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HomeMy WebLinkAboutCOM 0099.002 2020-2022 i Mitchell D. Roth Deanna S. Sako Mayor Director Steven A. Hunt Deputy Director I County of H wai`i Finance Department 25 Aupuni Street,Suite 2103 • Hilo,Hawaii 96720 (808)961-8234 • Fax(808)961-8569 February 23, 2021 Malle Medeiros David, Council Chair and Members of the Hawaii County Council Ha,:vai`i County Council 25 Aupuni Street Hilo, Hawaii 96720 Re: Nonprofit Grant Applications This is to transmit a revised list of Nonprofit Grant Applications, including five Nonprofit grant applications from the The Island of Hawai'i YMCA(YMCA), the YWCA of Hawai'i Island (YIVCA), and Halau E Hulali Mai I Ka La for inclusion in the applications previously submitted for the Council's consideration. Halau E Hulali Mai I Iia La application was timely submitted but that entity inadvertently referenced the wrong section within their bylaws regarding their proof of authorization(which was deemed to be missing). After further clarification, the issue was resolved, and the proper sec-ion within the bylaws was identified. The YMCA and YWCA applications were also timely submitted, however there was some confusion regarding organizational name changes that occurred several years ago and the documents necessary to support the flame changes. Upon review and discussion with Corporation Counsel, the issue was resolved. Per our discussion with Council Member Susan Lee Loy, Human Services & Social Services Committee (HSSSC) Chair, and in compliance with Chapter 2, Article 25 of the Hawaii County Code, I am submitting a revised list of the organizations and applicable information, and five Nonprofit Grant applications from The Island of Hawaii YMCA, the YWCA of Hawaii Island and Halau E Hulali Mai I Ka La for your review and appropriation of funds for the FY2021-22 nor-profit grant program. Comm. Ref. To: Hawaii County is an Equal Opportunity Employer and Provideftef. gate FEB 2 4 2424 Page 2 of 2 s 3 Should you have any questions,please feel free to call Lisa Tada at 961-8489. i I I Deanna S. Sako Dirictor of Finance a 3 3 Ene. Halau E Hula! Mai I Ka La Application for Nonprofit Grant Funds The Island of Hawaii YMCA Application for Nonprofit Grant Funds YWCA of Hawaii Island.Applications for Nonprofit Grant Funds Revised List of Nonprofit Grant Applicants i I I i I 3 3 3313 I 7 3 3 5i5 3 Hawaii County is.an Equal Opportunity Employer and Provider NONPROFIT GRANT APPLICANTS FOR FY2021-22 Sort order matches separation sheet numbers(hard copies). Note that the disqualified applicants sort order are AFTER qualified applicants. Numerical,' Sort Order Order ORGANIZATION NAME PROGRAM NAME REQUESTED 11 1 After-School All-Stars Hawai'i After-School at Ka'u High&Pahala Elementary 12,000.00 14 2 After-School All-Stars Hawaii After-School at Kea'au Middle School 12,000.00 13 3 After-School All-Stars Hawai'i After-School at Pahoa High&Intermediate 12,000.00 12 4 After-School All-Stars Hawai'i After-School at Waiakea Intermediate 12,000.00 234 5 'Aha Punana Leo,Inc. Halau Lamaku 295,349.00 232 6 Alex&Duke De Rego Foundation Water Safety&Ocean Awareness Education 62,671.00 141 7 Aloha Club of Hilo Hale'Oluea Clubhouse 45,800.00 32 9 Aloha Independent Living Hawaii lindependent Living Program 10,000.00 33 10 Aloha Independent Living Hawaii Transportation 10,000.00 Excellence in ALS Care Initiative-Equipment Loan Program and 29 12 ALS'Ohana of Hawaii Direct Assistance Grants 21,000.00 28 13 RLS'Ghana of Hawaii Excellence in ALS Care Initiative-Professional Care Management 46,000.00 86 15 American National Red Cross,The Disaster Preparedness&Response in Hawaii County 50,000.00 90 17 Arc of Kona Health and Wellness for All Abilities 22,400.00 81 18 Arts&Sciences Center ASC Community Education Services 105,000.00 42 19 jBig Island Mediation,Inc.DBA West Hawai'i Mediation Center Community Mediation 15,000.00 41 20 Big Island Mediation,Inc.DBA West Hawaii Mediation Center Peer Mediation and Youth Conflict Resolution Education 15,000.00 BIISC Invasive Species Early Detection and Rapid Response 153 22 Big Island Resource Conservation&Development Council Program 30,000.00 155 23 Big Island Resource Conservation&Development Council Education in Experiential Learning on Tropical Plants 10,000.00 156 24 Big Island Resource Conservation&Development Council Mauna Kea Watershed Alliance 20,000.00 154 25 Big Island Resource Conservation&Development Council Nutrition Grown Farming Educational Program 30,000.00 158 38 Boy Scouts of America Hawai'i Island Scouting Program-Sccutreach 51,780.00 Community Meal Support for Income-Challenged Youth,Kupuna, 196 39 jBoys&Girls Club of the Big Island and Families 100,000.00 Daily Transport Services of Critical Needs Resources for Income- 193 40 Boys&Girls Club of the Big Island Challenged Youth,Kupuna and Families 50,000.00 Critical Needs Resources,Academic Support,Youth Development 191 41 Boys&Girls Club of the Big Island,Hilo Club Programming for Income-Challenged Youth 70,000.00 Critical Needs Resources,Academic Support,Youth Development 198 42 Boys&Girls Club of the Big Island,Kea'au Club Programming for Income-Challenged Youth 70,000.00 Critical Needs Resources,Academic Support,Youth Development 199 43 Boys&Girls Club of the Big Island,Kealakehe Club Programming for Income-Challenged Youth 70,000.00 Critical Needs Resources,Academic Support,Youth Development 195 44 Boys&Girls Club of the Big Island,Ocean View Club Programming for Income-Challenged Youth 70,000.00 Critical Needs Resources,Academic Support,Youth Development 197 45 Boys&Girls Club of the Big Island,Pahala Club Programming for Income-Challenged Youth 70,000.00 Critical Needs Resources,Academic Support,Youth Development 192 46 Boys&Girls Club of the Big Island,Pahoa Club Programming for Income-Challenged Youth 70,000.00 Critical Needs Resources,Academic Support,Youth Development 194 47 Boys&Girls Club of the Big Island,Ulu WIN Club Programming for Income-Challenged Youth 70,000.00 122 48 Brantley Center Inc. Job Skills Development Program 30,000.00 120 49 Bridge House,Inc. Care Coordination 12,000.00 119 50 Bridge House,Inc. Clean&Sober Living Program 25,000.00 121 51 Bridge House,Inc. Vocational Skills Building Program 20,000.00 52 52 Center for Getting Things Started Ono-licious Youth Cooking Contest-Local Food Promotion 22,300.00 94 53 Child&Family Service East Hawai'i Alternatives to Violence 35,000.00 93 54 Child&Family Service East Hawaii Domestic Abuse Shelter 30,000.00 91 55 Child&Family Service West Hawai'i Alternatives to Violence 46,000.00 NONPROFIT GRANT APPLICANTS FOR FY2021-22 Sort order matches separation sheet numbers(hard copies). Note that the disqualified applicants sort order are AFTER qualified applicants. 92 56 JChild&Family Service West Hawaii Domestic Abuse Shelter 30,000.00 Project Permanence:Guardianships and Adoptions for At-Risk 209 57 Children's Law Project of Hawaii,The Kids 20,000.00 208 58 Children's Law Project of Hawai'i,The Victim Options for Investigation,Child Empowerment and Safety 20,000.00 157 59 Daniel R.Sayre Memorial Foundation,The The Daniel R.Sayre Memorial Foundation Tax ID 26-1097159 69,016.00 143 61 East Hawaii Cultural Council EHCC Exhibition and Lecture Series,FY2021-22 10,075.00 53 62 Effective Planning&Innovative Communication,Inc. HI HOPES Initiative HI HOPES Match 10,000.00 131 63 Family Support Services of West Hawai'i Fatherhood Initiative 35,000.00 130 64 Family Support Services of West Hawai'i Healthy Keiki 24,000.00 167 71 Food Basket,Inc.,The HAMAKUA Emergency Food Program 5,000.00 169 72 Food Basket,Inc.,The KA'O Emergency Food Program 9,000.00 165 73 Food Basket,Inc.,The NORTH HILO Emergency Food Program 3,000.00 170 74 Food Basket,Inc.,The NORTH KOHALA Emergency Food Program 1,000.00 163 75 Food Basket,Inc.,The NORTH KONA Emergency Food Program 10,000.00 168 76 Food Basket,Inc.,The PUNA Emerqencv Food Program 25,000.00 166 77 Food Basket,Inc.,The SOUTH HILO Emergency Food Program 42,000.00 164 78 Food Basket,Inc.,The SOUTH KOHALA Emergency Food Program 2,000.00 171 79 Food Basket,Inc.,The SOUTH KONA Emergency Food Program 3,000.00 87 80 Friends of Big Island Drug Court,Inc.(FOBIDC) Friends of Big Island Drug Court 10,000.00 44 84 Friends of the Children's Justice Center of East Hawaii Special Needs,Enhancement,Support,Education&Training 11,300.00 50 85 Friends of the Palace Theater Annual Musical 22,000.00 51 86 Friends of the Palace Theater Hawaiian Roots Festival of Talent 15,000.00 49 87 Friends of the Palace Theater Youth Theater Program 15,000,00 56 88 Full Life Adult Day Health Community Learning and Art Center 10,000.00 55 89 Full Life Associated Costs for Self-Determined Living 6,000.00 57 90 Full Life Empowering Creativity-Pua Na Pua and Abled Hawai'i Artists 9,000m 7 91 Girls Scouts of Hawai'i Hawaii Island Girl Scout Leadership Experience 40,000.00 145 92 Going Home Hawaii Hawai'i Island Going Home Consortium 32,751.00 107 93 Goodwill Industries of Hawaii,Inc. Career Services 30,000.00 108 94 Goodwill Industries of Hawaii,Inc. Hdolana Educational and Arts Program 40,000.00 106 95 Goodwill Industries of Hawaii,Inc. Ola I Ka Nana Youth Program 30,000.00 132a 96 JGrassroots Community Development Group Hawai'i Youth Business Center:Media Literacy 7,400.00 132b 97 Grassroots Community Development Group Hawai'i Youth Business Center:Ola'a Skatepark Phase 11 20,000.00 132 98 Grassroots Community Development Group La'au'Ohana Ekolu 9,000,00 117 101 Habitat for Humanity Hawaii Island N5nAwale Builds:Kilauea Recovery 50,000.00 31 102 lHalau E Hulali Mai I Ka La Spreading Hawaiian Culture 10,000.00 16 104 IHale Kipa,Inc. Kal Like Program 7,500.00 118 105 1 Hale 0 Hawaii:Housing and Lands Enterprise of Hawaii County Hale 0 Hawaii Capacity Building 31,000.001 109 106 HfamAkua Harvest,Inc. Demonstration Orchard at H6mAkua Harvest,Inc. 22,500.00 83a 107 Hbm5kua Youth Foundation,Inc. IH5m5kua Youth Center 20,000.00 i NONPROFIT GRANT APPLICANTS FOR FY2021-22 Sort order matches separation sheet numbers(hard copies). !Vote that the disqualified applicants sort order are AFTER qualified applicants. 