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HomeMy WebLinkAboutCOM 0125.000 2008-2010WilliamP. Kenoi Mn~'or County of Hawaii Finance Department 25 ~upuni Street, Room 118 1-Ilo, 1-Imvaii 96720 (808)96 1-8234 Pax (808)901-8248 February 4, 2009 Yoshimoto, Chairman and Members of the Hawaii County Council Hawaii County Council 25 Aupuni Street Hilo, Hawaii 96720 Re: Nonprofit Grant Application Nancy E. Crawford Dircolor Deanna S. Sako Dcpum Uirecmr 0 ~'o i1 T ~r rn ~, :;~ s ,, ?`r' ~~ 3 =I-rF e" ~~ ~ ~ G~ cn In compliance with Chapter 2, Article 25 of the Hawaii County Code, I am submitting the applications from eligible nonprofit organizations for your review grid appropriation of funds for the FY2009-10 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. This list also reflects one (1) organization that was ruled ineligible for consideration for a grant as they were still in the process of acquiring their 501(c)3 status from the IRS. We will be contacting this organization and informing them of their ineligibility. Should you have any questions, please feel free to call me. ~'~,~,/ Nancy .Crawford Director of Finance Enc. Applications for Nonprofit Grant Funds List of Nonprofit Grant Applicants (NOTE: Due to its size, duplicate copies of the attached applications are not made available; however, copies are available for viewing at the Clerk's Office.) Comm. No. 25 Ref. To: G Hawaii County is an Equal Opportunity Provider and Employer RBf, AQtB 4 ~~9' NONPROFIT GRANT APPLICANTS FOR FY2009-10 ORGANIZATION NAME PROGRAM NAME REQUESTED 1 American Cancer Society Quality of Life Programs for East Hawaii Cancer Patients $ 10,000.00 2 American Red Cross -Hawaii State Chapter Disaster Response & Preparedness for County of Hawaii 25,000.00 3 The Arc of Hilo Arc of Hilo Expanded Advocacy 46,500.00 4 The Arc of Kona Home and Community Based Services-Life Skills Program 20,000.00 5 Arts & Sciences Center HAAS Productions 65,000.00 6 Bay Clinic, Inc. Pahoa Women's Center 40,000.00 7 Big Island Resource Conservation and Development Council, Inc. Resource Conservation and Development Program 10,000.00 8 Big Island Substance Abuse Council East Hawaii Substance Abuse Program 30,000.00 9 Big Island Substance Abuse Council West Hawaii Substance Abuse Program 30,000.00 10 Boys & Girls Club of the Big Island ~ Positive Youth Development Programs: Hamakua Club 60,000.00 11 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club 60,000.00 12 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club 60,000.00 13 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club ~ 60,000.00 14 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club 60,000.00 15 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club 60,000.00 16 Brantley Center, Inc. Employment Rehabilitation Program 25,000.00 17 Bridge House, Inc. Vocational Skills Building Program 52,000.00 18 Child and Family Service Alternative to Violence - 35,000.00 19 Child and Family Service Hawai iCounty -Domestic Abuse Shelters 35,000.00 20 Child and Family Service Hilo Transitional Housing Program 40,000.00 21 Child and Family Service Therapeutic Foster Home Program 35,000.00 22 Eden Earthworks Mountain View Community Gardens 12,640.00 23 Family Support Services of West Hawaii Ka'u Family Center 55,000.00 24 Friends of Big Island Drug Court Assistance to Drug Court Clients & Program 10,000.00 25 Friends of the Children's Justice Center of East Hawaii Special Needs and Enhancement, Center Support, Prevention/Education and Trainin Pro rams 18,000.00 26 Friends of the Children's Justice Center of West Hawaii Enhancement and Basic Needs Program 15,000.00 27 Goodwill Industries of Hawaii, Inc. Job Connections 30,000.00 28 Goodwill Industries of Hawaii, Inc. Kona Retail Store Startup 40,000.00 29 Goodwill Industries of Hawaii, Inc. Work Experience Program 45,000.00 30 Grassroots Community Development Group Kupukupu After-School & Summer Program 60,000.00 31 Grassroots Community Development Group Ohia Lehua Entrepreneurial After-School Program 55,000.00 32 Hale Kipa Hawaii Advocate Program -East Hawaii 80,000.00 33 Hale Kipa Hawaii Advocate Program -West Hawaii 80,000.00 34 Hawai i Centers for Independent Living Independent Living Services 15,000.00 35 Hawaii Island Adult Care, Inc. Hilo Adult Day Center 25,000.00 36 Hawai i Island HIV/AIDS Foundation Multi-Disciplinary HIV Case Management, Hilo 20,000.00 37 Hawaii Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawaii Coun 20,000.00 38 Hawaii Island Workforce and Economic Deveopment Ohana Hale Nani Education Center - Equipment/Supplies 15,000.00 39 Hui Malama Ola Na'Oiwi West Hawaii Health Enhancement 75,864.00 40 The Island of Hawaii YMCA Impact: Youth Assets 2009-2010 65,000.00 41 Ka Hale O Na Keiki Preschool - Families-At-Risk 9,500.00 42 KalauonaoneoPUna 2nd Annual Kalapana Cultural Day 10,000.00 43 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 44 Ke Anuenue Area Health Education Center E Ninau Aku I Ke Kauka 4,944.32 45 Keaukaha One Youth Development Youth Development 10,000.00 46 Kokua Counseling Services Affordable Counseling -Operations 10,000.00 47 Kokua Counseling Services Client Assistance Fund 10,000.00 48 Kona Adult Day Center, Inc. Adult Day Care 30,000.00 49 Kona Literacy Council Kailua Learning Center ~ 2,000.00 50 Ku'ikahi Mediation Center Ku'ikahi Mediation Center 18,000.00 51 Laupahoehoe Train Museum Museum Mentorship Program 40,000.00 52 Lyman Museum Education and Public Programs 40,000.00 NONPROFIT GRANT APPLICANTS FOR FY2009-10 ORGANIZATION NAME PROGRAM NAME REQUESTED 53 Mala'ai: The Culinary Garden of Waimea Middle School Mala'ai: The Culinary Garden of Waimea Middle School 25,000.00 54 Mental Health Kokua Residential Rehabilitation Services 25,000.00 55 Neighborhood Place of Kona Neighborhood Place 200,000.00 56 Neighborhood Place of Puna Family Strengthening Home Visiting 20,000.00 57 Office for Social Ministry Beyond Shelter Transitional Housing Program 15,000.00 58 Office for Social Ministry Care-A-Van Homeless Outreach 20,000.00 59 Office for Social Ministry Kihei Pua Emergency Shelter - 20,000.00 60 Office for Social Ministry Pahoa Homeless Program: Puna Drop In Services 20,000.00 61 Ofhce for Social Ministry Ponahawaiola :Community Re-integration Services 20,000.00 62 Office for Social Ministry West Hawaii Emergency Housing Facility 30,000.00 63 Palekana Kai Ocean Safety, LLC Ocean Safety Education 30,020.00 64 Puna Community Medical Center Walk-in Acute Care Clinic: Indigent Care Program 190,080.00 65 The Salvation Army -Family Intervention Services Independent Living Skills Program -West Hawaii 49,991.00 66 The Salvation Army -Family Intervention Services Prevention Programs - Honokaa 47,066.00 67 The Salvation Army -Family Intervention Services Prevention Programs -Pahoa 46,270.00 68 Special Olympics Hawaii -East Hawaii Special Olympics Hawaii -East Hawayi 20,000.00 69 Special Olympics Hawaii -West Hawaii Special Olympics West Hawal'i -General Funding 15,000.00 70 Sure Foundation, Inc. Yeshua Outreach Center 107,450.00 71 Volunteer Legal Services Hawaii County of Hawaii Pro Bono Legal Services 54,898.00 72 West Hawaii Community Health Center Keiki Health Center (KHC) 47,741.00 73 West Hawaii Mediation Center Mediation Services 15,000.00 74 YWCA of Hawaii Island Empowering Alternatives Program 60,000.00 75 YWCA of Hawaii Island Hamakua Youth Center 50,000.00 76 YWCA of Hawaii Island Healthy Start Program 200,000.00 TOTAL $3,117,964.32 Note: The following non-qualifying organization did not meet the application's requirement(s). _ Green Will Conservancy Puna Farm Work Training Demonstration Project - Ho'o Mo'o Program 50,000.00 - (No proof of IRS 501(c)3 status) County of Hawaii Applications for Nonprofit Grant Funds Fiscal Year 2009-10 February 2009 1 American Cancer Society Quality of Life Programs for East Hawaii Cancer Patients American Cancer Society -Agency Name Quality of Life Programs for East Hawaii Cancer Patients- Program Name Agency Director: Tina Clothier Phone No.: (808) 595-7500 (Oahu) Contact Person: Cathy Hashimoto Phone No.: 935-0025 Mailing Address: 120 Pauahi Street; Suite 302 Hilo, HI 96720 Facility/Site Address: (same) Fax No.: 935-9780 Email Address: cathy.hashimoto@cancer.org Name of Accountant/CPA (include name of firm if applicable): Phone No.: Mailing Address: Amount of Request for County Funds: $10,000 Prior Year(s) Funding: 06-07 07-08 08-09 $ 0.00 $ 0.00 $ 0.00 Agency Mission Statement: Established in Hawaii in 1959, the American Cancer Society Hawaii Pacific, Inc., is part of the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem. Sharing in this mission, the East Hawaii field office works to prevent cancer, save lives, and diminish suffering through educational programs and support services offered to the residents of Hawaii County with special emphasis on the rural, underserved population such as Puna (the fastest growing community on the Big Island) and Kau. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 American Cancer Society -Agency Name Quality of Life Programs for East Hawaii Cancer Patients- Program Name Program Description: On any given day in East Hawaii, American Cancer Society assists with airfare for patients who must travel to another island for treatment, coordinates rides for patients to treatment centers and doctors' appointments, or provides nutritional supplements for patients too weak from chemotherapy to eat solid food. The American Cancer Society fills many gaps in patient care and community service not met by insurers or health care providers, and is dedicated to improving the quality of life for East Hawaii residents from Honokaa to Ocean View facing cancer. In order to improve the quality of life for East Hawaii cancer patients, Total Budget and Position Count Total Pro ram Bud et $44,250 Total Pro ram Position Count 0 Total A enc Bud et $3,936,888 Total A enc Position Count 35 Program Objectives: 1) To support East Hawaii residents newly diagnosed with cancer in the completion of their medical treatment; 2) To improve the quality of life for East Hawaii residents with a cancer diagnosis; Program Highlights: Three critical paths are colliding in the health care industry, specifically for cancer patients: 1) the trend of outpatient care for cancer patients is becoming the normal standard of treatment; 2) the large Baby Boomer generation is aging into the "cancer years" (60+ years); and 3) the depressed economy is creating a situation of hard choices being made in families (food, gas, rent or medical expenses). Individuals diagnosed with cancer face many medical, physical, financial and emotional issues surrounding the disease. The medical aspect is daunting and can mean hundreds of trips to doctors, specialists, hospitals, labs and treatments. These tailored services are intended to support cancer patients and open doors to the American Cancer Society's many programs. Upon NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 referral, East Hawaii residents seeking assistance are enrolled in person or by telephone. Once enrolled, each client receives detailed information on additional educational, and quality of life programs available through the East Hawaii field office, Patient Services Center, and through community colaborations. 1) TRANSPORTATION TO TREATMENT After diagnosing an individual with cancer, doctors create a treatment schedule of protocol. The protocol is specific to the cancer and pathology, and is based on years of research. To miss an appointment is to fail to comply with protocol, and is critical to a patient's survival. This presents a serious challenge for patients who lack the human and/or financial resources to find transportation to and from their treatment, including some who are too weak to drive after treatment. A standard treatment plan for radiation therapy is a six- to eight-week course, administered daily. There are three oncology centers in East Hawaii: Hawaii Pacific Oncology Center (radiation and chemotherapy), Hematology & Oncology Center (chemotherapy), and Kaiser Permanente Hilo (chemotherapy). For rural community cancer patients, their drive for radiation treatment may end up being a 45 to 99 mile ride each way from their homes in Hamakua, Puna, or Ka'u a substantial drive for anyone on a daily basis. The American Cancer Society operates two programs providing Transportation to Treatment: Transportation Assistance Funds and Road to Recovery: • Transportation Assistance Funds: The Society will assist with coordinating air, travel, and housing arrangements for patients who must travel to Oahu for cancer care and treatment or simply to the hospital on the other side of the Big Island. Services include: inter-island airfare, partial reimbursement for mainland cancer treatment flights, taxi services, and gasoline debit cards. • Road to Recovery: This program utilizes volunteer drivers, who provide rides to and from doctors' appointments for those unable to arrange their own transportation due to financial limitations or the effects of cancer and its treatment. Volunteer drivers, based upon availability, donate their time and use their own cars and gasoline for this program. Ground transportation to and from medical appointments, a simple courtesy deeply felt by patients too frail, weak, or emotionally drained to travel on their own. Drivers for the patients are specially trained volunteers, many of whom are themselves cancer survivors who can add a special measure of empathy and compassion to the journeys. 2) SUPPORT GROUPS Often, from the very first day of diagnosis, talking about cancer can be difficult, but conversation is open and therapeutic in American Cancer Society's support programs. Patients speak with each other and survivors in ways that only they can do, offering mutual understanding and sharing strength. The American Cancer Society develop and promote three programs NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 providing support groups to cancer patients and family members in East Hawaii: Reach to Recovery, Us Too, and I Can Cope: • Reach to Recovery: One-on-one support for women recently diagnosed with breast cancer; • Us Too: Prostate cancer support for men • I Can Cope Breast Cancer Support group for women: A new program in East Hawaii 3) PATIENT INFORMATION SUPPORT Information about cancer, its diagnoses, its treatments and its prognoses, are all offered with the sensitivities of patients and family members in mind from the American Cancer Society. Information is state-of-the-art and provides answers to those questions forgotten in the doctor's office. It is available on a personal basis in the East Hawaii field office and through staff and volunteers placed in health care settings. It also is accessible on the ACS website at www.cancer.org and through a 24/7 call center at 1-800-ACS-2345. 4) CHILDHOOD CANCER PROGRAMS The American Cancer Society offers three programs for keiki with cancer and their families. Having a child with cancer can turn a family upside down: adding to the heartbreak, there are time-consuming demands on parents, less time for the needs of siblings, and tremendous stress on the affected child. The Camps are offered free of charge to the keiki and their immediate family. • Camp Anuenue, a weeklong summer camp for children with cancer, ages 7 to 17. This experience provides an opportunity to build friendships with other children who also are fighting cancer. It has helped many keiki find the hope and physical strength to survive. • Ho`oulu Me Ka Ikaika ("Grow with Strength"), a retreat for teens and young adults, ages 14 to 21. This retreat empowers young people to face the combined stresses of cancer and the teen years. • Families CanvSurvVive, a family conference for children with cancer, their parents and siblings that provides an opportunity for families to discover their individual and family strengths while encouraging trust and communication. 5) NUTRITIONAL SUPPLEMENTS Nutritional supplements in the form of Ensure Plus or Glucerna. Cancer patients can find themselves debilitated physically and financially. Providing supplements to those who need them, when they need them, is often critical to their very survival. 6) LOOK GOOD...FEEL BETTER CLASSES A program that's like a make over for the spirit. Cancer can rob a woman of her energy, appitite and strenght. But it doesn't have to take away her self- confidence. Look Good... Feel Better is a free program that teaches beauty techniquest to women cancer patients in active treatment to help them compat the appearance-related side effects of cancer treatment. For those patients feeling a loss of physical self-esteem, these classes, shared with NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 other patients, have a therapeutic value far beyond their cosmetic tips. Patients may also drop in any time to select a wig, scarf and hat. 7) SURVIVOR CELEBRATIONS Cancer survivors celebrate life and the victory over crisis_at survivor celebrations at Relay for Life. By design, these survivor celebrations are empowering to those who faced their health crisis head on and provide hope and inspiration to those still in treatment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 American Cancer Society -Agency Name Quality of Life Programs for East Hawaii Cancer Patients - Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Total East Hawaii Cancer Patients 340 360 380 Served "ACS Days" -Hospital/Community 32 40 50 Health Center Visits Cancer Prevention/Early Detection 1300 1500 1600 Information Provided in Face-to- Face Discussions Cases of Nutritional Supplements 287 300 325 Provided Su port Group Participants 80 100 120 Inter-Island Airline Transportation 36 46 56 Se ments Provided Taxicab One-Wa Reimbursements 73 80 90 Gasoline $50 Debit Cards Provided 107 120 140 Look Good... Feel Better Class 0 24 32 , Partici ants Wi s Provided 30 50 60 Personal Health Manager Kits 30 100 125 Provided to Cancer Patients Road Ito Recovery Volunteer Drivers 4 6 8 "If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 0 0 0 Professional Fees 0 0 0 O erations 0 0 0 Equipment 0 0 0 Other" $37,611 $40,800 $44,250 Total $37,611 $40,800 $44,250 If applicable ~ Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 American Cancer Society -Agency Name Quality of Life Programs for East Hawaii Cancer Patients - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et "` FY 2009-10 Estimate Adrienne Won To ozaki Fund $4,000 $4,000 $4,000 Theodore A. Vierra Fund $7,500 $7,500 $7,500 Cancer Care Trust $3,143 $3,000 $3,000 Total $14,787 $14,500 $14,500 "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? Any shortfall in funding will be made up through the general operating funds from our community fundraising. Until major changes occur in health insurance coverage, physician and facility capacity, and cancer care protocols, we will continue to cobble together a safety net of volunteer programs, donated resources and grant funding for cancer patients. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 American Cancer Society -Agency Name Quality of Life Programs for East Hawaii Cancer Patients - 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 ayear-end report to the Legislative auditor within 60 davs 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 vour program's or agency's future funding requests. ~~ay~oa Date ~/a~loq Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 Signature of Executive Director American Cancer Society Hawaii Pacific, Inc. 1/zs/zoos July 1, 2009 to June 30, 2010 East Hawaii Patient Services -Quality of Life Program Budget Total East *Additional Hawaii Budaet Countv of Hawaii Fundina Direct Patient Services FY2009 Request Sources Ground Transportation to Treatment gasoline debit cards, for treatment travel on Hawaii and, if medically necessary, on Oahu $7,000 ~ $3,000 , $3,000 Taxicab Fare while on Oahu for cancer surgery or treatment $2,250 $0 $2,000 Inter-island Air Transportation to Treatment $8,400 $3,000 ~~ $3,900 Partial Transpacific Airfare Reimbursement $2,500 $0~ $2,500 Reach to Recovery personal visits, support services and supplies for breast cancer patients, and volunteer training $500 $0', $500 Road to Recovery development and volunteer training $500 $500 $0 Look Good...Feel Better Program classes, makeup kits, wigs, volunteer training $500 $500 $0 Nutritional Supplements $9,100 i $1,000 $7,400 Medical Equipment including shower seats, mist patient needs not insur. covered $1,SOOi $0 $1 500 Childhood Cancer Programs $8,000 $O $6,000 Newly Enrolled Client Services including the most up to date information on cancer and local resources; a lending library; and monthly meetings for patients; and educational materials and displays, Personal Health Managers. j $1,000 $1,OOOI 0 Ongoing Client Services including supplies for cancer patients, general services $2,000 $1,000'i $1,000 Survivor Celebration $3,000 $O, $3,000 Total Budget: S44,zso $10,000 $so,soo * Additional Anticipated Funding Sources include: ~I Theodore A. Viers Fund, Cancer Care Trust & Adrienne Wong Toyozaki Fund for 2009/2010 = $14,500 Remainder of funds to be raised b Relay for Life income and individual/cor orate donations. ~% American Red Cross -Hawaii State Chapter Disaster Response & Preparedness for County of Hawaii Agency Name: American Red Cross, Hawaii State Chapter Program Name: Disaster Response & Preparedness for County of Hawaii Agency Director: Coralie Chun Matayoshi, Chief Executive Officer Phone No.: 808-739-8101 Contact Person: Youline K. Kalima, County Executive Director Phone No.: 808-935-8305 Mailing Address: American Red Cross Hawaii County 55 Ululani St.. Hilo Hawaii 96720 Facility/Site Address: 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 CPA: CW Associates Phone No.: 808-531-1040 Mailing Address: 700 Bishop Street, Suite 1040 Honolulu, HI 96813 Amount of request for County Funds: 25 000 Prior Year(s) Funding: 2006-07 2007-08 2008-09 $5,000 $15,000 $25,000 Agency Mission Statement: The American Red Cross is a humanitarian organization led by volunteers and guided by its Congressional Charter and the Fundamental Principles of the International Red Cross Movement. Our mission is to prevent and alleviate human suffering by helping people prevent, prepare for, and respond to emergencies, and to provide disaster relief to the people of Hawaii 24 hours a day, 7 days a week, 365 days a year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 1 Although established by Congressional Charter in 1905, the American Red Cross is NOT a government agency and must rely on the generosity of Hawaii's people to provide critical services to the community. All disaster training, services, and financial assistance to victims is free. Therefore, fundraising is critical to ensure that services can continue. History: The Hawaii State Chapter was founded in 1917 and has assisted victims. of every major disaster in the islands' history, including the bombing of Pearl Harbor, Hilo tsunami, volcanic eruptions, Big Isle earthquake, Hurricanes Iwa and Iniki, New Years & Manoa floods, Kaloko Dam burst, Sacred Falls landslide, Xerox shooting, air transportation crashes, and hostage situations. 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. Program Description: The Hawaii County Red Cross Disaster Preparedness and Response Program includes disaster relief assistance to help victims of single family and major disasters overcome the physical and emotional distress of a disaster and meet their immediate emergency needs as they begin to rebuild their lives after a tragedy. This assistance includes food, clothing, shelter, mental health counseling, and financial assistance to help families recover more quickly from a disaster. Our volunteers are ready to respond to disasters 24 hours a day, 7 days a week, 365 days a year. We have 453 active disaster volunteers statewide and leverage the resources of our volunteers to provide this critical service. We also have over a thousand more volunteers statewide who are trained to help in a major disaster. Recruiting, training and mobilizing all of these volunteers is an ongoing job. Because a disaster can strike at any time without notice, advance preparation makes a significant difference in the well-being of a family or the resiliency of a business. As 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. All disaster training and response are provided free of charge. The Hawaii State Chapter continually trains volunteers to become disaster responders to serve during time of disasters (all disaster training is free). In the last fiscal year, the Red Cross conducted courses for 1,500 volunteers in different communities statewide to achieve our objective of providing a seamless response when disaster strikes. We train volunteers to be able to conduct disaster assessment in neighborhoods, serve as shelter managers, conduct crisis counseling and emergency first aid and provide financial assistance to those whose homes have been affected by disaster. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 2 Our volunteers actively exercise with state agencies in preparation for natural disasters, pandemics and acts of terrorism. Through trained and capable disaster responders, communities will be better prepared prior to, during and after disasters. In light of lessons learned from the recent flooding, Hurricane Katrina and in the past from Hurricane Iniki, it is critical to have trained and capable volunteers ready and prepared to respond if a large disaster struck our islands. In a larger disaster or tragic event, crisis counseling, mass care, disaster welfare information, emergency first aid and other support services as appropriate are also provided to victims. These services are 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. Another component of this program is community education, which empowers families and individuals to prepare for and respond to disasters before they strike. This will result in more aware and prepared communities. Red Cross volunteers and staff continually go out into the community to speak to the public about the importance of being prepared before a disaster strikes: get a disaster supplies kit, make a plan for your family and workers, and be informed. Because a disaster can strike at any time without notice, it is essential for communities to be prepared. Advance preparation can make a significant difference in the well-being of a family or the resiliency of a business. With the threat of avian flu, bio-terrorist attacks, and major natural disaster, the American Red Cross is more relevant and necessary than ever before. With global warming and changing weather patterns, it is not "if," but "when" a major disaster in Hawaii will occur. Hawaii is especially vulnerable to hurricanes, tsunami, earthquakes, and other natural disasters. When a disaster strikes, we will have to be able to survive longer on our own due to our isolation. It is critical for the Red Cross to be prepared for and respond to everyday disasters and major disasters. Bip 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. Who We Serve: The Hawaii Red Cross provides compassionate aid to people in Hawaii who fall victim to natural and man-made disasters that occur every 3 days in Hawaii. Disaster victims served by the Hawaii Red Cross are the poorest of the poor. All disaster training and response are provided free of charge, due to the generosity of our donors. According to an August 2006 Census Bureau report, 9.8% of Hawaii's population, about 110,000 people, live below the poverty level. Hawaii has the seventh- lowest poverty rate in the nation. This "poor and needy" population is particularly vulnerable to disasters and is dependent on Red Cross services when affected by a disaster. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 3 Based on family size and income levels, 45% of disaster families we served in FY08 on the Big Island were below the poverty level. The 2007 State of Hawaii Data Book states that 10.5% of Hawaii's households made less than $25,000. In FY08, the percentage of our Big Island client families making less than $7,500 per year was 17%, with 50% making less than $25,000. Since well over half of them do not own their homes and have no property insurance, they are truly destitute after a fire destroys everything they own or claims the life of a loved one. The Red Cross is truly a safety net for victims of "every day' disasters who have nowhere else to turn. The Red Cross not only offers food, clothing, and shelter to those who may have lost everything they own, but also volunteer caseworkers provide crisis counseling and emotional support to help these victims get back on their feet. Beyond the "every day' disasters, the Red Cross is preparing for and will respond to major disasters, which may affect the entire population of Hawaii, especially those with special needs like the elderly, frail, handicapped, and poor. When disasters occur, the American Red Cross will be there to support the County of Hawaii by providing families with relief assistance in time of need. The Hawaii State Chapter is requesting $25,000 from the County of Hawaii to help subsidize the financial aid we provide to Big Island disaster victims and emergency responders, train volunteer disaster responders so that local communities on the Big Island are prepared, and to share important preparedness information to people on what to do before a disaster strikes. This amount does not even begin to cover the staff and volunteer training, equipment, and support needed to respond to every day disasters, as well as educate and prepare Big Island residents for the next major disaster that is sure to come. Hawaii County Funding is critical to build resiliency and capacity for the communities of Hawaii County. Total Budget and Position Count . Total Program $252,700 Total Program Position Count 1.5 Budget for FY 09-10 Disaster Services Total Agency Budget $500,000 Total Agency Position Count 5 for FY 09-10 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), train volunteer responders and share critical preparedness information to the communities on the Big Island. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 4 Objectives: Provide for the immediate emergency needs of Big Island disaster victims (food, clothing, shelter, crisis counseling). All disaster services are free. 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. Prepare families, businesses, and communities with essential preparedness material and information because a disaster can strike at any time without notice. 4. Train volunteer disaster responders to serve their local communities during times of disaster. We train volunteers to be able to conduct disaster assessment in neighborhoods, run shelters, conduct crisis counseling and emergency first aid, and provide financial assistance to those whose homes have been affected by disaster. Our volunteers actively exercise with federal, state, and county agencies to prepare for natural disasters, pandemics and acts of terrorism. All disaster volunteer training is free. 2. Program Highlights: In the past fiscal year (July 1, 2007 through June 30, 2008), the American Red Cross in Hawaii County provided the following services to Big Island individuals and families: • Responded to 26 disasters on the Big Island enabling 111 individuals to recover from their losses and begin rebuilding their lives (does not include earthquake response). Less than half of the victims were homeowners and only 35% had structural insurance. 45% of families assisted. were below the poverty level (14% unknown). • Opened 5 shelters due to flooding and vog, sheltering 34 individuals who needed to evacuate or were unable to return to their residences. Served 68 meals to emergency workers and affected individuals. • Has 133 active disaster volunteers with 19 more signing up in FY08. • Reached over 1,500 persons with disaster preparedness information through community presentations. • 253 registered in disaster training courses. • In East Hawaii alone, provided 2,502 Hilo individuals with first aid and CPR training, 300 individuals with aquatics training and 25 individuals with other health and safety trainings. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 5 Examples of responses are as follows: Hilo 2/2/2008 Floods: Following 2 weeks of constant rain, a storm with torrential rain (40" within 3 days) occurred causing flooding to the Hilo and Puna areas of the Big Island and damaging several homes. The Red Cross responded with emergency assistance for 6 families. Mass Care provided 40 meals and 2 shelters were opened giving refuge to 4 people. In August, 2007, Hurricane Flossie threatened the Big Island. Although it was downgraded from hurricane status, the Red Cross did prepare those on island for storm-like effects. Schools were closed and the Red Cross opened 11 evacuation shelters at Kau High & Intermediate, Keaau High School, Pahoa High School, Mountain View Elementary, Waikoloa Elementary, North Kohala State Office Building, Kealakehe High School, Konawaena High School, Waiakea High School, Honokaa High School, and Waikoloa Elementary. There were over 220 overnight stays in these shelters. This was another example where the Red Cross was prepared and ready to help the communities on the Big Island during a time of potential disaster. In the first half of this fiscal year (FY09) to date, the Red Cross has already responded to 14 incidents on the Big Island from house fires, brush fires and flooding in Kailua- Kona, Ocean View, Hilo, Captain Cook, Keeau, Honokaa, Pahoa, Pepeekea, Waimea and Holualoa. Our efforts have enabled over 29 individuals to recover from their losses and begin rebuilding their lives. We opened one shelter in response to a brushfire and provided 13 individuals with a safe place to stay. Performance Measures: Disaster Response and Preparedness in Hawaii Countv -Performance Measures: FY 2007-08 Actual FY 2008-09 Bud et FY 2009-10 Estimate Disaster Res onses 26 30 30 Individuals Assisted After Disasters 111 120 120 Mass Shelters O ened 5 5 5 Numbers Reached through Disaster Presentations in Communities 1500 1500 2000 Trained Individuals in Disaster Res onse 253 300 300 Program Expenditures (Disaster Response and Preparedness): FY 2007-2008 Actual FY2008-2009 Bud et FY2009-2010 Estimate Salaries and Wa es 72,652 72,938 75,000 Operations (occupancy, communication, postage) 44,963 59,053 61,000 E ui ment 0 1,424 1,500 Materials Su lies 11,842 6,990 7,200 Travel 4,433 12,545 13,000 Disaster Relief Assistance * 22,444 22,400 23,000 Administrative/Tech Su ort ** 0 69,208 72,000 Total 156,334 244,558 252,700 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 6 * Monies are budgeted for the entire state for disaster relief assistance as it is unknown where disasters will occur. As disasters occur on the Big Island, expenses will increase accordingly. ** NOTE: It is important to note that expenses shown for FY07-08 do NOT include significant administrative, technical and programmatic support provided to the Red Cross on the Big Island. The budgets for FY08-09 and FY09-10 have now included these allocations. Program Funding Source (Disaster Response & Preparedness}- Identify all funding sources (specific to this program only) Revenue Source for Disaster Services Pro ram FY2007-2008 Actual FY2008-2009 Bud et FY2009-2010 Estimate Hawaii Coun 15,000 25,000 30,000 Hawaii Island United Wa 24,000 25,000 30,000 Contributions (Direct Mail & Grants * 33,086 33,247 34,000 Fundraisin Hats O * 4,800 5,000 5,000 TOTAL REVENUE 76,886 88,247 99,000 TOTAL EXPENSES 156,334 244,558 252,700 Amount Hawaii Chapter must subsidize for both Hilo and Kona offices to meet expenses for this ro ram dis svcs 79,448 156,311 153,700 NOTE: 1. HIUW. Total given is $50,000 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. 3. Grant funding not reflected above FY09 discretionary funding to preposition disaster equip/supplies Dept 552 Requested $26,000 approved $26,000 Hawaii County R&D 4/08 (Stacy Higa) Requested $5,000 approved $5,000 Dept 549 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 continue to work on increasing Red Cross visibility in the community in order to increase private individual and corporate donations from Big Island residents and businesses. We are looking at possible fundraising opportunities on the Big Island such as special events, along with major donor cultivation. 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 any amounts obtained during the award period. Failure to submit a timely complete ahd accurate vear end report may impact the evaluation of vour program's or agency's future funding requests. GLI G~~~y~'~~^~ January 22, 2009 Signature of Board President/Chair Coralie Chun Matavoshi, CEO Signature of Executive Director Date January 22, 2009 Date NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 8 3 The Arc of Hilo Arc of Hilo Expanded Advocacy The Arc of Hilo- Agency Name Arc of Hilo Expanded Advocacy -Program Name Agency Director: Contact Person: Mailing Address: FacilitylSite Address Fax No.. Email Address: M. Gleason Debbie Perkins 1099 Waianuenue Ave Hilo, Hawaii 96720 Phone No.: x208 Aging and Disabilities Resource Center (ADRC} Sun Sun Lau facility on Kinoole Street, Hilo 961-0148 dperkins@hiloarc.org Name of Accountant/CPA (include name of fine if applicable): Ann Fukuhara, CPA, MBA, An Accountancy Phone No.: 961-5582 Mailing Address: 714 Kanoelehua Ave, Box 6691, Hilo, HI 96720 Amount of Request for County Funds: $46, 500 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $ 29,000 $25,000 Agency Mission Statement: To improve the quality of life for people with developmental disabilities who reside on Hawaii through Education, Vocational Rehabilitation, Job Training, Job Placement, Life Skills Training, and Recreational Programs. Phone No.: 935-8535 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 ~_ The Arc of Hilo -Agency Name Arc of Hilo Expanded Advocacy- Program Name Program Description: The Expanded Advocacy Program is designed to assist people with disabilities and their families to access the social services they need in the community and this state. Services to people with disabilities include: Information and referral, advocacy, counselling, outreach, and education. Total Budget and Position Count Total Program Budget $46, 500 Total Program Position Count 1 Total Agency Budget $6 million Total Agency Position Count 173 Program Objectives: 1) The Arc of Hilo has been invited to be the lead agency to staff the new County Aging and Disabilities Resource Center (ADRC) in Hilo to deal with issues related to people with disabilities. The new Center will open this Spring and will give The Arc's newly trained staff person, vrginia Lopez, the opportunity to develop and utilize new plans to provide the very best services possible. Specific program objectives are to: 2) Advocate for people with disabilities in the community (including individuals and families from other island communities and cultures) to help them access services they need, such as job hunting and training, transportation, housing, and medical care. 3) Provide education services to individuals and community groups including schools and colleges and service organizations about disability issues. 4) Serve as a community resource for anyone needing information and referral on any disability relate issue. 5) Counsel individuals and their families on acculturation issues, adjustment, and any other disability related issues 6) Expand on the above objectives by developing new data management software which will improve information flow in the organization. 7) Prepare brochures and other training aids to present at information workshops and conferences with a future goal in the third year of developing informational workshops to be presented in the school system to reach students with disabilities before they leave the school system.. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Program Highlights: 1) Owing to cutback in funds budgeted, an abbreviated start up of this project was started by regular staff until a full time staff person was hired to begin the program in December. 2) The Arc of Hilo was selected as one of the lead agencies to support people with disability issues coming to the new County ADRC. Owing to delays in opening this Center, The Arc was unable to start the advocacy program on the scale originally proposed. 3) Intake forms were devised (see copy in attachments), and intake procedures were developed and temporary initial staffing at The Arc assisted 315 contacts (over a 4 month start up period) during the past year. 4) One month with full time staffing generated 160 contacts which suggests the annual contacts of a 12 month program could be in the order of 2000 per year. 5) Some issues our advocate has assisted with are: 1) Application for Social Security Insurance, or Social Security or Medicaid Waiver Services, 2) Assistance to find nursing support for persons with disabilities living independently to access medication, 3) Assistance to employed people who have difficulty reporting earnings to Social Security. 6) NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 The Arc of Hilo - A ency Name Arc of Hilo Expanded Advocacy -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Information and referral 360 Referral 120 Outreach 750 Advocacy 600 Education 50 Total Contacts 1880 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wages $40 000 $40,000 Professional Fees 288 Operations 12 Equipment Other 6200 Total $46, 500 " If applicable "Please explain in detail on separate sheaf NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 The Arc of Hito -Agency Name ' Expanded Advocacy -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et • Estimate None Total *If aaolicable 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~ustaining? Since this program wilt not directly generate revenue from the training sources The Arc of Hito normally relies on, The Arc will need to build its annual general revenue reserves to the point that it can cover the costs of this community service. The Arc's goal is to make this program self-sustaining within a three year period. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 The Arc of Hito -Agency Name Expanded Advocacy -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 davs 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 aaencv's future funding requests. t,C~ ~gnature of Board President/Chair ~~ ~~ Signature of Executive Director /~~/o ~ Date _/ 2 0 Dat UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 The Arc of Hilo Expanded Advocacy Program Notes from Page 3, "Other#" Operatio aIt I Exoe~cPC• i~r•todine tPta„t...,,o ta.•r.•:.• a rh Mileage Reimbursement 600 Advertising 2400 Postage 500 Business Cards 100 Promotional Items (giveaways) 1000 Fee for Health and Job Fairs Booths 100 Staff Training (Pacific Rim Conference) 700 Staff Training [Other Training) 800 Total $6200 Aging and Disability Resource Center (ADRC)- The Arc of Hilo 1055 Kino'ole Street, Hilo, Hawaii 96720 Referral Date: Name: Address: DOB: Type of Disability: Intake & Needs Assessment Form Outreach Advocacy Education. Age: Phone Number: (Home) (Other) (Cell) Caregiver's/Contact person: Association to Client: If agency, what agency: Phone Number: How were you referred to us: Arc Self/Walk-in: Friend: If agency, which agency: Reason for Visit/Call: Resources/Referrals/Outcome: Family: Agency: Continued Reason for Visit/Call: Reason for Visit/Call: 4 The Arc of Kona Home and Community Based Services-Life Skills Program Arc of Kona HOME AND COMMUNITY BASED SERVICES LIFE SKILLS PROGRAM Agency Director: Gretchen Lawson Phone No.: 808-323-2626 Contact Person: Jeani Navarro Phone No.: 808-775-1090 Mailing Address: P.O. Box 127 Kealakekua, HI 95640 Facility/Site Address: 81-1065 Konawaena School Road Kealakekua, HI 95640 Fax No.: 808-323-9444 Email Address: jeani@arcofkona.org Name of AccountantlCPA: 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: 06-07 07-08 08-09 $18,000 $20,000 $15,000 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 Fiscal Year 2009-2010 Page 1 of 7 Arc of Kona HOME AND COMMUNITY BASED SERVICES LIFE SKILLS PROGRAM Program Description: For nearly forty-two years, the Arc of Kona has successfully operated an Adult Day Health (ADH) standard classroom program that serves 20 participants on a daily basis and a Personal Assistant/Habilitation program island-wide that serves 50 participants on a daily basis in their community setting. Together, these two programs, are known as Home and Community Based Services for individuals with Developmental Disabilities/Mental Retardation (DD/MR). Individuals enrolled in the these programs are a mix of native Hawaiian, Asian/Pacific Islander, Filipino and Caucasian youth and adults ranging from 8 to 60 years of age with a core group of young adults in their late teens and mid 20's. All of the participants in the Home and Community Based Services programs have been identified as DD/MR (Developmentally Disabled/Mentally Retarded) 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 are cognitively not able to make good judgments and therefore need the types of supports that insure their safety and help with activities of daily living. They need to be in a caregiver's line of vision.at all times and require assistance gaining access to community services and activities that will allow them to begin integration into the communities where they reside. This population has several risk and protective factors that we consider when designing individual life skills training. First, this population is at risk of abuse, both sexual and physical, and need to be taught the skills for saying "NO" and reporting abuse. The DD/MR population is at risk for chronic disease and has a high incidence of diabetes and heart problems related to weight and diet. Finally they are all at risk for homelessness and/or being unprepared to prove they can live independently both with daily living skills and finances to prevent homelessness. Protective factors we consider include: a) training in social development, b) appropriate sexual behaviors, c) protection from abuse, including family members as well as strangers, d) proper nutrition, and e) preparing individuals to find their own housing accommodations and live as independently as possible, with or without other agency supports. The "community as a classroom" where participants can practice these skill sets becomes essential to strengthening the Nonprofit Grant Application Fiscal Year 2009-2010 Page 2 of 7 Arc of Kona HOME AND COMMUNITY BASED SERVICES LIFE SKILLS PROGRAM protective factors around this vulnerable population. When provided with community access services for their life skills component, our participants can share their many skills and gifts that benefit the larger community. The Arc of Kona's $20,000.00 request would enhance service delivery by purchasing life skills training supplies and funding mileage for access to and from home, classroom, and the community, as well as a portion of the staffing and payroll taxes attached to the salaries. Total Budget and Position Count: Total Program Budget 318,126 Total Program Position Count 6 Total Agency Budget 3,400,000 Total Agency Position Count 112 Program Objectives (Proposed): 1) Provide a safe, healthy, and supportive environment for daily living skills in the community setting for 365 days per year from July 1, 2009, to June 30, 2010. (These services will relieve families of the stress of daily care giving and allow them the opportunity to work if they desire and make a living and/or care for other children). 2) Provide individualized life skills training programs, with measurable goals and objectives 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 throughout the program year (7/09-6/10). 4) Provide needed materials to assess, instruct and support life skills specific training in health and safety areas relating to abuse and appropriate sexual behavior as well as hygiene, money management, household safety issues and nutrition. 5) Provide needed supports for interacting appropriately with each other and the public within the community setting throughout the program year that supports the independent living skills required to function on a day to day basis. Nonprofit Grant Application Fiscal Year 2009-2010 Page 3 of 7 Arc of Kona HOME AND COMMUNITY BASED SERVICES LIFE SKILLS PROGRAM Program Highlights from Last Year: (Adult Day Health Classroom) 1) Twenty (20) 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). The training positively resulted in a reduced number of behavior outbursts and incident reports. 2) Twenty (20) 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. 3) Twenty (20) participants were able to participate in yoga classes, walking and stretching training that has resulted in better balance and body awareness, and therefore less falling/tripping and more self esteem. 4) Twenty (20) 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) Twenty (20) participants attended a dental presentation from Dr. Alt, DDS, and received free dental cleanings. 6) Twenty (20) participants attended a free Kayak/Surf Day and were able to be in the water and participate in a water sport, many for the first time in their life. 7) Twenty (20) participants attended a free social event called the Black and white (Ball, which included invitations to people with Developmental Disabilities island-wide. 8) Fifteen (15) participants received a training presentation by an outside community source on 'social boundaries.' 9) Nineteen (19) participants received a training presentation by an outside community source on 'what makes you happy.' Nonprofit Grant Application Fiscal Year 2009-2010 Page 4 of 7 Arc of Kona HOME AND COMMUNITY BASED SERVICES LIFE SKILLS PROGRAM Performance Measures: Adult Day Health 1. Provide a safe, secure classroom environment with sufficient staff supervision, 5 days a week, 52 weeks a year, for 20 DD/MR participants. Note: The ADH program saw an increase of five participants upon high school graduation this past year bringing total of a minimum of 20 participants. We anticipate more referrals this coming year. New: Deliver on going life skills training in the classroom and the rural areas as per each individual's plan developed by the Department of Health, the family and the Arc of Kona. 2. Provide access to the community for hands-on life skills training experiences including food and clothing shopping, fire safety, ordering and eating in public, handling money, making appointments, nutrition and exercise, and appropriate behaviors in public 3. Provide on-going life skills assessments and data collection for each individual. This includes areas such as recognizing and reporting abuse, health, hygiene, safety, socialization, basic cooking skills, behaviors; consumerism, basic literacy and job skills training. FY 2007-08 Actual Adult Day Health 260 days of ADH standard classroom activities with a one staff to four participant ratio. 144 transports into the community for activities that promote individual life skills goals. classroom instruction for life skills and daily living activities with pre and post testing for assessment of base line skills, data collection and quarterly and year end reporting on achieved results. FY 2008-09 Budget Adult Day Health 260 days of ADH standard classroom activities with a one staff to four participant ratio. 144 transports into the community for activities that promote individual life skills goals. completed classroom instruction for life skills and daily living activities with pre and post testing for assessment of base line skills, data collection and quarterly and year end reporting on achieved results. Estimate New: Home and :ommunity Based This includes those participants outside of the classroom living in the rural areas. 365 transports proposed. 365 days of instruction. -It appucabie: Nonprofit Grant Application Fiscal Year 2009-2010 Page 5 of 7 Arc of Kona HOME AND COMMUNITY BASED SERVICES LIFE SKILLS PROGRAM Program Expenditures: FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Salaries and Wages 191,876 243,697 255,882 Professional Fees Operations 69,739 56,501 62,244 E ui ment Other" Total 261,615 300,198 318,126 If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate County of Hawaii 20,000 15,000 20,000 Hawaii Island United Wa 40,433 28,000 30,000 State Medicaid Waiver 194,802 252,398 265,126 Fund Raisin /Donations 6,380 4,800 3,000 Total 261,615 300,198 318,126 *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 42"d 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 June, we held a musical concert in conjunction with Hawaii Performing Arts, with plans to repeat the event again this year. We also have an upcoming Blue Grass benefit concerts with Grammy award winning artists Laurie Lewis and Tom Rozum scheduled at the Aloha Theater in March of 2009. We have been actively and successfully working with our donors for additional program support. We do not anticipate that this program will be self sustaining in the near future. However, the Arc of Kona is actively working with our Board of Directors and the community to offer events all through the year which will also educate the public about the needs of our population and generate a stronger donor list both local and through our website. Nonprofit Grant Application Fiscal Year 2009-2010 Page 6 of 7 Arc of Kona HOME AND COMMUNITY BASED SERVICES 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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of vour proaram's or agencv's future funding requests. ~~ Signature of Board B'resident/Chair Date Sig ture of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED Nonprofit Grant Application Fiscal Year 2009-2010 Page 7 of 7 5 Arts & Sciences Center HAAS Productions COPY Arts & Science Center- Agency Name HAAS Productions- Program Name Agency Director: Contact Person: 230-0618 Mailing Address: Facility/Site Address: Fax No.: Email Address: Gail Clarke Gloria Baraquio PO Box 2091 Pahoa, HI 96778 15-1397 Homestead Rd Pahoa, HI 96778 965-3733 gbaraquio@gmail.com Phone No.: 808- Name of Accountant/CPA (include name of firm if applicable): Peter Demichele, Carbonaro CPAs & Management Phone No.: 808-242-5002 Mailing Address: 1885 Main Street, Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $3,000-65,000 Prior Year(s) Funding: 06-07 07-08 08-09 $2000.00 $2000.00 $1925.00 Agency Mission Statement: To provide support services and infrastructure for community-based learning Phone No.: 965-3730 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Arts & Science Center -Agency Name HAAS Productions- Program Name Program Description: Launched in August 2008, HAAS Productions is ASC's newest project, with the purpose of 1) providing real-world experience for youth in TV production and 2) developing a digital media facility that will serve the Puna community and beyond. Directed by local TV ProducRar Gloria Baraquio, the current program consists of seven high school students at Hawaii Academy of Arts & Science and several adult volunteers (parents and film professionals). The team meets an average of 3 hours a week after school to produce, direct, write, host, and edit short videos to submit to local and global film competitions. HAAS Productions has partnered with Na Leo O Hawaii (Big Island Public Access TV Station), KYBC (Kea'au Youth Business Center), and the Big Island Film Office to utilize their facilities, equipment, and training programs. The program is seeking funding ($3,000-$65,800) to purchase its own equipment and to compensate its volunteers. Total Budget and Position Count Total Pro ram Bud et 67,800 Total Pro ram Position Count 2 Total A enc Bud et 183,354 Total A enc Position Count 13 Program Objectives: 1. Obtain HD (high-definition) film/edit equipment and facility by July 1, 2009. 2. Establish and attend weekly training workshops for students in filming/editing for the first academic quarter (August-December 2009). 3. Produce two short films per quarter (October-June) for contest submission and/or PSA broadcast. 4. Schedule and participate in 2 professional shoots where students can intern on production sets ("Living Local", "Living in Paradise", "Kama'aina Backroads", "Lost", and/or feature films in Hawaii) 5. Establish a competent team of student producers to create and broadcast a TV series on OC16 and/or a national network in 2011. The vision is that • Students will independently produce films, commercials, and TV shows, responsibly and ethically • Businesses, locally and globally, will hire students and graduates of HAAS Productions to produce films, commercials, and other media products for them. • Hawaii will be recognized for its booming independent film industry. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Program Highlights: , :. With limited time, funding, equipment, transportation, and experience, these amateur filmmakers of HAAS Productions have made considerable amounts of progress in producing, writing, hosting, directing, shooting, and editing skills. More notably, students have learned to work as a team, communicate effectively, listen to each other, take initiative, and build self-confidence. Essentially, these students are developing into leaders, while they become independent filmmakers. In four months, the team has successfully produced a total of four videos: 1. Intro to HAAS Productions. Filmmaker Chris Shaeffer donated his time and equipment for the students to film and interview each other about why they joined HAAS Productions and what they hope to get out of it. Students worked with cameras, lights, monitors, microphones, and makeup. The final video was 2:30. 2. This is our Hawaii. Students wrote and produced their own short film to submit to the E Malama Aina Film Festival on Sustainability. They shot on HAAS's miniDV camera and edited on a student's personal laptop, completing a 60-second video on our way of life here in Hawaii and how we can preserve it. Their video won the film contest at the Palace Theater in Hilo, and it will soon air on Kama'aina Backroads, a TV series that broadcasts statewide and in Las Vegas. 3. Season's Greetings. Na Leo Directors assigned our students to interview and film locals in Downtown Hilo to make their Christmas greetings. Students used Na Leo equipment and interviewed strangers in Hilo to produce a video to air on Na Leo. The final video was 2:30. 4. Real Food is...Grown. Independently produced by student Courtney Campbell, assisted by her teammates, this 3-minute video is a film submission to the Farm to School Video Contest on YouTube. The winning school will earn $1000 to go towards local produce in student meals. John Mason, Big Island Film Commissioner, escorted our students on the film set of "The Tempest", a Miramax film shot in Hilo. It was exciting for our students to witness professional actors, directors, and producers in action. This semester (January-June 2009), students are scheduled to submit films to 3 more video contests (HMSA video on health, E Ola Pono video on living in harmony, and Na Leo video on natural energy). Na Leo has also assigned them to interview and film the Legislative Session at the Capitol in Honolulu, a trip that Na Leo will sponsor for us. This will air on public TV. Students are also invited to work as production assistants on the set of "Living Local" in Honolulu to shoot episodes for the coming Spring season. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Arts & Science Center -Agency Name HAAS Productions -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Produced 4 videos, 0 $10,000_ About 100 hours of fieldwork and 0 $55,000 trainin n aNNiwauiC Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et " FY 2009-10 Estimate Salaries and Wa es 0 57200 Professional Fees 0 0 Operations 0 2000 E ui ment 0 8600 Other" 0 0 Total 0 67800 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Arts & Science Center -Agency Name HAAS Productions -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Healin Our Island 2000 Island Naturals ~. 5000 Arnott's Lodge 5000 Bank of Hawaii 5000 Hawaiian Electric Industries 5000 Fundraisers 5000 Total 27000 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 Productions will continue to seek funding through grants, sponsors, and investors, with the hope of being self-sustaining by June 2012. Revenue sources we anticipate as we develop our program: • Grant-in-Aid • HUD (Housing & Urban Development) • HSFCA (Hawaii State Foundation on Culture and the Arts) • CPB (Corporation for Public Broadcasting) • Gannett Foundation • MacArthur Foundation • Bill Gates Foundation • Kellogg Foundation • Doris Duke Foundation • NPR (National Public Radio) • NASDAQ • And other businesses and investors NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Arts & Science Center - A ency Name HAAS Productions -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 tosubmit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of vour program's or agency's future funding requests. ~ / Signature of Board President/Chair gnature of Executive Director l U ZOp Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Bay Clinic, Inc. Pahoa Women's Center Bay Clinic, Inc.- Agency Name Pahoa Women's Center- Program Name Agency Director: Paul Strauss Phone No.: 808-961-4083 Contact Person: Monica Adams Phone No.: 808-961-4080 Mailing Address: 244 Haili St., Bld. B. Hilo, HI 96720 Facility/Site Address: 15-2866 Pahoa Village Rd/ Pahoa, HI 96778 Fax No.: 808-961-5167 Email Address: madamsC~bayclinic.org Name of Accountant/CPA (include name of firm if applicable): Ann Fukuhara, CPA MBA An Accountancy Corporation Phone No.: 808.961.5532 Mailing Address: 714 Kanoelehua Avenue PO Box 6691 Hilo, Hawaii 96720 Amount of Request for County Funds: $40,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $40,000 $0 Agency Mission Statement: To provide high quality, patient centered comprehensive health care that is accessible, affordable, coordinated, culturally competent, and community directed for all. Program Description: Bay Clinic, Inc. is a non profit network of four community health centers spanning 2,048 square miles of rural East and South Hawaii Island, since 1983. Our clinics in Hilo, Kea'au, Pahoa and Ka'u provide primary medical, dental and behavioral health care services to 15,000 patients with 47,000 visits annually. We provide care to those who are uninsured, low-income, and/or underinsured, regardless of ability to pay for services. We serve 8,500 women and 3,500 children, 88% of whom are uninsured or underinsured. Our patients experience some of the highest poverty rates in the state: 36% receive food stamps and 48% live below the federal poverty level. Our patient and service area populations have the lowest per capita incomes in the state. Maternal and child health indicators are known to be disproportionately impacted by socioeconomic disadvantages. Women in our service area have NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Bay Clinic, Inc.- Agency Name Pahoa Women's Center- Program Name low utilization of breast and cervical cancer screening, dangerous levels of high risk sexual behavior, high rates of teen pregnancy, and inadequate access to prenatal care. Children in our service area have the highest risk of infant mortality statewide and low rates of childhood checkups and immunizations. To rectify this disparity in health outcomes, Bay Clinic, Inc. will open a dedicated Women's Health Center in Pahoa. This will provide for the whole health of mother and child by expanding access to breast and cervical cancer screening, reproductive health care, teen clinic, early childhood vaccination, safety net prenatal care, plus maternal and child health care services. We anticipate this program will have a community wide impact on teen pregnancy rates, prenatal care utilization, infant and maternal health, and childhood immunizations. To accomplish this we must add providers and support staff for women's and children's health services. Total Budget and Position Count Total Pro ram Bud et $559,188.00 Total Pro ram Position Count 9 Total A enc Bud et $9,800,000.00 Total A enc Position Count 120 Program Objectives: 1) Increase accessible and affordable breast and cervical screening services, adult and teen reproductive health care, childhood vaccinations, well child checkups and maternal and infant health care services at all of our health centers. This will be accomplished beginning in Spring 2009. 2) Complete construction of dur new 4 exam room Pahoa Women's Center. It will be the first of its kind on Hawaii Island; unique in that it is specifically designated for women's health, while allowing for expanded primary care for the general population in the Pahoa family health center, which is currently at maximum capacity. It is expected to be completed by Spring 2009. 3) Add providers and support staff for women's health services. This will include one obstetrician/gynecologist to compliment our certified nurse midwifes and nurses. Our midwives were hired in December 2009, we are currently conducting interviews for a obstetrician/gynecologist for hire by Summer 2009. 4) Increase access to teen reproductive health services through initiating a teen reproductive health clinic at the Pahoa Women's Center by April 2009. 5) Increase the number of prenatal and women's health patients we can service in all of our locations, including the Hilo and Ka u Family Health Centers, by rotating our new women's health providers at all of our health centers by Summer 2009. 6) Provide patients with referrals to WIC (women's infants and children supplemental nutrition program) and Medicaid/Quest (low-income insurance) if either is needed. 7) Provide a medical home in Pahoa, where all women, teens and infants receive compressive care combining social services with medical care to ensure the longer term whole health of patient and family by Spring 2009. 8) Improve maternal and infant health indicators, birth weights, infant mortality, and teen pregnancy rates community wide. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Bay Clinic, Inc.- Agency Name Pahoa Women's Center- Program Name Program Highlights: The past several years have been pivotal for us as an organization and we have risen to meet our challenges. Over the past two years we have: 1. Received National Recognition and American Diabetes Association Credentials for our Diabetes Self-Management Program -the first Federally Qualified Community Health Center program in the state to do so. 2. Introduced low-cost and free prenatal care to the low income and uninsured women of East Hawai i for the first time, in response to the dire statistics of infant and maternal community health. 3. Expanded capacity to meet the high need for care, by modifying our exam room capacity for improved patient flow and extending our hours from Sam - 5pm to lam - 7pm. 4. Initiated the first "Child Immunization Clinic" on Saturdays at our Kea'au Family Health Center. This program provides immunizations and well child check ups for children of working parents, who are unable to take time of work during the work week for appointments. 5. Initiated partnerships with the University of Hawaii at Hilo and Manoa to train new pharmacists, nurses, counselors, social workers and doctors on health care in a rural community health center setting. 6. Successfully relocated our Hilo Bay Clinic to a safer, newer, cleaner, and more appropriate clinical site to improve services for our patients. Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Increase prenatal visits from 30 to 2,000 30 30 2000 visits er ear Increase immunization and well child 1,103 1,103 2,206 checku s from 1,103 to 2,206 er ear Increase women's health visits from 1,668 1,668 1,668 3,336 to 3,336 er ear Increase teen reproductive health clinic 250 250 550 visits from 250-550 er ear 90 % of patients who qualify will be 90% 90% 90% referred to WIC (nutrition support) and Quest/Medicaid for insurance coves e Hire two certified nurse midwives and one 0 2 3 obstetrician/ necolo ist *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Bay Clinic, Inc.- Agency Name Pahoa Women's Center- Program Name Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es $0 $0 $272,688 Professional Fees $0 $0 $7,000 O erations $0 $0 $254,500 E ui ment $0 $0 $65,000 Other $0 $0 $0 Total $0 $0 $599,188 * If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate HI State Construction rant- Secured $0 $0 $60,000 Castle Foundation Grant, ultrasound urchase- Secured $0 $0 $15,000 GN Wilcox- Secured $0 $0 $25,000 Hawaii DOH- Pendin $0 $0 $300,000 March of Dimes- Pendin $0 $0 $27,500 Hawaii Community Foundation, private fund- Pendin $0 $0 $5,000 Count of Hawai i Grant- Pendin $0 $0 $40,000 Ba Clinic, Inc.- In Kind $0 $0 $126,688 Total $0 $0 $599,188 *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? After the initial first year start up costs, revenue is expected to be approximately $474,188 to support additional personnel and operating expenses. Obstetrical care receives higher reimbursement rates through insurance and state reimbursement programs. This sustainability plan is calculated through projected visit volumes and reimbursement rate averages. If not all funding is secured as planned, we will continue to seek additional grants and funding from foundations and organizations that are dedicated to improving and addressing critical health care needs in underserved and disadvantaged communities. Maternal and infant care is a priority for our community's welfare, and we will work to ensure that this program can successfully meet our community's expressed needs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Bay Clinic, Inc.- Agency Name Pahoa Women's 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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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, Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Signature of Executive Director 7 Big Island Resource Conservation and Development Council, Inc. Resource Conservation and Development Program BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL INC. RESOURCE CONSERVATION AND DEVELOPMENT PROGRAM Agency Director: David Marquez Phone: 987-9101 Contact Person: David Marquez Phone: 987-9101 Mailing Address: 101 Aupuni Street, Ste 229A Hilo, Hawaii 96720-4261 Facility/Site Address: Same as Mailing Fax No: 933-6995 Email Address: brcdCa?hawaii.rr.com Name of Accountant/CPA (Include name of firm, if applicable) Alex J. Smith, CPA Phone No: 808-737-7761 Mailing Address: 1403 Frank Street, Honolulu, HI Amount of Request for County Funds: $10,000.00 -Funds will be used to retain bookkeeper, CPA, training, provide for high speed Internet access, and continue to create an improved community Internet access system for the council to use and share with applicants and partners Prior Year(s) Funding: 06-07 $ NA 07-08 08-09 $NA $15,000.00 Agency Mission Statement: The Mission of the Big Island RC&D Council is to assist the people of the Big Island in achieving sustainable development while caring for and appreciating their natural environment; to ensure broadened economic opportunities, enriched communities and better lives. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL, Inc RESOURCE CONSERVATION AND DEVELOPMENT PROGRAM Program Description: Nationwide Statewide, and Local: There are 375 RC&D Areas authorized in the United States which cover approximately 70% of the nation. RC&D Areas are authorized by the U.S. Secretary of Agriculture and the RC&D Program is administered by the Natural Resources Conservation Service (NRCS) who provide technical assistance and information outreach support to the individual, private nonprofit councils. The State of Hawaii has four RC&D Areas -Oahu, Garden Island, Tri-Isle, and the Big Island. The Big Island RC&D, authorized in 1975, covers the entire island of Hawaii. The Council is incorporated and non-profit within the State of Hawaii. It is also tax-exempt, 501 (c)(3) by Internal Revenue Service determination. Network: The RC&D volunteer program is strengthened through a nationwide network. The Big Island RC&D belongs to the National Association of RC&D Councils (nationwide) and the Pacific Rim RC&D Association (regional). This network allows the RC&D Council to have an active role with issues being addressed at regional and national levels. Total Budget and Position Count Total Program Budget $14,040.00 Total Program Position Count 2 Total Agency Budget NA Total Agency Position Count 2 NOTE: Agency Budget is not directed to the non-profit council for administrative purposes. Council contracts 2 part-time positions that of CPA and a Book Keeper. Agency provides position support for program and community. Council is a private non- profit. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 2 Program Objectives: The Vision of the Big Island RC&D Council: Conserve, enhance and promote the economic, cultural, and natural environment of Hawaii. Program Highlights: The Big Island RC&D Council has completed numerous projects since 1975. Many partnerships were formed as a result of the networking that the RC&D Program builds. In addition, the council coordinates educational workshops to develop community awareness and resources. Requests for assistance are accomplished through submissions of the Big Island RC&D's basic concept application. Listed below are some of the activities the Council and its volunteer committees have done or are doing: • 2005 International Mycology Conference -Growers Class with Don Hemmer/Paul Staments. • RC&D Coordinator and NRCS assisted in development of Hilo Bay Watershed Restoration Plan • 2004- 2008 Hawaii World Heritage Festivals -Multi-cultural evens celebrating and showcasing Big Island Cultural diversity -scheduled for 2009 • Hilo Bay Watershed Advisory Group Storm Drain Stencil Project • Downtown Hilo Community Visioning Plan by Friends of Downtown Hilo • Conservation Innovation Grant for Shade Grown Coffee Study-This project explores inter-planting in native canopy and reduced clear-cutting for coffee, • Hilo Inter-tribal Powwow - A Native American cultural event that features art, culture, crafts, music and an exchange of Native American and Native Hawaiian cultural ceremony - 2006 - 2008 -scheduled for 2009 • Hawaii Agricultural Development Program (HADP) 2004-2005-2006- 2008-A series of grants successfully acquired by the RC&D Council through Senator Daniel Inouye have been used to fund and support approximately 40 separate agribusiness enterprises throughout the county. Phases I, II, and III have been complete, Phase IV will be completed March 2009. • Hawaii Island Festivals - 30 Days of Aloha - • Ka'u Coffee Festival • HI Sustainable Ag & Renewable Energy - a RBEG grant from USDA/RD for a planning grant to examine the feasibility of establishing an integrated cattle & bio-fuels development project on the Big Island NONPROFIT GRANT APPLICATION FISCAL YEAR 2009 - 2010 Page 3 Performance Measures 2008 Budget 2009 Proposed 2010 Budget Budget (Estimated) Totals-See $12,138.00 $14,040.00 $15,000.00 attached detailed sheets Program Expenditures - (See Attached Sheets) 2008 -Actual 2009 -Bud et 2010 -Estimate Salaries/Wa es 0 0 0 Professional Fees $1105.12 $5500.00 $6000.00 O erations $361,.84 $5290.00 $5500.00 E ui ment $1708.01 $200.00 $300.00 Other: Training $3030.85 $3000.00 $3000.00 Total $6205.82 $14,040.00 $14,900.00 tvoce: X14,4'/2.39 to program expenditures was paid by the Hawaii Agricultural Development Program as indirect project expenses for 2008. We were notified of this award late summer 2008. See attached sheets Program Funding Sources: Identify all funding sources (specific to this program onl ) Revenue Source 2008 -Actual 2009 -Bud et 2010 -Estimate Sponsors' Dues $2200.00 $2700.00 $2700.00 Admin Fees $12,045.47 $6000.00 $6000.00 County of Hawaii $7525.00 - Other $ 25.00 $ 500.00 $1000.00 Totals $21,770.47 $9200.00 $10,200.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 4 } l _.. .~ e~i,_ ~J ~~i r*2Jo~-~~J's~', ~ r,ziu ~.~~9 i9k ~~ u~l_.,;:j j L,rs~, i.q'_1;1 ~.~` 'ij.', r" ] r~~ q ir~l l 1..~~ '-~.~~J BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL, Inc. Proposed Operating Budget for 2009 INCOME Annual Dues $2700.00 Admin Fees -Projects $6000.00 Other $ 500.00 Total Income $9200.00 EXPENSE President's fund $500.00 D&0 & General Liability Insurance $1600.00 Training -National RC&D Conference $2500.00 Annual Filing Fees $5.00 CPA Compilation (4) $1950.00 Income Tax Preparation $600.00 Bookkeeper $3000.00 Equipment Purchase/Repairs $200.00 Contingencies $1000.00 Internet Fees $565.00 Anti Virus Upgrades $100.00 Stationery and Supplies $200.00 Telephone $575.00 Meals/Refreshments $495.00 Annual Dues $750.00 Total Expenses $14,040.00 ~`~~ .-~ BIRCD 6,rzsros Profit $ Loss July 2008 through June 2009 Ordinary Income/Expe~ue Income 4000 ~ Project Revenues 4540 ~ Local government grants 4541 • County of Hawaii 45475 • Other Supplemental Funding Total 4541 • County of Hawaii Total 4540 • Local government grants Total 4000 • Project Revenues Total Income Expense 7000 • Grant 8 contract expense 7020 ~ Professional Fees 7023•Bookkeeper Total 7020 • Professional Fees Total 7000 • Grant 8 contract expense 7500~O[her personnel expenses 7520•Accounting fees 7521 ~ Compilation Tota17520~Accounting fees Total 7500 • Other personnel expenses 8100~NOn-personnel expenses 8190 • Office Supplies Total B100~Non-personnel expenses Total Expense Net Ordinary Income Net Income Jul '08 -Jun 09 11,250.00 11,250.00 11,250.00 11,250.00 11,250.00 527.28 -- 527.28 527.28 611.00 ----------- - 611.00 611.00 1,705.51 ---- -- 1,705.51 ___ 2,843.79 8,406.21 8,406.21 Page 1 /Jx~,'~eio-Q ~ wv~ BIRCD ov2a/os Profit & Loss January through December 2008 Jan -Dec OS Ordinary Income/Expense Income 4000 • Project Revenues 4010 ~ Indiv/business contribution 25.00 Total 4000 • Project Revenues 25.00 5000 • Earned revenues 5180 • Program service tees 12,045.47 5220 • Dues-0rganizations 5222 ~ Dues•Kau SWCD 175.00 5224 • Dues-Mauna Kea SWCD 175.00 5225 • Dues-Puna SWCD ,75.00 5226 ~ Dues-Waikea SWCD ,75.00 5227 • Dues-County of Hawaii 1,500.00 Total 5220 ~ Dues-Organiutions 2,200.00 Total 5000 ~ Eamed revenues 14,245.47 Total Income 14,270.47 Expense 4001 ~ Reconciliation Discrepancies 7500 • Other personnel expenses 7520 • Accounting fees 7522 ~ Tax Preparation 434.84 Total 7520 • Accounting fees 434.84 Total 7500 ~ Other personnel expenses 434.84 8100 •Non-personnel expenses 8110 • Supplies 312.50 8130 • Telephone & telecommunications 8131 ~ Internet Access 46.82 8130 ~ Telephone 8 telecommunications -Other Total 8130 ~ Telephone & telecommunications 46.82 8140 • Postage, shipping, delivery 2.52 8190. Office Supplies 8192 • Bank Checks 16.45 8190 • Office Supplies -Other 2.50 Total 8190 • Office Supplies 18.95 Total 8100 ~ Non-personnel expenses 380.79 8300 • Travel 8 meetings expenses 8310 ~ Travel 6312 ~ Meals 363.46 Total 8310 • Travel 363.46 8320 ~ Conference,convention,meeting 8321 ~ Pacific Rim Conference 427.79 8322 • Leadership Forum Conference 2,239.60 Total 8320 ~ Conference,convention,meeting 2,667.39 Total 8300 ~ Travel & meetings expenses 3,030.85 Total Expense 3,846.48 Ne[ Ordinary Income 10,423.99 Net Income 10,423.99 Page 1 BIRCD oln5/os Profit tgt Loss January through December 2008 Ordinary IncomelExpense Income 4000 • Project Revenues 4010 ~ Indiv/business contribution 40101•YendorFees 4010 ~ Indivlbusiness contribution -Other Total 4010 •Indiv/business contribu0on 4230 ~ FoundatioNtrust grants 42301 • Richard Smart Fund Total 4230 • Foundation/trust grants 4520 -Federal grants 4521 ~ USDA-NRCS 45211•HADP-06 45212 ~ CIG 45213 ~ HADP-08 Total 4521 ~ USDA-NRCS 4522 ~ USDA/RD Total 4520 • Federal grants 4530 • State grants 4531 • HTAICPEP 4536 • Big Island Visitors Bureau Total 4530 • State grants 4540 • Local government grants 4541 ~ County of Hawaii 45411 • Healing Our Island 45412 • Research 8 Development 45413 • County Council Discretionary 45414 • Planning Department 454140•C2M Funding 45414 • Planning Department -Other Total 45414 ~ Planning Department 45415-Other Supplemental Funding Total 4541 ~ County of Hawaii 4542 ~ OHA Total 4540 • Local government grants Total 4000 ~ Project Revenues 4600 ~ Other Project Revenues Total Income Expense 7000 ~ Grant 8 contract expense 7010 •Supplies-Program Related 7011 ~ Administrative Fee 7020 • Professional Fees 7021 ~ Project Manager 7023 ~ Bookkeeper 7020 • Professional Fees -Other Total 7020 ~ Professional Fees Total 7000 ~ Grant 8 contract expense 7200 • Salaries 8 related expenses 7250 • Payroll taxes Total 7200 • Salaries 8 related expenses ct,¢x Ctcec~,.~,,;~ e~'~t'-~ G ~~,-.e.t~•~P ~~•~~ Jan -Dec OS 6,570.00 37,916.88 44,486.88 10,000.00 10,000.00 12,175.00 35,738.68 69,240.67 ---_~ 117,154.35 17,500.00 134,654.35 43,872.46 17,500.00 61,372.46 1,000.00 27,513.00 20,000.00 6,280.00 3,740.00 10,020.00 60,123.20 118,656.20 500.00 119,756.20 369,669.89 400.00 370,069.89 294,667.71 12,098.12 6,778.88 6,775.00 3,691.00 17,244.88 324,010.71 63.27 63.27 Page 1 L° BIRCD o,fz8fo9 Profit & Loss January through December 2008 7500 ~ Other personnel expenses 7520 • Accounting fees 7521 • Compilation 7522 ~ Tax Preparation Total 7520 ~ Accounting fees 7580 ~ Web Hosting Total 7500 ~ Other personnel expenses 8100•NOn-personnel expenses 8110 • Supplies 8130 ~ Telephone & telecommunications 8131 •Internet Access 8130 • Telephone & telecommunications -Other Total 8130 ~ Telephone & telecommunications 8140 • Postage, shipping, delivery 8150 ~ Mailing services 8170 • Printing & copying 6190 ~ Office Supplies 8192 • Bank Checks 8190 ~ Office Supplies -Other Total 8190 ~ Office Supplies Tota18100•NOn-personnel expenses 8300 • Travel R meetings expenses 8370 ~ Travel 8311-Lodging 8312 • Meals 8313 • Airfare 8314 • Mileage Total 8310 ~ Travel 8320 • Conference,convention,meeting 8321 ~ Pacific Rim Conference 8322 ~ Leadership Forum Conference 8320 ~ Conference,convention,meeting -Other Total 8320 • Conference,convention,meeting Total 8300 • Travel & meetings expenses 8500 ~ Misc expenses 8520 • Insurence 8530 ~ Membership dues -organization 8531 • Pacific Rim Dues 8532 ~ NARC&D Dues Total 8530 • Membership dues -organization 8570 ~ Advertising expenses Total 8500 ~ Misc expenses Total Expense Net Ordinary Income Net Income Jan -Dec 08 956.00 65.16 1,021.16 529.88 ---~- --- 1,551.04 78.40 517.41 520.00 1,037.41 63.05 23.20 1,034.57 16.45 7,843.92 1,860.37 4,097.00 12,945.79 2,856.56 1,047.89 1,700.62 ' 18,550.86 1,732.20 430.00 250.00 2,472.20 20,963.06 3,172.64 200.00 450.00 650.00 _____ 3,834.59 7,657.23 358,342.31 ___ 11_727.58 11,727.58 Page 2 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 Council will move toward a greater level of independence from government support by researching, developing and submitting capacity building grants. These funds will sponsor board training by commissioning subject matter experts in development of capital campaigns and endowment creation. The Council is also doing more outreach to the communities to bring in more projects thus increasing revenue. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 - Agency Name - 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 ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. 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 a9encv's future funding requests. Signature Board President/Chair t'i)(iit1A«~ C~n~c nnX ~ri~ic fx I~i~L• Signature of Executive Director 0(-,3fi ~ ~aU~i Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Big Island Substance Abuse Council East Hawaii Substance Abuse Program Agency Director: Dr. Stephen C. Zuniga Phone No.: 969-9994 Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address: Richard Teanio 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: 06-07 07-08 08-09 $30,000 $30,000 $20,000 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 2009-10 Page 1 Big 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 includes adolescents, adults, 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 or intervene with chronic relapse. BISAC recognizes the significant impact of crystal methamphetamine to the addicted individual and our communities, 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 offers separate adolescent outpatient services and school based services in twenty-three (23) schools. BISAC gives priority 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 and Therapeutic Living Program Treatment services to Adolescents and Adults 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. Total Budget and Position Count Total Pro ram Bud et 3,623,946 Total Pro ram Position Count 26 Total A enc Bud et 8,052,095 Total A enc Position Count 98 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Big Island Substance Abuse Council East Hawaii Substance Abuse Program 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) Decrease the number of days between when an individual requests treatment intervention services and the date that those services are delivered, by funding treatment-on-demand services while alternative reimbursement is identified. 4) Achieve understanding of disease concept of addiction and co-occurring disorders. 5) Reducing recidivism by 30% by not incurring additional arrests 6 months post-treatment. 6) Identify clean and sober social support networks and actively participate to identify and link with support systems in preparation for discharge. 7) Identification of individualized protective factors that will significantly reduce risk factors, and has identified and implemented a minimum of six within the first 90 days of treatment. 8) Complete 80% of identified treatment goals and has developed a transition plan to prepare for discharge. Program Highlights: • BISAC was able to admit approximately 755 adults into all levels of outpatient substance abuse treatment and Therapeutic Living services and 201 adolescents island-wide. Data collected from our 2007-2008 Annual Management Report disclosed the following: • 47% Completed Treatment. • 69% were employed, in school, vocational training or volunteering. • 86% had no new arrests post treatment. • 65% had no new treatment episodes. • 54% were involved in self-help groups post treatment. • 81 % have stable living arrangements post treatment. • 96% did not miss work or school due to drugs/alcohol. • 89% had no Emergency Room admissions post treatment. • 90% had no hospital admissions post treatment. • 88% had no significant psychological distress within 30 days post treatment. • 33% usage within in the last 30 days. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Substance Abuse Treatment Units 45,300 46,432 47,593 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 2,385,870 2,419,838 2,380,227 Professional Fees 65,302 97,001 78,467 O erations 1,007,307 1,010,878 1,082,292 IT Infrastructure 123,033 8,066 70,099 Vehicle 0 0 0 Total 3,581,512 3,535,783 3,611,085 * If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Count 20,000 30,000 30,000 State of Hawaii 1,671,521 2,042,546 2,312,273 Federal 800,074 800,074 800,074 HIUIIV 15,000 14,710 15,000 Private Foundation 123,367 81,500 46,614 Donations/Fundraisin 14,085 1,500 0 Private Insurance 297,627 307,232 258,599 Client Fees 136,624 169,500 137,280 Trainin 25,347 23,000 24,106 Total 3,103,645 3,470,062 3,623,946 If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Big Island Substance Abuse Council East Hawaii Substance Abuse Program 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 treatment services increased by 14% for fiscal year 2007-2008. Third party payors and administrative fees increased by 11 %. 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 2009-10 Page 5 Big 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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will imaact the evaluation of vour arogram's or agency's future funding requests. ~~ Signature of Board resident/Chair Patricia Engelhard ~ C~~ ~~ Signature of xecutive Director Dr. Stephen C. Zuniga /- S Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 9 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Big Island Substance Abuse Council West Hawaii Substance Abuse Program Agency Director: Dr. Stephen C. Zuniga Phone No.: 969-9994 Contact Person: Mailing Address: Facility/Site Address: Faz No.: Email Address: Dana Williams Phone No.: 322-3100 234 Waianuenue Avenue Suite 101, Hilo, HI 96720 81-947 Halekii Street, Kealakekua, HI 96750 969-7570 Dana.Williams@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: 06-07 07-08 08-09 $30,000 $30,000 $20,000 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 2009-10 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 includes adolescents, adults, 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 or intervene with chronic relapse. BISAC recognizes the significant impact of crystal methamphetamine to the addicted individual and our communities, 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 West Hawaii BISAC programs provide outpatient treatment and therapeutic living services to adults and offers separate adolescent outpatient services and school based services in twenty-three (23) schools. BISAC gives priority to pregnant women, HIV users, and those with co- occurring disorders. BISAC committed funds in 2007 to open 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 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. BISAC is requesting funds to subsidize Outpatient Treatment and Therapeutic Living Program services to Adolescents and Adults 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. Total Budget and Position Count Total Pro ram Bud et 2,629,585 Total Pro ram Position Count 16 Total A enc Bud et 8,052,095 Total A enc Position Count 98 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Big Island Substance Abuse Council West Hawaii Substance Abuse Program 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) Decrease the number of days between when an individual requests treatment intervention services and the date that those services are delivered, by funding treatment-on-demand services while alternative reimbursement is identified. 4) Achieve understanding of disease concept of addiction and co-occurring disorders. 5) Reducing recidivism by 30% by not incurring additional arrests 6 months post-treatment. 6) Identify clean and sober social support networks and actively participate to identify and link with support systems in preparation for discharge. 7) Identification of individualized protective factors that will significantly reduce risk factors, and has identified and implemented a minimum of six within the first 90 days of treatment. 8) Complete 80% of identified treatment goals and has developed a transition plan to prepare for discharge. Program Highlights: • BISAC was able to admit approximately 547 adults into all levels of outpatient substance abuse treatment and Therapeutic Living services and 201 adolescents island-wide. Data collected from our 2007-2008 Annual Management Report disclosed the following: • 47% Completed Treatment. • 69% were employed, in school, vocational training or volunteering. • 86% had no new arrests post treatment. • 65% had no new treatment episodes. • 54% were involved in self-help groups post treatment. • 81 % have stable living arrangements post treatment. • 96% did not miss work or school due to drugs/alcohol. • 89% had no Emergency Room admissions post treatment. • 90% had no hospital admissions post treatment. • 88% had no significant psychological distress within 30 days post treatment. • 33% usage within in the last 30 days. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Substance Abuse Treatment Units 25,025 25,650 26,292 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 1,114,466 1,706,781 1,678,842 Professional Fees 24,735 18,707 15,133 O erations 469,537 640,997 686,281 IT Infrastructure 73,228 6,185 53,751 Vehicle 0 0 0 Total 1,681,966 2,372,670 2,434,007 ' If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-OS Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Count 20,000 30,000 30,000 State of Hawaii 1,455,765 1,465,900 1,928,868 Federal 188,442 188,442 188,442 HIUW 15,000 19,290 15,000 Private Foundation 4,592 21,500 12,391 Donations/Fundraisin 14,085 0 0 Privatelnsurance 312,214 378,000 316,066 Client Fees 79,598 170,523 138,819 Total 2,089,696 2,273,655 2,629,586 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Bi Island Substance Abuse Council West Hawaii Substance Abuse Program 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 treatment services increased by 14% in fiscal year 2007-2008. Third party payors and administrative fees increased by 11 %. 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 West 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 2009-10 Page 5 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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 ignature of Board resident/Chair Patricia Engelhard ~'".'v~/ ~ .~~sJ Sig- n e of Exe Director Dr. Stephen C. Zuniga i-S- .Jody Date /L-3/- 2odS~" Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 10 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club ^ O ^~ Interim Agency Director: Warren H.W. Lee Phone No.: 961-5536 Contact Person: Mailing Address: FacilitylSite Address: Fax No.: Email Address: Warren H. W. Lee Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 43-1477 Hauola Road, Pa'auilo, Hawaii 96776 961-5189 warren@becbi.com Name of AccountantlCPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: (808) 737-1040 Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 06-07 07-08 OS-09 $0 $45,000 $40,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club Program Description: With most parents working, many of our Big Island youth find themselves with no adult care or supervision during the critical hours between school dismissal and dinnertime. Young people are often left to find their own recreation and companionship within their communities; more specifically, the streets. When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island (BGCBI) -Hamakua Club, provides those opportunities on a daily basis to the young people of the Pa'auilo community. The Hamakua Club offers programs and services aimed at instilling a positive sense of self, increase self-esteem, self-confidence, and teach the skills necessary to make good, sound decisions. Through fun and engaging activities, BGCBI provides a positive atmosphere for youth to explore their interests so that they can reach their full potential and contribute to their communities as good, responsible citizens. Founded as the Boys Club of Hilo in 1952, the BGCBI has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years, BGCBI Board of Directors and Club leadership have demonstrated their commitment by extending our service reach to the youth in Pahoa, Kea'au, Oceanview/Naalehu and Pahala. The mobile outreach program planted the seed for our newest Club in Pa'auilo along the Hamakua coast. BGCBI success is evident on the faces of the youth who attend our Clubs and the outcome results reported to the following federal, state and private funding agencies: the Office of Juvenile Justice and Prevention (OJJP), the Office of Youth Services (OYS), Office of Juvenile Prevention (OJP) Rural Youth Program, Tobacco Trust Settlement administered by the Hawaii Community Foundation (HCF), and the Hawaii Island United Way. Reports are available upon request. The Hamakua Club was established in May 2008. The Pa'auilo Hongwanji Church Community offered BGCBI their church hall to serve as a permanent Clubhouse. The youth of this community were served by our Mobile Rural Outreach Program prior to the establishment of the Hamakua Club. Located adjacent to the Pa'auilo Elementary & Intermediate School enables our members to safely walk to the club without crossing any major streets or roads. The Hongwanji hall is large enough to implement our five core program areas with ease and outdoor areas are used for sports and fitness activities. The Hamakua Club conducts daily after-school, weekend programs and half day intercession programs which include Boys & Girls Club of America's five core programs areas: • Sports. Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter-club leagues. The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. Education and Career Develoament: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high-yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program. Character & Leadershia Develoament: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year -local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol -youth program for youth introducing the Club to guest and new members. Youth For Unity is a Boys and Girls Club of America national diversity initiative that cultivates individuality, builds cultural identity and an appreciation of diversity. Health 8 Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. Project TNT (Toward No Tobacco) is a SAMSHA approved evidenced-based tobacco prevention program that gives youth the information and skills needed to stay tobacco-free. The Hamakua Club offers a positive, safe environment for our youth during those critical, non-school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Hamakua Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life-enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence -Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness -Young people know the satisfaction of doing something of value for others. • A sense of belonging -Young people know they are welcome and feel that they fR in and are accepted. • A sense of power and influence -Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Hamakua Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes of age 18 The Hamakua Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club Health and Well-Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access heath care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Hamakua Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Hamakua Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three Internet-based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Hamakua Club is making a difference in members' lives. The Hamakua Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Bud et $150,000 Total Pro ram Position Count 4 Total Agency Budget $1 200 000 Total A enc Position Count 35 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well- being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis 2007-2008 Program Highlights: 1) Total days of operation: 247 Total hours of operation: 1,116 - School days: 2:00 pm to 6:00 pm - School day off -- waiver days and intercessions: 9:00 am to 4:30 pm NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club 2) In the Fiscal Year 2007-2008 the Boys and Girls Club of the Big Island provided programs to 1452 young people ages 6 through 17 years. 89 of these youth attended the Hamakua Mobile Outreach Program. Our youth development professionals provided outreach to 715 students in our community schools through the implementation of two evidenced-based curriculum programs: SMART Moves Drug, Alcohol, and Pregnancy Prevention Program and Project TNT. Agreements were made with each individual school administration and conducted within the health curriculum guidelines of the Department of Education. The Hamakua Outreach Program conducted SMART Moves curriculum with 111 students along the Hamakua Coast schools. 3) Tobacco Education and Prevention was a major focus of Fiscal Year 2007- 2008 with BGCBI empowering their youth to make healthy decisions which ultimately lead to a healthy I'rfestyle. Some activities the Pa'auilo youth were involved in included participating in the political process of the passing of Bill 224. Below are some activities our Pa'auilo youth took part in: - Smoke Free Sign Wavings - Letter writing to County Council in support of the Bill - Participation in National Kick Butts Day -Hilo Club held an after-school special event of educational games and activities promoting a tobacco free lifestyle - Participation in the Tobacco Free Big Island Poster Contest promoting the new County no smoking law at beaches and recreation facilities (BGCBI had three winners in that competition - East Hawaii beach clean-ups of cigarette butts Some of the agencies BGCBI has formed relationships within FY 2007-2008 include: Tobacco Free Big Island Coalition, American Lung Association, American Cancer Society, REAL, the Salvation Army, Pahoa Weed and Seed Project, United States Tennis Association -Hawaii Pacific Section, Bay Clinic, State of Hawaii Department of Education, PATCH, Kick-the-Nic, Prosecuting Attorney's Office, and Hawaii County Department of Parks & Recreation. 4) A concentration on Character & Leadership Development through the following activities: - Community Service Projects included community park clean-ups, flyer distribution for the COPS Drug Free Event at Pa'auilo Park on 8/01/07. - Older members working with younger members in literacy program called 2by2 Reading. - Save the Earth Club consisted of members committed to starting a weekly recycling initiative around the Pa'auilo Park. - Diversity program with the Arc of Kona. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club - Welcome Patrol consisted of members making new youth feel welcome to be members of the Club. Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget * Estimate Youth will participate in The Arts Programs. Examples: / Arts and Crafts 67 75 50 / Dance / Music / Fine Arts Youth will participate in Character and Leadership programs. Examples: 22 30 25 / Keystone Club / Torch Club / Community Service Projects / Club Service Pro~ects Youth will participate in Education and Career Development Programs. Examples: / Power Hour 53 100 50 / Project Learn / Tutoring / Com uter Technolo Youth will participate in Health and Life Skills Programs. Examples: / SMART Moves 135 75 50 / Project TNT / Nutrition/Cooking Classes / Tri le Pla Youth will participate in Sports, Fitness and Recreation Programs. Examples: / Team/Individual Sports 89 100 50 / Games Room Activities / Fitness Activities and Pro rams Parents/families will participate in 4 events per 4 events per activities to promote family 15 families year year stren thenin and uni NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club Program Expenditure FY 2007-08 Actual* budget) FY 2008-09 Budget* (estimate FY 2009-10 Estimate Salaries and Wa es $96,697 $73,314 $95,000 Professional Fees $1,551 $6,260 $2,500 O erations $49,536 $57,577 $51,100 E ui ment $8,201 $2,423 $1,400 Other(Board Development) Total $155,985 $139,574 $150,000 * If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* (bud et) FY 2008-09 Budget* estimate) FY 2009-10 Estimate Coun of Hawaii -Non rofit Grant $45,000 $40,000 $60,000 Hawaii Community Foundation: HCF :Tobacco Fund $16,990 $1,849 Hawaii Island United Wa YMCA Rural Youth Program (RYP) Grant Outreach Office of Youth Services (OYS) Positive Youth Develo ment 08-26 $60,259 $68,225 $68,000 Intersession Pro ram Fees $735 $500 $1,200 Club Fundraisin Events $4,117 $4,000 $8,000 Communi Donations $18,884 $5,000 $7,000 County of Hawaii -Contingency Fund $10,000 $20,000 $5,800 Total $155,985 $139,574 $150,000 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club 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 2009-10 Page 9 & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Club 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 davs 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 ~--~v-o-~-* ~ Signature of Board President/Chair ~l/~ Signature of Executive Director i•.?8~®9 Date ~~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 11 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club C~Op~ Interim Agency Director: Warren H.W. Lee Contact Person Mailing Address: Facility/Site Address: Fax No.: Email Address Warren H.W. Lee Phone No.: 961-5536 Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 100 Kamakahonu Street, Hilo, Hawaii 96720 961-5189 warren@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: (808) 737-1040 Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $80,000 $40,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Program Description: With most parents working, many of our Big Island youth find themselves with no adult care or supervision during the critical hours between school dismissal and dinnertime. Young people are often left to find their own recreation and companionship within their communities; more specifically, the streets. When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island (BGCBI) -Hilo Club, provides those opportunities on a daily basis to the young people of the Hilo community. The Hilo Club offers programs and services aimed at instilling a positive sense of self, increase self-esteem, self-confidence, and teach the skills necessary to make good, sound decisions. Through fun and engaging activities, BGCBI provides a positive atmosphere for youth to explore their interests so that they can reach their full potential and contribute to their communities as good, responsible citizens. Founded as the Boys Club of Hilo in 1952, the BGCBI has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years, BGCBI Board of Directors and Club leadership have demonstrated their commitment by extending our service reach to the youth in Pahoa, Kea'au, Oceanview/Naalehu and Pahala. The mobile outreach program planted the seed for our newest Club in Pa'auilo. BGCBI success is evident on the faces of the youth who attend our Clubs and the outcome results reported to the following federal, state and private funding agencies: the Office of Juvenile Justice and Prevention (OJJP), the Office of Youth Services (OYS), Office of Juvenile Prevention (OJP) Rural Youth Program, Tobacco Trust Settlement administered by the Hawaii Community Foundation (HCF), and the Hawaii Island United Way. Reports are available upon request. The Hilo Cfub is located in downtown Hilo and sits on a 14 acre property of the Hilo Boarding School. This beautiful site includes 2 baseball fields, a small t-ball/soccer field, a full size gymnasium, a "currently under renovation" Club recreation room, art room, learning center, teen center, a computer lab, a kitchen, a patio for leisure and eating and two additional rooms for small group activities. A full size swimming pool is also part of the renovation plan to reestablish an aquatics program. The Hilo Club conducts daily after-school, evening, weekend and full-day intercession programs which include Boys & Girls Club of America's five core programs areas: • Snorts. Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter-club leagues. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. Education and Career Develoument: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high-yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program Character 8~ Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year -local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Wek:ome Patrol -youth program for youth introducing the Club to guest and new members. Youth For Unity is a Boys and Girls Club of America national diversity initiative that cultivates individuality, builds cultural identity and an appreciation of diversity. Health 8 Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. Project TNT (Toward No Tobacco) is a SAMSHA approved evidenced-based tobacco prevention program that gives youth the information and skills needed to stay tobacco-free. The Hilo Club offers a positive, safe environment for our youth during those critical, non-school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate, chartered member of our national organization, the Boys and Girls Club of America (BGCA), BGCBI strives #o provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-i0 Page 3 Bays & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life-enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses° which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence -Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness -Young people know the satisfaction of doing something of value for others. • A sense of belonging -Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence -Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Hilo Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program orjust "hanging out". Youth Development Outcomes at age 18 The Hilo Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes inc-ude: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well-Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club The Hilo Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Hilo Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. BGCA has developed three internet- based surveys (elementary, middle and high school) to collect and analyze information about whether the Hilo Club is making a difference in members' lives. The Hilo Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Program Budget $220,000 Total Program Position Count 9 Total A enc Bud et $1,200,000 Total A enc Position Count 35 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well- being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in postive civic and community events. 4) Increase participants' positive attitude toward schooUeducation. 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis 2007-2008 Program Highlights: 1) Total days of operation: 246 Total hours of operation: 1,454 - School days: 1:30 pm to 6:00 pm - School day off -waiver days and intercessions: 7:30 am to 5:30 pm 2) In the Fiscal Year 2007-2008 the Boys and Girls Club of the Big Island provided programs to 1452 young people ages 6 through 17 years. 727 of these youth attended the Hilo Club. BGCBI youth development professionals provided outreach to 715 students in our community schools through the implementation of two evidenced- based curriculum programs: SMART Moves Drug, Alcohol, and Pregnancy Prevention Program and Project TNT. Agreements were made with each individual school administration and conducted within the health curriculum NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club guidelines of the Department of Education. The Hilo Club conducted Stay SMART at Hilo High School with 121 students. 3) Tobacco Education and Prevention was a major focus of Fiscal Year 2007- 2008 with BGCBI empowering their youth to make healthy decisions which ultimately lead to a healthy lifestyle. Some activities the Hilo youth were involved in included participating in the political process of the passing of Bill 224. Below are some activities our Hilo youth took part in: - Smoke Free Sign Wavings - Letter writing to County Council in support of the Bill - Participation in National Kick Butts Day -Hilo Club held an after-school special event of educational games and activities promoting a tobacco free lifestyle - Participation in the Tobacco Free Big Island Poster Contest promoting the new County no smoking law at beaches and recreation facilities (BGCBI had three winners in that competition - East Hawaii beach clean-ups of cigarette butts - Hilo Downtown Association asked our youth to paint containers to place around the downtown area for cigarette disposal Some of the agencies BGCBI has formed relationships within FY 2007-2008 include: Tobacco Free Big Island Coalition, American Lung Association, American Cancer Society, REAL, the Salvation Army, Pahoa Weed and Seed Project, United States Tennis Association -Hawaii Pacific Section, Bay Clinic, State of Hawaii Department of Education, PATCH, Kick-the-Nic, Prosecuting Attorney's Office, and Hawaii County Department of Parks & Recreation. 4) Over 600 additional youth are served in the organized athletic program at the Hilo Boys and Girls Club. Our baseball fields are used year-round and the Hilo Club/Athletic Director serves as the Commissioner of all leagues played at the Boys and Girls Club. He works closely with all teams and creates an environment that promotes the philosophy of the Positive Coaching Alliance - to teach youth sports organization leaders how to create an organizational culture in which Honoring the Game is the norm. The Hilo Club hosts the following leagues throughout the year: - County Parks & Recreation's T-ball and Coach Pitch Leagues - Pony League -February through July - Winter League -September through December - RBI League -October through December AND May through July NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget * Estimate Youth will participate in The Arts Programs. Examples: / Arts and Crafts 354 300 300 / Dance / Music / Fine Arts Youth will participate in Character and Leadership programs. Examples: 193 150 150 / Keystone Club / Torch Club / Community Service Projects / Club Service Projects Youth will participate in Education and Career Development Programs. Examples: / Power Hour 380 300 300 / Project Learn / Tutoring / Com uter Technolo Youth will participate in Health and Life Skills Programs. Examples: / SMART Moves 269 300 300 / Project TNT / Nutrition/Cooking Classes / Tri le Pla Youth will participate in Sports, Fitness and Recreation Programs. Examples: / Team/Individual Sports 600 400 400 / Games Room Activities / Fitness Programs and Activities Parents/families will participate in activities to promote family 57 4 events per 4 events per stren thenin and uni ear ear NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Program Expenditure FY 2007-08 Actual* (bud et) FY 2008-09 Budget* (estimate) FY 2009-10 Estimate Salaries and Wa es $275,796 $131,994 $134,000 Professional Fees $2,400 $6,217 $6,000 O erations $102,467 $71,854 $75,000 E ui ment $1,361 $4,342 $5,000 Other renovations $1,136,079 $200,000 Total $1,518,103 $414,407 $220,000 * If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* (bud et) FY 2008-09 Budget* (estimate) FY 2009-10 Estimate Coun of Hawaii -Non rofit Grant $80,000 $40,000 $60,000 County of Hawaii - CDBG renovations $1,045,832 Office of Justice Pro rams -Hilo $40,000 $40,000 YMCA Rural Youth Program (RYP) Grant Center Base $39,260 $8,855 DHS OYS 09-10 $5,000 Office of Youth Services (OYS) Positive Youth Develo ment 4091 $53,322 $9,293 DHS OYS GIA Funds renov. $200,000 Hawaii Community Foundation: HCF :Tobacco Fund $33,979 $23,920 Hawaii Island United Wa $42,500 $9,766 $20,000 Alcohol Drug Abuse Division ADAD $25,000 $25,000 Boys & Girls Club of Hawaii: EDI Grant renovations $90,247 Office of Youth Services (OYS) Positive Youth Develo ment 08-26 $51,530 $11,417 $15,000 County of Hawaii -Contingency Fund $15,000 $10,000 $10,000 Intersession Program Fees $29,151 $13,800 $20,000 Club Fundraisin Events $8,944 $8,000 $10,000 Communi Donations $28,338 $14,356 $15,000 Total $1,518,103 $414,407 $220,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club *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 2009-10 Page 9 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 /• a ~ 0 9 Signature of Board President/Chair Signature of Executive Director Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 12 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club ~O ~~ Interim Agency Director: Warren H.W. Lee Contact Person Mailing Address: Warren H.W. Lee Phone No.: 961-5536 Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 Facility/Site Address: Fax No.: Email Address: 16-0565 Pahoa Road, Kea'au, Hawaii 96749 961-5189 warren@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: (808) 737-1040 Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 08-07 07-08 08-09 $0 $45,000 $40,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Keaau Club Program Description: With most parents working, many of our Big Island youth find themselves with no adult care or supervision during the critical hours between school dismissal and dinnertime. Young people are often left to find their own recreation and companionship within their communities; more specifically, the streets. When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island (BGCBI) -Keaau Club, provides those opportunities on a daily basis to the young people of the Keaau community. The Keaau Club offers programs and services aimed at instilling a positive sense of self, increase self-esteem, self-confidence, and teach the skills necessary to make good, sound decisions. Through fun and engaging activities, BGCBI provides a positive atmosphere for youth to explore their interests so that they can reach their full potential and contribute to their communities as good, responsible citizens. Founded as the Boys Club of Hilo in 1952, the BGCBI has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years, BGCBI Board of Directors and Club leadership have demonstrated their commitment by extending our service reach to the youth in Pahoa, Keaau, Oceanview/Naalehu and Pahala. The mobile outreach program planted the seed for our newest Club in Pa'auilo. BGCBI success is evident on the faces of the youth who attend our Clubs and the outcome results reported to the following federal, state and private funding agencies: the Office of Juvenile Justice and Prevention (OJJP), the Office of Youth Services (OYS), Office of Juvenile Prevention (OJP) Rural Youth Program, Tobacco Trust Settlement administered by the Hawaii Community Foundation (HCF), and the Hawaii Island United Way. Reports are available upon request. The Keaau Club is located on Keaau Middle School property on the mauka side of the old O'la'a School behind the O'la'a Community Center. The Club implements its youth development program in three connecting rooms. Sports and fitness activities are conducted on the outdoor grassy portions of the property. The Keaau Club conducts daily after-school, weekend and full day intercession programs which include Boys & Girls Club of America's five core programs areas: • Snorts. Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter-club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club arts and creative writing. Activities and programs include: arts & crafts, creative writing, fine art, dance and music. Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply .learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high-yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program Character 8 Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year -local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol -youth program for youth introducing the Club to guest and new members. Youth For Unity is a Boys and Girls Club of America national diversity initiative that cultivates individuality, builds cultural identity and an appreciation of diversity. Health 8 Life Skills Develoament: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. Project TNT (Toward No Tobacco) is a SAMSHA approved evidenced-based tobacco prevention program that gives youth the information and skills needed to stay tobacco-free. The Kea~au Club offers a positive, safe environment for our youth during those critical, non-school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Kea'au Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life-enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence -Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness -Young people know the satisfaction of doing something of value for others. • A sense of belonging -Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence -Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Kea'au Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program orjust "hanging out". Youth Development Outcomes at age 18 The Kea au Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well-Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Kea'au Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Kea'au Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. BGCA has developed three internet- based surveys (elementary, middle and high school) to collect and anatyze information about whether the Kea'au Club is making a difference in members' lives. The Kea'au Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Bud et $150,000 Total Pro ram Position Count 4 Total A enc Bud et $1,200,000 Total A enc Position Count 35 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well- being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis 2007-2008 Program Highlights: 1) Total days of operation: 243 Total hours of operation: 1,473 - School days: 1:30 pm to 6:00 pm - School day off -waiver days and intercessions: 7:30 am to 5:30 pm 2) In the Fiscal Year 2007-2008 the Boys and Girls Club of the Big Island provided programs to 1452 young people ages 6 through 17 years. 226 of these youth attended the Keaau Club. Our youth development professionals provided outreach to 715 students in our community schools through the implementation of two evidenced-based curriculum programs: SMART Moves Drug, Alcohol, and Pregnancy NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Keaau Club Prevention Program and Project TNT. Agreements were made with each individual school administration and conducted within the health curriculum guidelines of the Department of Education. The Keaau Club conducted SMART Moves programming to 281 youth who attend Keaau High School, Keaau Middle School, Keaau Elementary and Mountain View Elementary. 3) Tobacco Education and Prevention was a major focus of Fiscal Year 2007- 2008 with BGCBI empowering their youth to make healthy decisions which ultimately lead to a healthy lifestyle. Some activities the Keaau youth were involved in included participating in the pol'dical process of the passing of Bill 224. Below are some activities our Keaau youth took part in: - Smoke Free Sign Wavings - Letter writing to County Council in support of the Bill - Participation in National Kick Butts Day -Keaau Club held an atter- school special event of educational games and activities promoting a tobacco free lifestyle - Participation in the Tobacco Free Big Island Poster Contest promoting the new County no smoking law at beaches and recreation facilities (BGCBI had three winners in that competition - East Hawaii beach clean-ups and beautycation projects Some of the agencies BGCBI has formed relationships with in FY 2007-2008 include: Tobacco Free Big Island Coalition, American Lung Association, American Cancer Society, REAL, the Salvation Army, Pahoa Weed and Seed Project, United States Tennis Association -Hawaii Pack Section, Bay Clinic, State of Hawaii Department of Education, PATCH, Kick-the-Nic, Prosecuting Attorney's Office, and Hawaii County Department of Parks & Recreation. 4) Member Highlights from Keaau Youth Development Professionals: • Na ali I always resembles what we here in Keaau call a team player. He is always participating in all sporting events and activities consistently showing respect for the game and others. If another member get out of line, Na ali I always tries to be a role model for that member, showing the way of respect. • Chaslyn is an incredible help with Arts & Crafts preparation, member operator of the snack shop, and encourages other members to be model students. She is quick to lend a helping hand to staff and members, alike. She helps mediate with the older and younger members. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea`au Club Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget * Estimate Youth will participate in The Arts Programs. Examples: / Arts and Crafts 147 100 100 / Dance / Music / Fine Arts Youth will participate in Character and Leadership programs. 68 75 75 Examples: / Keystone Club / Torch Club / Community Service Projects / Club Service Projects Youth will participate in Education and Career Development Programs. Examples: / Power Hour 175 100 100 / Project Learn / Tutoring / Com uter Technolo Youth will participate in Health and Life Skills Programs. Examples: / SMART Moves 143 125 125 / Project TNT / Nutrition/Cooking Classes / Tri le Pla Youth will participate in Sports, Fitness and Recreation Programs. Examples: / Team/Individual Sports 197 120 120 / Games Room Activities / Fitness Activities and Pro rams Parentsffamilies will participate in activities to promote family 40 4 events per 4 events per stren thenin and unit . ear ear NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club Program Expenditure FY 2007-08 Actual* (budget) FY 2008-09 Budget' (estimate) FY 2009-10 Estimate Salaries and Wa es $93,271 $78,563 $95,000 Professional Fees $1,551 $2,117 $2,500 O erations $60,549 $21,127 $51,100 E ui ment $1,361 $1,395 $1,400 Other(eoard Development) Total $156,732 $103,201 $150,000 * If applicable "Please explain in detail on sepazate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* (budget) FY 2008-09 Budget* (estimate FY 2009-10 Estimate Coun of Hawaii -Non rofit Grant $45,000 $40,000 $60,000 Hawaii Community Foundation: Hawaii Island Meth Initiative $21,275.76 Office of Justice Pro rams $10,000 $20,000 Office of Justice Programs - Ca aci Dept of Education - OHCNP Hawaii Community Foundation: HCF :Tobacco Fund $16,990 $9,198 Boys & Girls Club of Hawaii/YMCA Rural Youth Pro ram -Outreach Boys & Girls Club of Hawaii: Abstinence-Onl Grant Alcohol Drug Abuse Division ADAD DHS OYS 09-10 $7,500 Hawaii Island United Wa $6,173 $10,000 County of Hawaii District - Contin enc Fund $10,000 $5,000 $5,000 Intersession Pro ram Fees $15,647 $10,000 $15,000 Club Fundraisin Events $28,935 $9,000 $17,500 Communi Donations $18,884 $13,830 $15,000 Total $156,732 $103,201 $150,000 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 & Girls Club of the Bid Island Positive Youth Development Programs: Kea'au Club 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 8~ 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 2009-10 Page 9 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club 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 davs 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 vear-end report will imaact the evaluation of vour program's or aaencv's future fundina requests. Signature of Board President/Chair V- Signature of Executive Director /• ~ 8 09 Date Date "V ~ N ~~ UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 13 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club c Boys & Girls Club of the Bii Positive Youth Development Programs Interim Agency Director: Warren H.W. Lee Island Oceanview Club ^ O ~~ Phone No.: 961-5536 Contact Person: Warren H.W. Lee Phone No.: 961-5536 Mailing Address: 100 Kamakahonu Street, Hilo, Hawaii 96720 Facility/Site Address: 95-5547 Mamalahoa Hwy, Naalehu, HI 96772 Fax No.: 961-5189 Email Address: warren@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka -Chinaka, Sui 8~ Co., CPAs Phone No.: (808) 737-1040 Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $45,000 $40,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club Program Description: With most parents working, many of our Big Island youth find themselves with no adult care or supervision during the critical hours between school dismissal and dinnertime. Young people are often left to find their own recreation and companionship within their communities; more specifically, the streets. When opportunities are available in a community for positive participation, chi-dren are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island (BGCBI) - Oceanview Club, provides those opportunities on a daily basis to the young people of the Oceanview and Naalehu communities. The Oceanview Club offers programs and services aimed at instilling a positive sense of self, increase self-esteem, self-confidence, and teach the skills necessary to make good, sound decisions. Through fun and engaging activities, BGCBI provides a positive atmosphere for youth to explore their interests so that they can reach their full potential and contribute to their communities as good, responsible citizens. Founded as the Boys Club of Hilo in 1952, the BGCBI has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years, BGCBI Board of Directors and Club leadership have demonstrated their commitment by extending our service reach to the youth in Pahoa, Kea'au, Oceanview/Naalehu and Pahala. The mobile outreach program planted the seed for our newest Club in Pa'auilo. BGCBI success is evident on the faces of the youth who attend our Clubs and the outcome results reported to the following federal, state and private funding agencies: the Office of Juvenile Justice and Prevention (OJJP), the Office of Youth Services (OYS), Office of Juvenile Prevention (OJP) Rural Youth Program, Tobacco Trust Settlement administered by the Hawaii Community Foundation (HCF), and the Hawaii Island United Way. Reports are available upon request. The Oceanview CIu6 opened its doors to the youth of the Kau District in February 2007 while based at the Oceanview Community Center. Transportation for this Ctub was a daily challenge and in May 2008, BGCBI chose to relocate the operation to Naalehu Elementary and Intermediate School where we are able to serve both communities with ease. The Club operates out of the school gymnasium and uses all outdoor facilities for sports and fitness activities. Through partnership with Hawaii County Parks & Recreation, the Naalehu Community Center is utilized twice a week to conduct game room/social recreation, computer technology, and health and nutrition programs. The Oceanview Club conducts daily after-school, weekend and half day intercession programs which include Boys & Girls Club of America's five core programs areas: • Snorts. Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter-club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. • Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high-yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program • Character 8 Leadershia Develoument: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year -local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol -youth program for youth introducing the Club to guest and new members. Youth For Unity is a Boys and Girls Club of America national diversity initiative that cultivates individuality, builds cultural identity and an appreciation of diversity. • Health 8~ Life Skills Develoument: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. Project TNT (Toward No Tobacco) is a SAMSHA approved evidenced-based tobacco prevention program that gives youth the information and skills needed to stay tobacco-free. The Oceanview Club offers a positive, safe environment for our youth during those critical, non-school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Oceanview Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate, chartered member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life-enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses° which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence -Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness -Young people know the satisfaction of doing something of value for others. • A sense of belonging -Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence -Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Oceanview Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Oceanview Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well-Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club Moral Compass: Youth have values enabling them to develop positive relationships wOh others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Oceanview Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Oceanview Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three Internet-based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Oceanview Club is making a difference in members' lives. The Oceanview Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Bud et $130,000 Total Pro ram Position Count 4 Total Agency Budget $1,200,000 Total Agency Position Count 35 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well- being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward schooUeducation 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis 2007-2008 Program Highlights: 1) Total days of operation: 234 Total hours of operation: 1,134 - Schaol days: 2:00 pm to 6:00 pm - School day off -waiver days and intercessions: 9:00 am to 5:00 pm 2) In the Fiscal Year 2007-2008 the Boys and Girls Club of the Big Island provided programs to 1452 young people ages 6 through 17 years. 123 of these youth attended the Oceanview Club. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club Many specialized needs were addressed by our Oceanview Youth Development Staff. Addressing the need for increased academic achievement was met by providing daily educational enhancement programs. Addressing the need for guidance was met by members participating in a daily Club gathering called Positive Peer Culture, emphasizing how to think before reacting or responding to a particular situation. Addressing the need for anger management with youth served by learning the S.T.O.P. method of positive peer culture - (S)top what you are doing....(T)hinkahout the situation and what is taking place....(O)bserve your behavior and possible resolution....(P)roceed with our actions - a positive resolution. All Oceanview members participated in these SMART Moves program activities. 3) Tobacco Education and Prevention was a major focus of Fiscal Year 2007- 2008 with BGCBI empowering their youth to make healthy decisions which uttimately lead to a healthy lifestyle. Some activities the Oceanview youth were involved in included participating in the political process of the passing of Bill 224. Below are some activities our Oceanview youth took part in: - Smoke Free Sign Wavings - Letter writing to County Council in support of the Bill - Participation in National Kick Butts Day - Oceanview Club held an atter- school special event of educational games and activities promoting a tobacco free lifestyle - Participation in the Tobacco Free Big Island Poster Contest promoting the new County no smoking law at beaches and recreation facilities (BGCBI had three winners in that competition - Hawaii Kau District beach clean-ups of cigarette butts Some of the agencies BGCBI has formed relationships within FY 2007-2008 include: Tobacco Free Big Island Coalition, American Lung Association, American Cancer Society, REAL, the Salvation Army, Pahoa Weed and Seed Project, United States Tennis Association -Hawaii Pacific Section, Bay Clinic, State of Hawaii Department of Education, PATCH, Kick-the-Nic, Prosecuting Attorney's Office, and Hawaii County Department of Parks & Recreation. 4) The Oceanview Club was a recipient of a Healing Our Island mini-grant, Hawaii County Department of Research and Development, to conduct a community drug prevention awareness event. The first annual "Ghana Day at the Park -- Boys and Girls Club Style" took place on May 31, 2008. This free event hosted @300 youth and their families. It was a day of fun with a purpose.....to promote healthy living, family strengthening and community cohesion. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Youth will participate in The Arts Programs. Examples: / Arts and Crafts 62 50 50 / Dance / Music / Fine Arts Youth will participate in Character and Leadership programs. 31 35 35 Examples: / Keystone Club / Torch Club / Community Service Projects / Club Service Projects Youth will participate in Education and Career Development Programs. Examples: / Power Hour 74 75 75 / Project Learn / Tutoring / Com uter Technolo Youth will participate in Health and Life Skills Programs. Examples: / SMART Moves 84 75 75 / Project TNT / Nutrition/Cooking Classes / Tri le Pla Youth will participate in Sports, Fitness and Recreation Programs. Examples: / Team/Individual Sports 98 100 100 / Games Room Activities / Fitness Activities and Pro rams Parents/families will participate in activities to promote family 60 4 events per 4 events per stren thenin and uni ear ear NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club Program Expenditure FY 2007-08 Actual* (budget) FY 2008-09 Budget* (estimate) FY 2009-10 Estimate Salaries and Wa es $95,661 $84,299 $90,000 Professional Fees $1,551 $2,182 $2,500 O erations $46,486 $27,041 $36,100 E ui ment $29,753 $1,275 $1,400 Other Total $173,451 $114,798 $130,000 * If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* (bud et FY 2008-09 Budget* (estimate) FY 2009-10 Estimate Coun of Hawaii -Non rofit Grant $45,000 $40,000 $60,000 Boys & Girls Club of Hawaii/YMCA Rural Youth Pro ram -Outreach $30,994 Office of Justice Programs -Ocean View $74,570 Hawaii Community Foundation: HCF :Tobacco Fund $5,364 Hawaii Community Foundation: Hawaii Island Meth Initiative $1,811 County of Hawaii -Contingency Fund $18,500 $10,000 Office of Youth Services (OYS) Positive Youth Develo ment 08-26 $56,775 $42,000 Hawaii Island United Wa $3,900 $4,000 Intersession Pro ram Fees $430 $600 $1,000 Club Fundraisin Events $704 $500 $500 Communi Donations $18,884 $7659 $12,500 Total $190,893 $114,798 $130,000 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club 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 2009-10 Page 9 Boys & Girls Club of the Big Island Positive Youth Development Programs: Oceanview Club 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. 1 (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 davs after June 30 of the fiscal vear. 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 aaencv's future funding requests. Signature of Board President/Chair ~,~.c~-. rt . Cam-: s ~~-~- ~ T~ P o Signature of Executive Director -~a r UJa.rr e,., Lc e , 1 h-~ri N-+ CP o /~ -Z ~- a S Date -- y9-o Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 14 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club ~ O ~~ Interim Agency Director: Warren H.W. Lee Phone No.: 961-5536 Contact Person: Warren H. W. Lee Phone No.: 961-5536 Mailing Address: 100 Kamakahonu Street, Hilo, Hawaii 96720 Facility/Site Address: 96-2945 Paauau Street, Pahala, Hawaii 96777 Fax No.: 961-5189 Email Address: warren@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: (808) 737-1040 Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $45,000 $40,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Progams: Pahala Club Program Description: With most parents working, many of our Big Island youth find themselves with no adult care or supervision during the critical hours between school dismissal and dinnertime. Young people are often left to find their own recreation and companionship within their communities; more specifically, the streets. When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island (BGCBI) -Pahala Club, provides those opportunities on a daily basis to the young people of the Pahala community. The Pahala Club offers programs and services aimed at instilling a positive sense of self, increase self-esteem, self-confidence, and teach the skills necessary to make good, sound decisions. Through fun and engaging activities, BGCBI provides a positive atmosphere for youth to explore their interests so that they can reach their full potential and contribute to their communities as good, responsible citizens. Founded as the Boys Club of Hilo in 1952, the BGCBI has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years, BGCBI Board of Directors and Club leadership have demonstrated their commitment by extending our service reach to the youth in Pahoa, Kea'au, Oceanview/Naalehu and Pahala. The mobile outreach program planted the seed for our newest Club in Pa'auilo. BGCBI success is evident on the faces of the youth who attend our Clubs and the outcome results reported to the following federal, state and private funding agencies: the Office of Juvenile Justice and Prevention (OJJP), the Office of Youth Services (OYS), Office of Juvenile Prevention (OJP) Rural Youth Program, Tobacco Trust Settlement administered by the Hawaii Community Foundation (HCF), and the Hawaii Island United Way. Reports are available upon request. The Pahala Club conducts daily after-school, weekend and half day intercession programs which include Boys 8~ Girls Club of America's five core programs areas: • Snorts. Fitness and Recreation Develoament: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter-club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visial arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high-yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program Character & Leadershiu Development: empowers our youth to support and influence their Ctub and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year -local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welwme Patrol -youth program for youth introducing the Club to guest and new members. Youth For Unity is a Boys and Girls Club of America national diversity initiative that cultivates individuality, builds cultural identity and an appreciation of diversity. Health 8 Life Skills Develoament; develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. Project TNT (Toward No Tobacco) is a SAMSHA approved evidenced-based tobacco prevention program that gives youth the information and skills needed to stay tobacco-free. The Pahala Club offers a positive, safe environment for our youth during those critical, non-school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Pahala Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate, chartered member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life-enhancing programs and character development experiences • Hope and opportuniiy Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic °senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence -Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness -Young people know the satisfaction of doing something of value for others. • A sense of belonging -Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence -Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Pahala Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging ouY'. Youth Development Outcomes at age 18 The Pahala Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well-Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club The Pahala Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Pahala Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. BGCA has developed three internet- based surveys (elementary, middle and high school) to collect and analyze information about whether the Pahala Club is making a difference in members' lives. The Pahala Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Bud et $150 000 Total Pro ram Position Count 4 Total A enc Bud et $1,200,000 Total A enc Position Count 35 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well- being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward schooUeducation 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis 2007-2008 Program Highlights: 1) Total days of operation: 238 Total hours of operation: 1,195 - School days: 1:30 pm to 6:00 pm - School day off -waiver days and intercessions: 8:00 am to 5:00 pm 2) In the Fiscal Year 2007-2008 the Boys and Girls Club of the Big Island provided programs to 1452 young people ages 6 through 17 years. 119 of these youth attended the Pahala Club. Our youth development professionals provided outreach to 715 students in our community schools through the implementation of two evidenced-based curriculum programs: SMART Moves Drug, Alcohol, and Pregnancy Prevention Program and Project TNT. Agreements were made with each individual school administration and conducted within the health curriculum NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club guidelines of the Department of Education. The Pahala Club conducted Project TNT at Kau Middle School with 23 students. 3) Tobacco Education and Prevention was a major focus of Fiscal Year 2007- 2008 with BGCBI empowering their youth to make healthy decisions which ultimately lead to a healthy lifestyle. Some activities the Pahala youth were involved in included participating in the political process of the passing of Bill 224. Below are some activities our Pahala youth took part in: - Smoke Free Sign Wavings - Letter writing to County Council in support of the Bill - Participation in National Kick Butts Day -Hilo Club held an after-school special event of educational games and activities promoting a tobacco free lifestyle - Participation in the Tobacco Free Big Island Poster Contest promoting the new County no smoking law at beaches and recreation facilities (BGCBI had three winners in that competition - Hawaii Kau District beach clean-ups of cigarette butts Some of the agencies BGCBI has formed relationships with in FY 2007-2008 include: Tobacco Free Big Island Coalition, American Lung Association, American Cancer Society, REAL, the Salvation Army, Pahoa Weed and Seed Project, United States Tennis Association -Hawaii Pacific Section, Bay Clinic, State of Hawaii Department of Education, PATCH, Kick-the-Nic, Prosecuting Attorney's Office, and Hawaii County Department of Parks & Recreation. 4) Twenty Pahala members participated in a week long environmental program sponsored by the Ocean Futures SocietylJean-Michel Cousteau Family Camp (www.oceanfuture.orp). The Ambassadors of the Environment Program: A New Vision For The Next Generation, "is an exciting new program created to help prepare the next generation to take stewardship of the planet." Thls was ahands-on, residential week long outdoor education program where our members learned in a variety of ways from snorkeling adventures to nature hikes to laboratory activities to interactive slide shows and discussions. There were individual and group challenge activities that encouraged our members to think more about themselves and their relationship with others. This varied program provided our youth with a greater understanding of connections: land to sea, humans to nature, people to people, and present to future. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 & Girls Club of the Bid Island Positive Youth Development Programs: Pahala Club Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget * Estimate Youth will participate in The Arts 43 50 50 Programs. Examples: / Arts and Crafts / Dance / Music / Fine Arts Youth will participate in Character 35 25 25 and Leadership programs. Examples: / Keystone Club / Torch Club / Community Service Projects / Club Service Pro ects Youth will participate in Education 89 75 75 and Career Development Programs. Examples: / Power Hour / Project Learn / Tutoring / Com uter Technolo Youth will participate in Health and 69 50 50 Life Skills Programs. Examples: / SMART Moves / Project TNT / Nutrition/Cooking Classes / Tri le Pla Youth will participate in Sports, 83 75 75 Fitness and Recreation Programs. Examples: / Teamllndividuat Sports / Games Room Activities / Fitness Activities and Pro rams Parents/families will participate in 30 4 events per 4 events per activities to promote family year year stren thenin and uni NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club Program Expenditure FY 2007-08 Actual* (budget) FY 2008-09 Budget* estimate) FY 2009-10 Estimate Salaries and Wa es $114,579 $74,086 $95,000 Professional Fees $1,551 $3,542 $2,500 O erations $53,107 $38,381 $51,100 E ui ment $1,361 $2,351 $1,400 Other Total $170,599 $118,360 $150,000 * If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* (bud et) FY 2008-09 Budget* (estimate) FY 2009-10 Estimate Coun of Hawaii -Non rofit Grant $45,000 $40,000 $60,000 Hawaii Community Foundation: Hawaii Island Meth Initiative $1,811 Office of Justice Pro rams -Pahala $74,513 Office of Justice Pro rams $20,000 $20,000 Hawaii Community Foundation: HCF): Tobacco Fund $4,972 Boys & Girls Club of Hawaii/YMCA Rural Youth Pro ram RYP Funds $30,994 Alcohol Drug Abuse Division ADAD $20,000 $25,000 Hawaii Island United Wa $4,151 $10,000 County of Hawaii -Contingency Fund $20,000 $10,000 $10,000 Intersession Pr ram Fees $608 $500 $1,000 Club Fundraisin Events $5,706 $4,000 $7,000 Communi Donations $18,984 $14,737 $17,000 Total $197,616 $118,360 $150,000 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 & Girls Club of the Bie Island Positive Youth Development Programs: Pahala Club 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 2009-10 Page 9 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of vour program's or aaencv's future funding requests. Signature of Board President/Chair ~~~~~ ~~ Signature of Executive Director Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 15 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club ~ O ~~ Interim Agency Director: Warren H.W. Lee Contact Person: Mailing Address: Warren H. W. Lee Phone No.: 961-5536 Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 Facility/Site Address: Fax No.: Email Address: 15-3038 Puna Road, Pahoa, Hawaii 96778 961-5189 warren@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: (808) 737-1040 Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 06-07 07-08 OS-09 $0 $45,000 $40,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Program Description: With most parents working, many of our Big Island youth find themselves with no adult care or supervision during the critical hours between school dismissal and dinnertime. Young people are often left to find their own recreation and companionship within their communities; more specifically, the streets. When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island (BGCBI) -Pahoa Club, provides those opportunities on a daily basis to the young people of the Pahoa community. The Pahoa Club offers programs and services aimed at instilling a positive sense of self, increase self-esteem, self-confidence, and teach the skills necessary to make good, sound decisions. Through fun and engaging activities, BGCBI provides a positive atmosphere for youth to explore their interests so that they can reach their full potential and contribute to their communities as good, responsible citizens. Founded as the Boys Club of Hilo in 1952, the BGCBI has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years, BGCBI Board of Directors and Club leadership have demonstrated their commitment by extending our service reach to the youth in Pahoa, Kea'au, Oceanview/Naalehu and Pahala. The mobile outreach program planted the seed for our newest Club in Pa'auilo. BGCBI success is evident on the faces of the youth who attend our Clubs and the outcome results reported to the following federal, state and private funding agencies: the Office of Juvenile Justice and Prevention (OJJP), the Office of Youth Services (OYS), Office of Juvenile Prevention (OJP) Rural Youth Program, Tobacco Trust Settlement administered by the Hawaii Community Foundation (HCF), and the Hawaii Island United Way. Reports are available upon request. The Pahoa Club has been making a difference in the Puna District since October 2003, initially providing services part-time 2-3 days a week at the Nanawale Subdivision's Community Center. In August 2004, the program expanded to five days a week and in June 2006 moved to their present location at Pahoa Intermediate and High School, operating Monday through Friday from 2:00 pm to 6:00 pm. On school days off and intercessions, the Club is open full-day providing care to those youth who parents are employed. The Pahoa Club has formed a strong relationship with the Pahoa DOE School Complex who supports our efforts by providing the BGCBI two large portable classrooms used for implementing BGCA core programs. We also have use of the school complex fields and outdoor facilities available for sports fitness and athletic activities. The Pahoa Club conducts daily after-school, weekend and full day intercession programs which include Boys & Girls Club of America's five core programs areas: NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Snorts Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoodoutdoor activities, table tournaments and inter-club leagues. The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. Education and Career Develoament: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high-yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program Character & Leadershia Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive sell-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year -local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol -youth program for youth introducing the Club to guest and new members. Youth For Unity is a Boys and Girls Club of America national diversity initiative that cultivates individuality, builds cultural identity and an appreciation of diversity. Health & Life Skills Oeveloament: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. Project TNT (Toward No Tobacco) is a SAMSHA approved evidenced-based tobacco prevention program that gives youth the information and skills needed to stay tobacco-free. The Pahoa Club offers a positive, safe environment for our youth during those critical, non-school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Pahoa Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club As an affiliate, chartered member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life-enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence -Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness -Young people know the satisfaction of doing something of value for others. A sense of belonging -Young people know they are welcome and feel that they fd in and are accepted. • A sense of power and influence -Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Pahoa Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Pahoa Glub strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well-Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Pahoa Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Pahoa Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. BGCA has developed three internet- based surveys (elementary, middle and high school) to collect and analyze information about whether the Pahoa Club is making a difference in members' lives. The Pahoa Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Bud et $150,000 Total Pro ram Position Count 4 Total A enc Bud et $1,200,000 Total A enc Position Count 35 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well- being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward schooVeducation 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis 2007-2008 Program Highlights: 1) Total days of operation: 240 Totaf hours of operation: 1,579 - School days: 1:30 pm to 6:00 pm - School day off -waiver days and intercessions: 7:30 am to 5:30 pm 2) In the Fiscal Year 2007-2008 the Boys and Girls Club of the Big Island provided programs to 1452 young people ages 6 through 17 years. 168 of these youth attended the Pahoa Club. Our youth development professionals provided outreach to 715 students in our community schools through the implementation of two evidenced-based curriculum programs: SMART Moves Drug, Alcohol, and Pregnancy NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Prevention Program and Project TNT. Agreements were made with each individual school administration and conducted within the health curriculum guidelines of the Department of Education. The Pahoa Club conducted SMART Moves curriculum and Project TNT at Pahoa High & Intermediate School with 95 students. 3) Tobacco Education and Prevention was a major focus of Fiscal Year 2007- 2008 with BGCBI empowering their youth to make healthy decisions which ultimately lead to a healthy lifestyle. Some activities the Pahoa youth were involved in included participating in the political process of the passing of Bill 224. Below are some activities our Pahoa youth took part in: - Smoke and Drug/Alcohol Free Sign Wavings - Letter writing to County Council in support of the Bill - Participation in National Kick Butts Day -Hilo Club held an after-school special event of educational games and activities promoting a tobacco free lifestyle - Participation in the Tobacco Free Big Island Poster Contest promoting the new County no smoking law at beaches and recreation facilities (BGCBI had three winners in that competition - East Hawaii beach clean-ups of cigarette butts and rubbish Some of the agencies BGCBI has formed relationships with in FY 2007-2008 include: Tobacco-Free Big Island Coalition, American Lung Association, American Cancer Society, REAL, the Salvation Army, Pahoa Weed and Seed Project, United States Tennis Association -Hawaii Pacific Section, Bay Clinic, State of Hawaii Department of Education, PATCH, Kick-the-Nic, Prosecuting Attorney's Office, and Hawaii County Department of Parks & Recreation. 4) FY 2007-2008 outstanding media accomplishments: - TV spot the entire month of August 2007 highlighting members doing weekly clean-up of Pohoiki Beach Park (Living In Paradise, Big Island local station 27) - The United States Tennis Association Hawaii Pacific partnership hosted 41 Pahoa members at "Pahoa Kids Day° at the University of Hawaii with the UH Hilo Vulcan's Men and Women's Tennis Teams (December 2007 published article in the Big Island Weekly) - Youth-led local theatre company, the Theatre Arts Conservatory, conducted dramatic workshops with Pahoa member (July 2007 published article in the Hawaii Tribune-Herald) - National and State participation in National Kick Butts Day (April 2008 published article in the Hawaii Tribune-Herald) - Pahoa members beautified area East Hawaii beaches during spring break 2008 and collected a total of 6,721 cigarette butts - a visual display for the Tobacco Free Big Island Coalition's fight for the passing of Bill 224 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget * Estimate Youth will participate in The Arts Programs. Examples: 151 75 75 / Arts and Crafts / Dance / Music / Fine Arts Youth will participate in Character and Leadership programs. Examples: / Keystone Club 68 40 40 / Torch Club / Community Service Projects / Club Service Projects Youth will participate in Education and Career Development Programs. Examples: / Power Hour 168 100 100 / Project Learn / Tutoring / Com uter Technolo Youth will participate in Health and Life Skills Programs. Examples: / SMART Moves 130 100 100 / Project TNT / Nutrition/Cooking Classes / Tri le PIa Youth will participate in Sports, Fitness and Recreation Programs. Examples: / Team/Individual Sports 168 120 120 / Games Room Activities / Fitness Activities and Pro rams Parentsffamilies will participate in activities to promote family 30 4 events per 4 events per stren thenin and uni year ear NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Program Expenditure FY 2007-08 Actual* (bud et) FY 2008-09 Budget* (estimate FY 2009-10 Estimate Salaries and Wa es $102,911 $74,638 $95,000 Professional Fees $1,551 $2,107 $2,500 O erations $76,646 $32,116 $51,100 E ui ment $1,361 $1,393 $1,400 Other Total $182,469 $110,254 $150,000 * If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* (bud et) FY 2008-09 Budget* (estimate) FY 2009-10 Estimate Coun of Hawaii -Non rofit Grant $45,000 $40,000 $60,000 Hawaii Community Foundation: Hawaii Island Meth Initiative $21,276 Hawaii Community Foundation: HCF :Tobacco Fund $16,990 $8,667 Office of Justice Pro rams -Pahoa $74,173 Office of Justice Pro rams -Growth Office of Justice Pro rams $40,000 Alcohol Drug Abuse Division ADAD Office of Youth Services (OYS) Positive Youth Develo ment De t of Education - OHCNP County of Hawaii -Contingency Fund $26,000 $10,000 Hawaii Island United Wa $5,587 $10,000 Intersession Pro ram Fees $13,403 $10,000 $15,000 Club Fundraisin Events $21,817 $15,000 $12,500 Communi Donations $18,884 $5,000 $2,500 Total $211,543 $110,254 $150,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club 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 2009-10 Page 9 & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club 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 vear. The report shall include an explanation of the public benefits denved 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 Signa#ure of Executive Director i~ ~ 8~ a9 Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 16 Brantley Center, Inc. Employment Rehabilitation Program Brantley Center, Inc. Employment Rehabilitation Program Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Cami Post Phone No.: 775-7245 Cami Post Phone No.: 775-7245 P.O. Box 1407, Honokaa, Hawaii 96727 45-370 Ohelo Road, Honokaa, Hawaii 96727 775-0211 bcenter2@hawaiiantel. net Name of Accountant/CPA (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: 06-07 07-08 08-09 $21,000 $25,000 $10,000 Agency Mission Statement: To provide quality rehabilitation services to people with disabilities that empower them to participate independently in their community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Brantley Center, Inc. Employment Rehabilitation Program Program Description: 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 Pro ram Bud et 209,960 Total Pro ram Position Count 4.1 Total A enc Bud et 425,140 Total A enc 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 12 clients. 2) Provided individualized employment planning services to 12 clients. 3) Provided work adjustment training to 18 clients. 4) Provided occupational skills training to 20 clients. 5) Provided job-readiness classes to 7 clients. 6) Placed 6 clients in competitive employment. 7) Provided work transition services to 8 high school students with disabilities. NONPROFTP GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Brantley Center, Inc. Employment Rehabilitation Program Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Number of clients who received 23 30 30 employment rehabilitation services. Number of clients with improved 9 20 20 scores on the Vocational Evaluation and Trainin Re ort. Number of clients who increased 12 20 20 their roductivi percenta es. Number of clients who successfully 6 18 18 completed the job-readiness classes. Number of high school students 8 10 10 with disabilities who received work transition services. Number of clients placed in 6 10 10 competitive employment for a minimum of 90 da s. "If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 134,223 134,225 135,555 Professional Fees 11,000 12,000 12,000 O erations 28,405 31,405 31,405 E ui ment 1,415 1,500 1,500 Other" ien ayes 29,426 29,500 29,500 Total 204,469 208,630 209,960 rc appucaoie ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Brantley Center, Inc. Employment Rehabilitation Program Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Coun Mass Transit 21,000 31,000 21.,000 State of Hawaii 30,000 30,000 30,000 Hawaii Island United Wa 27,500 25,500 25,500 Coun of Hawaii Non rofit Grant 25,000 10,000 25,000 Pro ram sales & services 100,969 105,130 108,460 Fundraisin 6,995 Total 204,469 208,625 209,960 *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 2009-2010 Brantley Center, Inc. plans to expand our grounds maintenance and janitorial services by submitting bids for public and private contracts. We also plan to enlarge the plant nursery that was started in 2008. This will provide participants with additional training opportunities and at the same time increase program revenue. On December 30, 2008 the Board of Directors formed a special fundraiser committee made up of community members to address the recent reduction in funding. The Board also plans to increase large donor contributions through special invitations to the Center to show case our program services. Approximately fifty 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 Braritley 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 2009-10 Page 4 Brantley Center, Inc. Employment Rehabilitation 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, Hawaii County Code, relating to Appropriation of Funds to Nonprofd Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that 1 (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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 (..- G~7/"ti ~~ Signature of Executive Director Date al~~ E~C~ Da e UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Brantley Center, Inc. Employment Rehabilitation Program Program Expenditures: The "Other" category is client wages. Clients get paid for the work they produce while they participate in this training program. 17 Bridge House, Inc. Vocational Skills Building Program Bridge House, Inc.- Agency Name Vocational Skills Building Program- Program Name Agency Din:ctor: Mark Schuster 322-3305 Contact Person: Mark Schuster 322-3305 Mailing Address: P.O. Box 2489 Kailua-Kona, HI 96745 Facility/Site Address: 78-0687-B Mamalahoa Hwy. Holualoa, HI 96725 Fax No.: 808-322-0809 Email Address: mark_bridgehouse@earthlink.net Phone No.: 808- Phone No.: 808- Name of AccouMant/CPA (include name of firm if applicable): Brenda Smith, Smart Solutions ,Inc. Phone No.: 808-960-5041 Mailing Address: P.O. Box 1164 Captain Cook, HI 96704 Amount of Request for County Funds: $52,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $15,000.00 $15,000.00 $12,000.00 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 The Bridge House mission is to assist adults who are in early recovery from drug and/or alcohol addiction, to develop successful living skills through residential and vocational experiences in a safe, structured and supportive environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Bridge House, Inc. -Agency Name Vocation) Skills Building Program- Program Name Program Description; The Vocational Skills Building Program (VSB) is a specialized in-house program offering that provides assessment, referrals and linkage, as well as training, that will ensure that graduating residents will have obtained successful employment prior to discharge. Total Budget and Position Count Total Pro ram Bud et 94,400.00 Total Pro ram Position Count 1-5 Total A enc Bud et 465,480.00 Total A enc Position Count 6 Program Objectives: 1) All incoming residents will complete an "Initial Vocational Employment Evaluation". 2) A vocational plan is developed that identifies areas of attention (e.g. skills building/training, enhancement of attitude and behavior, continuing education, job coaching, resume preparation, mock interviews, job search, etc). 3) All residents must contribute a minimum of 15 hours per week to the Bridge House 'ohana, completing work assignments on the property. This allows for on-site staff evaluation of attitude, commitrnent, and general assessment of job readiness. 4) At approximately 90 days of program participation, staff and resident complete apre-employment evaluation that assesses willingness to participate, punctuality, integrity, ability to establish and complete goals, and other measures of employment readiness. 5) Between 100-300 days of residency, individuals are encouraged and assisted to begin a job search for appropriate employment. Staff provides transportation to and from resource centers (e.g. Workforce Development, Dept of Voc Rehab), and job interviews, assists in the canpletion of job applications, assists in resume pneparation, and provides equipment such as computer, fax and copy machine to facilitate the job search process. 6) Upon securing employment, Bridge House staff will provide the resident transportation to and from the worksite. Program Highlights: NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 1) At time of admission, 100% of our 65 admits were deemed "unemployable". 2) At 6-months post-discharge 76% of graduates remained employed. 3) All graduates obtained clean and sober housing prior to discharge. 4) At 6-months follow-up, no graduates had law enforcement contact that led to arrest. 5) At 6-month follow-up, 85% of graduates reported ongoing involvement in self-help groups. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 _ Bridge House, Inc. -Agency Name Vocational Skills Building Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate 50% of all admits will complete the r ram 33°fo 45% 45% 70°k of all graduates will lie employed, in school, or in a training r ram 76% 70% 70% `It applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-70 Estimate Salaries and Wa es 47,587.00 49,800.00 49,800.00 Professional Fees 7,588.00 13,500.00 14,200.00 O rations 23,993.00 22,356.00 24,000.00 E ui ment 7,639.00 6,350.00 6,400.00 Other' Total 86,807.00 92,006.00 94,400.00 - it appnpoie ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Hawaii Island United Wa 23,500.00 21,000.00 21,000.00 State of Hawaii/ADAD 25,500.00 34,000.00 14,000.00 Pr ram Fees 12,919.00 17,000.00 6,000.00 Coun 15,000.00 12,000.00 52,000.00 Donations 9,888.00 12,000.00 1,400.00 Total .~~ _ 86,807.00 92,006.00 94,440.00 u appncaoie 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~ustainingl We continue to apply for vocational-based grants that might support or enrich this vital program. On an unfortunate note, we must report that we were unable to recognize any profit from our lychee crop this past season. Our agricultural wnsultants confirm that our crop was unable to mature and ripen due to the increased level of 'vog', as well as the significant amount of rainfall that fell upon the mauka area. We will continue to solicit financial donations of support from the West Hawaii community. It remains unlikely, however, that the VSB program will become self-sufficient until a major portion of our agricutural land is developed and able to produce marketable products. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Bridge House, Inc. -Agency Name Vocational Skills Building Program -Program Name I (we) have read and understood till of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal acxountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonproftt 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 yearend 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 sounses and amounts obtained during the award period. Failure to submit a timely. complete. an ~tti~ Signature of Board President/Chair Signature of Executive Director l,T o _ D e Da UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 18 Child and Family Service Alternative to Violence Child & Family Service -Agency Name Alternative to Violence -Program Name Agency Director: Howard Garval, President and CEO Phone No.: (808) 681-3500 Contact Person: Heidi Koop, Director of Hawaii Island Programs Phone No.: (808) 935-8229 Mailing Address: Child & Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 Facility/Site Address: 1266 Kamehameha Avenue, Suite A Hilo, Hawaii 96720 Fax No.: (808) 935-5589 Email Address: hkoop@cfs-hawaii.org Name of AccountanUCPA (include name of firm if applicable): N & K, CPAs, 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: $35,000.00 Prior Year(s) Funding: For Ke Ala Lokahi 06-07 07-08 08-09 $0.00 $0.00 $25,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Child & Famil Service - A enc Name Alternative to Violence -Program Name Agency Mission Statement: "Strengthening families and fostering the healthy development of children" Since 1899, Child & Family Service-has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child & 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 & 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 & 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. To ensure the continuation of comprehensive Domestic Violence services on the island of Hawaii, Child & Family Service agreed to a planned merger with Turning Point for Families, Inc. As of January 1, 2008, Child & Family Service oversees all of Turning Point for Families' programs in East and West Hawaii. Despite the added significant fiscal responsibilities, Child & Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child & 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 the operation of the Alternative to Violence (ATV) program in the county of Hawaii, more specifically two part-time Domestic Violence Specialists. Hawaii County funding will support batterers' groups in the county of Hawaii. The ATV program utilizes an evidence based curriculum that incorporates a cultural and a value based component. The ATV program provides an array of Domestic Violence Intervention (DVI) services to men, women and children. The services to victims included legal advocacy to complete and file temporary restraining orders, court advocacy, individualized safety planning, psycho-educational and pattern changing groups, victim support groups, case management and childcare services for group participants. The services to batterers include psycho-educational groups that teach skills of non-violence and accountably for their behavior. The primary service modality for the ATV program is group format. Best Practices suggest that groups are the most effective method in working with domestic violence issues. The batterers' groups assist the clients in making changes and can provide a supportive structure that makes it easier for clients to break the denial, blame and minimization and to facilitate offender accountability. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 __ Child & Family Service -Agency Name Alternative to Violence -Program Name Batterers' groups are staffed with both male and female Group Facilitators. Research suggests that groups for batterers should be staffed by facilitators of both genders in order to role model appropriate male and female interaction, communication and encourage gender equality. The intention is to serve clients of all cultural backgrounds with a sensitivity"that fosters engagement in the process of becoming violence-free. The ATV program monitors batterers on a routine basis (weekly, monthly, and quarterly) by the program staff for any increase or decrease in their level of risk or identified risk factors. Changes to the client's individual service plan are made incorporating any changes in services that are recommended and then reviewed with the client prior to implementation. All participants are assigned a case manager to monitor their participation and performance during group, maintain contact with probation and other related services, and to provide one to one counseling and referrals as needed. The goal is for clients to understand how violence is used as power in an intimate relationships and causes disrespect and harm that is inconsistent with the values, beliefs and conduct of every culture. This program philosophy and practice also incorporates the understanding of violence against women within a social, economic, and cultural analysis of gender and sexual oppression. Total Budget and Position Count Total Program 944,290 Total Program Position 21 Bud et Count Total Agency Budget 7,150,623 Total Agency Position 118 Count Program Objectives: 1. 60% of clients completing batterer intervention services will demonstrate the knowledge, skill and attitudes necessary for maintenance of non-abusive behavior, which includes learning non-violent conflict resolution and non- aggressive communication. 2. 100% of clients completing batterer intervention services will significantly increase their knowledge of the effects of domestic violence on children. 3. 80% of Victims participating in Support Services will be able to identify at least 3 personal safety skills. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Child & Famil Service - A enc Name Alternative to Violence -Program Name Program Highlights:. ATV clients who have been affected by domestic violence (offenders, victims, child witnesses,) were offered classes that taught them how to overcome the trauma of domestic violence and to be determined to live violence free. The objective is to remind the meh and women of the value of respect that can be found in every culture. In Fiscal Year'08, the program provided the following: • 128 men graduated from the program after a 28-week program. • 49 women graduated from the program after a 22-week program. • 494 classes were held for men • 99 classes were held for victims of domestic violence • 98 Pattern Changes classes were held Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Number of men graduated from 128 157 165 ro ram Number of women graduated from 49 53 55 ro ram Number of (28 weeks) classes for 494 500 525 men Number of 15-weeks classes for 99 105 50 women Number of 22-weeks pattern 98 105 50 Chan in rou for women *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Child & Family Service - A ency Name Alternative to Violence -Program Name Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 603,066 627,988 640,548 Professional Fees 4,654 5,000 5,100 O erations 324,505 329,184 335,768 E ui ment 0 0 0 Other" 0 0 0 Total 932,225 962,172 981,418 * If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Hawaii Count 35,000 25,000 40,000 Judicia 784,165 784,165 784,165 Pro ram Fees 84,960 120,125 120,125 H I UW 12,500 15,000 15,000 Private foundation 15,600 0 0 Total 932,225 944,290 959,290 *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? Child & Family Service has attempted to secure some additional funding for the ATV program but has not been successful. Additional funding will be requested from the Judiciary since a new court opened in Waimea that requires ATV services. To strengthen and to grow the program, Child & Family Service will continue to review national and local funding options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Child & Family Service - A ency Name Alternative to Violence -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, Sectioris 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 ayear-end report to the Legislative auditor within 60 davs 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. a '~-~-~ Signature of Board President/Chair Signature of Executive irector Patti Bates Chief Operating Officer I ~~ lII ~ Date ~~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 19 Child and Family Service Hawaii County -Domestic Abuse Shelters Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -Program Name Agency Director: Phone No.: Contact Person Phone No.: Mailing Address: Facility/Site Address: Fax No.: Email Address: Howard Garval, .President and CEO (808)681-3500 Heidemarie Koop, Director of Hawaii Island Programs. (808) 323-2664 Child & Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 81-6587 Mamalahoa Highway, Bldg. C Kealakekua, Hawaii 96750 (808) 323-2999 hkoop @ cfs-hawaii.org Name of Accountant/CPA (include name of firm if applicable): N&K CPAs, 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: $35,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $17,000.00 $25,000.00 $20,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -Program Name Agency Mission Statement: -- "Strengthening families and fostering the healthy development of children" Since 1899; Child & Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the Healthy development of children". The spectrum of Child & 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 & 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 & Family Service is known in the community for its willingness to work with hard-to-engage individuals and families facing a multitude of difficult problems. To ensure the continuation of comprehensive domestic violence services on the island of Hawaii, Child & Family Service agreed to a merger with Turning Point for Families, Inc. as of January 1, 2008, Child & Family Service oversees all of Turning Point for Families' programs in East and West Hawaii. Despite the added significant fiscal responsibilities, Child & Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child & 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 the operation of the West Hawaii and East Hawaii Domestic Abuse Shelters (DAS). Hawaii County funding will be used to support staffing, more specifically part-time Relief Shelter Workers, for the Shelters to meet the increasing demands for intensive services. In addition, funding will be used for ongoing repairs and supply needs. Child & Family Service Domestic Abuse Shelters (DAS) provide emergency shelter to single women and women with children who are victims of domestic violence (for a maximum of 90 days). These victims flee from the geographic areas of Ka'u all the way to Kohala, from the Volcano to Puna, from Puna to Hamakua. Victims from East Hawaii often access the DAS in West Hawaii and vice versa to ensure the highest degree of safety. There are no restrictions to enter the shelter as long as the circumstances of need are identified as a domestic violence issue. These two shelters are the only shelters on the Big Island to serve the immediate needs of the population seeking safety due to domestic violence. The shelter operates 24 hours aday/365 days a year including holidays. Staff members oversee the safety and needs of the residents. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -Program Name Child & Family Service has been providing emergency shelter to the Big Island community for 21 years. The West Hawaii°Shelter opened in 1988 followed by the East Hawaii Shelter in 1995. The main goal of the program is to provide' a safe environment. Experienced advocates help families identify their needs and develop a plan to meet these needs. In addition, the Shelters offer our residents emergency food, transportation, referrals as needed, case management, individual counseling, advocacy, outreach services, safety planning, assistance with Temporary Restraining Orders, support groups, and personal planning. A Mother/Child Specialist works with the mothers and children to assess for trauma, build healthy relationships and to strengthen the women's role as effective parents without using physical and/or verbal violence towards their children. We are committed to raising the consciousness of our society by educating our families on a violence free lifestyle, promoting family coping and stability, and providing a place of refuge. Each Shelter operates a 24-hour domestic violence hotline which provides crisis intervention, information, and referral services. During the last six months, the hotline utilization by victims of domestic violence has increased due to the added economic stressors in the communities of the Big Island. The hotline worker provides a safety assessment, makes recommendation and provides referral and resource information for the callers. It is expected that the hotline will continue to see an increase of calls due to rising violence in the home due to poverty and homelessness. The Shelter in West Hawaii provides three bedrooms with a total of 21 beds for families who enter into the program. In addition to the three bedrooms each room has a full bathroom to accommodate the residents who share the bedroom space. One bedroom is specifically geared towards housing our single women and women with disabilities. This room is ADA compliant. The facility also has an ADA ramp for easy access in/out of the Shelter. In addition to the client areas, the shelter also has two offices, a playground and a children's room. These offices are used for intake and exit interviews to provide client confidentiality, case management, and individual counseling. The Shelter also provides our residents with a laundry facility, full kitchen, and a large living and dining room area. On the Shelter site a large Matson container holds furniture items, clothing and household miscellaneous items. These items are donated throughout the year from the West Hawaii community members who support our Shelter. The East Hawaii Hale `Ghana Domestic Abuse Shelter is located in a two-story home on approximately three acres in an agricultural/residential area of East Hawaii and is set off from the roadway. It has three full bathrooms, four bedrooms and has a 20-person capacity. The downstairs of the Shelter facility NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -Program Name has a laundry room that is accessed through the covered double car garage entrance. A comfortable-sized living room-with an adjoining bathroom is accessible via the laundry room and a short walkway connects into the spacious kitchen area. There is an adjoining dining,room and pantry which is also accessible via an entrance off the side of tfie kitchen that exits into the side yard of the property. The Shelter facility is ADA-compliant by having an ADA ramp which leads to the lower floor where an ADA bedroom is located. Total Budget and Position Count Total Pro ram Bud et $938,922 Total Pro ram Position Count 18 Total A enc Bud et $7,150,623 Total A enc Position Count 118 Program Objectives: The Child & Family Service Domestic Abuse Shelter's objective is to: 1. 75% of clients will have an increase in knowledge of community resources. 2. 90% of clients in shelter will complete a Safety Plan for themselves and their children. 3. 60% of single adults and families will move from the shelter to anon-abusive home environment. Program Highlights: During the fiscal year of 2007-2008, the West Hawaii Domestic Abuse Shelter (WHDAS) served 230 people; 133 adults and 97 children. The annual goal of bed days for the DHS contract was to provide 3390 bed days. The WHDAS provided 7,580 bed days. The WHDAS received 172 hotline calls that involved a crisis due to domestic violence. During the fiscal year of 2007-2008, East Hawaii Domestic Abuse Shelter (Hale 'Ghana) served 233 people; 147 adults and 86 children. The annual goal of bed days for the DHS contract was to provide 3,390 bed days. Hale 'Ghana provided 5,974 bed days. Hale'Ohana received 347 hotline calls that involved a crisis due to domestic violence. Due to a concern of a possible increase in domestic violence incidents, we anticipate shelter services may increase but are unable to project a percentage of increase at this time. Both Domestic Abuse Shelters achieved 100% of their outcomes during the fiscal year of 2007-2008. These include: assisting the residents with personalized NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -Program Name safety planning, increasing awareness on the effects of children who witnessed domestic violence, increasing awareness of community resources, and educating the participants on healthy relationships. Performance Measures in West in Hawaii: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate** # of Bed Days 7,580 7,880 7,880 # of Hotline Calls 172 180 180 # of Sin le Women 53 40 46 # of Women w/children 42 48 50 # of Children Served 89 89 90 # of requests for information and referral onl 5015 5020 5030 # of group session 1303.25 in hrs 260 260 # of individual session hours rovided 2123.25 1800 1850 # of meals rovided 11,004 10,000 10,300 # of tri s trans ortation rovided 93 50 50 *If applicable ** Estimates are based on historical data. Performance Measures in East Hawaii: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate** # of Bed Days 5974 7168.8 7168.8 # of Hotline Calls 347 416.4 416.4 # of Sin le Women 96 115 115 # of Women w/children 51 61 61 # of Children Served 86 103 103 # of requests for information and referral onl 249 300 300 # of rou session 206 247 247 # of individual session hours rovided 2456.5 2947.80 2947.80 # of meals rovided 12,000 12,000 12,000 # of tri s trans ortation rovided 746 895.20 895.20 *If applicable ** Estimates are based on historical data. State projections are the same as in the FY 2008-09 column. East and West Domestic Abuse Shelter Program Expenditures NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -Program Name FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 482,859._ 594,387 606,275 Professional Fees 8,353- O erations 268,285- 357,935 365,094 E ui ment 4,974'. Other Total 764,471 952,322 971,369 * If applicable "Please explain in detail on separate sheet Program Funding Sourcess Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Department of Human Services 628,194 819,768 748,769 Pro ram Fees 8,838 14,902 14,902 Hawaii Island United Wa 24,653 22,500 22,500 HPHA Emer enc Shelter Grant 22,098 28,322 28,000 Prosecutor's VOCA 27,115 25,000 25,000 Hawaii Count 17,500 20,000 35,000 Private Foundation 20,960 8,500 Total 749,358 938,992 874,171 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -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? Child & Family Service strives to achieve swstainability for all its programs. Yet, Child & Family Service is also committed to supporting critical services in the community despite their budgetary limitations. Child & Family Service is active in writing grants for supplemental funding to keep its critical programs operating. Child & Family Service relies on other funding sources to fund its Domestic Abuse Shelters, such as Hawaii Island United Way (HIUW), Emergency Shelter Grant (ESG) and Victims of Crime Act from the Prosecutor's Office. In addition, the shelter also charges a modest fee for shelter to those clients with an ability to pay. Child & Family Service also received funding from Community Development Block Grant for much needed repairs and improvement projects in West and East Hawaii. During the last two fiscal years, the Domestic Abuse Shelters in the State of Hawaii received additional monies from the Department of Human Services; these allocations were from special funds and legislative action. It is expected that funding will be reduced to the Shelter's original funding in Fiscal Year 2009- 2010. Child & Family Service advocates for higher revenues at contract renewal as needed and will seek other sources of funding to continue the high quality of services in the community of West Hawaii. It is anticipated that the funds from DHS will be reduced in Fiscal Year 2009- 2010due to the economic challenges our state is facing. We are asking for additional funding from Hawaii County to help offset some of the cutbacks. Child & Family Service is committed to providing these services to our communities and will continue to advocate for no reductions in funding as well as to pursue other funding sources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Child & Family Service -Agency Name Hawaii County -Domestic Abuse Shelters -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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 Boar-d President/Chair ~l~t-YXit- ~7~~iL~/ Signature of Executive Director Patti Bates Chief Operating Officer 'laa ~~>' Date lz~ ~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 20 Child and Family Service Hilo Transitional Housing Program Child & Family Service -Agency Name Hilo Transitional Housing Program -Program Name Agency Director: Howard Garval, President and CEO Phone No.: (808) 681-3500 Contact Person: Heidemarie Koop, Director of Hawaii Island Programs Phone No.: (808) 935-8229 Mailing Address: Child & Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 Facility/Site Address: 1266 Kamehameha, Suite A Hilo, Hawaii 96720 Fax No.: (808) 935-5589 Email Address: hkoop@cfs-hawaii.org Name of AccountanUCPA (include name of firm if applicable): N&K, CPAs, 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: $40,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $30,000 $35,000 $35,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Child & Family Service -Agency Name Hilo Transitional Housing Program -Program Name Agency Mission Statement: "Strengthening families and fostering the healthy development of children" Since 1899, Child & Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child & 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 & 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 & 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. To ensure the continuation of comprehensive Domestic Violence services on the island of Hawaii, Child & Family Service agreed to a planned merger with Turning Point for Families, Inc. As of January 1, 2008, Child & Family Service oversees all of Turning Point for Families' programs in East and West Hawaii. Despite the added significant fiscal responsibilities, Child & Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child & 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 the operation of the East Hawaii Transitional Housing program. Hawaii County funding will be used to support the position of apart-time Domestic Violence Specialist and apart-time Mother/Child Specialist operating out of the Hilo office. Victims of Domestic Violence are faced with many challenges when making the courageous decision to finally leave their batterers. As women and men are provided services in our Domestic Abuse programs, when it comes to economic issues, it is mostly women who are confronted with financial challenges. When leaving the batterer, the victim embarks upon a path that is as fearful for her and her children as it is to stay with an abusive partner. Many of these women leave with just the clothes that they are wearing, seeking shelter, safety and most of all assurances that they made the right choice. Many lack the skills, tools and resources needed to sustain themselves and their children away from their batterer. In addition, many women are faced with the reality of no financial resources, and inability to access resources due to marital assets retained by the perpetrator which disqualifies her from qualifying for public assistance or possibly subsidized housing. Many women turn to the Hilo or Kona Domestic Abuse Shelters where they can recover and start planning a new life. The Domestic Abuse Shelters provide safety, basic needs, counseling and support up to 90 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Child & Family Service -Agency Name Hilo Transitional Housing Program -Program Name days. Securing a safe home for themselves and their children is one of the serious challenges that the victims are facing in the county of Hawaii due to an expensive rental market. At the end of the 90 days in a Domestic Abuse Shelter, the victim must make a decision not only for herself but for her children as well. Unfortunately that decision is often to return to the batterer she sought refuge from or to become homeless. The Hilo Transitional Housing is a 24 month program designed to assist victims of domestic violence and their children to rebuild their lives. The program goal is to assist victims and their children in gaining stability and independence while transitioning into aviolence-free lifestyle. Victims who qualify for services transition from the Domestic Abuse Shelters located in West and East Hawaii and can be placed in one of six apartments/houses. During their 24 month stay, victims and their families receive intensive support services with the goal to guide the victims and their families towards independence, to move to a regular home in the community, to secure income and to be able to care for the children. By providing weekly home visits, case management, individual family service plans, information and referrals to community resources, the program allows both the victims and their children the time to heal, and to live safely. The Program is in need of a full-time Domestic Violence Specialist to provide case management, counseling, and support to the women. Without the Hawaii County funding, only apart-time Domestic Violence Specialist can be supported. Due to the high need of the clients and intensive case management, afull-time Domestic Violence Specialist is able to offer the necessary services. The role of the Mother/Child Specialist is to provide trauma assessments for the family. The family is also provided with services to support and improve the mother/child relationships. The mothers learn practical parenting skills and receive child development education to help provide a safe home for their children. The Mother/Child Specialist provides therapeutic interventions to the children that help the child to overcome the traumatic effects of domestic violence. The Domestic Violence Specialist gives the victims weekly opportunities to learn or enhance their life skills, including budgeting, money management and job training. In doing so, the Domestic Violence Specialist addresses many of the barriers to establishing income, housing and independence. Total Budget and Position Count Total Pro ram Bud et $196,816 Total Pro ram Position Count 2.25 Total A enc Bud et $7,150,623 Total A enc Position Count 118 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Child & Family Service -Agency Name Hilo Transitional Housing Program -Program Name Program Objectives: 1. 