations to youth (12-18 years) in the public, charter and private schools. In addition our goal is to be able to provide TRO assistance in these rural areas on a regular basis. The curriculum for the men's groups is designed to assist the batterer in changing their abusive behaviors, challenge their belief system and taking personal responsibility for their abusive actions. Batterers learn to replace their abusive behaviors with positive behaviors, such as enhanced communication, anger control, and mutual respect. The benefits are: safety for family members, safety for neighbors, and community. In addition the program stops the perpetuation of domestic violence and provides an opportunity for abusers to change and become positive role models, which result in a reduction for the need of societal interventions. These batterers reside in rural areas of the County and have been referred or mandated to attend services. In most incidences they lack or have no reliable transportation to travel to Kona or Hilo where the majority of services are offered. The supportive and education services component of the program is to continue through active community interaction the prevention and education regarding the effects, issues and safety concerns regarding domestic violence. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 The targeted populations are residents in the rural communities of Ka'u, Kea'au, Pahoa, and Waimea that need to attend domestic violence intervention for batterers. The program also intends to continue education and supportive services to schools and community groups in these identified areas. In addition, TPFFI is exploring the need to have trained advocates available in these areas to assist with victim services and TRO Assistance Service and court advocacy. Total Budget and Position Count Total Program Budget 43,720.00 Total Program Position Count 04 Total Agency Budget 1,732,531.03 Total Agency Position Count 36.45 Program Objectives: 1. Maintain existing services (men's groups) in Kea'au, Waimea, Pahoa, and Ka'u. 2. Assist in building community awareness on domestic violence and its effect on our community. 3. Expand youth classroom presentations to include culturally relevant materials. 4. Create and support TRO assistance stations in the various rural areas where people can get help without driving into Hilo or Kona. 5. Assist in the establishment of women's and children's domestic violence support services in Puna, Keaau, Waimea, and Ka'u. Program Highlights: 1. VIOP/ATV is the only program offering direct services to perpetrators of domestic violence in the isolated rural Puna and Ka'u districts and North Hawaii districts. 2. Combined services in the four locations serviced over 100 men who attended batterers' groups. There are an average of 12-15 men who attend weekly 2.5 hour classes for 25 week sessions. There are groups that meet in Waimea every Monday, Pahoa every Tuesday evening, Ka'u every Thursday and Keaau every Friday evening. Few of these men have access to legal transportation to Hilo or Kailua; many even have difficulty getting to Pahoa and Naalehu to fulfill their court mandated service plan. Failure to comply results in more court dates and re -sentencing and does not address the education and pattern changing process that is needed. Access to services in rural areas is critical to the safety of families and well-being of our community. 3. An extension of services is for agency case managers and group facilitators to do presentations in the community and especially at our intermediate and high schools in these rural communities. There have been over 30 presentations by staff that speak directly to youth on relationship violence and provide local referral at public, charter, and NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 private schools as well as special need agencies, i.e. Interim Home, Big Island Substance Abuse Council (BISAC), and Baby Safe. Performance Measures: *If applicable Proaram Expenditures FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Presentations to community groups and schools in Pahoa, Ka'u, Waimea, Keaau n/a N/a 30* Men Completing Program, Pahoa 16 50 50 Men Completing Program, Ka'u 3 18 18 Men Completing Program, Waimea 10 15 15 Men Completing Program, Keaau 12 15 15 Youth attending class sessions on relationship violence, located in Hilo, Pahoa, Ka'u, Waimea, Keaau 2125 2125 2500 Intakes in Pahoa 55 n/a 60 Intakes in Ka'u 30 29 30 Intakes in Waimea 17 n/a 20 Intakes in Keaau 26 n/a 30 Men currently in groups not completed n/a 52 n/a *If applicable Proaram Expenditures * If applicable. The 2006-2007 Budget does not reflect the expenditures of the County - funded Bay Clinic's VIP Program. "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 503,296.66 17,330.98 37,000.00 Professional Fees 7,827.33 0 2,000.00 Operations 174,887.74 26,389.02 55,928.00 Equipment 3,906.23 0 1 0 Other" 0 1 0 Total 1 689,917.96 43,720.001 94,928.00 * If applicable. The 2006-2007 Budget does not reflect the expenditures of the County - funded Bay Clinic's VIP Program. "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Turning Point for Families, Inc. Violence Intervention Outreach Project Waimea, Keaau, Pahoa, Ka'u Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual* FY 2006-07 Budget* FY 2007-08 Estimate County of Hawaii 32,000.00 25,000.00 55,000.00 Program Fees 109,652.40 18,720.00 34,928.00 State of Hawaii -Judiciary 544,590.88 Fund Raisin /Donations 2,095.00 5,000.00 Private Foundations 99,925.00 Total 788,263.28 43,720.00 94,928.00 *If applicable. The 2006-2007 Budget does not reflect the County funding of Bay Clinic's VIP Program at $20,000. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? We are actively pursuing grant opportunities. Currently we are writing to the Awareness Foundation, Kaiser Permanente Cares for Communities and Five Mountains Inc for additional funds especially because we would like to expand services. We solicit donations and minimal fees (from batterers), from past donors for health education, clients and the community. We are also actively looking for additional sites to hold classes, as well as sites to do TRO assistance and advocacy. Various churches and community groups (Kohala, Naalehu and Honokaa) have been approached for consideration for future sites should this funding be awarded. TPFFI is committed and dedicated to continue servicing these rural communities and are dedicated to provide services for those who have no opportunity to attend in Hilo. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Turning Point for Families, Inc. - Agency Name Violence Intervention Outreach Project Waimea, Pahoa, Keaau, Ka'u I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii. grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. ~XignaturVQWoard Signature of Executive Dir ctor �I n-1 Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter Agency Director: Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address: Steve Zodrow Phone No.: 935-8229 Claudia Wilcox -Boucher Phone No.: 935-8229 P.O. Box 612 Hilo, Hawaii 96720 1266 Kamehameha Ave. Suite A5 (Main Office) Hilo, Hawaii 96720 808-935-8229 stevetpff@yahoo.com Name of Accountant/CPA: Sandy Moses, Fiscal Officer Phone No.: 808-935-8229 Mailing Address: P.O. Box 612, Hilo, HI 96720 Amount of Request for County Funds: $25,000 Prior Year(s) Funding: 04-05 05-06 06-07 $21,000 $22,000 $17,000 Agency Mission Statement: To provide Shelter, Counseling, Education and Advocacy to promote a violence - free community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter Program Description: Turning Point for Families, Inc. (TPFFI), is seeking funds for the West Hawaii Domestic Abuse Shelter Program. The West Hawaii shelter has been providing emergency shelter and services to victims of domestic violence and their children for more than quarter of a century. We are the only battered women's shelter providing services to the districts of Kau, Captain Cook, Kealakekua, Kailua Kona, Waikaloa, Kohala, and Waimea. The West Hawaii shelter also provides services to victims fleeing their perpetrators on the East side of the Island. The main goal if the shelter is to provide 24-hour emergency shelter to battered adults and their children. Furthermore, the shelter provides a safe environment 365 days a year. In addition to emergency shelter, the program provides the following: • Emergency food pantry • Maximum of 90 day stays • 24 hours crisis hotline ( information, referral, screening, and intake for the shelter) • Peer counseling and support groups • Advocacy • Case Management • Individualized safety planning • Assistance with completing and filing of Temporary Restraining Orders • Links to other TPFFI programs such as Alternative to Violence, youth services, and the children's programs, drug & alcohol program • Shelter transportation • Childcare during shelter group or individual counseling Total Budget and Position Count Total Program Budget 421,949.99 Total Program Position Count 7.5 Total Agency Budget 1,732,531.03 Total Agency Position Count 1 36.45 Program Objectives: 1) Provide 24 hour emergency shelter services for battered adults and their children. 2) Provide Case Management services, individual counseling, and group counseling to the victims of domestic violence to assist them in working NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 towards self-sufficiency and enable them to transition into a violence -free life style. 3) Provide a 24-hour crisis hotline to assist persons with a domestic violence crisis, providing information, crisis counseling, and appropriate referrals. Program Highlights: • For the first half of the Fiscal Year 2006-2007, the Shelter exceeded the annual target of 4068 bed nights by providing a total of 5500 bed nights for the half-year period (July through December 2006). • For the same six month time period, the Shelter provided services to 80 adults and 70 children who were victims of domestic violence in need of emergency shelter and services. • Habitat for Humanity assisted for two full work days during which the lanais were painted and major landscaping was completed. This beautification project boosted staff and resident's morale. It was a wonderful experience having staff and residents working together with these volunteers. • A complex playground set was purchased and then built in the backyard of the Shelter by five volunteers. • The Hawaii Island community continues on with gracious donations. Gifts of all sorts were donated to all clients but especially the children at the Shelter from the Thanksgiving time period through Christmas. And, the Central Union Church assisted the Shelter residents and staff with a Thanksgiving Day meal. Toys for Tots, Walmart, and Clark Realty donated many toys and other items to the Shelter clients. • The Central Union Church continues to donate throughout the year for children's school supplies and dinners for all major holidays. • Three families transferred into the Hale Kahua Pa'a Transitional Housing Program. The families were able to secure more permanent housing and work towards leading a stable violence -free lifestyle in our community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 Turning Point for Families, Inc. West Hawaii Domestic Shelter Performance Measures: *low number of recipients due to position vacancy for over 8 months Program Expenditures FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate 1. # of bed nights 4512 4068 6500 2. # of group service sessions hours 325 416 650 3. # of groups service recipients 266 200 325 4. # of individual session hours 2462 1500 2700 5.