83 1 108 Hamakua Youth Foundation,Inc. Intersession Gardening Program 10,000.00 84a 109 Hamakua Youth Foundation,Inc. Keiki Multicultural Awareness Program 20,000.00 84 110 Hamakua Youth Foundation,Inc. Opio(Teen)Program 10,000.00 74 111 Hawaii Children's Action Network(HCAN) Hawaii Diaper Bank(a fiscally sponsored program of HCAN) 25,000.00 177 112 Hawaii County Economic Opportunity Council East Hawaii Nutrition Transportation 195,469.59 178 113 Hawaii County Economic Opportunity Council East Hawaii Seniors Farmers'Market 37,784.75 179 114 Hawaii County Economic Opportunity Council Kbkua O Puna 250,000.00 180 115 1 Hawai'i County Economic Opportunity Council Mass Transit East Hawai'i 120,022.17 176 116 Hawaii County Economic Opportunity Council Mass Transit West Hawai'i 120,022.17 175 117 Hawai'i County Economic Opportunity Council West Hawaii Nutrition Transportation 195,469.59 174 118 Hawai'i County Economic Opportunity Council West Hawai'i Seniors Farmers'Market 37,784.75 186 120 Hawaii Institute of Pacific Agriculture(HIP Ag) 'Ama Lessons:Farm to Fork in Hawaii 16,100.00 188 121 Hawaii Institute of Pacific Agriculture(HIP Ag) Keiki to Kupuna Care Bags 45,887.00 Kohala Lalawai:Growing Kohala Farmers,A Farm to School 187 122 Hawai'i Institute of Pacific Agriculture(HIP Ag) Project 46,500.00 211 124 Hawai'i Island Home for Recovery,Inc.HIHR Consolidated HIHR Permanent Supportive Housing Programs 39,000.00 210 125 Hawai'i Island Home for Recovery,Inc.HIHR HIHR Kitchen&Pantry Food Outreach Programs 20,000.00 212 126 1 Hawai'i Island Home for Recovery,Inc.HIHR HIHR Transitional Housing Program 39,000.00 200 128 Hawaii Rise Foundation Family Assessment Center-Ulu WIN 38,000.00 Malama Na Keiki After-School and Weekend BackPack Food 202 129 Hawaii Rise Foundation Program 30,000.00 203 130 Hawaii Rise Foundation Rise-UP Domestic Violence Housing Program 30,000.00 201 131 Hawaii Rise Foundation Together We Can 187,000.00 43 132 Hawaii Society of OB/GYN Hawaii County OB/GYN Resident Program 78,400.00 82 133 Hawai'i Wildlife Center Native Wildlife Services 10,000.00 217 135 Hilo Community Players 2021 Fall Musical 13,500.00 219 136 Hilo Community Players 44th Annual Shakespeare in the Park Festival 10,500.00 221 137 Hilo Community Players Kid-Shakes Presents 4,000.00 222 138 Hilo Community Players LGBTQIA+Outreach 5,100.00 218 139 1 Hilo Community Players Na Mea Hawai'i Theatre 11,000.00 220 140 Hilo Community Players Rising Stars 8,300.00 Planning for a Community Agriculture-Based Resilience Hub in 173 142 Ho'ulu Lahui Puna 45,240.00 85 143 Holualoa Village'Ghana Coffee&Art Stroll 7,000.00 104 144 JH61ualoa Village'Ohana Music&Light Festival 5,000.00 226 145 Homeless Task Force dba 808 Homeless Task Force Fab Rehab Program 44,440.00 223 146 Homeless Task Force dba 808 Homeless Task Force Outreach and Engagement,"A Vision For You"Program 144,850.00 225 147 Homeless Task Force dba 808 Homeless Task Force Return to Work Program 69,440.00 224 148 Homeless Task Force dba 808 Homeless Task Force Safe Haven Options Program:Housing and Return Home 85,350.00 110 149 Ho'ola Veteran Services Growing Veterans:Incubator Farm 11,450.00 235 150 HOPE Services Hawaii,Inc. Permanent Supportive Housing 20,000.00 236 153 HOPE Services Hawai'i,Inc. Prevention Assistance 20,000.00 3 NONPROFIT GRANT APPLICANTS FOR FY2021-22 Sort order matches separation sheet numbers(hard copies). Note that the disqualified applicants sort order are AFTER qualified applicants. i 135 154 Hospice of Kona Maluihi Grief Center-Community Bereavement Program 25,000.00 j 213 158 Hui MAlama Ola W i'Oiwi Kokua Hall Specialty Para Transit 45,600.00 i 215 159 Hui Malama Ola NA'Oiwi Ladies`Night Out 9,250.00 214 160 Hui MAlama Ola Na'Oiwi Physical Fitness Program-Makahiki Games 38,519.00 I 40 161 Hui Pono Holoholona Low Cost Spa Neuter Clinics 51,000.00 45 167 Innovations Public Charter School Foundation Na Kalai Ola-Life Navigators-Wellness Program 10,000.00 96 168 Island of Hawaii YMCA,The Family Visitation Center(FVC) 78,000.00 Youth Services Program-New Horizons Summer-Child Care 97 169 Island of Hawaii YMCA,The Program 15,000.00 111 170 Japanese Cultural Center of Kona Land Acquisition Due Diligence Work 22,000.00 6 171 Kamuela Philharmonic Orchestra Society Elementary School Music Education Program 10,000.00 63 172 Keaukaha One Youth Development HoWa Hou-Hawaiian Warriorship Program 25,000.00 61 173 jKeaukaha One Youth Development Hokualaka'i Restoration Project 25,000.00 64 174 Keaukaha One Youth Development Junior Lifeguarding Program 25,000.00 62 175 Keaukaha One Youth Development PISCES-VEX IQ Robotics Program 25,000.00 59 176 Keaukaha One Youth Development RISE 21 st Century After School Program 25,000.00 65 177 Keaukaha One Youth Development Temple Children Collaboration Project 25,000.00 60 178 Keaukaha One Youth Development Youth Paddling Program 25,000.00 10 179 Kohala Animal Relocation And Education Service(KARES) Accessible Veterinary Support for Family Pets 68,000.00 160 181 Ku'ikahi Mediation Center Community Conflict Prevention&Resolution Services 25,000.00 159 182 Ku'ikahi Mediation Center Youth Peer Mediation Program 15,000.00 102 183 JKupu Hawaii Island Kupu ina Corps 2.0 500,000.00 78 184 1 La'i'Opua 2020 Ho`okahua-Business Basics 40,000.00 183 185 Laupahoehoe Train Museum 'Aina-Based Education Program for Youth and Community 20,000.00 182 186 Laupahoehoe Train Museum The Honeybee Education Program 10,000.00 3 187 Little Big Tots Foundation Scholarship Awards 20,000.00 136 188 Lokahi Treatment Centers,Inc Adolescent Substance Abuse Treatment Programs 35,000.00 137 189 Lokahi Treatment Centers,Inc Adult Substance Abuse Treatment Programs 50,000.00 138 190 Lokahi Treatment Centers,Inc Anger Management Treatment Programs 30,000.00 139 191 Lokahi Treatment Centers,Inc Domestic Violence Intervention Treatment Programs 35,000.00 140 192 Lokahi Treatment Centers,Inc Health&Fitness Program 25,000.00 189 198 Mala'ai Hawaii Island School Garden Network 54,000.00 190 199 Mala'ai The Culinary Garden of Waimea Middle School 55,000.00 4 204 Mental Health Kokua Case Management 15,000.00 5 205 Mental Health Kokua Residential Rehabilitation 15,000.00 89 206 NA'Alehu Main Street,Inc. Haumana A`o'Oihana'O KA'u 31,000.00 88 207 N5'Alehu Main Street,Inc. Raised Garden Initiative 35,000.00 72 208 Neighborhood Place of Puna Family Resource Center 25,000.00 147 209 North Kohala Community Resource Center Kohala Cares-Weekly Food Drive 10,260.00 146 1 210 1 North Kohala Community Resource Center Kohala Unupa'a Mauka to Makai Summer Camp 5,000.00 3 3 3 NONPROFIT GRANT APPLICANTS FOR FY2021-22 I Sort order matches separation sheet numbers(hard copies). Note that the disqualified applicants sort order are AFTER qualified applicants. 148 211 North Kohala Community Resource Center North Kohala Golf Park 5,400.00 115 212 'O Ka'G Kakou Family Fun Fest 8,000.00 j 116 213 'O Ka'G Kakou Ka'G Veterans'Day Celebration 3,000.00 i 114 214 'O Ka'G Kakou Ka'G Sanitation 9,000.00 I I 99 216 Pacific Tsunami Museum Tsunami Education through Distance Learning 21,866.00 30 217 1 PETFIX Spay and Neuter Spay and Neuter Clinics 10,000.00 233 218 Pohaha I Ka Lam Mahina'Ai 50,000.00 46 219 Project Vision Hawaii Better Vision for Keiki 25,000.00 j 47 220 Project Vision Hawaii HiEHiE-Hawai'i Island 25,000.00 j I 48 221 jProject Vision Hawaii Hui for Health-Hawai'i Island 25,000.00 j 98 222 Puna Canoe Club Outrigger Paddling Program 0.00 I 124 225 Salvation Army Family Intervention Services,The Cultural-Based Program-Island-Wide 20,000.00 123 226 Salvation Army Family Intervention Services,The Independent Living Skills Program-East Hawai'i 10,000.00 126 227 Salvation Army Family Intervention Services,The Kea'au Prevention and Outreach Programs 10,000.00 3 127 228 Salvation Army Family Intervention Services,The Pahoa Prevention and Outreach Programs 10,000.00 125 229 Salvation Army Family Intervention Services,The Project TLP Hilo 10,000.00 113 230 Services for Seniors Inc Services for Seniors 75,000.00 128a 231 Society for Kona's Education&Art(SKEA) Art Camps for Children and Teens 11,000.00 128b 232 Society for Kona's Education&Art(SKEA) South Kona Workshops and Events 10,000.00 58 233 Special Olympics Hawaii Special Olympics East Hawaii 15,000.00 54 234 ISpecial Olympics Hawai'i Special Olympics West Hawai'i 10,000.00 l 2 235 Teach for America Hawaii Hawaii Island Initiatives 40,000.00 j 1 238 Volunteer Legal Services Hawaii Hawaii County Pop-Up Legal Clinics 17,500.00 76 239 West Hawai'i Community Health Center,Inc.(WHCHC) Dental Expansion for Low Income in South Kona 20,000.00 75 240 West Hawaii Community Health Center,Inc.(WHCHC) Outreach to Vulnerable Populations Program 20,000.00 77 241 lWest Hawaii Community Health Center,Inc.(WHCHC) Street Medicine-Homeless Outreach Program 20,000.00 162 242 YWCA of Hawai'i Island Developmental Preschool 20,000.00 161 243 YWCA of Hawaii Island Sexual Assault Support Services(SASS) 30,000.00 Total 6,749,847.02 Note: The following applicants did not meet one or more application requirements dis ualitie 152 8 Aloha'Ilio Rescue Big Island Spay and Neuter Program 30,000.00 i 172 11 Aloha Performing Arts Company dba Aloha Theatre Mainstage Productions 20,000.00 73 14 American Lung Association,The Hawai'i County Tobacco Cessation and Education Program 16,677.31 i 95 16 American National Red Cross,The Disaster Preparedness&Response in Hawai'i County 50,000.00 i ii 184 21 Big Island Music&Arts Academy Voices of the Youth 10,000.00 26 26 Big Island Substance Abuse Council Community Outreach 10,000.00 25 27 Big Island Substance Abuse Council East Hawai'i Substance Abuse Treatment 95,000.00 18 28 Big Island Substance Abuse Council Hawaii Island Health&Wellness Center-Hilo 50,000.00 i NONPROFIT GRANT APPLICANTS FOR FY2021-22 Sort order matches separation sheet numbers(hard copies). Note that the disqualified applicants sort order are AFTER qualified applicants. j 22 29 Big Island Substance Abuse Council Hawai'i Island Health&Wellness Center-Kea`au 50,000.00 23 30 Big Island Substance Abuse Council Hawaii Island Health&Wellness Center-Provider Training 50,000.00 19 31 Big Island Substance Abuse Council Intensive Case Management Services 20,000.00 21 32 Big Island Substance Abuse Council Ola Kino Health Fitness Program 20,000.00 24 33 Big Island Substance Abuse Council Po'okela Vocational Training Program 75,000.00 27 34 Big Island Substance Abuse Council Therapeutic Living and Clean and Sober Program 100,000.00 17 35 Big Island Substance Abuse Council West Hawaii-Dual Diagnosis Treatment 100,000.00 20 36 Big Island Substance Abuse Council Youth Services Program 150,000.00 105 37 Big Island Wellness Solutions Big Island Wellness Solutions=Community Outreach 6,700.00 Safe Pets Safe Kids: Link Between Domestic Violence and Animal 34 60 Domestic Violence Hurts Animals and People Abuse 16,300.00 Kanaka O Kupuna's Men of PA'A;'Rina-Based Recovery in North 149 65 Feed Hawai'i Kohala 29,775.00 151 66 Feed Hawai'i Kanaka O Puna's Men of PA`A in Puna 27,995.00 150 67 Feed Hawaii Kohala Keia 2.0 15,125.00 69 68 Five Mountains Hawai'i dba Kipuka o ke Ola Healthcare Outreach and Education for Underserved Populations 11,000.00 Mental Health and Primary Care Services for Underserved 67 69 Five Mountains Hawaii dba Kipuka o ke Ola Populations 30,000.00 68 70 Five Mountains Hawaii dba Kipuka o ke Ola Preventative and Holistic Health Services 15,000.00 129 81 1 Friends of KPPCS dba West Hawaii Community Kitchen West Hawai'i Community Kitchen Value-Added Program 35,575.00 71 82 Friends of the Children of West Hawaii,Inc. Ready Center Initiative 100,000.00 70 83 Friends of the Children of West Hawai'i,Inc. Youth Leadership Alliance 25,000.00 79 99 Green Will Conservancy Inc,The Hui Mana'o 21,250.00 Malama Pono Program:Green Will Professional Learning 80 100 lGreen Will Conservancy Inc,The Community 19,000.00 100 103 Halau Hula Ka Makani Hall'Ala O Puna Hawaiian Cultural Center 15,000.00 15 119 Hawaii Filmmakers Collective Hawai'i Filmmakers Collective Big Island Chapter 5,000.00 8 123 Hawaii Island Adult Care,Inc. Adult Day Care 100,000.00 142 127 Hawai'i Oil Seed Producers(HOSPRO) Developing a Biofuel Stem Program for Hawaii County 16,600.00 181 134 Heart Ranch Heart Ranch 18,000.00 9 141 Ho'61a Na Pua Services for At-Risk Youth&Victims of Trafficking 75,000.00 237 151 HOPE Services Hawaii,Inc. Permanent Supportive Housing 20,000.00 238 152 HOPE Services Hawaii,Inc. Permanent Supportive Housing 20,000.00 134 155 Hospice of Kona,Inc./Hospice of Kona Foundation Nakamaru Hale 50,000.00 133 156 Hospice of Kona,Inc./Hospice of Kona Foundation Volunteer 15,000.00 University of Hawaii Internal Medicine Residency Program Rural 66 157 Hui Kahu Malama Health Elective(UHIMRP) 41,200.00 228 162 Humanity Hale Abuse Prevention&Diversity Training 76,000.00 231 163 1 Humanity Hale Art Therapy 96,000.00 227 164 Humanity Hale Hawaiian Arts 62,000.00 229 165 Humanity Hale Individual and Group Therapy 62,000.00 230 166 Humanity Hale Life Skills 96,000.00 112 180 Kona Coffee Cultural Festival 50th Kona Coffee Cultural Festival 25,000.00 39 1 193 Maika'i Health Corporation Building Public Health Infrastructure Within Primary Care 45,595.00 NONPROFIT GRANT APPLICANTS FOR FY2021-22 Sort order matches separation sheet numbers(hard copies). Note that the disqualified applicants sort order are AFTER qualified applicants. 