70% of the clients will reduce their level of stress as measured quarterly. 2. 70% of the clients will increase self-sufficiency as measured quarterly. 3. 90% of the clients will complete/have a Safety Plan for themselves and their children as measured quarterly. 4. 80 % of the clients will secure independent housing after 12 months of safe transitional housing. Program Highlights: 1. The program is fulfilling a high need for providing housing for victims of domestic abuse and their families. 2. Provided 11 families with transitional housing from July 2006 to June 2007. 3. Provided 12 families with transitional housing from July 2007 to June 2008. 4. Provided 10 families with transitional housing from July 2008 to January 2009, projected to service 3 additional families by June 2009. 5. The staff has developed a strong program that focuses on reintegrating victims of domestic abuse into independence and self-sufficiency. 6. All six units are occupied and there is a waiting list. 7. Five families have successfully transitioned into permanent housing since July 1, 2008. 8. One participant successfully obtained her GED within 3 months of entering transitional housing, which she had previously been working on achieving for the past 5 years. 9. Three participants are currently enrolled at the University of Hawaii, 2 are seeking a Certified Substance Abuse Counselor (CSAC) certificate, another is working on obtaining her Associate degree in Administration of Justice. 10.Of the eighteen participants who have transitioned out of program since its beginning in 2006, sixteen participants have made the decision not to re- involve themselves with their perpetrators. 11.The program has established collaboration with the Forward March job training program, which increases their job readiness skills and ability to obtain employment. 12. Program objectives have been met or exceeded: a) 100 % of clients have reduced stress levels. b) 100% of clients have increased self sufficiency, through increased knowledge in budgeting, obtaining employment, and regained confidence in doing things for themselves. c) 100% of all clients have a completed safety plan within 30 days of entering program. d) 50 % of clients secured permanent housing within 12 months of entering program. This percentage is lower due to the lack of funding available with county housing funds, such as section 8 vouchers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Child & Family Service -Agency Name Hilo Transitional Housing Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Budget * FY 2008-09 Estimate # of families rovided housin 12 14 14 # of service lans develo ed 12 14 14 # rovided case mana ement 12 14 14 # of safet lans develo ed 12 14 14 # rovided aftercare services 3 5 5 # w/secured income 12 14 14 # enrolled in education ro ram 3 4 4 # w/secure em to ment 4 6 6 # obtained ermanent housin 5 6 6 `If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es $ 61,068 $ 65,623 $ 77,312 Professional Fees O erations 142,280 131,193 133,552 E ui ment Other" Total $203,348 $196,816 $210,864 If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate US De artment of Justice $130,624 $163,545 $162,593 Count of Hawaii 30,650 25,000 40,000 Pro ram Fees 8,659 8,271 8,271 Total $169,933 $196,816 $210,864 *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? NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Child & Family Service -Agency Name Hilo Transitional Housing Program -Program Name The Transitional Housing program has been primarily supported by the Department of Justice, Office of Violence Against Women (OVW). Additional funding options that primarily focus on providing Transitional Housing services will be identified. Child & Family Service will seek support from the Hawaii Community Development Corporation of Hawaii (HCDCH) homeless stipend program and the Emergency Shelter Grant Program (ESG). NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Child & Family Service -Agency Name Hilo Transitional Housing 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, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 A~ ~ r~ Signature of Board President/Chair ~~~,~ ,~ Signature of Executive Director Patti Bates Chief Operating Officer '1~1a~' Date Datel ~t O UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 21 Child and Family Service Therapeutic Foster Home Program t~ Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -Program Agency Director: Howard Garval, President and CEO Phone No.: 681-3500 Contact Person: Heidemarie Koop Phone No.: 323-2664 Mailing Address: Child & Family Service 91-1841 Fort Weaver Road Ewa Beach. Hawaii 96706 Facility/Site Address: West Hawaii: 81-6587 Mamalahoa Hwy, Kealakekua 96750 East Hawaii: 460 Kilauea Avenue, Suite 101, Hilo 96720 Fax No.: (808) 323-2999 West Hawaii (808) 961-2073 East Hawaii Email Address: hgarval@cfs-hawaii.org h kooo @cfs-hawaii.org Name of AccountanUCPA (include name of firm if applicable): N & K, 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: $35,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -Program Prior Year(s) Funding: - Family Violence Continuum Programs 06-07 07-08 $9,000 $9,000 Therapeutic Foster Home West Hawaii 08-09 $20,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -Program Agency Mission Statement "Strengthening families and fostering the healthy development of children" Since 1899, Child & Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child & 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 & 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 & 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. Child & Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child & 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 the Therapeutic Foster Home program in their work with children who present with severe behavioral challenges such as self- injuries, property damage, physical assaults, truancy, substance abuse and stealing. These children are in high need of professional Skills Trainers who are able to give them one-on-one attention. Child & Family Service is requesting funding for ahalf-time Support Coordinator and monies to continue supporting therapeutic activities in the homes and the community. Child & Family Service Therapeutic Foster Home (TFH) program provides foster placement and clinical services for youth who have been identified as needing out-of-home placement. Additional resources are provided to accommodate their emotional, behavioral, and mental health issues. The TFH program offers a system of support, counseling and skill building services to youth as well as training and support to the caregivers and foster parents. The TFH program provides services countywide on the island of Hawaii. During the time in the program, the goal is to teach the child and their family how to build trusting relationships that support the child in achieving his or her highest potential. The behavioral health and residential programs at Child & Family Service continue to see an increase in the number of youth who are in need of line of sight supervision and therapeutic activities throughout the day including weekends. Often, these children are neurologically challenged due to exposure to substances in utero and/or to child abuse and neglect. Most of these children have experienced multiple unsuccessful placements and/or the members of the `ohana are unable to support that child in their homes due to the severity of the NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -Program behavior and/or other family and work commitments. Many of these children are so desperate that their behaviors place them in acute units of hospitals. In recent years, study after study has demonstrated the malevolent effects of substance abuse ornwomen and their children. Deterioration in the physical, mental, and emotional health of the substance-abusing mother and her child has been well documented, with particular emphasis on the potentially devastating effects on the fetus of prenatal maternal drug abuse. In the 1996 Blind Studv of Substance Abuse and Need for Treatment-Among Women of Childbearihg Age in Hawaii, women reported using alcohol, tobacco, marijuana, cocaine/crack, and methamphetamine in the greatest numbers. It is well documented that since the 1990s, there has been a dramatic increase in the use of methamphetamine ("ice"). It is anticipated that over time, the number of youth referred for behavioral health services, including therapeutic foster homes, will increase as Hawaii's "ice babies" grow up. Youth with neurological impairment exhibit combined cognitive, physical and emotional difficulties. They may have learning impairments, behavioral deficits, increased motor activity, and enhanced conditioned avoidance responses. Parents and foster parents become frustrated and cannot cope, resulting in many placements for these youth. Multiple placements often times reinforce problem behaviors and erode the self esteem of these youth. It is cost-beneficial to learn more about this population, provide interventions as early as possible, and prevent further problems from developing. The current staffing in East and West Hawaii consists of a Director of Hawaii Island Programs and a Program Director who provides programmatic oversight of the Therapeutic Foster Home. A Master's level Mental Health Specialist provides intensive clinical and case management services for the child, the therapeutic foster parents and biological family members. The Support Coordinators provide daily practical support to the therapeutic foster parents in regards to transportation and appointments. Other duties include the licensing of foster homes and preparing new intakes. Child & Family Service has been developing a program component that focuses on the needs of children who have neurological impairment over the past year. When these children are placed into our Therapeutic Foster Home program, there is a high need for providing one-on-one staffing to allow the child to adjust to his/her new therapeutic foster home. They are also often adjusting to a new school environment and making connections with other children in the community. Child & Family Service staff have received extensive training that focuses on working with children between the ages 5 and 18 years old with these difficulties. To further support this project, experienced Support Coordinators are needed to provide intensive services at the beginning of the placement, during crisis situations and transition to a permanent placement. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -Program The Support- Coordinator would be working under the direct supervision of a Program Director with guidance by the Master's level clinician. The Support Coordinator would provide groups to teach life skills that allow the children to manage their neurological challenges iri a fiealthy way. Total Budget and Position.Count Total Pro ram Bud et $1,103,548 Total Pro ram Position Count 9.75 Total A enc Bud et $7,150,623 Total A enc Position Count 118 Program Objectives The intermediate goal of the Therapeutic Foster Home Program is to provide a safe stable living environment to youth who experience emotional and/or behavioral problems. This stable environment is needed while the children engage in therapy to address their individualized mental health and behavioral issues. The long-term goal of the program is to provide the support and skill building necessary to empower youth to engage in socially appropriate and manageable behaviors, thereby facilitating the re-unification (if appropriate) of children with their biological families or at the very least to be able to move to a less restrictive environment. Measurable objectives for the Therapeutic Foster Home program include: 1. 90% of youth show progress in the development of interpersonal relations and life skills, as measured by their participation in extra curricular, community or otherwise pro-social activities as measured quarterly. 2. 90% of youth learn how to be a positive and productive member of a family as measured by their ability to follow daily scheduling and complete household duties as measured quarterly. 3. 100% of youth work towards their identified permanency plan goals as measured quarterly. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -Program Program Highlights The Therapeutic Foster Home (TFH) Program has focused intently on developing the program's ability to provide innovative and valuable therapeutic intervention to the youth in the County of Hawaii. During the last two fiscal years, we were able to provide intensive services to clients who were unsuccessful in other environments. As they are entering the program, the Support Coordinator provides one-on-one services that focus oh supporting the client while adjusting to the new environment and getting comfortable in their new community. The Support Coordinator collaborates with the school to make it a success for the child. The Support Coordinator also develops a schedule with the child that includes activities that foster the child's talents and strengths. Child & Family Service continues to be a pioneer in offering services that are trauma informed and that cater to the unique needs of these special children. This approach has helped to prevent children to be referred to acute services in Honolulu. Therapeutic Foster Home -County of Hawaii Performance Measures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Therapeutic Foster Home Program # of clients served 21 12 14 # of bed da s utilized 4,038 3,066 3,832 # of licensed foster homes 15 16 18 # of individual therapy, therapeutic activities and/or skill buildin 922 700 875 # famil thera sessions 173 350 432 # of discharges to a lateral or lower level of care 18 6 7 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 280,472 256,211 261,335 Professional Fees O erations 433,037 305,830 311,947 E ui ment Other" Total 713,509 562,041 573,382 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -Program Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-OS Actual * FY 2008-09 Bud et " FY 2009-10 Estimate Department of Health (Child Adolescent Mental Health 763,819 412,538 412,538 Count of Hawaii - 0 20,000 35,000 Total 763,819 432,538 447,538 *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? Child & Family Service strives to achieve sustainability for all its programs. Yet, Child & Family Service is also committed to providing critical services in the community and pursues new treatment modalities despite their budgetary limitations. Child & Family Service is active in writing grants for supplemental funding to keep its critical programs operating. Child & Family Service continues to apply to other funders to ensure continuing training by for neurological impairment to further the project of working with children who are experiencing neurological challenges. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Child & Family Service -Agency Therapeutic Foster Home Program -County of Hawaii -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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will impact the.evaluation of vour program's or agency's future funding requests. ~~_ Signature of Board President/Chair Signature of Executive Director Patti Bates Chief Operating Officer t/~1 /a~ Date I z~ 0 8' Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 22 Eden Earthworks Mountain View Community Gardens Eden Earthworks- Agency Name Mountain View Community Gardens- Program Name Agency Director: Neena Roumell, Ph.D. 808 333 7444 Contact Person: Neena Roume, Ph.D. 808 333 7444 Mailing Address: P O Box 711458 Facility/Site Address: 183840 S.Lauko Road Mountain View, HI 96771 Fax No.: Email Address: Edenearthworks@earthlink.net Name of Accountant/CPA (include name of firm if applicable): Phone No.: Mailing Address: Phone No.: Phone No.: Amount of Request for County Funds Prior Year(s) Funding: 06-07 07-08 $NA $NA $ NA Agency Mission Statement: 08-08 $12,640 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 i he organization is committed to planting, maintaining and harvesting organic produce to benefit "Lighthouse food" programs through local churches. The organization through its volunteers and volunteer non paid staff, produce and distribute organic food stuff to donate to the needy through a "Food Bank" program. The operations will be conducted on the organizations field farm and greenhouse located in Mountain View, HI. The farm land is donated by the director Neena Roumell. The projected date will be June of 2007. ~?ONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Eden Earthworks -Agency Name Mountain View Community Gardens- Program Name Program Description: =den Earthworks is donating thirty garden plots, tools, seeds, starter plants and the how-to of organic farming and greenhouse practice through hands-on teaching/instruction via cluster plot groups of participating individuals. This will be provided to low-income individuals (we are serving the underserved of Puna). Strategies include vegetable and herb bed preparation, crop planning, planting and maintenance, harvest and food distribution; the benefits and sources for healthy soil building, compost construction, dry seed preparation, vegetable and herb preparation (recipes) and marketing skills. Individuals (children, youth and families) will learn land and water resources. As the program training moves toward the third growing season, families will be rotated out of the program to tend their own gardens on a similar evolving garden plot. Alternatively families may elect to continue as trainers for families coming into this program. Eden Earthworks regards this as a leadership opportunity to build knowledge, empower and inspire action in participatory trainers. This will encourage a ripple effect of self-reliance for individuals, children/youth/ families and act as a powerful outreach. At the same time, this methodology will also mitigate against barriers to sustainability. Total Budget and Position Count Total Pro ram Bud et 29,897 Total Pro ram Position Count 32 Total A enc Bud et 40,000 Total A enc Position Count 34 Program Objectives: 1) The program objectives are as follows: 1) Empower low-income individuals to farm the land, play a critical role in their own and others' self- sufficiency-food security and self-employment; (plan, plant, maintain and harvest) healthy produce for the family table and 2) Market the surplus produce. 3) Awide-ranging goal is to contribute to the shaping of a stable local food system. 4) raise community awareness as to the benefits of sustainable, ecologically-minded agriculture. 5) The central underlying and most pervasive goal is to inspire a kindling of spirit for nourishing the land and an egalitarian spirit of many hands working together; connecting healthy low-cost food with people. 6)Encourage Hope through Roots, e.g., the support of a rapid proliferation of local food systems in Puna via an emerging coalition of community farming areas.Our expectation is a notable achievement of goals over the initial three growing seasons. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Program Highlights: 1) This is a new program. Therefore there is no data collection available from prior instructional-based growing cycles. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Eden Earthworks -Agency Name Mountain View Community Gardens -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Evaluation to determine program NA NA 80% (or >) effectiveness will be a pre and post measured questionnaire which addresses 1)numbers of individuals who are improvemen t successfully growing their own food 2) are growing their own food successfully and marketing the surplus 3) food choices and availability during a typical week; 4)agricultural and marketing skills; Paticipants will be asked questions at the onset of their participation in the growing cycle and again after the completion of the first and third growing cycles. Evaluation wil be used as a determinant for improvement in these four areas. Analysis of paritcipants responses will determine if we are meeting the goal of providing access from farm to table and distribution of food; to determine where changes need to be made to better meet these goals and to form new oats. I *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 5100 Professional Fees Operations 1300 E uipment 2751 Other 3489 Total 12,640 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 EDEN EARTHWORKS PROJECT FRESH: MOUNTAIN VIEW COMMUNITY GARDEN PROJECT BUDGET NARRATIVE 1- Salaries and Wags a. Major Partcipants Dr Neena Roumell (Project Coordinator) 75 hrs @ $20 /hr = $1,500 b. Other Management or Labor Hired: Hourly personnel: Internships, College of Ag, U-Hawaii, Hilo, Training Manager 240 hrs @ $15 /hr = $3,600 subtotal 5 100 2- Operations Chicken manure/fish fertilizer: 2 bags of SOIb bag/plot x 30 plotsC 60 bags @ $15 /bag = $900 Soil testing Kit (pre & post soil testing) 16 kits @ $25 /kit $400 subtotal 1 300 3- Equipment Chipper/Shredder (garden exchange) 1 @ $2,751 ea = 2 751 4- Other Top loading Scale: 1 per 10 Gardeners 3 @ $97 ea = $291 Portable Hand Washer: 1 per 10 plots 3 @ $51 ea = $153 Poly Landscape Wheelbarrow: 1 per 10 plots 3 @ $70 ea = $210 Water catchment 3,000 Gallons for gardeners use 1 @ $2,335 ea = $2,335 Water hose: 100ft @ $SOea per 3 plots 10 @ $50 ea = $500 subtotal 3 489 Total $12,640 - Agency Name - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Coun of Hawaii Non-Profit Grant 12.640 Hawaii Peo le's Fund 10,000 Healin The Island 2,000 Noncash Contribution Ar us,Tro'anLumber, Walmart 257 Total 24897 `If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. when do you antiapate your program to become self-sustaining? The Mountain View Community Garden project thrust for fuhding at this time is primarily for start-up funding. It is anticipated that self-sustainability should be accomplished within several years (within Tess than three years time). The maintenance needs of this program should be greatly reduced in several critical ways. First; We are anticipating our volunteer instructional force to increase as more community members are trained to garden and become mentors to others. This will in fact be encouraged via continued 'stipends' to 'trainers' in the form of family-sized portions of produce from our farm and also the continued availability of garden plots to those participating families. Second; Maintenance needs (for materials and supplies should also substantially decrease due to the massive on-site production of compost. This should completely cancel the need for outside materials and supplies, i.e., outside organic sustainable materials needed to produce healthy soil. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Eden Earthworks,lnc. -Agency Namv Mountain View Community Gardens -Program Name I (we) have read and understood all of the eligibility requirements; grant onditions; 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 Q L r~~ O~M~ Signature of Board President/Chair Signature of Executive Director t Zoo Date ~ ~ Z9 Zoa9 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 23 Family Support Services of West Hawaii Ka'u Family Center Family Support Services of West Hawaii Ka'u Family Center 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 Fax No.: (808) 326-4063 Email Address: kids@fsswh.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs 8~ Management Group Phone No.: (808) 242-5002 Mailing Address: 1885 Main Street, Suite 408 Wailuku, HI 96793 Amount of Request for County Funds Prior Year(s) Funding: 06-07 $45,000 07-08 $45,000 $55,000 08-09 , $40,000 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 2008-09 Page 1 Family Support Services of West Hawaii Ka'u Family Center Program Description: Neighborhoods can affect children in both positive and negative ways, according to a recent Child Trends Fact Sheet (September, 2007). For example, after-school programs in disadvantaged neighborhoods are associated with reductions in crime and violence. Several explanations underlie the association between neighborhood quality and child well-being. For instance, the supportiveness of neighbors can influence children's development through social connections, role models, trust and help. When neighbors report high levels of positive social ties, children tend to have more pro-social skills and display fewer problem behaviors. Family Resource Centers offer all parents what informal neighborhood 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. In the past, we have sought funding for both Ka'u and Kohala Family Centers. However, due to the state of our economy and the lack of services in the southern regions of Hawaii Island, focus will be placed on programming in Ka'u. Living in a remote, rural area of the island of Hawaii, families in Ka'u face challenges in accessing child care, health care, employment, housing, substance abuse, financial assistance, counseling and educational resources. The Ka'u Family Center is a warm and welcoming place where any family member can go, not only in times of need, but as a regular part of day-to-day life. The Ka'u Family Center offers emergency food and clothing, access to housing and financial assistance applications, parent education classes, child development activities, parent-to-parent support groups, access to educational support for out of school youth, computer 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 3,500 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 Family Center. Our purpose is to give parents the opportunity to reach out to community resources, to help one another and to learn together. The Family Center helps families prevent crises, define problems, identify strengths and become responsible for determining their own solutions. The Family Center is the only place in the district of Ka'u that all parents can go to get the help and support they need in a familiar setting. The FSSWH Family Center Coordinator not only responds to family needs, but also proactively creates and curates social networks. For example, the Ka'u Family Center has partnered with the Hawaii County Department of 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, includllg those with disabilities, and their families. Approximately 10% of the populations served are other Pacific Islanders: Marshallese or Micronesians. The Family Center Coordinator facilitated efforts by the Ka'u Community Partnership (Advisory Council) to complete a successful food drive where food and $1,000. cash donation was raised by the community for distribution within the community, Community residents were either beneficiaries or responded to the need for emergency food. Thus input and guidance from the community tells us that emergency food distribution by the Family Center is responsive to the needs of this community and should be developed more fully. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 The Family Center is one of the few places in the district of Ka'u 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. Compared with the rest of the State, Hawaii County served an increasingly greater percentage of individuals and families who lived in unsheltered conditions, including the park, in cars or at the beach (Homeless Service Utilization Report 2008). 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, and Early Intervention Services, have staff housed in the center and thus families are able to access these services without having to travel 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. The Ka'u Community Partnership meetings provide a linkage between programs and community and involve Boys and Girls Club, Queen Lili'uokalani Children's Center, Department of Human Services, Public Health Nursing, Friends of Kahuku Park, private business people and other community members. The goal of the facilitator is to engage community residents and human service programs and create connections so that they have better communication and ultimately be more effective in addressing the needs of the community. 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 Family Center 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 $ 60,000.00 Total Program Position Count 1 full time Total A enc Bud et $ 4,200,000.00 Total A enc Position Count 80 Program Objectives: 1) Mobilize public and private community resources td help children and families in need. 2) Assist families in achieving economic independence and self-sufficiency. 3) Decrease social isolation in rural communities 4) Enhance children's development and ability to attain academic and social success. 5) Promote successful transitions throughout a family's major milestones. Program Highlights: 1) #pformation and referral services were provided to 147 new and 424 returning individuals during the 2007-2008 fiscal year. There were a total of 596 requests for assistance of which 579 were able to be met over the year by the Ka'u Family Center. 2) Provided technological support for those without access to 184 individuals in Ka'u alone over the year. 3) Other community helping organizations were able to utilize the Ka'u Family Center to provide 182 hours of outside service to the community. These included: Hawaii Intake Services, VIP Men's Group, Bay Clinic's Reach Out and Read Literacy Program, Na'alehu Main Street, the Ka'u Partnership and the Ka'u Community Action Team. 4) The Family Center housed programs designed to support families at many different stages of development, such as Healthy Start, Enhanced Healthy Start, Malama Perinatal Program, the Ka'u NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Child Development Program for infants and toddlers with disabilities and their families, and the Youth Development Program. 5) There were several community-wide family events in which over 1,000 people participated, including an 'Ghana Health and Fun Day (substance abuse prevention) event and a partnership with local businesses in Ka'u providing 500 people with Christmas dinner and a gift for each community keiki. The Family Center provides a comprehensive array of family support programs, services and activities. • Health and developmental screenings • Immunizations • Evaluations for dev. delays • Access to pediatric care • Access to prenatal care • Access to general medical care • Info on diet, nutrition and health Jra•) a 4Ha r6~r~:~cg ?iti i ti:GU!'-5cih':a • Information • Resource and referral services • Access to mental health services • Support groups • Parenting education • Financial counseling, planning , and management • Housing • Tutorial programs • Access to GED programs • Literacy programs :;h~iciten~~ LSStieS • Play and Learn groups • Health, medical, & nutritional services • Therapeutic services for infants and toddlers with disabilities • Child safety in and out of the home ". ,~?l s~a~icas • Employment opportunities • Information and referral to other government and community resources • Emergency Food • Ka'u Partnership (Advisory Council] NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page -t Family Support Services of West Hawaii Ka'u Family Center Performance Measures: FY 2007-08 Actual * FY 2008-09 Budget* FY 2009-10 Estimate Education 20 25 25 Em to ment 15 20 25 Financial 10 25 25 Health 25 25 25 Parentin Information 25 30 25 Office Equip/Com uter Use 165 150 150 Food 60 65 60 Substance Abuse Su orUlnfo 75 75 40 Frr uui-utt ~ utt-uy measures were based on both the Ka'u and Kohala Family Centers. FY 09-10 are estimates only for the Ka'u Family Center. Program Expenditures FY 2006-07 Actual FY 2007-08 Bud et FY 2008-09 Estimate Salaries and Wa es $ 39,372.00 $ 39,792.00 $ 34,300.00 Professional Fees $ 144.00 O erations $ 651.00 $ 1.032.00 $ 1,135.00 E ui ment $ 2,322.00 $ 720.00 $ 1,000.00 Other" $ 28,581.00 $ 25,512.00 $ 32,209.00 Total $ 70,926.00 $ 67,200.00 $ 68,644.00 See Below Other Program Expenditures, con't FY 2006-07 Actual * FY 2007-08 Bud et * FY 2008-09 Estimate E to ee Benefits $ 7,451.00 $ 5,304.00 $ 4,288.00 Pa roll Taxes $ 4,577.00 $ 4,956.00 $ 4,288.00 Occu anc $ 13,313.00 $ 13,728.00 $ 18,700.00 Su lies $ 3,018.00 $ 900.00 $ 1,500.00 Travel--milea e $ 222.00 $ 144.00 $ 933.00 Insurance $ $480.00 $ 500.00 Total Other $ 28,581.00 $ 25,512.00 $ 32,209.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Family Support Services of West Hawaii Ka'u Family Center Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual ~ FY 2008-09 Budget* FY 2009-10 Estimate Hawaii Count $ 45,000.00 $ 40,000.00 $55,000.00 Private Donations $ 17,200.00 $ 5,000.00 $13,644.00 Total $ 67,200.00 $ 70,000.00 $68,644.00 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 pertormance 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 as a member of the community and on a greater scale, of the 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 cur Family Centers. Collaboration has been a key to the success of the Family Center programs and is recognized as a top prioi'tty 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 religions 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 2008-09 Page 6 Family Support Services of West Hawaii -Agency Name Ka'u Family Center 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 ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. 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 of your program's or aaency's future funding requests Signature of Boar& President S, m_ , ~, :,..~ r, .,;.fl k ~- r Sig ature of Executive Dir ct' r Date ~`~~'~ Date ~: UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 24 Friends of Big Island Drug Court Assistance to Drug Court Clients & Program Friends of Big Island Drug Court- Agency Name Assistance to Drug court Clients 8~ Program- Program Name Agency Director: None Phone No.: n/a Carol VanCamp, President Phone No.: Contact Person: (808) 982-9958 Mailing Address Facility/Site Address: Fax No.: Email Address: PMB 126, 111 E. Puainako St., Suite #585, Hilo, HI 96720. None 969-1499 cvancamp3@hawaii. rr. com Name of Accountant/CPA (include name of firm if applicable): Brian Iwata, C,pA, Take~ta~,ta, Hara & Assoc., LLC Phone No.: 935-5404 Mailing Address: 101 Aupuni St., Suite 139, Hilo, HI 96720 Amount of Request for County Funds: $10,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $0 $10,000 Agency Mission Statement: The mission of the Big Island Drug. Court is to help address societal problems related to substance abuse in order to minimize their societal and economic costs, and to protect the Big Island community by providing timely and effective NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-IO Page 1 treatment for drug offenders with appropriate sanctions and incentives. Simply stated, the "Friends of Big Island Drug Court" is a 501c3 organization created to provide financial and other support to Drug Court clients and the overall program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Friends of Big Island Drug Court - A ency Name Assistance to Drug Court Clients & Program- Program Name Program Description: The Friends of Big Island Drug Court provides funding and other support for the clients and programs of Big Island Drug Court. This includes rewards and incentives to clients during their drug-free journey (such as gift certificates, movie tickets, etc.), loans or awards for tuition to further their education, and loans or awards for housing, travel or other such needs. The Friends also sponsors graduation supplies for Drug Court clients, and responds to individual requests for support. All programs and activities are conducted by volunteers, as there are no paid employees. The organization is governed by a volunteer board of directors, representing across-section of individuals from the community. Total Budget and Position Count Total Pro ram Bud et $14,000.00 Total Pro ram Position Count 0 Total A enc Bud et $14,000.00 Total A enc Position Count 0 Program Objectives: 1) The Friends is designed to integrate community/private support into governmental efforts directed at the rehabilitation of adult men and women, and juveniles, who are charged with or convicted of non-violent felonies and assessed as chemically dependent on alcohol and/or other drugs, by securing financial support for governmental efforts to operate Big Island Drug Court in the Third Circuit. Program Highlights: 1) Through private donations and fundraising, we have been able to provide financial rewards and incentives to motivate Drug Court clients, and also to provide awards and loans for tuition, housing, or varoius other needs of Drug Court clients. The specific goal is to assist in ways that government cannot to help clients successfully complete the Drug Court program and return to society as contributing citizens. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Friends of Big Island Drug Court -Agency Name Assistance to Drug Court Clients & Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Balance Sheet as of Dec. 31, 2008 $11,639.72 Bud et for 2008-09 $14,000.00 Estimated Bud et for 2009-10 $14,000.00 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 0 0 0 Professional Fees $1,800.00 $1800.00 O erations 12,200.00 $12,200.00 E ui ment Other" Total $14,000.00 $14,000.00 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Friends of Big Island Drug Court -Agency Name Assistance to Drug Court Clients & Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Balance Sheet as of Dec. 31, 2008 $11,639.72 Bud et for 2008-09 $14,000.00 Estimated Bud et for 2009-10 $14,000.00 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et ` FY 2009-10 Estimate Salaries and Wa es 0 0 0 Professional Fees $1,800.00 $1800.00 O erations 12,200.00 $12,200.00 E ui ment Other" Total $14,000.00 $14,000.00 ' If applicable `Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Friends of Big Island Drug Court -Agency Name Assistance to Drug Court Clients & Programs -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Donations $2,500.00 $4,000.00 $4,000.00 Grants Coun of Hawaii $10,000.00 $10,000.00 $10,000.00 Total $12,500.00 $14,000.00 . $14,000.00 *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? As the number of clients accepted into the Big Island Drug Court program continues to increase, we will solicit more donations and in-kind support to keep pace with the needs. It is difficult to predict sustainability due to anticipated fluctuation in client numbers. In addition, the actual Drug Court program is reliant on government funding, and we cannot predict the continued availability of those funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Friends of Big Island Drug Court -Agency Name Assistance to Drug Court Clients & 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, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certity 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 ayear-end report to the Legislative auditor within 60 davs 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 ~. J~. Signature of Board Presid nt/Chair N'~} Signature of Executive Director ~~~% ~o ~ Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-IO Page 6 25 Friends of the Children's Justice Center of East Hawaii Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs Friends of the Children's Justice Center of East Hawaii- Agency Name Special Needs & Enhancement, Center Support, Prevention/Education & Training Programs - Program Name Agency Director: Katherine A. Garson, Board President Phone No.: 935-8755 Contact Person: Victoria Kravitsky, Program Coordinator Phone No.: 935-8755 Mailing Address: 1290 Kinoole Street, Hilo, Hawaii 96720 Facility/Site Address: 1290 Kinoole Street, Hilo, Hawaii 96720 Fax No.: 808-933-0968 Email Address: fcjceh@fcjc.org Name of Accountant/CPA (include name of firm if applicable): Jennifer Gossert, Jennifer Gossert, CPA Phone No.: 808-969-3115 Mailing Address: 688 Kinoole Street, Suite 201, Hilo, Hawaii 96720 Amount of Request for County Funds: $18,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $15,000.00 $12,000.00 $15,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Agency Mission Statement: The mission of the Friends of the Children's Justice Center of East Hawaii is to help sexually, physically and 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 2009-10 Page 2 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs & Enhancement, Center Support, Prevention/Education & 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 amulti-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 to provide resources for direct services and programs for child victims and their families which are not available through any other public or private source. The Friends accept requests for funding 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., and other agencies. The Friends serve children between the ages of 0-18, who are victims of abuse (sexual, physical, emotional, mental abuse or neglect) residing in East Hawaii. This includes North Hilo, South Hilo, Hamakua, Puna and parts of Ka'u. We serve children with active or documented cases of abuse and neglect. The Special Needs and Enhancement Program is designed to help child victims develop positive self-worth. The Friends provide resources 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 also have a holiday gift program for children not covered by other programs. Center Support: The Friends provide resources to help reduce trauma and ensure the safety and comfort of the children that come to the Children's Justice Center for interviews. The Friends maintain the Center's safe, child-friendly and homelike atmosphere with toys, games and snacks. This is often made possible by community donations and volunteerism. The Friends also help maintain the Center's appearance with repairs and refurbishing when needed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 The Prevention and Education Program is designed to educate the community regarding child abuse issues. This program plans 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 to learn state-of-the-art interviewing techniques and refine their overall skills. These professionals work with child victims and their families. Training opportunities enhance the quality of services and prevents victims from being re-traumatized by possible difficiencies in the system's response to the allegations of abuse. Total Budget and Position Count Total Pro ram Bud et 169720 Total Pro ram Position Count 1 Total A enc Bud et 169720 Total A enc Position Count 1 Program Objectives: 1) Provide funds for clothing, toiletries, bed/mattress and other necessities for children in emergency or relative foster placement. 2) Provide funds for tutoring, correspondence courses or summer school to allow a child to graduate or progress to the next grade level. 3) Provide funds for ground or air transportation for children to participate in family vacations/reunions, attend school or team events, or to see medical specialists. 4) Provide funds for children to participate in supervised Spring and Winter Intersession activities, or summer camps. 5) Pay for fees, equipment and supplies needed for extracuricular activities ie: sports, music, art, drama, dancing lessons, etc. 6) Provide funds for holiday or birthday gifts when a child would otherwise not receive a gift. 7) Provide gas coupons to families on a limited budget so children may be able to attend treatment programs. 8) Provide funds for diapers, car seats and other baby supplies for infants who are victims of abuse and neglect. 9) Pay for event fees, prom dresses, senior pictures, yearbooks, etc., to give a student a chance to participate in school functions. 10) 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. 11) Provide privacy, comfort and safety for children and family members who come to the Center, by maintaining its warm environment. 12) Participate with the East Hawaii Coalition for Child Abuse Prevention in community education activities to increase public awareness. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Program Highlights: 1) Filled 777 appropriate special needs and enhancement requests for abused and neglected children to provide for their specific needs that would otherwise have gone unmet. Many requests were for a larger amount than average requests from previous year. 2) Continued to partner with Children's Justice Center of East Hawaii to provide requested funds for professionals to attend trainings on Oahu and the mainland, including new Social Workers, police and other professionals who interface with alleged child victims of abuse. 3) Increased awareness of Abuse Prevention for the general public by participating in many educational activities including: ongoing work with the Coalition and collaborating with them during April -Child Abuse Prevention Month; participate in Coalition Celebrate Your Family Day event at the Sangha Hall in Hilo; participated in the Boy Scouts annual Makahiki Festival; attend community education fairs such as the Puna Informational Fair at the Pahoa Community Center; made presentations to the Rotary Club, to school counselors and to local churches. 4) Provided 150, $25 Holiday Gift Cards to the local shopping mall, to teens 12 to18 years old. Coordinated a group of volunteers from the local school Resource Team to assist with assembling of Christmas gift cards, stuffed toy animals, pens/pencils and trading cards. 5) Held our signature fundraiser (The Phantom) by distributing over 300 invitations and raised $17,000. 6) Sponsored a 5th Annual Prevent Child Abuse Golf Tournament for FCJCEH, at the Mauna Lani South Golf Course. 7) Distributed an 8-page newsletter insert within the Hawaii Tribune Herald which reached 22,000 community residents, marketing the FCJCEH services and providing information regarding child abuse prevention. 8) Held a Legislative Open House, December'08, inviting State Legislators to visit our agency and meet our Board and volunteers. 9) Submitted two new Grant Requests: one to Payless Shoes (awarded 75 $15. Gift Cards, which were distributed in addition to the shopping mall gift cards, within our Holiday Gift Program); and one to Young Brothers (awarded $1,000); and will continue to investigate other grant opportunities. 10) Assisted at Aid Station for runners participating in the 2008 Ironman Triathlon in Kona, as our service to the community. 11) Participated in the 2008 Annual Visitor Industry Charity Walk, a statewide event coordinated by the Hawaii Hotel & Lodging Association. 12) Recruited four new Board Members to our Board of Directors. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 - Agency Name - Program Name Performance Measures: FY 2007-08 Actual " FY 2008-09 Bud et * FY 2009-10 Estimate Special Needs and Enhancement Re uests 777 800 825 Christmas Gift Pro ram 150 150 150 'If applicable Program Expenditures FY 2007-08 Actual " FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 32905 42000 43000 Professional Fees 13250 8800 8850 O erations 9678 9170 9250 E ui ment Other" 75967 109750 120000 Total 131800 169720 181100 ' If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 - Agency Name - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Count of Hawaii 15500 18000 18000 Hawaii Island United Wa 12750 15000 15000 Charit Walk 10525 6500 6500 Theresa Hu es Foundation 35000 35000 35000 Geist Foundation 34671 45000 45000 Donations 8127 5000 5000 Fundraisin net 21306 34500 35000 Admin fees to administer CAC rant 1454 1500 1500 Cor orate rants 2000 4000 6000 Other Foundation rants 1000 4400 13700 One-time S ecial rants Count 6030 Interest income 1328 820 400 Total 149691 169720 181100 *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, striving to increase donations for our Phantom non-event fundraiser, and expanding participation in our golf tounament fundraiser. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 - Agency Name - 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 ayear-end report to the Legislative auditor within 60 davs 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 Boar ~ resident/Chair ~~~ Signature of ~1~~101 Date ~ ~ i~~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 26 Friends of the Children's Justice Center of West Hawaii Enhancement and Basic Needs Program FRIENDS of the CJC-WH- A ency Name Enhancement and Basic Needs Program- Program Name Agency Director: Alice Daniel Phone No.: 331-2425 Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Alice Daniel 77-6403 Nalani Street Kailua-Kona, HI 96740 77-6403 Nalani Street Kailua-Kona, HI 96740 327-4988 fcjcwh@hawaii. rr. com Phone No.: 331-2425 Name of Accountant/CPA (include name of firm if applicable): Denise Hill, Vice Pres. of Finance-Hualalai Resort Phone No.: 325-8413 Mailing Address: 73-4697 Kahualani Rd., Kailua-Kona, HI 96740 Amount of Request for County Funds: $15,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $12,000. $15,000 $15,000 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 2009-10 Page 1 FRIENDS of the CJC-WH -Agency Name Enhancement and Basic Needs 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 in 2001. The program for which we seek funds from the County of Hawaii is our "enchancement 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 range from $5.00 food coupons used when children are transported to court by social workers, to tuition for teens to attend Winners' Camp on Oahu, a 7-day residential, accelerated-learning program. 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 governmental 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 a clothing and school supplies. Typical requests received are for participation in athletic, music, dance, karate, sewing lessons, or attending summer programs or the Winners' Camp program on Oahu. The only exception to the statements above is that we do organize "reunion" activities for the teens who return from Winners' Camp to reinforce the positive lessons and skills they have learned at camp. For the past four years the FCJC-WH has sponsored athree-day reunion at Kalopa State Park over the Martin Luther King weekend. Eighteen teens participated this year. Approximately 30% of these teens were victims of sexual abuse. All are, or have been, in foster homes and are in need of on-going support. The FCJC-WH also assists the Children's Justice Center-WH 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-WH and participates in child abuse prevention activities in West Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Total Budget and Position Count Total Pro ram Bud et 116,150. Total Pro ram Position Count 1/2 Total A enc Bud et 140,463.50 Total A enc Position Count 1/2 Program Objectives: 1) Assist 20 or more teens to attend Winners' Camp by June 30, 2010; 2) Give holiday gift bags to 80 teenage youth by the end of December 2009; 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 2010; 4) Assist in planning and facilitating 6 reunion activities for Winners' Camp graduates by June 30, 2010; 5) Assess 600 enhancement or basic needs requests helping 375 individual children by June 30, 2010; 6) Support one or more training projects in West Hawaii, incollaboration 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 2010; 7) Participate in building community awareness of child abuse and prevention through activities in April, attening 10 Hui Laulima meetings and present 3 or more talks to community groups by June 30, 2010. Program Highlights: 1) 33 trips to Winners' Camp on Oahu were sponsored during the County's FY July 2007 -June 2008. Five our teen graduates served as junior staff for Winners' Camp. 2) 120 holiday gift bags were distributed to teens in December 2007. 3) 46 FRIEND Boxes were distributed to children during the County's FY 2007-2008. 4) 7 reunion activities were held for teens who were graduates of Winners' Camp during the County FY 2007-2008. 5) 3 training projects in West Hawaii were particially supported by the FCJC- WH during the County FY 2007-2008. 6) 777 enhancement and basic needs requests were accepted and processed during the 2008 calendar year serving 370 individual children. 7) The FCJC-WH participated in the April Family Fun Day, Hui Laulima meetings were attended regularly and several talks given to community groups. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 FRIENDS of-the CHC-WH -Agency Name Enhancement and Basic Needs -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Children benefitting from CJC-WH interviews 170 200 170 Needs Re nests 777 750 750 Holida Gift Bas 120 120 80 FRIEND Boxes 46 25 25 Winners' Cam attendees 33 25 30 Winners' Cam reunion activities 7 6 6 Individual Children Served 370 375 370 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 0.00 0.00 0.00 Professional Fees 14286.73 15,000.00 15,000.00 O erations 0.00 0.00 0.00 E ui ment 0.00 0.00 0.00 Other" 79,360.22 116000.00 101.150.00 Total 93,646.95 121,000.00 116,150.00 - it appucaoie # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 FRIENDS of the Children's Justice Center of West Hawaii ITEM 2007-2008 CY 2008 2007 Budget 2008 Budget 2009 Budget actual actual Athletic $ 3,907.72 $ 3,214.91 $ 5,000.00 $ 5,500.00 $ 5,000.00 Center Support $ 8,714.91 $ 9,080.23 $ 18,723.52 $ 16,400.00 $ 14,450.00 Child Care $ 260.00 $ 624.00 $ - $ - $ 500.00 Christmas Bags, Teens $ 3,331.45 $ 2,031.62 $ 3,000.00 $ 3,000.00 $ 3,000.00 Christmas, Other $ 1,200.00 $ - $ - $ 750.00 Clothing $ 3,850.00 $ 4,050.00 $ 4,000.00 $ 4,000.00 $ 4,000.00 Dental $ 101.33 $ 1,000.00 $ 5,000.00 $ 2,500.00 $ 1,200.00 Education $ 6,484.58 $ 5,440.61 $ 3,500.00 $ 3,500.00 $ 5,000.00 Enhancement, Basic Needs $ 2,805.00 $ 2,612.11 $ 2,000.00 $ 3,000.00 $ 3,000.00 Enhancement, Miscellaneous $ 3,970.63 $ 3,027.14 $ 4,000.00 $ 4,000.00 $ 4,000.00 Food Coupons $ 440.00 $ 754.81 $ 1,000.00 $ 1,000.00 $ 1,000.00 FRIEND Boxes $ 867.85 $ 1,076.80 $ 1,000.00 $ 1,000.00 $ 1,100.00 Furniture $ 973.23 $ 235.42 $ 1,000.00 $ 1,000.00 $ 500.00 Gas Coupons $ - $ - $ 100.00 $ 100.00 $ 100.00 Graduation $ 500.89 $ 4.27 $ 1,000.00 $ 1,000.00 $ 1,000.00 Medical ~ $ 2,253.45 $ 2,483.70 $ 1,000.00 $ 2,500.00 $ 2,500.00 Music Lessons $ 955.00 $ 376.07 $ 500.00 $ 1,000.00 $ 500.00 Performing Arts $ 1,719.42 $ 45.00 $ 2,000.00 $ 2,000.00 $ 1,500.00 Prevention/Awareness $ - $ - $ 500.00 $ 500.00 $ 500.00 Professional Fee-FCJC $ 9,557.72 $ 9,557.72 $ 9,000.00 $ 10,000.00 $ 10,000.00 School Break Programs $ 5,505.00 $ 4,295.00 $ 5,000.00 $ 10,000.00 $ 5,000.00 School Pictures/Yearbook $ (92.75) $ - $ 500.00 $ 500.00 $ 300.00 School Supplies/fees $ 756.90 $ 654.00 $ 1,000.00 $ 1,000.00 $ 1,000.00 Summer Camp/Fun $ 7,377.50 $ 8,002.50 $ 2,500.00 $ 2,500.00 $ 7,000.00 Summer School $ 933.00 $ 933.00 $ 1,750.00 $ 1,000.00 $ 1,000.00 Therapy $ 149.57 $ 260.00- $ - $ 250.00 Training & Education $ 809.20 $ - $ 4,000.00 $ 4,000.00 $ 2,000.00 Travel $ 4,207.16 $ 4,133.68 $ 10,000.00 $ 5,000.00 $ 5,000.00 Winners' Camp $ 19,784.74 $ 32,806.92 $ 30,000.00 $ 30,000.00 $ 30,000.00 Winners' Cam reunions $ 3,523.45 $ 3,517.97 $ 6,000.00 $ 5,000.00 $ 5,000.00 TOTALS: $ 93,646.95 $101,417.48 $123,073.52 $ 121,000.00 $116,150.00 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 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Coun of Hawaii 15,000.00 13,500.00 15,000.00 Private Foundations 62,375.00 58,250.00 60,250.00 Donations 16,271.95 49,250.00 40,900.00 Total 93,646.95 121,100.00 116,150.00 *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 selfsustaining? The FRIENDS of the Children's Justice Center of West Hawai'i'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 services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 FRIENDS of the CHC-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, Hawaii County Code, relating to Appropriation of Funds to Nonprofd 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 o oard President/Chair ~~~~. ~~~.~~~2 Signature of Executive Director ~C~'/l,l~u~ ~6, ~(aO~ ate ~~~.~.~~- ab~ ~DO~ mate UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 27 Goodwill Industries of Hawaii, Inc. Job Connections Goodwill Industries of Hawaii, Inc -Agency Name Job Connections -Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Laura Robertson Phone No.: 808-836-0313 Bettye Williams Phone No.: 808-961-0307 500 Kalanianaole Ave, Hilo, HI 96720 200 Kanoelehua Ave, Suite 102, Hilo, HI 96720 808-969-3861 bwilliams @ higoodwill.org Name of Accountant/CPA (include name of firm if applicable): Catha Combs, Wikoff Combs and Co., LLC Phone No.: 808-791-1420 Mailing Address: 1001 Bishop Street, Suite 2760, Honolulu, HI 96813 Amount of Request for County Funds: $30,000 *Note: This is one of three separate grant proposals submitted by Goodwill Industries of Hawaii. We have assigned the highest priority to the proposal from the Work Experience Program. We do not want to jeopardize the Work Experience Program as the County grant serves as funding of the last resort for our trainees who are people with disabilities, who have no other options. Prior Year(s) Funding: N/A 06-07 07-08 08-09 $0 $0 $14,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 1 Goodwill Industries of Hawaii, Inc - A ency Name Job Connections -Program Name 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. Goodwill Industries of Hawaii (Goodwill) 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/UFUE and Food Stamp recipients. • Ex-offenders transitioning from incarceration into the community With 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. The Hawaii County Branch opened in 1998 and has been serving our community since then. 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 2007 to June 2008, Goodwill successfully served 9,417 individuals and placed 1,863 people into gainful employment throughout the state. The Hawaii County Branch of Goodwill provided services to 1,918 individuals and placed 468 people into employment last year. Over the past six years, Goodwill has successfully provided training and employment services to 45,412 people with barriers to employment, and placed 8,432 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. Goodwill is a significant contributor to the local economy. As people become self-sufficient, the community is impacted economically. In the recent economic climate, the Job Connections employment and training services are being utilized NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 2 Goodwill Industries of Hawaii, Inc -Agency Name Job Connections -Program Name in record numbers. We've seen a 41 % increase in enrollment from July through December 2008 compared to the same period in the previous year. People are seeking ways to be competitive in today's employment market. Through training and support, our participants are finding employment despite the recent high unemployment rates. In previous years, Goodwill 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 are also provided follow-up support after placement into employment. Examples of agencies and partners with whom we coordinate services include the Hawaii Community Correctional Center, Hawaii Paroling Authority, Adult Probation Office, Hawaii Intake Service Center, Kulani Correctional Center, Workforce Development Division, Department of Human Services, Division of Vocational Rehabilitation, Department of Health, Turning Point for Families, Office for Social Ministry, C.A.R.E. Hawaii, Big Island Substance Abuse Council, Lokahi Treatment Center, Alu Like, Chamber of Commerce, Goodwill Industries International, employers in identified industries with job opportunities corresponding to participants' career goals, and others. In addition to partnerships with other agencies, the Job Connections program has played a major role in the development of the Mayor's Task Force on Employment Solutions, "Going Home" Reintegration Initiative to support inmates and ex-offenders transitioning from incarceration into our community. The Going Home Reintegration Initiative consists of more than 70 government agencies, private agencies and concerned citizens working together to support ex- offenders re-integrating back into the community in an effort to make our community safe, reunify families, and reduce recidivism by providing services that otherwise did not exist. Employment plays a major part of successful reintegration thereby reducing recidivism. A new Goodwill service that is housed within the Job Connections program is the Home Ownership Assistance Program (HOAP). The HOAP program assists Hawaiian Homeland beneficiaries to become employed leading to financial stability. As a result, participants are able to qualify for mortgages to build homes, as well as, avoid foreclosures. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 3 Goodwill Industries of Hawaii, Inc -Agency Name Job Connections -Program Name Program Description: Funding is requested to provide support services to low-income individuals (at or below 150% of the Federal Poverty Guidelines), and particularly to those recently unemployed due to lay=off, Hawaiian Homeland beneficiaries, and those who have been incarcerated. The funding requested will provide support services to address the need of the recent economic crisis as well as to target local ex- offenders for the purpose of creating a safer community and reunifying families by reducing recidivism. The funding requested will provide services for 18 individuals that include the following three components: 1) Intake and Assessment including Individual Program Plan Development 2) Job Readiness Training 3) Job Development and Job Placement Assistance Upon placement into employment, the Job Connections program will continue to provide case management and support until the individual achieves employment for one year. Job Connections also provides job development and support services to employers in the community. The Job Connections program has become a leader in providing motivational and inspirational training by using ahands-on approach. First, in the process of assessment, participants learn about themselves by identifying skills acquired, both inside and outside of correctional institutions. As part of assessment, participants are given skills, interests and personality assessments and corresponding choice of careers. The assessments help give participants language to describe themselves and their skills on a resume and talk about themselves to potential employers. The assessments also assist in career exploration and identifying personal career goals. Participants create their Individual Program Plan that serves as a guide to achieve their desired goals and outcomes. Second, in a 20 hour Job Readiness Training course is scheduled within one week to educate and support participants in becoming job ready. In the hands- on class, participants learn how to correctly fill out applications, write their resumes, create cover letters, learn interviewing skills, and learn innovative ways to job search. Graduation is a culmination of all the skills they have learned. They are expected to present themselves properly in appearance, body language, written material, and verbally in mock interviews. Other Goodwill Employment Counselors that participants are not familiar with conduct the mock interviews to simulate elements of a real interview. Third, the participant is assigned an Employment Counselor who helps the participant identify barriers to employment and solutions for removal of the barriers. The participant sets goals for him/herself and the Employment NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 4 Goodwill Industries of Hawaii, Inc -Agency Name Job Connections -Program Name Counselor supports them in their achievement. Job Development is an important part of the process of job placement. Counselors contact employers, post job openings on a daily basis, and uncover hidden job markets. Participants are invited to use the Job Connections office for their job search after graduation. They have access to: computers, Internet for job searches, researching companies, and filling out applications, daily newspaper, telephone and telephone books, fax machine, and their Employment Counselor's guidance. The result is job placement, self-sufficiency and a stronger local economy. In FY 2007-2008 the demographics of all participants in the program were: • 49% identified themselves as Hawaiian or part Hawaiian • 76% identified themselves as having a criminal background • 20% identified themselves as having less than a high school education Total Budget and Position Count Total Pro ram Bud et $30,000 Total Pro ram Position Count 2 Total A enc Bud et* $2,850,000 Total A enc Position Count 83 i * Totat Agency Budget denotes Hawaii County Branch only Program Objectives: 1) Enroll 18 participants in the Job Connections program. 2) Conduct Intake and Assessment including assessment of skills, personality, career goals, work history and barriers to employment. 3) Develop an Individual Program Plan with each participant that includes creating their goals and the steps needed to achieve them. 4) Conduct Job Readiness Training consisting of 20 hours of hands on classroom training. This may also incorporate topics related to Hawaiian Culture and Values as well as Post Incarceration Syndrome as applicable. 5) Place participants into employment. 6) Conduct job developing activities with employers including outreach, pre- screening, job placement and follow up to ensure a smooth transition into employment. The Job Connections program will continue to support the participants and employers for one year from date of placement with a focus on successful job retention and advancement. Program Highlights: 1) In FY 2007-08, the Job Connections program provided job placement and retention services to 155 participants identified as low income. All 78 participants who were seeking new employment completed assessments NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 5 Goodwill Industries of Hawaii, Inc -Agency Name Job Connections -Program Name and graduated from Job Readiness Training, and 72 were placed into employment. 2) Below are some recent success stories that illustrate the work being done: One participant had spent years away from his family working as a chef on a cruise ship. When he returned, his family life was in shambles. He became homeless, jobless, and had no transportation. To make things even more difficult, English was his second language. He walked everywhere; to Job Readiness Training, to pick up job applications and to apply for various positions which included IHOP in Hilo. His Employment Counselor coached him in using correct English repetitively to prep him. He decided to go to Oahu and look for a job when IHOP did not call him within a week. He was hired as a chef in a resort; still homeless, he slept on the beach. He saved up his money and bought a car to use for both transportation and housing. He received a call from the Hilo IHOP offering him a position as a cook, which he accepted. He is now reunited with his family, employed, approved for Section 8 housing, and has even started a small business cooking and selling his specialties with his daughter. An HCCC work furlough referral came into Job Connections after having been incarcerated for a second time. This participant is illiterate. His Employment Counselor had to spell every letter for every word on his job applications. He obtained employment at Five Star Maintenance as a result of our training and assistance in filling out the application. He now has a reading tutor, has retained his job, and was able to buy his own land and building kit for a studio cabin. This participant has made great progress and achieved success after his reincarceration. 3) Through participation in the Job Connections program ex-offenders experience a positive transition into the community. For Hawaii Community Correctional Center work furlough inmates, the Job Connections staff are the first people the inmates come into contact with when released to attend Job Readiness Training classes. Participants progress from fear of failure to becoming confident men and women in one week's time. The Hawaii Paroling Authority refers parolees who have been unsuccessful in obtaining employment. Our Employment Counselors work closely with parole officers to assist parolees in barrier removal and job placement. As a result, participants gain: • Empowerment • Initiative • Communication skills NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 6 Goodwill Industries of Hawaii, Inc - A ency Name Job Connections -Program Name • Recognizing triggers for re-offending • Work Ethics • Honesty Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Job Connections Pro ram $14,000 $30,000 Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete afollow-up survey used to evaluate the satisfaction and effectiveness of services. Upon program exit, each participant, employer and referring agency 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 2007-08, 97% of the participants were satisfied with their experience in the Job Connections Program. Participant comments included: • "I liked the small classroom training. Loved the psych test, it was me to a T...I recommend this training to people who may need this." • "I like the staff -they're awesome. Very sincere and helpful. Appreciative of the resources available, and knowing that I'm always welcome to utilize them." • "(Staff) took care of me and supported and helped me during a hard time. I don't know what would of happened to me." Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es $14,000 $30,000 Professional Fees O erations E ui ment Other (Payroll Processin Char es " NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 7 Goodwill Industries of Hawaii, Inc -Agency Name Job Connections -Program Name FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Total $14,000 $30,000 If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Coun of Hawaii Non-Profit Grant $14,000 $ 30,000 State of Hawaii $113,585 $138,100 $138,100 Total $113,585 $152,100 $168,100 *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? The funds requested in this application are for a component of an existing performance based program funded by the State of Hawaii. The money provided by the County allows us to conduct intake and assessment, conduct Job Readiness Training and place participants into employment. The remaining State of Hawaii funding will cover the case management and job retention support for the participant and employer until employment for one year is achieved. We will continue to support participants to reach job retention goals of 90 days, 180 days and 360 days on the job. We are working with our funder as well as the Going Home Reintegration Initiative to seek opportunities to apply for additional funding. As mentioned earlier, this is the third of three separate applications Goodwill submitted this year. Our top priority is the Work Experience Program. Funding for Job Connections should only be considered if the Work Experience Program is accepted by the County. We do not want to jeopardize the Work Experience Program as the County grant serves as funding of last resort for our trainees who are people with disabilities, who have no other options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page S Goodwill Industries of Hawaii, Inc -Agency Name Jvb Connections -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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 Hawaf'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, an of Board President/Chair ~ o~ Signature of Executive Director D e 1ZgSo D to UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATIt7N F'ISC:1L YEAR 2009-10 Page 28 Goodwill Industries of Hawaii, Inc. Kona Retail Store Startup Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Name of Accountant/CPA (include name of firm if applicable): Catha Combs, Wikoff Combs and Co., LLC Phone No.: 808-791-1420 Mailing Address: 1001 Bishop Street, Suite 2760, Honolulu, HI 96813 Amount of Request for County Funds: $40,000* *Note: This is one of three separate grant proposals submitted by Goodwill Industries of Hawaii. We have assigned the highest priority to the proposal from the Work Experience Program. We do not want to jeopardize the Work Experience Program as the County grant serves as funding of the last resort for our trainees who are people with disabilities, who have no other options. Laura Robertson Phone No.: 808-836-0313 Bettye Williams Phone No.: 808-961-0307 500 Kalanianaole Ave, Hilo, HI 96720 500 Kalanianaole Ave, Hilo, HI 96720 808-969-3861 BW illiams C~3 higoodwill.org Prior Year(s) Funding: N/A 06-07 $0 07-08 $0 08-09 $0 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 1 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name 1. Agency Mission Statement: Goodwill Industries of Hawaii, Inc. helps people with employment barriers to reach their full potential and become self-sufficient. 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/UFUE and Food Stamp recipients. • Ex-offenders transitioning from incarceration into the community With 50 years of experience operating vocational training programs as well as teaching life skills, Goodwill Industries of Hawaii has developed an expertise in bringing about success for the people we serve. We are affiliated with Goodwill Industries International (GII), an organization that includes 173 community- based, autonomous member organizations that serve people with workplace disadvantages and disabilities in the United States, Canada, and 22 other countries. The Hawaii County Branch opened in 1998 and has been serving our community since then. Last year, Goodwill Industries of Hawaii served over 9,400 individuals in its employment and training programs and placed over 1,800 into employment. During the same period, the Hawaii County Branch provided services to 1,918 individuals and placed 468 people into employment. Over the past six years, Goodwill has successfully provided training and employment services to 45,412 people with barriers to employment, and placed 8,432 people into employment. These numbers reflect that Goodwill has the necessary skills and experience to meet its mission. Goodwill is a significant contributor to the local economy. As people become self-sufficient, the community is impacted economically. Goodwill provides for its own financial needs to make programs a reality primarily through the operation of its retail stores and business operations. In our retail stores, donations are collected from the community and are prepared for sale to the public. The revenues generated from business operations account for 90% of the revenues needed to run Goodwill's training and employment programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 2 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name Goodwill Industries of Hawaii is fully accredited by CARF...The Rehabilitation Accreditation Commission, which sets national standards for programs serving people with employment needs. 2. Program Description: Funding is requested to subsidize startup costs for opening and equipping a "sustainable business model" retail store in the Kona area of West Hawaii. In 2008, the Hawaii County Branch of Goodwill Industries of Hawaii celebrated its ten year anniversary. The Branch has grown from offering a single program on the east side in Hilo, to a broad array of programs -First to Work TAONF, First to Work Vocational Rehabilitation, First to Work UFUE, Job Connections and Personal Assistance & Habilitation Services. The Ola I Ka Hana youth program and the Supporting Employment Empowerment (SEE) program also operate in West Hawaii. The Hawaii County Branch has enormous potential for expanded and new services, especially in West Hawaii. As previously mentioned, one of the methods that Goodwill uses to fund its operations is its retail stores. By asking the public for gently used donations of clothing and household goods, Goodwill is able to transform these donations into revenues to support its programs. Retail operations currently include eight retail stores in the State, with seven on Oahu and one in Hilo. The proposal to open a retail store in Kona is important to the residents of the area and to future support of Goodwill programs and fulfillment of our mission. In addition to donations from the public, Goodwill Industries International has a vendor program with Target to purchase returned, damaged or salvaged (unsold) merchandise by local Goodwills. These items are considered new goods merchandise by Goodwill. Many Goodwills across the United States have found the Target Resource Recovery Program very beneficial to increasing their net profits as well as providing quality merchandise for their stores. With Target opening three stores (Kapolei, Salt Lake and Kona) in Hawaii in 2009, Goodwill Industries of Hawaii will have an opporutnity to be part of this Target Vendor Program. In it's agreements with local Goodwills, Target requires that a local Goodwill partner accept merchanidse from all Target stores within it's territory. For Goodwill Industries of Hawaii, that means that in order to accept merchandise on Oahu, we also must be able to accept merchandise from Target's new Kona Store adding to the list of reasons to open a store in the Kona area. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 3 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name These retail operations function as a training center in support of the agency mission of serving people with disabilities, while providing our communities a viable recycle and reuse alternative to mainstream retail. The impact of these Store operations provide a base of employment opportunities in creating meaningful entry level jobs that form the foundation of potential movement to greater employment in the community. In the process, these store operations help to divert a substantial amount of materials that would have otherwise been destined for placement in the landfills. Current operations annually divert over 5.8 million pounds of material with over 565,000 shoppers each year that support our mission of providing a viable training center for people with disabilities. In year two of the Kona startup, we plan to be certified to operate a H15 redemption center in Kona. Recycling efforts through our H15 Certified Redemption Centers provide yet one additional source of income. Currently we operate six State HI5 Certified Redemption Centers, five on Oahu and one in Hilo. These centers allow the public to bring in their certified beverage containers (plastic, aluminum and glass) and obtain their 5 cent per container redemptive value. Goodwill earns .01-.015 cents per container redeemed, which is used to support programs. These comprehensive business operation services provide aone-stop convenient location to the public for all of their recycling and reuse needs. This creates a "sustainable business model", which is allows us to expand our operations, and thus expand our mission based services to other locations within the State of Hawaii, and at present to the Kona side of Hawaii County. 3. Total Budget and Position Count Total Program Budget $358,231 Total Program Position Count Total Agency Budget• $2,850,000 Total Agency Position Count * Total Agency Budget denotes Hawaii County Branch only 3.5 83 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 4 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name 4. Program Objectives: Three Year Operational Plan Year 1 Activities: Year 2 Activities: Year 3 Activities: 1. Negotiate Lease, Build 1. Build on Retail Sales, 1. Maximize retails sales out and open retail store expect to break-even by and market share potential. using decentralized end of Year 2. rocessin model. 2. Establish 2 support 2. Discuss HI5 Beverage 2. Begin to integrate Attended Donation Centers Container Redemption additional mission service to provide goods for sale. opportunities with local programs into the branch. Work closely with Hawaii government officials and County on partnering on the integrate into site for a Recycle /Reuse efforts in secondary revenue source. establishing diversion of reusable products in support of increased donation levels. Develop "interim" alternative donation supply plan in support of store operational needs as donation market is bein develo ed. 3. Integrate the Target 3. Begin to maximize 3. Marketing program Resource Recovery salvage recovery revenue refocused on mission Program into store sales. through as-is sales and or service aspects of branch auctions. Incorporate operations, with continued secondary recovery of campaign for retail textile salvage through sales/donations. shipment to off-shore salva a dealers. 4. Implement aggressive 4. Continue marketing marketing program using program using print/radio print/radio media to inform media to inform public and public and gain gain shopper/donors. sho er/donors. 5. Program Highlights: Since the proposed Kona Retail Store is a new operation, additional information on how Goodwill Industries of Hawaii stores operate is highlighted below: A key concept of our store operation will include following our Kaizen processing model to keep our operational procedures highly efficient. The term Kaizen is derived from a Japanese word defining a process of "continuous improvement" that has been applied to Goodwill's internal store operating processes by NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 5 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name designing equipment, procedures and processes to create physical efficiencies in movement /handling of products. This process is a key focal point in development of our processing of donations, layout of work stations, and tracking of production of merchandise from donations as a system of defining productivity of our operations. The process not only applies to establishing physical layouts, and procedures, but also applies to other operational functions including transportation services. Example of kaizening a transportation route for truck pick /drop off schedule would evaluate the entire route and maximize time and mileage based on the most efficient route of travel in completing a task at hand. Kaizen as a system's philosophy, when applied and embraced by a team, produces a high level of productivity and accountability within the total operation. Our donated goods program is based on an everyday pricing system as determined by a Good, Better, Best pricing format. Our production teams are trained and management personnel monitor pricing of donated goods to provide a compelling "value" to our shoppers while assuring the most efficient sell- through of products produced. The pricing system is further enhanced for maximizing sell-through as a means of increasing revenues by the use of a "progressive mark down" program based on inventory rotation. All products produced are color coded such that inventory can be identified for aging purpose and upon final rotation out of the system with a 50% off prior to being pulled from the sales floor. This system has proven to be very effective in maximizing sell- through of product and to help reduce volume of product requiring secondary material recovery. The retail store operations have made major progress in customer base and achieve brand recognition. Store operations are focused on providing a clean, organized shopping experience with a posture towards providing a "value" to our shoppers. This model has been timely in light of current economic times and we have experienced additional customer followings. Our store standards are targeted toward enhancing the shopping experience with staff that is trained on customer service and focused on a pleasant shopping experience. Part of this tracking of customer service and enhancement of the shopping experience is monitored with a "secret shopper" program designed to survey and evaluate our customer service levels. Reports resulting from planned shops are evaluated and reviewed with store managers for compliance with standards and remediation training to effect the desired outcomes. Our retail stores are technologically up to date with a state of the art touch screen computerized "point of sales" register system. The system is highly capable of providing historical data for evaluating merchandising decisions as well as providing security in reviewing financial integrity of the point of sales cash control system. Audit trails have been instrumental in recreating information needed to secure issues of fraud, internal theft, and outright stealing and misappropriation of company assets. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 6 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name Another factor for efficient service will be to brand each attended donation center will help to create a consistent look and feel for customers. This familiar feeling will reassure the customer that they understand how a center operates no matter which Goodwill center they are at. This concept is used in most retail store layouts. When you enter a chain grocery store whether it is in Hilo or Waimea or Kona -you have a sense of the layout of that store and where you would find certain items. Goodwill uses this same concept in terms of layout and signage. Visible and easy to read signs with clearly understood language and pictures to illustrate concepts will help customers to learn how to prepare their recyclables to easily speed through the redemption process. 6. Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Kona Retail Store Startup $358,231 Goodwill Industries of Hawaii has assessed quantifiable indicators of public and client benefits from opening a store in the Kona area. 1. Revenue from Store sales benefit human service programs operated by Goodwill. The stores become "sustainable business models" and help fund programs and decrease the impact of cutbacks in government and other funding sources. 2. Goodwill's stores function as a training center in support of the agency mission of serving people with disabilities. Store operations create meaningful entry level jobs that form the foundation of potential movement to greater employment in the community. 3 Our community has a viable recycle and reuse alternative to mainstream retail which will benefit residents and visitors alike. 4. Store operations divert a substantial amount of materials that would have otherwise been destined for placement in the landfills. These reuse/recycle efforts would be a major support to the County of Hawaii's Zero Waste Initiatives. Opening a retail operation in Kona will provide residents with a convenient place to donate unwanted goods. Space on an island is very limited; rather than filling landfills full of unwanted materials, Goodwill provides a convenient solution for Hawaii's residents. The Big Island has been working diligently to educate the public about the limited resources and environmental impact of discarded materials. The County is further supporting these efforts through recent public policy decisions. The new store in Kona will provide a solid, viable outlet for NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 7 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name donations. Donating spare goods is convenient, eco-friendly and "green", and the Store provides other community members with necessities at an affordable price and supports Goodwill's mission of getting Hawaii back to work. Current plans for the Kona operation in the first year are focus on establishing a reliable source of donations to drive the retail sales efforts by opening a minimum of 2 ADC (attended donation centers) in support of the store location which also will serve as a donation center location. Our plans are to work closely with Hawaii County in a partnering effort on establishing these ADC locations. Hawaii County's aggressive plans fora "zero waste to landfills" program by 2010 will assist Goodwill in our efforts to partner. We plan to work closely with the County on making every effort to secure these ADC locations which would be synergistic for both of our organization's operational goals. A contingency plan to assure the necessary donation levels are available will be developed in support of operations until the ADC systems are operational to assure adequate donations for the sales program. Donation effectiveness is another measure of a store's performance. Currently, Goodwill collects over 7.5 million pounds of donations from the public each year. This represents over one-half million customers that we serve on an annual basis. Our success is largely from being customer-service oriented. Through an annual omnibus marketing study that is conducted of Goodwill's customers each year, customers report that the single most important factor when making their decision about where to go to drop off a donation is customer convenience and friendly service. Our customer service agents receive high marks on their ability to assist donation customers, and in fact, each customer service representative undergoes a customer service-training program titled "CARE: Customers Are Really Everything. 7. Program Expenditures As part of our analysis of business potential of the Kona market, we utilized a Goodwill Industries International Site Selection Model. We have completed a site analysis of the Kona market to determine the viability of proposed locations for store operations. Analysis is driven by a review of potential revenues based on analysis of potential customer counts derived from demographic analysis of market income, population density, and potential foot traffic as correlated to convenience of travel time to proposed store locations. With this analysis, proposed store locations can be evaluated on feasibility based on a more quantitative analysis for potential of success. We have deployed this base store selection model to assist with selection of site locations. A recent review of potential operating proforma and minimum operating requirements indicate that an ideal store size for the Kona market will range from NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 8 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name 5,000 - 6,000 square feet. The store will be open 7 days a week, Monday through Saturday hours of gam - 6pm and Sunday hours of 10am - 5pm. The first year, FY 2009-10 estimated startup budget for the Kona Retail Store is below: Personnel (3.5 FTE) Staffing 84,240 Payroll Taxes 15,163 Medical Ins. 12,960 Occupancy 112,363 Electric $ 32,000 Rent 90,000 CAM 21,000 GET 4,624 $147,624 Other Operating Exp. GET on Sales 15,000 Advertising 3,750 Startup Costs (1/10) 27,700* Other Operating 51,794 98.244 TOTAL BUDGET $358,231 *Reflects one-tenth of leasehold build out and equipment startup costs of $277,000 amortized over 10 years. 8. Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-OS Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Coun of Hawaii Non-Profit Grant $ 40,000 Goodwill Industries of Hawaii $318,231 Total $358,231 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? Given, the current economic uncertainty, it is anticipated that the Kona Retail Store will achieve self-sufficiency by the third year of operation. This follows a NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 9 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -Program Name similar startup pattern of the other eight retail stores operated by Goodwill in the State of Hawaii. 9. Future Program Support As indicated above, our "sustainable business model" for store operations, will provide sufficient funding for store operations and over time, financial support for Goodwill's human service programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 10 Goodwill Industries of Hawaii, Inc -Agency Name Kona Retail Store Startup -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, l (we) understand and will comply with the requirement to submit ayear-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. am PresidenUChair (,iCLt-uQ- ~v . aJ0~1~-. Signature of Executive Director ~ _ Da e Da UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFTT GRANT APPLICATION FISCAL YEAR 2009-10 Page 29 Goodwill Industries of Hawaii, Inc. Work Experience Program Goodwill Industries Of Hawaii, Inc.- Agency Name Work Experience Program- Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Laura Robertson Phone No.: 808-836-0313 Phone No.: 808-961-0307 500 Kalanianaole Ave, Hilo, HI 96720 500 Kalanianaole Ave, Hilo, HI 96720 808-969-3861 Name of Accountant/CPA (include name of firm if applicable): Catha Combs, Wikoff Combs and Co., LLC Phone No.: 808-791-1420 Mailing Address: 1001 Bishop Street, Suite 2760, Honolulu, Hi 96813 Amount of Request for County Funds: $45,000 Prior Year(s) Funding: 06-07 07-08 08-09 $20,000 $28,500 $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 2009-2010 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 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, Hawaii Island Branch 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 2007 to June 2008, GIH successfully provided services to 9,417 people statewide, and placed 1,863 people into gainful employment. The Hawaii Island Branch of Goodwill Industries provided services to 1,918 individuals and placed 468 people into employment in 2007-2008. Over the past five years, Goodwill has provided training and employment services to almost 45,412 people with barriers to employment, and placed 8,432 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 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 2 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program- Program Name literacy, GED, ESL, and Earned Income Tax Credit filing. Participants also receive follow-up supports and transitional services once they are employed. 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: • a standard be set for each work station community wage survey be conducted annually, and each participant'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 positions(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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 3 Goodwill Industries Of Hawaii, Inc. - A ency Name Work Experience Program- Program Name In 2007-2008, the Work Experience Program served 20 participants that were enrolled in a Goodwill training program. The format allowed work-training 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 expand pre-employment and computer based training for persons with more severe physical limitations. The additional funding will be used for purchases to include 4 dedicated computers, assistive technology devices such as ergonomic and large sight keyboards and mice, joy sticks, touch windows, voice recognition systems, larger monitors, assistive communication software as well as job readiness and job retention training software. Assistive technology will particularly assist our participants with sight and hearing impairments, Cerebral Palsy and other physical disabilities which limit their use of standard equipment. Additionally, it will enhance our successful Work Experience Program and give all participants additional tools for independence and self-sufficiency in an increasingly competitive job market. Total Budget and Position Count Total Pro ram Bud et $45,000 Total Pro ram Position Count 2 Total A enc Bud et $2,850,000 Total A enc Position Count 83 *Total Agency Budget denotes Hawaii Island Branch only 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 4 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program- Program Name 9) Conduct time study for each participant every six months. 