# of adults receiving individual service hours 148 100 170 6. # of children receiving individual sessions 50* 130 200 7. # of outreach hours 177 234 250 8. # of follow-up hours 117 234 200 9. # of hotline crisis calls 159 210 250 10. # of referrals 798 465 500 11. # of van trips by staff for clients 178 260 300 *low number of recipients due to position vacancy for over 8 months Program Expenditures If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 228,690.80 295,473.01 235,919.23 Professional Fees 958.40 12,500.00 11,000.00 Operations 75,368.39 106,476.89 93,213.77 Equipment 5,316.60 7,500.00 0.00 Other* 0.00 0.00 0.00 Total 310,334.19 421,949.99 340,133.00 If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2005-06 Actual* FY 2006-07 Budget * FY 2007-08 Estimate County of Hawaii 22,000.00 17,000.00 25,000.00 State of Hawaii 95,424.00 95,424.00 95,424.00 Federal 177,509.00 262,338.23 149,909.00 Private Foundations Donations 2,450.97 7,387.76 10,000.00 Service/Program Fees 6,661.04 9,800.00 9,800.00 Vending 20,000.00 -Fundraising Internet Income * Other Income HIUW 30,000.00 30,000.00 30,000.00 CACFP 5,625.99 Events -Special Total 339,671.00 421,949.99 340,133.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? It is hard to predict when the emergency shelter will become self-sustaining or better yet when it will not even be needed. However, every effort to become sustainable will be made. Most clients who access the program have no income or they receive income that is below the 30% median for the area. The Department of Human Services continues to provide major funding for the shelter. TPFF intends to seek other sources of funding during 2007-08 from private foundations and federal & state agencies. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 Turning Point for Families, Inc. - Agency Name West Hawaii Domestic Abuse Shelter - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your proaram's or agency's future funding requests. // AWMZ,,>� ature bp6ard-President/Ch air Signature of Executiv irector Date 5 1- 6 UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 West Hawaii Mediation Center Mediation Services Agency Director: Deborah Chat Phone No.: 885-5525 Contact Person: Deborah Chai Phone No.: 885-5525 Mailing Address: PO Box 7020, Kamuela, HI 96743 Facility/Site Address: 65-1279 Kawaihae Rd., Ste. 213, Kamuela, HI 96743 Fax No.: 887-0525 Email Address: westhimed001(8lhawaii.rr.cem Name of Accountant/CPA: John Carbonaro Carbonaro CPA's Phone No.: 808-242-5002 Mailing Address: 1885 Main Street, Suite 408, Watluku, HI 96793 Amount of Request for County Funds: $10,000.00 Prior Year(s) Funding: 03-04 04-05 05_06 $4000.00 $5000.00 $7000.00 Agency Mission Statement: West Hawaii Mediation Center exists to improve the way people deal with conflict by providing mediation, facilitation, conflict resolution education and training services. Program Description: The funds are requested to support West Hawaii Mediation Center (WHMC) which serves the districts of Hamakua, North & South Kohala, North & South Kona, and Ka'u. WHMC provides community-based mediation services for both self-refened and courtflegal system referred clients. These services are provided in an accessible and affordable manner to ensure any and all disputes in West Hawaii can be resolved in a safe, fair and appropriate way without the expense (time and money) of litigation. WHMC utilizes trained community volunteers to deliver this vital service to their fellow community members. Total Budget and Position Count Total Program Budget 96,577Total Program Position Count 1.25 Total Agency Budget 133,000 1 Total Agency Position Count 1.75 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 West Hawaii Mediation Center Mediation Services Program Objectives: 1) Provide information and referral services to individuals who need services instead of, or in addition to, the mediation services offered at WHMC. 2) Recruit, train and retain high quality volunteer community mediators. 3) Provide mediation services in an affordable and accessible manner for disputes arising both in and out of the courttlegal system. 4) Offer mediation services for a wide array of dispute issues including neighbor -neighbor, divorce (property division, finances, parenting plans), landlord -tenant, consumer - merchant, real estate, small claims, condominium, civil rights, special education, victim - offender, and community issues. 5) Provide adequate case management services to adequately serve all referred cases. 6) Provide community outreach and education around constructive conflict resolution practices. Program Highlights: 1) Delivered 1,665 hours of case intake services. 2) Served 238 cases (69% court/legal system referred; 41 % self-referred) with 561 clients served. 3) Utilized 37 volunteer mediators in 144 mediation sessions for a total of 425.95 hours of mediation. 4) Reached full agreement in 58% of cases mediated. 5) Achieved a 91% service satisfaction rating by respondents (post -mediation satisfaction survey). 6) Achieved a 98% rating by respondents indicating that they would recommend mediation to others in the future. 7) Provided 39% of total services to low income clients (annual income under $20,625). 