35 194 Maikal Health Corporation Clinical Pharmacist Provider Program 55,279.00 37 195 Maikal Health Corporation COVID-19 Vaccine Response 65,149.00 Expanding Alternative Access to Health Care Services in East 38 196 Maika'i Health Corporation Hawai'i 82,440.00 36 197 Maika'i Health Corporation Pharmacy-Public Health Initiative 50,420.00 205 200 Malamalama Waldorf School Hawaiian Arts and Culture 10,900.00 207 201 Malamalama Waldorf School Hui'Ano'Ano Parent/Child Development Program 11,500.00 204 202 Malamalama Waldorf School Puna Arts in the Park 10,650.00 206 203 IMalamalama Waldorf School Puna Off The Streets And Aftercare 9,880.00 103 215 'O Maku'u Ke Kahua Community Center 'O Maku'u Ke Kahua Community Center 100,000.00 "Food Taco"Program-Food Security through Raised Garden 216 223 Pure KNF Foundation Beds 11,000.00 185 224 Recycle Hawai'i Zero Waste Support Services 0.00 101a 236 Uhane Pohaku Na Moku O Hawaii Ho'okupu Hula No Ka'u Cultural Festival 11,200.00 101 237 Uhane Pohaku Na Moku O Hawai'i Mo'olelo Traditions of a Mo'o Lawai'a Phase II 10,000.00 Total 2,466,214.31 i i i i Halau E Wali Mai 1 Ka La i Spreading Hawaiian Culture i i 102 i i i i i i 1 County of Hawai'i Nonprofit Grant Application FY2021-22 Agency e®Halau E Hulali Mai I Ka La Program Name:Spreading Hawaiian Culture Agency Director: Puanani lea iota Phone No.:(808 ) 895 —9634 Contact Person: Pam McBride, Board Secretary Phone No.:(208 )816 —0794 Mailing Address: Address: 88-1961 Milolii Rd. Address: City,ST,Zip Captain Cook, Hl 96704 Facility Address: Address: one Faith Center Suite B3 Address: P.O. Box 385 City,ST,zip Kealakekua, Hl 96750 Email Address: pamdotmcbride@gmaii.com Fax No.: NA — Accountant/CPA: Stephen Arnett, CPA Phone o.:( 03) 323 —3210 Firm (if applicable): Stephen J. Arnett, CPA Mailing Address: Address: P.O. Box 839 city,ST,zip Kealakekua, H 1 96750 YOU ARE RESPONSIBLE TO KEEP THE ABOVE INFORMATION CURRENTAND TO PROMPTLY NOTIFY THE FINANCE DEPARTMENTAND COUNCIL OF ANY CHANUS Amount of Request for County Nonprofit Grant Program Funds: $10,000.00 Geographical Areas To Be Served: (One or more can be checked) E-1 Puna ❑ H5m5kua g North Kona E] South Hilo ❑ North Kohala Rm❑South Kona ❑ North Hilo E]South Kohala ❑ Ka'a Services or Activities To Be Provided: (One or more can be checked) Educational concerns RE Youth ❑Victims of Crimes ❑ Culture and the arts ❑Aged ❑Victims of Health or Social Crises ❑ Needs of the poor ❑ Physical/Emotional Disabilities ❑ Public Health and Welfare of the People and the Environment EXHIBITA NONPROFIT GRANT APPLICATION FY 2021-2022 Page 1of8 County�y ox Hawau'i Nonprofit Grant Application F Y20/21-22 � Name: Ka La Agency � Program NSpreading Hawaiian Culture 1. Prior Year Award of County Nonprofit Grant Program Funds: NA NA NA � 2. Agency Mission Statement: H51au EHulaliMai| Ka L5 shares and perpetuates love and passion for our Hawaiian culture through teaching and performing dance, music, history,language,chants,arts and craft. We are dedicated 0ostrengthening our community by providing accessibility to all individuals,particularly those who are disadvantaged. Lessons instill dedication, respect, and perseverance. Under the direction of kumu hula Chrissy Henriques,the halau has won awards in both hula and Tahitian competitions. One ofits members performed onnational TV's Little Big Shots program. The ha|auhas been asked 0operform atthe opening ceremonies for k8enieMonarch for the past 4years. The Hawaii Tourism Authority asked them toperform ai Volcanoes National Park, Prior to the pmndemic,they pehbnnad every third Friday at Nemhou Shopping Center,as well as appearing atprivate and community events. County grant funds will help sustain this cultural outreach. 3. Program Description: Ha!auEHu|a|iMai | KaLoiaenun-pmfit. S0io3organization which provides lessons and performances inHawaiian and Polynesian dance, music,and crafts. Funds are requested for operating costs, including rent for the halau's practice space, 100 students and 1,200 audience members from around the world will gain a deeper understanding of Hawaiian arts and culture thanks tothe county's investment inthis program. 48volunteers will improve their knowledge ofHawaiian culture and their leadership skills tobenefit their communities. Most students come from South Kona or Ka'u,regions that are less affluent than that served by most other hula groups. Attendance grew to almost 100 students before the pandernic,but less than half those students are currently attending in-person classes. Students range inage from 4&m7Oyears old, Participation isopen hmall who are willing tocommit their time, regardless wfskill level,ability cultural orethnic background,race,gender,orsexual identification, Receiving help with operating costs will allow us to reduce the economic impact of participation on our studentsand their families. VVeknow that many parents have lost jobs during the pandemic. Many families have multiple children. Others have taken onadded responsibilities for extended family members. Several grandparents are raising their grandchildren. We don't want economic concerns tuprevent people from learning about dance and their culture. KumuChrioayfeels strongly about strengthening community and heritage in this area,so she teaches,designs costumes,and coordinates performances with nocharge for her time. Other volunteers make costumes,gather flowers,and provide teaching and administrative support. 4.Total Budget& Position Count: Total Program Budget: 42,402 Total Program Position Count: 40 volunteers Total Agency Budget: 94,992 Total Agency Position Count: 40 volunteers EXAUBKTANONPR{>F|T GRANT APPLICATION P/2O21-ZU22 Page ZofO , �� ~J� ~'~ Application ��"W-�0/�� �� ���� ������� u /���x �� -��� County x�� x��un���u ��u��xu /����xxv�«��u�mu � � ^� � �����]0�� Name: ��alaU E ��Wla>i Mai I Ka [a Agency Program NameSpreading Hawaiian Culture S. Program Funding Sources(identify All sources of funding applied to this program,Supplies from students 5,000 Revenue Source Estimate Tuition from students 12,000 � Income from performances at community venues 6,000 Grants 15.000 Community service projects 3,000 Donations 1,402 TOTAL: 42,402 Attach additional pages,if needed. ! | 6. Explain what plans your agency or program has to increase revenues to support this program: Revenue for the Spreading Hawaiian Culture Project comes from several sources: student contributions, performance income,grants and donations,and fundraising. The pandemic has agreat impact oneach mfthese sources. VVeaim bo expand revenues in FY 21-22 by increasing performances and seeking additional grant and private donations. Our primary source nfincome iefrom our students. Students pay for their tuition,costumes, implements,and instruments. Costumes,implements,and instruments are required to perform and spread cultural awareness to the public,but the cost is high. Students doprivate and group fundraising Vmhelp defray these costs. VVewill increase those events when itiu possible todothem safely. For example,we received a subcontract to help decorate a hotel for the holidays. The halau has performed at community venues such as the Keahou Shopping Center and the Kona Christmas tree lighting parade. That revenue has been non-existent since March, 2020,but we expect it to return and increase as tourism grows safely. Finally,we seek grants and private donations to support this program and reduce the economic burden on our students. We received$5,000 from a private foundation in January and have 2 other requests pending. VYehave been unable bm secure COVID relief funds because our agency relies on a strong volunteer base instead of paid employees. Volunteer leaders include experienced cultural practitioners and grant managers. 7. Program Objectives Using County Nonprofit Grant Program Funds: 1. Improve cultural understanding of and artistic ability in Hawaiian and Polynesian dance and drumming for 100 students over the project period. a.Conduct weekly classes for different ages and ability levels,from keiki to kupuna,for at least 8 months. i Conduct in-person classes following Department of Education and Department of Health safety guidelines, ii. Expand access 10instruction byusing virtual technology. b. Teach the use of culturally significant implements and instruments to 100 students. o. Teach construction techniques for culturally appropriate costumes and adornments to 100 students and their family members. 2. Spread understanding ofHawaiian and Polynesian arts and culture Luatleast 1.2OOmembers ofthe public during the project period. o. Halau members will perform in venues freely open to the public,averaging 100 audience members,at least 12 times during the project period. 3. Sustain the agency's mission and expand leadership skills by actively engaging at least 40 volunteers during the project period. a. Volunteers will serve as class leaders for logistical coordination,create adornments,and assist with fundralsing. b. Experienced leaders will mentor new volunteers. EXHIBIT ANOWpR0F[TGR4NT APPLICATION FY2021-2O22 Page 3ofQ County of a 1`ifit Grant Application ®22 Agency e° Halau E Hulah Mai I Ka La Program e® Spreading Hawaiian Culture .TABLE 1: What are the measurable performance outcomes that would be achieved with this funding? PERFORMANCETG E (i.e.:Now ore youmeasuring what happens for the Participants after they have participated in your program?Describe,be specific.) SEE ATTACHMENT FOR MORE LEGIBLE VERSION 100 students will demonstrate improved artistic ability in and cultural understanding of Hawaiian arts and culture. At least 1,200 members of the public will gain a deeper appreciation of Hawaiian and Polynesian arts and culture by attending free performances. 