10) Update wages according to productivity level. 11) Instruct computer skills utilizing assistive technology for persons with physical disabilities (hearing loss, sight impairment, cerebral palsy, etc.) 12) Instruct on computer based programs which focus on creating resumes, completing applications and learning the fundamentals of the job search and job retention. 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 20 participants in the Work Experience Program in 2007/2008. 2) In a random audit of program participants we found an average 20% 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. 7) Instructed and reinforced correct work procedures with each participant. 8) Tracked work hours, daily or as scheduled to work. 9) Paid participants on asemi-monthly basis, according to hours worked. 10) Conducted time study of each participant every six months. 11) Updated wages according to productivity level. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 5 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program- Program Name 12) Purchased adaptive equipment for textile processing to accommodate each participant. 13) Placed three individual in competitive employment. 14) Assisted one individual to reach her goal of self-employment. 15) Placed two individuals in volunteer positions Through participation in the work experience program, six participants have gained valuable job skills and have transitioned to competitive, self or volunteer employment. Seven additional participants volunteer serving food to the homeless one day per week during Adult Day Health Program hours. The Goodwill Aina Keepers, a rotating team of ten participants, paints over graffiti in the community. In the work experience program, participants 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 worked in the Goodwill store and two times per week volunteered at Hilo Medical Center in the Extended Care program. Another trainee started her own business, designing, sewing and selling Hawaiian crafts. Her creations are showcased on a website of products and services provided by persons with disabilities on the Big Island. This trainee developed a business plan, did a market analysis and started selling her products. 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: • Confidence • Initiative • Willingness to learn • Desire to work • Cooperation • Attendance • Communication skills • Team play • Flexibility • Honesty • Respect for coworkers, workplace, and equipment NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 6 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program- Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Work Ex erience Pro ram $28,500 $20,000 $45,000 Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete afollow-up survey used to evaluate the satisfaction and effectiveness of services. Upon 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 2007-08, the Work Experience Program participants that were also enrolled in the Home & Community Based Services Program indicated a participant and advocate satisfaction rate of 99% in the categories of "Very Good" to "Excellent". Participant's comments included: The building is a workable place. The workers are friendly and easy to talk to. • It gives my son choices of activities to participate in with great support. Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es $24,340 $19,000 $28,000 Professional Fees O erations E ui ment $15,000 Other (Payroll Processin Char es " $4,160 $1,000 $2,000 Total $28,500 $20,000 $45,000 * If applicable ~ Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 7 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2008-09 Estimate Coun of Hawaii Non-Profit Grant $ 28,500 $20,000 $45,000 GoodwilllndustriesofHawaii $1,000 $1,000 $1,000 State of Hawaii $270,000 $279,000 $285,000 Total $299,500 $300,000 $331,000 *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 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 afull-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. The County grant serves as funding of last resort for our trainees, who have no other options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 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; grans 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 afl 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of alf 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, am Signature iif~oard PresidenUChair Signature of Executive Director Dat za og Da UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 30 Grassroots Community Development Group KupukupuRfter-School & Summer Program Grassroots Community Development Group- Agency Name Kupukupu After-School ~ Summer Program- Program Name Agency Director: Trina Nahm-Mijo Phone No.: 640- 5109 Contact Person: Same Phone No.: 640-5109 Mailing Address: P.O. Box 1772, Kea'au, HI 96749 Facility/Site Address: 15-0565 Kea'au-Pahao Highway, Bdng. G Fax No.: 974-7757 Email Address: nahmmijo@hawaii.edu Name of Accountant/CPA (include name of firm if applicable): Joel Peralto/Peralto and Co. CPA Inc. Phone No.: 961-3462 MailingAddreSS: 180 Kinoole St., Ste. 302, Hilo, HI 96720 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 06-07 07-08 08-09 $42,5000 $50,000 $45,000 Agency Mission Statement: NONPROFIT GRANT' APPLICATION FISCAL YEAR 2009-]0 Pagc l 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 F[SCAL YEAR 2009-10 Page 2 Grassroots Community Development Group -Agency Name Kupukupu After-School & 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 6th, 7th, and 8th 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, asix-week, all day program was successfully continued. Total Budget and Position Count Total Program Budget 80, 000 Total Program Position Count 5 Total Agency Budget 185, 000 Total A ency Position Count 10 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) The summer program emphasized special skill building workshops in cooking, digital arts, and geocaching. These activities were seen as an enhancement for their academic growth. Canoe culture classes also enhanced physical conditioning as well as knowledge of ocean culture and Hawaiian cultural values. 2) The repeat collaboration with UH-Manoa's Quentin-Burdick Interdisciplinary Program brought 4 more interns to the program. They presented workshops on health, sex education, nutrition, and peer relationships which augmented the drug prevention curriculum. N~DNPROFTT GRANT APPLICATION FISCAL, YEAR 2009-] 0 Page 3 3) GCDG also continued its participation as a Compassion Capital Fellowship grantee which enabled the continuation of Board and staff training, strategic planning, and the institution of an in-house payroll system. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-i0 Page 4 Grassroots Community Development Group -Agency Name Kupukupu After-School & Summer Program -Program Name Performance Measures: FY 2007-08 Actual' FY 2008-09 Budget' FY 2009-10 Estimate Youth achieve pro-social and communication skills competency 65% 68% 70% Youth report being drug-free 100% 100% 100% Youth participate in communiy activities which teach active citizenry 40% 50% 60% Families of youth participate in family strengthening events 25% 30% 35% `If applicable Program Expenditures FY 2007-08 Actual ~ FY 2008-09 Budget" FY 2009-10 Estimate Salaries and Wages 45,000 45,000 95, 000 Professional Fees 10,000 10,000 10, 000 Operations 10,000 15,000 15, 000 Equipment 20,000 15,000 15, 000 Other" Total 85,000 85,000 85, 000 ' If applicable # Please explain in detail on separate sheet NONPT2OFIT GRANT APPLICATION FISCAL YEAR 2009-IO Page i Grassroots Community Development Group -Agency Name Kupukupu After-School & Summer Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual ° FY 2008-09 Budget' FY 2009-10 Estimate HI Island Meth Initiative Grant 17,720 Kuki'o Grant 5000 5,000 County of Hawaii 50,000 45,000 50,000 Prosecutors Office 12,000 Research & Dev. 1,200 CCF 12, 349 Donations 5,000 5,000 7000 Program Service Fees 1050 1000 1000 Tobacco Trust Fund 15000 15000 Other Grants 7000 Total ~ 92 314 78 000 85 000 `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) Fundraising events. The goal is to be self-sustaining in four years. NONPROFIT GRAM" APPLICATION t'fSCAL YEAR 2009-10 Page fi Grassroots Community Development Group -Agency Name Kupukupu After-School & Summer 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, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs 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 vear-end report will impact the evaluation of vour program's or agency's future funding requests. Signature ~ -~ f1 D to (. ~~-~ ~~ ~ ~ l j~~h ~U~ Signature of Exe ttV~ Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 31 Grassroots Community Development Group Ohia Lehua Entrepreneurial After-School Program Grassroots Community Development Group- Agency Name Ohia Lehua Entrepreneurial After-School Program- Program Name Agency Director: 5109 Contact Person: Trina Nahm-Mijo Phone No.: 640- Mailing Address Facility/Site Address Same Phone No.: 640-5109 P.O Box 1772, Kea'au HI 96749 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): Joel Peralto/Peralto and Co. CPA Inc. Phone No.: 961-3962 Mailing Address: 180 Kinoole St., Ste. 302, Hilo, HI 96720 Amount of Request for County Funds: $55,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $ 0 $ $95,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YPAR 2009-10 Page ] To strengthen our communities through the cooperative development of programs and services for all of Puna. To provide a quality Afer-School Program for area youth, family strengthening, health and wellness, cultural diversity and economic development activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Grassroots Community Development Group -Agency Name Ohia Lehua Entrepreneurial After-School Program- Program Name Program Description: This free or low-cost after-school program was first started through a HUD Alaskan Native/Native Hawaiian Institutions Assisting communities grant in 2007 in response to the ice epidemic and the low social-ecomomic standing of the Puna community. The target population is youth, 14-24 years old, predominantly from the Puna area. The program is being held at the Kea'au Youth Business Center located in the Kea'au Town Center which has astate-of-the-art multimedia computer lab; the largest fully equipped sound recording studio in East Hawaii; and a certified mobile kitchen on wheels. The After-School program held M-F, from 2-5 p.m., will offer skill building in digital media arts, graphic and publishing arts, music and sound recording, and culinary arts. Besides the skill building training, participants will learn business, teaming and entrepreneurial skills which will give them tools to survive and thirive in a 215` century global economy and to add to the social and ecomomic capital of their communities. Total Budget and Position Count Total Program Budget 105,000 Total Program Position Count 5 PT Total Agency Budget 190,000 Total Agency Position Count 10 PT Program Objectives: 1) Prevent drug use and other anti-social behaviors in Puna area youth; 2) Provide skill development in digital media arts, music and sound recording, and culinary arts; 3) Cultivate the talents and economic viability of area youth; 4) Provide Youth Leadership opportunities through community engagement, entrepreneurial training, and product and talent development. Program Highlights: 1) 2008 was the first year of full operation of the Ohia Lehua Entrepreneurial Program at Kea'au Youth Business Center (KYBC). In collaboration with NONPROFIT GRANT APPLICATION ['ISCAL YEAR 2009-10 Page 3 Middle College, the day program at KYBC with its entrepreneurial goals, the program was recognized with three awards. 2) Middle College graduate and culinary arts mentor, Lance Garner, won the state and then the national "Spirit of Youth" Award for an adjudicated youth who is giving back to his community. He was appointed to the Governor's Advisory Committee on Youth. 3) The Middle College Program at KYBC was awarded the UHCC's system- wide award for "community development" in April 2008. 4) The video team won the "Pono Award" for high school category sponsored by the HI Civil Rights Commission and PBS. 5) Also, the Ohia Lehua Video participants wrote, filmed and edited afull- length film, directed by 16 year old Jesse Tunison called RX with a launch date slated for May 2009. 6) The Sound Recording Ohia Lehua participants created, performed and recorded a CD called "Na Ano (Native Seeds) to be launched on Feb. 14, 2009 at a community event to be held at Ola~a Community Center. 7) KYBC hosted a Digital Media Arts exhibit at Wailoa Art Center for the month of January which included work from 5 high schools--including Hilo, Waiakea, Kea'au, Kamehameha, Kau, and Konawaena. 8) The Culinary Arts Program continued to participate in at least 2 catering events per month including the Taste of Hilo IX; three "Key Ingredients" events in conjunction with the exhibit at the Lyman Museum; Health Fairs in conjunction with Bay Clinic, Inc. and Pacific Culture Wellness Festival; Ka'Umeke Public Charter School events; NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Pagc 4 .Grassroots Community Development Group -Agency Name Ohia Lehua Entrepreneurial After-School Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate 50 Youth develop video/graphic arts skills 70% 80% 90% 50 Youth develop music/sound recording engineering skills 70% 80% 90% 50 Youth develop culinary arts skills 70% 80% 90% 50 Youth develop entrepreneurial trainin 70% 80% 90% *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wages $31,000 $40,000 $40, 000 Professional Fees $17,000 $20,000 520, 000 Operations $11,000 $25,000 530, 000 Equipment $6,000 $20,000 520, 000 Other" Total $65,000 $105,000 5110, 000 If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-]0 Page ~ Grassroots Community Development Group -Agency Name Ohia Lehua Entrepreneurial After-School Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate HI Tobacco Prevention and Cessation Trust Fund $75,000 $75,000 575, 000 County of Hawaii $45,000 550, 000 Fundraising 57, 000 Other grants Total $75,000 $112,000 5113, 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 agencies 2) Fundraising events 3) Entrepreneurial projerts and products The goal is to be self-sustaining in five years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Grassroots Community Development Group -Agency Name Ohia Lehua Entrepreneurial 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, 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 ayear-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. ~~~L(,t Signature of Boa d Presi ent/Ch~ir ~. ;% t, ~'~ /' ~ ignature of Exec ~ Director I ; ~. D to !~'/7 U ~ U Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 32 Hale Kipa Hawaii Advocate Program -East Hawaii /, ""~ Hale Kipa _ A ency 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 622 Hinano Street 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: $80,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $50,000* $30,000** *FY 07-08 was an island wide grant **FY-08-09 was an East Hawaii only grant amount, Hale Kipa was also awarded the same amount for West Hawaii for a total of $60,000. Agency Mission Statement: 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 2009-2010 Page 1 ,R ,!'~ 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 Hawaii 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 2009-2010 Page 2 • /~ Hale Itipa _ 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 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 AccessibilitylCrisis/Emergency Interventions POPULATION 8 ADMISSION CRITERIA Youth ages 5-18 (or up to 20 if youth is on parole) who live in the East Hawaii area to include North and South Hilo and Puna. Families referred to Child Welfare Services (CWS) that have been assessed to NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 3 • /~ Hale Kipa _ Agency Name Hawaii Advocate Program -Program Name require supportive services, but not accepted for child protection services Families assessed and confirmed for child abuse or neglect by CWS that need 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 placement at the Hawaii Youth Correctional Facility (HYCF) on Oahu. 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 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 4 /,"'~ Ha1e Itipa _ Agency Name Hawaii Advocate Program -Program Name Total Budget and Position Count Total Pro ram Bud et $478,211 Total Pro ram Position Count 12 Total A enc Bud et $11,374,322 Total A enc Position Count 301 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) 80% 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, the Catalyst Group, conducted follow-up with all clients over the past three 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 2009-2010 Page 5 /"'+ Hale Itipa _ Agency Name Hawaii Advocate Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Number of at-risk outh served 54 62 60 Number of DHS referrals 48 50 45 Number of Famil Court referrals 56 60 60 Number of advocate hours 9128 9,975 9,500 Number of rou s held 60 70 65 Number of ouths transported 54 62 60 Numbers of total milea a 12,248 13,575 13,500 Numbers of families financially assisted 44 58 50 Number of referrals made for other services needed b families 106 120 120 n/a n/a n/a *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Salaries and Wa es 203,728 256,528 295,295 Professional Fees 42214. 52,431 23,255 O erations 85635 90,775 154,930 E ui ment 4455 5266 5,322 Other 0 0 0 Total 336,032 405,000 478,211 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 6 /'~ Hale xipa _ Agency Name Hawaii Advocate Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate State of Hawaii/DHS 311,032 325,000 388,211 Count of Hawaii 25,000* 30,000 80,000 Hawaii Island United Wa 5,000 10,000 Total 336,032 360,000 478,211 *If applicable *2007-08 County grant for $50,000 was for both East and West Hawaii. 50% of the grant was allocated to East Hawaii and 50% to West 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? 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 $17 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 2009-2010 Page 7 Haig lCi~a -Agency Name 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, I (we) understand and will comply with the requirement to submit ayear-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 `-~ ""7~' Signature o oard President/Chair Signature of Executive Director ~-Y7-~j Date l~ 27.Q~r Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 8 33 Hale Kipa Hawaii Advocate Program -West Hawaii ~~ a-„~~ ~ia1e Kipa _ A ency Name Hawaii Advocate Program- Program Name Agency Director: Punky Pletan-Cross Steven Pavao Phone No.: 589-1829 Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address: Phone No.: 969-1935 615 Pi'ikoi Street Suite 203 Honolulu, Hawaii 96814 74-381 Kealakehe Parkway #1 Kailua-Kona, Hawaii 96740 329-6395 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: $80,000 Prior Year(s) Funding: 08-07 07-08 08-09 $0 $50,000* $30,000"" `FY 07-08 was an island wide grant *FY-08-09 was a West Hawaii only grant amount, Hale Kipa was also awarded the same amount for East Hawaii for a total of $60,000. Agency Mission Statement: 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 2009-2010 Page 1 ~,; ='~~' ~~~~ ~~~~ -A ency 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 Hawaii 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 2009-2010 Page 2 •.: µ Hale Kipa _ A ency 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 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 8~ ADMISSION CRITERIA Youth ages 5-18 (or up to 20 if youth is on parole) who live in the West Hawaii area to include North and South Kona, North and South Kohala and Kau. Families referred to Child Welfare Services (CWS) that have been assessed to NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 3 r. ~~~~ Kipa -Agency Name Hawaii Advocate Program -Program Name require supportive services, but not accepted for child protection services Families assessed and confirmed for child abuse or neglect by CWS that need 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 placement at the Hawaii Youth Correctional Facility (HYCF) on Oahu. 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 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 4 :_ "~ FCale Kipa -Agency Name Hawaii Advocate Program -Program Name Total Budget and Position Count Total Program Budget $303,692 Total Pro ram Position Count 9 Total A enc Bud et $11,374,322 Total A enc Position Count 301 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) 80% 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, the Catalyst Group, conducted follow-up with all clients over the past three 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 2009-2010 Page 5 ~_ Hale C{ipa _ Agency Name Hawaii Advocate Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Number of at-risk outh served 54 62 60 Number of DHS referrals 48 50 45 Number of Famil Court referrals 56 60 60 Number of advocate hours 9128 9,975 9,500 Number of rou s held 60 70 65 Number of youths transported 54 62 60 Numbers of total miles a 12,248 13,575 13,500 Numbers of families financially assisted 44 58 50 Number of referrals made for other services needed by families 106 120 120 n/a n/a n/a *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Salaries and Wa es 163,728 196,528 188,537 Professional Fees 12,214. 12,431 11,315 Operations 85635 90,775 100,088 Equi ment 4455 5266 3,751 Other" 0 0 0 Total 266,032 345,000 303,692 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 6 ~~e` Hale ~°~'~ -Agency Name Hawaii Advocate Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate State of Hawaii/DHS 231,032 310,000 213,000 Count of Hawaii 25,000* 30,000 80,000 Hawaii Island United Wa 5,000 10,000 Total 266,032 345,000 303,692 *If applicable *2007-08 County grant for $50,000 was for both East and West Hawaii. 50% of the grant was allocated to East Hawaii and 50% to West 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? 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 $17 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 2009-2010 Page 7 1/ ' ~ai~ hi~7a - Aaencv Name 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, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 o oard President/Chair ~~ a.. ~. Signature of Executive Director Q-Y7-~-i Date !~ 27.Q~r Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 8 34 Hawaii Centers for Independent Living Independent Living Services Hawaii Centers for Independent Living- Agency Name Independent Living Services- Program Name Agency Director: 808-522-5400 Contact Person: 770-5914 Mailing Address: Facility/Site Address Fax No.: Email Address: Philip Ana (Temporary) Nathan Holmes 414 Kuwili Street, Suite 102 Honolulu, HI 96817 400 Hualani Street, Suite 16D Hilo, HI 96720 808-522-5427 Phone No.: Phone No.: 866- nathanh@pacificil.org and/or Philipa@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: 1481 S. King Street, Suite 232, Honolulu, HI 96814 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 08-07 07-08 08-09 $15,000 $15,000 $15,000 Agency Mission Statement: Hawaii Centers for Independent Living, people with. disabilities, building access, independence, and choice. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page I NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Hawaii Centers for Independent Living -Agency Name Independent Living Serivices- Program Name Program Description: The Hawaii Centers for Independent Living (HCIL) is anon-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 insititutional care settings. As anon-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 opportunties, and choices in life, no matter how severe their disability. To accomplish this, HCIL actively seeks aystems change and promotes self- advocacy. The Philosophy that guides HCIL is Three-fold: 1. HCIL's objectives is to present information on a wide array of options, from full independence to other forms of community-base 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 distinguished HCIL and its services. Total Budget and Position Count Total Pro ram Bud et 327,797 Total Pro ram Position Count 6 Total A enc Bud et 1,539,483 Total A enc Position Count 33 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: 7/01/09 - 6/30/10 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 2) Provide Consumers with personal care attenandant and referrals'who 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 attendant. This prevents institutionalization and dependenance on family, friends, and neighbors. this service will be provided to 60-70 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: 7/1/09 - 6/30/10 3) Provide one--on-one independent living skills to assist consumers in carving out their everyday living activities such as housekeeping, shopping, laundry, cooking, etc. This will reduce dependence on others. This service wll be provided to 15-20 individuals. Timeline 7/1/09- 6/30/10 4) Provide consumer with information on their legal rights, how to access consumers to empower self-advocacy. This service will be provided to 50 individuals. Timeline 7/1/09 - 6/30/10 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: 7/1/09- 6/30/10 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 70 consumers. Timeline: 7/1/09 - 6/30/10 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. 30 people with locate and move into housing. Timeline 7/1/09 - 6/30/10 8) Provide consumers with information and referral services to increase their options of various resources in the community. This will increase their independence. Timeline 7/1/09 - 6/30/10 Program Highlights: 1) During the past year HCIL- Hawaii provided services to 260 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 170 person in the county and helped people get into housing in 2008. 4) HCIL -Hawaii helped 93 individuals get personal assistants in 2008. 5) HCIL-Hawaii taught 24 individuals independent livings skills in 2008. (Please note this is an unduplicated count of persons not the number of classes provided) 6) HCIL -Hawaii provided classes and technical assistance to 2 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 7) 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. 8) 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. 9) 85 of our customer, who received services were over age 60. 10) 167 of our customer, who received services were between age 20-59 11) 8 were below age 20. 12) 4 had cognitive disabilities 13) 24 had mental emotional disabilities 14) 40 had physical disabilities 15) 32 had a hearing disability 16) 4 were blind or had low vision 17) 156 had more than one disability. 18) 160 had other kinds of disabilities such as cancer, heart problems, etc. (includes the number that are listed in #9-11) NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Hawaii Centers for Independent Living -Agency Name Independent Living Services -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate 11 Pieces of ada tive a ui ment 201.71 201.74 201.74 161 Housin and Shelter Services 2,952.74 2,952.74 2,952.74 151 Inde endent Livin Skills Srvcs 2,769.34 2,769.34 2,769.34 227 Self-care Services 4,163.18 4,163.18 4163.18 36 Recreational Services 660.24 660.24 660.24 11 Vocational Services 201.74 201.74 201.74 21 Trans ortation Services 385.14 385.14 385.14 11 Communication Services 201.74 201.74 201.74 50 Personal Resource Mana ement 917.00 917.00 917.00 43 Self-Avocac Services 788.62 788.62 788.62 21 Advocac Services 385.14 385.14 385.14 75 Access the Community/Social anticipation 1,375.50 1,375.50 1,375.50 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 9,794.43 9,500 9,500 Professional Fees 1,058.13 1,000 1,000 O erations 4,437.97 2,750 2,750 E ui ment 127.47 500 500 Other 337.81 1,250 1,250 Total 15,755.81 15,000 15,000 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 2007-08 Actual " FY 2008-09 Bud et * FY 2009-10 Estimate State of Hawaii 103,726 117,726 117,726 Federal Funds 176,836 175,071 175,071 Hawaii Count 15,000 15,000 15,000 Hawaii United Wa 20,000 20,000 20,000 Total 315,622 327,797 327,797 *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 have increased services statewide using funds that are specified for each island. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Hawaii Centers for Independent Living -Agency Name Independnet 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, 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 ayear-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 aaency's future funding requests. C1v~o.,..E,.~ ~~N. I d.zn~vw.e,vn ~ Signature of Board President/ hair 11~:.~ ~~ Signature of Executive Director ~_~~_pry Date 1-30-09 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 35 Hawaii Island Adult Care, Inc. Hilo Adult Day Center Hawaii island Aduli Care, Inc. - l~gency Name Hilo Rdult Day Center -Program Name Agency Director: Paula Uusitalo Phone No.: 961-3747 Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address Paula Uusitalo 34 Rainbow Drive Hilo, Hawaii 96720 Same as above 961-3740 Phone No.: 961-3747 PuusitaloQ hawaiiislandcare.org Name of Accountant/CPA (include name of firm if applicable): Jennifer L. Gossert, CPA Phone No.: 969-3115 Mailing Address: 688 Kinoole St., Hilo, HI 96720 Amount of Request for County Funds: $25,000 Prior Year(s) Funding: 06-07 07-08 08-09 $16,000 $18,000 $20,000 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 2009-10 Page 1 hawaii Island Adult Care, inc. -Agency Dame Hilo Adult Day Center -Program Name Program Description: Hilo Adult Day Center provides a safe, socially active, quality adult daytime program for frail elders and mentally/physically challenged adults who need supervised care. The center is open from Monday to Friday, from 7:00 AM to 5:00 PM, and Saturdays from 8:00 AM to 4:00 PM. Total Budget and Position Count Total Program Budget 1,015,848.00 Total Program Position Count 23 Total Agenc Budget 1,305,968.00 Total Agency Position Count 47 Program Objectives: 1) Provide a safe, caring, socially active, healthy daytime environment for frail elders and mentally/physically challenged adults including those with Alzheimer's disease; all of whom need assistance with some of their active daily living skills, many are under doctor's orders for supervised care. 2) Provide interaction/socialization with others, hands-on games and 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, and dignity at this difficult time in their lives. 3) Provide the opportunity for elders to continue living in their own homes, to be with family and to be a part of the community for the rest of their days if possible. 4) Deter pre-mature institionalization into long term care facilities, allow our elders to live at home in dignity, and also assist with taxpayer savings which would be paying for the long term care institutionalization. Ninety percent of the patients in long term care facilities in Hawaii State are paid for by Medicaid funds. 5) Provide respite for caregivers and deter "caregiver burnout", and for caregivers, who work, provide the opportunity for continuing their employment while attending to their frail loved ones in the evenings and weekends. NONPROi'IT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 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 for poverty level and low income individuals. Program Highlights: 1) Hawaii Island Adult Care provided day care services to 141 individuals having varied physical and/or mental challenges in FY 2007-2008. 2) For the fiscal year ending June 30, 2008, new participants enrolled: 83; discharged, 44, attending the full year, 54. Three 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). Of the 141 participants, 69% were over eighty years old. 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, Services for Seniors and the Hawaii County Office of Aging. 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. After February 1, 2009, with the privatization of Medicaid Waiver individuals, this figure will change. Have been working with DHS, Ohana Health and Evercare Health plans to proceed with privatization as of February 1. 4) Continued working with numerous agencies including the Interdisciplinary team(IDT) organized by the state Department of Health to provide elder client specific case management, other agencies included are DHS Nursing Home without Walls, 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, no-one was limited in the days they needed to attend. 6) Continued the Caregiver support group, and received a HMSA Foundation grant to provide caregiver training classes and hands on caregiver care sessions for the community at large, at least two classes per month including Saturdays. 7) Hilo Adult Day Center has been relicensed by Dept. of Human Services for two more years to January 2010. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Hawaii Island Adult Care, Inc. -Agency Name Hilo Adult Day Center -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget * Estimate Average monthly attendance 82 89 91 Total number of individuals 141 147 154 Participant continue to live in their 115 120 125 own home Families/Caregivers able to 59 61 65 continue employment Families/Caregivers receiving 101 105 110 respite Participant continue after 6 month 103 106 112 Participant continue after 1 year 85 88 91 Participant continue after 2 ears 36 37 39 Partici ant continue after 5 ears 16 16 17 Average cost of care in a long term $108,000.00 $108,000.00 $111,240.00 facilit for 1 ear (1 Person) Average cost of care at Hilo Adult -16,500.00 -16,500.00 -16,995.00 Da Center for 1 ear (1 Person Annual Medical monies saved on 1 $91,500.00 $91,500.00 $94,245.00 participants attending day care versus those living in long term care institutions Savings based on discharged into $915,000.00 $915,000.00 $942,450.00 long term care during a one year period. (based on 10 clients dischar a in FY 2007 - 2008) `Ii applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 575,421.00 620,596.00 630,000.00 Professional Fees 16,597.00 12,500.00 12,500.00 O erations 192,030.00 200,452.00 205,000.00 Equi ment 2,015.00 2,300.00 2,000.00 Other" 167,273.00 180,000.00 180,000.00 Total 953,336.00 1,015,848.00 1,029,500.00 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Tuition/Fees 515,530.00 534,000.00 547,000.00 State - DHS and Nursing Home without Walls 112,547.00 162,148.00 160,000.00 Federal -Nursing Home without Walls and Kupuna Care 41,426.00 42,000.00 40,000.00 County of Hawaii 18,000.00 20,000.00 25,000.00 Hawaii Island United Wa 25,000.00 25,000.00 25,000.00 Ma Templeton Hopper Fund 50,493.00 75,000.00 75,000.00 Mclnerny / Gwenfread-Allen / HHA-Charity Walk /Friends of Hawaii Charities /Other Grants 81,292.00 66,000.00 65,000.00 Donations 8,066.00 12,750.00 11,000.00 USDA Lunch reimbursement 32,081.00 35,000.00 39,500.00 PIN rant mana ement 5,000.00 6,000.00 6,000.00 Fundraising/interest/vending machine/misc. sales 26,593.00 27,950.00 28,000.00 See Program 37,758.00 10,000.00 8,000.00 Total 953,786.00 1,015,848.00 1,029,500.00 it appucanie 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 Hilo Adult Day Center receives more than 50% of its revenue from the tuition and fees, as of Fiscal Year 2007-2008, the fee rates are now adjusted annually to sustain the program. The Board of Directors held a third annual golf tournament in July, 2008, which was very successful, netting $22,000 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 YI/AR 2009-10 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, 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 ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. 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 Signatu of oard PresidenUChair ignature of Executive Director r~~ lD9 Date i~~/v9 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Hawaii Island Adult Care, Inc. County of Hawaii Nonprofit Grant Application 2009-10 Attachment Explanation Page 4: Program Expenditures Other: This is Direct Client Assistance, it is the tuition assistance to help cover tuition costs for participants can not afford full costs. 36 Hawaii Island HIV/AIDS Foundation Multi-Disciplinary HIV Case Management, Hilo HA'll''~All ISLAND HIV/AIDi~> FOUNDATION- Agency Name MUL TI-DISCIPLINARY HI'+,/ CASE MANAGEMENT, HILO- Progr'am Name Agenc~~y~ Director: 8177 Contara:~t Person: 8177 Mailirna;p Address: Facilii~h!ipdSite Address: Fax hlr.r.: Email ~~~ddress: Georgie I-Cennedy Georgie G';ennedy 75-240 ~la~ni Kailua Drive, Suite 5, Kailua Kona, HI 96740 16-204 Nl;lekahiwa Place #1 Kea'au, I-fl 96749 331-076;1: or 982-8802 georgie~i)Inihaf.org Phone No.: 331- Phone No.: 331- Nam~e~ of Accountant/CPA (includaa name of firm if applicable): James D. Jennings, CPS. Inc. Phonia^ No.: 808-942-8813 Mailimr~r,I Address: 1600 Kai;:riiolani Bivd., Suite 730, Honolulu, HI 96814 Amoo.rrrt of Request for County Funnds: $20,000.00 Prior ""f"ear(s) Funding: 06-0'~f 07-08 08-09 $10,!.100 $15,000 $15,000 NONPROFIT d~,RANT APPLICATION FISC~V,I. YEAR 2009-IO Page 1 Agency fiflission Statement: The Hawaii Island HIV/AIDS Foundation (here~iinafter HIHAF) is anon-profit organization dedicated to assisting those affecaed by HIV/AIDS to maximize i:heir quality of life, and to ending the spread of HIV. We also utilize the lessons learned in the HIV epidemic to care and advorarte for others in the fight agair~u;:a HIV and related diseases. Our vision is to buiUri a healthier, stronger, and rrw>re sustainable community that supports all its me~rnbers with a focus on HIV is'.>uies. HIHAF is an IRS-designated 501(c)(3) tax-exempt non-profit organization wkiich provides care and services for people living with HIV/AIDS (PLWHA), and vira;;~ provide HIV prevention and education to the n;:nsidents of Hawaii County. Because most of the clients served at the Keai a:ru office live in the Hilo area, ~nae refer to the Kea'au office as "HIV Foundation ~ I-lilo." Required checklist fonv is are attached at the end of this proposal. HIHAF has been providing services to people r:rt risk for, infected with, and affected by HIV/AIDS since 1986. Our Foundatliion has an efficient and effecrl:iwe system to provide a comprehensive continuum of prevention, care, and supp¢a~rt services with regard to HIV/AIDS for the entirer IBig Island. As treatment anti medical care for HPV-infected individuals continues to dwindle with the grealb~st loss of medical professionals on our island, HIIIFiAF's role in helping our clientc:~ manage HIV and AIDS becomes increasingly crucial. As reported by the Hawaii State Department cdf Health, Hawaii County has !I'l~ie highest number of AIDS cases outside of O'aknu at 13%. The number of pe~wpde living with HIV/AIDS continues to climb steadily with each passing year of th4; epidemic, and the modes of transmission arerhanging. HIV is no longer press,ent primarily in high risk populations. In fact, half r:rF the 65,000 new annual infections in the United States take place as a result of heterosexual transmission. Half of these new infections alsa:r occur among people aged 'I!I ~-23. This indicates to us that we will continue seeir•ul a rise in clients and their nEau:ads will change as the epidemic continues to shaper our client population. Presr:arul;ly, HIV Foundation -Hilo provides multi-disciplinauy team HIV case management, advocacy, information and referral, food pantr~r; client financial assistance, <aind other support services for more than 128 PLV~J'IiA and affected persons in E:a:r,>t Hawaii. Over the course of the year of Decerrober, 2007 through November„ 2008, a total of 172 clients have been oared frrr in Hilo. Gare team members support client independence and self-determination by providing a range of supportive services. The:,e include knowledge and assistance in accessing a variety of public and private benefit programs, mea ical 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 reteinion and active participation irs~ primary medical care. The services received k~~y each client are monitored regularly to determine the effectiveness of the ~~;ervice plan, identify emergirr9;;p needs, and measure the outcome(s) of serviaF~ delivery. N®NPROFIT GRANT AHnPLICATI(DN FISCAL Yk:AR 2iV09-10 Page 2 HIV Fcn.mdation -Hilo proposes to continue its provision of high quality multi- discipliu~ary team HIV case management and primary prevention services, incluclisul anonymous HIV-antibody trsting and counseling services, for at (east one hundred and ninety (190) peope: living with HIV/ AIDS during FY 2009-2010. As in lac:ast years, we continue to experience decreases in State of Hawaii Depariarnent of Health funding allocaa:ed 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 alway~:e, to provide the highest qualityr of services to all our clients, despite the decre;~ises in funding available to us. Perhaapa~:; the greatest challenge that case management has had to face in the last two yes;ars is the island-wide loss of I:airimary and HIV-treating physicians. Many doctor., providing treatment to HIV-positive individuals in East and West Hawaii have I~~ft private practice in the last .e: years. Thus we have had to cobble togetirr~;~~r treatment for people with HIII'~J. One solution we have brokered is having the pir~;~sicians from the AIDS Clinic:nl Trials, through John Burns Medical School, see p;airlients on a monthly basis in b~crth East and West Hawaii. This has brought high ciui ality treatment to many of our clients who are currently without a physici',3in. At the present time they s:u~e seeing over 70 HIV+ clients on the Big Island. Additicrrially, these clients need a priirnary care physician locally. With so few doctoirs available those remaining aria being overwhelmed by the influx of new patiei°rls. Finding a primary physici,eu~ who understands the complicated nature of clinically treating HIV, often along>ide other health issues, adds to the scope and cc,~nnplexities of HIHAF's care team work. Our c:a:une team not only educates doa::tors on resources for the treatment of HIV, they <:u;.i: as a liaison between clients and their health care providers. They are advocrl:es for comprehensive treatnrnent of the medical and psycho-social needs of our e:;lients in this rural underserveua area. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 HA'W'i~1'All ISLAND~HIV/AID~a~ FOUNDATION -Agency Name MUiI.._~TI-DISCIPLINARY HI's,+~ CASE MANAGEMENT, HILO- Proglram Name Progra~rn~ Description: HIV are+;:I AIDS still carry a debilitating stigma in our society. As a result, many of those ~ruho are infected with, affected) by, and at-risk for HIV hide their challenges concerr•iiing the disease and managirug it in their lives. HIHAF is one organization at whlr.:P+ HIV-positive individuals do not have to hide, where they are understood, and Nrllaere all their needs can at leas): be addressed, if not fully resolved. A multi~;aiisciplinary team composed caf two full-time (2.0 FTE) case managers,(a Treatnnr:,nt Advocate, RN; and a Benefits Specialist); one half-time (0.5 FTE) housirw;;l specialist and one half-time (0.5 FTE) client services facilitator provide the dirract care services for PLWHA residing in East Hawaii. (The housing speciaali:>t also serves clients on the unrest side of the island.) The nronnthly average active caseloa,:J for the East Side office of the Foundation this pr:r.:t year is one hundred and finrenty eight (128) clients. Twenty-eight percer3l (28%) of the HIV Foundation - Hilo's clients are homeless, multiply diagrncsed, drug misusers and/or mentally ill. Eighty-six percent (86%) fall into two oir more special population cate~aories as defined by the federal Ryan White CARE: ~^,ct Title II. Addressing clients' HIV and AIDS neu:~ds often begins and ends in completely different: arenas. HIHAF's care teann negotiates and juggles relationships with clients asrnd their families, social sen+ice agencies, and state and federal agencies and prcngrams. They reach across Hawaii and other states to build relationships with t:rukor AIDS service organizations to find medical and benefits records, and to establi=.>h client histories and needs. They are active in statewide and nationwide care c:x;~alitions to enable us to bring the latests and most up to date information and tr+: ~.rtment to our clients. A rec+a,rrt example deals with a newl!,~ diagnosed woman who was in an abusive relatic:rr+ship and also has a young ct•iild. In order for her to be safe and begin treatrruent it was necessary for her to leave her residence, which was owned by the abusive partner. She was extremely frightened, concerned that the abusive partrne:r would follow her and contin+.ae to hurt and threaten both her and her daughi:er. She was dependent upon this person for all her financial needs and didn9i 6,now how she would survive without him. We were able to arrange a safe exit frr,~rn the premises for both of them. During the next few months she and her daugiuter resided at the Women's Shelter and were protected from harm. The care tr>am mobilized, found benefits that she was able to qualify for, connected her witVr excellent health care, facilitated safe housing through our Federal NONPROFIT C~~RANT APPLICATION FISCAJL YEAR 2009-10 Page 4 housinga program. She began her tre.tment with an HIV specialist and during that prz:~~~:ess other health problems piresented. Additionally, she began treatment with a ii:~sychologist which helped her to deal with her present situation and review ~n~~hy and how she found herseaf in the abusive relationship. After 12 months> her health is stable, she is safe, has her own apartment, and her daugtrtr:;r is in school and doing well. Notwithstanding being diagnosed with a life threateining disease,she has control crf her life for the first time in many years. There ..are many challenges yet to be; faced by this individual, but with the help of this dyr;.~mic, caring team she can et;pect to live many years, raise her daughter and live,.: a full life. She is hopeful of rk:aurning to work and becoming, once again, a prodi.iictive member of our community. Due G:a I:he complex nature of treating HIV HIHAF advocates will continue to work tn~~ith this client's and all other dr.,~ctors and care providers in the area. Maint,auiriing strong relationships with professionals and agencies that serve a myriad) a:af social and other needs is only one small part of our advocates' jobs. Our c=ire teams' holistic care for and) dedication to working with all our clients need:, i:e; motivated by HIHAF's misai~an of serving people who are living with HIV to have: the fullest most complete life: (possible. For m<ainy people living with HIV, the: financial and logistic difficulties of managing their diisease are complicated by fear and stigma. Several of our older, female, Hawaiian clients feel that HIHAF is this only safe place for them to let down their barrier:,.„-speak of their fear for themselves and their families, and discuss how this do<:~r;:ase and their possible deaths will affect them. In the safety of our facility, they r.,~:3in show the depth of their feelings, they can find necessary, life-saving, and cliff,ease-monitoring clinical care .:and drugs. They also find a shoulder to lean on area resources for themselves anc9 their families. Over i:hie holidays our entire organization rallied to make sure that each and every client and family had the resorrces to have a wonderful meal for both Than)<.,_=giving and Christmas and th<:r1: each child had at least one gift for Christmas. Fund::: were raised by the board anti staff having garage sales, bake sales, etc. We ca ritacted as many resources as possible to ensure that each child had at least crrre gift and that that gift was rrreaningful to them. Some examples were: a bicyclf fora 6 year old, a new outfit )for a 12 year old girl, a skateboard fora pre- teen, F.=.ac. We were extremely fortunate and were able to truly share the intent of these holidays with our less fortunate clients. Holidays are sometimes very difficr.itil for those who are ill or isolatead from their community and family. Our Care tr;:;am members spent a substantial amount of time calling all clients to ensurer; they were doing well and del:ermining if there was anything further we could rlo to assist them. Indivic9ir.ialswffth mental health issues: are at a greater risk of acquiring HIV. Thus man, ~::~f our clients have mental he,~alth problems which complicates their ability to carp.: for themselves and take their medications properly. There are very few psycttr~lligists on the Big Island who have experience with people with HIV. We NONPROFIT GRANT APPLICATION FISCA;t. YEAR 2009-t0 Page 5 have irrikiated monthly visits by such ,:~ qualified individual to provide therapy to our mast affected clients. This psychologist practices and lives in Honolulu so it is necessary for him to come to the iE~~iig Island twice each month. The benefit is that oiiur most affected ini~ividuals ha~~ae adequate mental health care and the more _,ihable they become the less cfrance that they will pass on this disease to others.. We are very proud of this program and have seen the difference it has made in the lives of our clients with serious mental illness. Anoth~„ ~r substantial challenge for otar care team is to adapt to the new federal prescriiption drug plan legislation (Medicare D). This program while on the surfar.,i~ is designed to help those in irreed of medication help, it also greatly compli~rates accessing necessary medicines through multiple layers of complex eligibillilCy criteria, and constant chanclies to plan structures, As the r:umber of clients continues too grow, the burden on our care team to provide;, adequate care also grows. I~tlany of our clients face multiple health issues .and need medications to sup~aress HIV, need other drugs to address side effects .;if HIV drugs, need additional drugs to treat opportunistic infections relate:~; l l:o HIV. Most clients who are taking medications, take from 6 to 10 drugs daily.:':1ome of our clients take up to ?5 medications daily or multiple times during the d,ery. In orcPr::rr to enable clients to acquire their medications at the lowest possible cost througiF: this new plan, care team members must understand the client's current incorrra~ and drug coverage plan, knraw what drugs the client needs and which plans ~:rover it. They must have knoue:ledge of the client's other medical needs, understand which pharmacies will accept which drug coverage program, and have ,arr understanding of HIV and c:.tlher pharmaceuticals to compare pricing. HIHA.f 's; care team members are compassionate and talented. For them, treatirrfi,l someone's HIV encompasses the entire person -not just the disease. Our clients, many who live with fear ,:and stigma, who deal with other medical and social tissues, and face declining acrt;ess to medical services in Hawaii, HIHAF is the orrl}r place to.come for support. FiIHAF's care team members are often the only per.:ogle that HIV positive individuals on this island know and trust. They are sensitivv~e professionals who navigators the complications that HIV brings to the body a:+~nd soul. In orclrrsr to best serve the needs of Door clients, a written service plan is developed cooperatively by the client and the r.;are team annually. The service plan identifies client needs, defines the sl:~ecific goals and objectives that address identified needs, and lists the actions ::>teps required to accomplish the client's stateaa goals and objectives. The sass~vice plan is developed and implemented within i:~roo weeks following the intake, of a new client and then updated quarterly or me::rr-,: frequently, if necessary, unl:il the client is discharged. In addition to servic+= plan updates, clients are contracted at (east once a month to monitor their healtf~ :status and identify emerging needs. Acute clients in need of more freque: nt contact receive telephone a::alls and/ or office or home visits three to four times per week. A minimum of one hundred and fifty (160) service plans will be N®NPR®FIT iC;rRANT APPY,aCATtC9N FISCAJI_~ YEAR 200'J-YO Page G develolaed or revised during the upc+aming FY 2009-2010 ,grant period in the East Hawaii office. A similar amount will h~~e completed in the West Hawaii office. To en::u~ure appropriate access the Fcaandation's hours of operation are Monday throucliha Friday, 8:00 a.m. to 4:00 p.rp. Staff frequently visit clients in their homes, at the Ihiospital, during their monthly galnysician's visits and outside of both home and ofi'ire, if that is what is necessao ~d to help clients engage in their own care. The Cllic::nt Service Facilitator is respc:rnsible solely for the delivery of support servicss, including food bank, food deliveries, transportation, volunteers, and cleric~:3ii support. In 2009 the Found„dfion created a new position: Director of Progr~mrnming. This individual provide, program administrative oversight and progrs~irn supervision for care staff. She also produces quarterly reports for all fundeirr,•>, job counseling, staff training, and crisis intervention. This individual works directly with the care teams and is supervised by the Executive Director. Volund:+=:ers assist clients with online searches, distribution of food, clerical assisl~:!u~ice, and helping clients shop in the food pantry. HIHAJ=' provides invaluable support lia HIV-infected individuals to assist them in keepinc7 their loved ones free of HIV. Primary HIV prevention is based upon a cultursrlly appropriate harm reduction methodology. When a new client begins their reslationship with HIHAF, we tala:e care to assess their current relationships activities they may participate in tha9 imight put others at risk for HIV infection. Care 4~E::am members either provide such interventions themselves or make referrals to the HIV Foundation - Hilra"s prevention department. Care team memla~~:rs also offer anonymous HI~~'-antibody counseling and testing for family memh~+srs and significant others. QUAP+tTITATIVE EVALUATION: Quantil:ative evaluation measures fcrrmutti-disciplinary team case management servir.,r::,> include the collection, tabull~ation and entry of service data into a comps er tracking system provided k>y the State of Hawaii (The Reggie System). Data r~;a~utinely tracked include: nunul;~er of clients, types of service provided, and the nui~rnber of services provided by service category as well as the casts for these e>ervices. Planning estimations, for service delivery during the FY2009- 2010 currently project that a total of twenty-six (26) separate case management servic:r:~s will be individually provided 'For 160 to 190 clients living with HIV/AIDS. Service.=.s include, but are not limited I:o, intake, assessment; treatment advocacy, morts.ility and morbidity, benefits cor.enseling, volunteer referrals, hospital and home ~~eiisits, medical liaison, crisis intervention, emergency financial assistance, housiracy assistance, home care and i:ransportation. Data collection consists of counting the number of written service plans that are develol^~ed or revised each quarter. I:;omputer reports indicating number and kinds of services delivered by each csase manager are generated on a monthly basis. If projections are met or exceeded, service delivery is considered succeu,-;:aful. The service component: is also considered successful if ninety iVOP1PROFIT Q:~~~ItAN~' APPI,ICA'I'L®1m1 FISCA.]I:., YPActt 2009-10 Page 7 percerr9. (90%) of clients have a mecliir.;al care provider and adhere to their treatnrnFant routine. QUAI..n-fATIVE ANALYSIS: A clierrt satisfaction survey is mailed I:o all clients annually. Completed surveys are rc;taarned anonymously and talliert survey results are distributed to HIHAF' s Board of Directors, staff, clients and ;~aate and federal granting organizations. Exec,„ii:ive Director and/or board merrobers rnay, on an unannounced basis meet with clii~ernts to discuss their satisfactiion with services. The Foundation has three client mx:rpresentatives on the Board to bring forward issues specific to clients needs and desires. CHAP~fie,:::~ES FOR 2009 HIHA,I= initiatied a hiring and salary freeze and cost cutting activities during the past sii:u months in response to the dl,relining economy and in anticipation of fundinyl decreases. While each staff member has taken on more work without the arukucipation of additional financi,3dl reward, they have done so cheerfully and with a Ic:vel of commitment that is a::;tounding. We and our clients are fortunate to ha+,~t:: such a talented and committo:ad group of people who have put others above themselves. Our E3c:,ard of Directors has also marile an even greater commitment to this Found ation. They are giving more caf their time and talent to make sure that we weath~n-.r this difficult time and grow ;ers an organization at the same time. We have recently received a grant to do additional training with our Board to enhance their ,,;ruganizational and fundraising <7bilities as well as doing strategic planning for thee: next five years. Totall 1:3~udget and Position Count Totan_6'=~'rogram Budget 391,E~D8A(1 Total Program Position Count 3.5 Totall_ Aa~gencY Budget 1 358,17170.00 Total Agency Position Count 15 ~__ ~_ Progrraum Objectives: 1) objective One: By June 30, ~?010, 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 p:>ercent (90%) of all PLWHA +a~rhose access to high quality primary care, ancillary health care and specialty medical care would otherwise be in jeopardy. NONPRO&IT ~(:;I2ANT APPLICATION R1SCA; E~ YEAR 2009-10 Page fd 2) r:)bjectivza ~i`wo: L,y June 30, z?U10 anrf wwithin ~ivveni:y~-r'ive drays fc,llc~wilrata a ~eteTernlination of need, as i~t r1~ less tkran ninety percent (90%) of <all eligible !='LVV4-if~! wPja request r,:~r d~mi~r'~sfraie ~ nr~tvd foi° substance rinisuse {rE*atmeni:, menial health cor.u'7acling, Errrai h~<rlth care, HIV-related medication, ~i~ood andlor trans~,p~x~tation r:PSSisTance i:o obi,~in such go~::u:Ts ,arid services Through appropri~atc~ rcicrral ,and practicai support. 3) i)bjnctivc -'f"tPree: Fay June 3q, 2010 and within tvvcanty-five days follov~:~ing a deicrminati~n ~f need, iorest,:all homele>:>snr-.ss by providing tin:ancial ~~,uplloii and/car housing reloc~eation assis.tancc for no less'ihan ninety percE~nt (90%) rn° all eligibie P~IIm.Wk~tA rc~:auFSting or demon;,-tratiny ~~ n'~w~:vd tilt emery~ncy she>ITer, or eiia'ira'short-ix:~rm or long-ten-n shelter or 11na.1iny assisfanrc. ~4) l)bjecfivc~ 1=o1.rr: f3uriny The nr;;xt iwelv~::~ months otter >"tiV preventive r~dlu;ation andlor anonyrnol.r=; HIV-aniit~~ody ccrunseliny and Testing sc~rvic~-s tp a minimum of 25 ai risk inc!'ividuals Irr addition, ia1Pa I-91V F~rlundafii~~ri~n - I-1iIc1:=~,Giall provide the typE=s and ler~`~E:.~Is of b21;~C? nlanayC-~nl@r1t. I'elat(?d SU(JpOri:IVG! ;~bi?fVIGeS f01" li`9 COnSUl7lerS, tisti~:i1 I~t?IOW. '(-JnE`.fIQS t'iSSf-!~i;3rY16°nlf/C()Un<iC`tll'lg C`Ilf`nT Ti3rY111~/ COI.rnS!:?Iln(~ ~~~l'OC)CE:SSIVI: CASE' nOieS ~. rIS15 rntE?YV(?nt10n Health carC; a:~iSE?SSPYII:nt/COUIlIS('ling k-IGiCt /(31kIC(: VlsriS f~Jiedlcal trC'2~TiTlE.?911: rCi'C'17a15 i'iOmC~ VISI"LS I~~lOU51ng aSSeSSnlBniS lntak~/e'~S5E'SSm2nl5 t_eya~ dOCUtYrent aSSl5idnCE, ~ FlllanClal bet1P.,tlt:i 6'~r,rneral/eetate coordination Gcn~ric rlssistancc/rounselirrg kiousiny assistance HealTh care benefits Lcagal advocacy assistance Clie;rri: monitoring/assessmur'~11 P~lufiritional asc,<;ssmentlcP~un.~;~eiing I :isle assessmentlcounseling IUienfial hc:ali:h assessms~nf/counseling S<?rvice cc)ordinafior~i I'~erlial he~itti counseling rr~fE_~.rrals "iranspoii: activities :~;ubsT a1c€: abuse assesrnc:nf 3ubsiarlce ;al7r.r~rc; TrE;atr'n~r1r rraerr~ais (r~r> :availa k~le) "I'otai ru.u11k1t:~r ofi service cateElories: 26 Tin~~elir~e: Sr;rvice plans are rtevelopcta t2nttrin ivr~o weeks of the initirr~B intake session and revievvcd quaeterly. Service dc;livery will he on grainy draring f=Y 200!)-2010. The :>e~rvices lis~fwd <abovEa r~presc;nt basEalincr 7ervir.e projcctiorls_ d:,lieni cr~rltered Chitcorne(s): /~ rninlirroi+rn of c,ne hundred fifty (1G0) +::Uen~ts acrd their i~~rvrilies will acres-, c;riticral sc!ivicL s including medical, iinarl~;:Mal, social, care givr>rs, legal, nuts°itional, oti;, ~tYu'oregh the !-ITV FC.~undation - F-iilo's case rnranaNNgr-..rppr))r~~en}}~~fi and vc)luntc;er tc~~p~m(~/. ~f~ptplepa7pst ninety percer'it ~~4yi~llP9~QY11~~~~~3k0~1V~ f'~.11~~~111ll LL.lRitlll~tYlV V~If~rGls,IC.'irH~;laf~ r~164D°9-IIdD (f?~0%) of clients will secure a larimary care physician and remain in medical treatment. Progr,~una Highlights: 1) l o date during FY 2008-2009, medical case management services irucluded one hundred ninety eight (198) clients receiving medical ,.assessment, patient education, treatment advice, nutrition, medical liaison, c:lental liaison. 2) +~as of December 2008, all clients are receiving the highest quality primary irnedical care; however, 20% a:u•e receiving care through public health ~rllinics, which at times cannot meet all their needs. 3) "I"here are only 6 people on thr; waiting list for subsidized housing and we inave no homeless clients. 4) li~he number of hospital visits dluring this fiscal year increased slightly from Vaast year due to the death of A clients during this time. 5) ~c~.ddition of the Director of Programming has created a smooth, more seamless experience for all cllients. NONPROFIT iGRANT APPLICATION FISCAL L. YEAR 2009-10 Page 10 HA'~I'1/Ail ISLAND HIV/AID:: FOUNDATION -Agency Name MUIL..TI-DISCIPLINARY HI~~~` CASE MANAGEMENT, HILO - Program Name Perfonrr•I~ance Measures: _. FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Number and types of case manac~f_~ment services provided 26 26 26 Numb~,;r of clients receiving case mana~~i~ement services _ 150 _ 172 160-190 Risk F3r;;havior Assistment, Couns~„ling & Prevention Edu. _ 250 250 250 HIV C;rna.lnseling & Testing 25 25 25-50 `If api::olicable Proge•,am Expenditures - _ --- FY 200 i''-~08 ActuaV * FY 2008-09 Budc et * FY 2009-10 Estimate Salari+>s and Wages ___170,;!.!36.00 170,286.00 165,558.00 Profe~=sional Fees 2,Ad30.00 2,480.00 2,480.00 O era4:ions 229,!_:123.00 229,823.00 226,460.00 E ui~au~rent 0 0 0 Other" 0 0 0 Total 422,!:89.00 402,589.00 394,498.00 If appllicable # Please explain in detail on separate sheer' NONPROFIT rt :RANT APPLICATION FISCA.][, YEAR 2009-10 Page 11 HA~~~h/All ISLAND HIV/AIDrc~a~ FOUNDATION -Agency Name IViUI..:~fl-DISCIPLINARY HI~~J CASE MANAGEMENT, HILO - Progiram Name ProgrAuan Funding Sources: Identili~~~ alb funding sources (specific to this progr°a:annn only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate _ _ Coun4~~,,~ of Hawaii _ _ 15,000.00 __ 15,000.00 20,000.00 De t crt Health _ _ 192,808.00 192,808.00 192,808.00 AIDS f:;ommunity CARE Team _.._ 74,000.00 72,000.00 75,000.00 HIUW _ 10,000.00 15,000.00 15,000.00 _ Housin;i Special Proj. HUD _ 15,000.00 13,500.00 14,000.00 Privai;+::,: Foundations 30,000.00 28,900.00 30,000.00 _ Donatians/Fundraisi~_ 43,000.00 45,000.00 50,000.00 _._- --- Totai __ 379,808.00 382,308 396,808.00 *If apl:ullicable Expl~auin what plans, if any, your agiency and/or program has to increase reveru~+.ies to support this program, 1Rlhen do you anticipate your program to beas+ame self-sustaining? Unfori+.mately, the HIVlAIDS epiden•ric shows no sign of ending, and indeed contiru~es to grow. There is often a noisrepresentation of facts about the epideratic in the media, indicating a lessening of urgency in dealing with this epideniric. The fact is, there are still .:a minimum of 65,000 new cases in the US each ~~+ear, and half of these new ini(ections occur through heterosexual transrroission and in the age group olf 15-23 year-olds. Each newly infected individual presents with a myriad of challenges to be met and overcome. Becar.ase the epidemic continues to ~~Irow, we do not see a specific point at which our pru:~gram might become self-sustaining. We are, however, looking at develrspment of various income prorlucing businesses which could help to suppcairt the activities of our non-profit. We h,~rve received level or decreasing funding from our main revenue source, the State +::df Hawai'i Department of Heallih, for the last 16 years. During this time, the numi:rc.r of people we are caring for ~l~ias more than doubled, and may well double NONPR®FI'I' C:aRANT APYI.ICATIQ)N ;FISCAL IL, YEAR 2009-IO Page 12 again ewer the next 10 years. The co>ts for personnel, health insurance, rent, utilities; etc have risen dramatically a~rer the past few years and no funder seems to recccr;lnize the kind of stress this a~r:;ates for the non-profit sector. In addiPion, our clients live longer novv because of the availability of new drug treatmr:ucts. This is wonderful in that nl: allows those who are infected to continue as proal~i.ictive members of society. :isimultaneously, it also raises challenges for us as ,~i Foundation to continue to suf,~port their health so that they can be producal:ive. Few however are well enr.NUgh to work full time and thus their income level pi..its them into a position of continuing to need our services. We are:; 1:he only HIV/AIDS services organization in Hawaii County providing these ~,~ilal care and prevention servie::es. For now, we are very grateful that we have thus support from the County, and we want to thank you for this opportunity to applo/ to you for funding. NONPROFIT (::RANT APPLICATION FISCAIL YEAR 2009-10 Page 13 HAh~''~~,~All ISLAND HIV/AID::, FOUNDATION - Agent Name MUL..TI-DISCIPLINARY HI\,,~ CASE MANAGEMENT, HILO - Progiram Name I (we) tu,~:,ve read and understood all cif the eligibility requirements; grant conditih-,ins; award procedures; and r~arords, reporting and fiscal accountability requirE.=, rnents as mandated in Article :25, Sections 2-135 - 2-142.2, Hawaii Counii~~,+ Code, relating to Appropriation of Funds to Nonprofit Organizations. (we) hereby certify that information supplied herein including all supporting docurnf=nts is correct and that I (we) nave the authority and ability to fully admini~>I:er the program(s) pursuant tc;~ law. I (we) tmderstand that information suq:>plied herein shall be made public accorcliing to Chapter 92F, Hawaii F;evised Statutes. If awa~maied a grant from the Counl:~i~ of Mawai`i, I (we) understand and will compn~yr with the requirement to submit ayear-end report to the Legislative audit~~i~N• within 60 days after June ;~0 of the fiscal year. The report shall inclu,~l~~: an explanation of the public benefits derived from the awarding of the go•,~ant, a complete accounting ~r.,f all expenditures supported by County of Hav~a.ai`i grant funds, and a Iistirvtl of other funding sources and amounts obtainmed during the award period. ,Failure to submit a timely, complete, and accuis~~nil:e Year-end report will impart;t the evaluation of your program's or auen~G;;+~Ps future funding requests,, Signato.nre of Board PresidenUChair _ rL~.t~~ r ~~~ Date t ~- ,~~~~ ,, fir,' Sig ati_ire of Ex cu 've Directo Date UNSIGNED PROPOS,G,ILS WILL NOT BE ACCEPTED! NONPROFIT Q~~RANT APPLICATION FISCA~JL YEAR 2009-10 Page 14 37 Hawaii Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawaii County I-~lawai'i Island HIV/AIC);3 Foundation- Agency Name Tr~ar~lsmission Prevention 'I"'~or HIV+ Women in West Hawaii County- k'rogram Name Agerur,:ryr Director: Georgie htl:ennedy Phone No.: 331- 8177 Cont~in~ca Person: Same Phone No.: 331-8177 Mailir~u~rp Address: 75-240 PJani Kailua Dr. #5 Kailua Kr.~na, HI 96740 Facilliitl~y~/Site Address: Same Fax hillin.: 331-076?'. Emaiil ,Address: georgie(ia),.hihaf.org Nami~^ of AccountantlCPA (includlr;> name of firm if applicable): James [:). Jennings, CPS, Inc. Phoinr;> No.: 808-942-8813 Mailiro?~ Address: 1600 Ka~f>iolani Blvd., #730, Honolulu, HI 96814 Amoai mt of Request for County Fa.mds: $20,000.00 Prior Y(ear(s) Funding: 06-0'i"' 07-08 08-09 $10,Q~~00 $15,000 $15,000 Agennr.:y Mission Statement: The I~lawaii Island HIV/AIDS Foundation is anon-profit organization dedicated to assi::cling those affected by HIV/AIC1::i to maximize their quality of life, and to NONPROFIT 4iRANT APPLICATION FISCA.',L YEAR 2009-IO Page 1 ending the spread of HIV. We also rNtilize the lessons learned in the HIV epidenruic to care and advocate for others in the fight against related diseases. Our vi~siion is to build a healthier, strc:rriger, and more sustainable community that supports all its members with a focus on HIV issues. We are an IRS-designated 501(c)(3j tax-exempt non-profit organization that provid,a care services for People Li~~~ing With HIV/AIDS (PLWHA), and provides HIV prr:::vention and education of the: residents of Hawaii County. HIHA,1= has been providing services to people at risk for, infected with, and affecfc=rl by HIV/AIDS, since 1986. Clur Foundation has an efficient and effective systerrr to provide a comprehensive continuum of prevention, care, and support servicx=s with regard to HIV/AIDS for the entire Big Island. We refer to the Kona office: a:as "HIV Foundation -Kona". As rererrrted by the Hawaii State Delpartment of Health, Hawaii County has the higher=,t number of AIDS cases outslidle of Oahu, with 13/0 of all AIDS cases repor4~sd in the state since the begirru•iing of the epidemic coming from the Island of Hai:~rai'i. The number of people with HIV/AIC+;i; climbs steadily upward every year of the epidermic. In the US alone, there arc: 65,000 new cases of HIV every year. Currerrtly, we know that half of all these new infections occur through heterar;,exual transmission, putting ~,nnomen at a very high risk of HIV infection. As can I:}o assumed, the proportion of cases diagnosed in women has been incre~:i<>ing steadily over time, and v~~«,~ have little reason to believe it will decrease anytiune soon. This is a distressing increase in infection among women. The fc:rnale population in other US and global communities continue to bear the brunt raf new HIV infections. Women's rights are often compromised within relafi~-~rrships and, due to gender imlaalances within relationships, women contiiruue to be more vulnerable to HIV infection than men. Our Foundation belie~~~rs in upholding a strong focus on prevention programming, and specifically targe;:tiirrg women and populations vulnerable to HIV infection. Through working with I-tlV-positive women and addrE;~sing their behaviors and empowering them thror.rtillh education and prevention 2u;;aivities, we plan to continue contributing stror~u-~ly to stopping the spread of hilt/ and AIDS. Wonnen living with HIV face additiorsal challenges, as they must prevent transunitting HIV to not only their pai1lners, but to their infants as well. This ~,~car, we received a telephone call from Kona Hospital regarding a very ill HIV+ rnan. When we made our visit we discovered that he was near death and that threre was a distinct possiblility that his wife was infected as well. Within a few da=rt's the man had died. His wife; came to us not really clear why her husk:~ra~nd had died and wanting sorne answers. During our discussion she becarme aware that she rnight be imfected and agreed to be tested immediately. Unfortranately, she too is HIV+. The shock of her husbands' death and her own infectiion brought her close to a psyr..hological break. We were able to work with NONPROFIT' ~rRANT APPLICATION FISC:ri.:L YEAR 2009-10 Page 2 her, c~r.~r7nect her up with a great psychologist and begin her HIV treatment. Many of her friends and some family believed, for some reason, that she had infected her hi~uoband and that she was respor7sible for his death. No one will ever know if they inribected each other or a third p<:~rty was involved. What we do know is that in a very short period of time this woman found herself very ill, destitute, homedc::rss and to a greater or lesser ~rxtent friendless. The actions of our care and pr~wention teams brought her tYurough this very difficult first six months. We needed to work closely with her on t:rrevention issues because she had never lived alone and was actively seeking comfort from a number of male friends. I am h<~Irpy to say that our efforts paid) off. She is now in a committed relationship with a rnan who knows her status ar•i~rl the risk factors involved in their relatie~irrship. They both have actively sought help from us and the psychologist to malcc=, sure that they do not infect each other or anyone else. Withora# this aggressive prevention ir~dtervention many more individuals in our commcanity might have become infer;l:ed by this single individual. We ar4, also actively working with young women who are being treated at the Big Island ;~~ubstance Abuse Council. T'h~ese young women have already been expos>r;~d to risky behavior by their dro.cg use. In addition many of them have low self e;;rlieem, little or no education, aund see themselves as worthless. By working with ttrrse young women, getting them tested for HIV and other sexually transn~uHtted diseases, and showing'fFiem their self worth we can break the cycle of drr.u p use, casual sex, and destructive behavior. At BI:~~,~a,C, we were working closely with three young women, ages 13, 17, and 18, a€V of whom are pregnant. Two crf them have partners who are in jail and the third a relationship with a substantially older male. None of them had any plans for the:~rnselves or their babies, didn'I: see themselves as mothers, or acknoardledge the consequences of I:Iveir actions. Over a four month period by meetlirii~g once a week we were able lip influnce two of these individuals to make dram~rtic changes in their lives. Thea,~ are back in school, having counseling, not using ~:trugs, and working towards a future with their unborn children. We continue to experience decreases in the State of Hawaii Department of HealRlr~ funding allocated to HIV/AID~;~> prevention services on all islands. This is refleca+..=.>d in our Program Expenditures and Program Funding Sources tables. NotwifPastanding these challenges Nr~ continue to do our very best to reach as many rnromen as possible and providle them with high quality services. Our comrni4ted prevention staff is repre<.rentative of the women we serve and are a great: ~4~xample to the participants of vuhat they can become if they make the right choice; . NONPROFIT C~I2ANT APPLICA'fI®N FISCAL 'YEAR 2009-10 P~~e 3 •1;-lawai'i Island HIV/AID~i Foundafiion -Agency Name Trai~tsmission Prevention tt~r HIV+ Women in West Hawaii County- f~rogram Name Proge•~~;aim Description: The Fifaowai'i Island HIV/AIDS Foundation -Kona is proposing to continue funding for the: I-!IV transmission prevention iarograms for all HIV+ women in West Hawaii Courdt;r, including individual and group protocols and counseling and testing of womr::ru at risk. This program is desirt;lned to STOP HIV at the source, with indivi:rli.aals who can transmit the dis~aase to others. The lrrr:~~gram also provides early treatment for newly diagnosed HIV positive wom~ei•r, maintenance of stable heall:h and well being for all HIV+ women in West Hawai'°i County, long term planning if:>r health maintenance, and transmission preverdiion interactions. A reef=^int addition to women's prevention services is the SISTA Project, "Sisters Informing Sisters about Topics on A,iiDS". This program is directed to local womrnn at high risk for infection and transmission of HIV. and is an in-depth behavif:~ral change program. Our Women's Outreach Specialist leads a social skills (:raining intervention, aimed at reducing HIV sexual risk behavior among minori!h/ women who are at highest risk for HIV and other sexually transmitted dise~:uses. This includes women who experience poverty, drug addiction, violer~c,e and sexual abuse. The prr.,~ject consists of five once-a-week two-hour sessir: ns, and includes a sixth, "boo.<.>ter" session one month after the women graduate at the fifth session. Most c7f the women participating are referred to the progr:;i,rn from other local agencies and organizations serving community needs. To d~a1Ce, all SISTA series that have been undertaken have been extremely well recei~,+ed, with very positive feedbarlr, for the program facilitator as well as HIHAF. We ii~~iclude the SISTA Project in thi<, application because it is instrumental in helpirrrp us reach women who may (:already be HIV positive to get them tested and into a:.are services, as well as providing the type of behavior change training that has br_:en accepted by the U.S. Cerrl:ers for Disease Control and Prevention as the n•io~st effective. EVAL..iL.IATION: Quanliitative evaluation measures fioir this program includes the collection, tabulation and entry of participant dl=ita into a computer tracking system provided by thf~ Centers for Disease Control (;PEMS). Data routinely tracked include: numtrr::r of clients, ethnicity, social s,l:atus, risk categories, type of intervention, numtaer of interventions, outcome irdformation during program and 30 and 60 days a:~fter completion of program. NONPROFIT Q~RANT APPLICATION FISC,"~1L YEAR 2009-10 Page 4 Planning estimations for intervention;; and programing for women FY2009-2010 curren~lay project that a minimum of cane hundred women (100) will participate in at lezcsai five (5) sessions and two (2;i follow up sessions. For HI^t/+ women a minimum of eigtal:y five (85) women will have assessment sessions, quartrly reviews and quarterly individual prevention sessions. QUAi..ll'T'ATIVE ANALYSIS: Partirilpants fill our apre-test at the'daeginning of a program. They also fill out knowl~~rtge level questionnaires as 1a~ie sessions progress. A final post test is admini<,>tered to determine level of k;r~owledge, increase or decrease in self awarcarress of actions, and other sali~e:nt data. A participant satisfaction survey is also a,ilministered to determine the efficacy of the presenter, the material, the settintt, etc. This cl;ata is reported quarterly to thc; Centers for Disease Control and the Dept. of He;:!~Nlh of the State of Hawaii. Additional data is kept on the number of HIV tests send their results as well as Hep. C screenings done each and every month. All the above information is also provided to the Board of Directors, staff, and other interested parties to help us improve the quality of our prevention progir~,~rns. CHAh9~;:3ES FOR 2009 HIHE~~I' initiatied a hiring and salary freeze and cost cutting activities during the past pair: months in response to the a:leclining economy and in anticipation of fundirrrl decreases. While each sta19 member has taken on more work without the anticipation of additional financial reward, they have done so cheerfully and with a level of commitment that is astounding. We and our community are forturn-rte to have such a talented arrd committed group of people who have put other.:.:, ,above themselves. Our F3~r_rard of Directors has also made an even greater commitment to this Fourxal~:~tion. They are giving more of their time and talent to make sure that we weaiau.~r this difficult time and grow aas an organization at the same time. We have; r-e:centiy received a grant to da] additional training with our Board to enhance their caa~ganizational and fundraising abilities as well as doing strategic planning forth+:: next five years. Total IE3udget and Position Counll Total IProgram Bud get 69,000.00 Total Program Position Count 2.0 _ Total A enc Bud et 1,358,000.00 Total Agency Position Count 15 _~ NONPROFIT ;;;RANT APPLICATION FISC~""-IMF YEAR 2009-10 Page 5 Progu•a::rcro Objectives: 1) I~teview each HIV+ woman's Ir;ansmission prevention service plan in first month of program, and/or initiiate new transmission prevention plan for urewly infected women. (Estimated 85 women, 1-2 hours per client.) 2) 'Refer women to appropriate l;;u~oviders if needed, i.e. mental health providers, substance abuse providers, etc. within the first month. These providers can deal with some Hof the behaviors which place these women at risk of transmitting this dises:rcse. These professional counseling sessions are paid for by other funding sources. 3) Initiate transmission prevention? protocol (estimated 85 clients, 1 hour ~e~ach) in the first session, them quarterly, as needed when problems arise. 4) I~locument progress and adhr:rence to transmission prevention protocol with input from client each quarter (85). 5) flAonthly support for HIV+ wonnen dealing with self-esteem, negotiation, sexual issues, transmission prevention. 6) (Referral by participants to other women who may be at risk of contracting r>r transmitting HIV to others. (Referral to result in HIV counseling and testing by prevention outreactu staff and screening for possible referral for I:rarticipation in the SISTA prcaject. 7) i;;ontinuation of SISTA projec:ii including 5-2 hour sessions and 1-booster session for a minimum of 10CI .at risk women in Hawaii County. Progr,,rrm Highlights: 1) ~r'~chieved a review of care pnevention service plans for forty-five (45) women during first half of furvding year 2008-2009. 2) (Referred women to specializ~~;~d care for health and/or prevention issues dluring first half of the funding year. 3) l=teviewed and updated healttu plans for all participants quarterly. 4) initiated in-depth transmission protocols with all participants, and met with ~..=.~ach participant on aone-to-r,;nne basis quarterly. 5) 16Aore than seventy-five (75%') percent of HIV+ women and participants in 1':he Sista program have reporl:ed 100% compliance with prevention protocols by second session Qi.e., use of condoms or other protection during all sexual encounters.) 6) Twenty-five (25%) percent of l:~articipants have reported compliance 90% oaf the time to date, with the goal of 100% compliance by the end of the year. 7) I'~Jinety (90%) percent of participants are documented to have benefited from the program by maintenrance of good health, increased self-esteem, and ability to interact with seacual partners in a safe manner, thereby ilecreasing the prossibility of ;>exual transmission. NONPR®FIT i[;;RANT tLPPL.ICATI®N FISCAI. Yfl;AR 2009-I O Page 6 8) ,~ of December 2008, zero tr,:ansmission of HIV by any participants in +;ither program. No hospitalizations, stable health, and maintenance of ~>mployment. 9) ~'~ total of 65 women of unknovun HIV infection status have participated in i:he SISTA Project training sessions as of December, 2008. 10) C)n going associations and coboborations wifh Alternatives i:o Violence, the 4~"Vomen's Shelter, Big Island £iubstance Abuse Council, Neighborhood f''lace, and various other programs that provide services to women in our community. NONPROFIT iCxI2ANT APPLICATION FISCAL, YEAIL 2009-10 Page 7 1-ilawai'i Island HIV/AID~.r:~ Foundation -Agency Name Tr<:~Ir1SmISSIOn Prevention for HIV+ Women in West Hawaii County - If'rogram Name Perfcniru•nance Measures: _.. _. FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate HIV+'~-Individual transmission reverd:ion session (assessment) 92 85 85 _ Heallaiprevention plan review uart:f~r1y 92 85 85 _ Quarit~~rty individual transmission reve:.rd:ion sessions (1 hr each) _ 90 85 85 Revienfv and documentation of ro ra:ann quarterly 92 85 85 SISTa~_~project participation _ 65 85 100 *If at:,l~~~~licable Procpo°aam Expenditures __..... ..r. FY 200'i -08 Actuadl * FY 2008-09 Bud et * FY 2009-10 Estimate Salari~as and Wa es 3!i,000. 35,000 40,000 Profe~;sional Fees 0 0 0 O er;ations 22,000 22,000. 25,000. E ui1,,nnent _ _ 0 0 0 Other"_` 4,000. 4,000. 4,000 TotaA Ei't ,000. 61,000. 69,000. If applicable " Plea:r,~ explain in detail on separate sheet NONPROFIT' t~RANT APPLICATION FISC~I,1L YEAR 2009-10 Page 8 l~;lawai'i Island HIV/AIDE:; Foundation -Agency Name Tra~ilsmission Prevention ifr,~r HIV+ Women in West Hawaii County - I~'r°ogram Name Prograsrn Funding Sources: Identiifp! all funding sources (specific to this progr~s~rn only) Revenue Source - FY 2007-08 ~-- ~4ctual * FY 2008-09 Bud et * FY 2009-10 Estimate Coumi~,r of Hawaii _15,000. 15,000. 20,000. Dept taf Health-State of Hawaii 33%~ womerii only (1/2 for Kona) _ 11,000. 11,000. 10,000. Life F„~randation/Sista Program 25,000. 20,000 20,000 Founc:t~tions 0 4,000. 6,000. Fundr<r,isin~______ 4,000. 4,000. 5,000. - - - -- Total ___ _ 55,000._ 54,000. 61,000. *tf apFrtiicable Expl<sirs what plans, if any, your ai;;yency andfor program has to increase revere€rres to support this programs. when do you anticipate your program to bea',cDme self-sustaining? Unforl;unately, the HIV/AIDS epidemic shows no sign of ending, and indeed continues to grow. Often, there is a misrepresentation of facts about the epidermic in the media. The fact is, tl~iere are still people becoming infected, regar~rllr>ss of the rate at which that kuappens. And each newly infected individual preserrls with a myriad of challenges to be met and overcome. Because the epideav,~ic continues to grow, we do riot see a specific point at which our program for pre~wention might become self-sustaining. The more people who become infectr;ri, the greater the possibility of new cases of the disease. We he,~~re received level or decreasing funding from our main revenue source, the State r,:if Hawaii Department of Health, for the last 16 years. During this time, the numbr:n~ of people we are testing and counseling and are caring for has more than doubled, and may well double <~gain over the next /0 years or sooner. In additic~rr, our clients live longer now Ic~ecause of the availability of new drug NONPROF'I'T' iGI2ANT APPLICATION F'ISCA]G I'F,AR 2009-10 Page 9 treatnnc~nts. This is wonderful in that: it allows those who are infected to continue as prcvtluctive members of society. IE:~ut it also raises additional challenges for us as a 1=inundation to continue to support them in their productivity. We have gone throu~ah an assessment and are reor~i;lanizing our Foundation to put us into a position where we can operate as economically as possible and continue to provide; high quality services. The r.,r,:osts for doing business have risen exponentially especially in the areas of healtto insurance, liability insurance, c.itilities, rent, mileage, etc. Unfortunately, most fu.mders only want to fund indiviiduals to do the program but neglect the realit~,~ of housing the Foundation, lictk•rting, electricity, communications, etc. We have r~.~quested a modest increase ailong with increasing the number of individa.ials that we serve in the cominnunity. The increase would only cover the incre,=u:ues in infra-structure, not incre=,<~sed salaries. We aro, the only HIV/AIDS services ~~rganization in Hawaii County providing these °rital care and prevention services. We are currently working to develop an affiliat;r~d for-profit business, whose F=rofits would help sustain our Foundation and the viral services we provide. But this will happen at some unknown and perhaps distant point in the future. For now, ~inve are very grateful that we have this suppor~l from the County, and we want to thank you for this opportunity to apply to yoiu for funding. NONPI20P'IT 4.~iI~ANT APPLICATION I+ISCA.]L YLAA2 2009-10 P~nge IO II-~awai'i Island HIV/AIC;> Foundation -Agency Name Trar-ismission Prevention 1`for HIV+ Women in West Hawaii County - (Program Name I (we) Have read and understood all of the eligibility requirements; grant condiil6r,:ms; award procedures; and rr:;cords, reporting and fiscal accountability requinr:~rnents as mandated in Article: 25, Sections 2-135 - 2-142.2, Hawaii Coun9!,~ Code, relating to Appropriation of Funds to Nonprofit Organizations. (we) Ituereby certify that information supplied herein including all supporting docurrrents is correct and that I (wey have the authority and ability to fully admir7i::>ter the program(s) pursuant to law. (we) i_inderstand that information sapplied herein shall be made public accorr;ling to Chapter 92F, Hawaii Revised Statutes. If awair•~ded a grant from the Count~l~ of Hawaii, I (we) understand and will comp~llyr with the requirement to sanbmit a year-end report to the Legislative auditac+n• within 60 days after June _30 of the fiscal year. The report shall inclu~ale an explanation of the public benefits derived from the awarding of the tyrant, a complete accounting a>f all expenditures supported by County of H~ao~d+~~ai`i grant funds, and a listing of other funding sources and amounts obtaiir~ied during the award period. Faiilure to submit a timely. complete, an ageruq,,_y's future funding requests,,,. e I~~I®~ Date ~ ~~ o, Date UNSIGNED PROPOS~~rsLS WILL NOT BE ACCEPTED! NONPROFIT' iGRANT APPLICATION FISC.4JL YEAR 2009-IO Page 11 ~~ ~ r`~' i ~'II.~-~,~.~CC~i3~. ` p 5F Sigrralhare of Board President/Chair 38 Hawaii Island Workforce and Economic Deveopment Ohana Hale Nani Education Center - Equipment/Supplies Hawaii Island Workforce and Economic Development Ohana (Apency Name) Hale Nani Education Center - Equipment/Supplies (Program Name) Agency Director: Contact Name: Mailing Address: Facility/Site Address: Fax No.: Email Address John Carroll John Carroll 1990 Kinoole Street Hilo, HI 96720 1990 Kinoole Street Hilo, HI 96720 (808)998-2880 Phone No.: (808) 981-2860 ext 240 Phone No.: (808) 981-2860 ext 240 jmkcarroll@gmail.com Name of Accountant/CPA (include name of firm if applicable): Clydo Oshiro Phone No.: (808) 935-0885 Mailing Address: 319 Kinoole Street, Hilo, HI 96720 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 06-07 00.00 07-08 00.00 Agency Mission Statement: 08-09 00.00 The Hawaii Island Workforce and Economic Development Ohana (HIWEDO) is a private non-profit organization incepted in 2005. The organization's mission is to "promote the development of a highly competent and productive workforce by coordinating the efforts of educational institutions, labor, business, economic development organizations and the entire community in order to sustain a vibrant Big Island economy and lifestyle." HIWEDO bridges economic and workforce development through collaborations with the Hawaii County Workforce Investment Board (WIB), the Department of Labor's Workforce Development Division, the Hawaii Island Economic Development Board (HIEDB), the County Research and Development Division, and business and industry leaders. HIWEDO complements and does not compete with or duplicates the services of other organizations. In facilitating and coordinating these employment and training and economic development activities between government, private industry and community groups HIWEDO is able to NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Hawaii Island Workforce and Economic Development Ohana (Agency Name) Hale Nani Education Center -Equipment/Supplies (Program Name) provide a forum for strategic discussions, organizational structure and goal and outcome orientation to initiatives and community based collaborations. Program Description: The Going Home Initiative was first started in August 2004 as part of Hawaii County Mayor's Task Force on Employment Solutions. Mayor Kim had called on workforce development, housing, transportation, training and education leaders from public institutions and private community organizations to work collaboratively and creatively on integrated solutions to address workforce shortages and challenges. As one of several key initiatives Going Home aimed at reaching out to, preparing, and training the under-utilized segments of the Big Islands workforce. It soon became clear that with the target group of incarcerated and ex- offenders, employment and training were not just a single issue. A comprehensive approach was necessary to address the population's needs and challenges. At that point the initiative grew from its original focus to include other areas such as education, housing, transportation, substance abuse and mental health services. Ten subcommittees were formed and currently over 40 public and private entities and their representatives actively participate in monthly meetings pushing forward the initiative's agenda. Going Home has grown from infancy into a broad community effort and is now at a point where it needs more substantial administrative and fiscal management structures. In late 2008, HIWEDO assumed these responsibilities and now provides Going Home with an organizational basis of operations into the future. Through Going Home's efforts, the Department of Public Safety has been appropriated $200,000 by the State Legislature to build an education and training center next to the Hale Nani Correctional Facility re-entry program site. The building was completed in December 2008 and a grand opening ceremony took place on January 14, 2009. The building is 24 x 60 ft. and provides space for one classroom (dividable into two rooms), one office, one storage area and two bathrooms. Lack of space limited the amount of assistance HCCC was able to provide to foster the successful transition of those incarcerated (Na Pa'ahao) back into communities after their release through employment, training and other supportive services provided by community agencies. Even though HCCC directs the operation of the Hale Nani Re-integration Program Building, the opportunities available with the facility are tied to community efforts undertaken through the Going Home Program. The core re-integration curriculum consists of Project Metamorphosis (Cognitive Change), Budget & Finance, Employment Readiness, and Building Healthy Relationships. Supplemental classes and programs include: SKIP (Supporting Keiki of Incarcerated Parents), parenting, female gender specific issues (e.g. sex abuse), alcohol and drug education, dealing with loss (life, property, relationship), obtaining a driver's permit/license, attitudinal healing, literacy & tutoring, vocational training and education, GED/CB, mentoring program, AA/NA meetings, various religious programs, and work safety. Service providers conducting classes, counseling and programs include, but are not limited to HCCC staff, Alu Like, Workforce Development Division, Goodwill Industries, University of Hawaii at Hilo, Hawaii Community College, Center for Attitudinal Healing, Office of Social Ministry, CALC/Hilo Public Library, Hilo Community School for Adults, Institute for Native Pacific Education and Culture, Institute for Family Enrichment, Queen Liliuokalani Children's Center, Read to Me, Alcoholic Anonymous, Narcotics Anonymous, various community churches and HCCC/community volunteers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Hawaii Island Workforce and Economic Development Ohana (Agency Name) Hale Nanl Education Center - Equipment/Supplies (Program Name) In its coordination role, HIWEDO assists Going Home by assessing the needs of the program at the new building site and then securing some of the funding for the operation and purchase of initial equipment, supplies and furniture. HIWEDO will also facilitate the purchase of any item paid with its funds. An agreement between HIWEDO and the Hawaii Community Correctional Center is in place, which details all equipment and furniture will become the property of HCCC and will be maintained by them. The agreement also explains that all supplies purchased with HIWEDO funding are only to be used in the delivery of the programs in the initial year of operation. HCCC is responsible to secure funding for materials and supplies in the future (see Attachment A). Target population to be served through the Hale Nani Re-integration Program are sentenced felons (incarceration over one year), who are preparing for possible release on parole and will see the parole board within 18 months of their tentative parole date. Also receiving services are sentenced jail individuals (incarceration one year and less) upon completion of their sentence and usually serving a term on probation. Pre-Trial Females who are awaiting disposition of their cases will also receive gender specific programming to be determined by the START Committee. The program anticipates serving a total of 325 jail, prison and pre-trial inmates in 2009. For a more detailed description of the Successful Transitions and Re-Entry Together (START) Program see Attachment B. Total Budget and Position Count: Total Program Total Program Budget $23,530 Position Count 7 Total Agency Position Total Agency Budget $548,000 Count 3 Program Objectives: Going Home Initiative (1) Program Operation: Provide/hire adequate staff, manage program on a daily basis (2) Development and implementation of program strategies and objectives: Develop strategic plan, detail implementation tasks, define time lines and responsibilities for implementation (3) Coordination of Coalition Efforts: Continue the community-based coalition work, strengthen/direct networking and linking efforts between coalition partners in support of the overall goal. (4) Fiscal Responsibility and Funding Resources: Secure funding for program operation and for re-granting to direct service providers, administer funds, develop and manage RFP processes as needed, provide evaluation and outcome measurement services, report back to funders. (5) HCCC -Hale Nani Re-integration Program Building: Coordinate needs assessment, secure funding for supplies, equipment and furniture, assist in purchasing items, measure and evaluate outcomes, report back to funders. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 3 Hawaii Island Workforce and Economic Development Ohana (Apency Name) Hale Nani Education Center - Equipment/Supplies (Program Name) Program Highlights: 1) HIWEDO was able to secure $5,000 of initial funding for equipment and supplies from the Cooke Foundation in 2008. Office computers, printers, computer desks and some of the basic furniture have been purchased. Storage cabinets have been secured. 2) The completion of the program building was a major milestone overcoming many challenges and hold-ups. All construction work was provided by the Correctional Industries, many of the other preparation and planning elements were a community effort, involving community groups and contractors. 3) Coalition efforts and work put together by the participants of the Going Home Initiative over several years are remarkable. The focus will now shift from planning to implementation. Community service providers are now seeking funding to take on educational components to be offered in the program building. 4) HIWEDO has secured operational funding for the coordination of the Going Home Initiative through Federal Reed Act Funds until June 2010. Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual Budget Estimate No. of sentenced 0 females 25 females 30 females felons 0 males 80 males 85 males No. of sentenced jail 0 females 50 females 55 females inmates 0 males 120 males 125 males No. of pre-trial 0 females 50 females 55 females inmates Type of classes No classes Core Curriculum, Expansion of services provided, number of have been supplemental classes participants provided and programs (see program description) Network of No classes Elements of the core Intensified effort to Community Service have been curriculum and increase the availability Providers provided supplemental classes of funding for services will be provided by provided by community community organizations organizations, i.e. BISAC, Goodwill Industries, Alu Like, OSM, etc. Program Expenditures: Equipment/Supplies for first year of Hale Nani Education Center set-up and operation FY 2007-08 FY 2008-09 FY 2009-10 Actual Bud et Estimate NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 4 Hawaii Island Workforce and Economic Development Ohana (Agency Name) Hale Nani Education Center - Equipment/Supplies (Program Name) Salaries and Wa es Professional Fees O erations E ui ment $23,530 Other# Total $23,530.00 Please explain in detail on separate sheet: Please, see Attachment C for detailed expense budget breakdown. Program Funding Sources: identify all funding sources (specific to this program only) Equipment/Supplies for first year of Hale Nani Education Center set-up and operation Revenue Source FY 2007-08 Actual FY 2008-09 Bud et FY 2009-10 Estimate Cooke Foundation received $5,000.00 Hawaii Coun Grant $15,000.00 In-Kind Goin Home Initiative $2,000.00 Other Grants $1,530.00 Total $23,530.00 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? Overall, the proposed program is a one-time effort to purchase start-up and initial equipment, supplies and furniture for the Hale Nani Education Center Program Building's first year of operation. After this first phase it is to be expected, that further supplies can be provided through the Department of Public Safety. In a next phase, HIWEDO will assist the Re- integration program to secure some funding for community service providers to be compensated for conducting classes and serving the target population as part of the START program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Hawaii Island Workforce and Economic Development Ohana (Agency Name) Hale Nani Education Center - Equipment/Supplies (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, Section 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 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 ayear-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. o.~„~ a. Signature of Board Vice Pre dent Gi-. r ~l Signafil e of Executive Director ~ 3~ s Date ~U b~, Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 6 Attachment A MEMORANDUM OF AGREEMENT This agreement is entered into between the Hawaii Island Workforce & Economic Development Ohana (HIWEDO), anon-profit organization serving Hawaii County, and the Hawaii Community Correctional Center (HCCC). In response to a community- based initiative, the legislature appropriated funding to construct the Reintegration Program Building at Hale Nani. This building will provide space for instructors and/or agencies to conduct classes and provide training opportunities that will prepare those incarcerated for successful release into the community. 1. Since no funds are currently available through State sources for equipment, furniture and materials, HIWEDO and HCCC will collaborate in furnishing the facility for its intended use. 2. HIWEDO will seek community support for the purchase of equipment such as computers; furniture such as tables, desks, bookcases; and initial operating supplies and materials to support the programs offered at the facility. 3. HIWEDO will facilitate the purchases of the equipment, furniture and supplies/materials. 4. All furniture and equipment will become the property of HCCC and will be maintained by them, and replaced as needed. 5. Supplies will be used in the delivery of programs in the initial year of operation. In future years HCCC will secure funding for materials and supplies. Signed this 13th f February, 2008 by: eter Cabreros ing Warden Hawaii Community Correctional Center ~~a.~ GG~c~L-~i 'Sandra Sa<aguc Executive Director HIWEDO Attachment B START "Successful Transitions And Re-Entry Together" A partnership between Hawaii Community Correctional Center and Hawaii Island Community Agencies to provide effective intervention strategies that enhance public safety by maximizing the successful re-entry of offenders into the community. Hawaii Community Correctional Center's Communes Based Re-Entry Program Research on inmate populations indicate that factors such as substance abuse, homelessness, unemployment, minimal or no supportive ties in the community, poverty, and the lack of education may lead to continued participation in criminal activity. Local communities are no longer able to exert any influence of the behavior of their residents and therefore need the support of correctional centers and community agencies to restore ties that were severed due to criminal activity. In addition to our local communities, families of those incarcerated often suffer the effects of incarceration in various ways. Providing support to the families of those incarcerated will also help in the reunification of the incarcerated individual and their family. Act 932 indicates "systems and programs that provide assistance with offenders' transition from institutional to community life are critical to the families, neighborhoods, and communities to which the offender returns." It further states "that in order for an offender to successfully reenter the community, the offender must have access to a full continuum of services during incarceration and immediately upon release." As the gateway for these inmates to be released into our communities, the Hawaii Community Correctional Center, in collaboration with various supportive community agencies, hope to provide programs that will prepare these inmates for eventual release into the community, and provide a foundation for them to live a pro-social lifestyle. Families of the incarcerated individual will also receive programming to help them in the reunification process. ti ti f~p~ Purpose To provide programs for inmates that will enhance their ability to be successful in the community upon release to parole, or expiration of their sentence. - Target Population Sentenced Felons Inmates who are transferred to HCCC from other facilities for eventual release on parole or to "max out" on their sentence. • Accounts for approximately 15% of the inmate population in the Hale Nani Community based housing unit • They have served indeterminate periods of incarceration ranging from 2 years to Life with the possibility of parole. • Usually completes all recommended programs determined by the RAD unit and Hawaii Paroling Authority prior to transfer. • Must obtain sustainable employment, reintegrate with their family, exhibit some sign of rehabilitation, and have reasonable expectations of success in order to be granted release on parole. Sentenced Felon/Misdemeanant Probationers • Inmates serving less than a year in jail and are anticipating eventual release into the community. • Accounts for approximately 80% of the inmate population in the Hale Nani Community based housing unit. • Early release from their sentence is determined by the court and is usually granted upon an inmate's admission into a residential substance abuse program. Motivation for this category of inmates to participate in a reintegration program is minimal as they have such "short" periods of incarceration. • With the support of the Adult Probation Office, Family Court Probation Office, and Department of Human Services, we hope to inspire this population to participate in the START Program in order to enhance their success on probation. Sentenced Misdemeants/Petty Misdemeants • Inmates serving less than a year in jail without supervision upon release by any probation office. • Accounts for approximately 5% of the inmate population in the Hale Nani Community based housing unit. • Motivation for this category of inmates to participate in a reintegration program is minimal as they have such "short" periods of incarceration. - Eligibility • Sentenced with a classification of "Community" status • Must have 4 months or more left on their sentence to serve • No Pending Misconducts No Pending Charges • No guilty findings on moderate misconducts for the past 3 months, high misconducts for the last 6 months, and greatest category misconducts within the current term of incarceration. • Medically cleared to participate • Must be housed at the HCCC Hale Nani Community Based Facility • Application must be completed (See Attachment A) - Levels of Participation - - ;1; ~N,: Level I: Orientation and Evaluation • Indeterminate period based upon attitude, participation in in-house worklines, meets all eligibility requirements, and is recommended by the Program Committee for participation in the START program. • Supervising agencies are contacted to provide input for program participation. • HCCC Offender Services will maintain a database of all inmates approved for participation. Level II: Placement in the START Program • An individual re-entry plan will be created to outline goals, objectives, and program and educational needs of the inmate during incarceration and subsequent release. - Inmates are placed in the START program with the understanding that all homework assignments must be completed, remain misconduct free, consistently demonstrate excellent attitudes, initiative, responsible behavior, and good work habits while in the program. • Supervising agencies are notified of an inmate's participation in the program. • Progress reports will be provided to supervising agencies upon request. Level III: Completion of START Program • Re-Entry Support Team (REST) will meet to re-evaluate transition plan for pending release from incarceration • Inmates may be considered for release on the Electronic Monitoring Program with Hawaii Intake Service Center one month prior to their expected release date to begin transition into the community. • Supervising agencies will be contacted to provide input for consideration of EMP placement Finalized transition plans and certificates of completion will be provided to supervising agencies to provide continued support on re-entry ~,~. Ding Igo -- C~ m~ - Re-Entry Support Team (REST) • The Re-Entry Support Team may consist of parole officers, probation officers, offender services staff, security staff, teachers, mentors, substance abuse counselors, mental health social workers, CPS case workers, and other agencies who will be assisting the inmate in transition. • Case management meetings will be held upon the completion of the program, or as necessary. All participants of the START Program will be prepared with an individualized reintegration plan that will identify targeted goals and strategies to enhance their success in the community upon release (See Attachment B). Referrals for continued transition services will be made, and follow-up on transitional progress will be monitored by the inmate's probation officer, parole officer, or the Hawaii Intake Service Center's Re-Entry Coordinator. - Community Resource Agencies The more contact an inmate has with community resource agencies while incarcerated, the more likely they will seek out their assistance while in the community. • Some community resource agencies utilized for the START Program will include, and is not limited to Alu Like, Goodwill, Hawaii Workforce Development, Office of Social Ministry, Catholic Charities, PATCH, TIFFE, faith-based institutions, Alcoholics Anonymous, Narcotics Anonymous, BISAC, Hawaii's Center for Attitudinal Healing, Hawaii Community College, Community School for Adults, Division for Vocational Rehabilitation, Soul Sisters/Brother 2 Brother support group, and others. • Community agencies offering classes in the START Program will be provided with statistics on the START program to assist them in securing grants for continued support of the program. A community resource display will be available to inmates in the program building. - Curriculum for the START Program • The core curriculum for the START Program will be 7 weeks in duration and consist of three mandatory classes: Men and Women In Transition, Budget and Finance, and Job Readiness (See Attachment C). • Supplemental Classes and Programs offered are: Alcohol and Drug Education, Strengthening Keiki of Incarcerated Parents Program (SKIPP), Attitudinal Healing, Worship and Praise Program, Alcoholics/Narcotics Anonymous, Vocational Training, Life Skills, Yoga, and Women Of Grace. Additional classes and programs will be offered on a rotating basis or as the class and instructor is available. - Measures of Program Outcomes A database containing statistical information on participants in the START program will be created and maintained by the HCCC Offender Services Office. A review will be conducted annually to determine the appropriateness of programs offered and the availability of resources to enhance the program's success. Annual reports will be created for distribution to all service providers as well as Department of Public Safety administrators. Attachment C HAWAII ISLAND WORKFORCE AND ECONOMIC DEVELOPMENT GHANA GOING HOME -INCARCERATED COMMUNITY RE-INTEGRATION -SUPPLIES, EQUIPMENT FURNITURE (NEW BUILDING) EXPENSE BUDGET FOR 2008 (JANUARY 1, -DECEMBER 31, 2008) Supplies $ 6,230 Office and program supplies, including folders, hole punchers, paper clips, composition books, paper, pens, pencils, dry-erase board, etc. $ 2,000 Video: "Accepting Responsibility" by Dr. Stanton Samenow $ 695 Video: "Commitment to Change: Overcoming Errors in Thinking" Part I, II, III by Dr. Samenow $ 995 Video: "Commitment To Change: Tactics: Habits that Block Change" Part IV, V, VI by Dr. Stanton Samenow $ 995 Video: "Commitment to Change: The Power of Consequences" Part Vll, VII, IX by Dr. Stanton Samenow $ 995 Video: "Rage, Recidivism, and Recovery" by Danny Trejo $ 550 Equipment $ 11,270 2 Office computers, including monitors @ $900 per computer/monitor $ 1,800 1 Laser printer - $ 250 , 1 Laptop $ 900 1 Router to connect 2nd office computer to DSL $ 100 DSL services for Instructor computers for 12 months @ $50 per month $ 600 5 Computers for program participants @ $600 per computer $ 3,000 2 Inkjet printers for program participant use @ $100 per printer $ 200 1 Telephone (cordless) $ 100 2 Projection Screens $ 320 2 Overhead Projector $ 300 1 32 inch TV $ 500 1 DVDNCR $ 100 1 Multi Media Projector $ 600 Video Conferencing Equipment $ 2,500 Furniture $ 6,030 2 Instructor's desks $ 1,000 2 Instructor's chairs $ 350 1 Teaching podium/lectern $ 300 12 6 ft. Folding tables @ $125 per table $ 1,500 32 Student chairs @ $110 per four chairs $ 880 2 Large storage cabinets for supplies $ 1,500 1 AudioNisual Stand $500 TOTAL COST FOR HALE NANI PROGRAM BUILDING: SUPPLIES, EQUIPMENT & FURN ITURE $ 23,530 Page 1 39 Hui Malama Ola Na 'Oiwi West Hawaii Health Enhancement Hui Malama Ola Na 'Oiwi - Agencv Name West Hawaii Health Enhancement -Program Name Agency Director: Michelle Teuber Phone No.: 808-969-9220 Contact Person: Mailing Address Facility/Site Address: Fax No.: Email Address Kelsey Hiraishi Phone No.: 808-969-9220 69 Railroad Avenue Hilo, Hawaii 96720 69 Railroad Avenue Hilo, Hawaii 96720 808-961- 4794 michelle@huimalamahawaii.com Name of Accountant/CPA (include name of firm if applicable): Alex J. Smith CPA Phone No.: (877) 257-6484 Mailing Address: 1403 Frank Street, Honolulu, Hawaii 96816 Amount of Request for County Funds: Prior Year(s) Funding: 06-07 $ 00 07-08 $ 00 Agency Mission Statement: 08-09 $ 00 $75, 864 Hui Malama Ola Na `Oiwi is a 501 (c) 3, nonprofit organization, designated through the Native Hawaiian Health Care Improvement Act of 1988, Public Law 100-579, whose operations began in 1991. Our mission statement is "to provide health services and to enhance the quality of life among the Native Hawaiian community. Our vision is "We envision a healthy community, Native Hawaiians and their'ohana, where everyone achieves their full potential-spiritually, mentally and physically". Lt~ L( NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Hui Malama Ola Na 'Oiwi - /-~g@t1Cy Naf71@ West Hawaii Health Enhancement - PCOgI"alTl Na111@ Program Description: Hui Malama Ola Na ~Oiwi: Native Hawaiian Health Care System - Moku O Kcawe proposes to enhance health education services to Native hlawaiians and residents of West Hawaii. Current services provided by our Health Enhancement Progratn include - ouh~each, referrals and linkages to community resources, health risk appraisals, health insurance application assistance, home visits, health assessments, health screening, oral health referrals, emergency medical assistance, health monitoring, transportation services for medical reasons, and health education through the following programs: Hypertensiou/Stroke Prevention and EducationDiabetes Education and Mai Ka Mala'ai (`'from the garden"), Nutrition and Weight Management, Cancer Education including Prevention and Tobacco Cessation. Currently, our organization employs 38 permanent staff members at five locations, including Hilo, Pahoa, Kau, Waimea and Kona. Both our administrative and primary care headquarters are located at separate sites in Hilo town, from where activities are coordinated for each of the satellite clinics. We currently employ one Community Health Educator that travels to satellite clinics out of our Hilo headquarters. While residents within satellite sites are currently referred to clinics and physicians in the vicinity, we feel that West Hawaii (from Ocean View to Kohala to Waimea) needs a dedicated Community Health Educator to provide health care education. Currently, Outreach services have been the primary service delivery into West Hawaii. The Need: Hawaii County's population stood at 162,971 in 2004 with most of its residents living in the South Hilo, Puna, North Kona, and South Kohala districts. Most recent statistics from Hawaii County Research and Development July 2007 shows Hawaii County's population at 173,057. ~ During the period of 1999 to 2004 Hawaii County experienced population growth of 10.9 percent. The districts that saw the fastest population growth during this period were Puna, South Kohala, North Kohala, Kau, and North Kona.' Hui Malama's West Hawaii health enhancement team has a current caseload of 527 clients that receive health enhancement services. Approxitnately 36% of our client caseload in the West Hawaii district is comprised of adults age 50 and above. It is anticipated that funding of a West Hawaii Health Community Educator would increase our effectiveness to provide health education services to West Hawaii clients and communities. Currently, our West Hawaii Outreach staff refers clients who have health education needs in hypertension, diabetes, tobacco prevention/cessation, dietary/nutrition and cancer to West Hawaii Community Health Center, Hui Malama's East Hawaii Community Health Educator and other community resources available. However, the turn around time for clients referred to receive education services in hypertension, diabetes, tobacco and cancer often takes a few weeks and in many cases a few months. Hui Malama has one (1) Community Health Educator that tries to service the entire island and ~ Department of Research and Development, County of Hawaii Statistics November 2008. s Hawaii County Profile, Department of labor and Industrial relations, March 2006. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 with our client base of 1 100 island wide, we have limited capacity to provide community health classes' and one to one services to all. The Hawaii Health survey 2005 reports 28,759 Native Hawaiians, between the ages of 1 - 74, have hypertension. Native Hawaiians rate third of the ethnic groups with high incidences of hypertension. There were 405 cases of hypertension among our young children ages 0-14. There were 7,885 cases of Native Hawaiians between the ages of 55- 64. Studies show hypertension can increase the risk of strokes and heart attacks. Cun~ent statistics show that Native Hawaiian women have the highest incidence and mortality rates for breast cancer in Hawaii among the five major ethnic groups 3 American Cancer Society reports that approximately 100 women die from breast cancer each year. Breast cancer continues to be the most common cancer amoug women in Hawaii. Most female breast cancer incidence (more than 60%) occurs in women age 55 and older and the mortality rate for Native Hawaiian females is almost L2 times that of Caucasian females, and more than twice the mortality rate for Chinese, Japanese, and Filipino females in Hawaii. Research shows that survival is excellent when breast cancer is diagnosed at its earliest stage.4 In the area of obesity and diabetes, overweight/obesity ishighest in the Native Hawaiian population (Hawaii Health Survey 2000). Unhealthy lifestyle, often lead to chronic disease or debilitating health conditions that may end in premature death. The Native Hawaiian population rank second highest in number of Diabetes cases reported (Hawaii Health Survey 2005). Unmanaged diabetes leads to complications and even death. The Response: Hui Malama proposes to mirror East Hawaii staffing to include a designated West Hawaii Community Health Educator that will impact enhancement of health education services to Ocean View, South Kona, North Kona, Kohala, Waimea and Honoka'a. The benefits to our targeted West Hawaii client population would be an increase in health education pertinent to individual case by case needs and a team oriented support system for clients in improving their personal health milestones and learning to take the best possible avenues of self care to increase their quality of life. The Community Health Educator will also serve as a community resource for health education needed for other community based organizations. Hui Malama's Health Enhancement Education Programs to be organized, coordinated and implemented by the West Hawaii Community Educator includes the: E Malama Ka Pu~u Wai Program which is Hui Malama's Hypertension/Stroke Prevention Education Program: Classes are structured into 6 sessions per class. Curriculwn is designed to increase knowledge end identification of risk factors, prevention through awareness of signs and symptoms that can be hypertension/stroke related, effects of substance abuse, treatment through medication and use of vitamin supplements, behavioral changes that take place as a result of hypertension and strokes and the need for exercise and healthy nutrition and diet. Each session incorporates ~ 'Imi Hale Native Hawaiian Cancer Network, Native liawaiiau Cancer Fact Sheet, Patl 2004. Hawaii Cancer Facts and Figures 2003-2004. ACS NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-IO Page 3 nuWtion and the need for eating healthy with healthy foods provided as a modeling precedence for participants. Ho~okcle I Ke Ola Program which is Hui Malama's Cancer Navigation Program. The Ho'okele I Ke Ola Program provides support for diagnosed cancer clients as well as cancer prevention education. The program is designed to educate and navigate clients through the process as they deal with a diagnosed cancer. Navigation often encompass insurance issues, cost, understanding what "cancer' means, learning to cope with anxiety and tears, preventative practices that increases protective factors and connecting clients with services available to them. Health monitoring is completed during the program with regularly visits and a link to Primary Care services. Hui Malama also conducts our Ho~ola Hou Program that provides Tobacco Prevention and Cessation classes for clients. This 8 week program provides participants with preventative foundation with updated facts and statistics of the dangers of tobacco use, the factors that contribute to tobacco addiction and the increase of protective factors such as diet intake and exercise that keeps us healthy. Tobacco cessation in this program uses prevention strategies mentioned above p]us realistic daily routine activities such as active lifestyle, lots of fluid intake, deep breathing exercises, maintaining a positive attitude, taking walks and a variety of others. The delivery of this program is very culturally based with a major emphasis on the 1-lawaiian value and belief system. Hawaiian chants, proverbs and stories from ancient Hawaii is incorporated with the intention of increasing the value that participants place on their existence. Hui Malama will provide clinical screening of vitals (blood pressure, heart rate and weight) for health monitoring management. Obesity and Weight Management Education Program nrovides nutrition education, diet counseling and behavioral modification strategies and to assist clients in becoming physically active in order to prevent further weight gain and/or to lose weight. Making healthier food choices, cooking healthier, and planning healthier meals are important goals of the Weight Management Program. This program makes use of the State of 1-lawaii, Department of Health's Hele Mai Ai curriculwn. Hele Mai Ai is a comprehensive and culturally appropriate delivery curriculum with a variety of health modules designed to promote healthy lifestyles. Health monitoring provides the specific performance measures to assess the impact of this program. Mai Ka Mala ai Program provides an educational setting that will encourage clients to increase their knowledge about diabetes, it's risk factors and associated complications; to learn skills to manage their diabetes and to take action. This is a 10 week program that includes clinical screening (BMI, Blood sugar, cholesterol blood pressure, 3 day food intake and physical activity assessment). Monitoring participants in glucose levels, lifestyle adjustments, insulin and oral agents and establishing routine care schedules are important components in this program. Special presentations by other community health professionals are incorporated into class agendas and a system of refemng clients is an integral part of program function. Classes will also center on a 4 x 4 garden box that will provide food, physical activity, relaxation and a common focus from which class participants can share experiences about their lifelong condition. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Total Budget and Position Count Total Program Budget $75 847 Total Program Position Count 2 Total Agency Budget $2 419 518 Total Agency Position Count 38 Program Objectives: liui Malama Ola Na ~Oiwi Health Enhancement Program will complete the following objectives: Hypertension Education objectives will be to reduce the complications of hypertension of the Native Hawaiian Population. By June 30, 2010, Hui Malama's Community Health Educator will: 1. Enroll 24 (6/qtr) clients in Hypertension Program of which 80% will show an improvement in at least 3 of the following health areas: blood pressure; weight, waist measurement, diet and exercise. 2. Provide at least 5 community presentations in Hypertension Education. 3. Provide at least 100 blood pressure and cholesterol screening at events targeted at Native Hawaiians. Cancer Awareness Education objectives will be to reduce the rates of preventable cancer through effecting change in lifestyle behavior and provide support for diagnosed Cancer in Native Hawaiians. By June 30, 2010, Hui Malama's Commuuity Health Educator will: 1. Enroll 20 (5/Qtr) in the Cancer Awareness Education Program of which 90% of the enrolled women without mammogram will schedule an appointment and complete the mammography exam. 2. Coordinate and provide at least 3 community presentations in Cancer awareness. 3. Enroll 20 (5/Qtr) in the Ho'okele 1 I<e Ola Program of which 80% of participants will provide positive testimonial feedback on how this navigation program helped them. 4. Enroll 20 (5/Qtr) in the Ho~ola Hou Program of which 75% of the participants will not start smoking and/or quit. Obesity and Weight Management Education will reduce ovenvcight and obesity in Native Hawaiians through nutrition education and promotion of physical activity. By June 30, 2010, Hui Malama's Community Flealth Educator will: 1. Enroll 24 (6/qtr) overweight clients in weight management program of which 80% will show improvement in at least 3 of the following health areas: weight, waist measurement, diet and exercise 2. Provide 3 Helc Mai Ai classes in the year. Diabetes Self-Manasement Program-Community Screening and Education will reduce the chronic complications from diabetes to the Native Hawaiian population. By June 30, 2010, Hui Malama's Community Health Educator will: NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 1. Enroll at least 32 (8/qtr) clients with diabetes of which 75% of clients will show improvement in at least 3 of the following health areas: weight, blood sugar, HbAlc, blood pressure, cholesterol, diet and exercise. 2. Provide 5 community presentations on Diabetes Belt=management education. 3. Complete 100 glucose screenings in the community targeted at Native Hawaiians. Program Highlights: Hui Malama Ola Na 'Oiwi accomplished the following in fiscal year 2007-2008. Our Universal Data Report submitted to the Health Resources Services Administration (HRSA) is based on a calendar year. (January 1, 2008 -December 31, 2008) Hui Malama Ola Na 'Oiwi accomplished the following island wide. • Total clients served = l 103 • West Hawaii clients = 527 • Tota] client encounters or face to face direct service = 4700 • West Hawaii encounters = 1566 Hui Malama Health Enhancement Services Program completed 5553 total Health Fair and presentations encounters in the year 2008. Conununiq~ Education Progrwn data as retlected in the Perfonnancc Measures table for the year 2007-2008 are very low as our one (1) Community Health Educator (Located in East Hawaii) could only provide limited education services to clients in West Hawaii. This is the premise on which Hui Malama is advocating in this proposal a need for a designated West Hawaii Community Health Educator. Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget " Estimate Hypertension Education 1. Enroll 24 (6/qtr) West Hawaii N/A 2 24 clients in Hypertension Program. 2. 24 clients will complete the six N/A 2 24 (6) session of the Hypertension Education Program. 3. 75% of the clients completing N/A 2 18 the Hypertension Education Program will show an improvement in at least 3 of the following health areas: blood pressure, weight, waist measurement, diet and exercise. 4. Provide at least 5 West Hawaii N/A 2 5 community presentations in Hypertension/Stroke Prevention Education. NONPROFIT GRANT APPLICATION F[SCAL YEAR 2009-10 Page 6 5. Provide at least 100 blood N/A 100 100 pressures and cholesterol screening at events targeted at Native Hawaiians in West Hawaii.. Cancer Awareness Education 1. Enroll 20 (5/Qtr) West Hawaii N1A 0 18 women in the Cancer Awareness Education Program of which 90% of the enrolled women without mammogram will schedule an appointment and complete the mammogra by exam. 2. Coordinate and provide at least N/A 1 3 3 West Hawaii community presentations in Cancer awareness. 3. Enroll 20 (5/Qtr) Wcst Hawaii N/A 1 16 c]icnts in the Ho~okele I Ke Ola Program of which 80% of clients will provide positive testimonial feedback on how this navigation program helped them. 4. Emoll 20 (5/Qtr) West Hawaii N/A 2 15 clients in the Hobla Hou Program of which 75% of the participants will not start smoking and/or quit. Obesity and Weight Management Education 1. Enrol124 (6/qtr) West Hawaii N/A 2 18 overweight clients in Weight Management Program of which 75% will show improvement in at least 3 of the following health areas: weight, waist measurement, diet and exercise 2. Provide 3 Hele Mai Ai classes. N/A 0 3 classes in the year. Diabetes Self-Management Program- Community Screening and Education 1. Enroll at least 32 (8/qtr) West N/A 0 24 Hawaii clients with diabetes in the Mai Ka Mala`ai Program of NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 which 75% of clients will show improvement in at least 3 of the following health areas: weight, blood sugar, HbA 1 c, blood pressure, cholesterol, diet and exercise. 2. Provide 5 West Hawaii N/A 1 5 community presentations on Diabetes Self-Managcmeut Education. 3. Complete 100 glucose N/A 100 100 screenings in the community targeted at Native Hawaiians. *ff applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wages N/A N/A $63,407 Professional Fees N/A N/A 0 Operations N/A N/A $12,457 E uipment N/A N/A 0 Other" N/A N/A 0 Total N/A N/A $75, 864 ' If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-OS Actual * FY 2008-09 Budget * FY 2009-10 Estimate County Of Hawaii N/A N/A $75, 864 Total N/A N/A $75, 864 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 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? Hui Malama Ola Na'Oiwi will be looking initially at two avenues to increase revenues and/or the ability to sustain over a period of time. 1. Currently assessing the credentialing of health enhancement services positions such as Che Community Health Educator, Nutritionist and/or Dietician, Registered Nurse (RN) and Licensed Practical Nurse (LPN) and Certified Nurse Assistant (CAN) level program services and Cancer Navigator for capturing billed revenue. 2. Currently advocating for an increase in funding for FY 2010 - 201 1 from Health Resources Services Administration (HRSA). It is our intention to expand our current West Hawaii Services in our scope of delivery. Hui Malama will be increasing the West Hawaii collaboration with West Hawaii Community Health Center to enhance services needed in health education and outreach as well as participant accessibility to health center services. We believe HRSA will sec and agree that a Community Health Education component in West Hawaii is a viable service needed. 3. Hui Malama is currently exploring resource development plans with Papa Ola Lokahi to strengthen Native Hawaiian Health Care Systems ability to sustain our services provided through annual campaign, fimdraiscrs. seeking foundation and other grant opportunities as appropriate. In Summary, Hui Malama believes that our West Hawaii area of the island is in critical need for health enhancement services. Delivery through our current outreach services in this area has been excellent but there is a great need a Commmnity Health Education Program available to provide a more clinical education foundation for families and the community. We anticipate stabilizing this program in 2010-201 1. NONPROFIT GRANT APPLICATION FISCAL, YEAR 2009-10 Page 9 Hui Malama Ola Na ~Oiwi - Ag@nCy Na1712 West Hawaii Health Enhancement - PI'OgfaCn NaCT12 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 ayear-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 ~ency's future funding requests. ~ ~ ~~C ~----~4 January 30 2009 -- Signature ofBoar - -"" air Date i~ January 30 2009 Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION F[SCAL YEAR 2009-10 Page 10 40 The Island of Hawaii YMCA Impact: Youth Assets 2009-2010 The Island of Hawaii YMCA -Agency Name IMPACT: YOUTH ASSETS 2009 - 2010 -Program Name Agency Director: Wayne Kamitaki, Chief Volunteer Officer Phone No.: 895-6226 Contact Person: Bobby Stivers, Vice President of Phone No.: 935-3721 Operations/Executive Director Mailing Address: The Island of Hawaii YMC P.O. Box 7067 Kamuela, HI 96743 FacilitylSite Address: Hilo - Waiakea Settlement YMCA 300 W. Lanikaula St., Hilo, HI 96720 Kona -Kona Family YMCA O 75-7522 Hamana St. #1106 Kailua-Kona, HI 96740 Waimea -Waimea Family YMCA P.O. Box 2998 Fax No.: 887-1861 Email Address: ymca-stivers@hawaii.rr.com Name of AccountantlCPAArncF uuhara, AnfAc ountancly Corporation Phone No.: 961-5532 Mailing Address: 714 Kanoelehua Ave. P.O. Box 6691 Hilo, HI 96721 Amount of Request for County Funds: $65,000 O Prior Year(s) Funding: 06-07 07-08 08-09 $35,000 $50,000 $10,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 0 Agency Mission Statement: The mission statement of The Island of Hawaii YMCA is: Aloha Ke Akua - God is Love." To bring God's Love to children, adults and families of all races and faiths by putting Christian principles into practice through programs that build healthy spirit, mind and body for all. YMCA Core Values: We teach and demonstrate caring, respect, responsibility and honesty. YMCA Theme: We build strong kids, strong, families, strong communities. O O NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 O The Island of Hawaii YMCA -Agency Name IMPACT: YOUTH ASSETS 2009 - 2010 -Program Name Program Description: Recently, many local and national funders have charged youth-serving agencies to develop methods of evaluating their programs that document the positive benefits and impacts of program participation on youth. They want to ensure that the programs they support are making a difference in the lives of young people. _ _ . _ _.Young people need what everybody needs. In addition to food, shelter, and other basics, they need support, encouragement, positive relationships and skills, and opportunities. Research shows, however, that most young people aren't getting all of what they need in order to succeed in life. Many are engaged in school and learning; but lots aren't. Lots of young people have strong positive family relationships; some don't. A few know and are connected with several caring adults; more have no positive friendships with adult role models outside of their families. O The YMCA as early has 2000 embraced the Search Institute 40 Developmental Assets approach. The framework of developmental assets is grounded in extensive research on child and adolescent development, resiliency, health promotion, disease prevention and public health. Numerous researchers found that assets provide strength for children and youth. For instance, the more assets young people have, the more likely they will grow up to be caring, competent, responsible adults. The more assets young people have, the better their chances for contributing to society and finding a meaningful purpose in life. On average, young people with more assets: > Engage in fewer negative, high-risk behaviors, such as using drugs and alcohol or having premarital sex > Exhibit more positive behaviors, such as succeeding in school, assuming leadership roles and valuing diversity > Demonstrate resilience in the face of challenges, stresses and difficult situations. Youth development programs such as the YMCA are facing an unprecedented call for accountability -documentation of the effectiveness of their programs. Two kinds of evidence are available that demonstrate the role of youth development programs in the lives of young people, One is theoretical--it examines the role, content, and strategies of programs in promoting the healthy development of young people. Secondly, research has demonstrated that program participation has a positive impact on youth outcomes. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 O YMCA programs are tools used to develop the fullest potential of every young person. Programs are directed by trained, caring and nurturing adult role models. Impact of Recreation & Sports Programs. From soccer to softball to afterschool, recreational sports programs are some of the most common and popular programs for young people. Much of the research in these types of programs points to the positive nature of physical activity for health and well-being for youth of all ages. The benefits of different recreation programs vary widely, from getting involved in shared activities, to opportunities for skill deveeopment, to relationships with other adults as well as peers. Studies have demonstrated that involvement in sports increase self-esteem and success in school. __.. The Island of Hawaii YMCA has demonstrated for the past two (2) years results that show participation in YMCA programs does impact the lives of young people. The YMCA intentionally administered youth surveys to its summer program participants island wide. The surveys are collected from the three YMCA branches and are tabulated on the mainland and a comprehensive report is produced. O The report reflects what youth in YMCA programs have reported about their experiences in the YMCA program. The data in this report provides a means for learning how youth feel about their activities and understanding how well their experiences help them build assets they need for positive development that compares the Island of Hawaii responses with responses from young people in YMCAs across the county. The Island of Hawaii YMCA produces a comparison of selected assets that shows the National YMCA benchmarks against the surverys from Hilo, Kona and Waimea. The Island of Hawaii YMCA for 2009 - 2010 will continue building youth assets. The YMCA expects to serve over 2,400 children and youth through its recreation and sports programs. From Kona to Waimea to Hilo young people will participate and be invovled in the YMCA after school, intercession break (Fall, Spring, Winter), summer fun, teen and family programs. While recreation and sports in nature, these programs provide further development of leadership skills, relationship buidling, service to others and family strengthening. In addition, all YMCA programs incorporate YMCA Character Development that teach and demonstrate the core values of caring, respect, responsiiblity and honesty while providing opportunities to build positive assets through the 40 Developmental Assets approach. O As part of the ongoing efforts to build strong kids, strong families, and strong communities, the YMCA is committed to helping all adults get involved in supportive, healthy ways with young people. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 O Fdr'better`nr for worse; we ati make a difference. Working together, we can strive to give young people 100 percent of what they need. Total Budget and Position Count Total Program Budget 201,776 Total Pro ram Position Count 52 Total Agency Budget 2 230 788 ~ Totai Agency Posiiwi~ ..~..~~• ~ 72 Program Objectives: 1) 85% of responding parents in after school programs are satisfied with the program. 2) 90% of responding children in after school programs are satisfied with t e program. 3) 85% of responding children in after school agree/strongly agree that t ey are expected to try harder and do their best. 4) 85% of the responding children in after school agree/strongly agree that O there are clear rules about what they can and cannot do at the YMCA. 5) 85% of responding children in after school agree/strongly agree that YMCA activities have helped them get along with others. 6) 85% of responding children in summer day camp agree/strongly agree that YMCA activities help them feel successful in the activities they have been a part of. 6. 85% of responding children in summer day camp agree/strongly agree that YMCA activities help them learn how to be a leader. Program Highlights: 1) Accomplishments from 2007-08: 2) The YMCA served over 2,400 children and youth island wide. 3) Over 600 children participated in 9 month after school programs in Kona, Waimea and Hilo. 4) Over 500 children participated in YMCA summer programs. 5) YMCA administers surveys that can demonstrate the impact YMCA programs have on youth's participation in its programs. ~J 6) about themselves ~ompared toe93°/Mrespondents of YMCAs across9hed county. 7) 96% of youth respondents stated if I break one of the rules, I usually hear about it from YMCA staff compared to 88% respondents of YMCAs across NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 O the county.This indicates follow through from the Island of Hawaii staff with'youths'in oar~programs. O O NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 0 O O The Island of Hawaii YMCA -Agency Name IMPACT: YOUTH ASSETS 2009 - 2010 -Program Name *If applicable Program Expenditures and Wa ~ anal Fees Y 2007-08 Actual 135,011 Total 21 * If applicable "Please explain in detail on separate sheet 1,776 210 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 2008-09 FY 2009-10 ~d et * Estimate 114,704 120,C Performance Measures: f~ The island of Hawaii YMCA -Agency Name IMPACT: YOUTH ASSETS 2009 - 2010 -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-OS FY 2008-09 FY 2009-10 d et * Estimate * B u Actual United Wa 14,100 20,000 000 10,000 50 30,000 65,000 Count of Hawaii , 129 150,000 142 115,000 Pro ram Fees Indiviual Contributions , 13,575 21,777 804 201,777 219 210,OOi Total , *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? In this economic climate we are finding it very hard to increase revenue. Parents need our services more than ever, but are unable to pay. Our donors do not have the funds available to give at their previous level. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 TnP island of Hawaii YMCA -Agency Name IMPACT YOUTH ASSETS 2009 - 2010 -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. O 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 ayear-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 time)„r~~ am s ors- - aaency's future funding requests. i - 3D -~9 Dat----- Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Signature of Board President/Chair 6 ature xecutive Direc r Page 9 41 Ka Hale O Na Keiki Preschool Families-At-Risk Ka Hale O Na Keiki Preschool- Agency Name Families-At-Risk- Program Name Agency Director: A. Pualani Coburn Phone No.: 775- 9870 Contact Person: Pua Colburn Phone No.: 775-9870 Mailing Address: 45-3668 Honoka'a Waipio Rd. Honoka'a, HI 96727 Facility/Site Address: same Fax No.: 808-775-9870 Email Address: pualani_colburn@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Ho'olaea Andrade of Andrade Accounting Services Phone No.: 775-1319 Mailing Address: 46-1068 Kinimaka St. Honoka'a, HI 96727 Amount of Request for County Funds: $9500.00 Prior Year(s) Funding: 06-07 07-08 08-09 $5000.00 $4000.00 $3000.00 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page I 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. Above all, our children come first. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Ka Hale O Na Keiki Preschool -Agency Name Families-At-Risk- 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.We are currently the only preschool with a true year round calendar. This enables parents to accept positions in the food and beverage industry, hotel, or private companies servicing the tourist industry( butlers, private houskeeping, etc.) 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.O.'s, High School graduation rates, and success than their peers. 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. 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 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 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 even more limited due to the recent hit to.our economy. 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. I realize we have asked for more money this year than in previous years. This is because of the increased amount of "at-risk" families. We must extend the type of services offered and be available to provide a variety of counseling and refferal services. Total Budget and Position Count Total Pro ram Bud et 64000.00 Total Pro ram Position Count 6 Total A enc Bud et 263922.65 Total A enc Position Count 8 Program Objectives: 1) Make care and educational services available between the hours of 2:30 and 5:30 pm daily, to accommodate at-risk families and their children 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 5) Maintain a developmentally appropriate learning environment among all students, ensuring progress in social, emotional, cognitive, language, and physical development. 6) 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. 7) Increase the parenting skills, and understanding of the educational and developmental needs of children of the at-risk parents we serve. Program Highlights: 1) Remained open for the at-risk families until 5:30 pm daily, including during holiday breaks and Summer. 2) Remained open for the at-risk families until 5:30 pm while installing the new EPA required septic tank and playground renovations. 3) Provided a developmentally appropriate, high-quality childcare and educational facility to the working poor of the Hamakua Coast. 4) Provided fourjobs in our local community, in order to operate the Families-At-Risk Project. 5) Offered scholarship/tuition assistance to eighteen families using the Families-At-Risk Project, an increase by two from 2003-2004. 6) Succeeded in keeping our budget for the Project low and within reason, while being able to increase our services. 7) Referred two children, and their families, to special services counseling, to meet their special needs, as identified by our teaching staff. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Ka Hale O Na Keiki -Agency Name Families-At-Risk -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Enrollment 37 36 36 Children enrolled 2:30-5:30 Families-At-Risk pro~ect 29 30 31 Families receiving financial assistance from Ka Hale O Na Keiki for; Families-At-Risk 29 30 31 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wages 31500 34650 40500 Professional Fees 2450 2550 3800 Operations 8500 9100 12700 E ui ment 3500 4700 4200 Other" 2800 Total 45950 51000 64000 - it appucaoie "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 "Explain in detail on separate sheet of paper, other program expenditures." Typical upkeep of the facility, playground area, parking lot, accessible ramps, and more are currently in need of repair. These are required not only for our State license and national reaccreditation, but for the beauty and aesthetics essential for these rural children to learn in. Our chain link fence is in need of strengthening and tying of loosened links. The paint is beginning to chip on the interior kitchen walls and the exterior entrance of our building. Previous allotted funds were spent on the newly installed septic tank and a beautiful playground structure (Mahalo to the previous County Councilmen and women). We are now ready to return the focus back to the existing school building. There is a large crack in the children's cemented bike path. This crack may be too large to repair so removal and replacement may be our only option. We have written several grants for these specific projects however the Families-At-Risk Program is dependent on this facility as well as the licensure and the accreditation of the school which enables us to provide a higher percentage scholarship. We have recently received several in-kind commitments for labor in addition to a few monetary donations specifically intended for the repair of the fence, and part of the paint and supplies needed. We have submitted and are awaiting confirmation from several granting agencies. We have broadened our reach when searching for grants this fiscal year. We will be committing $2800.00 from the Families-At-Risk Project to the repair of the bike path as this bilateral movement is a prerequisite of reading and writing and fundamental in increasing the children's dexterity and stamina. We will also be spending this money on the fence repair to ensure safe outdoor play while adhering to the minimum requirement for teacher-student ratio. Our community supports us in various ways. We depend on their kindness and generosity. Even in this time of economic turbulence, we were able to solicit 3 thousand dollars from our community members. This is proof they believe in our positive impact on the youngest community members. Ka Hale O Na Keiki Preschool -Agency Name Families-At-Risk -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Payment from families for Families- At Risk Pro ram 16800 13020 11160 Donations/Fundraisers 500 1780 4340 Count of Hawaii rant 7800 5000 9500 Youn Bros. rant 1000 0 1000 Friends of Hawaii Charities 1500 1700 2000 Wilcox Foundation 1000 2000 6000 Frear Trust 1500 0 0 Mclnern 0 7500 8000 Healin our Island 0 0 2000 State of Hawaii Poverty ECE Pro ram 10000 15000 0 Day program payment from families' portion allocated to Families-At-Risk ro~ect 4350 3000 9000 Hard Foundation 1500 2000 1000 OHA-CBED 0 0 10000 Total 45950 51000 64000 `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? Ninety percent of our parents pay little, or nothing additional per month for their child's tuition as we keep our monthly rates low enough so State Supplement payments cover the monthly tuition fees. When charging our families even $50 per month more could mean taking food off these families' tables, we simply must look for other avenues of revenue, other than simply increasing monthly tuition rates to our families. The state average cost, per child, for a child to attend a quality ECE program is $8900 per year. Yet, we strive to keep our annual budget affordable, with our average cost, per child, being budgeted at only about $7300 per year, and even less in the past. And, this budget of ours includes sending our teachers back to NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 college for further training and education, to make them better teachers and caregivers. With our being a Nationallly Accredited preschool, not only this National standing insures that we are providing the best quality care and education to our children, but also our parents can receive higher State Supplement payments, as the reimbursement rates are higher for Accredited schools. Being Accredited has proven costly to our school, as, for example, we needed to renovate our playground to bring it up to National safety standards, as well help our teachers increase their educational resumes, also an Accreditation requirement. Our past budgets have taken funds away from our Day Program in order to help support the Families-At-Risk afternoon program, putting our entire operation at risk. This practice simply cannot continue. We are doing everything possible to obtaih outside funds to support this critical Families-At-Risk Project. The unexpected and retroactive loss of the receipt of State funding for preschools serving poverty familes in June 2008 was devistating to our financial plans. We have applied for funding for next fiscal year from the Wilcox Foundation, the Mclnerny Foundation, and OHA, and are optimistic that these foundations will provide much-needed funds to help our entire program, including our Families- At-Risk Project. Our family and community volunteers work tirelessly to provide costly services for free. Our Annual Fund solicitation for 2008 trippled. Our highly trained and educated teaching staff continues to work for poverty wages, to help balance our budget while continuing to keep our Families-At-Risk Project, and our entire school, available to the families of our community. We have cut back teacher's hours, reduced benefits to staff, and have made even more sacrifices on the fiscal budget. We are cutting back or eliminating the purchase of class materials, office and paper supplies, and even cleaning fluids in order to continue providing a safe place for these children to be and learn. With optimism, and with our Federal government's apparent renewed interest in providing funds for Early Childhood Education, we hope to be financially solvent and without need for continued County funds within the next five years. Our program is one that we were told "could not be done", as our isolated community could not provide the qualified teaching staff to run such a program, and that our community did not have the economic base to afford such a program. But, the need was there, and we did it. We just need the County's continued support for a few more years; that's all we ask. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 Ka Hale O Na Keiki Preschool -Agency Name Families-At-Risk -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 tosubmit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of your program's or agency's future funding requests 9~~A~.t.~:x.~ti-tvJ I't'l~ I -~3-oq Signature of Board President/Chair Date Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 42 KalauonaoneoPuna 2nd Annual Kalapana Cultural Day KalauonaoneoPuna- Agency Name 2"° Annual Kalapana Cultural Day- Program Name Agency Director: Leroy Dikito Phone No.: 965-9001 Contact Person: Maile Moulds-Carr Phone No.: 965- 1976 Mailing Address: Facility/Site Address: Fax No.: Email Address: 12-2475 Kikala Loop Pahoa, HI 96778 12-2475 Kikala Loop Pahoa, HI 96778 alexandkaui@yahoo.com Name of AccountantlCPA (include name of firm if applicable): Nancy J. Kramer Phone No.: 965-2729 Mailing Address: 14-2662 Pahoa Village Road, #306, Pahoa, HI 96778 Amount of Request for County Funds: $10,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $ $ $7,000.00 Agency Mission Statement: The mission of KalauonaoneoPuna is to preserve the lifestyle that was unique to the 'ohana of Kalapana, the families of Kalapana.. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 KalauonaoneoPuna -Agency Name Annual Cultural Day- Program Name Program Description: The 2nd Annual Cultural Day of Kalapana is scheduled for Saturday, the 22"d of August, 2009. Like it's previous cultural day, it will feature interactive craft demonstrations, all day entertainment, and food and craft vendor booths. This year's theme is "Na 'Ohana", the families, and will feature an interactive display of the families in Kalapana in the early part of the 20~' century. Total Budget and Position Count Total Program Budget $10,500 Total Program Position Count 5 Total A enc Bud et $10,500 Total Agency Position Count 5 Program Objectives: 1) To attract 'ohana back to Kalapana to share their knowledge, experiences, and talents. 2) To familiarize kamai aina (residents) and malihini (newcomers) with the Hawaiian life style and the importance placed on family ties.. Program Highlights: 1) The event will be held on Apo Street, a short deadend street in the Keokea segment of the Kikala-Keokea subdivision that was established by the State of Hawaii Act 314, passed in 1991, to rebuild the Hawaiian community of Kalapana. 2) The event is scheduled for Saturday, the 22nd of August, 2009 from 10:00 AM to 3:00 PM. 3) The first tent will feature an interactive display of the families in residency in Kalapana in the early 1900's. The descendants that are known will be filled in and as'ohana arrive, they can fill in their part of the family trees. 4) The next tent will feature interactive craft activities such as coconut weaving, lei making, and canoe building, etc. 5) The following tents will have craft and art vendors, followed by tents for food vendors, and finally tents for the attendees to sit, visit, eat and enjoy the entertainment that will feature Kalapana 'ohana. 6) NONPROFTT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 NONPROFTT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 KalauonaoneoPuna Name 2"° Annual Kalapana Cultural Day -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Budget " Estimate Attendance-500+ $7,209.64 $10,500.00 "If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Salaries and Wa es Professional Fees Operations $3,660.64 $5,500.00 E ui ment $3,549.00 $5,000.00 Other" Total $7,209.64 $10,500.00 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 KalauonaoneoPuna -Agency Name 2"° Annual Kalapana Cultural Day -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 FY 2008-09 FY 2009-10 Actual' Budgets Estimate Count of Hawaii-R & D De t. $7,000.00 $10,000.00 KalauonaoneoPuna $209.64 $500.00 Total $7,209.64 $10,500.00 "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? We need to begin work on establishing our Hawaiian Cultural Center as a year long concern to be able to raise enough funds to hold our cultural days without outside financing. We are continuing to work with the State of Hawaii and the Department of Land and Natural Resources to that end. We have completed a financial study and have preliminary drawings for the proposed site. So far we have been stymied by the Department of Land and Natural Resources in the awarding of the lease on the site. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 KalauonaoneoPuna -Agency Name Annual Kalapana Cultural Day -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 Nonprofd 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. 1 (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 yearend report to the Legislative auditor within 60 days after June 30 of the fiscal near. 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 Gam`„~' ,--~..'- Signat~re °Bo`~rd Pr ident/Chair Signature of Executive Director l ~ ~~ ~ ~~' Date /~-~5 - ~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 43 Kapi'olani Medical Center for Women & Children Kapio'lani Child Protection Center -West Hawaii Title IV-B-West Hli Counseling & Supportive Living Project 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: Dr. Steven Choy -KCPC Director Dr. Franco Acquaro -Clinical Manager-KCPC Big Island 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 - 26`h 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@kapiolani.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: 06-07 07-08 08-09 $5,000 $10,000 $0 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 Agency Mission Statement: The mission of the Kapi'olani Child Protection Center is to protect children and strengthen families. 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. 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 continued this service in FY07-08. We have now expanded to help train, consult and provide technical assistance to additional therapists in East Hawaii. Unfortunately, due to an error in communication between our Big Island and Oahu offices, we delayed in getting our Year End County Report in on a timely manner for FY 07-08. And, although the County had just graciously increased our funding from $5,000 (FY 06-07) to $10,000 (FY 07-08), it meant that we were disqualified from receiving County funding in FY 08-09. Instead of keeping our County supported services at the same level or even increasing them, we instead NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 had to reduce the total number of services to our clients. We inquired if we could again be considered for County funding in FY 09-10 and were encouraged to re- apply. In short, we hope that the County will see fit to generously support our program at the funding level we last received in FY 07-08, which was $10,000. It will allow us to make this invaluable service available to the increasing numbers of families we anticipate in FY 09-10 provided KCPC receives adequate funding from the Hawaii County Grant, and HIUW. As the financial hardship facing our country, and particularly our island, continue to increase, it is essential that the creative and successful human services program we offer, be continued and even expanded. We have also hired a Clinical Manager on the Big Island to directly oversee implementation of the services, and who can track reporting activities so that important deadlines for reporting outcomes are adhered to. About 10 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 19 mentor-mentee pairs. KCPC has formalized its mentor training program and initiated replication of this, program for foster youth on the Big Island in FY 07-08. We now have 5mentor-mentee pairs in our Big Island program, and the interest level continues to grow. We will continue to provide and expand this service if there is adequate funding from the Hawaii County Grant, and HIUW. In FY07-08, KCPC began 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 service will continue to be available provided there is adequate funding from the Hawaii County Grant and HIUW. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 Total Budget and Position Count Total Pro ram Bud et $375,000 Total Pro ram Position Count 4.5 Total A enc Bud et $2,526,523 Total A enc Position Count 20 '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 FY2008 the following performance measures were obtained: 1) Provided services to 139 families, 213 adults and 291 children. 2) Received Permanency Planning Assistance - 3 families. 3) Completed all services - 62% of individuals served. 4) Reduced CA/N risks - 89% 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 2009-10 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 Performance Measures: FY 2006-07 FY 2007-08 FY 2008-09 Actual * Actual * Goal Individuals Com letin Service Plan $0% 80% 80% Individuals completing service plan who have established and implemented a 95% 95% 95% child safet lan at closure. Families completing Service Plan who have no new confirmed report of child abuse or 90% 90% 90% ne lect at 6-month follow-u Families completing Service Plan who have no new confirmed report of child abuse or 90% 90% 90% ne lect at 1 ear follow-u Families participating in the Parent-Child Interaction Therapy will achieve CDI N/A 75% 75% relational skill maste Mentor-Mentee Pairs Trained and participated in Recreational/Service N/A 90%. 90% activities: *If applicable a NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 Prooram Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 268,492 268,492 268,492 Professional Fees 0 erations 109,508 109,508 109,508 E ui ment 0 3,000 0 Other Indirect Cost 16,000 16,000 16,000 Total 394,000 394,000 394,000 Prooram Funding Sources Revenue Source FY 2007-08 Actual* FY 2008-09 Bud et* FY 2009-10 Estimate Title IV-B Federal Grant $360,000 $360,000 $360.000 HIUW $5,000 $5,000 $5.000 Charit Walk $3,000 $3,000 $3.000 HI Count Grant $10,000 $0 $10.000 KMCWC Matchin Indirect Write-off 16,000 16.000 Total $394,000 $384,000 $394,000 n a~pucdoie 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 needed to fund other KCPC West Hawaii Programs that did not receive full funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 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, 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 Chapfer 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-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 27 ~ Steven J. Choy; ?Dh. Date KCPC Dir~ctor'~ ~ ,~ ~~~~ ~ ~~ \~~. pt 2~~ Fra`hco Acquaro, Ppi.D. Clinical Manager-KCPC Big Island Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 44 Ke Anuenue Area Health Education Center E Ninau Aku I Ke Kauka Ke Anuenue Area Health Education Center- Agency Name E Ninau Aku I Ke Kauka- Program Name Agency Director: Nicole Moore Phone No.: 808.935.8658 Contact Person: Nicole Moore Phone No.: 808.935.8658 Mailing Address: 1028 Kino`ole St., #101 Hilo, HI 96720 Facility/Site Address: 1028 Kino'ole St., #101 Hilo, HI 96720 Fax No.: 808.933.1890 Email Address: nicole@keanuenue.org Name of Accountant/CPA (include name of firm if applicable): N/A Phone No.: Mailing Address: Amount of Request for County Funds: $4,944.32 Prior Year(s) Funding: 06-07 07-08 08-09 $195,000 $110,000 $107,000 Agency Mission Statement: Ke Anuenue Area Health Education Center's mission is to improve the health of the underserved through education. We provide health education classes using video teleconference technology to communities across the County of Hawaii with particular focus on rural areas. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Ke Anuenue Area Health Education Center -Agency Name E Ninau Aku I Ke Kauka- Program Name Program Description: E Ninau Aku I Ke Kauka, Ask-A-Healer, is a community health education program that is community driven in that the subjects covered are topics requested by the attendees. Topics from previous classes have included Diabetes 101, Menopause, Heart Health, Eye Care for the Aging Eye, Alzheimer's Disease, and many others. Using video teleconference technology we are able to broadcast these classes to community learning centers in Pahala, Kamuela, and Kohala. In the upcoming year we will be seeking to expand to sites in Puna and Kona. One of the goals of E Ninau Aku 1 Ke Kauka (ENAIKK) is to give participants the tools to participate in their own health care. So many times we hear about people who go to the doctor, get medication, and go home without knowing what the medicine is for, when they are supposed to take it, and if it will interact with medications that they may be taking for a chronic illness. Another goal is to provide a safe environment for the dissemination of health information. Every culture has certain taboos regarding their bodies. It is, therefore, sometimes very difficult to discuss this subject. It is also difficult to discuss such topics if there is a mixed gender group. We strive to provide a comfortable environment which is conducive to open discussions. We strive to remove any judgment of the subject, the participant, or the speaker. Total Budget and Position Count Total Pro ram Bud et 13,168.64 Total Pro ram Position Count 1 Total Agenc Bud et 107,000 Total Agency Position Count 3 Program Objectives: 1) Provide a nutrition and healthy cooking class on the second Thursday of every month. Nutrition curriculum will include how to read labels, carbohydrate counting and portion control throughout the year. The healthy cooking class will feature local chefs from Hawaii County and Maui County. 2) Facilitate various health education classes on the fourth Thursday of every month. These topics will include Diabetes Prevention, Healthy Heart education, Eye Care for the Aging Eye, Asthma 101, and several others to be determined during the year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Ke Anuenue Area Health Education Center -Agency Name E Ninau Aku I Ke Kauka -Program Name Program Highlights: 1) Installation of video teleconference equipment at Kohala Intergenerational Center (KIC) which allows the Kohala community to participate in ENAIKK. 2) Use of the video teleconference equipment to allow healthy cooking challenge for teenagers across the state. The students had to research what a "healthy" recipe was, find one that they could prepare on a budget of $25 to feed at least four people, and they had to produce a food label that listed the calories, carbohydrates, sodium, and fat content of their dishes. Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 1,600.00 1,600.00 2,000.00 Professional Fees 3,000.00 1,500.00 1,500.00 O erations 1,624.32 1,624.32 3,248.64 E ui ment 6,000.00 Other" 200.00 450.00 500.00 Total 6,434.32 4,934.32 13,168.64 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Ke Anuenue Area Health Education Center -Agency Name E Ninau Aku I Ke Kauka -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual " FY 2008-09 Budget * FY 2009-10 Estimate Area Health Education Grant 3224.32 3224.32 6224.32 HMSA Foundation 210.00 In-Kind/Donations 3000.00 1710.00 200.00 Total 6434.32 4934.32 8224.32 "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 are currently seeking partners that have the same goal of providing health education to community members that may be interested in co-sponsoring E Ninau Aku I Ke Kauka. We intend to submit grants to the Cooke Foundation and HMSA Foundation. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Ke Anuenue Area Health Education Center - Agenc Name E Ninau Aku I Ke Kauka -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 ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of your program's or agency's future funding requests. ignature of Board President/Chair ~~~ ~~ ~~ Signature of Executive Director ao a oaq ate ~~ ~j0 2e~`1 Dat UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 45 Keaukaha One Youth Development Youth Development Keaukaha One Youth Development -Agency Name Youth Development -Program Name Agency Director: Mike Divinski Phone No.: 935-5866 Contact Person: Mike Divinski Phone No.: 935-5866 Mailing Address: 101 Aupuni Street, Suite 124 Hilo, Hawaii 96720 Facility/Site Address: Bayfront Hilo, Hawaii Fax No.: 935-3945 Email Address: HiloMichael@aol.com Name of AccountantlCPA (include name of firm if applicable): Brian M. Iwata - Taketa, Iwata & Hara Phone No.: 935-5404 Mailing Address: 101 Aupuni Street, Suite 139, Hilo, Hawaii 96720 Amount of Request for County Funds: Prior Year(s) Funding: 06-07 07-08 08-09 $0 $10,000.00 $10,000.00 Agency Mission Statement: See following page: $10,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page I General scope of the Public Charity Activities for Keaukaha One Youth Development is the 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 2009-10 Page 2 KEAUHAKA 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 relating to ocean activities. Total Budget and Position Count Total Pro ram Bud et $10,000.00 Total Pro ram Position Count 0 Total A enc Bud et $10,000.00 Total A enc Position Count 0 Program Objectives: 1) The program (a) stresses physical fitness; (b) provides instructional use and maintenance of canoes; (c) strives for perfection of swimming skills; (d) provides training in physical fitness at Keaukaha Gym; and (e) provides the use of Hawaiian canoes and volunteer coaching to minor children. The charity strives to coordinate these activities with local schools. Program Highlights: 1) Highlights for the 2008-2009 season include the fabrication and delivery of the one-man trailer and the purchase of cross-training equipment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 KEAUKAHA ONE YOUTH DEVELOPMENT -Agency Name Youth Development -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate See above. $10,000 $10,000 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es Professional Fees 0 erations E ui ment $10,000.00 $10,000.00 #$10,000.00 Other" Total $10,000.00 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 KEAUKAHA ONE YOUTH DEVELOPMENT -Agency Name Youth Development -Program Name Pro ram Ex enditures E ui ment Exercise E ui ment $1,500.00 Su lies for otable water 500.00 Su lies for travel 1,000.00 Paddlin E ui ment 1,000.00 Uniforms 2,500.00 Escort Boat E ui ment 1,000.00 Office Su lies 2,500.00 $10,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4A 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 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Count of Hawaii $10,000.00 $10,000.00 $10,000.00 Total $10,000.00 $10,000.00 $10,000.00 *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 continues to rely on contributions from the public and private sector in conjunction with fund-raising activities. We strive for community support to spread the word of the accomplishments of the youth, to garner interest from the community at large and benefactors to subsidize our cause of cultural development and physical well being. Our aspiration is to become aself- sustaining program. Note: Keaukaha One completed its performance of its $30,000 cultural grant to educate young local paddlers abot the historic design and construction of koa racing canoes. This grant was administered through the County of Hawaii Prosecutor's Office and was completed in late June 2008. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 Hawaii, I (we) understand and will comply with the requirement to submit ayear-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 aaency's future funding requests. ~` ~~ Signature of Board President/Chair Date ~~~ ~-aS^ Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! 09 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 46 Kokua Counseling Services Affordable Counseling -Operations Affordab'le' Counseling -Operations -Program Name Agency Director: Pat Merrill Phone No.: 935-0222 (office) Contact Name: Jerry or Pat Merrill Phone No.: 934-0940 (home) Mailing Address: P. O. Box 10397 Hilo. HI 96721 Facility/Site Address: 243 Ululani Street Hilo, HI 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, Hara & Associates, LLC Phone No.: 935-5405 Mailing Address: 101 Aupuni St., Suite 139, Hilo, HI 96720 Amount of Request for County Funds: $10,000 Prior Year(s) Funding: 06-07 07-08 08-09 00.00 $10,000 $20,000 (two programs, $10,000 each) Agency Mission Statement Kokua's primary mission is to provide confidential therapy and counseling services, which are respectful and affordable; to a broad demographic of individuals, couples and families and; to offer educational programs designed to foster positive and enriching relationships that improve the quality of life by assisting individuals in reaching their own personal mental health goals.. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 1 Affordable; Counseling -Operations Program Description: gency Name - Program Name 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 4he~ 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. In its first year of operation (January 1 -December 31, 2006), KCS saw 42 clients in 210 sessions. In its second year of operation (January 1 -December 31, 2007), those numbers had increased to 74 cliehts in 461 dlinical sessions. In its third year of operation (January 1 - December 31, 2008) KCS served 100 clients in 774 sessions. This dramatic rise confirms the need for affordable,, professional counseling services to residents of East Hawaii. This increase in the number of clients served. required a move to a larger facility in order to accommodate three therapists. All clients ore currently served at the KCS office located at 342 Ululani Street in Hilo. Hawaii County has, some of the highest levels of social, health, economic and family problems in the State. according to the 2005 Aloha United Way report'. These highlights are indicators providing an insight into the socio-economic environment affecting the lives and mental health of individuals. With the current downturn of the economy and deep cuts in public funding the situation has worsened for a large segment of the population. KCS expects to expand its services to serve a minimum of 120 clients in 2009. Many of the services provided in East Hawaii focus on specific issues such as substance abuse, serious mental illness, child development, job readiness and employment, housing etc. or are only open to specific faith groups. However, there are very few opportunities for persons in need of• cdunseling and psychotherapy, regardless of their faith or financial abilities, to turn to. Kokua Counseling Services is the only non-profit organization in East Hawaii respohding tothis need by providing affordable professional services with its group of certified counselors and psychotherapists. KCS counseling costs are much lower than other for-profit providers,ard a client assistance fund and a sliding fee structure help even the lowest income groups to be able to access services. All clients served by KCS are eligible for the KCS Client Assistance Furid which provides a financial subsidy of all or a portion of counseling fees. Thislenables KCS to provide services to anyone in need, even if the client has no health insurance or is underinsured. Total Budget and Position Count: Total Program Budget $136,586 Total Program Position 4 Count Total Agency Budget $136,586 Total Agency Position 4 Count It is KCS' goal to expand its services and to provide counseling and psychotherapy to 120 clients in approximately 600 sessions in 2009. The following are KCS' 2009 program objectives: ' Aloha United Way Report 2005: Quality of Life in Hawaii - htto'//uhfamily hawaii edu/publications/brochures/QualityOfLifeinHawaii2005 pdf NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 2 - Aaencv Name Affordab'le' Counseling -Operations -Program Name 1. Hire afull-time Executive Director to work with the Board of Directors to implement the agency's goals anii objectives, 2. Develop and implement the 2008 fund development and marketing plan to reach self- sustainability,including donor development and cultivation, special event, public relations activities etc., 3. Increase the Client Assistance Fund to be able to serve at least 45 low-income, uninsured or underinsured persons, 4. Continue to develop and expand KCS, Inc.'s cooperative peer mental health organization relationships and network to benefit the community, 5. Explore opportunities to implement a 3-Year Strategic Plan commencing in 2009 to include controlled-expansion of the KCS service area to include two (2) additional satellite facilities to serve the communities of the Puna and Kau Districts, 6. Work with new referral sources to reach out to additional populations and put necessary prdcedures in place, i.e. Department of Labor - ex-offenders, Hawaii National Guard -veterans and their families. 7. Track 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 br2-and post- counseling surveys to assess the ability of clients to function well vl~ithin his/her family and community. Program Highlights: 1) The expansion inknumbers of clients served and the establishment of a Puna office and possibly a Kauirepresentation will make KCS' services more accessible to a greater population closer~to where they live. Since transportation is a major concern of those residing in outlying areas; it is anticipated that individuals in need will be more likely to seek counseling services: The need for such services is indicated by the fact that the Puna District ranks the lowest of any district in Hawaii County on nearly all economic and social indicators. 2) The present three-clinician staff of KCS location fills the present location. A continuing increase in the number of clients will require a move to a larger facility. 3) The hiring of a:full-time Executive Director will provide KCS with the management capacity to promote and coordinate the organization's efforts, including the qualification process for Medicare/Medicaid reimbursements, daily operations and the implementation of the organization's fund'developmentand marketing plan. Currently many of these operational functions are coordinated by the board of directors. 4) The successful and continued implementation of the organization's fund development and marketing plan will provide additional funding for the agency, further supporting expansion and growth. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 3 Affordable Counseling -Operations -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual* Budget* Estimate* 1 /1 /-12/31 /08 1 /1 /-12!31 /09 1 /1 /-12/31 /10 Total No. of KCS 100 110 120 clients Total No. of 774 800 min. 900 sessions No. of KCS clients and No. of sessions 22clients 25 clients 30 clients partially or fully 158 sessions 175 sessions 210 sessions supported by the Client Assistance Fund No. of KCS clients and No. of sessions 71 clients 75 clients 70 clients fully covered by 533 sessions 562 sessions 592 sessions insurance reimbursements No. of KCS clients and No. of sessions 7 clients 9 clients 13 clients who paid fully out of 21 sessions 45 sessions 65 sessions ocket No. of KCS clients Track demographic information who reside in 53 clients 50 clients about KCS clients to include districts other than district of residency Hilo No. of KCS Clients KCS is currently in negotiations with who reside in the 38 clients (35%) 68 other agencies to partner on sharing Puna District Lower Puna: 30 office space in Pahoa. It is expected Upper Puna: 8 for 2010 to serve approximately 75 clients in the Puna area. No. of KCS clients 2 After opening a Pahoa location, KCS who reside in Kau 0 will field the options for a Kau District presence. As resources in Kau are very scarce, it is to be expected, that there will be a very positive response to the availabilit of services. Pre- and post- Administer pre- and post- counseling counseling surveys 100 100 surveys to assess the ability of (all clients) clients to function well within his/her Tamil and communit No. of sessions at 774 785 the Hilo office No. of sessions at a 0 Availability of marriage & family satellite office therapist at a Puna office where personal and family counseling sessions are conducted 'Budget year is January 1 -December 31 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 4 Counseling -Operations -Program Name Program Expenditures: FY 2007-08 Actual* 1 /1 /-12131 /08 FY 2008-09 Budget* 1 /1 /-12/31 /09 FY 2009-10 Estimate* 1 /1 /-12/31110 Salaries and Wages $51,382 $52,000.00 $56,000.00 Professional Fees $10,540.00 $2,000 $3,500.00 O erations $27,431.00 $46,980.00 $62,000.00 E ui ment $1,420.00 $0.00 $1,500.00 Other# $633.00 $2,520.00 $1,000.00 Total $91,406 $103,500.00 $124,00000 *Budget year is January 1-December 31 #Please explain in detail on separate sheet Note: 'KCS counselors are contract (not salaried) clinicians; accordingly, client services are shown as "Operations" expenditures ($60, 000). Contract fees for counselors are covered by insurance payments, client out-of-pocket payments and the Client Assistance Fund. Note: z OtherExpenditures include: Travel expenses (mileage, airfare, per diem, rental car) ($1,520) and professional development and training expenses ($1,000). Program Funding Sources: identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* 1 /1 /-12/31 /08 FY 2008-09 Budget* 1 /1 /-12/31 /09 FY 2009-10 Estimate* 1 /1 /-12!31 /10 Foundation Grants $30,000.00 $40,000.00 $42,000.00 Count of Hawaii $20,000.00 $20,000.00 $20,000.00 Client out-of-pocket pa ments $3,100/00 $3,500.00 $2,500.00 Donations $7,760.00 $2,300.00 $15,000.00 Insurance Reimbursement $37,241.00 $40,000.00 $45,000.00 Total $98,101.00 $105,800.00 $124,500.00 *Budget year is January 2 -December 31 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 its first year of opehation KCS successfully applied for inclusion in the Compassion Capital Fellows Program (CGFP) jointly administered by the UH Manoa Center on the Family, Hawaii Community Foundation and Hawaii Islands Ministries. Through the CCFP, KCS received NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 5 a Counseli Affordable Counseling -Operations -Program Name two organizational "capacity-building" grants totaling $30,000. These grants provided aone- yeartraining programfor 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 th'e KCS operating budget or Client Assistance Fund. The second CCFP;grant enabled KCS to contract with a Big Island-based consultant who expanded on the work done by Solid Concepts. In 2008, KCS implemented its fund development/marketing plan to generate income streams from public and corporate donations, foundatiori grants, and special events. A percentage of any income received is being placed in the Client Assistahce Fund. Award of a County human services grant will provide critical funding in support of our services to low-income citizens in East Hawaii while we undertake these steps to become self-sustaining. In 2008 KCS was able to raise $7,760 in donations in and $b`6,863 in grants in total income. Of that, $14,255 went into the Client Assistance Fund. Unless action is taken at the federal or state level, there will continue to be residents of Hawaii County who do not have any health insurance or have very limited mental health coverage. Therefore; viewed as a separate entity, the Client Assistance Fund will likely never be self-sustaining. KCS is, however, working toward the establishment of an Operational Endowment Fund which will ensure ongoing revenue for the overall function of the agency. For 2009 KCS expects to continue its work on building its donor data base and expanding its circle of donors overall, as marketing and fund development efforts are refined and increased. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 - Aaencv Name Affordable' Counseling -Operations -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, Section 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 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 ayear-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 accouhfi,ng 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 requests. ~' ~ Z Sign re q Board reasurer D to Signature of Executive Director D to NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 7 47 Kokua Counseling Services Client Assistance Fund Kokua Counseling Services -Agency Name Client Assistance Fund -Program Name Agency Director: Pat Merrill Phone No.: 935-0222 (office) Contact Name: Jerry or Pat Merrill Phone No.: 934-0940 (home) Mailing Address: P. O. Box 10397 Hilo, HI 96721 Facility/Site Address: 243 Ululani Street Hilo, HI 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, Hara & Associates, LLC Phone No.: 935-5405 Mailing Address: 101 Aupuni St., Suite 139, Hilo, HI 96720 Amount of Request for County Funds: $10,000 Prior Year(s) Funding: 06-07 07-08 08-09 00.00 $10,000 $20,000 (two programs, $10,000 each) Agency Mission Statement: Kokua's primary mission is to provide confidential therapy and counseling services respectful and affordable; to a broad demographic range of individuals, couples and families and; to offer educational programs designed to foster positive and enriching relationships that improve the quality of life by assisting individuals in reaching their own personal mental health goals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 1 Assistance Fund - Program Descrip Kokua Counseling education for East family and marriag substance abuse,' management. Ouc wisdom of religidu: of body, mind, and of clients. The Client Assi: to individuals, cc insurance; and/c Counseling Sen clients in need v -two clinical soy National Associ< Family Therapy, 30-40% of all clip Program Name Services provides affordable professional counseling, therapy and iawau residents who face difficult life situations including conflicts in life, employment and job dissatisfaction, depression, anxiety, nancial :distress, loss and grief, major life decisions and anger services integrate the insights from behavioral sciences with the traditions to understand and work with persons seeking wholeness >pirit. All services are sensitive to the particular beliefs and cultures ce Fund provides subsidized low-cost or no-cost counseling services les and families who have no health insurance, restrictive health nited financial resources. The Assistance Fund enables Kokua s (KCS) to provide low-cost, affordable counseling services for adequately compensating its professional staff. KCS staff clinicians workers and one marriage and family therapist -are certified by the ~ of Social Workers and the American Association for Marriage and ~pectively, and are licensed by the State of Hawaii. Approximately > served by KCS require "gap group" subsidized services. Total Budget acid Position Count: Total Program Total Program Budget $20,000 Position Count 3 Total Agency Position Total Agency Budget $136,586 Count 4 Program Objectives: 1) Insure that no client in need of professional counseling services is turned away due to an inability to;pa'y 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 ho one "falls through the cracks" due to eligibility criteria or inability to pay. 2) Provide services to clients with no health insurance to assure that successful therapeutic and life outcdmes are achieved. According to the "Quality of Life" report issued by Aloha United Way, 12% of Hawaii County residents are medically uninsured. 3) 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 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Client Assistance Fund -Program Name reimbursed by insurance is insufficient to fulfill healthy outcomes, the Client Assistance Fund is used to supplement insurance coverage. 4) Expand service deliveryto clients referred by other area agencies - e.g., YMCA, Salvation Army, iCare Hawaii -and expand outreach, networking and collaborative partnerships with other behavioral health agencies in Hawaii County. 5) Track performarice measures to (a) record the actual number of clients requiring assistance from;the Clieht Assistance Fund; (b) calculate the number of financially assisted clients as a percentage of the total number of KCS clients; and (c) 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 o~ fully subsidized counseling services for 34% of all KCS clients. During its second year of operation (January-December, 2007), the Client Assistance Fund partially or fully subsidized counseling services for 21 % of all new KCS clients. During its third year of operation (January -December 2008), the Client Assistance Fund partially o'r fully subsidized counseling service for 20% of all 2008 KCS clients. Overall, 24.6% of 774 counseling sessions were partially or fully supported by the Client Assistance Fund, expending a total of $11,785.00. 2) The Client Assistance Fund enabled many clients to achieve personal health goals and improve'th~ir marriage and family relationships. Performance Mea§ures: FY 2007-08 FY 2008-09 FY 2009-10 Actual* Budget* Estimate* (1/1/-12/31/08) (1/1/-12/31/09) (1/1/-12/31/10) Information applicable to KCS clients supported by the Client Assistance Fund No. of uninsured Provide professional clinical and clients served by 17 25-30 family/marriage counseling to 25- Kokua's Client 30 clients who require subsidized Assessment Fund services through the Client Assistance Fund No. of underinsured Provide professional counseling clients served by 5 8-10 to 8-10 clients who lack sufficient Kokua's Client health insurance benefits to fulfill Assistance Fund treatment modalities and healthy outcomes NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 3 - Aaen istance Fund -Program Name Total no. of clients Record the number of clients served by Kokua's 22 30 needing assistance from the Client Assistance Client Assistance Fund and Fund calculate the number of such financially assisted clients as a percentage of the total number of clients Total number of Record the number of client client sessions 158 175 sessions for which the Client covered by Client Assistance Fund was used Assistance Fund Information applicable to-all KCS clients: Total no. of new Expand outreach, networking and clients served via 70 85 referral to public and nonprofit outreach and referral agencies to provide services to 80+ new clients annually Pre- and post- Administer pre- and post- counseling surveys 100 120 counseling surveys to assess the (all clients) ability of clients to function well within his/her family and community *Budget year is January 1-December 31 Program Expenditures: FY 2007-08 Actual* 1 /1 /-12/31 /08 FY 2008-09 Budget* 1 /1 /-12/31 /09 FY 2009-10 Estimate* 1 /1 /-12/31 /10 Salaries and Wa e's Professional Fees O erations $51 125. $60,000.00 $70,000.00 E ui ment $13,500 $5,000.00 $10,000.00 Other# Total $64,625.00 $65,000.00 $80,000.00 *Budget year is Jahuary 1-December 31 #Please explain in detail on separate sheet Note: 'KCS counselors are contract (not salaried) clinicians; accordingly, client services subsidized by the Client Assistance Fund are shown as "Operations" expenditures. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 4 Services - Assistance Fund -Program Name Program Funding Sources Identify all funding sources (specific to this program only) „ri'. g am~s`peClfc Lilen~`IAssistahce'Filnd Revenue Source FY 2007-08 Actual* 1 /1 /-12/31 /08 FY 2008-09 Budget* 1 /1 /-12/31 /09 FY 2009-t0 Estimate* 1 /1 /-12/31 /10 Cor orate Donatiohs+ $1,000.00 $1,000.00 $2,000.00 Church Donatiohs+ $800.00 $1,000.00 $1,200.00 Jer and Pat Merrill+ $ $ $ Other Contriblitibns+ $1,000.00 $ $1,000.00 Count of Hawaii Grant++ $10,000.00 $10,000.00 $$10,000.00 Other Grants+ $5,000.00 $9,000.00 $10,000.00 Total $17,800.00 $21,000.00 $24,200.00 'budget year is January 1 -December 31 + A source of additional Client Assistance Funds, if needed. ++Entire amount goes into Client Assistance Fund. Explain what plaris, 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 its first year of o Capital Fellows Pry Family, Hawaii Coi CCFP, KCS receiv These grants prbvi funded the prepare Development" by ; that no funds from Client Assistance F The second CCFP who expanded on 1 donations, found is being placed it will provide critic; Hawaii while we I able to raise $7, went into the CIiE Friends of Hawai women in East H ~ration,KCS successfully applied for inclusion in the Compassion Tram (CCFP) jointly administered by the UH Manoa Center on the munityjFoundation and Hawaii Islands Ministries. Through the J two organizational "capacity-building" grants totaling $30,000. =_d a oie-year training program for two KCS board members and on of an "Infrastructure Assessment in Preparation for Major Gift lid Corcepts, Inc. in Honolulu on behalf of KCS. It should be noted ie CCFP grants could be applied to the KCS operating budget or grant enabled KCS to contract with a Big Island-based consultant ie work done by Solid Concepts. In 2008, KCS implemented its fund Ming plan to generate income streams from public and corporate >n grants, and special events. A percentage of any income received ie Client Assistance Fund. Award of a County human services grant unding in support of our services to low-income citizens in East fertake these steps to become self-sustaining. In 2008 KCS was in donations and $56,863 in grants in total income. Of that, $14,255 Assistance Fund. In 2008 KCS also received $5,000 from the harities for the Client Assistance. Fund in support of low-income Unless action is taken at the federal or state level, there will continue to be residents of Hawaii County v/ho do not have any health insurance or have very limited mental health coverage. Therefore, viewed as a separate entity, the Client Assistance Fund will likely never be self-sustaining. KCS is, however, working toward the establishment of an Operational Endow{nent Fund which will ensure ongoing revenue for the overall function of the agency. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 5 okua Counseling Services - Agency Nary 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, Section 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) understands 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 ayear-end report to the Legislative auditor withinl6d days after June 30 of the fiscal year. The report shall include an explanation Hof the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grartit funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and < ~ 2~ Sign ure~ Boar` reasure Da e ~.,~ ,Vyle~„~,~,D l 7 9 0 Signature of Executive Director Date NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 6 48 Kona Adult Day Center, Inc. Adult Day Care KONIA ADULT DAY CENTER, IN'C. ADULT DAY CARE Agency Director: ROWENA L. TIQUI Phone No.: 322-7977 Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address ROWENA L. TIQUI P. O. BOX 1360 KEALAKEKUA HI 96750 81-989 HALEKII STREET KEALAKEKUA HI 96750 808-322-0614 Phone No.: 322-7977 kadcrowena@hawaii. rr.com Name of AccountantlCPA (include name of firm if applicable): RONALD G. HAWKS, CPA Phone No.: 808-939-7392 Mailing Address: P. O. BOX 2030 KEALAKEKUA HI 96750 Amount of Request for County Funds: $30,000.00 Prior Year(s) Funding: 08-07 07-08 08-09 $15,000.00 $30,000.00 $30,000.00 Agency Mission Statement: "Our mission is to provide health, sicial and recreational programs and activities that enable impaired adults to experience feeling of being, friendship, acceptance, accomplishment and independence in a caring and secure environment." NONPROFHT GRANT APPLICATPON FYSCAL YEAR 2009-10 Page 1 KONA ADULT DAY CENTER, fNC ADULT DAY CARE 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 work force. 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 types of care, such as home nursing or institutionalization. Total Budget and Position Count Total Pro ram Bud et 305379.68 Total Pro ram Position Count 7 Total A enc Bud et 305379.68 Total A enc Position Count 7 Program Objectives: 1) Program Goals for 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. The client's maximum level of independence will be assessed through the individual program planning. d. Mentally and physically impaired adults will be maintained at t heir highest level of functioning, thus preventing or delaying further deterioration. e. Health monitoring as well as protective and supportive care for the frail and disabled adults will be included in care planning and services. f. The caregiver's knowledge of and access to elderly services available in the community. g. Socializing, peer interaction and continued relationship with the community. h. Isolation and prejudice often associated with frail and disabled adults will be reduced. 2) Program Goals for Families and Other Caregivers a. Families that desire to keep elderly members in the home will be given relief for full-time care of an impaired adult. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-IO Page 2 b. Family members will be able to continue productive careers instead of being homebound with an elderly, disabled spouse, parent or other family member. c. Families and other caregivers will be assured that elders dependent upon them are being cared for appropriately during the day. Program Highlights: 1) Participants continue to live at home for a minimum of 6 months with adult care services. 2) Maintained or improved socialization skills of participants. 3) Maintained or improved hygiene/self-care of participants. 4) Surveyed caregivers expressed deep satisfaction with Kona Adult Day Center. 5) Had intergenerational interaction activities. NONPR®FLT GRANT' APPL,LCATI®N FISCAL. PEAR 2009-LO Page 3 KONA ADULT DAY CENTER, INC. ADULT DAY CARE Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Clients Served 44 50 60 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 1158476.13 162960 163000 Professional Fees 4185.05 9240 5000 O erations 138276.50 120984 117000 E ui ment 4442.00 2400 35000 Other" Total 305379.68 295584 320000 ` If applicable "Please explain in detail on separate sheet NONPR®FIT GRANT APPLdCATd®N FdSCAL YEAR 2009-10 Page 4 KONA ADULT DAY CENTER, fNC. ADULT DAY CARE Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate DHS POS Pro ram 27048.13 27900 30000 DHS NHWW 45862.00 46500 47000 Coun of Hawaii 30000.00 20000 30000 Ma Tem leton Ho er 37945.00 30000 50000 Hawaii Island United Wa 12750.00 10500 10500 Other Grants 9909.16 9000 9000 Nichols 9370.00 Tuition 115731.90 114984 116000 Trans ortation Fees 9905.00 8800 9000 Bathin Fees 10945.00 14280 12000 Food Pro ram 5133.06 7680 6000 Intake Fees 600.00 600 600 Fundraisin Donations 23780.00 1600 15000 Fundraisin Membershi 4545.00 10000 10000 Fundraisin Sales 14331.50 2000 15000 Administration Fees 3000.00 3000 3000 Interest Income 3386.69 3300 5000 Unrealized <Loss> <525.36> Total 363956.08 325824 364100 *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 plan 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 2009-IO Page 5 KONA ADULT DAY CENTER, f NC. Adult Day Care 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 Gounty of Hawaii, I (we) understand and will comply with the requirement to subm!t a yearend report to the Legislative aud!tor within fi0 davs after June 3tl of the fiscal vear. 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 Gounty of Hawaii grant funds, and a l'cstfng of other funding sources and amounts obtained during the award period. Failure to subm!t a timely. complete. and accurate vear-end report will impact the evaluation of your proaram`s or aaency`s future fund'cna requests. v~` !7 d~l~---~ Signatur of oard vicE rxssznErrr snxsnxn xossow ') ~' Signature of Ex utiv Dir ctor Rowena L. Tiqui 1/14/09 Date 1/14/09 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED!' NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 49 Kona Literacy Council Kailua Learning Center Kona Literacy Council- Agency Name Kailua Learning Center- Program Name Agency Director: Brenda Natina 1180 Contact Person: Brenda Natina Mailing Address: Kailua Learning Center 75-5766 Kuakini Highway 106 A Kailua-Kona, HI 96740 FacilitylSite Address: Kailua Learning Center Same Fax No.: 329-1180 Email Address: konalit@msn.com Phone No.: 329- Phone No.: Same Name of Accountant/CPA (include name of firm if applicable): None Phone No.: Mailing Address: Amount of Request for County Funds: $2,000 Prior Year(s) Funding: 06-07 07-08 08-09 $1,500 $1,500 $2,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 2009-10 Page 2 Kona Literacy Council -Agency Name Kailua Learning Center- 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 Pro ram Bud et 5,600 Total Pro ram Position Count 7 Total Agency Budget 5,600 Total Agency Position Count 7 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, schedule, match learner with tutor, and prepare programs for 12 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, 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 leamers to get and hold jobs. 6) Improve family literacy services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 leamers. 9) Publish a newsletter three times a year. 10) Hold general membership and public meetings three times a year. 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 8 basic literacy students. (includes reading, math & computer literacy) 2) Tutored 11 English as a Second Language students. 3) Left the program and attained employment: 2 students. 4) Retained employment: 7 students. 5) Studying for the citizenship test: 5 students. 6) Entered other educational programs: 2 student. 7) Increased involvement with children's education: 3 students 8) Met goals: 5 students. 9) Utilized 2 volunteer tutors, 4 auxiliary personnel, plus the Program Director. 10) Tutored 385 hours of actual tutoring. 11) Contributed aproximately 400 hours by volunteers in other areas. 12) Trained 0 new tutor. 13) Passed Citizenship Test: 3. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Kona Literacy Council -Agency Name Kailua Learning Center -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Tutored Adult Basic Ed. Students 8 9 10 Tutored ESL Students 11 10 10 Citizenshi Students 5 3 4 New Tutors 0 3 2. Newsletters 3 3 3 Board & General Public Meetin s 3 3 3 Total Tutorin Hours 385 500 400 Total Non-Tutorin Hours 400 500 450 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 0 0 0 Professional Fees 0 0 0 O erations 4,511 4,700 4,700 E ui ment 430 400 400 Other Insurance 500 500 500 Total 5,441 5,600 5,600 ' It applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Kona Council -Agency Name Kailua Learning Center -Program Name Program Funding Sources: Identify ail funding sources (specific to this program only) Revenue Source FY 2007-08 FY 2008-09 FY 2009-10 Coun Grant Membershi Dues Wal-Mart Donations Fundraisin Federal Cam ai n Youn Brothers Kukio Actual * 1,500 10 250 237 0 669 0 0 Bud et * 2,000 50 250 1,000 500 800 0 1,000 Estimate 2,000 50 250 500 500 800 1,000 500 Total *If ^JnnGroLJe 2,666 5,600 5 600 M,.r.~,,,..,~.. 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~ustaining? The Kona Literacy Council plans to participate in more fundraising and grant proposal writing. Since we do not charge our clients for our iteracy services, we will have to continue to rely on the generosity of our community supporters. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Kona L Council - Name Kailua Learning 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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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- romn~o*e s.,, Signet re of oa d P sid nt/ r S~jna ure of Executi a Director Dat / a3 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDt NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 50 Ku'ikahi Mediation Center Ku'ikahi Mediation Center Ku'ikahi Mediation Center. Name Ku'ikahi Mediation Center= Program Name Agency Director: Catherine Lampton Phone No.: 808-935-7844 Contact Person; Catherine Lampton Phone No.: 808-640-1080 Mailing Address: FacilityFSite Address: Fax No.: (Email Address: 120 Keawe St., Suite 203, Hilo, Hawaii 96720 120 Keawe St., Suite 203, Hilo, Hawaii 96720 961-9727 ku ikahi_mediation@ hawaiiantel. net !Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs Phor-e No.: 808-242-5002 'Ma'iling Address: 1885 Main 5t., Suite 408, Wailuku, Hawaii 96793 Amount of Request for County Funds: $18,000 'Prior Year(s) Funding: X06-07 0T-08 08-09 $4000 $ 7000 $13,000 !Agency Mission Statement: To provide a safe environment, an impartial process and well-trained volunteer personnel for the delivery of affordable dispute resolution services (mediation NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 and neutral facilitation of meetings) to the East Hawaii community on a nonprofit basis. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Ku'ikahi Mediation Center; Agency Name Ku'ikahi Mediation Center-' Program Name f~rogram Description: i<u'ikahi Mediation Center is the only agency providing afforable mediation and facilitsltion services to our East Havvai'i community, including Kau, Puna, North sand South Hilo and Hamakua~Districts. Because conflict resolution is a part of all walks ;of life and exists in every organization, Kii'ikahi is one of the few nonprofits serving all members of our community: youth, seniors, adults, 'ohana, the disabled, the disenfranchised,. private and public organizations, and the government. 47% of our clients' households earn less than $20,650 per year, which~is at or below the 2008 Federal Department of Human Services poverty guidelines for 2-5 person households in Hawaii. We bridge boundaries and create space for common ground to emerge among Nifferent points of view. This Has trifold results: , (1), developing better communication and uriderstanding between disputants through awareness and experience of peacefulconflict resolution, (2), building a safer and more cohesive community through the rippling effects of mediation to 'ohana, neighborhoods, schools, and workplaces, and (3)' creating a sense of real hope that we cah cooperate and collaborate to resolve tougher, more complex issues facing us as a community. The. County is familiar with our services and has supported us over the last years because you understand that;Ku'ikahi's services are both unique and vital to our community. As resources become more scarce; stress and conflict escalate. We are seeing an increase in the;number of clientsiwho cannot afford to pay the nominal fees set by the Judiciary and who need to make payment plans and rite waiver letters. We are already seeing an increase in landlord/tenant, collections, and civil TRO cases and expect to see more increases there as well es workplace mediations and small claims, especially if the limit is increased to $7,000. Tension and anger are on the rise in our schools, courtrooms, and in our 'neighborhoods according to teachers, judges and assessment of the nature of 'recent cases. We need more than the traditional methods for handling this (through the police, courts, incarceration, government and social service agencies 'because: (1) those systems are already overloaded, (2) their solutions are generally more punitive than curative or durable, and (3) many times they're simply not the best tool for the job. Ku'kahi's caseload continues.to grow. Since 06/07 with 378 cases, we expect to handle over 500 cases this FY 08/09, a 30+% increase. Over the same time !period, our funding has remained the same from the Judiciary and our staff and NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 hours:have decreased due to ..budget limitations. While the County grant monies have increased over the years (for which we are very grateful), the demand for sterVices continues to outpace the budget. This will only increase as the "recession" plays out over the coming years. proximately 70% of our cases have historically come from the District and rtily Courts. That number is now approaching 80%, in part because dlo'rd/tenant, consumer/merchant (collections), civil TROs, and family ~aration cases are increasing during these challenging times. Resolving these es Hof cases through mediation can help: (1) residents stay in their homes, (2); keep families together with coparenting agreements, (3)~ assist folks to better manage their finances and protect their credit ratings, li (4) neighborhoods and workplaces stay safer and more secure because members know they have a way to resolve their differences peacefully. i To provide these essential services, Ku'ikahi trains and develops volunteers who have an average agreement success rate of between 70-75% in resolving disputes that include, in addition to the cases above, special education, condominium owners, civil rights and other private civil disputes. This is the highest success rate among the six community ;mediation centers in the state. Our.low cost-to-free services are offered on a sliding scale according to income, and no one is turned away for inability to pay. Ku'ikahi enables many members of our community without adequate resources to find.. solutions they otherwise would not have. Without access to mediation, these same folks could find themselves engaged in escalated situations that dross the line into criminal behaviors and vigilante justice, further taxing the police!, courts and prison systems. Because mediation is an opportunity to resolve differences prior to them escalating out .of control, it is a critical dompgnent to be considered during the challenges ahead. Ku'ikahi's successful mediations have reduced the number of calls requiring police response as well ~s the threat of violence on sdhool campuses, in the work place, and in neighborhoods. Ku'ikahi also provides education, training and outreach services. Ku'ikahi educates the community by promoting peaceful problem-solving skills, encouraging participation in mediation and generating volunteers to become mediators. To maintain a high level of competency in the members of our volunteer mediator team, we provide an intensive basic mediator training, apprenticeship training, and advanced training in specialized areas like divorce and coparenting. Ku'i kahi's facilitation of meetings to community;groups, business, and others enables us to work with large, potentially contentious groups, enabling participants to be heard and important information to be gathered and prioritized So that progress can be made. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 'ikahi Mediation Center has served the Hawaii Island community for 26 years: r 1!983 to 2005 under the auspices of the YMCA and since January 1, 2006 an independent nonprofit corporation. We are part of a network of six nmunity-based mediation centers in the state, Mediation Centers of Hawaii, ier~contract to the Hawaii Judiciary.The partial funding from the Judiciary proximately one-third of our budget) has notikept pace with the demand for its n services, let alone the increased demand from self-referrals. We appreciate any assistance you can offer us to tt~ission serving the conflict resolution needs and community. Mahalo for your time and attention. be able to continue to fulfill our demands of our East Hawaii Totaf Budget and Position Count Total Program Budget $142,804 Total Program Position Count 2.9FTE Total Agency Budget $142,804 Total Agency Position Count 2.9FTE Program Objectives: 1) Provide two basic trainings for at;least 30 new mediators to increase our mediator pool for services to mahage the increase in caseload. L) Recruit and train a Puria team of mediators to better serve our Puna residents. We have access to a room to hold mediations and the administration will be managed by the Hilo office, but we need more ~ mediators who can travel to or already live in Puna. 3) 'Offer partial training scholarships mediators who are from groups that are :not well represented in. our current mediation team, ie. Filipino, Hawaiian, ;youth and young adults under the age of, 40. 4) :Provide training for 10 new mediators in Divorce and Co-parenting. 5) Create a new part time staff position, Outreach and Education Coordinator, and add at least one full-time staff position (or equivalent). ' These positions are essential to the meet current service delivery as well as the requests for increased services. 6) Develop funding to pay participant fees ih a "Victim-Offender Mediated Dialogue" (Restorative Justice) with theiProcecutors' Victims Assistance Program. Such programs assist the sentencing process and reduce recividism by the offender as well as enable the victim to gain closure. 7) Solicit and provide education and training for county agencies and local businesses in mediation skills. 8) Continue to pursue peer mediation training and programs in local schools, including training for DOE faculty and staff. This would include developing contracts for services with the DOE. 9) Collaborate with County Police Department in suggesting mediation as an option to a TRO for those disputes that are not likely to provoke violence, but are very disruptive. The outcome will reduce need for Court and Police Department responses to restraining orders. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 10) Increase mediation services to the Family Court, and stimulate more self- referrals to mediation --which will be a source of additional income. 11) Continue to provide Board training in Capacity Building, Resource Development and fundraising in order to~engage in strategic planning and identify other sources of support and income. 12) Continue to develop partnerships with other agencies and potential client ,sectors to build awareriess of mediation„educate about dispute resolutions, and seek funding options. ibrogram Highlights: i 1) ~ We moved into larger office space in January 2008, increasing our usable space by about 450 square feet tb over 900 square feet. This resolved our issues with confidentiality because we now have two separate waiting areas, a mediator work room as well as a better space configuration for ~, staff to protect their work. ADA accommodations are better, and utilities included in the rent paymerit has helped stablize our budget. Parking remains an issue. 2) 07/08 cases were 57%landlord/tenant, divorce/coparenting, and civil TROs, with an additional 16% consumer%merchant cases. This means that our work is 73% related to Helping people with their basic shelter, safety and financial needs. We also mitigate the potential family and ' neighborhood violence"that could erupt if people did not have access to ;mediation. 3) 15% increase in overall caseload from last year, with a projected 20% increase again this year. We have been handling this increase with fewer :staff and staff hours as well.as surviving a 75% staff turnover. 4) 1163 clients served in FY 07-08, up 21% from FY 06-07. This is the I largest percentage increase among the community mediation centers. 5) ' 1546 volunteer mediator hours worked in FY 07-08, up 9% from FY 06-07. 6) 'Percent of mediations reaching agreement has remained stable between 70-75%, the highest among. the six centers serving the Judiciary contract. 7) Conducted four in-house training refreshers for Ku'ikahi mediators and facilitators. We are committed to keeping our mediator pool updated with the latest info and to refining their skills on an ongong basis. Our mediator pool has diminished somewhat and this year's trainings are especially important to our ability to handle the increased case load. 8) ED & two board members attended 1-day HANG Capacity Building seminar in Honolulu and ED & one board member attended 2-day Facilitative Leadership Seminar with Donna Ching. 9) Sent three mediators to Honolulu for civil, rights training. 10) Continued to participate in planning meetings with Prosecutor's office toward the goal of increasing mediation services to victims and offenders through Restorative Justice. ~11) Monthly mediator Memo seht to Mediators resulting in more mediators volunteering to support our staff work, court intakes, and training events. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 12) Ku'ikahi Kids Team continued to mediate disputes involving youth, especially on school campuses.To date,'we are enjoying a 100% success/agreement rate with these mediations.The mediators on this team all have a background in working with youth. Parents are always invited to participate in parts of the mediation so there is follow-though on agreements. The program is called "Peace it Together". NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Ku'ikahi Mediation Center. - Agency Name ' Ku'ikahi Mediation Center - Program Name Performance Measures: FY 2007, 08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Cases o ened 378 500 625 Volunteer mediators 42 42 60 Mediations held 330 435 544 A reement rate 70%` 73% 72% Domestic/co arentin cases 58 ' 76 96 Court'referrals 315 400 488 Self-referrals 43 60 73 Percent of satisfied clients 91 % 92% 93% Percent of clients below $20,000/ ~ 47% 46% 55% Percent of Native Hawaiians served 28% 24% 30% i "If applicable Program Expenditures i FY 2007-OS Actual * FY 2008-09 ,Bud et * FY 2009-10 Estimate Salaries and Wa es $93,226 $87,455 $101,058 Professional Fees $4,400 $4,400 $5,000 Operations $30,599 $50,949 $61,000 E ui ment $2,000 00 00 Other" Total. $130,255 $142,804 $167,058 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 Ku'ikahi Mediation Center:- Agency Name Ku'ikahi Mediation Center -Program Name I (we)~have read and understdod all of the eligibility requirements; grant aoncJitions; award procedures; and records, reporting and fiscal accountability Fequirements as mandated in Article 25; Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. II (we); hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully admiriister the program(s) pursuant to law. I (we); understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. awarded a grant from theCounty of Wawai`i, I (we) understand and will imply with the requirement tosubmit ayear-end report to the Legislative aude an explanation of the public be t~g'rant, a complete accounting of all Hawaii grant funds, and a listing of twined during the:award period. Fail Sigh ture of Board President/Chair t I 'nature of Executive Director ;cal ear. The report hall ,derived from the awarding of iditures supported by County Funding sources and amounts Jon v ~1 200 Date ate ~~ UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 9 51 Laupahoehoe Train Museum Museum Mentorship Program Laupahoehoe Train Museum- A envy Name Museum Mentorship Program- Program Name Agency Director: Lisa Barton Phone No.: 962-6300 Contact Person Mailing Address Facility/Site Address: Fax No.: Email Address Lisa Barton P.O. Box 358 Laupahoehoe, HI 96764 36-2377 Mamalahoa Hwy Laupahoehoe,H196764 962-6957 Phone No.: 962-6300 laupahoehoetrainmuseum@yahoo.com Name of AccountanUCPA (include name of firm if applicable): Natalie J. Iwasa, CPA, Inc. Phone No.: 808-395-3233 Mailing Address: 1331 Lunalilo Home Road, Honolulu, HI 96825 Amount of Request for County Funds: $40,000 Prior Year(s) Funding: 06-07 07-08 08-09 $35,000 $40,000 $10,000 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. We are more than just a train museum and provide many community services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page I Laupahoehoe Train Museum -Agency Name Museum Mentorship Program- Program Name Program Description: The goal of this program is to make the best use of our facility as an educational resource and highlight in the community. As part of the Hilo Hamakua Heritage Corridor we preserve and protect our islands railroad, plantation and local history and assist the community by providing social and economic stimulation in the area. This program will focus on our efforts to provide mentoring activities and job opportunity to our youth while continuing on our efforts towards museum sustainability. This program, while providing economic stimulation, will help us create maximum visitor satisfaction by providing more dynamic hands on displays for all ages. With funding, we will partner college and high school students with local businesses to provide mentorship training . We want to partner a local auto mechanic and electrician as they work to provide video and audio capabilities within the interior of the caboose and hydraulics to the body of the caboose to give it the sound and feeling of `riding on the rails. It is our goal to show the donated video clips that we have in the caboose as soon as the interior is finished. This will be a very unique experience for our visitors and with funding this would be possible. We will complete the restoration of the historic 'wye' in the yard which is an area where an engine could be switched to head north or south on the railroad. Completing the last 100' of rail on this line would create a longer area for our mascot engine Rusty to run on. Our visitors are thrilled when Rusty starts up and actually moves smashing pennies for souvenirs. Finishing this area in the yard would also give a better understanding of the significance of this area to the railroad and a more rounded experience as visitors stroll around the museum grounds. We will take our current volunteers, both students and adults, on archival research expeditions to the local museums in Hilo and Kona to learn more about researching data, creating interpretive displays and preserving our islands history and heritages. We have had many success stories throughout our ten years in operation of students working with local employers to provide training and we look at this project as another great partnering experience. These activities would provide several individuals with part-time work as well as provide the museum with the much needed assistance in completing new displays to offer more to our visitors, and locally creating more word of mouth advertising. Total Budget and Position Count NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Total Pro ram Bud et 156,000 Total Pro ram Position Count 2 Total Agency Budget 162,000 Total A enc Position Count 12 Program Objectives: 1) Pay for local electrician to wire in overhead and display lighting, computer and video monitor in the interior of the caboose. 2) Pay for a mechanic to create hydraulic system under carriage of the caboose to gently rock the caboose to mimic the motion of a real train ride. 3) Work with local college and high school to find students to train under these professionals to complete the task. 4) Work in cooperation with our current researcher/coordinator to take two student docents to Lyman museum to find more information and photos to add to our interior displays. Provide transportation to students requiring driver to and from museum during afterschool or weekend project work days. 5) Provide additional capital to increase displays and support volunteers to encourage increased visitor satisfaction which in turn should increase our sustainability over the downturn of the economy. Program Highlights: 1) Mentorship is very important in students discovering what fields they want to explore as careers. Paying for their labor rewards their efforts, even if only in part time experiences. These mentorship projects are helpful in providing references to students for future employment opportunity in their chosen fields. To the mentor much is provided in the way of giving back to the community in a small but powerful way. Funding the mentors creates connections in the community, improving individual economies and assist at fostering employer employee relationships. 2) This project would be beneficial to the museum with work being done to bring the museum displays to a new level of excitement in visitor experience, creating more word of mouth advertising which would in turn bring in more visitors and assist us in our sustainability. We have worked in this way before with previous years funding from the County and it has been a mutually successful program and look forward to doing this again with a great projected success. 3) In addition to running the museum, LTM has supported various community projects, like the O'okala Community Forest, community sports and afterschool activities, mentorship and community service restitution programs, and the newly formed Laupahoehoe Farmer's Market and Hamakua CERT. Your support will help keep these programs operational. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Laupahoehoe Train Museum -Agency Name Museum Mentorship Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Increase visitor count b 10% 6,000 6,600 Increase ift sho sales net $6,000 10,000 Increase admissions/donanations $10,000 $15,000 Increase membershi su ort $5,000 $6,000 Increase aid staff FTE 2 3 Increase dis la s 2 3 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 64,000 75,000 Professional Fees 5,000 5,000 O erations 10,000 50,000 E ui ment 0 0 Other" 26,000 26,000 Total 105,000 156,000 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Laupahoehoe Train Museum -Agency Name Museum Mentorship Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Count A ro riation 10,000 40,000 IMLS federal fundin 43,000 50,000 donationsladmissions fees 10,000 15,000 membershi dues 5,000 6,000 ift sho sales net 6,000 10,000 misc rants/revenues 5,000 9,000 Docent in-kind 18,000 18,000 Mana ement in-kind 8,000 8,000 Total 105,000 156,000 *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? We have received a 3-year Institute of Museum and Library Services grant to fund a program coordinator position. In addition we are applying for an USDA community development grant to fund $30,000 worth of new wye restoration and improve our rolling stock displays. We are aggressively pursueing federal grants and increasing our membership to become more self sustaining. Meanwhile, the downturn in the economy has reduced our income for the first time in our ten year history and state funds continue to look as if they are going to be very hard to obtain. We rely on county funds to expand our displays and leverage our federal funds until the economy improves and we can support ourselves on the income from tourist and local visitors. Explanation of Program Expenditures: In regard to the column marked "Other": in FY 2008-09 LTM estimated $26,000 for our in-kind volunteer hours. Paying key staff positions have been very iomportant to the museum in terms of maintaing museum hours, researching information for new displays, display creation and maintenance of the facility. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Laupahoehoe Train Museum - A ency Name Museum Mentorship 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, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of vour program's or agency's future funding requests. ident/Chair J ~' ~~ Signatur of i Kb~ls~; aC-'~C / ~~) d Date /~3~~U~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 52 Lyman Museum Education and Public Programs Lyman Museum -Agency Name Education and Public Programs -Program Name Agency Director: Marie D. Strazar 5021 Contact Person: Marie D. Strazar 5021 Mailing Address: 276 Haili Street Hilo. HI 96720 Facility/Site Address: 276 Haili Street Hilo, HI 96720 Fax No.: 969-7685 Email Address: director@lymanmuseum.org Phone No.: 935- Phone No.: 935- Name of Accountant/CPA (include name of firm if applicable): Alex Smith, CPA Phone No.: 808-737-7761 Mailing Address: 1403 Frank Street, Honolulu, HI 96816 Amount of Request for County Funds $40,000 Prior Year(s) Funding: 06-07 07-08 $54,000* $31,500* *HTA/CPEP not for this program 08-09 $30,000 Agency Mission Statement: To tell the story of Hawaii, its islands and its people. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 The Museum exists to: Collect, preserve, and exhibit artifacts, artwork, and memorabilia relating to the culture, art, and historical heritage of Hawaii. Educate and encourage awareness in these areas through visually exciting as well as interpretive exhibitions, informative tours, special programs, and activities. Serve as a learning resource center for those seeking information, entertainment, and knowledge. Fully extend itself to the public in order to instill community pride and support. Maintain a standard of excellence and professionalism, seeking to improve, progress, and realize its full potential as a museum. The Lyman Mission House and Museum, founded in 1931, consists of the Lyman family home, first built in 1839, and a modern museum building constructed in 1973. The restored Lyman Mission House is furnished to depict missionary life in the period 1840 to 1880. It is a reminder of a devoted band of men and women who dedicated their lives to bringing their Christian faith to the people of these islands and whose presence here exerted a profound effect on the development of these island communities. The adjacent modern Museum houses exhibits and presents programs and activities designed to interpret the physical environment and ecology of the islands as well as the rich and varied ethnic heritage of our island people, that there may be a deeper understanding and appreciation of the ongoing human process here in the fiftieth state in the heart of the Pacific Basin. The historical, cultural, and contemporary artifacts are presented in the following manner: 1. Hawaiian life prior and subsequent to European discovery. 2. The Missionary period of 1840--1880. 3. The traditional lifestyles of Hawaii's major immigrant groups. 4. The natural history of Hawaii, including its volcanos, flora, and fauna. 5. Other exhibits, such as Pacific shells and worldwide minerals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Lyman Museum -Agency Name Education and Public Programs -Program Name Program Description: Education and Public Programs at the Lyman Museum both reaches out to the community and draws it in to the Museum, to "tell the story of Hawaii, its islands and its people" through programs, events, and activities that educate and encourage involvement by the public. Such efforts include focused educational tours; outreach student workshops and outreach instructor training; standards- linked curriculum enhancement; docent training for school tours; teacher workshops; dissemination of information to teachers about Museum school- related programs; an annual agenda of lectures, demonstrations, performances, workshops, and other presentations for the community; and public programming specifically linked to traveling and special exhibits at the Museum. Total Budget and Position Count Total Pro ram Bud et 92,070 Total Pro ram Position Count 2 Total Agenc Budget 567,902 Total A enc Position Count 14 Program Objectives: 1) Conduct curriculum-appropriate school tours at the Lyman Museum for student groups of any grade level. 2) Provide teachers on the Island of Hawaii with information about available Lyman Museum educational, school-related programs and how to access them. 3) Train docents to lead school tours. 4) Develop age-appropriate curriculum on the history of Hawaii. 5) Provide educational outreach workshops on topics related to the natural and cultural history of Hawaii for County of Hawaii schools. 6) Train outreach workshop instructors. 7) Conduct teacher workshops on Hawaii history topics to link to school standards. 8) Carry out an annual public program for adult members of the community with monthly lectures, performances, workshops, demonstrations, or other presentations. 9) Develop and present special programming for each traveling or special exhibit at the Museum. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Program Highlights: 1) Trained 5 docents for Lyman Museum school tours. 2) Serviced 2591 students with school tours. 3) Trained 4 outreach workshop instructors. 4) Conducted 42 outreach workshops for students. 5) Serviced 998 students with outreach workshops. 6) Conducted 33 public programs relating to special exhibits. 7) Serviced 1041 community participants with public programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Lyman Museum -Agency Name Education and Public Programs -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Service students with school tours 2,488 2,591 2,600 Train docents for school tours 2 5 5 Provide monthly adult public ro rams 12 29 12 Service community participants with public ro rams 400 1,041 1,050 Disseminate Lyman Museum education information to teachers 107 150 150 Develo curriculuar material 0 1 1 Conduct educational outreach workshops at schools and Museum 3 42 50 Train outreach worksho instructors 2 4 5 Conduct teachers worksho s 0 1 2 Conduct special exhibit-related ro rams 4 33 5 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 57,764 70,070 70,070 Professional Fees 9,200 2,000 0 O erations 15,000 20,000 22,000 E ui ment 0 0 0 Other" 4,529 0 0 Total 86,493 92,070 92,070 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Lyman Museum -Agency Name Education and Public Programs -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Hawaii Council for the Humanities 3,000 2,500 0 Anonymous private donation for public ro rammin 2,500 5,000 5,000 Kukulu'Ola 13,729 2,000 0 Lyman Museum Operations funds (earned income, donations, and endowment allotment) 67,264 52,570 47,070 Count non rofit rant funds 0 30,000 40,000 Total 86,493 92,070 92,070 *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? By offering a regular calendar of public programs scheduled in advance, the Museum anticipates being able to increase paid memberships which allow free admission to such programs. The Museum has recently begun charging a nominal program admission fee to nonmembers which has stimulated an increase in paid memberships. Currently, some grant-funded public programs are offered free to the community. Educational services, on the other hand, are never self-sustaining in that they are offered as a public service. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Lyman Museum -Agency Name Education and Public 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, 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 (vve) 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 ayear-end report to the Legislative auditor within 60 davs 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 vear-end report will impact the evaluation of vour program's or agency's future funding requests. Signature of Board President/Chair / / Signature of E utive Director t_~~ _.pQ Date J Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL Y1JAR 2009-10 Page 7 53 Mala'ai: The Culinary Garden of Waimea Middle School Mala'ai: The Culinary Garden of Waimea Middle School Mala'ai: the Culinary Garden of Waimea Middle School - Agency Name Mala'ai: The Culinary Garden of Waimea Middle School - Program Name Agency Director: Matilda Tompson Phone No.: 885-9206 Contact Person: Mailing Address Facility/Site Address: Fax No.: Email Address: Matilda Tompson P.O. Box 6954 Kamuela, HI 96743 67-1229 Mamalahoa Hwy Kamuela, HI 96743 808-775-0470 Phone No.: 885-9206 tompsonp001 @hawaii. rr.com Name of Accountant/CPA (include name of firm if applicable): Patti Schumacher Phone No.: Mailing Address: 808-322-4909 P.O. Box 4384 Kailua-Kona, HI 96743 Amount of Request for County Funds: $25,000 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $ 0 $ 0 Agency Mission Statement: To deepen Waimea Middle School students' relationship with food by creating and sustaining an organic garden and kitchen c-assroom that encourages them in all aspects of growing, harvesting, preparing and sharing nourishing, healthy food. Ultimately we intend for all food served in the school to be wholesome, fresh and delicious. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Mala'ai: the Culinary Garden of Waimea Middle School - Agency Name Mala'ai: the Culinary Garden of Waimea Middle School - Program Name Program Description: Mala'ai is a non-profit educational program working with Waimea Middle School. Under the direction of our Garden Teacher, and with the assistance of teachers and community volunteers, more than 270 students a Quarter work together to create and sustain abeautiful'/, acre food garden. Supporting culturally responsive place-based learning, integrated with core curriculum, a cooperative hands-on experiential approach is used to teach students how to act as stewards of the land, to collaborate with others, and to enjoy first-hand the outcomes of their work. Mala'ai is currently expanding outreach into the community with gardening classes and occasional free food (and recipe) markets. Total Budget and Position Count Total Pro ram Bud et $187,518 Total Pro ram Position Count 2.5 Total A enc Bud et n/a Total A enc Position Count n/a Program Objectives: 1. Provide Waimea Middle school students with the transfomtative experience of working with the earth to grow nourishing food, and the pleasure of preparing and sharing food. 2. Encourage better eating habits and food choices. 3. Provide outdoor class time and exercise 4. Teach fun and productive work and social skills which can be taken home and implemented. 5. Provide gardening classes to the community to assist in food sustainability. 6. Be a distribution center for donated produce and excess from the Mala'ai Garden to the school and larger community. Program Highlights: please see attached Program Highlights 2008 (page 1) NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Mala'ai: the Culinary Garden of Waimea Middle School - Agency Name Mala'ai: the Culinary Garden of Waimea Middle School - Program Name Pertormance Measures: Please see attached -Performance Measures (page 2) The numbers below indicate number of events/number of participants total FY 2007- FY 2008-09 FY 2009-10 08 Actual Budget * 2009 Estimate 2010 *2008 WMS student garden classes 30 month/ 30/275 30/275 275 Garden classes for visiting 5/130 51150 6/180 schools Summer Dig & Eat 2/19 1/25 1/25 Ho'o Ulu 'Aina partici ation Community Information 18/1000 20/1500 20/1500 Events Communi Worksho s 3/90 6/200 6/200 Mala'ai Free Food Markets 3/80 4/160 6/300 *If applicable Estimates are based on present staffing, and limited by school population for student numbers at WMS. Summer Camp and Ho'o Ulu 'Aina will run concurrently in 2009 and 2010. Program Expenditures Mala'ai financials are based on a calendar year Mala'ai budoets are on a calendar vaar FY 2007-08 Actual *2008 FY 2008-09 Bud et * 2009 FY 2009-10 Estimate 2010 Salaries and Wa es 113,019 152,968 160,000 Professional Fees 0 1,500 7,500 O erations 5,415 9,550 10,000 E ui ment 192 16,000 5,000 Other"progr8ii0ave1opniant 2,549 7,500 10,000 Total 121,175 187,518 192,500 * If applicable ° Please explain in detail on separate sheet see attached Page 3 for explanations NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Mala'ai: the Culinary Garden of Waimea Middle School - Agency Name Mala'ai: the Culinary Garden of Waimea Middle School - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Mala'ai huflnatc ara nn a calanlly vmr Revenue Source FY 2007-08 Actual * 2008 FY 2008-09 Budget * 2009 FY 2009-10 Estimate 2010 Direct Public Grants 79,890 100,000 100,000 Cor orate Contributions 30,175 25,000 25,000 Individual Donors 7,769 5,000 5,000 Fundraiser/Art Auction 17,810 20,000 20,000 Coun /Federal Grants 0 50,000 50,000 Total 135,633 200,000 200,000 In Kind Donations: Plants & Labor 8,550 2,500 $1,000 Clearin and Earth-movin 2,000 4,000 $1,000 Mowin and Maintanence 1,200 1,200 $1,200 Volunteer hours $10.00 9,360 15,000 $15,000 1040 hrs minimum @15.00 Board of Director 15,600 15,600 $15,600 Total 36,710 38,300 $33,800 *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 selfsustaining? For the foreseeable future Mala'ai will be requesting funds from private foundations, individuals and government granting sources. Mala'ai has been asked to participate in 2 federally funded studies which will provide substantial revenue in 2009. A second annual fundraiser is planned for June 2009. It was very successful in 2008, raising 15,000 after expenses (-$2,000). There are plans to build ashade/propagation house at the garden where plants can be started for sale at the farmer's market. There is discussion of starting an endowment fund. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Mala'ai: the Culinary Garden of Waimea Middle School - Agency Name Mala'ai: the Culinary Garden of Waimea Middle School - 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 timeiv_ ~~~.,~ioro i~~, gnature of Board President/Chair ~,~~~~ Signature of Executive Director f ~' 09 Date Date 'l~~Icti UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Mala'ai: The Culinary Garden of Waimea Middle School Program Highlights 2008 Dec. Quindembo Bamboo donated and planted a windbreak of 13 clumping bamboos )an. Celebration and tree planting honored Mala'ai founder, Michelle Suber Feb. Jim Williams, of Green Flash Service cleared the south side of garden, doubling cultivation area Lanakila Mangauil gave kalo class to students and a Saturday class for the community Mar. Waimea chefs, Neil Murphy of Merriman's Restaurant and Daniel Thiebaut of Daniel Thiebaut's. tied in the Waimea Homestead Farmer's Market first Iron Chef Event, in conjunction with Kahilu collaboration April Free film night linked to promote "The Greatest Show Off Earth", a fundraising collaboration with Mala'ai and Alethea Lai of Kahilu Theater and Angel Prince of Prince Dance. Shakespeare garden planted on his 400°i birthday by 8'" grade Language Arts classes Keiki Fest - Mala'ai hosted a flower tasting and seed saving table at the event and a compost workshop at garden May "The Greatest Show off Earth" presented 2 public and 2 school performances Honoka'a High agriculture class, under the direction of Manuel Jadulang, made cubbies for the tent classroom "Let Us Grow Lettuce" 2 workshops held teaching soil preparation, planting, harvesting and preparing salad greens for Take it Off Hawaii participants in collaboration with Five Mountain Hawaii Celebration of life hosted in the garden for JoAnn Kaida, WMS teacher and avid garden supporter Mala'ai became an official non-profit with the 501 c3 determination received from IRS June Pua Case taught students the oli mahalo, or gratitude chant, and represented our school and our garden at Ho'oulu 'Aina, a statewide youth gathering about food sovereignty Students attended a week of Seed Camp, ending with an overnight campout and sharing seeds at the Eighth Annual Amy Greenwell Ethnobotanical Garden Seed Exchange Art & Sol, first annual fundraiser, a project of Mala'ai Board of Directors, was held at Merriman's Restaurant The Program Director and Garden Teacher, and Executive Director were hired as full time employees July Sunflowers, pumpkins, cassava, wheat, popcorn, buckwheat, sun hemp and amaranth were planted in the garden which volunteers, kept watered and weeded Aug. Amanda and Matilda attended the Slow Food in the Schools Conference in conjunction with Slow Food Nation. Amanda gave a presentation about using the culture of place in garden teaching. Sept. Students harvested wheat, popcorn, and sunflower seeds flowers. First Free Food Market with Mala'ai produce and donations from Urban Farming held at the school Oct. Studies of ancient civilizations were explored as students threshed, winnowed and ground wheat. Sandwich Island Bread Company owners Cay and Kevin Cabera baked whole wheat picas with students using herbs from the garden in the toppings. Mala'ai staff and volunteers had an information booth at the annual Taste of the Range Scarecrow Fundraiser -students made scarecrows to order -dressed by Saint James Thrift Store. Ku'ulei Kekelani and Pua Case presented the legend of Poliahu and Mauna Kea chant to 6"' graders . Nov. Pumpkin harvest toped 585 pounds -Second Mala'ai Free Food Market held featuring pumpkins and herbs Dec. 3" Mala'ai Free Food Market held featuring chard, lettuce, kale, lemons, limes, clementines and herbs Lanakila Mangauil taught the Hawaiian creation myth of Haloa, harvested the kalo and made poi at the garden Throughout the year: First Saturday at Waimea Homestead Farmers Market, tea and talk story and gardening discussions with shoppers Monthly weekend workdays followed by a potluck Attendance of the monthly meetings of the Leadership Advisory Panel of Waimea Middle School Work with the Hawaii Island School Garden Network -ongoing information resource and partner attachment to 2009-10 Hawaii County Nonprofit Grant Application page 1 Mala'ai: The Culinary Garden of Waimea Middle School Performance Measures In addition to the numbers indicated on the performance measures chart, another way we gauge the effectiveness of our program is through use entrance and exit surveys. An entrance survey is completed by sixth grade students at the beginning the school year to assess the knowledge they bring regarding gardening and the cycles and seasons, Hawaiian cultural practices, attitudes about work and food and how they affect health and wellbeing. An exit survey provides information on what the students have learned during the time in the garden. The collated information is used by the teachers and the garden director to focus the direction of the teaching, the program and the surveys to best serve the students. Over the course of the last 3 years several things have become evident. In the exit survey the students are expressing gratitude for garden class, and pride in their culture, as well as an increased excitement about learning. As students have experience in the garden, they exhibit an increased understanding of the culture of the garden itself, and know what to do when they arrive at the garden for a class. The students show genuine enthusiasm for the opportunity to spend the time in the garden. The teachers are giving more time to incorporating the garden into their teaching schedule. Mala'ai has a policy of working only with teachers who choose to dedicate class time to participating in the program. There is no administrative incentive or mandate for them to participate. In the first quarter of the program Qanuary 2005) 2 classes worked in the garden. This quarter Qanuary 2009) there are 6-6`h grade, 7-7`h grade and an 8`h grade elective class scheduled to meet and work in the garden on a regular bases. Once a teacher begins bringing classes to the garden, she/he generally continues. Other teachers use the garden classroom for specific projects where the garden can provide hands on learning. Mala'ai is considered a model for other school gardening programs, and 5 schools, including a class from UH Hilo, came to work and learn at the garden in 2008. For the larger community, the garden is offering workshops to teach our school families and neighbors how to establish a garden to grow some of their own food. Mala'ai has also become a distribution center for excess produce gathered by Urban Farmers, a homeschool gleaning organization, as well as any abundance grown at the garden. Three Mala'ai Free Markets have been held, with students, faculty and community members coming to taste food made from the produce offered, and take food and recipes home to eat. Mala'ai is working towards creating a greater sense of food security and sustainability for our community. The garden itself is very reflective of all the hard work, which has gone into its creation. Starting with a pasture grass field, no tools or shelter, the garden now flourishes. attachment to 2009-10 Hawaii County Nonprofit Grant Application page 2 Mala'ai: The Culinary Garden of Waimea Middle School Program Expenditures Explanations Salaries and Wages - The increase is due to adding a half time assistant to allow the Garden Teacher more time with students, and a small housing stipend for an intern. Professional Fees - Mala'ai has hired an Accountant/CPA this year and anticipates an audit in 2010. Equipment - Includes a foundation slab for a tent classroom and a vegetable washing station in 2009, anticipated new infrastructure/equipment is expected to diminish in 2010. Operations -The increase in expense for 2009 include the standard operating expenses with the addition of web site expenses, some materials for the fundraising event and Board insurance. Other -Includes the program development supplies -garden materials, tools, class materials, staff development and mileage. attachment to 2009-10 Hawaii County Non Profit Grant Application page 3 54 Mental Health Kokua Residential Rehabilitation Services Mental Health Kokua Residential Rehabilitation Services Agency Director: Greg Payton 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.: 331-1378 Email Address: konamhkta'~mentalhealthkokua or~c 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: 08-07 07-08 08-09 $20,000 $25,000 $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 2009-10 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. Mental Health Kokua will offer 24 beds in Hilo and 14 beds in Kailua-Kona, a total of 38 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 also 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, community based alternatives to institutional care and/or homelessness. Transitional bed day costs for FY 2010 are estimated at $94. Comparative bed day costs in a psychiatric hospital are estimated at $800 to $1000 a day. Total Budget and Position Count Total Pro ram Bud et 1,300,391 Total Pro ram Position Count 22 Total A enc Bud et 8,132,460 Total A enc Position Count 121 Program Objectives: 1) Provide residential and social rehabilitation services to 125 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 (CARE) and other monitoring recommendations. 5) Show evidence of satisfaction with services received at 95% of consumers served 6) Show improvement in daily living skill scores upon discharge in at least 90% of consumers served. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Mental Health Kokua Residential Rehabilitation Services 7) Place at least 75% of consumers served in more independent living settings following planned discharge. Program Highlights: 1) Provided transitional residential rehabilitation services in FY 2008 to eighty-five (85) unduplicated clients at PATCH Place and Hale Amau in Hilo and twenty-six (26) unduplicated clients at Hale Alanoe and Kealahou in Kailua-Kona. 2) Discharged 58% of clients to more independent living in the community. All clients showed improvement in daily living skills. 3) Provided a total of 10,684 bed days and 21,368 meals in our transitional residential programs during FY 2008. 4) Successful in increasing community awareness of the residential rehabilitation services we provide on the Big Island through several activities/events. Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et* Estimate Number of unduplicated consumers 111 120 125 served Percentage of consumers served 58% 70% 75% who were discharged to more inde endent livin settin s Number of consumers served 4 3 2 re uirin hos italization Percentage of consumer satisfied 93% 95% 98% with services -ir applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Mental Health Kokua Residential Rehabilitation Services Program Expenditures: FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Salaries and Wa es 658,776 691,715 726,301 Professional Fees 1.9,035 19,987 20,986 O erations 525,468 551,741 579,328 E ui ment Other: Total 1,203,280 1,263,444 1,326,616 - iT appucaoie ttPlease explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Count of Hawaii 25,000 25,000 25,000 State of Hawaii -Department of Health 807,863 807,863 807,863 United Wa 7,812 7,812 7,812 Pro ram Service Fee 127,399 127,399 127,399 CCS Fees 73,816 73,816 73,816 Donation/other 41,157 41,157 41,157 Other: MHK Su ort 120,233 180,397 243,569 Total 1,203,280 1,263,444 1,326,616 n appncaoie Explain what plans, if any, your agency andlor 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 and special events. To both increase NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Mental Health Kokua Residential Rehabilitation Services our public awareness and generate revenue, in November 2008 we held the first annual Benefit Concert for our residential services on the Big Island During the more than 30 years of providing services to people with mental illness in Hawaii we have been successful in building strong relationships with many foundations and trusts, which have become pivotal in providing funding for new properties and major renovations to existing properties. We continue to explore ways for the agency to become fully self-sustaining. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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, 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 (:ve) understand that information supplied hereinahall he 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 ayear-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 ~~~ ~ , ~ ~ Via:,. _ Signature of ~o'ard Preside hair Signature'of xecuti Director 1 /27/09 Date 1 /27/09 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 55 Neighborhood Place of Kona Neighborhood Place Neighborhood Place of Kona -Agency Name Neighborhood Place -Program Name Agency Director: Gregory C. Chun, PhD Contact Person: Mailing Address: Christy A. Schumann Facility/Site Address: Fax No.: Email Address Phone No.: 808-331-8777 Phone No.: 808-331-8777 74-5565 Luhia St B-1 Kailua Kona, HI 96740 74-5565 Luhia St B-1 Kailua Kona, HI 96740 (808)-331-8774 cschumann @ hawaii. rr.com Name of AccountanUCPA (include name of firm if applicable): Carbonaro CPA & Associates, Inc. Phone No.: (808) 968-1002 Mailing Address: P.O. Box 4372 Hilo, HI 96720 Amount of Request for County Funds: $200,000 Prior Year(s) Funding: 06-07 07-08 08-09 $582,323 $556,207 $581,651 Agency Mission Statement: The mission of Neighborhood Place of Kona is to ensure the well being of our children and families by promoting environments of peace and safety. Program Description: The Neighborhood Place Program (NPP) provides afamily-centered, community-based walk-in facility, offering free, voluntary, and confidential services to the public assuring the safety and well being of children and families. This program embraces families in crisis at risk of child abuse or neglect by providing compassionate, non-judgmental services, resources, education, case management, and a hug as needed to keiki, their parents, and kupuna, with the purpose of strengthening the family, helping them to heal themselves. When this happens families can avoid either entering or reentering the Child Welfare Service system. NONPROFIT GRANT APPLICATION -FISCAL YEAR 2009-10 Page 1 Neighborhood Place of Kona - A ency Name Neighborhood Place -Program Name Total Budget and Position Count Total Pro ram Bud et $200,000 Total Pro ram Position Count 2.5 Total A enc Bud et $500,000 Total A enc Position Count 7 Program Objectives: 1) Neighborhood Place of Kona, through the Neighborhood Place Program (NPP) provides the public with a broad range of services aimed at strengthening families. No referral is needed, families can self refer and walk through our doors and receive the same quality service as a family referred by an agency. Services include education, information, referral linkage, case management and follow-up. This program is built upon a vision that every child in Hawaii will grow up in a loving family, nurturing home, and a safe environment. Program services center on strengthening family relationships and preventing child abuse and neglect. 2) Guided by values rooted in Hawaiian Culture we help strengthen family relationships through a process of increasing knowledge of child development, improving parenting and coping skills, and enhancing problem-solving abilities. NPP provides informational sessions, training and workshops such as Ke Ala Kupono parenting classes and Ho oponopono. 3) NPP partners with other agencies and through collaboration and advocacy, designs and leads activities to increase awareness of family needs and risk factors associated with the prevention of child abuse and neglect. Our community outreach serves to inform, educate, and engage families and inspire caring communities. 4) Our approach to delivery is both cultural and spiritual, incorporating the spirit of pu'uhonua (safety and peace) in each action taken with every person encountered. Our work is based upon delivering quality services following current social services best practices. Program Highlights: 1) NPP delivers quality services to families and provides linkages to community- based support. Delivery is tailored to meet the needs of families who are at-risk for or are experiencing recurring issues of child abuse and neglect. 2) NPP provides crisis intervention through informal counseling, family strengthening, and training in all aspects of childhood development. 3) NPP offers classes to increase the knowledge of child development, improving parenting and coping skills, and enhance problem-solving abilities; assists clients with basic needs, including, not limited to, applying for housing, childcare, and/or finanical assistance, connecting clients to resources for substance abuse, anger management, domestic violence, assessments, and counseling. 4) NPP develops and implements an Individualized Program Plan (IPP) for each family, providing case planning and management. Trained, educated, and experienced care coordinators monitor and record family progress during program involvement with a goal of completion within 6 months. 5) NPP encourages and engages the communities we live and work in to widen the circle of accountability to accomplish the goal of creating environments of peace and safety, ensuring the well being of children and families through: a) community outreach events and activities to increase family strengthening; b) activities for the service provider community to increase effective service delivery and to improve child abuse and neglect prevention services. NONPROFIT GRANT APPLICATION -FISCAL YEAR 2009-10 Page 2 Neighborhood Place of Kona -Agency Name Neighborhood Place -Program Name Performance Measures: Figures represent number of Families Served and to be served in 2009-2010. FY 2007-08 FY 2008-09 FY 2009-10 Actual Bud et * Estimate Family Strengthening"a nd Prevention 66 75 100 ° Services Minimum of New Clients 50 55 75 Families assessed and provided services to prevent child abuse and 53 50 50 ne lect Families provided information and 241 245 240 referral services onl of prevention families not confirmed for child abuse or neglect while in the 100% 95% 95% ro ram of families not confirmed for child abuse or neglect within 6 months of NP 100% 90% 90% case closure Note 1: Assessments completed within 30 days of intake that address the strengths, competencies, needs, and risks of families and youths. ` FY 2008-09 Budget revised at 6 months to reflect actual run rate. Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries & Wa es "°'e' 108,765 117,758 132,800 Professional Fees 969 4,768 5,000 O erations 34,470 41,368 50,000 E ui ment 823 2,106 2,200 Other Note2 0 0 10,000 Total 145,027 166,000 200,000 If applicable Note 1: Salaries include Care Coordinator and Community Outreach Coordinator, Part-time Administrative Assistant and Program/Accounting Manager. Note 2: Community Outreach Program activities and supplies in direct support of families, including family fun days hosted in the communities of Kohala, Kona, and Naalehu. NONPROFIT GRANT APPLICATION -FISCAL YEAR 2009-10 Page 3 Neighborhood Place of Kona -Agency Name Neighborhood Place -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Contract with Blue rint for Chan e 145,027 166,000 Uncertain Count of Hawaii 200,000 Fund raisin efforts 10,000 Other Grants 7,500 Annual Givin Cam ai n 5,000 Total 145,027 166,000 222,500 *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? NPK Board of Directors recognizes the need to step-up fund development and revenue diversification. During 2008 NPK held its 5`h annual golf tournament fundraiser at The Club at Hokulia raising $25,000 for family and community outreach programs. We anticipate the 6'h annual golf event scheduled for September 2009 will raise another $25,000 with $10,000 for community outreach activities under this program. The County of Hawai inon-profit grant, if awarded, will connect with and engage with local area government, serving to educate and inform our community leaders. NPK is encouraged by the Hawaii Community Foundation to apply for grants that align with the NPK mission. The Neighborhood Place Program is the foundation upon which Neighborhood Place of Kona was established and founded. This program has served communities throughout West Hawaii for 10 years, sustained primarily through state contracts. Our service record is recognized throughout the human services community. Our affiliation with other similarly operating NP programs (Oahu, Maui) is recognized by the Dept. of Human Services at the state level. Funding for this program has been sustained through a subcontract with Blueprint for Change, anon-profit organization based on Oahu, funded by the Dept. of Human Services, via Temporary Assistance for Needy Families (TANF) funding. With the State of Hawaii facing significant budget shortfalls we have been forewarned by state legislature and representatives that funding will be cut. With uncertainty surrounding this valuable and needed "one-of-a-kind" program we are applying for and seeking support from the County of Hawai inon-profit grant so that we may continue to serve families and children in our West Hawaii communities. Given current and near term economic conditions the needs of our families have and continue to increase. NPK is proactively seeking funding sources far the FY 2009-2010 to maintain continuity and avoid disruption of services. Our objective is to ensure this program will continue to support families in need, stretching from North Kohala to Ka'u, including Honokaa, Waimea, Kohala, North and South Kona, Ocean View, and Naalehu. NONPROFIT GRANT APPLICATION -FISCAL YEAR 2009-10 Page 4 Neighborhood Place of Kona - A ency Name Neighborhood Place -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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of vour program's or agency's future funding requests. Sign u Board PresidenUChair Interim Executive Director Team - ~c-~--- Signature Business Manager ~,d~- rl/l Signature of fr~g(~m Manager Signature of Community Outreach Coordinator ~~09 Date i ~-~ a Date /J2 sro9 Date ate UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION -FISCAL YEAR 2009-10 Page 5 56 Neighborhood Place of Puna Family Strengthening Home Visiting ~ ., Neighborhood Place of Puna- Agency Name Family Strengthening Home Visiting- Program Name Agency Director: Contact Person Mailing Address: Facility/site Address Fax No.: Email Address: Mary Hyslop Mary Hyslop PO Box 2020 Pahoa, HI 96778 15-3039 Pahoa Village Rd. Pahoa. H196778 965-5109 npp2020@hawaii. rr.com Phone No.: 965-5550 Phone No.: 965-5550 Name of Accountant/CPA (include name of firm if applicable): Alex Smith, CPA Phone No.: 808-737-7761 Mailing Address: 1403 Frank Street Honolulu, HI 96816 Amount of `Request for County Funds Prior Year(s) Funding: 06-07 07-08 $ $15,000 but not for this program: Agency Mission Statement: $20,000 08-09 $15,000 The goal of the Neighborhood Place of Puna is to prevent child abuse and neglect by strengthening families. The vision: "To Nurture, Strengthen and Celebrate 'Ghana". 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 2009-IO n,.,.., , ~a Neighborhood Place of Puna -Agency Name Family Strengthening Home Visiting- Program Name Program Description: Our goal is to strengthen families so that they are not at risk for child abuse and neglect. We work to improve the quality of life for families, make certain they have food, housing and that they are safe. Child abuse and neglect cannot be seen in a vacuum. Until parents and families have the resources they need they cannot be expected to be "ideal" parents. Until families feel nurtured they cannot nurture their children. By establishing trust through home visits, we help nurture our families, stabilize them and then we begin the process of helping parents/grandparents understand the typical growth and development stages of their children so that they are then able to foster optimal growth in their children. Referrals for Neighborhood Place Home Visiting services come from many sources including schools, courts, churches, agencies and self referrals. Once a referral for services is received, Neighborhood Place home visitors meet with the family and do a child safety assessment. A service plan is developed with each family and the service plan includes what it is that families want and what steps they are going to take to achieve their goals along with what steps Neightborhood Place workers need to take with the families to help them actualize their goals. For some families it is finding a place to live, others it is employent or assistance with finding resources. All service plans include assistance around the growth and development of each child. A family typically receives weekly home visits for a period of six months or until the goals on the service plan are reached. For some families services need to extend to one year or more; others may reach their goals after a few months. Once a family has successfully completed their "Family Success Plan" they are closed. Follow up begins at six months from closure with the Department of Human Services -Child Welfare Services Department. Many Puna families are living in substandard housing -two by fours, wood pallets and blue tarps. Neighborhood Place has been able to find generators, beds, blankets, refrigerators, solar batteries, school clothing, etc. We have helped with the supplies to build water catchment systems. We have provided 911 phones and prepared temporary restraining orders. Safety plans for families are developed -especially when there is or has been domestic violence in the home. We have tutored children who needed to pass one class to move to the next grade and we provide the needed advocacy with state and county agencies when families do not know how to access services. Home visiting has been proven to be one of the practices that works to strengthen families and reduce incidents of child abuse and neglect. Prevention programming is very important - if we do not pay now we will definitely pay later. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 n...~„ ~ Foster care for abused children is very costly, prisons are filled with adults who never received nurturing in their homes. The statistics for families in Puna are alarming -one fourth of the County's children live in Puna. From 1998 to 2001, Puna had the most confirmed cases of child abuse and neglect. Reported cases are 11.7% compared to the County (9.5%) and State (5.9%). Unfortunately, Puna rates high on all child abuse indicators including: 45% of families with incomes under 200% poverty level (State 25.9%); 13.8% of families receiving public assistance (State 4.9%); Single parent families 30% (State 18.3%). The two most alarming statistics are the high rate of abuse of 34 children per 1000 and the rate of removal of children in East Hawaii, which is higher than any other area in the state. Neighborhood Place of Puna, is one of two primary prevention programs for child abuse and neglect in East Hawaii -without the primary prevention programs we will see a rise in abuse and neglect. Total Budget and Position Count Total Pro ram Bud et $153,400 Total Pro ram Position Count 2.5 Total Agency Budget $246,100 Total Agency Position Count 4 Program Objectives: 1) The mission of the Neighborhood Place of Puna is to "Empower families and communities in Puna by building a strong foundation through healthy relationships that value each person's uniqueness. E malama pono kakou." Home visiting services designed to strengthen families and help them provide a safe and nurturning home for their families. Home visits are a proven way to provide family strengthening activities to the entire family and to work with the family in an environment where they feel most comfortable. Office visits are offered to all families but 98% prefer family visitation. The following objectives will be carried out during home visits to families at risk for child abuse and neglect: 2) Talk story assessments will be done on each family to determine family strengths, needs and protective factors 3) Development of culturally appropriate and collaborative family service plans which address where the family is, what they want and how to get there. 4) Providing information and referrals to formal and informal services 5) Providing advocacy and family support 6) Providing education around how to get needed services 7) Teaching parents the skills they need inorder to raise safe and healthy children. 8) Promoting cultural roots and economic stability NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 n..,.,. ~ 9) Follow up and evaluation Program Highlights: 1) Neighborhood Place of Puna did not received funding in 07-08 for this home visiting program. During the first two quarters of the 08-09 fiscal year, NPP provided home visiting services to 41 families in the Puna district. One hundred percent of families closed successfully completed their service plans and were not confirmed for child abuse or neglect while in the program. One hundred percent of families closed for six months were not confirmed for child abuse and neglect after case closure. 2) Some of the highlights include: Helping 52 adults and 150 children have a Christmas with new toys, food coupons and gift certificates for the teens. 3) Helping one family get an insurance claim, this enabled them to purchase a car for transportation. Helping 10 families access benefits that they did not know they were eligible for 4) Helping advocate for 6 families so that their children could receive special education services 5) Providing trainings for parents and grandparents on nurturing and disciplining children 6) Collaborating with other organizations i.e. Kamehameha Schools, Queen Lili'uokalani Children's Center, Pahoa Weed and Seed to provide family fun events and to get school supplies into the hands of 1300 school children 7) Convening the East Hawaii Coalition for the Prevention of Child Abuse and Neglect and the Puna Round Table in an effort to strengthen the community to reduce child abuse and neglect in East Hawaii 8) • In the first six months of 2008-2009 fiscal year, Neighborhood Place of Puna answered 269 calls from families asking for information and referrals. 9) During the first six months of 2008 - 2009, Neighborhood Place of Puna provided or collaborated in 28 community activities for families to increase their engagement in child abuse and neglect prevention and 65 community activities to coordinated effective community resources to families of risk of child abuse and neglect. 10) Recently one of our family members returned our consumer survey. Her comments summarize the scope of our program. She writes: "Words are not enough to express how thankful I am to have been a participant in this program. I was in a pretty desperate state when I walked through your doors. There were many crises within my household, but my outreach worker was always at my side to help me with information and referrals. She played an enormous part in advocating for my grandson and myself to get him properly diagnosed and in alerting his school to adapt his educational program to meet his needs. We eventually got out of unstable housing and now live in a decent house with running water. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 n,.,.,, ~ She helped with school supplies and helped me obtain things to make our house a home. She was available when I needed and always did follow up on the various goals I was working on. I have become so much more independent and much more able to advocate on my own. Thank you for all the work you did along side of me! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-L0 n.,.~,. e Neighborhood Place of Puna -Agency Name Family Strengthening Home Visiting -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Budget' FY 2009-10 Estimate Weekly home visits NA NA 25 FAMILIES Assessments and service plans developed NA NA 25 Advocacy, information and referral NA NA 25 FAMILIES Participants successfully complete service Ian NA NA 25 Participants free of child abuse and ne lect while in the ro ram NA NA 90% Participants free of child abuse and neglect six months from case closure NA NA 85% Family evaluations of home visiting services NA NA 90% *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wages NA $109,960 109,960 Professional Fees NA 8,700 8,700 Operations NA 29,540 29,540 E ui ment NA 0 Other" NA 5,200 5,200 Total NA $153,400 $153,400 " If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 o....,. c Neighborhood Place of Puna -Agency Name Family Strengthening Home Visiting -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual'" FY 2008-09 Bud et" FY 2009-10 Estimate Blue rint for Chan e (TANF NA 87,368 90,000 Hawaii Children's Trust Fund NA 25,532 8,000 Hawaii Island United Wa NA 17,000 20,000 Count of Hawaii NA 15,000 20,000 Contributions NA 1,000 1200 Consuelo Foundation NA 7,500 0 Misc. Foundations 14,200 Total 153,400 153,400 "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? Agency will increase grant writing. We have a community participant grant into Kamehameha schools. Will write for OHA monies, which we have had in the past. Blueprint for Change is seeking additional funding to increase grant monies to Neighborhood Places, who have had flat funding for six years. After sitting out one year, Neighborhood Place of Puna will be able to reapply for Hawaii Children's Trust Fund. Program will not become self sustaining -there are no fees, all services are free and this is a primary prevention program for child abuse and neglect. NONPROFIT GRANT APPLICATION FISCAL YIrAR 2009-10 D...... 7 County Application 2009 - 2010 Neighborhood Place of Puna: Family Strengthening Home Visiting Program Budget Explanation Other: Office supplies $ 230.00 Resource Manual for Clients $ 435.00 Program supplies: (Includes food coupons, gas coupons, emergency shelter repair) $4535.00 Total: $5200.00 7a Neighborhood Place of Puna -Agency Name Family Strengthening Home Visiting -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 ayear-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. Sign e f Board residenUChair f~'l~z~ /J L~ Signature f E e utive Director o ~ lz~/o~ Date ~/~ ~ /a Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 v..,... e 57 Office for Social Ministry Beyond Shelter Transitional Housing Program r Roman Catholic Church in the State of Hawaii, = ~ l~ ~' ,_ Office for Social Ministry n ! ~ ~ I Beyond Shelter Transitional Housing Program l~ Agency Director: Phone No.: Contact Person: Phone No.: Mailing Address: Facility/Site Address: Fax no.: Email Address: Carol R. Ignacio (808) 935-3050 Grandee Menino (808) 938-3050 140 B Holomua St., Hilo, Hawaii 96720 110 Ululani Street, Hilo, HI 96720 (808) 935-3794 bmenino @ rcchawaii.ora Name of Accountant/CPA (include name of firm if applicable): Accountant: Nancy Kay Lee, BBA, MBA (808) 935-3050 140-B Holomua Street Detor & Williams Phone No.: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds Prior Year(s) Funding: 06-07 07-08 $0.00 $20,000.00 Agency Mission Statement: $ 15,000.00 08-09 $15,000.00 The Office for Social Ministry is amulti-faceted department of the Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community-at-large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page I Roman Catholic Church in the State of Hawaii, _ Office for Social Ministry Beyond Shelter Transitional Housing Program 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 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 proud 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 Pro ram Bud et 118,700 Total Pro ram Position Count 1 Total A enc Budget 4,154,317 Total A enc Position Count 63 Program Objectives: For FY 09-10: 1. 10% of program participants will enroll in apost-secondary higher education institution. 2. 50% of unemployed program participants to enroll in higher/further educational opportunity including college courses, continuing education classes, vocational training orjob-readiness/employment programs. 3. 80% of employed participants will maintain employment for at least three months. 4. 80% of participants who transition to permanent housing will remain in housing for at least six months. 5. 90% of program participants will test clean during random drug testing. 6. 75% of school age children residing at Beyond shelter will have participated in at least one extra-curricular activity throughout their program stay. 7. 75% of school age children residing at Beyond Shelter will have received tutoring and homework assistance services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Roman Catholic Church in the State of Hawaii, - Office for Social Ministry Beyond Shelter Transitional Housing Program 8. 25% of school age children residing at Beyond Shelter for at least one year, will improve their grades (or grading marks) by at least one higher grade/mark Program Highlights: 1) During this fiscal year there was an increased level of clients that were approved for subsidized units through Hawaii Public Housing Authority. Families were able to move out of Beyond Shelter within a shorter time frame from transitional housing to affordable public housing rental units where families pay 30% of their income towards rent and the State subsidizes the remaining contract rent. 2) Effective November 1, 2007, the County's Section 8 program also implemented a homeless preference allowing our clients to move to the top of the waitlist and be served. Our clients were able to obtain a TBRA (tenant-based rental assistance) voucher allowing them to obtain subsidized housing in the private market. This resulted in being able to shelter additional homeless families in Beyond Shelter. 3) Since the inception of the Beyond Shelter Program on June 1, 2006, 100% of participants that have completed the program successfully and transitioned to permanent housing, have maintained their housing for over 6 months. Pertormance Measures: FY 2007-OS FY2008-09 FY 2009-10 Actual * Bud et * Estimate 1. No. of participants who have completed (developed) an initial 59 50 50 social services plans. (Plan shall list all of the participant's goals -basic goals, as well as complex ones and goals attainable in the short term, as well as goals which will take some time to achieve. 2. No. of duplicated participants completed training or education 3 5 5 ro ram e. . GED, 'ob trainin ,etc. 3. No. of unduplicated adults completed a phase of a substance 0 2 2 abuse treatment ro ram 4. No. of unduplicated participants participated in community 0 10 10 activities e. .resident association, securit watch, etc. 5. No. of unduplicated participants who retained employment for 5 10 10 at least three months 6. No. of unduplicated participants transitioned off welfare 7 5 5 7. No. of unduplicated participants transitioned to permanent 37 25 25 housin 8. No. of unduplicated participants retaining permanent housing 23 25 25 for at least six months after exiting program and were not counted in revious re orts . ~~ u eppucaoie NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter Transitional Housing Program Program Expenditures: FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Salaries and Wa es $61,703.45 $6,010. $27,933 Professional Fees Operations $69,752.67 $121,010 $90,767 E ui ment Other Subsidies # Total $98,456.12 $127,020 $118,700 it applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY2008-09 Bud et * FY 2009-10 Estimate HPHA contract 07-08 $40,612.50 $61,800.00 $60,400.00 Count of Hawaii $20,000.00 $20,000.00 $15,000.00 HIUW $3,500.00 $7,000.00 $4,900.00 Pro ram Fees $50,430.18 $38,220.00 $38,400.00 ii aNNiweuie 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 received support from the State's Hawaii Public Housing Authority (HPHA), the County of Hawaii and the Hawaii Island United Way. OSM intends to submit grant applications to the Hawaii Community Foundation (HCF), the Kaneta Foundation, and maximize in-kind resources from St. Joseph Church and from the community at large. Program fees generated from the transitional housing program provides an additional revenue stream for operational costs to offset expenses. OSM also submitted an application to the State's Department of Labor, Office of Community Services in response to a request for proposal to implement the "Employment Core Services" program for low income persons. OSM is still awaiting a response of the State's grant application findings. This program will complement the work being done to employ and prepare Beyond Shelter residents obtain and maintain employment. OSM also intends to offset operational expenses by reducing waste and going green by recycling, and transition from paper records to web-based case management notes. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Roman Catholic Church in the State of Hawaii, Beyond Shelter Housing Program I (we) have read and understood all of the eligibility requirements; gran conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-1422, 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 1 (we) have the authority and ability to fully administer the program(s) pursuant to law, I (we) understand that information supplies 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 wfth the requirement tosubmit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall Include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expendftures 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 vear-end L Z~ Signature o~Board / esidenUChair Signature of Executive Dir t ~Ia~le9 Date ~ ~, o ~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 58 Office for Social Ministry Care-A-Van Homeless Outreach .- Roman Catholic Church in the State of Hawaii, Office for Social Ministry: ~ `, , Care-A-Van Homeless Outreach ~i Agency Director: Phone No.: Contact Person: Phone No.: Mailing Address: Facility/Site Address: Fax no.: Email Address: Carol R. Ignacio (808)935-3050 Grandee Menino (808) 938-3050 140 B Holomua St., Hilo, Hawaii 96720 479 Kinoole Street, Hilo, Hawaii 96720 (808) 935-3794 bmenino @ rcchawaii.org Name of AccountantlCPA (include name of firm if applicable): Accountant: Nancy Kay Lee, BBA, MBA (808) 935-3050 140-B Holomua Street Detor & Williams Phone No.: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds: $ 20,000.00 Prior Year(s) Funding: 06-07 $35,000.00 07-08 $35,000.00 Agency Mission Statement: 08-09 $20,000.00 The Office for Social Ministry is amulti-faceted department of the Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community-at-large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry: Care-A-Van Homeless Outreach Program Description: For nearly 17 years, Care-A-Van (hereinafter, CAV) has served nearly 16,000 homeless persons. CAV is the only outreach program on Hawaii Island that specifically targets the unsheltered homeless population. In building a healthier community, staff members travel to where the homeless congregate and assist them ultimately into stable housing situations. Staffs drive to remote beaches, parks, woods, lava fields, emergency homeless shelters, domestic violence shelters or in and around downtown Hilo, Puna, Hamakua and Kailua-Kona. Outreach Specialists offer a cup of coffee and listen to the person's concerns as the first step in connecting him or her to housing and mainstream services. Through this type of "outreach" and engagement, trust is established with these consumers to eventually link them with needed services. Outreach Specialists will continue to provide supportive services, intervene during crises, and provide emergency items such as food, clothing, blankets, towels, hygiene products, first aid and other essentials as tools of engagement and establishing a trusting relationship. Effective engagement and initiating outreach efforts is the first step toward receiving more formal mental health services. Once a trusting relationship is established and adequate rapport is apparent, case management services may commence, as a transition into the formal system of mental health services. Interim case management services will be provided while consumer awaits eligibility determination and formally linked with a mental health case management provider. Interim case management allows a slow progression towards a more formal mental health system of care. Other support services that CAV shall provide include transportation for unsheltered homeless individuals seeking medical care, substance abuse or mental health treatment, attend court hearings, and assist with employment searches. Staff also help search for housing opportunities, prepare consumers for housing presentation and interview, and complete housing applications for Federal, State and County units. CAV owns and operates four-wheel drive vehicles to provide these mobile outreach services. Through a flexible service delivery system, tailored to each person, CAV begins with an intake process and assesses their homeless situation. CAV staff often assists people with obtaining their birth certificates enabling them to acquire a picture ID. With picture identification, they can receive social security entitlements, welfare and food stamp assistance, establish a mailing address, look for employment, and cash their checks. All of these kinds of assistance move consumers towards self-sufficiency and building a healthier community. Most importantly, CAV advocates for clients who may not be getting the services they need and they do not know how to advocate for themselves. CAV seeks to impart hope to each person and helps with the process of setting goals, no matter how small or large, that will help a client start down the path towards self-sufficiency. The goal of this program is to connect homeless consumers to more traditional program services, health care, mainstream community programs and to ultimately move them into shelter, transitional and permanent housing. Engagement and effective outreach efforts are crucial processes and a critical link to the community. Total Budget and Position Count Total Pro ram Bud et 1,940,312 Total Pro ram Position Count 27 Total A ency Budget 4,154,317 Total A enc Position Count 63 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry: Care-A-Van Homeless Outreach Program Objectives: 1. 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. 2. 50% of program participants to enroll in higher/further educational opportunity including college courses, continuing education classes, vocational training orjob-readiness/employment programs. 3. 80% of participants who enrolled in shelter programs will remain there until other housing is secured. 4. 90% of eligible program participants who received monthly rental subsidies will pay their rent on time for at least 6 months. 5. 90% of AMHD-eligible participants will enroll in at least one AMHD-contracted program. 6. 80% of program participants will not violate the terms of their lease or be evicted for at least six months. Program Highlights: 1. Served 846 unduplicated homeless persons in Hawaii County, including 110 unduplicated families with children (332 individuals in families); 514 unduplicated single persons; and 679 new program participants. We can speculate that possible factors in the decrease of homeless persons served include a decrease in Outreach staff due to a budget cut of more than $100,000 from the State's Department of Health, Adult Mental Health Division, the establishment of the Grant Program that helps pay for back due rent and prevents families at-risk of homelessness to remain in housing, more families being assisted through the State's public housing projects due to renovation and repairs completed to their units, and the establishment of the County's homeless preference in their Section 8 program by distributing rental vouchers and making rent affordable. 2. 2007-2008 was CAV's fourth 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 eighty-nine (89) unsheltered homeless persons into forty-five (45) rental units, including fifty-three (53) adults and thirty-six (36) 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. 3. Housing Retention: By providing on-going case management and linkage to the TANF Housing Placement program we have successfully assisted 97% remain in housing for at least six months. 