8) Provided conflict resolution education and peer mediation training to over 700 elementary students in West Hawaii. Performance Measures: If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 FY 2005-06 Actual' FY 2006-07 Budget FY 2007-08 Estimate` Case Management Hours 1665 1665 1665 Mediation Cases Served 238 260 280 Mediation Sessions Conducted 144 160 170 Agreements reached in mediation 58% 60% 65% Clients' satisfied with service 91% 90% 90% Client's willing to recommend service to others 98°x6 95% 95% Skills enhancement trainings offered for volunteers 8 8 8 Affordable service to low income (%of clients considered low income 39% 40% 40% Community Awareness and Education Sessions 5 6 7 If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 West Hawaii Mediation Center Mediation Services Program Expenditures: "Please explain in detail on separate sheet Program Funding Sources: Revenue Source FY 2005-06 Actual* FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages 70,550.00 72,000 75,000 Professional Fees 305.00 47,622.00 Operations 25,152.00 27,000.00 28,000.00 Equipment 270.00 500.00 1,000.00 Other* 7,440.00 5,000.00Service/P Total 1 96,577 1 99,500 104,000 "Please explain in detail on separate sheet Program Funding Sources: Revenue Source FY 2005-06 Actual • FY 2006-07 Budget " I FY 2007-08 Estimate of Hawaii 7,000.00 10,000.00&4,000.00 -County State of Hawaii 47,622.00 47,622.00 Private Foundations 4,000.00 4,000.00Donations 11,217.71 13,000.00Fundraisin 7,440.00 5,000.00Service/P ram Fees 5175.00 5000.00 Client Private fees 5175.00 5000.00 Total 87,629.71 80,122.00 91,122.00 If applicable Future Program Support: As our services are offered at no cost to those unable to afford it, it is difficult to rely on service fees to help support our program. This fiscal year, we saw a slight decline from the previous fiscal year (approximately 4%), however, we anticipate a 10% increase from last fiscal year in the upcoming year. We a planning a Wine Tasting/Fundraising Event in the spring. We are also in the process of researching a major fundraising event to raise money as well as awareness of our Center and its services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 West Hawaii Mediation Center Mediation Services 1 (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete. and Signature of Board President/Chair Signature of xecutiv Director � Date Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 YWCA of Hawai'i Island- Agency Name Empowering Alternatives- Program Name Agency Director: Cynthia Albers Contact Person: Lorraine Davis Mailing Address: 145 Ululani Street Hilo, Hawaii 93720 Phone No.: 935-7141 ext. 102 Phone No.: 935-7141 ext. 103 Facility/Site Address: 197 Kinoole Street, Hilo, Hawaii 96720 75-5759 Kuakini Hwy, Suite 103C, Kailua-Kona, Hawaii 96740 Fax No.: 935-5150 Email Address: calbers@ywcahawaiiisland.org; Idavis@ywcahawaiiisland.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs and Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street, Suite 408, Wailuku, Hawaii 96793 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 04-05 05-06 06-07 $46,000 $50,000 $45,000 Agency Mission Statement: The YWCA 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 YWCA draws together members who strive to create opportunities for women's growth, leadership and power in order to attain a common vision: peace, justice, freedom and dignity for all people. The YWCA will thrust its collective power toward the elimination of racism wherever it exists and by any means necessary. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 1 YWCA of Hawaii Island - Agency Name Empowering Alternatives- Program Name Program Description: The Program's mission is to work to reduce the incidence of sexual assault on the Big Island and to reduce disability to those who have been victimized. The YWCA Empowering Altematives (formerly known as the SAVE Program) operates a rape crisis center for the island of Hawaii. Skilled and supportive Crisis Workers provide phone support to callers on the 24-hour Sexual Assault Crisis Line, or offer face-to- face help in East and West Hawai'i to sex assault victims who report the crime to the police. Crisis Workers function as team members with police investigators and sex assault forensic examiners (SAFE) in the Hawaii County Protocol for forensic examination of sex assault victims. Full-time masters -prepared Therapists are employed in Hilo and Kailua-Kona to provide psychotherapy, case management and legal system advocacy by appointment or walk-in. Community professionals, the general public, and school -aged groups are helped to become aware of sexual assault suvivor needs, available services and prevention strategies through the Empowering Alternatives Program's community prevention education activities. The YWCA of Hawai'i Island is now in our third decade of helping sex assault survivors, who are women and men, girls and boys. Primary funding of the program is through the Attorney General's office through a subcdntract with the Kapi'olani Women's and Children Medical Center, Sex Assault Treatment Center (SATC). As a result, quality assurance, program and fiscal monitoring of services are maintained at state and industry established standards. If the County of Hawai'i decides favorably for continued funding of the Empowering Alternatives Program, it can do so with the knowledge that professional standards are practiced in both service delivery and expenditure of funds. Total Budget and Position Count Total Program Budget 1 $480,000 1 Total Program Position Count 12 Total Agency Budget $4,389,600 1 Total Agency Position Count 105 NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 2 YWCA of Hawai'i Island - Agency Name Empowering Alternatives - Program Name Program Objectives: 1) Continue to operate the 24-hour Crisis Hotline intercepting calls from persons seeking support, information and referral that may lead to face-to-face support in Objective #2 below. 2) Provide an Empowering Alternatives Crisis Worker to support each sexual assault victim undergoing medical -legal examination in the period July 1, 2007 through June 30, 2008. 3) Deliver professional counseling and/or case management services to 100 sexual assault survivors. 