40 volunteers will improve leadership skills and understanding of Hawaiian culture. The halau will sustain its mission of promoting Hawaiian culture through active students,volunteers,and audience members. Attach additional pages as necessary. .TABLE 11: EXPENDITURESY -21 FY 21-22 FY 21-22 PROGRAM Actual* Total Budget Grant Reg Salary and Wages 0 0 0 Professional Fees 550 550 0 Operations 18,852 18,852 10,000 Supplies 10,533 20,000 0 Equipment 0 0 Other: Musician fees 1,423 3,000 Other: Other: Other: FY20-21 expenses low due to pandemic Other: FY20-21 expenses estimated until books close TTL 31,358 42,402 *If applicable EXHIBITA NONPROFIT GRANT APPLICATION FY 2021-2022 Page 4 of 8 County of Hawai'i Nonprofit Grant Application FY2021-22 Agency Name: Halau E Hulali Mai I Ka La Program Name:Spreading Hawaiian Culture sm lo. ORGANIZATION CONFLICT DISCLOSURE FORM Please disclose any conflicts or potential conflicts of interest that any board member, officer, director, or administrator of your organization may have with the County of Hawaii. Only those listed below need to be disclosed. One form per person with a conflict is needed. If no conflicts exist, one form for the organization, with the "No conflicts exist" option checked needs to be submitted. Please duplicate as needed to fully disclose. All disclosure forms must be stoned, regardless whether a conflict Lqd, re_ q fligt exists. NAME: POSITION: May have a conflict or potential conflict of interest, including any familial relationship, with any of the following (check all that apply): [3 Member or members of the Council r] Staff appointed by a member of the Council [3 The Mayor [3 The Managing Director [3 The Director of Finance The Corporation Counsel,the Assistant Corporation Counsel, or a Deputy Corporation Counsel Conflict of Interest is defined as:a substantial probability that action token by an individual will result in measurable direct benefits accruing to the individual as opposed to benefits accruing in general to an industry. Please specify any and all mitigation measures to avoid, in fact or appearance, any conflicts or potential conflicts of interest: If no conflicts exist, check here. 1 Signature of Authorized Person (specify title) Date EXHIBITA NONPROFIT GRANT APPLICATION FY 2021-2022 Page 5 of 8 County of Hawai'i Nonprofit Grant Application FY2021-22 Agency Name: Halau E Hulali Mai I Ka La Program Name:Spreading Hawaiian Culture NEEM u. Certification of Understanding (Page 1 of 2) 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—2-142.1, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) agree to allow the County (the Legislative Auditor,the Department of Finance, designated Council representative, or expend i ng/ove rsight agency) full,free, and unrestricted access and authority to examine and inspect any facility, equipment, property, or records pertinent to the grant, contract, or program for which funds were used. 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. I (we) understand that applications will not be reviewed by County personnel receiving our County Nonprofit Grant submittal, and that we have full responsibility to ensure that all documents are complete and accurate prior to submittal. I (we) understand that all documents requiring a current signature must be the ORIGINAL, SIGNED document. Unsigned documents will be disqualified. Faxed or copied documents will not be accepted as original documents. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to enroll with Hawaii Compliance Express and be compliant prior to receiving payment(s). To register, go to hjjQjjvendors.ehawa*H.F v complete the easy step-by-step process, and pay the annual registration fee online using a credit card. 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 County Council within 60 days after June 30 of the contractual year for which the grant was awarded. The report, using the template provided, shall include an explanation of the public benefits derived from thea r in the grant (focusing on specific, measurable outcomes), a complete accounting of all expenditures supported by County of Hawaii grant funds,and a listing of other funding sources and amounts obtained during thea and period. Failure to submit a timely, complete and accurate year-end report, using the template provided, will impact the evaluation of your program's or agency's future funding requests. EXHIBITA NONPROFIT GRANT APPLICATION FY 2021-2022 Page 6 of 8 County ai`i Nonprofit Grant ApplicationAgency e: Halau E Hulali Mai I Ka La Program e;Spreading Hawaiian Culture ii. Certificationr (Page 2 of 2) If awarded a grant from the County of Hawaii, I (we) understand that a current Certificate of Liability ($1,000,000 general liability, $50,000 each occurrence) must be provided to the County of Hawaii Finance Department, which specifically and explicitly indicates that the County of Hawaii is an additional insured prior to receiving any payment(s). I (we) understand that failure to submit the final report within 60 days of June 30th shall result in loss of all grant funds received during e grant period (must a refunded to Countyl and exclusion from future rant Darticipation fora minimum of one year or until a writtenreport is submitted to,and accepted by.the council. 1 understand there is no provision for furthern iicaion to submit e final report. Information and instructions are available at htt :Lwww.hawaiicount°LgovZfp-nonprofit rant-forms;on or about May 30 of the year the final report is due. As part of this application, you acknowledge that any funds awarded will be restricted for the purposes stated in the application, except for a maximum ten percent (10%)for administrative and overhead costs. Any funds unused by lune 30, 2022 must be returned to the County of Hawaii with the final report. Failure to return these funds in a timely manner will impact the evaluation of your agency's future funding request and may result in actions taken to recover these funds. Awards cannot provide funds for Capital Improvements(Cost of Construction, materials, insurance or securities) on private properties unless otherwise authorized by law. By signing below, you are acknowledging that you have read and understood these requirements. 1/24/21 Signature of Authorized Person Date President Title/Position of Authorized Person EXHIBIT NONPROFIT GRANT APPLICATION FY 2021 -2022 Page 7 of 8 County of Hawai'i Nonprofit Grant Application2 - e Cy e: Halau E Hulali Mai I Ka La Program e:Spreading Hawaiian Culture 12> COUNCIL AWARD WORKSHEET TABLE I: PERFORMANCEPROGRAM Applicant Council Proposed Projected Results Projected Result Students demonstrate improved artistic ability in and cultural understanding of Hawaiian arts and culture. 100 Members of the public gain a deeper appreciation of Hawaiian arts and culture at free performances. 1,200 Volunteers improve leadership skills and understanding of Hawaiian culture. 40 Mission of promoting Hawaiian culture sustained through active students,volunteers,and audience members. 1 TABLE II: FY 21- 2 Council PROGRAM EXPENDITURES Grant Request Award Salary and Wages 0 Professional Fees 0 Operations 10,000 Supplies 0 Equipment 0 Other: Other: Other: Other: Other: TOTAL 10,000 Additional Council directives regarding award: EXHIBIT B NONPROFIT GRANT APPLICATION FY 2020-2021 Page 8 of 8 alae E Hulali Mai I Ka La Spreading Hawaiian Culture Program County Nonprofit Grant Application 2021-22 [due to formatting issues, this is a more legible version of item 8. Table 1: What are the measurable performance outcomes that would be achieved with this funding? 1. 100 students will demonstrate improved artistic ability in and cultural understanding of Hawaiian arts and culture. . At least 1,200 members of the public will gain a deeper appreciation of Hawaiian and Polynesian arts and culture by attending free performances. 3. 40 volunteers will improve leadership skills and understanding of Hawaiian culture. 4. The halau will sustain its mission of promoting Hawaiian culture through active students, volunteers, and audience members. i I i Island of Hawail YMCA,The. Family Visitation Center (FVC) 168 County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name: The Island of Hawaii YMCA Program Name: Family Visitation Center (FVC) Agency Director: Wendy S. Botelho-Cortez, CEO Phone No.:($08 ) 935 —3721 Contact Person: Wendy S. Botelho-Cortez, CEO Phone N®.:(808 )896 —7224 Mailing Address: Address: 300 West Lanikaula Street Address: City,ST,Zip Hilo, HI 96720 Facility Address: address: 300 West Lanikaula Street Address: City,ST,Zip Hilo, HI 96720 Email Address: Wendy.cortez@islandofhawaiiymca.org Fax No.: (808 ) 369 _1227 Accountant/CPA: Carbonaro CPAs & Management Grou phone No.:(808 ) 930 _6850 Firm (if applicable): Mailing Address: Address: P.O. Box 4372 City,ST,Zip Hilo, HI 96720 YOU ARE RESPONSIBLE TO KEEP THE ABOVE INFORMATION CURRENT AND TO PROMPTLY NOTIFY THE FINANCE DEPARTMENT AND COUNCIL OF ANY CHANGES Amount of Request for County Nonprofit Grant Program Funds: $78,000 Geographical Areas To Be Served: (One or more can be checked) Q Puna Q Hamakua Q North Kona Q South Hilo Q North Kohala R South Kona Q North Hilo 0 South Kohala R Ka'u Services or Activities To Be Provided: (One or more can be checked) ❑ Educational concerns QQ Youth FOI Victims of Crimes ❑ Culture and the arts ❑Aged QQ Victims of Health or Social Crises Q Needs of the poor Q Physical/Emotional Disabilities R Public Health and Welfare of the People and the Environment EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 1 of 8 County of Hawaii Nonprofit Grant Application F2021- 2 Agency Name: The Island of Hawaii YMCA Program Name: Family Visitation Center (FVC) 1. Prior Year Award of County Nonprofit Grant Program Funds: FY 18-19 FY 19-20 FY 20-21 $28,925 $23,049 $49,500 3 I 2.Agency Mission Statement: As described on the YMCA's national website, all YMCA's share three areas of focus: Our Areas of Focus The YMCA focuses on building a strong community. A strong community invests in the Youth,teaching them good health, community involvement and social responsibility. Defining our areas of focus: YOUTH DEVELOPMENT:Nurturing the potential of every child and teen. HEALTHY LIVING:Improving the nation's health and well-being. SOCIAL RESPONSIBILITY:Giving back and providing support to our neighbors. i Opportunities for All The Y is for everyone.Our programs,services and initiatives enable kids to realize their potential, prepare teens for college,offer ways for families to have fun together,empower people to be healthier in spirit, mind and body;prepare people for employment,welcome and embrace newcomers and help foster a nationwide service ethic.And that's just the beginning. I I 3. Program Description: What is the Family Visitation Center(FVC)? (Located at the YMCA in Hilo,plus a new branch in Waimea.) The YMCA FVC is the least restrictive, most homelike environment where children can come to visit their parent who was removed from the household due to domestic violence. The YMCA is a safe place staffed with Safety and Security Officers,Visitation Associates,and a Visitation Associate Supervisor. The FVC is open Wednesdays, Fridays, Saturdays, and Sundays for visits. We offer Intermittent Supervised Visits, Full Direct,one to one,Supervised Exchange,Supervised telephone visits,and Face Time supervised visits. At the FVC,families are referred to us from Family Court as a result of domestic violence cases,divorce cases,child protective cases,and on occasion,self referral. The FVC will assess, assist and arrange type,duration,and schedule for the visits. The FVC will also inform the court on the status of visitation prior to a court date, and on occasion send letters periodically inform the court of significant events at visitation.