4. Housing Partners: We have a formal established partnership with Day Lum Rentals and Property Management in which two memorandum of agreements were put in motion as pilot projects to assist individuals and families who perhaps have not established credit, or poor credit or have been convicted of criminal acts move into housing. These types of barriers, including poor rental history, creates barriers for families to move into housing from homelessness. Landlords and property owners are least likely to rent to this population because of these reasons. Hence, Nancy Cabral, owner of Day Lum rentals, was willing to initiate a pilot project to help these families move in housing. Day Lum waives the credit and criminal background checks and accepts our referrals for direct renter ship. This partnership allows "hard to place' families directly from the streets and into housing. Performance Measures: FY 2007-08 Actual * FY2008-09 Bud et * FY 2009-10 Estimate Number of ersons laced in emer enc or transitional housin 252 250 250 Number of ersons laced in ermanent housin 280 250 250 Number of ersons rovided food and/or emer enc su lies 846 800 800 Number of persons provided or referred for medical or dental services du licated 846 800 800 Number of ersons who obtained em to ment 88 75 75 Number of ersons accessin mental health services 56 50 50 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry: Care-A-Van Homeless Outreach Program Expenditures: FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Salaries and Wages $1,354,070.35 $1,555,158 $1,018,042 Professional Fees O erations $338,145.80 $526,908 $484,383 E ui ment Other Subsidies # $319,654.87 $313,766 $384,147 Total $2,011,871.02 $2,395,832 $1,886,572 * If applicable # Please explain in detail on separate sheet: This line item is strictly direct financial assistance to subsidize rental units in the private rental market. Program participants pay 30% of their gross monthly income towards their rent while OSM pay the remaining balance directly to the landlord each month the participant is in the program. This is known as rapid-rehousing...moving individuals and families from the street and directly into housing as fast as possible and wrap supportive services around the participant so they have the ability to increase their income and skills. Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY2008-09 Budget * FY 2009-10 Estimate HPHA contract HPS OS-24 $22,912.00 HPHA contract HPS 07-08 $534,375.00 $785,000.00 $687,260.00 SHEG $130,750.00 $180,000.00 TANF $633,608.38 $800,000.00 $528,000.00 Non-TANF $814.00 $0.00 $0.00 Kukui Shelter Plus $18,743.85 $125,832.00 $125,832.00 Adult Mental Health Outreach $277,253.38 $412,000.00 $100,000.00 Adult Mental Health Rep Pa ee $139.329.30 $228,000.00 $204,480.00 County of Hawaii $35,000.00 $35,00000 $20,000.00 HIUW $10,833.34 $10,000.00 $7,000.00 Charity Walk $5,000.00 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 submitted a grant application to renew our current Kukui rental subsidy program for another year as our current contract of five years will come to an end April 30, 2009. OSM submitted a new grant application through the U.S. Housing and Urban Development (HUD) SuperNOFA application process for a second Shelter Plus Care program to run concurrently with the Kukui program. These rental subsidies allow us to assist more disabled homeless persons to move into rental housing and make their rental affordable, sometime an impossible task while living on a fixed monthly income. OSM intends to continue pursuing operational funding from HPHA again this year, submit an application with the Hawaii Island United Way, and participate in the Visitor Industry's Charity Walk again this year. OSM also submitted an application to the State's Department of Labor, Office and Community Services in response to a request for proposal to implement the "Employment Core Services' program for low income persons. OSM is still awaiting a response of the State's grant application findings. This program will complement the work being done to employ and prepare previously incarcerated persons obtain and maintain employment. OSM also intends to offset operational expenses by reducing waste and going green by recycling, and transition from paper records to web-based case management notes. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 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; gran conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-1422, 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 supplies herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawal'i, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. 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 and accurate year-end requests. Signature of B~oard~resiilenUChair ~~30~09 Date Signature of Executive Direc 1 30 ~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 59 Office for Social Ministry Kihei Pua Emergency Shelter Roman Catholic Church in the State of Hawaii, Office for Social Minist Kihei Pua Emergency Shelter Agency Director: Phone No.: Contact Person: Phone No.: Mailing Address: Facility/Site Address Fax no.: Email Address: Carol R. Ignacio (808) 935-3050 Brandee Menino (808) 938-3050 140 B Holomua St., Hilo, Hawaii 96720 115 Kapiolani Street, Hilo, HI 96720 (808) 935-3794 bmenino @ rcchawaii.org Name of AccountanUCPA (include name of firm if applicable): Accountant: Nancy Kay Lee, BBA, MBA (808) 935-3050 140-B Holomua Street Detor & Williams Phone No.: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds: $ 20,000.00 Prior Year(s) Funding: 06-07 07-08 OS-09 $20,000.00 $30,000.00 $20,000.00 Agency Mission Statement: The Office for Social Ministry is amulti-faceted department of the Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community-at-large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry: Kihei Pua Emergency Shelter 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 provides emergency housing for up to 16 families. Kihei Pua is a fast-paced (6) six-week program for families ready to move forward in improving their living situation from unsheltered homelessness to permanent housing. This program is an essential program in our community in strengthening families and building healthier communities. Kihei Pua, the only emergency shelter for families in Hawaii County, offers families and individuals experiencing homelessness the opportunity to obtain permanent housing and initiate cognitive restructuring of people's behaviors by offering education classes on Being a good renter, be a contributing community member, establish and stick to a practical budget, stay clean and sober, and respect themselves and thy neighbors. The target group for 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 who possesses a 45- day eviction notice. Additionally, preference is given to families, with shelter being provided for individuals as space becomes 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 Pro ram Bud et 669,762 Total Pro ram Position Count 12 Total Agenc Bud et 4,154,317 Total A enc Position Count 63 Program Objectives: For FY-09-10: 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: 1. All children within the age range of 0-5 years old were referred to YWCA Advanced Healthy Start and Head Start. "Kindermusik" provided an introduction to music and a music NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter appreciation program for infants and toddlers along with their parents. Keiki Play Mornings by The Institute for Family Enrichment (TIFFE) provided a structured play group for young children and their parents. 2. On-site tutoring services were available for homeless children through the Department of Education. OSM sponsored tuition fees for children to participate in after-school activities at the Boys and Girls Club. The YMCA also sponsored tuition fees for their summer & teen program. Some children have participated in other extracurricular activities such as canoe paddling and the Salvation Army's summer youth camp. Our aim is to provide the children in our programs with structured activities, community involvement and opportunities to succeed despite their families current struggles. 3. Family activities are planned regularly throughout the month to increase family strengthening thus stabilizing the family unit. Such activities include nightly family dinners, family game nights (2) two times per week and family movie nights (2) times monthly. Participants agree and plan how to celebrate traditional family holidays with staff support and supplies available as needed. Birthdays and accomplishments (i.e. finding employment or securing housing) are also planned by the individual family with staff support and supplies available as needed. Donated gifts, birthday cakes, and food are also available for families as needed. 4. Health Education classes were offered on site through the Extended Food and Nutrition Education Program (EFNEP) and University of Hawaii at Hilo Nursing Department. Exercise classes were also offered to participants. Participants were given opportunities to join staff in regular walks around Coconut Island and enroll in hula classes with Kumu Hula Lehua Yuen. 5. A mini grant was awarded to Kihei Pua by Na Maka O Hau Loa through the assistance of Ka'iana Haili. This grant provided funds needed to purchase material to build a community garden. Under the supervision of Ka'iana Haili, inmates from the Hale Nani Workline built (2) two garden beds on-site while program participants and staff took an active role in planting and maintaining the gardens. The gardens provide vegetables and herbs for participants to use for their household meals and are also used for nightly family dinners. Participants acquire skills to maintain a small garden and are encouraged to take plant clippings from the garden when they transition to permanent housing. 6. Established partnerships with Bay Clinic, Hui Malama, and Dr. Stephan Harmeling to provide non- emergent medical care to uninsured and under-insured participants at a reduced fee. Also scheduled monthly "dental runs" to Mobile Care Health project for regular and emergency dental care for participants at their Honokaa site. Shelter staff provided transportation to MobileCare, made possible through a generous donation of a '94 Plymoth Voyager (7) seven- passenger van. Performance Measures: FY 2007-08 FY2008-09 FY 2009-10 Actual * Bud et * Estimate 1. No. of unduplicated participants exited to permanent 125 125 125 housin 2. No. of unduplicated participants exited to transitional 36 35 35 shelter or other transitional ro rams 3. No. of duplicated participants enrolled in training or 36 35 35 education ro ram e. . GED, 'ob trainin ,etc. 4. No. of unduplicated participants obtained employment 18 20 20 5. No. of unduplicated adults in need of substance abuse 1 2 2 treatment enrolled in a hase of such ro ram 6. No. of unduplicated participants in need of mental health 27 25 25 services accessin such services NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry: Kihei Pua Emergency Shelter Program Expenditures: FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Salaries and Wa es $392,712.96 $418,501. $425,454 Professional Fees Operations $199,792.96 $150,109 $244308 E ui ment Other Subsidies Total $592,505.92 $568,610 $669,762 If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-OS Actual * FY2008-09 Budget * FY 2009-10 Estimate HPHA contract 06-07 $161,500.00 HPHA contract 07-08 $219,877.50 ESG 06 $50,100.00 ESG 07 $23,403.96 $81,610.00 Ma or's Fund $66,453.36 $38,220.00 HPHA contract 08-09 $423,400.00 HPHA contract 09-10 $ $549,600.00 ESG 09 $ $62,850.00 Count of Hawaii $30,000.00 $35,000.00 $20.000.00 HIUW $12,454.16 $14,000.00 $9,800.00 Pro ram Fees $17,766.00 $14,600.00 $27,512.00 Donations $490.59 Laund $529.39 *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 received support from the State's Hawaii Public Housing Authority (HPHA), the County of Hawaii and the Hawaii Island United Way. OSM intends to submit grant applications to the Hawaii Community Foundation (HCF), the Kaneta Foundation, and maximize in-kind resources from faith-based organizations and from the community at large. Program fees generated from the emergency shelter provides an additional revenue stream for operational costs to offset expenses. OSM also submitted an application to the State's Department of Labor, Office of Community Services in response to a request for proposal to implement the "Employment Core Services" program for low income persons. OSM is still awaiting a response of the State's grant application findings. This program will complement the work being done to employ and prepare Kihei Pua residents obtain and maintain employment. OSM also intends to offset operational expenses by reducing waste and going green by recycling, and transition from paper records to web-based case management notes. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministrv• Kihei Pua Emergency Shelter I (we) have read and understood all of the eligibility requirements; gran conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-1422, 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 supplies herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawal'i, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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, cote and ~'u~--- Signature of Board PresidenUChair Signature of F~cecutive Dire o Date ~~3c1o9 ~D ~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEEPTED[ NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 60 Office for Social Ministry Pahoa Homeless Program: Puna Drop In Services ~, Roman Catholic Church in the State of Hawaii, Pahoa Homeless Program: Puna Drop In Services Agency Director: Carol R. Ignacio Phone No.: (808) 935-3050 Contact Person: Brandee Menino Phone No.: (808) 938-3050 Mailing Address: 140 B Holomua St., Hilo, Hawaii 96720 Facility/Site Address: Pahoa Village Center: 15-2866 Pahoa Village Road, HI 96778, Building E, Space No.2. Fax no.: (808) 935-3794 Email Address: bmeninoC~rcchawaii.oro Name of AccountanUCPA (include name of firm if applicable): Accountant: Nancy Kay Lee, BBA, MBA (808) 935-3050 140-B Holomua Street Detor & Williams Phone No.: (808) 521-0002 Mailing Address, 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds: $ 20,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $0.00 $0.00 Agency Mission Statement: $0.00 The Office for Social Ministry is amulti-faceted department of the Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community-at-large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. .,`, NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page I Roman Catholic Church in the State of Hawaii, Office for Social Ministry Pahoa Homeless Program: Puna Drop In Services Program Description: Since May 2008, OSM began operating a drop in center in Pahoa town called the "Puna Drop In Center." This facility was initiated by County Councilwoman Emily Naeole with a start up grant of $25,000 to operate a homeless program in lower puna. The Puna Drop In Center offers an array of services including emergency non-perishable food, hygiene supplies, clothing, housing placement, and weekly renter's education/life skills classes. An outreach staff making linkages to community resources, triage to the emergency shelter, transitional housing programs, sober living group homes or permanent rental housing. Outreach staff engages and builds rapport with persons experiencing homelessness: instilling hope, and offering support and information to take the next step towards shelter, and ultimately affordable housing. This is an alternative form of homeless outreach services commonly known as "in-reach" by having an Outreach Specialist consistently on site to meet with persons experiencing homelessness...as outreaching We foresee this site as an opportunity to engage and be available to this sometimes forgotten population. Offering hands of hope, meeting their basic needs and connecting them to more "formal" systems of care (medical, dental, mental health and substance abuse treatment services if applicable), long-term case management and shelter or housing opportunities. An emergency food pantry will be on-site, complementing existing community resources; clothing bank, for employment/housing search and emergencies; and linkages/referrals to OSM-operated shelter and housing programs. The vision of this "drop-in" center is to meet the basic needs of the homeless community. We began operations in May of 2008. This program works in conjunction with the mobile outreach Care-A-Van program and the West Hawaii "Friendly Place" drop in center...all sites in existence to help meet the basic needs of the homeless community. The Puna Community Development Plan has housing and support services as a high priority. Total Budget and Position Count Total Pro ram Bud et 82,740 Total Pro ram Position Count 1 Total A enc Bud et 4,154,317 Total A enc Position Count 63 Program Objectives: 1. Projected to serve 250 unduplicated homeless persons 2. 50% will receive emergency supplies (food, clothing or hygiene items) NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Pahoa Homeless Program: Puna Drop In Services 3. 15% will access health services (whether it be mental health; substance abuse treatment services; medical or dental care); 4. 15% will increase their income (through employment opportunities and/or receive government entitlements when initial income is none); 5. 15% will be placed into emergency shelter; 6. 10% will be placed into transitional housing programs; 7. 15% will be placed into permanent housing (subsidized or any private rental) Program Highlights: 1) Member of "Da Poi Bowl" -assisting low income persons access a monthly food pantry and hot meal program. Assisted community with organizing initial distributions and helped Sacred Heart's church member access $2,000 seed grant to offer monthly hot meals at this venue. 2) Furnished new facility with clothing closets, office space, classroom instruction space for training, resource room and currently building new cabinets and added a sink, microwave and refrigerator to offer a place where the homeless community can prepare quick meals. 3) Strengthened community partnerships with surrounding non-profit and government agencies. Performance Measures: *Program opened May 2008. Thus 2007-2008 #s are from May-December 2008 only. FY 2007-08 FY2008-09 FY 2009-10 Actual * Bud et * Estimate Number of unduplicated homeless persons served at the Drop In Center 143 250 250 Number of unduplicated persons who will receive food and/or emergency supplies (ex. 141 200 200 Clothin , blanket, h iene su lies, back ack Number of persons who accessed health care services (mental health, dental, physical) 25 40 40 Number of persons who gained employment (seasonal, part time, full time) 5 20 20 Number of persons who began receiving financial benefits through mainstream 10 20 20 ro rams ex. DHS, Social Securit ,Veteran Number of persons placed in emergency shelter 14 20 20 Number of persons placed in transitional housing programs. 2 5 5 Number of persons placed in permanent housing 14 20 20 If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministrv~ Pahoa Homeless Program: Puna Drop In Services Program Expenditures: FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Salaries and Wa es $45,707 Professional Fees O erations $37,033 E ui ment Other# Total $82,740 ~~ If applicable N Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY2008-09 Bud et * FY 2009-10 Estimate HPHA contract $62,740 Count of Hawaii $20,000 Hawaii Island United Wa $5,000 Private Donations $2,500 -Ir appucaole 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 received supplemental support from Hawaii Public Housing Authority (HPHA) for the cost of staff in this initial year of operation. OSM intends to continue pursuing operational funding from HPHA again this year, submit an application with the Hawaii Island United Way for first time funding for this program and solicit the community for support. OSM also submitted an application to the State's Department of Labor, Office and Community Services in response to a request for proposal to implement the "Employment Core Services" program for low income persons. OSM is still awaiting a response of the State's grant application findings. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Roman Catholic Church in the State of Hawaii, Homeless Puna Drop In I (we) have read and understood all of the eligibility requirements; gran conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-1422, 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 supplies 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shaii 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 and accurate vear-end requests. ~~ ~ >s Signature of Board President/Chair ~ I3o~o9 Date Signature of Executive Direc r t 36 0 Date UNSIGNED PROPOSALS WILL NOT BE ACCEEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 61 Office for Social Ministry Ponahawaiola :Community Re-integration Services Roman Catholic Church in the State of Hawaii, ~ ~ 1' Y Office for Social Ministn.~• Ponahawaiola: Community Re-integration Services Agency Director: Carol R. Ignacio Phone No.: (808) 935-3050 Contact Person: Brandee Menino Phone No.: (808) 938-3050 Mailing Address: 140 B Holomua St., Hilo, Hawaii 96720 Facility/Site Address: 483 Kinoole Street, Hilo, Hawaii 96720 Fax no.: (808) 935-3794 Email Address: bmeninoC~rcchawaii.oro Name of Accountant/CPA (include name of firm if applicable): Accountant: Nancy Kay Lee, BBA, MBA (808) 935-3050 140-B Holomua Street Detor & Williams Phone No.: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds: $ 20,000.00 Prior Year(s) Funding: 06-07 07-08 OS-09 $0.00 $30,000.00 $20,000.00 Agency Mission Statement: The Office for Social Ministry is amulti-faceted department of the Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community-at-large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawaiola: 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 Kekahi (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 Total Pro ram Bud et 534,840 Total Pro ram Position Count 9 Total A enc Bud et 4,154,317 Total A enc Position Count 63 Program Objectives: For FY-09-10: 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; 4. 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. Program Highlights: (1) Decreased rate of recidivism - Of the 27 participants that left the program during this funding period, 96% exited back into the community successfully, while only 4% was re-incarcerated directly from the program. This translates into an increase of public safety as a result of this program. (2) Partnerships established with a number of local realtors to provide housing placements with no background checks further reducing housing barriers and increasing housing opportunities for persons with criminal histories. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawaiola: Community Re-integration Services (3) Weekly house meetings give participants opportunities to discuss and offer solutions to issues that may arise as part of a group living arrangement. Ongoing life skills classes also address daily living skills such as budgeting, healthy communication and coping skills, developing and maintaining healthy relationships, and leisure activities. These leisure activities provide participants with sober and structured socialization activities. (4) Participants are currently active in the New Hope Community Softball League. This league consists of community agencies and churches and gives participants the opportunity to network and develop relationships with pro-social community citizens. Participants also took part in the following community events: Domestic Violence Vigil, Native American Pow Wow, Substance Abuse Recovery Events, Hawaii Island Food Basket Spring Food Drive, and the Hawaii Island Business Bureau Charity Walk. (5) Continue to utilize cognitive restructuring classes through the Hazelden model, gender specific group meetings and motivational interviewing methods which serve to increase program effectiveness aimed at targeting criminogenic needs and reducing recidivism rates. (6) Established network of partnerships for participants through ongoing in-services provided by community agencies for our participants. Topics include domestic violence awareness, cultural sensitivity, community empowerment, politics and responsible citizenship. (7) Acquired avolunteer/advocate, Lillian Tavares, to educate our participants on topics such as, legal issues, domestic violence, political awareness, cultural awareness and sensitivity and community resources. As a direct result of these classes, all program participants have become registered voters making them eligible to vote in the recent primary and upcoming elections. Lillian is a Domestic Violence/Sex Assault Victim Services Coordinator with HPD and a Victim Services Assistant with County Civil Service. She also has past experience as a police radio dispatcher 8 supervisor, family law under the supervision of current Family Court Judge Lloyd Van De Car and has volunteered in the Prosecutors Office under the direction Susan Heftel Liquido. (8) Development of the "PIER" (Ponahawaiola Independent Living Readiness) group which is primarily operated by program participants with support available from staff as needed. This group relies on a team approach to ensure that it is run properly and meets every morning. Discussions focus on current issues and provide real-life solutions that increase participants' opportunities for self-sufficiency and is aimed at reducing barriers to employment, education and housing. The PIER group was recently awarded a grant in the amount of $16,500 through the local Catholic Campaign for Human Development, an economic development initiative, far the purpose of obtaining technical assistance, which included leadership development, succession planning, community events, business planning, problem salving and fundraising. This grant will also position them to apply for the national grant upon completion of this award. (9) Developed a "Buddy System" to foster positive mentoring by pairing a new client with a client that has demonstrated motivation and made positive changes in their life while at Ponahawaiola. A "Mentoring Manual" was also created as a training tool and guide for mentors and mentees. Performance Measures: FY 2007-08 Actual * FY2008-09 Bud et * FY 2009-10 Estimate Number of ersons laced in transitional housin 52 28 28 Number of ersons laced in ermanent housin 15 10 10 Number of ersons in em to ment 37 28 28 Number of persons placed into drug treatment or alcohol treatment 12 15 15 Number of persons receiving education/job training assistance 52 28 28 NVNYKVrIl IiKAN1 AYYLICA'11UN FISCAL YEAR 2009-10 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawaiola: Communit Re-inte ration Services Number of persons accessing health services (nutrition, 38 28 28 medical, erontolo , thera eutic massa e, aerobic Number of ersons accessin mental health services * ~~ 26 10 10 ii dNNii~auie Program Expenditures: FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Salaries and Wa es $376,450.10 $366,389 $222,872 Professional Fees O erations $249,643.20 $297,791 $311,968 E ui ment Other Subsidies # Total * $626,093.30 $664,180 $534,840 If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY2008-09 Bud et * FY 2009-10 Estimate HCF -Federal Meth $14,379.25 HPHA contract HPS 07-08 $285,000.00 $500,000.00 $400,000.00 Count of Hawaii $30,000.00 $35,000.00 $20,000.00 HIUW $10,000.00 $20,000.00 $10,000.00 Charit Walk $3,100.00 $3,100.00 $5,000.00 Pro ram Fees $89,408.90 $106,080.00 $99,840.00 Kaneta Foundation $5,000.00 "Ir 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 intends to apply for a new funding opportunity through the State's Department of Public Safety to offset expenses. OSM intends to continue pursuing operational funding from HPHA again this year, submit an application with the Hawaii Island United Way, and participate in the Visitor Industry's Charity Walk again this year. OSM also submitted an application to the State's Department of Labor, Office and Community Services in response to a request for proposal to implement the "Employment Core Services' program for low income persons. OSM is still awaiting a response of the State's grant application findings. This program will complement the work being done to employ and prepare previously incarcerated persons obtain and maintain employment. OSM also intends to offset operational expenses by reducing waste and going green by recycling, and transition from paper records to web-based case management notes. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Roman Catholic Church in the State of Hawaii, _ Office for Social Ministrv• Ponahawaiola: Community Re-integration Services I (we) have read and understood all of the eligibility requirements; gran conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-1422, 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 supplies herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'1, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs 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 o B and President/C~iair ~I3O~°`i Date (3a e Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 62 Office for Social Ministry West Hawaii Emergency Housing Facility Roman Catholic Church in the State of Hawaii, Office for Social Ministry `~= West Hawaii Emergency Housing Facility Agency Director: Phone No.: Contact Person: Phone No.: Mailing Address: Facility/Site Address: Fax no.: Email Address: Carol R. Ignacio (808) 935-3050 Grandee Menino (808) 938-3050 140 B Holomua St., Hilo, Hawaii 96720 74-5593 Pawai Place, Kailua-Kona, Hawaii 96745 (808)935-3794 bmenino@ rcchawaii.oro Name of Accountant/CPA (include name of firm if applicable): Accountant: Nancy Kay Lee, BBA, MBA (808) 935-3050 140-B Holomua Street Detor & Williams Phone No.: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds: $ 30,000.00 Prior Year(s) Funding: 06-07 07-08 08-09 $0.00 $0.00 $0.00 Agency Mission Statement: The Office for Social Ministry is amulti-faceted department of the Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community-at-large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry West Hawaii Emergency Housing Facility Program Description: In February 2010, the Office for Social Ministry (OSM) plans to assume fiscal and operational responsibilities of the West Hawaii Emergency Housing program. This facility will be built directly behind the County's "Friendly Place" Drop In Center at 74- 5593 Pawai Place in Kailua-Kona. The County has informed OSM that the project should be built and completed by February 2010. This program will provide emergency housing for up to 29 individuals at a time. The West Hawaii Emergency Housing Program will be aservice-enriched emergency shelter for single individuals experiencing homelessness, with a target stay of no more than 6 months. Due to the high cost of living in West Hawaii and the uncertainty of economic times, program participants will be offered six months to work towards gaining employment, and work towards permanent rental housing. During the duration of the program, life skills workshops will be provided on site to better prepare participants to live independently. Life skills workshops will include establishing a budget, being a good neighbor, be a contributing community citizen, and remaining clean and sober. This program is a critical resource for the community as there is no other emergency housing in West Hawaii for individuals experiencing homelessness. The emergency shelter will be open 365 days a year for 15 hours a day, 7 days a week, opening at 5pm each night and closing at Sam each morning. The emergency shelter will be staffed 15 hours a day. The West Hawaii Emergency Housing program is a service-enriched emergency shelter program with its ultimate goal to assist individuals move into permanent housing and work towards becoming self-sufficient. In the initial year of operation, OSM will focus on the transition of opening a new program. This is a great need long awaited by the West Hawaii community. With the assistance from the Office of Housing and Community Development, OSM hopes to have a lease in place by February 2010. Target Group: Individuals who are experiencing homelessness, including the unsheltered homeless, those living in emergency and transitional housing programs/shelters, and those at-risk of homelessness with a 45-day eviction notice willing to stay clean and sober and seek outpatient treatment if applicable. Total Budget and Position Count Total Pro ram Bud et 250,450 Total Pro ram Position Count 4 Total A enc Bud et 4,154,317 Total A enc Position Count 63 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry West Hawaii Emergency Housing Facility Program Objectives: For FY-09-10: 1. Provide 20 program participants with emergency housing and case management; 2. Maintain clean and sober housing for 100% of program participants; 3. Assist 50% of program participants in obtaining transitional or permanent housing; 4. Assist 50% of program participants in obtaining employment (ex. Seasonal, part-time of full-time); 5. Assist 25% of program participants to enroll in training or education programs (examples: job-readiness programs, obtain a GED, higher education); 6. Assist 25% of program participants' access mental health and substance use treatment, supportive services or after-care programs. Program Highlights: This is a new program that will directly benefit the West Hawaii community. According to the County of Hawaii's, Office of Housing and Community Development department, the West Hawaii Emergency Housing facility is projected to be ready for occupancy February 2010. Performance Measures: * FY08-09 will be based on the five (5) months remaining in fhe fiscal year from February 1 to June 30, 2009 FY 2007-08 FY2008-09 FY 2009-10 Actual * Bud et * Estimate 1. No. of unduplicated participants served N/A 20 30 and rovided emer enc shelter 2. No. of unduplicated participants exited to N/A 2 15 transitional or ermanent housin 3. No. of unduplicated adults in need of N/A 5 10 substance abuse treatment enrolled in a hase of such ro ram 4. No. of unduplicated participants in need N/A 7 15 of mental health services accessing such services 5. No. of duplicated participants enrolled in N/A 7 15 training or education program (e.g. GED, ob trainin ,etc. 6. No. of unduplicated participants obtained N/A 7 15 em to ment If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry West Hawaii Emergency Housing Facility Program Expenditures: FY 2007-08 Actual * FY 2008-09 Bud et* FY 2009-10 Estimate Salaries and Wa es $118,496 Professional Fees Operations $131, 954 E ui ment Other Total $250,450 "" It applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY2008-09 Bud et * FY 2009-10 Estimate HPHA $104,400 Hawaii Count $30,000 Ma or's Fund $35,000 HIUW $10,000 HCF $30,000 ESG 09 $28,000 Pro ram Fees $13,050 --ii appncaole 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 is a new program. OSM submitted an application with the State's Hawaii Public Housing Authority for ESG (Emergency Shelter Grant) funding. OSM will seek assistance from the Mayor's office, Hawaii Island United Way, and Hawaii Community Foundation to help defray initial start-up costs like the appliances, common area, multi-purpose room and office furniture to furnish all 29 living units and to supplement the initial year's operational costs. Program fees will also be another stream of revenue to help offset staff and utility expenses. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Roman Catholic Church in the State of Hawaii, Emergency I (we) have read and understood all of the eligibility requirements; gran conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-1422, Hawaii 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 supplies 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 and accurate vear-end requests. ~~~ ~'^ Signature of Board resiiient/Chair Date ~~30~09 Signature of Executive Direc ~ 3 ° 6-~-- Date UNSIGNED PROPOSALS WILL NOT BE ACCEEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 63 Palekana Kai Ocean Safety, LLC Ocean Safety Education Palekana Kai Ocean Safety, LLC.-Agency Name Ocean Safety Education- Program Name Agency Director: Harlen Phone No.: 937-9805 Contact Person: Harlen Phone No.: 937-9805 Mailing Address: 980 Railroad Avenue Hilo, Hawaii 96720 Facility/Site Address: 980 Railroad Avenue Hilo, Hawaii 96720 Fax No.: Email Address: palekanakai@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Phone No.: Mailing Address: Amount of Request for County Funds: $30,020 Prior Year(s) Funding: 06-07 07-08 08-09 $ 0 $ 0 $ 20,000 Agency Mission Statement: To educate community youth about ocean water safety while providing opportunities and alternative activities that build these young adults confidence, self-esteem, motivitation, and a lifelong respect for the ocean and the skills needed to enjoy the ocean safely. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 D...... 1 Palekana Kai Ocean Safety, LLC -Agency Name Ocean Safety Education- Program Name Program Description: Palekana Kai Ocean Safety LLC. is anon-profit 501 c (3) organization that provides ocean awareness, ocean safety, and ocean rescue training along with lifeguard, First Aid/CPR, AED training free-of-charge for community youth between the ages of eleven and eighteen. Additionally, the team conducts First Aid/CPR and AED training for staff of community organizations island-wide. Palekana Kai also provides rescue services at numerous ocean water sports events, such as outrigger canoe regatta, Business Man, The Queen Lili'uokalani Long Distance Race, the Richardson Rough Water Swim, long distance races for the Big Island Racing Association, and the One Man Canoe Races. Palekana Kai's main objective is to educate and promote public safety and awareness through their water safety programs that include: ocean water safety, First Aid/CPR, AED (Automated External Defibrillation) and Lifeguard Training at various Public Schools and Youth Agencies. The Team's five experienced lifeguards conduct ocean safety classes voluntarily at four public high schools located in the Hilo and Puna Districts of Hawaii County. Activities are scheduled throughout the year. Youth between the ages of elelven and fifteen complete basic skills courses and earn certificates of completion that recognize their readiness for the next levels of training. The next levels of training include First Aid/CPR, AED, Ocean Awareness and Safety, and Ocean Rescue. After completing the additional training levels, youth between the ages of sixteen and eighteen will have the opportunity to complete a basic Lifeguard Training course and earn a Lifeguard Certificate. This certificate is recognized by the County of Hawaii as evidence of meeting the primary requirements for an entry level paid Lifeguard 1 position. Total Budget and Position Count Total Pro ram Bud et 21,800.00 Total Pro ram Position Count 7 Total A enc Bud et 21,800.00 Total A enc Position Count 7 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 D...... 1 Program Objectives: 1) Obtain equipment needed to expand the current training program and on- site activities enabling our Certified Instructors and Staff to continue educating community youth and at-risk youth effectively in the areas of Ocean Awareness/Safety, First Aid/CPR,AED (automated external defribillator), Oxygen and Bloodbourne Pathogens. 2) Conduct informational classes for community youth and at-risk youth in the areas of Ocean Awareness/Safety, First Aid/CPR, AED (automated external defribillator). It will enable youth to be prepared to respond to an emergency situation. 3) Conduct informational classes in the areas of Ocean Awareness/Safety, First Aid/CPR, AED (automated external defribillator) for various agencies, organizations and residents of Hawaii County to enable them to be prepared to respond to an emergency situation. 4) Conduct informational classes in Lifeguarding skills, Oxygen and Bloodbourne Pathogens for community youth, at-risk youth, various agencies and organizations. These skills will increase the number of Hawaii County residents to assist in an emergency situation at recreational water sites and our local beaches. It will enhance youth's self-esteem and confidence, opening a large door of opportunities to prepare them for future employment. 5) Decrease the number of injuries and accidents. Decrease the possibility of drowning and death following an emergency situation. 6) Acquire a 1,500 square foot facility that will serve as a classroom to conduct informational classes and hands-on activities. Also serve as a storage area for training equipment Program Highlights: 1) (8) Water Awareness Classes were conducted - 65 youth participated 2) Youth Mentorship Program conducted 2x's a month - 12 youth participated 3) (6) First Aid/CPR, AED (automated external defibrillator) classes were conducted - 45 youth participated 4) (4) Lifeguarding Classes were conducted - 16 youth participated, 5) (8) First Aid/CPR, AED (automated external defibrillator), Oxygen, Bloodbourne Pathogen Classes were conducted - 62 Adults participated 6) (7) Youth who participated in these informational classes were able to use their certificates of completion as experience on their resumes and 4 are currently employed 7) Palekana Kai Ocean Rescue Team provided services at 10 Canoe Races,Regattas, the Business Man, One-man, Rough Water Swim and the Queen Lili'uokalani Long Distance Race -able to service approximately 1500 participants NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Palekana Kai Ocean Safety, LLC. -Agency Name Ocean Safety Education -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Water Awareness Classes -Youth 60 70 70 Youth Mentorshi Pro ram 12 12 12 First Aid/CPR/AED -Youth 40 45 45 Life uardin Class -Youth 10 20 20 Youth found employment as a result of artici atin in classes 6 10 10 First Aid/CPR/AED -Adult 50 70 70 First Aid/CPR/AED/Oxygen Life uard Trainin -Adults 20 20 20 Provide Rescue at 10 Canoe Races: Business Man, One-Man Race, Regattas, Rough Water Swim, Queen Lili'uokalani Long- Distance Race - artici ants served 1000 1500 1500 `It applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es Professional Fees O erations 3,200.00 3,800.00 4,000.00 E ui ment 2,000.00 18,000.00 27,000.00 Other" Total 5,200.00 21,800.00 31,000.00 - rc appucaoie ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 D...... A Palekana Kai Ocean Safety, LLC. -Agency Name Ocean Safety Education -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Coun of Hawaii 0 20,000.00 30,020.00 Healin Our Island Mini-Grant 2,000.00 2,000.00 2,000.00 Fund Raisers 4,000.00 4,000.00 5,000.00 Total 6,000.00 26,000.00 37,020.00 *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? Currently fundraising events, car washes, bake sales, garage sales continue to cover the basic program expenses such as insurance, licensing and registration fees as well as annual First Aid/CPR/AED certification fees. In October of 2008, the County of Hawaii awarded the organization a $2000.00 "Healing Our Island" mini grant to support the organization's efforts in mentoring the Island's youth by providing healthy, drug and alcohol-free activities to build self-esteem and confidence in themselves. The mini-grant was used to purchase T-shirts and rashguards for participants, with the logo's of collaborating agencies that continue to support our purpose. The County of Hawaii Non-Profit Grants has generously awarded Palekana Kai a $20,000.00 grant in July of 2008. This grant was used to purchase brand new training equipment, office equipment and our General Liability Insurance which was very much needed in order to provide a consistent level of program delivery and to teach our youth and others in our community effectively. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 U...... G Through its community capacity-building program the County of Hawaii Department of Research and Development has recognized the services that Palekana Kai provides and is providing technical assistance related to non-profit board development, reporting fundraising strategies. The values of this consultation is valued at $2000.00. Funding requests to the Ludwick Family Foundation, the Hawaii Community Foundation and other local funders are being developed. The group will continue its fundraising activities, car washes, bake sales, craft fairs, to help defray basic operational expenses. Finally, Palekana Kai will develop an earned income stream of revenue, eventually charging nominal fees to some of the non-profit organizations and event organizers served. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 D...... G Palekana Kai Ocean Safety, LLC. - A ency Name Ocean Safety Education -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, l (we) understand and will comply with the requirement tosubmit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 ~f'~ Signature of E cutive Director aeencv's fu~re funding requests. 12 Signature of B and President/Chair ~ Date ~ 2`~ ~ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Do.... 1 64 Puna Community Medical Center Walk-in Acute Care Clinic: Indigent Care Program Puna Community Medical Center Walk-in Acute Care Clinic: Indigent Care Program President of the Board of Directors: Tiffany Edwards Hunt 938-8592 Clinical Programs Director: Daniel DiDomizio 930-6001 Mailing Address: 15-2662 Pahoa Village Rd., Suite 306, PMB 8741, Pahoa, Hawaii 96778 Site Address: 15-2662 Pahoa Village Rd., Suite 303, Pahoa, HI 96778 Fax No. 930-6007 Email Address: dand(a~punahealth.org Janet Hara, CPA Taketa, Iwata, Hara & Associates, LLC 101 Aupuni Street, Suite 139 Hilo, HI 96720 Amount of Request for County Funds: $ 190,080 Prior Year Funding: FY08-09 $ 170,000 PCMC Mission Statement: To provide accessible, competent and compassionate health care to the residents of and visitors to the Puna District. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 Puna Community Medical Center Walk-in Acute Care Clinic -Indigent Care Program Program Description: Our first HSEDC grant of $170,000 was $100,000 less than our estimated need to get our clinic started, as there were many costly one-time expenses, such asbuild-out and medical equipment. Because the HSEDC awazd checks arrive on a quarterly basis, and until medical insurance reimbursements start coming in (oRen a 120 day lag time) we will be unable to achieve our goal of providing urgent caze to the Puna community, including the indigent, on a 24/7 basis. Yet Puna District has the dubious distinction of not only being the fastest growing district in the entire state, with a major shortfall of infrastructure and healthcare services, it also has the worst economic indicators in both the county and state, according to the most recent State of Hawaii Primary Caze Needs Assessment Data Book for 2007. Highway 130 has the highest vehicular accident rate in the State. Furthermore, Puna has a federal designation of being medically underserved and with a provider shortage. The Board, Staff, Advisory Committee and Volunteers of FCMC want to turn these statistics around: the program for which we are requesting funding will ensure that, starting during our first year, our clinic can be open for extended hours and days, including weekends and holidays, on a walk-in/no appointment needed basis, to serve even those with no healthcare covera¢e at all, i.e., the people who fall throueh the cracks. Total Budget and Position Count Total Program Budget = $190,080 Total Agency Budget = $ 553,848 Total Program Position Count = 3 Total Agency Position Count = 6 Program Objectives: I) To provide acute care for common medical problems, such as infectious diseases of the Respiratory System (eg. colds, bronchitis and asthma); of the Digestive System (enteritis, constipation); of the Genito-Urinary System (bladder infections, STD's); the Skin, etc. and for common surgical problems (cuts and abrasions, sprains and strains, contusions, etc.). These services will be provided on a walk-in basis, with no appointment needed. 2) PCMC will do Physical Exams (school, athletic, Pop Warner, PUC, etc.) which are needed immediately and cannot be scheduled in a timely way with the client's primary care provider, if any. 3) PCMC will provide short-course refills of medications for chronic illness (Hypertension, Diabetes, etc.) should the client run out of these medications. Clinic Labs and the Puna Pharmacy are also located in the Pahoa Marketplace, which makes this process easier and faster. 4) PCMC will have ready access to 911 services (ambulance, fire, police) located across Highway 130, should the need arise to transfer clients to HMC's ER. 5) PCMC will continue its various fundraising efforts to generate a positive cash flow based upon fees for services and other methods, sufficient to sustain operations indefinitely. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 ~d~~ Puna Community Medical Center Walk-in Acute Care Clinic -Indigent Care Pragram 6) To enter into partnerships and/or collaborative agreements with other non-profit corporations for the purpose of creating a larger, more comprehensive health care center for Puna Makai. (It already has agreements with P3hoa Weed and Seed and Malama O Puna). 7) To establish an Indigent Care Program to provide all the above-listed services to clients who are uninsured/underinsured and would otherwise go untreated. This would include discounted or free medication. 8) To increase its staff to 9 employees. 9) To keep the clinic open starting at 5 days/week, including weekends, and during the first year increase the hours to 7 days/week. 10) To provide emergent health services for 150-210 clients/week, including the indigent, during the first year of operation. 11) To continue to engage in fundraising through charitable contributions, benefits, events and grant-writing, to supplement the funding for this program. Planned for 2009 are Theater Arts Conservatory's 4 performances of the Broadway hit "Rena°, a garden party and another Women's Comedy Night performance. Program Highlights: 1) Through a large donation by our landlord/contractor and a $50,000 grant from the Harry and Jeanette Weinberg Foundation, buildout of the clinic has been completed, and the Certificate of Occupancy has been issued. 2) The FY2007-08 HSEDC grant, $127,500 of which has already been received, has paid for furnishings, office and medical equipment, office and medical supplies, medical software, phone and computer system installations, payroll, employee medical insurance (HMSA) and rent.' 3) PCMC bas applied for and received its IRS federa1501(c)(3), Hawaii State Tax Exemption Certificate, Department of Labor Permit, Liability and Malpractice Insurance Policies. It is compliant with all Dept. of Health regulations. 4) PCMC has already hired a physician, a physician's assistant, an office manager and a medical records manager. A receptionist and a registered nurse will be hired this month (January, 2009). 4) PCMC held its Grand Opening Celebration on January 11's to introduce the facility to the community. 5) PCMC's volunteers have had several fundraising events: can bottle recycling, rummage sale, and two performance events (Women's Comedy Night). Performance Measures: See: Program Objectives, especially #8-10. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 PaEe 3 Puna Community Medical Center ~4'alk-in Acute Care Clinic -Indigent Care Program Sources of Funding specific to this program only: REVENUE SOURCE FY 2008-09 FY 2009-10 Bud¢et* Estimate* HSEDC want N/A $ 190,080 NB: re 2008-9 we were raising money to build, equip, and stock the clinic, not for this program. PROGRAM EXPENDTTURES Salaries and Waees (3 part time employees) $ 103,680 Professional Fees Operations Total $ 190 080 *if applicable ** please explain in detail on separate sheet: Cost of care, medications, egpt. depreciation, etc, for clients who cannot pay for services and are not eligible for other coverage. This is based on experience at other East Hawaii facilities. PCMC's plans to fund the Indieent Care Proeram: PCMC will continue to write and submit grant proposals to various State, Federal and Private funding sources (foundations, businesses, individuals). PCMC will continue to organize and hold fundraising events and benefits to raise money to support the program. Already planned for 2009 are 4 performances of the Broadway musical "Rent" by the Theater Arts Conservatory (end of January), °A Walk in Beauty" garden party benefit (including a silent auction and plant sale) on February 14th, and a Health Fair on April 4~h. We hope that $30,000 can be generated from these events. Another Women's Comedy Night is also planned for November. Lona-Ranee Sustainability: Since the program itself, unlike regular clinic operations, will not bring in any income (by definition), it looks like we will have to continue to raise money for its operation annually using the above listed methods. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 huna Community IVled---cal Center Wa!!~=ill Acute Care C.inic: I:Idigeot Care Program I (we) have read and understood ail of the eligibility requirements; grant conditions; aware 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 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 ayear-end report to the Legislative auditor within 60 days after 3une 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 pro ram's or aeency's future fundine requests. L%2~%zG~f~ ~v w't~ Sign r Boazd President Sig o mical Director ~/~~/°~ Date l/1~Q Date NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-LO Page 5 65 The Salvation Army -Family Intervention Services Independent Living Skills Program -West Hawaii 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: 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: $49,991 Prior Year Funding: 06-07 07-08 08-09 $28,000 $20,000 $15,000 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 is designed to help foster youth and emancipated foster youth ages 12-21 prepare for and manage the transition to productive, self-sufficient adulthood with a base of independent living skills. The curriculum emphasizes career, education and job-skills development, utilizing aschool-based skills format (recognized by DOE for elective NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 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, jobs 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 Building (Apr) • Daily Living & Community Involvement (May) • Evaluation, Youth Recognition (June) Group sessions are held at Konawaena High School on Wednesdays, and Kealakehe High School on Mondays. Each foster youth is required to attend one 2-hour session per week as well as individual sessions. Aside from group activities, we integrate homework, study hall, computer knowledge, community service projects and extra curricular activities. They include: College Fairs, Job Fairs, Housing Fairs, World of Work Tours sponsored by the Hawaii Community College, West Hawaii Community College, University of Hawaii at Hilo, Hawaii National Park Service, National Energy Laboratory Hawaii Authority, Sheraton Keauhou Beach Resort and Spa, Work Force Development Division-West Hawaii and many others. We strongly encourage our participants to engage in civic connectedness and giving back to ones community. The Department of Human Services currently funds our Independent Living Skills Program. Our area of coverage is West Hawaii which includes: Kohala, Waimea, Waikoloa, Kealakehe, Konawaena and the Kau District. This contract supports only a 1.00 FTE Youth Development Specialist IV, which is not enough to cover this vast district. Funding received through the County would help suppdrt 1.00 FTE Youth Development Specialist III position to increase staff coverage to the West Hawaii District. Total Budaet and Position Count Total Pro ram Bud et 143,991 Total Pro ram Position Count 1.OFTE Total A enc Bud et 5,641,957 Total A enc Position Count 73 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Program Objectives: The objective of the program is to accomplish the following for 30 foster youth in West Hawaii each year: • Of the 30 foster youth, ages 12-15 participating in the program, 75% will demonstrate increased independent living skills, as identified in their IL plan. • Of the 30 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. • Of the foster youth, ages 18 plus, participating in the program, 80% will participate in Higher education, Vocational Training, Employment and/or Military • 75% of youth will avoid non-marital childbirth, incarceration and homelessness during program participation. Program Highlights: FY 2007-OS In our 2007-2008 fiscal year, The Independent Living Skills Program in West Hawaii provided over 1,200 direct service hours to foster youth and obtained the following performance measures: • 64% of foster youth age 12-15 demonstrated an increase in Independent Living Skills, as identified in their IL plan, • 100%of foster youth age 16 plus completed their Independent Living Skills Program and attained at least a fair prognosis of achieving goals, as identified in their IL plan • 100% of foster youth 18 plus, participated in Higher Education, Vocational Training Employment and/or Military • 89% avoided non-marital childbirth, incarceration and homelessness during program participation In addition, we provided opportunities for our foster youth to attend college and career fairs at University of Hawaii at Hilo, presentations by Legal Aid Society, Social Security Office, Maui community College, Maui Job Corp, Maui Farms, and many others. We had the youth focus on healthy meal preparations, accessing healthcare, and access to workshops that gave hands on approach in filling out Financial Aid Forms (FASFA). We strongly believe in being a partner with our community and have accessed many businesses, resource agencies, and civic clubs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Note: Performance Measures for FY 2008-09 was under a different TSA-FIS program. For FY 2009-10, we are requesting funds for our Independent Living Skills Program as in the FY 2007-08. Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Com letion of ILSP 25 30 Partici ates in IL Activities 30 30 Partici ates in IL Plan 30 30 Follow u and Monitorin 30 30 Pro ram Ex enditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 67,489.44 74,240 108,352 Professional Fees O erations 27,509.22 30,760 35,639 Equipment Other* Total 94,998.66 105,000 143,991 Program Funding Sources Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate De artment of Human Services 94,000 94,000 Total 94,000 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? 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 outreach 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 Outreach services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 The Salvation Army Family Intervention Services Independent Living Program-West Hawaii 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 ayear-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, .~z~-. Signature of Board P sident/Chair pCW'~-"' Signature of Executive Director ~Z~ G Date i~z 3~u 9 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 66 The Salvation Army -Family Intervention Services Prevention Programs - Honokaa The Salvation A rmy Family Intervention Services Prevention Programs-Honokaa Agency Director: Contact Person Mailing Address Pauline Pavao Raymond Dangaran Facility/Site Address: Fax No.: Email Address: Phone No.: 935-4411 Phone No.: 935-4411 P.O. Box 5085 Hilo, HI 96720 21 W. Ohea St. Hilo, HI 96720 933-9810 pauline.pavan@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: $47,066 Prior Year Funding: 06-07 07-08 08-09 $28,000 $35,000 $20,000 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-Prevention Programs 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 attendance. This will be NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 accomplished by implementing Outreach Services (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, PerFormingA/isual Arts and Humanities, Educational, Cultural, and Youth Leadership Activities. Other prevention activities consist of Community Service and Learning Projects, Drug-free dances, anc 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 in conjunction with the Teenage Pregnancy Prevention & Family Strengthening Program in Honokaa, currently funded by the Department of Defense. 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: 2-Youth Development Specialist I at 20 hours a week. These positions will help support an after-school program and provide sufficient supervision and safety for each youth served. Total Bud et and Position Count Total Pro ram Bud et 135,066 Total Pro ram Position Count 2.0 Total A enc Bud et 5,641,957 Total A enc Position Count 73 Program Objectives: 1) Of the 45 youth targeted to participate in the Prevention Programs, 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 45 youth participating in the prevention 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. Program Highlights: 2007-08 Throughout the year, we provided in school and after-school services (group facilitations, youth retreats, skill-building activities, positive alternative activities, and follow-up and monitoring NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 services). Also, we collaborated with school personnel, community groups and associations, and community agencies and services to network, build relationships, and provide support with activities and special events. Finally, we provided family strengthening activities to increase communication, understanding, and positive relationships between youth and family. Other activities provided as follows: The YDS conducted ten sessions of the L.E.A.D. curriculum to the students in the 7`h and 8`~' grade class. All students increased their knowledge of substance abuse awareness. The activities that were most effective were the posters the students made as well as the invited speakers. The Lokahi Center referred a speaker who was a recovered alcoholic and drug user. MADD, (Mothers Against Drunk Driving), sent a speaker who shared her personal loss to the combined Intermediate classes and Dr. Scully, a lung surgeon, came to the Intermediate school and did a powerpoint presentation on smoking and its effects on the body and lungs. This really got the attention of the students, especially when he showed them a lung he had surgically removed from a patient who was a chronic chain smoker. The DARE Program invited us to give presentations of our programs at the "Drug-free Pool Bash for the 7`h and 8`h graders. The Police Dept. and the Salvation Army Family Intervention Services try to combine these community awareness activities. In December, we participated at a dance in Waimea that all the intermediate schools attended that promoted the awareness of substance abuse. In collaboration with the Parks and Recreation, Honokaa High School, and the Community, we successfully completed a colorful sea creature theme mural at the Honoka' a Pool. The life guard at the pool has commented numerous times about how the public is very pleased with the "Face- Lift." It does make the pool more kid-friendly and the community is pleased with the colorful sea creature theme mural. The Honokaa High School 11`s grade Art class did all the planning and research for the fish that were later drawn on butcher paper. After the students did several drawings of their sea creatures from different perspectives, they painted the walls of the pool with white primer. The fish and sea creature drawings were enlarged by making "cartoons" which is a grid transfer drawing. This taught the students how to enlarge their drawings and make them transfer-ready. This was a rather large project and the art students learned how to start a project from scratch and then how to make it become a reality. They have a lot of pride in the work they did and it will give youth a sense of ownership to their community. For years to come, they can enjoy the mural and show it to their friends and possibly their children. Now that the pool is a more attractive place to spend time we are looking forward to summer weekend evenings at the pool It is very important to have activities for the youth on weekends and at the same time be involved with the community. Community Collaborations: Linkages with Other Agencies: At this time the agencies that we have been in contact with is the DOE, Parks and Recreation Department, Police Department, and YWCA. The support that the Honokaa high and Intermediate schools have given us has been tremendous, they have invited us into there classrooms, given us a place to provide our services and staff support. We collaborated with the YWCA and sponsored a Community Mixer. The luncheon was held at the North Hawaii Educational Research Center. The objective was to have an opportunity for local agencies to find out what was offered in the community. It was a big success; over 45 people attended. A list of e-mail addresses and agencies' phone numbers was printed up and distributed in a group e-mail. We are hoping that we will all meet on a regular basis, perhaps every three months and plan at least one or two events for the youth in the community. Each one of the NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 agencies will sponsor something either together with a partner agency or by themselves. We will also have a communal calendar so we can share special events. Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Partici ates in L.E.A. D. Team 45 45 45 Participates in Pos. Alter. Activities 45 45 45 Participates in Comm. Srv. Projects 45 45 45 Follow up and Monitoring _ 45 45 45 ~If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 115,253.88 76,953 101,695 Professional Fees 0 0 0 O erations 45,044.74 31,047 33,371 Equipment 0 0 0 Other" 0 0 0 Total 160,298.62 108,000 135,066 Program Funding Sources Revenue Source FY 2007-08 Actual' FY 2008-09 Bud et* FY 2009-10 Estimate De artment of Defense DOD ' 125,000 88,000 88,000 County of Hawaii 35,000 20,000 47,066 Total 160,000 108,000 135,066 *Teenage Pregnancy Prevention & Family Strengthening Program funded under DOD. 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 2009-10 Page 4 The Salvation Army-Family Intervention Services Prevention Program-Honokaa 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 ayear-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 a en future fundin re uests. ~ ~~ Signature of Boa (President/_Ch~air~ Date Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 67 The Salvation Army -Family Intervention Services Prevention Programs - Pahoa The Salvation A rmy Family Intervention Services Prevention Programs-Pahoa Agency Director: Pauline Pavao Phone No.: 935-4411 Contact Person: Raymond Dangaran Phone No.: 935-4411 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.pavan@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: $46,270 Prior Year Funding: 06-07 07-08 08-09 $32,000 $35,000 $20,000 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-Prevention Programs 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 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 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. - 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 a compilation of Prevention Programs currently funded by the Office of Youth Services, Hawaii Community Foundation, and Department of Health. 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 0.25 FTE Youth Development Specialist IV and 2-Youth Development Specialist I at 19 hours per week. Supplemental funding from the Office of Youth Services-Positive Youth Development will help support and establish a 1.00 FTE Youth Development Specialist IV to provide outreach services to the Puna Community. The 2-Youth Development Specialist I will help support an after school program and provide sufficient supervision and safety for each youth served. Total Budget and Position Count Total Program Budget 110,000 Total Program Position Count 1.95 Total A enc Bud et 5,641,957 Total A enc Position Count 73 Program Objectives: 1) Of the 60 youth targeted to participate in the Prevention 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. 2) Of the 60 youth participating in the prevention 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 2007-08 J_u_ly 2007-June 2008 • "End of Summer Bash" put on at the Nanawale Long House that consisted of a Talent Show, Family Activities, Potluck Dinner & DJ (Dancing). There were a total of 40 youth and their families participating in the event. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 • There was a School Supply Distribution @ The Maku'u Market Swap Meet Site. We aze part of the Youth Empowerment Subcommittee (Pahoa Weed and Seed) and went out to request for donations and gave them away to over 900 youth and their families from Puna & Upper Puna. • We participated with the YES Committee/Pahoa Weed & Seed -and assisted with the Wrestling Clinic put on for the Pahoa Community at the Pahoa High & Intermediate Gym. • High School youth from our program organized a Halloween Party/Activities at the Nanawale Long House. The 10 older High School youth decorated, set up games and participated to make the event fun for the 20 younger youth. • Community Service Project-The High School group helped sort out donated Christmas gifts that for Angel Tree with the Salvation Army Hilo Temple. We also participated with the registration and collection of gifts for the annual Salvation Army "Angel Tree" at the Prince Kuhio Plaza for needy families. We also distributed the Angel Tree Gifts to Needy Families in our prevention programs. • "Hearts Al] Over the World" Dance- Pahoa Recreation Center. Our High School group organized and conducted a youth dance for the middle school students. Over 50 youth came out for a night of dancing, lucky numbers, and fellowship with their peers. • The 15 middle school youth participated in creating "Care Packages" for the Homeless people in the Pahoa community. They decorated the bags and filled it with a sandwich, cookies and a drink to give to the homeless who were less fortunate than themselves. This was a success and made the youth appreciate what they already have. • We collaborated with the Kamehameha Schools' Community Resource Fair in Pahoa-We provided Family Pictures and Frame Making Booth at the Pahoa Recreation Center. We made 100 frames for that event. • The "Spring Fling" Community Outreach Activity was held at the Pahoa Recreation Center for Families in the Puna Area. We had live music, door prizes, jumping castles and a wonderful spaghetti dinner for all who attended. Our services, flyers, registration forms were there and our services were talked about it to all in attendance. Over 200 people came and enjoyed themselves. • We collaborated with the Pahoa High & Intermediate School Students from Alternative Learning Center, Middle CSAP & High School CSAP classes for a rewards day excursion. Youth planned a menu, shopped for the items, and prepared and cooked the meal at the beach on the grill. They practiced social skills and put their leadership skills to work. • We conducted an "End of the school year Dance" held at the Pahoa High & Intemrediate Gym. Middle School Students were invited to a drug, alcohol and tobacco free event from 6-9p on the night before school ended. We provided Picture Taking, Refreshments, Trivia Questions and Contests to 100 youth. • In collaboration with Palekana Kai, water safety/rescue resource, provided a Water Awareness Program for 20 youth of Puna. The kids learned how to canoe paddle, water safety, First Aid/CPR, and completed community service clean-ups the beach daily. We ended the exciting fun-filled program with a BBQ at Bay front and Bowling for the youth. • A Girl's Day Retreat was put on for 5 participants in Puna. We traveled to Kailua, Kailua, Kona and went on the Atlantis Submarines. We had lunch at Bubba Gump's and went to Hot Nails Spa for a manicure & pedicure. This was all a part of setting goals, and taking care of health and welhress. The girls were grateful for being part of this opportunity. • We provided a Tea Party atNani Mau Gardens with guest speaker Marcie Herring Drug Free Hawaii, who facilitated activities that promotes health and wellness to 10 female youth in our programs. The activities were gender specific to assist youth discover more about their mind, body, and spirits. We will be collaborating with Marcie Herring to continue gender specific activities throughout the year. Community Collaborations: Linkages with Other Agencies: Referrals to the prevention programs are currently coordinated through the In-School Services at Keaau Elementary, Middle, and High School, Pahoa Elementary, Intermediate NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 and High Schools, HAAS (Hawaii Academy of Arts and Sciences), Kua O'Kala, Keonepoko Elementary, and Mountain View 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; Pahoa Parks and Recreation; Boys and Girls Club of the Big Island; Alulike ]nc; Pahoa Weed and Seed, and Nanawale Community Center. Performance Measures: FY 2007-08 Actual." FY 2008-09 Bud et * FY 2009-10 Estimate Com letion of L.E.A.D. Team 65 60 60 Partici ates in Pos. Alter. Activities 66 60 60 Partici ates in Pro~ect Famil 65 60 60 Follow u and Monitorin 67 60 60 Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wages 82,692.93 67,432 90,808 Professional Fees 0 0 0 Operations 28,539 27,568 30,462 Equipment 0 0 0 Other* 0 0 0 Total 111,231.93 95,000 121,270 Program Funding Sources Revenue Source FY 2007-08 Actual FY 2008-09 Bud et * FY 2009-10 Estimate Office Of Youth Services' 75,000 75,000 75,000 Count of Hawaii 35,000 20,000 46,270 Total 110,000 95,000 121,270 *Positive Youth Development services funded under Office of Youth Services. 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 2009-10 Page 4 The Salvation Army-Family Intervention Services Prevention Program-Puna 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 ayear-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, ~~'r/J i ~/~~-- Sign)at~ur~e~of~B~oard reside~nt/~C~hair~ y ~~~u.c~C.e-csrC~ ~~~~,,~ e"'~ Signature of Executive Director i~ .~ 0 9 Date ~~ IQ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 68 Special Olympics Hawaii -East Hawaii Special Olympics Hawaii -East Hawaii • . .. ~~~ Special Olympics Hawaii- Agency Name Special Olympics Hawaii-East Hawaii- Program Name Agency Director: 943-8808 x 22 Contact Person: 935-0537 Mailing Address: Facility/Site Address: Fax No.: Email Address: Nancy Bottelo Carey Uchida P.O.Box 7265 Hilo. HI 96720 138 Kaikuono Place Hilo, HI 96720 935-1968 careyuchida@hotmail.com Phone No.: 808 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. #900 Honolulu, HI 96814 Amount of Request for County Funds: $20,000 Prior Year(s) Funding: 06-07 07-08 08-09 $12,000 $12,000 $12,000 NONPROFIT-GRANT APPLICATION ` FISCAL YEAR 2009-10 Page 1 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 children and adults 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 2009-10 Page 2 Special Olympics Hawaii -Agency Name Special Olympics Hawaii-East Hawaii- Program Name Program Description: Forty years ago, Eunice Kennedy Shriver organized the first Special Olympics Games at Soldier Field in Chicago to give those with intellectual diabilites the opportunity to participate in sports. "Shriver's movement did nothing less than release an entire propulation from a prison of ignorance & misunderstanding.You watch and what you see is nothing less than a transformation, the passage of someone who has been labeled unfortunate, handicapped, disabled or challenged to something else...an athlete." 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 independently as adults. Special Olympics helps to give individuals with a intellectual 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. Additionally, with the budget cuts of the social agencies through the Department of Health and Department of Education, services to the intellectually disabled will be further reduced. Special Olympics East Hawaii fulfills this need to provide the necessary programs through year round sports training to allow the intellectually disabled to continue to strive for improved health through their participation in sports. The benefits that all the athletes receive from their participation in Special Olympics include: improved physical fitness and motor skills, greater self- confidence, amore positive 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 who participate become stronger as they learn a greater appreciation for their child's talents. We have found that our strongest supporters and best volunteers are the family members of our Special Olympics athletes. We provide a "safe haven" for families where they know that their child is accepted for who they are and for what they can do. Community volunteers find out what good friends the athletes can be. Everyone learns more about the capabilities of people with intellectual disabilities. The need for the Special Olympics East Hawaii program to continue here on this island is extremely high. Special training is provided for our athletes and the coaching staff throughout the year. The training is essential due to the unique services that we provide. These services are not available anywhere else but NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 with our program. We not only touch the lives of our Special Olympics athletes, but also their families and the hundreds of volunteers from our community. Our founder, Eunice Kennedy Shriver, believes sports training and competition opportunities should be available for all who qualify rather than all who could afford to participate. Therefore, our program is free of cost to all of our athletes, special partners, and coaches. We 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 our East Hawaii area 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, trainings, and our Athlete Leadership Program (ALPS). Our program not only benefits the athletes, we also provide an annual conference on Oahu which give families the opportunity to network at the conference and to also listen to speakers on important topics like: What to expect upon graduation from high school, what to do when your intellectually disabled child turns 18, facts about Supplemental Social Security, special needs trust, Medicaid, job opportunities, preparing the athlete for independent living etc. all at no cost to the families. The families who are attend these annual conferences are a major support group willing to share what they've learned to others. Special Olympics East Hawaii's largest expense for 2009-2010 is transportation. It is an essential part of our program that Special Olympics athletes are provided an opportunity to interact and compete against people with similar athletic abilities. Unfortunately our area program is too small to be able to provide quality competition based on ability levels, 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 free health exams through the Healthy Athlete Program. The Healthy Athlete program provides free dental, vision, hearing, podiatry, flexibility & nutrition screening and education 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. Every athlete who gets a vision screening and provides a prescription for glasses, will be given a free pair of glasses or sports goggles. Special Olympics East Hawaii wishes to continue to provide these fantastic opportunities to all the athletes that are currently involved and be able to reach out to new special needs individuals through out our community. In order to do this, we will need funds to maintain our services and to outreach to athletes and volunteers, training for coaches and athletes, pay for bowling fees, and provide transportation for athletes to get to practices and competitions. Special Olympics Hawaii-East Hawaii Area is asking for $20,000.00 from the County of Hawaii to help fund our Special Olympics East Hawaii program activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Total Budget and Position Count Total Pro ram Bud et $136,600 Total Pro ram Position Count 1 Total A enc Bud et $1,685,423 Total A enc Position Count 18 Program Objectives: 1) To provide quality sports training and Olympic type competitions in our area program by June 2010 to 256 athletes and special partners, an increase of 10%. 2) To increase the number of participants in the Honokaa area by June 2010, so more intellectually disabled rural athletes will be able to take part in our program, as there are no organized sports programs outside of school for them to participate in. 3) To increase the number of participants in the Keaau-Pahoa area by June 2010, so that we can provide the intellectually disabled rural athletes an opportunity to participate in our sports program, to become more physically fit, to become a healthier person, to be able to socialize with their peers, and be able to compete with other athletes with the same abilities in large state competitions. 4) To provide sports specific coaches training or recertification for 10 coaches in various Olympic type sports and various ability levels so that they may provide appropriate training to the athletes within their delegations, an increase of 20% by June 2010. 5) To provide our families, coaches, volunteers and athletes with 3 family activities throughout the year, which will be conducted by our family Ohana Task Force) committee by June 2010. 6) To provide transportation to 145 athletes, coaches and special partners three times per year, so that they may compete at each State Competition with athletes of the same ability level by June 2010. 7) To provide the opportunity for three athlete delegates from East Hawaii to represent our area program by providing our area's perspective on upcoming issues and introduce ideas offered by our area athletes at the State Athlete Congress by June 2010. 8) To increase business participation in our Mile of Quarters campaign in order to raise more funds to cover our annual budget. 9) To add a fourth fundraiser in which participants will be selling candy to help cover anticipated increases in cost this year and the possibility of reduced donations due to the economic down turn currently occurring. 10) To provide an opportunity to 450 community volunteers to interact with our Special Olympic athletes throughout the year, providing them with the chance to "change the world." NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 Program Highlights: 1) We continued to conduct 4 major area athletic compeetitions for our athletes and Special partners. On October 13, 2007, we conducted our area singles bowling competition with 61 athlete, 6 coaches, 4 delegations, 40 families and 55 community volunteers in attendance. On October 14, 2007 we held our unified team bowling. competition with 24 athletes, 24 unified (special) partners, 4 coaches, 4 delegations, 18 families, and 12 community volunteers in attendance. On November 4, 2007, we hosted the Weinberg. Regional basketball tournament at UH Hilo Gym, welcoming 6 teams from the Big Island and Maui. On April 26, 2008, we held our area track & field competition at Keaau High School with 75 athletes, 10 coaches, 9 delegations (including the West Hawaii athletes), 45 families, 22 program volunteers and over 140 community volunteers helping or attending. 2) We provided sports training, competition and transportation to: 24 soccer athletes, 18 bocce athletes and 18 unified partners, along with 8 coaches and 4 chaperones during the Aukake season which runs June 15~ to mid August. For the Winter season, we provided the same for: 82 athletes, 23 unified partners, 13 coaches and 10 chaperones who attended the 2007 Holiday Classic State Games. During the Summer season, we provided training, competition and transportation to: 80 athletes, 22 coaches, 5 unified partners, and 26 chaperones who participated. 3) Our Ohana task force committee provided our families, coaches, volunteers and athletes with 3 family events. On September 22, 2007, we held our annual "End of Summer Bash" picnic which was attended by 102 people. We provided free a free lunch with games and prizes for all in attendance. On December 15, 2007, we held our 2nd annual Christmas Party with 90 people attending. Finger foods were provided along with lots of dancing, and a small gift for each athlete to take home. Everyone joined in to sing Christmas Carols, the PALS group consisting of intellectually disabled performers entertained us, and we gave out our area award trophies to the 2007 area winners. Our last event put on by the Ohana Task Force was a spring dance called the "Bunny Hop" on March 15, 2008. The 75 Athletes and families who attended were provided with finger foods, drinks and the opportunity to join in on an old fashion "bunny hop." 4) All positions on our outstanding Area management Team, who help to coordinate all activities for Special Olympics East Hawaii's area program, were filled and met monthly to discuss and plan operation for the year. 5) Our Mile of Quarters fundraiser added a new business to help us raise much needed funds. CU Hawaii Federal Credit Union joined HFS Federal Credit Union and Ken's House of Pancakes in this years Mile of Quarters campaign and together with Keaau High School and Kalanianole School, raised $22,000 to help us reach our $136,600 annual budget. 6) Athletes, Coaches, volunteers and families conducted 4 fundraisers this year, selling, bentos, chili & candies and were successful in raising a net of $11,458 to help us reach our annual budget. NONPROFIT GRANT APPLICATION FISCAL YEAR2009-10 Page 6 7) We outreached to teachers at the Teachers Institute on. October 16, 2008 at Keaau High School by setting up a table with information and brochures about our program for interested teachers to receive. 8) We increased the number of athletes and special partners participating from 202 last year to 233 this year, an increase of 32 athletes or an increase of 16 %. 9) The number of certified coaches in specific sports increased by 10% this year. 10) We continue to provide our athletes, families and volunteers an opportunity to give back to the community through our annual community service project. Over 25 athletes, coaches, volunteers and family members joined in singing Christmas Carols to the residents at Hale Anuenue in December of 2007. 11) We offered a new sport, golf, to athletes this past summer. Four athletes participated and excelled in this sport. This make 9, the total number of sports that we have available to the athletes in our East Hawaii program for them to participate in. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Special Olympics Hawaii -Agency Name Special Olympics Hawaii-East Hawaii -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Athlete & Special (Unified) Partner 202 233 256 articipants Volunteers from the communit 420 426 435 Famil Members 85 98 110 Mana ement team members 10 11 12 Communit Service Pro'ects 1 1 1 State Competitions attended on 3 3 3 Oahu Area/re Tonal competitions attended 7 7 8 Delegation (schools) within the 5 6 7 D.O.E. s stem artici atin Total number of delegations 7 8 9 artici atin this ear Number of famil events rovided 2 3 3 Number of volunteer hours provided 9,577 10,146 10,700' by volunteers for training, com etitions and fundraisin (Note: these figures are not dollar amounts, but rather in the number of eo le, events, schools or hours *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 2,140 2,140 2,140 Professional Fees 0 0 0 O erations 77,288 90,088 128,080 Equi ment 3,229 4,589 6,440 Other" Total 82,657 96,817 136,660 If applicable ~ Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page S 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 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Count of Hawaii Grant 12,000 12,000 20,000 Foundations 11,500 10,800 4,000 Individual contributions 6,979 8,432 9,250 Cor orate Contributions 8,800 5,150 5,250 S ecial Events 44,627 43,537 43,400 HSO Co-o monies 0 55 3,450 Interest Income 22 950 500 Merchandise sales 43,361 24,364 35,400 Service Clubs 2,200 140 100 Total 129,489 105,428 121,350 *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? 2009-2010 plans to increase revenues to support our programs: 1) We are planning to expand our Mile of Quarters fundraising campaign to more businesses. This is an icon sale fundraiser in which we raised $22,423 during one campaign in the Spring of 2008. 2) We are planning to increase our donations for Cop on Top by obtaining permission from Prince Kuhio Plaza management and Long's Drugs management to be able to solicit customers of Long's Drugs during our event. 3) We are planning to took into applying for more grants that may be come available to East Hawaii Non-Profits. 4) We will be adding a candy sale fundraiser n which we hope to net approximately $6,000 - $7,000 in the Spring of 2010. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 9 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 volunteers within our community, and with increases in costs, 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 andlor we would have to cut back on our outreach goals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 Special Olympics Hawaii -Agency Name Special Olympics 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, 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 ayear-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 vear-end report will impact the evaluation of your program's or agency's future funding requests. ~y Signature of Board President/Chair ~U Sign ture of cutive Director 1 ~~~G `1 Date l~/~~O~L Date ' UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 11 69 Special Olympics Hawaii -West Hawaii Special Olympics West Hawaii -General Funding . ~ ,. ~, Special Olympics West Hawaii- Agency Name SOWH General Funding- Program Name Agency Director: Nancy Botello Phone No.: 943- 8808x22 Contact Person: David Ross Phone No.: 345-1344 Mailing Address: P.O. Box 390358, Keauhou, HI 96740 Facility/Site Address: 77-296 Kalani Way #2 Kailua-Kona, HI 96740 Fax No.: 808-943-8814 Email Address: sowhdave@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Akamine, Oyadomari, and Kosaki CPA's, Inc. Phone No.: 941-0500 Mailing Address: 440 Kapiolani Blvd., Suite #900, Honolulu, HI 96814 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 06-07 07-08 08-09 $10,000 $10,000 $12,000 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 2009-10 Page 1 sharing of gifts, skills and friendship with their families, other Special Olympics athletes and the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Special Olympics West Hawaii -Agency Name SOWN General Funding- Program Name Program Description: Special Olympics believes that 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 independently as adults. Special Olympics helps to give individuals with a intellectual 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 West Hawaii fulfills that need and provides the necessary skills for people to continue good health throughout their lives within our community. Thanks to the Hawaii County grant, Special Olympics West Hawaii is able to continue to provide many opportunities for the special needs individuals in our community. The benefits that all the athletes receive from their participation in Special Olympics include: improved physical fitness and motor skills, greater self- confidence, amore positive 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 who participate become stronger as they learn a greater appreciation for their Childs' talents. We have found that many of our strongest supporters and best volunteers are the family members of our Special Olympics athletes. We provide a "safe haven" for families where they know that their child is not judged and is accepted for who they are and for what they can do. Community volunteers find out what good friends the athletes can be and make long lasting bonds that continue off of the sports field. Everyone learns more about the capabilities of people with intellectual disabilities, and a huge majority of our volunteers continue with the program year after year. These active volunteers are often a source of new volunteers to the program as they share their stories with friends, neighbors and co-workers. Special Olympics West Hawaii Unified Sports Program is a vital program where these 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 Special Olympics West Hawaii has a unified softball team, 8 unified bowling teams and 6 unified bocce teams that participate. The need for the Special Olympics West Hawaii program to continue here on this island is extremely high. There is no other program in our Area to provide these services to our athletes. Special training is provided for our athletes and the coaching staff throughout the year. The training is essential due to the unique services that we provide. We not only touch the lives of our Special Olympics athletes, but also their families and the hundreds of volunteers from our community. Our founder, Eunice Kennedy Shriver, believes sports training and competition opportunities should be available for all who qualify rather than all who could afford to participate. Therefore, our program is free of cost to all of our athletes, special partners, and coaches. We receive no money from the Kennedy Foundation or the Federal Government. Due to this aspect of our program , a volunteer committee under the leadership of our Area Director must raise all the funds needed for our West Hawaii area program. Those funds will pay for all aspects of the Special Olympics progam. Our largest needs for 2009-2010 is to purchase new uniforms for the sports whose uniforms have yet to be replaced and new equipment. As always our largest cost is airfare to get our athletes to their competitions where they compete against their peers from around the state of Hawaii. 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 free health exams through the Healthy Athlete Program. This Healthy Athlete program provides free dental, vision, hearing, podiatry, flexibility & nutrition screening and education 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. Special Olympics West Hawaii wishes to continue to provide these opportunities to all the athletes that are currently involved and be able to reach out to new special needs individuals througout our communities. In order to do this, we will need funds to maintain our services and to purchase new uniforms and equipment as well as provide transportation for athletes to get to competitions. Special Olympics Hawaii-West Hawaii Area is asking for $15,000.00 from the County of Hawaii to help fund our Special Olympics West Hawaii program activities. Total Budget and Position Count Total Pro ram Bud et 57,200 Total Pro ram Position Count 1 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 Total A enc Bud et 1,646,781 Total A enc Position Count 18 Program Objectives: 1) Increase participation in South Kona / Kau area and adding a delegation in the region. 2) Increase the strength of our new Waimea / Kohala delegation. 3) Continue to add community service events to give back to the community that is so supportive of us. 4) Continue Unified Sports programs to involve more family members and general public. 5) Add Special Olympics Golf as a summer season sport. 6) Train new delegations on ways to maintain current and new athletes, coaches and volunteers. 7) Provide financial support for current sports. 8) Provide quality activities for families and athlete support systems. 9) Continue to provide high quality training and competition to the intillectually disabled in the West Hawaii region. 10) Expand and get more involved with local schools with the goal of beginning delegations in them. 11) Increase fundraising opportunities for Special Olympics West Hawaii. 12) Continue to provide athletes an opportunity to be involved with planning and attending social events. 13) Provide athletes with additional opportunities of learning, broadening community awareness and self sufficiency. 14) Diversify and expand our management team to include more members of our community. Program Highlights: 1) Added the "Fueling Dreams" and "Miles of Quarters" fundraisers to increse our revenue stream. 2) Received the Air National Guard flight credit for our travel to Holiday Classic saving us several thousands of dollars. 3) Developed the beginnings of a new delegation in the Waimea area. They will formally participate in Spring 2009. 4) Trained and competed in 9 Special Olympics official sports. 5) Special Olympics West Hawaii volunteered at 2 groundskeeping and planting sessions at the West Hawaii Veterans Cemetary. 