4) Attend and participate in monthly case tracking and interagency team coordinator meetings of the East and West Hawai'i Children's Justice Centers throughout the fiscal year. 5) Provide sexual assault awareness and prevention education to 500 school - aged students. Provide education to 25 professionals about the needs of adult/child survivors of sexual assualt and methods to detect and report sexual child abuse or abuse of dependent adults. Program Highlights: 1) Three University of Hawai'i, Hilo nursing students began their practicum for their senior community health seminar in January 2007 through the YWCA Empowering Altematives Program. 2) Members of the Empowering Alternatives staff and YWCA administrators participated in the Children's Justice Center Interagency Advisory Committee meetings, the Big Island Coalition Against Physical and Sexual Assault meetings, the Hawai'i Coalition Against Sexual Assault meetings. These committees or coalitions include the involvement by staff from the following agencies: The Hawai'i County Police Department, Child Welfare Services, Office of the Prosecuting Attorney, OPA's victim Assistance Counselor, Family Court, Juvenile Probation Officers, the Deputy Attorney General, Public Health Nurses, CAMH Division of the Department of Health, Department of Human Services, Department of Education and statewide service providers. These meetings foster consistent care throughout the County and State for sexual assault services and working together as agencies to provide the best practices care for sexual assault survivors. 3) In October 2006, through Hawaii County funding, Empowering Alternatives hired one, .8 FTE Prevention Educator for West Hawaii, a position that has not been funded for the last 4 -years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 3 _ YWCA of Hawai'i Island - Agency Name Empowering Alternatives - Program Name Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 FY 2005-06 FY 2006-07 FY 2007-08 Actual * Budget* Estimate Fully trained personnel are Phone line was Phone line Phone line available to assess and respond available 24 available 24 available 24 to callers on the Sexual Assault hours/day 365 hours/day, hours/day, Crisis phone line. daystyear 365 daystyear 365 392 phone calls estimated 350 daystyear were taken calls estimated 350 calls Crisis counseling, legal systems 177 crisis 150 crisis 150 crisis advocacy, information and outreach outreach outreach referral are provided to each sex contacts were contacts contacts assault victim undergoing made medical -legal examination in East Hawaii and West Hawaii Survivors of sexual assault 155 survivors 100 survivors 100 survivors receive psychotherapy services received psycho - and intensive clinical case therapy services management from Empowering Alternatives masters level practitioners in East Hawaii and West Hawaii Preschool and school aged 852 students 500 students 1000 students receive sexual assault received students prevention and awareness prevention and training awareness training Professional receive training in 165 agencies 25 25 awareness of needs of adult and received training professionals professionals child sexual assault survivors, where how to detect and report child professionals sexual abuse or sexual abuse of and adults were dependent adults present and 25 professionals received technical training *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 4 _ YWCA of Hawaii Island - Agency Name Empowering Alternatives - Program Name *If applicable e Please explain in detail on separate sheet Pro ram Funding Sources: Identify all funding Sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wa es $197,186 $257,854 $260,750 Professional Fees 0 $1,460 $7,500 O embons $74,785 $202,954 $206,750 Equipment $453 $5,500 $5,000 Others 0 0 0 Total $272,424.00 $467,768 $480,000 *If applicable e Please explain in detail on separate sheet Pro ram Funding Sources: Identify all funding Sources (specific to this program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget * FY 2007-08 Estimate County of Hawai'i❑ $50,000 $45,000 $60,000 State of Hawai'i, Attorney General Office, KWCMC / SATC❑ $162,434 $349,175 $360,000 * Federal Funding-VAWA, VOCA,VAWA, PSEI $30,319 # $60,259 $45,000 State of Hawai'i DoH - KWCMC Rainy Day Funds $34,624 $13,334 0 YWCA Support $7,007 0 0 Donations❑ $115 0 0 0 Total $284,499.00 $467,768 $480,000 ** A portion of funds in this category include expenditure in the following fiscal year. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? In the past two years, the YWCA of Hawaii Island has worked closely with the Sex Assault Treatment Center, the Hawaii Coalition Against Sexual Assault, community members and the legislature to have sex assault treatment funding through the Attorney General's office instead of the Department of Health. Through the efforts of all parties mentioned, the Legislature and Governor Lingle increased annual funds for sexual assault services by an additional 1 million dollars in order to provide standardized services throughout the state. With this effort, the baseline program for sexual assault treatment was paid for under one contract. Additional funding being sought are project specific and are being used to enhance baseline services. The money requested from the County is earmarked to support prevention education and sexual assault awareness above and beyond what the baseline services allow. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 5 YWCA of Hawai'i Island - Agency Name Empowering Alternatives - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. ff awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete and accurate year-end report will n Hugo, Board Cy is Albers, Executive Director �aoo Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 Page 6 YWCA of Hawaii Island- Agency Name Hamakua Youth Center- Program Name Agency Director: Cynthia Albers Phone No.: 935-7141 Contact Person: Cynthia Albers Phone No.: 935-7141 Mailing Address: 145 Ululani St., Hilo, Hawai'i 96720 Facility/Site Address: 45-3396 Mamane St. Honoka'a, Hawai'i 96727 Fax No.: 935-5150 Email Address: calbers@ywcahawaiiisland.