- The FVC has also expanded on Saturdays into Waimea;from 8:30am-5:00pm, assisting families in West Hawaii. -- What services does the Family Visitation Center offer? SUPERVISED EXCHANGES-Children can go from one parent to the other without the parents meeting each other. The exchange of the children is supervised and occurs at the Center. SUPERVISED VISITATION-Center staff supervise visits between children and parents in a stable and supportive environment. Different levels of supervision are available, including full direct, intermittent,and beginning&ending supervision. Homeless parents are offered change of clothes and a warm shower before the visit with the child. SUPERVISED TELEPHONE VISITS-Center staff monitor telephone calls between children and parents.Children come to the FVC with their custodial parent,and the"visiting parent"calls the center. Face Time Visits over Internet is possible. To arrange visits at the Center,you need a court order or an agreement of all the adults involvd. SUPERVISED FACE TIME VISITATION-The child/children are in a room with the FVC Associate and a Face Time call is made to the visiting parent. The staff will engage the child with the other parent on the I pad. I 4.Total Budget& Position Count: Total Program Budget: $196,000 Total Program Position Count: 11 Total Agency Budget: $697,000 Total Agency Position Count: 43 I I 3 EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 2 of 8 County of Hawai`i Nonprofit Grant Application FY2021-22 Agency Name: The Island of Hawaii YMCA PrOram Name: Family Visitation Center (FVC) S. Program Funding Sources(identify all sources of funding applied to this program): FY21-22 Revenue Source Estimate Visitation fees paid y participants (Both parents are responsible. ,000 TOTAL: $42,000 Attach additional pages,if needed. 6. Explain what plans your agency or program has to increase revenues to support this program: The FVC has a fee for service. Each type of visitation has a minimal amount charged, all fees are split between the visiting parent and the custodial parent. Fees are collected before the visit from both parents. Quarterly fundraisers are organized in attempt to provide scholarships to individuals who are experiencing financial difficulties. In some cases, where one parent has a significantly larger income, it is ordered that that parent make the payments to the FVC. In the recent past the FVC has been much more disciplined in collecting fees,and has made an increase in fee collection from annually$5,000 to annually$35,000. This increase is due to appropriate management of employees and collection monitoring and verification. Even with the noted increase in fee for service,this income does not cover the operations of the Family Visitation Center. The YMCA Board of Directors acknowledges the importance of this service to the community and continues to look for financial support from private sources and grants to fund this program. Many other needs are not met in order to fund this critical program for the children. It should also be noted that the FVC staff often volunteer or stay late to accomplish all tasks at hand and to assist with fundraising events. 7. Program Objectives Using County Nonprofit Grant Program Funds: This application for County Nonprofit Grant Program Funds would be used to help maintain approximately the current level of service at its Hilo and Waimea facility. The YMCA continues to look for new long term sources of revenue. Most recently the FVC has ventured off to open in Waimea,on Saturdays only, however we are able to offer all of the visitation types in the Waimea FVC. Continuation of the Family Visitation Center provides an invaluable resource for the judicial and social services systems on our island,significantly relieving pressures in society that could lead to further abuse, neglect,violence,and perhaps even deaths.To put it bluntly,the Center also reduces expenses that would have been spent on social work, police,court, prison,and other services if dysfunctions in the families instead continued and worsened. The County Nonprofit Grant Program funds would be used to help maintain the Hilo and Waimea facility operations. If other sufficient long-term funds become available from whatever sources,the YMCA's Family Visitation Center would like to start a West Hawaii(Kona)branch center. Participants from the West Hawaii area and other areas outside Hilo have valued this program so much that they have travelled to Hilo to participate.This compounds the emotional and financial stresses they are under due to the travel time and travel expenses involved. Further, if sufficient long-term funds become available,additional staff and days of service per week is desired for Hilo and Kona. EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 3 of 8 3 i i County of Hawaii Nonprofit Grant Application FY201-22 Agency Name: The Island of Hawaii YMCA I I Program Name: Family Visitation Center {FVC} 3 8.TABLE I: What are the measurable performance outcomes that would be achieved with this funding? PROGRAM PERFORMANCE OUTCOMES i (i.e.:How are youmeasuring what happens for the Participants after they have participated in your program?Describe,be s eci c.) adults to be served 625 Tamily units to be served 260 i children and teens under 18 years old to be served 780 volunteers--State DHS, First To Work/Judiciary Community Service ours ours u Likelcommunity members 2 (1200 hours)/102000 ours FVC Employee volunteer hours 8 1000 ours YMCA Board ot Directors volunteers 16 (650 hours) i Attach additional pages as necessary. 9.TABLE II: 3 3 PROGRAM EXPENDITURES FY 20-21FY 21-22 FY 21-22 Actual* Total Budget Grant Req Salary and Wages $62,000 $196,000 $78,000 Professional Fees i Operations 3 Supplies Equipment Other: Other: Other: i Other: I Other: TOTAL $62,000 $196,000 $78,000 I *If applicable i I I 3 3 3 I 3 EXHIBIT A 3 NONPROFIT GRANT APPLICATION FY 2021-2022 Page 4 of 8 I i 3 j a i County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name: The Island of Hawaii YMCA Program Name: Family Visitation Center (FVC) so. ORGANIZATION CONFLICT DISCLOSURE FORM I Please disclose any conflicts or potential conflicts of interest that any board member, officer, director, or administrator of your organization may have with the County of Hawaii. Only those listed below need to be disclosed. One form per person with a conflict is needed. If no conflicts exist, one form for the organization,with the "No conflicts exist" option checked needs to be submitted. Please duplicate as needed to fully disclose. All disclosure forms must be signed, regardless of whether a conflict exists. NAME: POSITION: May have a conflict or potential conflict of interest, including any familial relationship,with any of the following(check all that apply): ® Member or members of the Council Staff appointed by a member of the Council The Mayor ® The Managing Director The Director of Finance The Corporation Counsel,the Assistant Corporation Counsel,or a Deputy Corporation Counsel Conflict of Interest is defined as:a substantial probability that action taken by an individual will result in measurable direct benefits accruing to the individual as opposed to benefits accruing in general to an industry. Please specify any and all mitigation measures to avoid, in fact or appearance, any conflicts or potential conflicts of interest: If no conflicts exist, check here. Dc"tVll KI.1!"Cl("Iara, -hie`VC3it("€iee:"t:tiftGef K''yIOJ! `Bo aCd Cnair" Signature of Authorized Person (specify title) Date EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 5 of 8 JI 4 E I County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name: The Island of Hawaii YMCA Program Name: Family Visitation Center (FVC) 11. Certification of Understanding (Page 1 of 2) 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—2-142.1, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) agree to allow the County(the Legislative Auditor,the Department of Finance, designated Council representative, or expending/oversight agency)full,free, and unrestricted access and authority to examine and inspect any facility, equipment, property, or records pertinent to the grant, contract, or program for which funds were used. 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. I (we) understand that applications will not be reviewed by County personnel receiving our County Nonprofit Grant submittal, and that we have full responsibility to ensure that all documents are complete and accurate prior to submittal. 1 (we) understand that all documents requiring a current signature must be the ORIGINAL, SIGNED document. Unsigned documents will be disqualified. Faxed or copied documents will not be accepted as original documents. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to enroll with Hawai'i Compliance Express and be compliant prior to receiving payment(s). To register, go to http:J/vendors.ehawaii.�ov, complete the easy step-by-step process, and pay the annual registration fee online using a credit card. 