6) Extended the knowledge of what Special Olympics is all about through press releases, newspaper articles, other printed materials and radio spots. 7) Created professional quality yearbooks for all athletes, volunteers and coaches which inspire pride and joy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 8) West Hawaii has made more events, meetings and competitions increasingly open to the public. 9) Continued the developmant of our Unified Partner program wth a unified softball team. We continued training and competeing in unified Bocce (lawn bowling) and Bowling with 8 teams (16 bowling pairs). 10) Continued to support family specific events and booths at competitions. 11) Our Kona Lions soccer team won gold at the state games for the first time in 9 years. 12) Added and certified 5 new coaches. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Special Olympics West Hawaii -Agency Name SOHI General Funding -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Communit Service Pro'ects 8 8 10 State Competitions on Oahu 3 3 3 Area / Re Tonal Com etitions 8 8 g Re Tonal Com etitions Held in W.H. 3 3 3 Number of Famil Events g g g Number of Athletes Within Pro ram 35 37 40 Number of S ecial Partners 27 30 32 Number of Unified Bowlin Teams 12 10 10 Number of Unified Bocce Teams Teams 4 g g Number of Families Involved 35 37 40 ~i aNN~i~auia Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es 8700 9260 10000 Professional Fees 1700 2000 2200 O erations 7900 10000 11000 Equi ment 6300 8000 9000 Other" 22800 23000 25000 Total 46400 52260 57200 ~~ o'. r.~o.ovic # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 Special Olympics West Hawaii -Agency Name SOHI General Funding -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Count of Hawaii Non-Profit Grant 10000 12000 15000 Ironman Foundation 750 500 500 Private Donations 3375 4500 4000 Merchandise Sales 360 300 300 Co on Top 12000 12000 12000 Corporate Contributions 3500 4000 4000 Underpants Run 3500 3500 3500 Fuelin Dreams 3000 3500 3850 Interest Income 52 50 50 SOHI Co-Op Mone / Weinber 5000 3000 2000 Lar Mitchell Memorial Fund 2000 2000 2000 Visitor Industry Charit Walk 10,000 10,000 10,000 Total 53,537 55,350 57,200 it appucaoie 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? 1) We are planning to maintain our donations for our Cop on Top event in 2009. 2) We will plan to expand our Fueling Dreams event with the Law Enforcement personnel in Kona in partnership with Tesoro. We would like to make it a 2 day event instead of a one day event, due to economy, we projected a very modest increase. 3) We will work with the Air National Guard to hopefully receive the free airlift from Kona to Oahu for our State Games in December, saving us thousands of dollars. 4) Due to the economic forecast, we believe we will just maintain our individual and corporation revenues. However as we continue to meet our mission of continuing to outreach to new athletes, family members and volunteers within our community, our budget NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 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. Cutting any services would be tragic since in many areas we are the only services of our kind to the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 9 _.01/22/2009 1d:25 FAX 80869d8301 BANG OF HAWAII-CORP BN%G Special Olym~~ics West Hawaii -Agency flame SOHI GenE:ral Funding -Program Narie I (we) have read and understood all of the eligibility requirement:: grant conditions; award procedures; and records, reporting and fiscal ~~ccountability requirements as mandated in Article 25, Sections 2-135 - 2-142 2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Orc anizations. I (we) hereby certify that information supplied herein including al 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, Flawai'i Revised Statutes. If awarded a grant from the County of kfawai`i, 1 (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days aftesr June 30 of the fiscal vear_ The r eport shall include an explanation of the public benefits derived from tine awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, arnd a listing of oth®r funding sources and amounts obtained during the award period. Failure to submit a time) r. complete, an. aaencv's future fundinw n-guests. ~ronram's or Signature of Board Pres entlChair Date -, ` `J ~... I?~ ~~~ `U Signature of Exe~ ive Director Date UNSIGNED PI20POSALS WILL NOT BE ACCEPT NONPROFIT CxRANT APPLICATION FISCAL YJEAIt 2009-10 Page 10 002 Received 01-22-2009 02:57am From-9096949301 To-SPECIAL OLYMPICS HAW Page 002 70 Sure Foundation, Inc. Yeshua Outreach Center ,a Sure Foundation, Inc.- Agency Name Yeshua Outreach Center- Program Name Agency Director: Gary Thomas Phone No.: 969-6489 Contact Person: Susan Kaneshiro Phone No.: 969-6489 Mailing Address: P.O. Box 1598 Kea'au, HI 96749 Facility/Site Address: 16-1592 Pohaku Circle Kea'au, HI 96749 Fax No.: 966-6712 Email Address: gthomas@surefoundation.ty Name of AccountantlCPA (include name of firm if applicable): Carolee Fernandez, Strategy By Numbers, Inc. Phone No.: 808-982-3900 Mailing Address: PO Box 4130 Hilo, HI 96720 Amount of Request for County Funds: $107,450 Prior Year(s) Funding: 06-07 07-08 08-09 $0 $0 $0 Agency Mission Statement: Sure Foundation's mission is to build bridges and connect people to Christ. Our vision for the Yeshua Outreach Center is to impact lives, families and our community through Yeshua, which is Hebrew for healing, wholeness and victory. Our mission is to turn lives around through quality Christ-centered mentoring, fitness and support programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 I Sure Foundation, Inc. -Agency Name Yeshua Outreach Center- Program Name - - Program Description: The Yeshua Center at Sure Foundation in Puna, Hawaii is designed to provide an alternative outlet for whole families in the community to focus their energy and set personal goals for their future. We hope that by providing a nurturing environment, which focuses on three athletic programs, boxing, weightlifting, and martial arts, we can give families in our community a positive environment in which to develop. In addition to these athletic programs, we offer counseling and community service programs in drug and alcohol abuse, nutrition, and outreach to youth. We hope that in the process of pursuing personal fitness goals, we can offer members of our community some guidance and mentoring that will help prevent them from the distractions of drugs, alcohol and crime. This model for drug and crime prevention has been proven in many cities and communities throughout our country. We are led by Gary Thomas, a Colonel in the United States Air Force, who has already helped establish a Yeshua Outreach Center in Houston, TX. By combining efforts with local law enforcement and justice department officials, we hope to mainstream our efforts to the broader community. Sure Foundation church has offered their lazge recreational gymnasium as a site for our center, and all of our volunteer staff aze members of either the Hilo or Puna branches of the church. Total Budget and Position Count Total Pro ram Bud et $253,400 Total Pro ram Position Count 1.6 FTE Total Agency Budget $1,085,194 Total Agency Position Count 8.0 FTE Program Objectives: 1) To enhance membership by 100% though increased enrollment of community members and expansion of our boxing, weightlifting, and martial arts programs (15i 2"a and 3`a quarters, 2009) 2) To hold regular boxing exhibitions to promote the athletic programs offered by the Yeshua Center (3-4 per year, starting 3`a quarter, 2009) 3) To promote community service classes on Friday nights at 7PM by increasing attendance 200% of community members with problems such as domestic violence, anger management, alcohol and drug abuse and health and nutrition (1St quarter, 2009) 4) To develop strong partnerships with local judiciary in order to reduce recidivism rates for youth and adult offenders (2"a and 3`a quarters, 2009) 5) To coordinate program schedules with the local school system, specifically, Kea'au and Pahoa High Schools, to facilitate enrollment of youth for after school and intercession programs (2"a quarter, 2009) 6) To involve local private businesses and organizations, such as other Hawaii USA Boxing clubs, Rotary, County government, local Fire and Police Departments, University of Hawaii Hilo, YMCA, AG Churches, Teen Challenge Hawaii, and HIANG/HIARNG, in our Yeshua programs to further assist our community families and promote awareness of the Yeshua Center (ongoing, 2009-10) NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 Sure Foundation, Inc. -Agency Name Yeshua Outreach Center -Program Name Program Highlights: 1) Yeshua Center Grand Opening, Mazch 8, 2008, attended by more 1000 community members. Events featured a) USA-sanctioned exhibition amateur boxing matches in between `Oahu trained amateurs from Pearlside Boxing, Inc., led by Former National AAU Boxing Champion Eiichi Jumawan and Texas amateurs led by former World Welterweight Title Contender Ron Collins, b) weightlifting exhibition by world champion powerlifter, Tiny Meeker, and world champion women's powerlifter, Courtney Gathright, and c) Universal Kempo Karate demonstration led by sixth degree black belt, Marie Stiles. The Opening ceremony was overseen by Mayor Harry Kim. 2) March, 2008, Boxing and Kazate programs began accepting enrollment and - holding regulaz trainings run by all volunteer staff. Volunteer boxing trainers were certified prior to beginning of boxing program. 3) Synergy Youth Program holds regular Friday night meetings for youth between 6th and 12'h grades with free dinner and sports, break-dancing and other activities run by volunteers from Sure Foundation 4) September, 2008, Tutoring program began to assist program participant students with school and homework during after school hours run by all volunteer staff 5) September 26, 2008, Community Service education series began with 3 week Friday night classes from 7-8 PM covering the topics Building Better Health, Overcoming Addictions, Domestic Violence and Anger Management led by Dr. Tony Brown 6) October 7, 2008, Weightlifting program begins accepting enrollment and holding regular trainings run by all volunteer staff 7) November 15, 2008, USA Boxing-sanctioned bouts attended by over 500 community members, and featuring the first Yeshua amateur boxers versus boxers from Pearlside Boxing, Inc. 8) December, 2008, enrollment in Yeshua programs stands as follows: Boxing, 45; Karate, 23; Weightlifting, 12; Community Series, 10; Friday Night Youth, 80, with a cun•ent total of 170 community members. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 I I 1 Sure Foundation, Inc. -Agency Name Yeshua Outreach Center -Program Name Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate Boxing enrollment (5% increase 45 70 month) Karate enrollment (10% increase 23 50 month) Weightlifting enrollment (20% 12 30 increase month) Community Series attendance (20% 10 25 increase eve 3 week series Friday Night Youth attendance (5% 80 125 increase month) Total enrollment in Yeshua 170 300 Reduction in school absenteeism of NA Reduce by outh involved in pro rams 50% Recidivism rates for law offenders NA Reduce by who become members 50% Attendance rate of members NA >90% *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es $40,000 $48,000 Professional Fees $2,850 $7,700 Operations $62,000 $96,825 E ui ment $19,500 $70,875 '' Other* Ca ital Costs $5,000 $30,000 Total $129,350 $253,400 If applicable "Please explain in detail on separate sheet *** See attached spreadsheet for breakdown of estimated expenses for each program NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 I I Sure Foundation, Inc. -Agency Name Yeshua Outreach Center - Program Name .. Q G ry U O F N I ~ 01 0 N ~ R :a w o ~ Y ;~. W O L w" C O n w O ~ ~ x O G 4 0 G O p 4 U1 W fA fA [A O rJ ffl ~ ~ G o G o o ~n ~. o ~ w G N M ~ 69 ~ b9 M s9 w O G, O O ~/~ nl O G O O O O '~ O .G.~ ~ .-a Vl .--i ~fl Imo.' Fn t~' N ~ Ffd ~ P b 69 O 0 0 0 0 0 0 G9 v3 V7 V to 47 V1 ~ ~ .^. v ~~.. d « v C v « d .^. O G 0 0 0 0 0 0 d F -f /' .~ C d N ~~ 0 v w r+ w v Q ~ N N i"' (C~) L.n ti ~ u ~ ~ .O u W .". O .Y w ~ ~ V W O 4 4 °a °o O_ O_ cR M N .~ N N F V a, N 0 w K a v 0 O O ~Y9 u W 0 c .N W 6 Q O G 0 G O 69 E, .-~y V C O +n efl 0 lJ as Ci G O 4 O G O O W ° r-. rH O G n ni M b O1 N U O r- N G O O O ~y t `^ o ~I o 0 o k o µ~ N F+ R a Q. W ~ 4L ~ _ Y Gi :r p~fi ~ W n ~ '~ 'N .~. a b R cn y ~, r .~ O C.7 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 .. N O (~J W O v 0 G ~_ ~. N i. D O O O W ~' w Q 0 R M N N N w W N U ten, O U ~l N w Q v 'G `~i i~ Sure Foundation, Inc. -Agency Name Yeshua Outreach Center -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual' FY 2008-09 Bud et" FY 2009-10 Estimate Count Grant $0 $107,450 Tuition from membershi $6,125 $23,750 Net Income from s ecial events $1,800 $7200 Healin Our Island $3,955 $4000 Cash Donations $2,000 $3,000 Sure Foundation will cover all salaries of permanent staff $40,000 $48,000 Sure Foundation will donate its recreational facility for Yeshua $5000/month in-kind) $50,000 $60,000 Sure Foundation will cover shortfall $25,470 $0 Total $129,350 $253,400 '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? Initially, the Yeshua Center will continue to work on a limited budget comprised of a volunteer work force made up of Sure Foundation church members, a recreational facility donated by Sure Foundation Church and used equipment donated from local businesses and organizations. During the next year of operations, we anticipate growing interest from local businesses and state agencies through promotions, partnerships and community support. Our long-term goal is to support the operating costs of the Yeshua Center from an increase in enrollment, business partnerships, endowment and state agency funding. The goal is to make the Yeshua Outreach Center self-sustaining within five years. At that point, we hope to have at least 300 hundred members enrolled in tuition based athletic prograzns (approximately $100,000 revenue per yeaz), multiple businesses donating equipment and supplies for the fitness programs, funds donated through the church allocated for an endowment, and a good track record established with local judges and correctional facilities. By having Sure Foundation lend its support throughout our growth, we hope to gain momentum for this important community program over the next yeaz and quickly develop our own independence. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 Sure Foundation; Inc. -Agency Name Yeshua Outreach 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, 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 ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of your program's or agency's future funding requests. ignature of Board President/Chair~ Sign re of Executive Director e ~%~ Zo, Zoo q Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 71 Volunteer Legal Services Hawaii County of Hawaii Pro Bono Legal Services VOLUNTEER LEGAL SERVICES HAWAII- Agency Name County of Hawaii Pro Bono Legal Services- Program Name Agency Director: Moya Gray Phone No.: 528-7051 Contact Person: Moya Gray Phone No.: Same Mailing Address: 545 Queen Street, Suite 100 Honolulu, Hawaii 96813 Facility/Site Address: 545 Queen Street; Suite 100 Honolulu, Hawaii 96813 Fax No.: (808) 524-2147 Email Address: MOYA@VLSH.ORG Name of Accountant/CPA (include name of firm if applicable): James Jennings Phone No.: (808) 942-8813 Ext. 24 Mailing Address: 1600 Kapiolani Blvd, Suite 730, Honolulu, Hi 96814 Amount of Request for County Funds: $54,898 Prior Year(s) Funding: 06-07 07-OS 08-09 $ N/A $ N/A $N/A Agency Mission Statement: Volunteer Legal Services Hawaii was created by the Young Lawyers Division of the Hawaii Bar Association in 1981 as one of the country's first pro Bono legal organizations whose mission was to give low-income people access to justice by matching them with expert pro bono lawyers. The organization serves the NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 I Page 1 indigent, working poor, children and elderly creating access to legal services they could not otherwise afford. Today, Volunteer Legal Services Hawaii serves people who are at or below 200% of the federal poverty guidelines in all four counties of the State of Hawaii. Volunteer Legal Services Hawaii operates on a volunteer service delivery model, thereby both reducing costs and providing professional expertise. Unlike other legal service providers, such as Legal Aid Society of Hawaii, that hire lawyers to deliver professional services, Volunteer Legal Services Hawaii's employed staff generally provides administrative support to its volunteer lawyers and other community and professional volunteers who provide client services. This method has proven effective at keeping costs low while delivering high quality legal services. With strong support from the private bar, the Supreme Court's adoption of Rule 6.1 of the Hawaii Rules of Professional Conduct, urging all attorneys to donate 50 pro bono hours per year, has further strengthened pro bono service as a viable method of delivering essential legal services to the vulnerable populations of Hawaii. Over its 27years of existence, Volunteer Legal Services Hawaii has matured and its programs are well known within the community. Volunteer Legal Services Hawaii has a staff of 12.66 FTE employees and a pool of 850 volunteers on its roster; it is governed by a Board of Directors and managed by an experienced executive director, Moya Gray, who has over 27 years of legal and administrative experience and community leadership in Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 VOLUNTEER LEGAL SERVICES HAWAII -Agency Name County of Hawaii Pro Bono Legal Services- Program Name Program Description: NEED FOR LEGAL SERVICES: As a country, we pride ourselves on living by the "rule of law" ensuring that whether one is in the majority or a minority, everyone has the right to be treated in a just manner and that everyone has enforceable rights. However, the system of laws that has grown up with this country has become so complex that one needs a lawyer to navigate them through many different contexts. For those who can afford it, being represented by a lawyer is their only way to access our system of justice. Unfortunately, the cost of lawyers is high. For those who are unemployed, earn low wages, are ill, elderly or young, work two jobs, are caring for a parent or a child, or who are simply disadvantaged, hiring a lawyer is not a realistic possibility. For these people, lack of earning power effectively locks them out of the halls of justice. In 1993 the Spangenberg Report, a survey of the civil legal needs of the low- income community in the State of Hawaii, found that only 10% of the legal need was then being met. Since 1993 the rate of poverty in Hawaii has only climbed. Today Hawaii has a homeless population the growth of which is rapidly outstripping our ability to help. With the economic downturn we anticipate the low-income population needing legal services to grow significantly. In 2005 the Access to Justice Hui, composed of representatives from multiple legal services providers including Volunteer Legal Services Hawaii, conducted an assessment of civil legal needs and barriers of low and moderate-income people in Hawaii, the results of which were published in 2007. See Achieving Access To Justice For Hawaii's People at http://www.hsba.org/resources/1 /Documents/Access%20to%20Justice.pdf (hereinafter "Report"). The Hui collected information from a variety of sources to determine the current extent of unmet legal needs, identify barriers to getting legal help, and receive community recommendations to improve access to justice. Report at i. In summary, the Report noted an increase of 28% of those living below the poverty line; that only 1 in 5 low and moderate-income residents have their legal needs met; that legal service providers are only able to assist 1 in 3 of those who actually contact them for assistance, that the areas with the greatest unmet civil legal needs are housing (24%), family (23%), domestic violence (8%) and consumer (7%). Significant barriers to obtaining legal assistance, in addition to not be able to pay for a lawyer, include language and cultural barriers, lack of NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 knowledge of one's rights, lack of knowledge of available services and difficulty in access legal service programs. Report at ii. More significantly, despite there being 2 general legal service providers, the report found that of this group of people only 1 of every 3 people was served by a legal service provider because the legal service provider lacked capacity to serve the other 2. Volunteer Legal Services Hawaii has seen this very real need grow over the past few years. Between 2006 and 2007 Volunteer Legal Services Hawaii experienced a 30% increase in demand for legal services across the State of Hawaii and in 2008 we again saw an 33% increase over the prior year in demand for services. BENEFIT TO COUNTY OF HAWAII RESIDENTS Of those living in poverty in our state, over 18,488 reside in the County of Hawaii. With our legal assistance low-income people will receive legal assistance or other representation, our clients can keep their homes, their jobs, get insurance, see their children or collect child support, keep their children safe, collect social security and other benefits, and maybe even pay off their debts. We assist clients with adoption, guardianship of minors, adults and elders, child custody, visitation and support, divorce, civil rights, landlord-tenant disputes, employment disputes, consumer credit issues including collections, foreclosures, immigration, housing, powers of attorney, paternity, social security, tax liabilities, temporary restraining orders, and welfare issues. Most of the existing legal service providers provide "niche" services - to Native Hawaiians, only to Americans, only to immigrants or only to domestic violence victims. Unfortunately for the low-income community, all of these providers have restrictions on who they can serve. Some restrictions arise out of two low- income people being part of the same suit (lawyers cannot represent people who have or may have competing interests), some restrictions arise because there are restrictions on how many cases an attorney can handle at any one time, some restrictions are placed on who that provider can serve (Congress prohibits Legal Aid from representing non-citizens) -whether from a conflict of interest, caseload or financial restrictions, all of these providers turn people away. If a client is turned away from another legal service provider, such as Legal Aid Society of Hawaii, Domestic Violence Action Center, Hawaii Immigrant Justice Center, the American Civil Liberties Union or the UH Elder Law Program because they cannot service those clients, Volunteer Legal Services Hawaii is able to provide legal services to those people who would not otherwise be represented by a lawyer. For those people, without Volunteer Legal Services Hawaii, there would be no access to justice. As Volunteer Legal Services Hawaii provides civil legal services mostly through pro bono lawyers, generally we do not have conflicts of interest, caseload or financial restrictions. Today, there are over 6,000 licensed attorneys who can NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 provide pro bono legal services. Thus the only restriction that Volunteer Legal Services Hawaii's faces is a practical one -the lack of staff to help find lawyers for our clients. TARGET POPULATION: The most recent census results estimate that 9% of Hawai'i's population lives below the poverty line. For the County of Hawaii of the total population of 171,191, 10.8% or 18,488 people live in poverty. (http://q u ickfacts. census/gov/qfd/states/15/15001. htm I) POVERTY IS EXPECTED TO INCREASE: In November 2008 Bloomberg.com reported that Goldman Sachs Group Inc. increased its recession estimates... [projecting that unemployment will reach 9 percent by the fourth quarter of 2009." [Emphasis added]. http://www. Bloomberg. com/apps/news?pid=20601087&sid=a6e16aGOf0oA&refer =home. On January 8, 2009, The Center on Budget and Policy Priorities' released its report entitled Number of Homeless Families Climbing Due to Recession, by Barbara Sard (hereinafter "Homeless Families Report") at http://www.cbpp.org/1- 8-09hous.htm. This report projects that if the unemployment rate does rise to 9 percent by the fourth quarter of 2009 and continuing rising into 2010, then the population of homeless families will grow significantly over the next two years. The Homeless Families Report projects that the ranks of the poor could expand up to 10 million and the ranks of those in sever poverty could expand by up to 6 million. Those who live in poverty have significant needs for qualified legal advice, counsel and representation. Because these individuals have very little discretionary income after paying rent, utilities, food, childcare and bills, they have very limited ability to deal with problems. Therefore, the hardships they face have a serious impact upon their daily lives. More so than those who have the monetary ability to get legal assistance. For example, if your landlord hasn't fixed the broken toilet in your low-rent apartment, you might choose to wait rather than complain and take the chance that your landlord will raise your rent. Poverty seriously restricts an individuals choices, thus, to promote justice, both in the community and in legal proceedings, Volunteer Legal Services Hawaii's mission is to make legal services accessible to the poor, the working poor and the elderly through its programs. These factors are only compounded when these people are homeless or at imminent risk of homelessness. HOMELESSNESS & POVERTY WILL HAVE ADVERSE LONG-TERM CONSEQUENCES FOR CHILDREN: According to the Homeless Families Report, the increase of homelessness will have significant adverse long-term consequences for children: "studies have found that housing instability and homelessness lower academic performance, NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 increase the chance of repeating a grade, and reduce high school completion rates and puts children at greater risk of serious physical health problems." Id at 3. Before the coming of this recession, 19 out of 100 of our State's children lived in poverty. Many of these children, due to a variety of circumstances end up in the foster care system. In 2005, there were 2,762 children in foster care. The western legal system under which Hawaii operates gives no voice to minors, anticipating that the child's interest will be best served by their parents. When the parent or parents are no longer capable of advocating for their children because one or both parents have died, their parental rights are jeopardy, they are incapacitated for medical reasons, drug abuse, or engage in violence, our children have no one to speak out for them. Older children are more likely to take action on their own in an effort to protect their own interests, but they lack education, experience and capacity to truly nurture themselves or the children that they may bring into the world, and they too need legal assistance and support. And other family members, grandparents, aunts and uncles, may want to assist the children, but they too lack the wherewithal, education, experience and capacity to make a difference without legal assistance and support. OUR ELDERS ARE A SIGNIFICANTLY VULNERABLE AND GROWING GROUP: The kupuna is a very vulnerable group of people. -The Report noted that there is an increased elderly population that was particularly in need of legal services and that the support systems have not kept up with the increasing population. Report at A-73. The Hui noted that "[t]he number of seniors living in Hawaii has increased dramatically as compared to other age groups in the last seventeen years. In 1989 the population of those over 65 was estimated at 125,055. In 1999 that number had grown to 154,598 and in 2006 it was estimated that 174,972 seniors lived in Hawaii, representing an overall growth of 39.97%." Report at II-16. The Hawaii State Plan on Aging 2008 - 2011 (hereinafter "Plan") notes that for the County of Hawaii, the unmet legal need for those 60+ is significant. The plan's author, the Executive Office on Aging estimates that only 2% of legal needs of this population were being met. For those people 65+ who were living alone, only 7% of the needs were being met. Plan at II-30. HAWAII IS AT RISK OF INCREASED HOMELESSNESS: The housing market crisis is adding to the risk of increased homelessness as foreclosures push many families in to the rental market, driving up rents in these areas and making housing less affordable. Worse, the Pew Center on the States predicts that 1 in 29 Hawaii homeowners is expected to experience foreclosure by the end of 2010 due to the 'high-cost loan' (subprime mortgages). This foreclosure rate exceeds the USA average of 1 in 33 homeowners. The "ripple effects of those foreclosures are projected to hit more than half of Hawaii's homeowners and cost more than $4 billion in lost property value." See The Pew Center on the States at http://www. pewcenteronthestates.org/uploaded Files/wwwpewcenteronthestateso rg/Fact_Sheets/Subprime_state factsheets.pdf NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 As a significant group of low-income people, Hawaii's homeless need specialized legal advice. Whether because of family problems, consumer credit/debt, landlord/tenant, or employment problems, among a host of others, these people have specialized legal problems that stand between them and their ability to have or keep a home. Non-Profit Organizations that Serve the Same Population: Those non-profit organizations that serve the same population that Volunteer Legal Services Hawaii does, that is the poverty population, also rieeds legal assistance. Many of these organizations who are struggling to help our community themselves need legal help. These organizations, often with a very small staff and with a small operations budget and no funds for legal services need lawyers to help them comply with the law and ensure that their wonderful programs don't fail. Volunteer Legal Services Hawaii provides legal workshops, advice and counsel and pro bono matching services to this group of worthy and needy non-profit organizations. CURRENT SERVICES PROVIDED IN THE COUNTY OF HAWAII Although we have been providing legal services to residents of the County of Hawaii most of the service was through administrative staff and volunteers located on Oahu. In 2005, however, we began to operate a monthly Neighborhood Legal Clinic ih Hilo. The following year we added a monthly Neighborhood Legal Clinic in Kona, and this year we are operating two monthly Neighborhood Legal Clinics in Hilo and one in Kona. Clinics and workshops are provided at facilities located in downtown Hilo and Kona, Hawaii. For pregnant and parenting teenagers, we deliver legal services through the Department of Education's GRAD's program in public high schools in the County. As we have a physical 'presence' in the County of Hawaii only during these 3- hour monthly clinics, these services are not well known in the community. The minimal amount of time we spend in the community means that clients don't know how to find and access legal services from Volunteer Legal Services Hawaii. This fact is reiterated in the Access to Justice Hui's report which found that a significant reason that clients are underserved is because they do not know where to turn to get legal assistance. With the increased demand for services, we want to establish a continued community presence in Hilo by securing facilities and staffing them on a daily basis. This proposal would allow Volunteer Legal Services Hawaii to hire apart-time person in Hilo and to dedicate a small percentage of the Honolulu Staff Attorney's time to clients in the County of Hawaii to support services provided by volunteer attorneys. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7 PROGRAM DESCRIPTION Using staff and volunteers Volunteer Legal Services Hawaii will provide general civil legal services in the County of Hawaii to those who are at or below 200% of the federal poverty guidelines. Services will be offered in locations and times that are convenient for our target populations through the following programs: • Intake & Referral receives all requests for legal services. The Intake & Referral program conducts an intake on each customer to ensure that the person is eligible for all services, that we understand the basic nature of their legal issue and that all data is appropriately recorded. The program staff then make appropriate referrals to both Volunteer Legal Services Hawaii's programs or, if inappropriate or the client is not eligible for services, then referrals to other providers. • The Pro Bono Referral Program provides those clients who need full representation with pro bono licensed lawyers for the life of the matter. • The Neighborhood Legal Clinics provides clients with legal advice, consultation and brief services from general law lawyers or lawyers who specialize in family law. Clients meet with licensed lawyers who provide individualized legal advice, consultation and or a brief service for each client's situation. Neighborhood Legal Clinics are held twice a month in Hilo and once a month in Kona. Should a client's matter require an urgent consultant with an attorney, scheduled appointments are provided individual clients outside of the scheduled clinic times through telephone or face-to-face consultations, depending upon the location and need. • The Uncontested Divorce Workshops are staffed by licensed lawyers (both volunteers and staff), administrative staff and volunteer paralegals. These legal professionals teach clients about the uncontested divorce process, assist clients with completion of all legal documents and file the documents for the clients. These 'full-service' Workshops are held twice a month on Oahu. A limited version of the Workshops is currently offered in the County of Hawaii and with additional funding the full-service workshop would be offered. We provide specialized legal services through the following programs: Children's & Special Services Division: Within the Children's & Special Services Division Volunteer Legal Services Hawaii offers multiple programs, the primary goals of which are to serve and assist Hawaii's children, elders and others with supportive and legal services. This systemic approach to issues facing Hawaii's children strengthens families and keeps children safe and out of foster care; keeps our kupuna safe and as protected as possible during their times of vulnerability, all of which saves the government hard to find dollars. • Na Keiki Law Center works to promote change in processes, laws, and policies that harm children by advocating on behalf of Hawaii's children who suffer due to legal and familial conflict. Na Keiki Law Center supports children NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 8 and families in crisis by focusing on the best interests of children whose legal needs and rights are not sufficiently protected by existing legal and social services. When appropriate, we work with others to promote systemic change in government, social, legal, & other systems dealing with children; to identify the legal &psycho-social needs of vulnerable children and families; to identify child- related community problems in order to create effective alleviation strategies & pilot programs for eventual staffing by community volunteers; we develop and implement child-centered programs that employ mediation and other alternatives to litigation in child-related, familial conflicts; we promote community involvement & education in child-related issues; and engage community volunteers to accomplish mission-related tasks. Na Keiki Law Center offers three specific programs in the County of Hawaii that all assist children in some fashion. • Guardianship Services in which staff lawyers, assisted by law students and licensed volunteer lawyers, provide legal assistance and full representation of families in matters involving guardianship of children, thus helping families to take care of their children when parents aren't able. • Young Families in Need which provides statewide legal assistance to pregnant and parenting teenagers through its staff and volunteer lawyers in partnership with the Department of Education's GRAD classes. Through this program, Na Keiki Law Center prevents child maltreatment by educating young parents with children who are at high risk for maltreatment. Through the Young Families in Need program, Na Keiki Law Center brings volunteer attorneys into public school statewide to educate young parents on their legal rights and how to promote the best interest of their baby. The program works with extended families to establish practices that promote the baby's connections to both mother and father and reduce the need for child welfare service intervention in the future. • Parenting Plans Program, a pilot program, in which staff and volunteer lawyers and mediators educate and mediate parenting plans from the best interest of the child standard. Through its Parenting Plan program, Na Keiki Law Center educates parents involved in contested divorce in the realms of child custody, visitation, and co-parenting from separate households in a manner that protects children from the controversy and conflict traditionally associated with the contested divorce process. By educating parents on the potentially harmful nature of the process, mediating parenting plan agreements between parties, and involving extended families in a culturally sensitive process, Na Keiki Law Center hopes to foster a stable and supportive post divorce environment for children. Once mediated the parties can then file these plans in pro se contested divorce cases. Na Keiki Law Center's work to foster stable and supportive post- divorce environments will ultimate help to reduce child maltreatment and ultimately saving the government the cost to both prevent and treat the impact of child abuse, neglect and maltreatment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 9 Total Budget and Position Count Total Program Budget 90,621 Total Program Position Count 3 in County +6on Oahu Total A enc Bud et 1,072,000 Total A enc Position Count 12.66 Program Objectives: 1) For the County of Hawaii, we anticipate receiving over 1970 or requests for Legal Services. 2) To meet our objective of providing timely opportunities to meet with a lawyer, we will hold 22 clinics in Hilo (averaging 1.83 clinics a month) and 12 legal clinics in Kona (1 a month) at which a client may see an attorney for advice and counsel, and brief services. 3) We anticipate that we will provide 2 volunteers per clinic, each meeting with a total of 6 clients each, for a total of 408 clients. 4) For those clients whose matter cannot wait until the next scheduled clinic, we will provide virtual clinics for each of those clinics. We anticipate that we will receive requests for virtual clinics from 37 people. 5) We anticipate that we will find 22 volunteers to represent 22 clients in litigated cases. 6) We will provide 12 Uncontested Divorce workshops of 3 clients each, for a total of 36 clients 7) We will offer 8 workshops for nonprofit organizations with 24 attendees. 8) We will offer GRADS attorneys for each public school with a GRADS class who will provide legal education, advice and counsel to each class with an anticipated total of 36 students. 9) We anticipate that we will provide 700 hours of legal services over all at an hourly cost to the County of $78.42 per hour. Program Highlights: 1) The following are the highlights from our state wide program: 2) Received 15,000 telephone calls for legal assistance in 2008, an increase of over 60% low-income and vulnerable clients across the State of Hawaii since 2006. 3) Operated 387 Neighborhood Legal Clinics countywide 4) Opened and provided legal representation in court for 158 clients 5) Completed legal representation in 65 cases NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 10 6) Provided advice and counsel services to 2913 low-income clients 7) Provided uncontested divorce workshops and pro se support to 39 low- income clients. 8) Provided to over 826 clients who were experiencing homelessness 108 legal education classes and advice and counsel session 9) Provided to 207 pregnant and parenting teenagers of those 45 schools statewide offering GRADS classes, legal education, advice and counsel, and representation. 10) Recruited 150 new volunteers statewide and through those volunteers provided over 6000 volunteer hours worth $1.3 million dollars NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 11 VOLUNTEER LEGAL SERVICES HAWAII -Agency Name County of Hawaii Pro Bono Legal Services -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Re uests for Le al Services 1970 Advice & Counsel Services 445 Full Re resentation 22 Uncontested Divorces 36 Youn Families in Need Services 36 Nei hborhood Le al Clinics 34 Legal Education -DOE GRADS SCHOOLS 7 Volunteer Hours 700 *If applicable Program Expenditures FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Salaries and Wa es n/a n/a 64,120 Professional Fees n/a n/a 3,912 O erations n/a n/a 20,339 Equi ment n/a n/a 2,250 Other" n/a n/a Total n/a n/a 90,621 * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 12 VOLUNTEER LEGAL SERVICES HAWAII -Agency Name County of Hawaii Pro Bono Legal Services -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 FY 2008-09 FY 2009-10 Actual * Bud et * Estimate State Grant-in-Aid 22,000 Hawaii Justice Foundation 10000 HSBA 2,000 Donations 1,723 Total 35,723 '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? Volunteer Legal Services Hawaii is anon-profit that provides civil legal services through volunteer and paid staff and relative to other delivery models, this model saves money in two ways: first, our legal services are preventative in nature, thus keeping people in their homes and out of homeless shelters, keeping children in safe homes and out of the jurisdiction of the Child Protective Services, and helping families keep their kupuna safe and in their homes; and second, our legal services are provided primarily by volunteer lawyers and, for this reason, are extremely cost-efficient. Volunteer Legal Services Hawaii has sustained this cost effective model for 27 years through a variety of revenue streams, including federal, state and county government funding, foundation grants, and donations from the legal and business community. Using a combination of professional volunteers, paid administrative staff and these varied funding streams, we continually invest in our communities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 13 VOLUNTEER LEGAL SERVICES HAWAII -Agency Name County of Hawaii Pro Bono Legal 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, 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 ayear-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. ~li~ w 12~ o~ Signature of Board President/Chair Vt~ ~.S~pE.a~r Date 1~ o~ Signature of Executive Director. Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 14 72 West Hawaii Community Health Center Keiki Health Center (KHC) West Hawaii Community Health Center Keiki Health Center (KHC) Agency Director: Richard Taaffe Phone No.: 808-326-3884 Contact Person: Gayle Hunt Phone No.: 808-326-3594 Mailing Address: 75-5751 Kuakini Hwy., Suite 203 Kailua Kona, HI 96740 Facility/Site Address: 86-6627 Mamalahoa Hwy, Suite 106 Kealakekua, HI 96750 Fax No.: 808-327-1939 Email Address: ghunt(a~,westhawaiichc.ore Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPAs, INC. Phone No.: 808-524-2255 Mailing Address: American Savings Bank Tower 1001 Bishop Street., Suite 1700 Honolulu, HI 96813-3696 Amount of Request for County Funds: Prior Year(s) Funding: 06-07 $0 07-08 $0 $47,741 08-09 $ 20,000 Agency Mission Statement: The mission of the West Hawaii Community Health Center (WHCHC) is to make quality, comprehensive, and integrated health services accessible to all who pass through our doors regardless of income. These services will be culturally sensitive and will promote community wellbeing through the practice of "rnalarna pono ". Program Description: The Need The December 2007 Hawaii Island Healthcare Conference -" T/ze Crisis. The Challenge. T/ee Commitment" clearly reflected the urgency of the healthcare issues on the Big Island. If the island is experiencing health care challenges for all its inhabitants, then the crisis is understandab]y magnified for the uninsured and low income. For WI [CHC with the greater Kona Coast as our service area, approximately 70% of the 4600 patients who found their way to our doors in 2007 fall in these categories. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 1 West Hawaii Community Health Center West Hawaii Community Health Center Children's Clinic Pediatrics There are few private pediatricians on the Kona Coast, even fewer who accept a limited number of Medicaid patients due to a low reimbursement rate. Except for West Hawaii Community Health Center (WHCHC), none see the community's uninsured keiki . Until May 2008 when WHCHC opened the doors of its Keiki Health Center (KHC), family physicians at WHCHC's Kuakini site were the only safety net medical providers on the Kona Coast who see everyone, including children, regardless of ability to pay. Since its May opening, Dr. Locatclli has already seen over 700 Medicaid/uninsured patients at KHC's temporary facility. Dental The need for dental services for children who receive Medicaid or who are uninsured is huge. Although children may have Medicaid coverage, the problem of access to care remains because of the limited number of private practice dentists that accept Medicaid. In 2007, 1460 children were flown to Oahu from the Big Island for pediatric dental services at a cost of $628,332 for air transportation alone. This is an increase in numbers of children from previous years: 438 children in 2004; 496 children in 2003; 372 children in 2002. Mental Health A similar situation exists with pediatric mental health practitioners on the Kona Coast willing to accept uninsured children as well as those children covered by all types of Medicaid insurances. Currently, WHCHC mental health professionals work with their young patients as needed. Many children, however, go unserved, particularly outside Kailua Kona due to distance and transportation issues. WHCHC's Solution -The Keiki Health Center in Kealakekua This proposal, which requests assistance with `second year operating funds,' intends to continue WI-ICHC's integrated care model of health services (medical, dental, mental health) which focuses on children of Wcst Hawaii. Particularly targeted for services are those Medicaid and uninsured children living in the sparsely populated areas to the south of Kailua Kona. KHC's new location minimizes the challenges imposed by distance and infrequent bus service. Furthermore, where there is a need because of lack of health care practitioners in the greater Kona area, KHC provides integrated, pediatric expertise to all children along our 80 miles of coastline, regardless of their parents' income status. The KHC is proud of its integrated model of service. Providers (medical, dental, behavioral health) are trained to look for issues beyond their own area of focus, talk to the parent(s), and should it be warranted, immediately introduce the parent(s) to a fellow provider during the office visit. KHC providers practice this warrn handoff which embraces the entire child and is at the core of a truly integrated practice. Office space for the Keiki Health Center has undergone significant renovation to include 3 dental opcratories, 3 exam rooms, a behavioral specialist office, waiting area, and administrative and lab space. The permanent home of KHC is scheduled for a February 2009 grand opening. Future expansion plans include space for an additional dental operatory and two exam rooms. Because our pediatric dentist and hygienist were ready and willing even though the facility was not, our pediatric dental professionals initiated an Infant Oral Health Program in the community, targeting program participants who were underserved. The Kawaihae Transitional Shelter and other perinatal program sites offered perfect venues for on-site baby oral health checks and parent education. Since October 2008, approximately 40 infants, ages 0-3 years, have received oral health checkups by Dr. Sakima while reclining on the laps of their mothers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 2 West Hawaii Community Health Center West Hawaii Community Health Center Chi]dren's Clinic Ouce the dental operatories are available for patient use in February 2009, we expect to apply our dental performance measure as articulated in our 2008 and current applications. Total Budeet and Position Count Total Pro ram Bud et $861,241 Total Pro ram Position Count 8 FT; 2 PT Total A enc Bud et $4,456,779 Total A enc Position Count 32FT; 6 PT Program Objectives: 1. Provide quality nsedical care to 2600 children by end of grant period with the majority being Medicaid and uninsured; 2. Provide quality dental cure to 900 children by end of grant period with the majority being Medicaid and uninsured; 3. Provide quality mental health care to 200 children by end of grant period with the majority being Medicaid and uninsured. Program Highlights: 1. Medical care exceeded the 6 month projection in spite of working in a minimal, temporary office space the entire 6 months due to office renovation. Dr. Locatelli & staff made it work comfortably for patients and parents alike. 2. Renovation delays did not deter initiation of dental services; instead, the focus shifred to providing infant oral health assessments, prevention services, and education at targeted organizations and schools in the community. 3. Dental professionals became intimately involved in the Hawaii Island Task Force, the Hawaii County Oral Health Task Force, the Office for Social Ministry Dental Van Program, and the Maternal Consortium -all in preparation for the opening of the Keiki I-lealth Center's Oral Health Program. Performance Measures: FY 2007-08 FY 2008-09 FY 2009-10 Actual* Bud et Estimate Number of uninsured or Medicaid children seen - 0 1400 (70% of 1430 (55% of medical 2000 2600 Number of uninsured or Medicaid children seen - 0 630 (70% of 630 (70% of dental 900 900 Number of uninsured or Medicaid children seen - 0 140 (70% of 110 (55% of mental health 200) 200) *not applicable West Hawaii Community Health Center NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 3 Wes[ Hawaii Community Health Center Children's Clinic Program Expenditures: see Attachment A for budget details FY 2007-08 Actual* FY 2008-09 Budget FY 2009-10 Estimate Salaries and Wages# 0 $515,400 $729,120 Professional Fees# 0 $2,500 $3,500 O erations# 0 $64,200 $65,016 Equipment# 0 $25,600 $32,605 Other # 0 $7,500 $31,000 TOTAL 0 $615,200 $861,241 nor. applrcante Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual* FY 2008-09 Bud et FY 2009-10 Estimate Patient Generated (self pay, private insurance, Medicaid) 0 **$493,000 ***$788,500 330e rant (federal) 0 $60,000 $45,000 County of HI (re uested) 0 $60,000 $27,741 TOTAL o $615,200 $861,241 not applicable ** estimated 6800 visits x $72.5 average reimbursement = $493,000 *** estimated 8300 visits x $95 average reimbursement = $788,500 (5200 medical + 2700 dental + 400 behavioral health visits = 8300 total visits) 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? While the majority of funding is patient generated and supplemented with federal funds, the need for keiki health care continues to rise within the uninsured and underinsured population. West Hawaii Community IIealth Center's (WHCHC) conservative fiscal philosophy as well as a team of professionals who spend prudently assists WHCHC in accepting everyone who walks through our doors, regardless of abiliTy to pay. In 2009 and beyond, WHCHC will continue to seek funding from a variety of additional funding sources, both public and private, in order to meet the growing health needs of our community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-]0 4 West Hawaii Community Health Center -Agency Name WHCHC Keiki Health 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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report will impact the evaluation of vour program's or agency's future funding requests '~ -- ,~~ .,e,. ~.. signature of Board President/Ch Signature of Ex cutiverr ctor / ^27-0 ~ Date D to UNSIGNED PROPOSALS WILL NOT BE ACCEPTED NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 ATTACHMENT A !/28/09 Keiki Health Center (a West Hawaii Community Health Center satellite) Project Year 2 (2009-2010) -Operations Budget Detail EXPENSES: Salaries and Wages Pediatrician (1.OFTE) Pediatric Dentist (I.OFTE) Nurse Practitioner (.SFTE) Dental Hygienist (1.OFTE) Registered Nurse (1.OFTE) Operations Manager (1.OFTE) Dental Assistant(s) (2.OFTEs) Dental Office Assistant (1.OFTE) Psychologist (.6FTE) SUBTOTAL BENEFITS @ 20% TOTAL Professional Fees (5 professionals x $500; plus licensing & other associated fees) Operations Rent ($2100x12mos) Electricity ($273x12mos) Water ($125x 12mos) Telephone/Internet ($420x12mos) IT (EHR & Pm suppori;$2500x12) TOTAL $135,000 $130,000 $ 42,500 $ 70,000 $ 50,000 $ 41,500 $ 62,400 $ 31,200 $ 45.000 $607,600 $121,520 25,200 3,276 1,500 5,040 30,000 Equipment & Supplies Medical ($2.65x5200visits = $13,780) Dental ($4.75x2700visits = $12,825) Office ($6,000) Other CME expenses for 4 professionals @$2,500 Locum tenens ($700/day x 30days ine salary&travel) $729,120 3,500 $ 65,016 $ 32,605 $ 31,000 TOTAL $861,241 73 West Hawaii Mediation Center Mediation Services West Hawaii Mediation Center Mediation Services Agency Director: Janie Chandler-Edmondson Phone No.: 885-5525 Contact Person: Janie Chandler-Edmondson Phone No.: 885-5525 Mailing Address: PO Box 7020, Kamuela, HI 98743 Facility/Site Address: 65-1279 Kawaihae Rd., Ste. 213, Kamuela, HI 96743 Fax No.: 887-0525 Email Address: westhimed001~hawaii.rr.com Name of AccountanUCPA: John Carbonaro Carbonaro CPA's Phone No.: 808-242-5002 Mailing Address: 1885 Main Street, Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: Prior Year(s) Funding: 06-07 $7,000.00 07-08 10,000.00 $15,000.00 08-09 10,000.00 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-referred and court legal system referred clients. These services are provided in an accessible and afforciable 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 Pro ram Bud et 105,000 Total Pro ram Position Count 1.50 Total A ency Bud et 112,000 Total Agency Position Count 1.75 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 continuing education opportunities for volunteer mediators as well as specialty treinings, i.e., condominium, special education, civil rights, and domestic mediation. 4) Provide mediation services in an affordable and accessible manner for disputes arising both in and out of the courtllegal system. 5) 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. 6) Provide adequate case management services to adequately serve all referred cases. 7) Provide community outreach and education around constructive conflict resolution practices. Program Highlights: 1) Delivered 1,690 hours of case intake services. 2) Served 289 cases (87°~ court/legal system referred; 47% self-referred and 2% other State or County agencies) with 685 clients served. 3) Served 78 Domestic cases (an increase of over 78°k in Family Court referred cases). 4) Utilized 38 volunteer mediators in 508 mediation sessions for a total of 517.10 hours of mediation. 5) Reached full agreement in 60% of cases mediated. 8) Achieved a 90% service satisfaction rating by respondents (post-mediation satisfaction survey). 7) Achieved a 96°k rating by respondents indicating that they would recommend mediation to others in the future. 8) Provided 37% of total services to low income clients (annual income under $20,625). 9) Provided conflict resolution education and peer mediation training to over 500 elementary students in West Hawaii. Performance Measures: FY 2007-08 Actual" FY 2008-09 Bud et" FY 2009-10 Estimate* Case Mana ement Hours 1690 1740 1740 Mediation Cases Served 289 300 300 Mediation Sessions Conducted 165 170 180 A reements reached in mediation 60°~ 65% 135% Clients' satisfied with service 90% 95% 95% Client's willing to recommend service to others 96% 95% 95°h Skills enhancement trainings offered for volunteers 8 8 g Affordable service to low income (°~of clients considered low income 37°~ 45% 45% Community Awareness and Education Sessions 2 4 7 If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 West Hawaii Mediation Center Mediation Services Program Expenditures: FY 2007-08 Actual* FY 2008-09 Budget FY 2009-10 Estimate Salaries and Wa es 70,478 77,000 82,000 Professional Fees 461 500 500 O erations 30,000.00 32,000.00 34,000.00 E ui ment 660 500.00 1,000.00 OtheP Total 101,599 110,000 117,500 * If Applicable #Please explain in detail on separate sheet Program Funding Sources: Revenue Source FY 2007-08 Actual * FY 2008-09 Budget * FY 2009-10 Estimate Count of Hawaii 10,000.00 10,000.00 15,000.00 State of Hawaii 48,672.00 48,672.00 48,672.00 Hawaii Justice Foundation 13,000.00 11,000.00 9,000.00 Hawaii Island United Wa 9,000.00 12,600.00 15,000.00 Private Foundations 4,296.00 5,000.00 6,000.00 Donations 7,144.80 7500 8,000.00 Fundraisin 11,435.00 13,000.00 15,000.00 Service/Pro ram Fees 580.00 600.00 700.00 Client Private fees 7,922.00 5,000.00 6,000.00 Total 112,049.80 113,372.00 123,372.00 *If applicable Future Program Support: 1. West Hawaii Mediation Center completed its second Wine Tasting and Silent Auction in August of 2008. Again the event was very successful netting over 15,000.00. We are planning our next Wine Tasting event for 2010. In addition to the Wine Tasting event we will continue with our annual Sponsors and Supporters Campaign. This year's Sponsors and Supporters Campaign will be completed in March 2009. 2. West Hawaii Mediation Center continues to receive and seek support from the United Way and other private agencies. Four new grant proposals have been submitted this fiscal year. 3. Developing a culture of engagement that results in major gifts. The current Executive Director attended a HANO seminar in August 2008 entitled "Creating a Culture of Engagement that Results in Major Gifts Workshop" in order to team techniques needed to secure major donors for the Center and encourage ongoing support from current donors. The Center is working to implement these ideas. 4. Revise limitations on upper income fee schedule Mediation Centers of Hawaii has a submitted a proposal to amend the current contract with the State Judiciary to include a market appropriate fee schedule for clients and business with incomes in excess of $100,000.00 per year. These fees will help support the services we provide to low-income clients. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 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 inGuding 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 Chapier 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 yearend report to the Legislative auditor within 60 davs 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 funding reauests. L , ~/~~~~ -Signature of Boarc1 President/Chair `~~_ f ignature of Executive Director L /~ L QC Date ~ / Da e UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFtf GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 74 YWCA of Hawaii Island Empowering Alternatives Program YWCA Hawaii Island- Agency Name ~ ~ I ~ ~ Empowering Alternatives Program- Program Name Agency.Director: Cynthia Albers, Executive Director Phone No.: 935-7141 ext. 102 Business Cell: 987-1850 Contact Person: Lorraine Davis, Quality Assurance Director Phone No.: 961-3877, ext. 162 Business Cell: 854-5856 Mailing Address: 145 Ululani Street Hilo, Hawaii 96720 Facility/Site Address: 1382 Kilauea Avenue, Hilo, Hawaii 96720 and 755-5759 Kuakini Hwy., Kailua-Kona, Hawaii 96740 Fax No.: 808-935-5150 (YWCA main) 808-935-3196 (program Hilo) 334-0406 (program Kona) Email Address: calbers@ywcahawaiiisland.org or Idavis@ywcahawai iisland. org Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPA & Associates Phone No.: 808-968-1002 Mailing Address: P.O. Box 4372, Hilo, HI 93720 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 06-07 07-08 08-09 $45,000 $52,000 $20,000 Agency Mission Statement: "The YWCA of Hawaii 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 woman'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 towards the elimination of racism wherever it exists." NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 1 YWCA 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.lsland and to reduce disability to those who have been victimized. The YWCA Empowering Alternatives Program operates the 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 Hawaii to sex assault victims. Crisis Workers function as team members with police investigators and sex assault nurse examiners (SANE) in the Hawaii County Protocol for forensic examination of sex assault victims. A full time masters- prepared Therapist is employed at each Empowering Alternatives Program office (Hilo and Kailua - Kona) to provide psychotherapy, case management and legal system advocacy by appointment or walk in. The YWCA 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 State of Hawaii, Office of the Attorney General's through a subcontract with the Kapiolani Women's and Children Medical Center, Sex Assault Treatment Center. As a result, quality assurance, program and fiscal monitoring of services is maintained at standards. If the County of Hawaii decides favorably for continued funding of the Empowering Alternatives Program, it can do so with the knowledge that professional standards are practiced in the both service delivery and expenditure of funds. Total Budget and Position Count Total Program 367,440 Total Program Position 17 Bud et Count Total Agency "$1,500,000 - $3,000,000 Total Agency Position 60-85 Bud et Count - -- -- -- - " Fiscal year 2009-2010 agency budget is a range due to the unknowns of state of Hawaii contract services which comprise major funding of several YWCA programs. Program Objectives: Program Objectives: The Attorney General's Office of the State of Hawaii administers state funds for statewide sexual assault services and has announced a 20% reduction in funding for FY 2009-2010, which reduces by $69,835 funds to provide the same services to our expanding island population. YWCA Empowering Alternatives Program is a subcontractor through the Kapiolani Medical Center for Women and Children, Sex Assault Treatment Center (SATC). YWCA intends a reduction in staff and must eliminate the prevention education and community health promotions component of Empowering Alternatives, as has been agreed upon by SATC. The EAP mission objective is best realized through athree-pronged approach of providing 1, crisis intervention and stabilization, 2, therapy and legal advocacy, and 3, public awareness and prevention education service. The request for funding. of $60,000 from the County would ensure that components 1 and 2 remain fully intact for delivery of services at current levels and to provide for prevention education activities at a 50% reduction of prior years services. An assessment to determine the most vital services has been established by reviewing the first 6 months of FY 2009 data and comparing it to a previous year's outcomes. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 YWCA of Hawaii Island -Agency Name Empowering Alternatives Program -Program Name The program objectives are: 1) Continue to operate the 24-hour Crisis Hotline receiving calls from persons seeking support, information and referral that may lead to face to face support as decribed in program objective 2. 2) Provide a Empowering Alternatives Program Crisis Worker to support each sex assault victim undergoing medical-legal examination as a vital member of the Sexual Assault Response Team comprised of Police Department, Forensic Nurse Examiners and the Children's Justice Center. 3) Deliver professional counseling and/or case management services to at least 100 sex assault survivors. 4) Attend and participate in monthly case tracking and interagency team coordination meetings of the East and West Hawai Children's Justice Centers throughout the fiscal year. 5. Provide information and educational programs to the communtiy and to the schools surrounding sexual assault and sexual assault services. Program Highlights: In early 2008, the program changed how we receive crisis calls in order to eliminate lost calls, decrease the wait for a caller to connect with a crisis worker and avoid the intermediary conversation with the operator at the call center answering service. YWCA EAP ended our use of the answering service to route calls to the crisis worker and now all calls are answered directly by crisis workers. This led to an increase of calls for two reasons: Less waiting time to get assistance with immediate help available and call ended during the wait for the crisis worker to be connected. Members of the Empowering Alternatives Program staff and YWCA administrators participated in the Children's Justice Center Interagency Advisory Committee, the Hawaii Coalition Against Sexual Assault, and the Big Island Coalition Against Physical and Sexual Assault. These committees or coalitions include the involvement by staff from the following agencies: the Hawaii County Police Department, Child Welfare Services, Prosecuting Attorney, Victim Assistance Counselor, Family Court, Juvenile Probation Officers, Deputy Attorney General, Public Health Nurses, CAMH Division of the Department of Health, Department of Human Services, Department of Education and statewide service providers. The efforts fosters consistent care throughout the County and State for sex assault services and working together as agencies to provide the best practices care for the victims. The Empowering Alternatives Program Director/Quality Assurance Director participates in SATC state provider meetings in the review of policies, protocols and best practices throughout the State. The Quality Assurance Director is also working with the Hawaii Sexual Response Training (HSART) through a federal grant (VAWA grant through SATC) to identify concerns and problems, upcoming trends, and establish protocols and training to address these needs. The activities of the staff, in addition to the day-to-day services that are provided through crisis intervention, advocacy, therapy and prevention education are providing healing for those who have suffered through sexual assault and all it's ramifications. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 YWCA Hawaii Island -Agency Name Empowering Alternatives Program -Program Name Performance Measures: FY 2007-08 Actual * FY 2008-09 FY 2009-10 Bud et * Estimate Fully trained personnel are Phone line available Phone line Phone line available available to assess and 24 hours/day, 365 available 24 24 hours/day, 365 respond to callers on the days a year estimate hours/day, 365 days a year estimate Sexual Assault Crisis serving at least 300 days a year serving at least 400 phone line. callers. estimate serving at callers least 400 callers In FY 2007-2008, we served 476 The first 6 months callers of this year, we have served 291 callers Crisis counseling, legal 150 victim service 150 victim service 150-200 victim systems advocacy, contacts. contacts. service contacts information and referral are The first 6 months provided to each sex In FY 2007-2008, of this year, we assault victim undergoing we served 150 have served 177 medical-legal examination clients clients in East Hawaii and West Hawaii Survivors of sexual assault Estimated 100 100 100 receive psychotherapy services and intensive In FY 2007-2008, The first 6 months clinical case management we served 155 of this year, we from masters prepared clients have served 101 therapists in East Hawaii or clients. West Hawaii Community professionals Estimated 25 125 100 receive training in awareness of the needs of In FY 2007-2008 we In the first 6 adults and child sexual trained 46 months of this assault survivors, how to professional staff. year, we have detect and report child trained 80 sexual abuse or sexual professional staff abuse of de endent adults The community becomes In the first 6 2000-4000 more aware of sexual months of this assault, how to identify and year, we have deter sexual assualt, and provided are informed of where to information and receive help and services education to 2680 as a reslut of outreach individuals presentations, community activities and classroom resentations. *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 YWCA Hawaii Island -Agency Name Empowering Alternatives Program -Program Name Program Expenditures FY 2007-08 Actual * FY 2008-09 .Bud et * FY 2009-10 Estimate Salaries and Wa es 312,574 286,648 230,630 Professional Fees 1,108 1,000 6,800 O erations 128,780 133,367 130,010 E ui ment 798 Othe Total 443,260 421,015 367,440 * If applicable ~ Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate Sex Assault Treatment Center through the Attorne General's Office 349,175 349,175 279,340 Count of Hawaii 52,000 20,000 60,000 Victims of Crime Act 37,607 44,000 28,100 Other 4,005 7,840 Total 442,787 421,015 367,440 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Empowering Alternative Program is working with partner agencies to cross train and keep the continuum of services going where ever there is a gap in services. The YWCA Hawaii is seeking funding elsewhere through grant-writing, fund development activities and evaluatiing processes to determine where stream-lining is appropriate. In the event that the funding is not offered for these services, prevention education and community awareness activities will be eliminated from the program until further funding is available. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 YWCA Hawaii Island -Agency Name Empowering Alternatives 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, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs 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 funding requests. Q renda Olcott, Board President Da `, /-~~j-o Cyn a Albers, Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 75 YWCA of Hawaii Island Hamakua Youth Center YWCA Hawaii Island Agencv Name ~~ Hamakua Youth Center Program Name Agency Director: Cynthia AlbersPhone No.: 935-7141 x 102 business cell: 987-1850 Contact Person: Venica Ftacek Phone No.: 775-0976 business cell: 896-3670 Mailing Address: 145 Ululani St. Hilo, Hawaii 96720 Facility/Site Address: 45-3396 Mamane St. Honoka'a, Hawaii 96727 Fax No.: 935-5150 (main) 775-0976 (program) Email Address: calbers@ywcahawaiiisland.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro and Associates Phone No.: (808) 968-1002 1-866-728-6430 Mailing Address: P.O. Box 4372, Hilo, Hawaii 96720 Amount of Request for County Funds: FY 2009-2010 $50,000 Prior Year(s) Funding: Zoos-o7 Zoo7-oa .zoos-os $30,000 $45,000 $20,000 Agency Mission Statement: "The YWCA of Hawaii 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 woman'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 towards the elimination of racism wherever it exists." Program Description: The YWCA Hamakua Youth Center (HYC) 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. HYC provides a protective factor in youth's lives by providing a safe youth focused environment, daily nutritious meals, homework assistance, youth leadership, cultural education, life skills, arts education and special projects throughout the year. HYC provides support to families by providing no fee services for youth in a safe and structured environment during work hours thus assisting with childcare, food costs and homework. A majority of households have both parents working outside the home. In addition to the standard eight hour work day commuting to North Kohala or Kona adds an additional three to four hours to the time parents are out of the home community, leaving children on their own in the mornings, after school and often times in the evenings. As the Hawaii State legislature states: "The legislature finds many children are on their own in the mornings and afternoons before and after the school bell rings. Nationally, nearly two thirds of the school age children are in homes with both parents working, yet very few communities have a comprehensive system of before and after school care for children. While Hawaii is fortunate to have A+ program for K-6, older children also need adult supervision. When older children are unsupervised in the morning, afternoon, evening, weekend and holiday hours, statistics clearly show rates of juvenile crime, drug use, and experimentation with tobacco, alcohol, and sex increases." NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 1 YWCA Hawaii Island Agency Name Hamakua Youth Center Program Name The YWCA Hamakua Youth Center (HYC), located at 45-3396 Mamane Street in Honoka'a, is directly across the street from Honoka'a Elementary/Middle and High Schools, making it readily accessible to students. The center is attended daily by 25-50 or more youth aged 5-20 years who flock to the center to enjoy the company of peers and access resources in a safe setting. In 2008- 2009 HYC provided services for'110 registered youth and 309 drop in participants. Our services reached 419 youth throughout 2007-2008. The 900 square foot rented facility includes homework and computer lab with six internet connected work stations with several printers, social area, pool ping-pong table and Foos ball tables, multimedia studio, community garden and cultural arts workstation. HYC is dedicated to working cooperatively within our community to bring services to our youth and assist with other civic based groups with their projects. The Hamakua Advisory Community Council (HACC) of the YWCA Hamakua Youth Center, made up of individuals dedicated to the ongoing growth and is made up of independent citizens, representatives from agencies, businesses and civic groups, as well as several youth delegates, to assure that the youth and communities perspectives guide actions, direction and decisions of HYC. A liaison from the YWCA Board of Directors is a member of the HACC to strengthen relationships and ensure support and accountability in accordance with non-profit operations. HACC launched a fund raising campaign "Friends of HYC" which provides fundraising trainings for the members and hosts fundraising events throughout the year. The Friends group has established a goal of raising $20,000 annually toward the operational budget for HYC. HACC believes in gathering local community support while providing quarterly fund raising events to provide funding which support youth programs. Total Budoet and Position Count FY2009-2010 Total Pro ram Bud et $120,000 Total Pro ram Position Count 5 Total Agency Budget *$1,500,000 - $3,000,000 Total Agency Position Count 60-85 * Fiscal year 2009-2010 agency budget is a range due to the unknowns of state of Hawaii contract services which comprise major funding of several YWCA programs. 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 pro-social behaviors and bonding of youth with peers and adults 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. Increase Cultural Awareness and Appreciation 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, observation 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 During the 2008-09 school years, the YWCA Hamakua Youth Center continued to provide the After-School Drop-In center with structured and unstructured activities for youth at no cost. As of December 31, 2008, 225 youth have participated. We are open weekdays after school from 2:00-6:00 pm, Wednesdays from 1:00-6:00 pm to accommodate the schools early dismissal and provided special evening and weekend activities twice a month. During school breaks and in the summer months open hours were expanded and modified for highest use during working hours, generally from 10:00 am-5:00 pm. The HYC welcomes both boys and girls who take part in their choice of the following activities: Internet-Computer Lab Multimedia Studio Jr. Reforestation Projects Homework Lab Youth Music Exchange Arts, Painting, Ceramics Youth Leadership Council Hawaiian Studies Program Domestic Engineering Recreation Billiards Community garden Life Skills NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 2 YWCA Hawaii Island Agencv Name Hamakua Youth Center Program Name Environmental Education Community Service Teen Court Community Service Family Court Programs and Special Activities Domestic EngineeringlLife Skills Educational Series This educational series presented twice weekly by Activity Specialist, Susan Saunders, is comprised of four components, Introduction to Cultural Foods, Cleanliness and Sanitation, Introduction to Tools and their Practical Life Skill Application, and Pro-Social Life Skills including manners, etiquette and Cultural Protocol. Youth learn valuable lessons about the many differing cultural practices that apply to home, social and professional environments. Recreation Daily access to pool (billiards) and ping-pong recreation continues with both instruction and tournaments taking place weekly led by members of the YWCA HYC staff and volunteers. Youth learn 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. In response to a spontaneous and increased playing of Chess we are hosting weekly chess tournaments with guest adult mentors and staff. Hawaiian Cultural Education Activity Specialist and Hawaiian Cultural Specialist, Lanakila Mangauil, a graduate of Kanu O Ka Aina Public Charter School and participant in the Ka Piko O Ka Lei Lehua Kupuna training program, directs numerous programs and activities. Youth are provided thrice-weekly traditional Hawaiian cultural classes and experiences, including oli and mete, hula, olelo, kakala'au, values, and as well as traditional tool and instrument making, music, forestry, Kupuna visiting program and participate in cultural festivals island wide.. Additionally, youth take part in the tradition of the Pa'ani Makahiki, training and competing in the annual Makahiki games. Multi Media Music and Studiol Comic Book project Youth artists founded a record label Howzit records which supports music for change. Youth identified a motto "Changing our community note by note" and planned a Concert of Equality set for January 30'" 2009. Youth sponsored a community open mic monthly and recorded a cd on Howzd records label. Youth worked with professional mentors in the field of music, engineering, marketing and art which followed a 16 week curriculum designed to prepare youth for work in the music industry. In addition to a recording studio, record label, cd and concert planning, youth have identified equality education as their target and will donate proceeds of their sales to support equality education. HYC plans to continue this valuable program and incorporate a fourth quarter of our comic book project which uses comic booking to address social issues. Supporters and Partners The YWCA Hamakua Youth Center has nurtured many new and expanded relationships with businesses, public and private organizations who have provided support, services and collaboration. Key partners include: Alu Like Honoka'a Police Department Simply Natural Cafe Boys and Girls Club of Hilo Hospice of Hilo Teen Services YWCA Teen Court Charles Ricaido, Professional Kanu O Ka Aina Public Charter Hilo Hamakua Community Musician and Mentor School Development Corporation Family Court Marimed, Youth Treatment Program Healing our Island Five Generations Foundation Na Pua No'eau United Way of Hawaii Island Hamakua Girl's Academy North Hawaii Coalition for Drug Dominic Yagong Hamakua Health Center Free HI Five Forty Five & Fate Art Studio Hawaiian Honey Company North Hawaii Youth Coalition JJ's Meat Market HLP Hamakua Community Power of Choice Hamakua Griffco Corporation Foundation Honoka'a Fire Rock- N -Renew Foundation Department- Salvation Army NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 3 YWCA Hawaii Island Aoencv Name Hamakua Youth Center Program Name Performance Measures• FY 2007-08 FY 2008-09 FY 2009-2010 Actual Target and Actual as of Target 12/30/08 Average daily attendance by youth 30 Target: 35 30 as of 12/31/08 30 Total number of youth served annually 190 Target: 300 191 as of 12/30/08 400 Total number of waivers on file signed 103 Target: 275 150 by parents of youth participants 55 as of 12/30/08 Number youth received Orientation, including worksheets on pro-social n/a Target: n/a 100 behaviors, and conflict resolution 23 as of 12/31/08 lessons. Surveyor Interviews reflecting self- Target: 100 report of youth about responsible vs. 103 24 as of 12/31/08 100 reckless or irres onsible behaviors Percentage of youth responses Target: 80% reporting an Increased or improved 103 70% (14 of 24) 100 social bonding of youth with peers and as of 12/31/08 adults Tracking pro-social behavior of select n/a Target: 90 100 youth 25 as of 12/31/08 Total number of partnerships 30 Target: 22 28 as of 12/31/08 25 Total number of parent participants 10 Target: 25 9 as of 12!31/08 10 Total number of partner projects or 30 Target: 100 100 activities presented or conducted 48 as of 12/31/08 Total number of volunteers 53 Target: 75 47 as of 12/31/08 75 NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 4 YWCA Hawaii Island Aaencv Name Hamakua Youth Center Program Name Program Expenditures FY 2007-2008 Actual FY 2008-09 Estimate from actual ro osal FY 2009-10 Estimate Salaries Wages Benefits and taxes $93,489 $85,512 $80,000 Professional Fees $ 0 0 Operations $34,578. $47,966 $40,000 Equipment $1,919 0 0 Other 0 0 0 Total $132,229 $133,478 $120,000 Note: FY 2008-09 the YWCA Board adopted a ($12,727) deficit budget for the Hamakua Youth Center. * please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2007-08 Actual * FY 2008-09 Budget FY 2009-10 Estimate County of Hawaii $45,000 $20,000 $50,000 State of Hawaii, Office of Youth Services $79,438 $12,251 0 Private Foundations $5,000 $7,333 $34,500 Hawaii Island United Way $0,000 $25,500 $15,500 Donations (Restricted & Unrestricted) $7035 $20,000 0 Fundraising Friends of the YWCA Hamakua Youth Center 0 $8,000 $20,000 Hawaii County Contingency Allocation, Council Member Dominic. Ya on 0 $25,000 0 Total $136,473 $120,751 $120,000 Footnotes to Program Budget Table Kuki'o Community Fund $5000 and Ellen Ashton Foundation $2,333. z Includes HIUW Deferred funds from FY 2008 of $10,000 and FY 2009 award of $15,500 s Private donations of 20,000 is currently restricted for relocation expenses. "Increased support from trusts and foundations will be sought for 2009- 2010. s Contingency funds are for the period December 26, 2008 0 September 30, 2009 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 are working in cooperation with the Hamakua Community Advisory Council and the newly formed Friends of the Hamakua Youth Center to assure the continuance of the Hamakua Youth Center. The collaborations include fundraising, special events, facility rental, developing relationships with private donors, applications to Trusts and Foundations and potentially to develop an endowment fund. We will continue to rely upon our partnerships with County of Hawaii, Hawaii Island United Way, and business community to assure funding for programs for youth in the Hamakua area. 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. While need exists and cooperation prevails, we aim to provide free, youth driven, volunteer supported programming to ensure healthy choices for the youth in Hamakua. As the model proves successful in the Honoka'a community, we will work in partnership with other agencies and communities where a similar need exists for non-school hour programs. NONPROFIT GRANT APPLICATION FISCAL PEAR 2009-2010 Page 5 YWCA Hawaii Island Aaency 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, 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 ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. 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 vear-end report 40 i nature, Brenda Olcott, Board President D to / -~ ~ / "-4 Signat ,Cynthia Albers, Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-2010 Page 6 76 YWCA of Hawaii Island Healthy Start Program Agency Director: Cynthia Albers, Executive DirectorPhone No.:(808) 935-7141 ext. 102 Business Cell: 987-1850 Contact Person: Andrew A. Kahili, Progam Director Phone No.: (808) 961-3877 ext. 127 Business Cell: 430-0749 Mailing Address: 145 Ululani Street Hilo, Hawaii 96720 Facility/Site Address: 1382 Kilauea Avenue Hilo, Hawaii 96720 Fax No.: 808-935-5150 (YWCA Main) (808) 961-9140 (program) Email Address: calbers@ywcahawaiiisland.org or or Idavis@ywcahawaiiisland.org or akahili@ywcahawaiiisland.org Name of AccountantlCPA (include name of firm if applicable): Carbonaro and Associates Phone No.: (808)968-1002 1-866-728-6430 Mailing Address: P.O. Box 4372, Hilo, Hawaii 96720 Amount of Request for County Funds: $200,000 Prior Year(s) Funding: 06-07 $0 07-08 $0 08-09 $0 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 2009-10 Page 1 Healthy Start Program- Program Name YWCA Hawaii Island -Agency Name Healthy Start Program- Program Name Program Description: The goal of the YWCA Healthy Start program is to identify and prevent potential child abuse and/or neglect in families with very young children throughout the Districts of Hilo, Hamakua and Puna. The YWCA Hawaii Island Healthy Start Program ("YWCA HSP") is part of the Hawaii State Department of Health, Hawaii Healthy Start Program. The program is a statewide, voluntary home visiting program that supports families and promotes positive child relationships. Prenatal women and families of infants and children under the age of three (3) years may enter the program. Currently the YWCA HSP Program consists of two components, Early Identification ("EID") and Home Visiting ("HV"). Our EID component provides screening and assessments of all births at Hilo Medical Center to identify prenatal and postnatal women and families at-risk for sub-optimal health, developmental delays, and child maltreatment. Our HV component utilizes a multi-disciplinary team approach and provides culturally appropriate support services within the family's natural environment (in their homes) and primarily focus on the reduction of parental, social and environmental stressors, which are directly related to child maltreatment. These stressors frequently include lack of employment, sub-standard living conditions, domestic violence, substance abuse, teen and/or single parent, lack of access to transportation, health care and other resources. Children identified at-risk for parental and environmental. stressors is a significant problem for Hawaii's children. These children are at increased risk for sub-optimal health, developmental delay and maltreatment. Current research indicates this problem is a serious threat to the lives of these children and will have a tremendous impact on the community in the future. The home visiting program utilizes Family Support Workers who are paraprofessionals and work with a team consisting of a Clinical Supervisor, Clinical Specialist (CSp), and Child Development Specialist (CDS). Home visiting services include screenings/assessments for possible delays and referrals for early intervention services. In addition, the program provides child development and parenting information, problem solving skills, and links families with appropriate community resources. For two decades now, the YWCA HSP has been a stabilizing farce for families of Hawaii Island reaching out to thousands of parents of newborns and toddlers to help them cope with family responsibilities. Many are facing issues of domestic violence and substance abuse. Healthy Start helps families learn parenting skills, positive relationships through bonding, nurturing, and professional assistance. In addition, the program helps with the necessities of life - by assisting with access to community resources, which provide food, clothing, medical care and shelter. Healthy Start provides safety net services to Hawaii's most vulnerable families and infants. As part of Blueprint for Change planning , UH economist David McClain conducted a cost benefit study on Healthy Start which showed a 3:1 positive cost benefit ratio. Nationally, prevention and early intervention programs have shown 7:1 cost benefit ratios. According to economist James Heckman (NYT op-ed, 7-29-08) "Big gaps in potential for educational attainment are present at age 5. Some children are bathed in an atmosphere that promotes human capital and increasingly more or not. By age five, it is depressingly possible to predict who will finish school and college and who will not". This has a real impact on development of human capital and the overall economy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 2 YWCA Hawaii Island -Agency Name Healthy Start Program- Program Name Total B~daet and Position Count Total Program $1,062,200 Total Program Position Count 18 Bud et Total Agency '$1,500,000 - $3,000,000 Total Agency Position Count 60-85 Bud et 'Fiscal year 2009-2010 agency budget is a range due to the unknowns of state of Hawaii contract services which comprise major funding of several YWCA programs. Program Objectives: 1) Develop an Individualized Family Support Plan (IFSP) to address identified risk factors for each child and their family enrolled. 2) Identify family's risk factors. 3) Utilize a cohesive team approach in providing services. The home visiting team members work with the family to develop outcomes, and break those outcomes into meaningful strategies to ensure success. 4) Monitor and review family's progress in completing their objectives/strategies. In order to support the growth in the family, the home visiting team members and the family review the family's progress in completing their objectives/strategies toward the overall achievement of their outcomes. 5) Deliver home visitation services. Home visits are conducted ih the family's natural environment by the home visiting team members, in accordance with the IFSP, in a seamless, cohesive manner where all disciplines involved communicate with one another regarding their relationship to the family. 6) Ensure care coordination services are provided to families. The care coordinator is responsible to ensure that services delivered by appropriate staff and agencies are coordinated and delivered in timely manner, including assess and monitor families identified with issues of family violence, substance abuse and mental health. 7) Assess and monitor children identified with developmental status and health care needs. 8) Promote positive child health development. 9) Promote positive parent child interaction. 10) Promote a health and safe home environment. 11) Promote early and ongoing prenatal care. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 3 _ YWCA Hawaii Island -Agency Name Healthy Start Program- Program Name Program Highlights: 1) Healthy Start systematically and comprehensively identified families at risk for child abuse and developmental delays for all births numbering 1,137 at the Hilo Medical Center during FY 2008. 2) 417 of referred families enrolled in home visiting services aimed at reducing risk and promoting healthy development. 3) Healthy Start assessed 523 of children for developmental delays and referred approximately 5% for professional management. Early referral such as these reduces future special education costs by facilitating early intervention during the critical first three years of life. 4) Healthy Start is the point of intake for high risk infants conducts developmental screening and refers for developmental delays, to a medical home, and other early childhood services aimed at assuring children are ready to learn. 5) Healthy Start assist families in meets concrete, emergency survival needs of over- stressed, impoverished families with newborns. (Food, supplies, housing, jobs, emergency financial assistance). 6) In a recent letter from Dr. Elizabeth McFarlane and Dr. Anne Duggan of Johns Hopkins University, it states, "the Healthy Start Program has one of the strongest practice-research partnership in the county. Many service programs in Hawaii and the across the nation have limited objective evidence of how services are delivered and the results achieved" it also states "the Healthy Start Program practice-research partnership has provided solid evidence of the program's accomplishments and a solid understanding of how to improve program practice to have even greater impact for more families". NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 4 YWCA Hawaii Island -Agency Name Healthy Start Program- Program Name Parfnrmance Measures' FY 2007-08 FY 2008-09 FY 2009-70 Actual " Budget' Estimate (actual as of 12/31 /OS Number of children enrolled in the Healthy Start 417 340 f 350 Pro ram home visitin com onent. 9 9 p (actual as o 12/31108 170 Conduct assessments and screens for to identify families at-risk for child abuse and/or neglect to 1,137 1,100 1,150 100% of births at Hilo Medical Center in Hilo. 106 met the Families remaining in service for 12 months or 12 month in 98% based more with no child abuse and ne lect. g 158 service and 104 were w/o on prior year actual CAN re ort Children enrolled at least 45 days shall have a 217 or 64% completed Individualized Family Support Plan 268 or 64% (actual as of 227 or 65% IFSP . 1z/svoa 1os~ Target of 100% Children and their families in service for 6 months or more shall have an 204 163 target 175 target identified "medical home' for well and sick care. Of 32 children 100% of children are fully immunized by 2 years aged 2° years, 81 /° ° 24 or 83 /° ° 24 or 83 /° of age. or 26 immunized. 100 % pregnant women shall receive prenatal 41 or 100% 31 or 100% 31 or 100% care within 30 days of enrolling into the program. Conduct child development screening and parent-child interaction scales for potential 371 or 89% 302 or 89% 311 or 89% develo mental and social-emotional dela s 95% of families remaining service for 12 months 93% or 147 families or more shall receive family planning enrolled for g5% 95% information. 12 months "If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 5 YWCA Hawaii Island -Agency Name Healthy Start Program- Program Name Program Expenditures FY 2007-08 Actual * FY 2008-09 .Bud et * FY 2009-10 Estimate Salaries and Wa es $925,219 $717,022 $717,022 Professional Fees $4868 $3,500 $7605 O erations $317,705 $301,941 $337,573 E ui ment $3,407 $0 $0 Othe Total $1,251,199 $1,022,463 $1,062,200 * If applicable ~ Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source """See notes below FY 2007-08 Actual * FY 2008-09 Bud et * FY 2009-10 Estimate State of Hawaii -De t. of Health $1,279,382 $1,022,463 *$662,200 Count of Hawaii $200,000 Office of Hawaiian Affairs $150,000 Hawaii Island United Wa $50,000 Total $1,279,382 $1,022,463 $1,062,200 *If applicable **All funding for FY 2009-10 is proposed amounts and are not secured funds. *State of Hawaii, Department of Health funding represents 7% of the proposed 9.46 million dollars for Healthy Start in fiscal year 2010. 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? Since 1998 the program has been funded 100% by the State of Hawaii, Department of Health, Family Health Services Division, and Maternal Child Health Branch. On December 23, 2008 Governor Linda Lingle's announced in a news conference her plans to eliminate funding in fiscal year 2010. Given this information the program is currently working with all Hawaii State Lawmakers on reinstating a portion of funding from the state budget totaling $9,460,000 dollars. In addition the program will be submitting grant proposals to the following organizations; Hawaii Island United Way, Office of Hawaiian Affairs, Hawaii Community Foundation and United States, Department of Health and Human Services, Administration for Children and Families. NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 6 YWCA Hawaii Island -Agency Name Healthy Start 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, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs 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 funding requests. a., S' nature, Brenda Olcott, Board President Sign re, Cynthia Albers, Executive Director a D e r~2~-a9 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2009-10 Page 7