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro and Associates Phone No.: (808) 242-5002 Mailing Address: 1885 Main Street, Suite 4081 Wailuku, Hawaii 96793 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 04-05 05-06 06-07 $6,000 $10,000 $30,000 Agency Mission Statement: "The YWCA of Hawai'i Island is a women's membership movement nurtured 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 opportunity for women's growth, leadership, and power in order to attain a common vision- Peace, justice, freedom and dignity for all people. The YWCA will thrust its collective power toward the elimination of racism wherever it exists and by any means necessary." Program Description: The YWCA Hamakua Youth Center has served the Honoka'a community since 1996 and continues to serve an important role for youth and their families by providing free, after-school and school break activities in a center dedicated to needs of youth. NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 1 YWCA of Hawaii Island - Agency Name Hamakua Youth Center- Program Name The YWCA Hamakua Youth Center, located at 45-3396 Mamane Street in Honoka'a, is directly across the street from Honoka'a Middle and High Schools, making it readily accessible to students. The center is attended daily by 25-50 or more youth aged 9-16 years who flock to the center to enjoy the company of peers and access resources in a safe setting. The 900 square foot rented facility includes a social area, pool and ping-pong table, homework area and a computer lab with 6 intemet connected workstations and several printers. The Advisory Committee of the Hamakua Youth Center, made up of individuals dedicated to the ongoing growth of the HYC, continues to support the program through volunteerism and fundraising. The group is made up of independent citizens, representatives from agencies, businesses and civic groups, as well as several youth delegates, to assure that the youth perspectives guide actions, direction and decisions. Total Budget and Position Count FY2007-08 Total Program Budget $153,200. I Total Program Position Count 3 Total Agency Budget $4,389,600 1 Total Agency Position Count 105 Program Objectives: The primary purpose of the YWCA Hamakua Youth Center is to provide youth with a safe environment during non -school hours. Both structured and unstructured activities with adult supervision reduce the risk factors and increase the protective factors influencing the behaviors of and outcomes for youth in Hamakua. The objectives are to: 1. Increase social bonding of youth with peers and adults i 2. Promote participation in activities that foster healthy choices 3. Reduce reckless or risky behaviors 4. Delay the age of initiation to alcohol, tobacco and other drugs 5. Encourage parents to be more actively involved with youth 6. Build stronger community partnerships Objectives #1-5 shall be measured by use of data from records of attendance and participation in YWCA Hamakua Youth Center programs and through a process that includes surveys and interviews to assess youth participants' behaviors and attitudes. Objective #6 will be measured by the number partnerships and the number of collaborative activities achieved by the groups. Program Highlights: Overview In 2006, the YWCA Hamakua Youth Center continued to provide the After -School Drop -In center with structured and unstructured activities for youth at no cost. At least 221 youth have participated as of 12/30/06, a substantial increase over recent periods. We were open nearly every day after school from 2:00-6:00 pm and provided special evening activities four to six times each month. During school breaks and in the summer months open hours were modified for highest use during daytime or evening hours, based on student requests. The center welcomes both genders who enjoy use of computers with internet access, multi media software, recreation programs, CHOICES for Girls (an evening weekly event), music recording studio, videography studio, arts and crafts, community service projects or taking part in discussions on current events or topics relative to youth. The center provides literature geared to young adults with information on variety of subjects related to youth, such as dating, domestic violence, pregnancy prevention, coping with grief, death and dying, substance abuse, relationships, personal safety, higher education and life!. Youth sign -in and out to increase accountability of their whereabouts as well as to provide accurate data on program use. Growth has characterized the year, as evidenced by the range of activities provided, increased involvement by numerous volunteers, and as a result of many new partnerships with businesses and other organizations who have come together to support the activities of the Hamakua Youth Center. NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 2 YWCA of Hawaii Island - Agency Name Hamakua Youth Center- Program Name Programs and Special Activities CHOICES (Cultivating Healthy Options in Community, Education and Service) The weekly evening sessions welcome all girls to take part in activities with an emphasis on the unique perspectives of women and girls. Weekly sessions were characterized by meal preparation and sharing, which encouraged nurturing and bonding, followed by dialogue groups, health and wellness education, peer presentations, self defense, art, dance workshops, domestic violence education, and teenage grief workshops. Recreation: Under the direction of volunteer recreation specialist, Harold Van Doren, both pool and ping- pong instruction and tournaments are provided. Youth have learned valuable lessons through sportsmanship experiences including how to win, how to lose, play fair, support others, persevere, develop geometrical thinking skills, and take pride and ownership in the