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 County Council within 60 days after June 30 of the contractual year for which the grant was awarded.The report, using the template provided,shall include an explanation of the public benefits derived from the awarding of the grant(focusing on specific, measurable outcomes),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, using the template provided will impact the evaluation of your program's or agency's future funding requests. EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 6 of 8 County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name: The Island of Hawaii YMCA Program Name: Family Visitation Center (FVC) ii. Certification of Understanding (Page 2 of 2) If awarded a grant from the County of Hawaii, I (we) understand that a current Certificate of Liability ($1,000,000 general liability, $50,000 each occurrence) must be provided to the County of Hawaii Finance Department, which specifically and explicitly indicates that the County of Hawaii is an additional insured prior to receiving any payment(s). I (we) understand that failure to submit the final report within 60 days of June 30th shall result in loss of all grant funds received during the grant period (must be refunded to County)and exclusion from future grant participation for a minimum of one year or until a written report is submitted to,and accepted by,the council. I (we) understand there is no provision for further notification to submit the final report. Information and instructions are available at on or about May 30 of the year the final report is due. As part of this application,you acknowledge that any funds awarded will be restricted for the purposes stated in the application,except for a maximum ten percent (10%)for administrative and overhead costs. Any funds unused by June 30, 2022 must be returned to the County of Hawai'i with the final report. Failure to return these funds in a timely manner will impact the evaluation of your agency's future funding request and may result in actions taken to recover these funds. Awards cannot provide funds for Capital Improvements(Cost of Construction, materials, insurance or securities)on private properties unless otherwise authorized by law. By signing below,you are acknowledging that you have read and understood these requirements. David Kurohara Signature of Authorized Person Date Chief Volunteer Officer (CVO)/ "Board Chair" Title/Position of Authorized Person EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 7 of 8 I i 3 County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name: The Island of Hawaii YMCA Program Name: Family Visitation Center (FVC) i 12. COUNCIL AWARD WORKSHEET i TABLE I: 3 Applicant Council Proposed PROGRAM PERFORMANCE MEASURES Projected Results Projected Result adults to be served 625 family units to be served 260 children and teens under 18 years old to be served 780 volunteers--State DHS, First To Work/Judiciary Community Service (8500hrs)f25(2500 hrs) Alu Like/community members 2(1200hrs)110(2000 hrs 3 FVC Employee volunteer hours 8 (1000 hours) YMCA Board of Directors volunteers 16 (650 hours) I 3 TABLE II: ! R EXPENDITURES FY 21-22 Council PR I OGM EXP A E D TURES Grant Request Award Salary and Wages $78,000 Professional Fees Operations i Supplies Equipment Other: Other: Other: Other: Other: TOTAL 1$78,000 Additional Council directives regarding award: EXHIBIT B NONPROFIT GRANT APPLICATION FY 2020-2021 Page 8 of 8 E, i i Island of Hawaii YMCA,The Youth Services Program - New Horizons Summer- Child Care Program 169 3 I ti County of IHawai`i Nonprofit Grant Application FY2021-22 Agency Name:The Island of Hawaii YMCA i Program Name:Youth Services Program - New Horizons Summer- Child Care Program Agency Director: Wendy S. Botelho-Cortez, CEO Phone No.:1308 }935 —3721 Contact Person: Wendy S. Botelho-Cortez, CEO Phone No.:(808 )898 —7224 3 Mailing Address: Address: 300 West Lanikaula Street Address: city,sT,zip Hilo, HI 96720 Facility Address: Address: 300 West Lanikaula Street Address: city,sT,zip Hilo, HI 96720 Email Address: Wendy.cortez@islandofhawaiiymca.org Fax No.: (808 )969 —1227 Accountant/CPA: Carbonaro CPAs & Management Groi Phone No.:(808 )930 —6850 Firm (if applicable): Mailing Address: Address: P.O. Box 4372 City,sT,zip Hilo, HI 96720 YOU ARE RESPONSIBLE TO KEEP THE ABOVE INFORMATION CURRENT AND TO PROMPTLY NOTIFY THE FINANCE DEPARTMENT AND COUNCIL OF ANY CHANGES Amount of Request for County Nonprofit Grant Program Funds:$15,000 Geographical Areas To Be Served: (One or more can be checked) 0 Puna Q Hamakua ❑ North Kona 0 South Hilo ❑ North Kohala ❑South Kona R North Hilo ❑South Kohala ❑ Ka'u Services or Activities To Be Provided: (One or more can be checked) ❑ Educational concerns 0 Youth ❑Victims of Crimes ❑ Culture and the arts ❑Aged ❑Victims of Health or Social Crises Q Needs of the poor Q Physical/Emotional Disabilities 0 Public Health and Welfare of the People and the Environment EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 1 of 8 County of Hawaii Nonprofit Grant Application F 2021-22 Agency Name:The Island of Hawaii YMCA Program Name:Youth Services Program - New Horizons Summer- Child Care Program 1. Prior Year Award of County Nonprofit Grant Program Funds: FY 18-19 FY 19-20 FY 20-21 0 0 $13,754 2.Agency Mission Statement: As described on the YMCA's national website,all YMCA's share three areas of focus: Our Areas of Focus The YMCA focuses on building a strong community. A strong community invests in the Youth,teaching them good health, community involvement and social responsibility. Defining our areas of focus: YOUTH DEVELOPMENT:Nurturing the potential of every child and teen. HEALTHY LIVING: Improving the nation's health and well-being. SOCIAL RESPONSIBILITY:Giving back and providing support to our neighbors. Opportunities for All The Y is for everyone.Our programs,services and initiatives enable kids to realize their potential,prepare teens for college,offer ways for families to have fun together, empower people to be healthier in spirit, mind and body; prepare people for employment,welcome and embrace newcomers and help foster a nationwide service ethic.And that's just the beginning. 3. Program Description: The Island of Hawaii YMCA(YMCA)implements a child care program for 5-14 year old children during periods when public schools are on spring,summer,fall,and winter breaks. When school is out,the YMCA is in. We serve hundreds of children throughout the year. YMCA New Horizons Child Care programs provide learning and socializing skills implemented through the Youth Program Director,and up to 15 trained staff. Activities include theater and arts,cultural dance and art,exercise,sports,water play, excursions,cursive writing,anger management,COVID education, peer relations,distance learning,cooking and socializing. The cost per child is$125 for Spring and Fall sessions(separately) which are one-week long each and serves approximately 45 children on average. The cost per child for the two-week Winter session is$250. Average number of participants is 50. The Summer session's cost is$1,125 for nine weeks with an average of 80 participants. Due to the high demand of this service,we often have a wait list. Due to the pandemic and other factors,current projections for 2021 summer participants is expected to be closer to 80. THIS GRANT REQUEST IS TO SUPPORT PART OF THE SUMMER SESSION AND SCHOOL BREAKS. The YMCA New Horizons Child Care programs provide a breakfast,lunch, and 2 healthy snacks daily. This program is open from 6:30 am and closes at 5:30 pm. This time is ideal for the working parents. Parents are able to maintain their full-time employment when the children are out of school and attending the program at the YMCA. Children partake in breakfast,morning activity,snack,mid-day exercise, lunch, rest time,afternoon crafts,afternoon play and distance learning as needed. Children are provided safe socializing with COVID-19 precautions in place. Virtual"chat room"socialization is not encouraged. Children are energized as they are fed well(seconds and thirds are offered should they remain hungry),and supervised. They learn creative and expressive skills,social and analytical skills through a myriad of program activities and games designed to stimulate these interactions. Average number of meals/snacks prepared and served per day range between 150 and 170 depending on the number of children attending on that day. 4.Total Budget& Position Count: Total Program Budget: J$29,804 Total Program Position Count: 4 Total Agency Budget: $697,0Q0 Total Agency Position Count: 43 EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 2 of 8 County of Hawaii Nonprofit Grant Application FY20 1-22 Agency Name:The Island of Hawaii YMCA Program Name:Youth Services Program - New Horizons Summer- Child Care Program S. Program Funding Sources(identify all sources of funding applied to this program): FY21-22 Revenue Source Estimate Hawaii County Council - Contingency Fund from Council members 0 Projected fees collected from participating families for July 2021 only) $36,000 Based on 80 participants multiplied b 450 in Jul TOTAL: $36,000 Attach additional pages,if needed. 6. Explain what plans your agency or program has to increase revenues to support this program: The YMCA believes that the New Horizons Program strives to be self-sustainable. The majority of the costs is covered within projected participation fee levels. The YMCA is resourceful in utilizing volunteer and Alu Like employees,which keeps participant costs affordable. The YMCA rate is 20-30% less than standard child care rates,while serving two balanced meals and snacks to the children. The YMCA also provides up to 5 scholarships to qualifying families,waiving the entire costs for these families. Keeping costs affordable is one way to increase program participation and program revenues. The YMCA Board of Directors has a community based Annual Support Campaign fundraising effort that spans four months every year. This income supports all programs, including Child Care. The Campaign generates between$30,000- $40,000 annually from private,government,and business donations. The Board is also very active in pursuing grants and has been awarded over$86,000 from funders such as First Hawaiian Bank and the Atherton Family Foundation. Other supporters have included HPM Building Supply,KTA Superstores,Matson Navigation,the County of Hawaii,and the County Council;as well as hundreds of smaller private and in-kind contributions. 7. Program Objectives Using County Nonprofit Grant Program Funds: This grant application is specifically to support the New Horizons Summer Child Care Program and intersession breaks. Since the County's fiscal year begins on July 1,2021,this grant funding would be applied to the later half of the 44 days of the June 1 to July 31 Summer Session, Fall Break and one-half of Winter Break. The expenses for the month of July that the grant could help with are: personnel costs, (Director,Youth Associate, Kitchen Associate). Their total personnel costs for July would be$31,695. Supplies cost per month is estimated at$1,500. Other costs anticipated are: bathroom rental at$1,500 per month(unless improvement work is done by then)and scholarships to assist 5 needy children($550 x 5 children=$2,750). EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 3 of 8 County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name:The Island of Hawaii YMCA Program Name:Youth Services Program - New Horizons Summer- Child Care Program 8.TABLE I: What are the measurable performance outcomes that would be achieved with this funding? PROGRAM PERFORMANCE OUTCOMES (i.e.:How are youmeasuring what happens for the Participants after they have participated in your program?Describe,be s eci c. Children to be served 80 Children will have an opportunitV to practice COVID-19 socialization and at the same time learn cursive writing and anger manac jement. Parents to be served 160 Parents will be able to maintain full-time employment and be productive community members Attach additional pages as necessary. 