care and maintenance of recreation gear. Participants have recently begun travel to neighboring community and youth centers for tournaments as well as hosting tournaments. This increases positive relationships between rural and suburban youth and communities. Mr. Van Doren conducts weekly "pick-up" lessons and at least monthly tournaments with 15-25 participants. Hawaiian Cultural Education: Hawaiian Language teacher Lanakila Mangauil, a participant in the Ka Piko O Ka Lei Lehua kupuna training program, has directed numerous activities as a volunteer. Youth have participated in various weekly traditional classes, including oli and mele (Hawaiian chant and song), hula, olelo (language), values, kakala'au (staff), and drumming. Additionally, youth were exposed to the tradition of the Pa'ani Makahiki including opportunities to learn and compete in the games Videography and Multi Media Music Studio: In response to fervent desire by youth, emphasis has been increased on developing a leaming opportunity for Videography, multimedia, and music production. Leonardo Beltran, a professional videographer, along with other volunteers with expertise in multimedia and music provided instruction during the July to Decembe period. A gift ear -marked to support Videography from an anonymous donor, has allowed us to expand the videography and multimedia program. The HYC is poised to undertake its first production of a 2.5 minute trailer and 30 minute video documentary produced by the emergent youth production company who has christened themselves as EVOKE. The project is youth conceived, produced and filmed and features the youth of North Hawaii as they relate the choices that they face. The production, titled WAVES of Change, will be accompanied by a six song youth produced musical CD. The film intends to look at how youth can adopt healthy choices when faced with alcohol, peer pressure, violence, drugs, hopes, fears and fulfilling their dreams. EVOKE will aim to produce a final product that may be of value to businesses, schools and others who want to highlight the positive choices and aspects of youth growing up in Hawaii. Partnerships The HYC has nurtured many new and expanded relationships with businesses, public and private organizations who have provided support, services and collaboration. Key partners include: Blane's Restaurant Boys and Girls Club of Hilo Family Court Five Generations Foundation Hamakua Girl's Academy Hamakua Health Center HLP Hamakua Community Foundation Honoka'a Fire Department Honoka'a Police Department Hospice of Hilo Teen Services Hula Moon Boutique JJ's Meat Market Lokahi Treatment Centers Marimed, Youth Treatment Program Na Pua No'eau North Hawai'i Coalition for Drug Free Hawaii North Hawaii Youth Coalition Power of Choice Hamakua PTSA Hamakua High School Simply Natural Cafe YWCA Teen Court NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 3 YWCA of Hawaii Island - Agency Name Hamakua Youth Center - Program Name Performance Measures: 'Surveys were distributed as related to the varying activities and groups within the overall Youth Center, including CHOICES for Girls and an environmental lifestyles awareness. 'n/a Program staff have learned that written surveys seeking to gather the information listed above to be inappropriate based on the following: • It was observed that youth responded with verbal self reporting with both staff and volunteer facilitators readily, after trust had been built. Subject matters including grief, violence, drug abuse, sexuality, pregnancy prevention and sexual assault is intensely personal and were presented in intimate, group sessions, which used conversation and personal sharing as the medium of exchange. 2 n1 Data collection tool must be refined to inspire voluntary response by youth participants, be it an electronic, kinesthetic or verbal method to be tested. Data collection methods will include electronic interviews, peer to peer interviews and anonymous written surveys. In an effort to encourage youth participation and honest feedback, data collection must be tailored to a comfortable or preferred method. NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 4 FY 2005-06 FY 2006-07 FY 2007-08 Actual as of 12130/06 Estimate Average daily attendance by youth 35 Target: 35 35 30 as of 12/30/06 Total number of youth served annually 180 Target: 170 221 as of 12/30/06 300 Total number of waivers on file signed Target: 165 by parents of youth participants 165 266 275 as of 12/30/06 Survey or Interviews reflecting self- Target: 80 report of youth about responsible vs. n/a `27 100 reckless or irresponsible behaviors as of 12/30/06 % surveys reporting an Increased or Target: 80% improved social bonding of youth with n/a ga% or 26 80% peers and adults % surveys reporting no or reduced reckless n/a I 'n/a or risky behaviors % surveys reporting no use of n/a 'n/a 2n/a alcohol, tobacco and other drugs % surveys reporting limited use of alcohol, n/a n/a tobacco and other drugs Total number of partnerships (see # 5 n/a Target: 12 22 above 20 as of 12/30/06 Total number of parents participants Target: 20 (in special events, as partners, n/a 10 as of 12/30/06 25 supporters or volunteer Total number of partner projects or n1a Target: 10 100 activities presented or conducted 70 as of 12/30/06 Total number of volunteers Target: 10 75 53 as of 12/30/06 'Surveys were distributed as related to the varying activities and groups within the overall Youth Center, including CHOICES for Girls and an environmental lifestyles awareness. 'n/a Program staff have learned that written surveys seeking to gather the information listed above to be inappropriate based on the following: • It was observed that youth responded with verbal self reporting with both staff and volunteer facilitators readily, after trust had been built. Subject matters including grief, violence, drug abuse, sexuality, pregnancy prevention and sexual assault is intensely personal and were presented in intimate, group sessions, which used conversation and personal sharing as the medium of exchange. 