9.TABLE II: PROGRAM EXPENDITURES FY 20-21 FY 21-22 FY 21-22 Actual* Total Budget Grant Req Salary and Wages $24,000 $31,695 $15,000 Professional Fees $2,700 Operations $2,200 Supplies $600 $1,500 Equipment $500 Other: bus transportation $4,200 Other: cost of raw food, ingredients $14,500 Other: appliance repairs, general maintenance $1,000 Other: bathroom rental ($1,500/month) $1,500 Other: scholarships (quantity: 5? ) x $563/month TOTAL $49,700 1$34,695 j$15,000 *If applicable EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 4 of 8 County of Hawaii Nonprofit Grant Application FY2021-2 Agency Name:The Island of Hawaii YMCA Program Name:Youth Services Program - New Horizons Summer- Child Care Program so. ORGANIZATION CONFLICT DISCLOSURE FORM Please disclose any conflicts or potential conflicts of interest that any board member, officer, director, or administrator of your organization may have with the County of Hawaii. Only those listed below need to be disclosed. One form per person with a conflict is needed. If no conflicts exist, one form for the organization,with the "No conflicts exist" option checked needs to be submitted. Please duplicate as needed to fully disclose. All disclosure forms must be signed, regardless of whether a conflict exists. NAME: POSITION: May have a conflict or potential conflict of interest, including any familial relationship,with any of the following (check all that apply): ® Member or members of the Council El Staff appointed by a member of the Council The Mayor The Managing Director ® The Director of Finance ® The Corporation Counsel, the Assistant Corporation Counsel,or a Deputy Corporation Counsel Conflict of Interest is defined as:a substantial probability that action taken by an individual will result in measurable direct benefits accruing to the individual as opposed to benefits accruing in general to an industry. Please specify any and all mitigation measures to avoid, in fact or appearance, any conflicts or potential conflicts of interest: If no conflicts exist, check here. David Kurohara, Chief Volunteer Officer (CVO)/ Signature o ad C uthorized Person (specify title) Date EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 5 of 8 i 3 County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name:The Island of Hawaii YMCA Program Name;Youth Services Program - New Horizons Summer- Child Care Program 11. Certification of Understanding (Page 1 of 2) 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—2-142.1, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) agree to allow the County(the Legislative Auditor,the Department of Finance, designated Council representative, or expending/oversight agency)full,free, and unrestricted access and authority to examine and inspect any facility, equipment, property, or records pertinent to the grant,contract, or program for which funds were used. 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. 1 (we) understand that applications will not be reviewed by County personnel receiving our County Nonprofit Grant submittal, and that we have full responsibility to ensure that all documents are complete and accurate prior to submittal. I (we) understand that all documents requiring a current signature must be the ORIGINAL,SIGNED document. Unsigned documents will be disqualified. Faxed or copied documents will not be accepted as original documents. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to enroll with Hawaii Compliance Express and be compliant prior to receiving payment(s). To register, go to httoWyendors.ehawaii.gov' complete the easy step-by-step process,and pay the annual registration fee online using a credit card. 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 County Council within 60 days after June 30 of the contractual year for which the grant was awarded.The report, using the template provided,shall include an explanation of the public benefits derived from the awarding of the grant(focusing on specific, measurable outcomes),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 using the template provided, will impact the evaluation of Your program's or agency's future funding requests. EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 6 of 8 County of Hawaii Nonprofit Grant Application F 021-22 Agency Name:The Island of Hawaii YMCA Program Name:Youth Services Program - New Horizons Summer- Child Care Program 11. Certification of Understanding (Page 2 of 2) If awarded a grant from the County of Hawaii, I (we) understand that a current Certificate of Liability ($1,000,000 general liability, $50,000 each occurrence) must be provided to the County of Hawaii Finance Department,which specifically and explicitly indicates that the County of Hawaii is an additional insured prior to receiving any payment(s). 1 (we) understand that failure to submit the final report within 60 days of June 30th shall result in loss of all grant funds received during the grant period (must be refunded to County)and exclusion from future grant participation for a minimum of one year or until a written report is submitted to,and accepted by,the council. I (we) understand there is no provision for further notification to submit the final report. Information and instructions are available at http://www.hiawaiCiicounty.2ov/Lfn-nonporofit- rant-formsl on or about May 30 of the year the final report is due. As part of this application,you acknowledge that any funds awarded will be restricted for the purposes stated in the application, except for a maximum ten percent (10%)for administrative and overhead costs. Any funds unused by lune 30, 2022 must be returned to the County of Hawaii with the final report. Failure to return these funds in a timely manner will impact the evaluation of your agency's future funding request and may result in actions taken to recover these funds. Awards cannot provide funds for Capital Improvements(Cost of Construction, materials, insurance or securities)on private properties unless otherwise authorized by law. By signing below,you are acknowledging that you have read and understood these requirements. David Kurohara Signature of Authorized Person Date Chief Volunteer Officer (CVO)/ "Board Chair" Title/Position of Authorized Person EXHIBIT A NONPROFIT GRANT APPLICATION FY 2021-2022 Page 7 of 8 County of Hawaii Nonprofit Grant Application FY2021-22 Agency Name:The Island of Hawaii YMCA Program Name:Youth Services Program - New Horizons Summer- Child Care Program 12. COUNCIL AWARD WORKSHEET TABLE 1: PROGRAM PERFORMANCE MEASURES Applicant Council Proposed Projected Results Projected Result Children affected 80 Children will be COVID-19 educated. Peer socialization COVID-sty Children will be able to write in cursive. Children will be able to manage their temper in heated situations. Parents affected 160 Parents remain gainfully employed. Parents are productive community members who contribute to our community. TABLE 11: PROGRAM EXPENDITURES FY 21-22 Council Grant Request Award Salary and Wages $15,000 Professional Fees Operations Supplies Equipment Other: Other: Other: Other: Other: TOTAL $15,000 Additional Council directives regarding award: EXHIBIT B NONPROFIT GRANT APPLICATION FY 2020-2021 Page 8 of 8 YWCA of Hawaii Island Developmental Preschool 242 3 I 3 I VII/ - --h- 'acr,�i-t c a 2021-22 Y �'j IJ, -r--- PDVVs {rid Ecop 'r h I n 0(-AjeioiDj i-mal Presd oo c r g q-c , !�,Ia i e ---------------- Agency Director. Katr-deen McGilvreay Phone No.:(808 ) 935 -6067 Contact Person: Michelle Flemming Phone No,:(808 ) 930 -5767 Mailing Address: Address: YWCA klawai'i Island Address: 1382 Kilauea Avenue City,ST, zip Hilo, 1-11, 96720 Facility Address: Address: MCA Developmental Preschool Address: 145 Ululani Street City,sT,zip Hilo, 1-11. 96720 Email Address. rnflernming@ywcahawaiiisiand.org Fax No.: (808 ) 935 -5051 Accountant/CPA: Taketa, lwata, Hara & Associates Phone No.:(808) 935 -5404 Firm (if applicable): Mailing Address: Address: '101 Aupuni Street #139 City,ST,zip Hilo, HI. 96720 YOU ARE RESPONSMLE TO KEEP R-1E ABOVE INFORMAT10fU CURRENTAND TO PRO MP11Y NOTIFY THE RIVAINCE DEPART MENT AND COUNCIL OFANY U-YANGES Amount of Request for County Nonprofit Grant Program Funds: Geogr-aphical Areas To Be Served: (Orde or more can be checked) Puna RD H5i-nAkua El North Kona M South Hilo E] North Kohala ❑South Kona ❑ North Hilo E]South Kohala ❑ Ka'O Serv�jces or Ac-OvNies To Be Provided: (One or more can be checked) Educational concerns r]Youth ❑Victims of Crimes ❑ Culture and the arts ❑Aged ❑Victims of Health or Social Crises Needs of the poor ❑ Physical/Emotional Disabilities Public Health and Welfare of the People and the Environment EXH BIT A 1\110rEPROFIT GRANT APPLICATION FY 2021-2022 Page 3 of 8 - ' ' -� m- ----- / 0- -- - —4­ - 11 ipm-�� -F ,-/2 0-2 ~2-- r 8- �Wf_,/ i-laVV@i^i |S�GOd ?'JCID� Vax-fie03Ve|Opmentad PresC i`lDd 1. F--7 Fri c" Vaar Awvamd'lmJ Comn2%,f Hom�proQ�_-Gnaniic P"ro gmomm F;­Aarlm. 2. Agenicy0fillsdon YWCA Hawaii Island is dedicated to eliminating racism, ompower|ngwoma n an d promoting p euro.juatice.freedom u dom a n d dignity for all, In 1919, visionary Hilo women responded to the need lor safe housing for young women,founding the YWCA Hawai'i Island as part of a national and world-wide women's movement. Over the years,the needs of women and their families have shaped the programs and services provided by the YWCA. Today, we remain an advocate for women and children, ready as ever to respond to the needs and desires of women to make their place in the world. In keeping with our mission statement,the preschool empowers women through providing a hny|tky,safe, learning environment in which to place their child when they are in school to better their family's future or so they can be gainfully employed without having 1nworry about their child. The preschool also works toward eliminating racism, and promoting peace,justice,freedom and dignity for all through Our Curriculum which provides for character and values education as well as teaching tolerance and cooperation through mentoring,modeling and being acaregiver(Lioknne. 1992). Reference Lickona,T.