2 n1 Data collection tool must be refined to inspire voluntary response by youth participants, be it an electronic, kinesthetic or verbal method to be tested. Data collection methods will include electronic interviews, peer to peer interviews and anonymous written surveys. In an effort to encourage youth participation and honest feedback, data collection must be tailored to a comfortable or preferred method. NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 4 YWCA of Hawaii Island - Agency Name Hamakua Youth Center - Program Name Program Expenditures Salaries and Wages include 3FTE, taxes and benefits " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to m $ program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $38,696 $43,594 $94,803 Professional Fees 0 0 0 Operations $21,954 $28,550 $55,397 Equipment 0 0 3000 Other' 0 0 0 Total $60,560 572,144 $153,200.00 Salaries and Wages include 3FTE, taxes and benefits " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to m $ program only) Revenue Source FY 2005-06 Actual * FY 2006-07 Budget* FY 2007-08 Estimate County of Hawaii $10,000 $30,000 $50,000 State of Hawaii, Office of Youth Services 0 0 $65,000 Co of HIM Tourism Authority $1,134 0 0 Prosecuting Attorney, Emergency Funds, County of Hawaii $10,000 0 0 Private Foundations $8,750 $26,0001 $15,000 Hawaii Island United Way' 8,749 0 $10,000 Donations $10,875 $10,000 $10,000 Program Service Fee $50 0 0 Fundraising (Special Events) 0 $5,000 $2,000 Other (Rent of facility) 0 900 $1200 YWCA Suppoif $19,750 244 0 Total $69,308.00 $72,144.00 rjj53,200.00 Private Foundation Revenue FY 2007-08 Bank of Hawaii Foundation $10,000 Kukio Community Fund $ 5,000 FY 2006-0007 (Noted below are awards from Trusts and Foundations awarded (a), reduced award (ra) pending (p) or not awarded (na). Bank of Hawaii Foundation $15,000 (p) Hawaii Women's Fund $ 5,000 (na) John M. Ross Foundation $10,000 (na) Kukio Community Fund $ 5,000 (a) recd in FY 2005-06 to be expensed in 2006-07 2 HIUW request for funds for calendar year 2008 to be submitted for $20,000. If awarded, $10,000 will be for expenditures in the 2n° half of FY 2007-08. 3 YWCA Support Shortfalls in HYC budget projections require YWCA board to increase fundraising in order to sustain operations. NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 5 YWCA of Hawaii Island - Agency Name Hamakua Youth Center - Program Name Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The YWCA staff and board of directors is working in cooperation with the Advisory Committee to assure the continuance of the Hamakua Youth Center through fundraising, special events, facility rental, developing long-term relationships with private donors, applications to Trusts and Foundations and endowment possibilities. During the past year, much energy has necessarily focused on developing relationships between Venica Ftacek, Program Coordinator, the many youth who access the services, their parents, community members, area educators and other agencies that provide youth services. Both Cynthia Albers, YWCA Executive Director and Ms. Ftacek attended the 5 day Grantsmanship Training presented by Hawaii County Research and Development, to better improve skills in grant research and grant writing. The Advisory Committee is spearheading a fundraising initiative, tentatively called The Angels Club, which invites ongoing donations by local residents and business so that the HYC prospers and so that donors may see the benefit of their donor dollar at work in their community. This effort will extend to families of youth who use the services, so that families with the means to provide financial support have a mechanism to do so, while maintaining the ability for all youth to attend without regard for ability to pay. To answer to the question "When do you anticipate your program to become self- sustaining", the YWCA Hamakua Youth Center exists due to the demand and commitment of citizens in the community whose goal is to keep those services available at no cost. The YWCA will continue to seek both public and private funds in order to maintain services, and this year will submit a proposal for funding from the Office of Youth Services for a significant percentage of our projected growth budget. Other possible funding streams include partnerships with area businesses, and developing youth business that provide sales of merchandise, such as greeting cards, multi media art pieces, youth production studio, music CD's or videos. These will require ingenuity, expertise and seed money to develop, yet we are optimistic that the civic resources exist and the possibilities for these to occur are within reach over time. "Self -sustainability" in its truest sense is neither desired nor expected, since we will always rely on the cooperation, collaboration and commitment of others. We are of course, receptive to an endowment gift that would help provide assured operational funds ("if you build it, they will come") and state this with our affirmations of growth and prosperity. As long as the need exists and cooperation prevails, we aim to provide free, youth driven, volunteer supported programming so that more opportunities for healthy choices are available for the youth in North Hawaii. NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 6 _ YWCA of Hawai'i Island - Agency Name Hamakua Youth Center - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit program's or agency's future funding requests. 3 0 -2-o re Julie Hugo, goard President Date 11 4il:u4re, Cynthia Albers, Executive Director UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATIONFISCAL YEAR 2007-2008 Page 7