(1992). Educating for Character: How our Schools can Teach Respect and Responsibility. New York. Bantam Book 3. Program Description- YWCA Developmental Preschool focuses nnthe whole child 000ia||y, oognitivo|y, emotionally and physioa||y. Our program in Licensed bythe State ofHawai'i Department ofHuman Serves(DHS)and we are accredited through the National Association for the Education ofYoung Children(NAEYC), YWCA Developmental Preschool in unique because we expose children to the academic world in m nurturing,safe and secure environment that iscatered ioeach individual child. Vnare able toaccomplish this through the curriculum mause which isTeaching Strategies Creative Curriculum. |nour classrooms, the children get abalance ofestructured learning environment as well as time to learn through their own self-initiated discovery. Our indoor and Outdoor school environments offer opportunities for children tomake choices that will enhance [heir naturally emerging skills. Our belief is that children don't need to be forced to learn;they want to learn and they will. 4.Ta�aKudgetEll PositilonCount: Total Agency B TU�,11 Pc CL�un, udget-+$2,737 24�.O,, 4 E HH B|U_ & NONPROFIT GRANT APPLICATION FY 2021 3O22 Paige lof8 p� � V����'�� F�7�^~�1 ��� �.~ ., ^= ~ ^ `~. ^^�^~ .,^=�= � ^"�=~� � ^ ^�"^~ � ~�^~ �}aV�\DprD8Mel iPreSChOO} �. ��m�mmmm �m���m����wc�s ���em�i��a� s��nces m�0m��i��m��U����o � tlevenura Somme Castle Tuition Assistance $17,000M Castle Strengthening Children and Families $25,000.00 Hawaii Island United Way $6,000.00 Hawaii Coniniunity Foundation-Promising Minds $14,597.00 Prograrn Fees-Tuition+Operations $514,800.00 Fundraisers $5,000.00 TOTAL: $582,397.00 Attach odddiono/pages, if needed. G. EXpKzAnWhat Plans, Vuuragency cw ip�roglrammhas 8o imxresmerexerkmes0esuppoyt'dAs programm: We will continue to look for and write more grants, as well as continue to partner with other agencies in our community. You will note that weare showing m$2O0.000shortfall for the coming year. VVeare using assumptions'that wnwill still be insome form ofrestriction due tnCOV|D-19. Should the restrictions be lifted,we will be able to bring in additional revenue through the addition ofStudents inonincreased ratio oftoaoheostudents. However,wnstill believe that with the additional revenue potential, our food costs will increase proportionately with the number of students. Due toCOV!D19we have had anumber nfparents who have lost their jobs. Raising tuition was not inthe best interest n[our community who were working hard\oget back nntheir feet. As a way for us to keep our costs low for Our meals,we are in the process of integrating a sustainable agriculture curriculum. With the cost of groceries at an all [line high, being able to grow and harvest meals for the preschool will assist usinkeeping food cost low. We are asking for support in Our food program and not requesting funds to support our shortfall, 7. Program Objectives UsUng Cavjn8V Nonprofit Grant Progr2mmFm�1615: Due to COVID-1 9 the rising cost of food has become exorbitant. With the redLctiOJI ofstudents (redLIGIon is approximately 5U%)but requiring to maintain the same amount of staff,we had for double the amount ol students,aside trorn labor and benefits, meals forstudents have become emajor cost ofour program. One hundred percent of our students in our preschool receive a nutritious breakfast, lunch and afternoon snack at no additional cost to the tuition. In addition, a majority of our student's families qualify for free or reduced lunch due to their economic situation. Currently,we order an average of 50 lunches a day for the 50 students enrolled, On average, we spend an additional$3.40 a day on breakfast Lunch and afternoon snack per child for a total daily cost offood at $6.25/day per child.This is about a 50%increase from 2019-2020 school year where our costs were a total of$3.40/day per child. Nutrition isone ofthe most important factors when it comes to children's developanent. Pfcper nutrition is essential for children to succeed in school. By feeding children a proper diet,we are helpicg fl-ern to be able to func tion properly in sohoo|inaddihontofostaringthoirAmwingmindsandbodies.VVobo|ievo(hatwkenchiN/en'cph�aicn!needoaremet. they're able 1nlearn better. We are requesting$20,000.00 to assist us provide nutritious breakfast, lunch aftei nc,lnj sroOx fo all of fiie,c1iildren in our preschool. E%H 13,�7F /\ NONPROHTGRANT APPLICATION FY 2021, 2022 1,ia0e3of8 pjp--1 ic--a F 2 -22 0 in _2 ]-"k!a-fi-A e, nievelopa-lental Preschool i. Z l What are the rneasurable performance outcomes that would be achieved with this funding? f-`1R0GRA\hh PIEV70RAKAB-z OUTCONTvv-3 (i-e-:Now are younreasuring whathappertsfor the Participants after they have participated in your program?Describe,be specific-) AAenrolled ll children will receive a nutritious lunch 100% .s Healthier snack choices LAII fo=ods se=rved=willbe USDA/CACFPI approved Staff involved with the CACFP program will receive annual training on Food Prograrn&Data Collection Associated staff will have certificates of attendance Annual acceptance of program by USDA/CACFP Renmran a partner with USDA/CACFP A Itoch additional poges as necessary. P TA-P L 1;." 11: FY 20-21 FY 21-22 FY 21-22 Act-Lual* Total Sudget Girain't Req Salary Fl�ary�and d We g es $486,342.00 $556,622.00 $7,000.00 Professional Fees $33,398.00 $32,739.00 Operations $123,479,78 $109,826.00 $1,818.18 Supplies $19,502.00 $16,500.00 Equipment Other: Breakfast, Lunch 8" Afternoon Snack $60,235.63 $60,000,00 $11,181.82 Other: Repair & Maintenance and Janitorial Services $241500.00 $50,770,00 Other: Utilities $10,991.00 $12,500.00 Other: Audit $7,380.00 $7,590.00 Other: TOTAL $765,828.41 $846,54700 $20,000.00 If applicable N "hi RO FIT GRANT AP P Ll CATI 0 N FY 2021 2(JZ2 Page 4 of 8 a 4 s t - _ — k �:. .�rl_ �_ �+� �� — ..' I i," tet, lr �., �,., ! ��' � ( _.�,-1 J .��✓U . �_ 1� ?� i i _J 4.�. .� t.,r�. 0 .ui h. �.d ,� r` ..�..,,e t. stm 'cr .i.. t^ t f B,r.. r— , £ S- ... a . ^,pi r r-•, �r e ,t £ �; £' 9 _ , 99 r fur ab Iv 4 Cu t a "'ry e i t ,.$-. S • t t .,.8 - ,�1-� r .(,. + i s u G i -u�.,. 3ic 1�C.,i v_. II y C _ a r ,­lt,J rEc'l E est v _ `.:Ss rf1, F'e� to I a.-4 �.frt r' aS�x x4 e, se,sU ^.,t. I! .. r "• " , { f'r rs' r - -= -�� i i �a,.,.z� u _,..r.. _k� _�_is§; •sa. Q S Y3 cf, c1 ,�I',? £F.r..� r,G. 'c.'.l_ti Tt.� i u7Y r,i,, F�✓lr t�7, .�;,, �✓c�elits cfG`Lrv,"n,,_y to thf-fr"iG t f,, tfCai ou op.0 _J f i_1 s' n, ii.s u ccrt,l#"r'(j in r v?n .rr, to co..+d,,.4 I a `:_' ^c.CI, kr ..l�r:fiur.,.� t 3 n i.'� Imo.µii 4 F 111U�[ /l^n �� -�~^��' W �! .����� YVVL�\ M�VV�|l /5/��� �mr I eV8l0p8OtBl �»re8Sr | ~��� m� U 8����������n�~�g ��age �«�2) / kme\ have read and understood eUnfthe e|igibi|kxnequirernents grant oond�ion� avvandprocedures; ondnecord� reporLin{� and �sca/ accountability requirements asrnanda1edinArtide2S, Sections 2- 135-2-142.1, Ham/ai'iCounty Code, relating toAppropriation ufFunds toMonpro�tOrganizations, / (vve) agree toaUmm/the County (the Legislative Audito� 1heQepaMLnncntofFinance, designated Cound| representaUve, orexpending/oversight agency) fu|[ �ee, and unrestricted access and authority to exannine and inspect any facility, equipment, property, or records pedinenttothe grant, contract, or prn8rarnfor vvhichfunds were used. | (m/e) hereby certify that information supplied herein, including aUsupporting documents, /scorrect and that | (we) have the authority and ability to fully administer the program(s) pursuant to law,| (vve) unders!and1hatinfnrmadonsupp|iedhereinsh8|| bennadepub|icaccordinbtoChapter92F, Havvai'i Revised Statutes, | /vve\ understand that applications vvi|| not bereviewed byCounty personnel receiving our County Nonprofit Grant submittal, and that we have full responsibility to ensure that ail documents are curnp|eteand accurate prior tuaubnoitta|, | /vve\ understand that aUdL ncunnenisrequirin� acurrentsi8na�uremustbeLheORfG|N� 88NED docurnen1. Unsigned docunoentsvvi|| bedisqua|ihed. Faxed orcopied docurnentsvvi|lI�tbeaccepted esoriginal documents. |faxvardedagrant fnonnthe County ofHavvai'i, | (vve) understand and vvi|| cornp|yvvi1hthe requirennent toenroUvviLh ' and becornp|iantprior tureceiving payment/si To register, go to |It18�//v��dl���havua�.��� complete the easystep-by'step process, and pay the annual registration fee online using credit card, If awarded a grant from the tV of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Coun ual vear {b awarded. The repor� using 2he temm�ha�e provU�ed, sh�ll incUu�ean explanation mfthepu� �� UU� �e��� s derived from ihe awarding ofS�e gra��(focus�mg OnspecifTc, measurable outcomes), a complete 2cmountKng of all ex�� n �� � � unea � � � s� ��o�� �V�� n0Hn V�� � � �/ mi gran� � ��� � funds, and ammoun8s ���m���� dm ��eeJ�� r��� �nx�r� � � . ��. NON PROFIT GRANT APPLICA TION FY 2021 2022 n�8 ;UL r7 I cft i7 E di '1 5 1 j F-r -'x ire0--St u'':2 P�C' 4C'Yoad" �4-j n-, j r t L J S 0,111, U�ll P, Ul "'o s u Rua R( Ilg;tu 1-2%, F�]cP s'z�'u llCl'' L"�dl c; t a U M, v r.0I o r'c'�h c fi a I n-- n": rd"u P's Fja�rt 4.'- ort -l-'JS ap"'pAi tha-an—fund'll'z 'J'h e'-�j o' r -6 �'g U Y K"I, 11 D-'b T'D V C�"ll S u i0'I.rvv T�uncls un-,�� sE�d bv'juna 2';C' z2CD,224 a,-j�a, "t; � Co 1"M'Kil fro 1-?, J [±'1-1 1-il IN 1,re t I C", -s c PJ o s YA P 1A o A, 11 g rz,i.u e, 0'1 C- rs n I J -F'-',,(2 0'11- 2 2,j Y I,=',]E FIET App nIca rnt- Cound Proposed Projerted Resul-as PrOjeCted Result YABLE H. IV 21-22 counrcill PF10GRAM EXPE-V,,J113,l'YUr-,ES Grant Pequeslc Airvardl Salary and Wages Professional Fees Operations supplies Equipment Other: Other: Other: Other: Other: T OTA L Adl&'LioneA Cound directives vaaggavcoljmg g2vt6 Lj ry (NONPROFIT G RANT AP PLIC'ATI 0 N FY 2020-202"1 Page 8 of 8 E I t i s t t s t { y$ t } E I i s YWCA of Haw►ai`i Island Sexual Assault Support Services (SASS) I 243 I i i i i 1 (..€ !i.Jj ' i 66 V\� l � I 1 ,.: I, Cyran I fl rl u'I 20,� 11 ^ x (• f`"FAtI 1 It�;-r 7--,'S t v ... _ °sal/r'1a .,f Hawaii llaras:l Lid 11 Nana Sexual Assault S uppo Services (SASS) Agency Director: �(athleen McGilvray Phone No.: I (808 } 935 —71-�i Contact Person: Lorraine Davis Phone No.:(808 ) 854 —5856 Mailing Address: Address: 1382 Kilauea Ave. Address: City,ST,Zip Hilo, Fll 96720 Fa,-ility Address: Address: 1382 Kilauea Ave„ filo, HI 96720 Address: 75-5706 Hanama Place, Suite 202, Kailua-Kona, l-ll 96740 City,ST,Zip Email Address: Idavis@ywcahavvaiiisland.orcg Fax No.: (808 ) 961 —9140 Accountant/CPA: Phone no.U08) 935 —5404 Firm (if applicable): I"aketa, lwata, Nara and Associates, LLC Mailing Address: Address: 101 AuQuni Street, Suite 1.39 City,ST,Zip Hilo, HI 96720 X7 MMY NOTIFY ME RIVA, AVCS DEPA R T E lT A NQ CO UCIL OF A iv Y GHANGE5 Arnount of Request for County nonprofit Grant Program f=unds: Geographical Areas To Be Served: lone or more ran be checked) EEfl Puna FD] Hamal<ua North Kona South Hilo 0 north Kohala South Kona North Hilo South I(ohala Ka`u Servlces oar Acthd les To Be Provided: (,,One or snore can be checked) ❑ Educational concerns Youth Victims of Crimes ❑ Culture and the arts ❑Aged Victims of Health or Social Crises ❑ needs of the poor ❑ Physical/Emotional Disabilities ❑ Public Health and V1!elfare of the People and the Environment l l' l A NONPROFIT GRANT APPLICATION FY 2021.-2022 Page 1 of 8 r' I€ t-�r r� � d � t� a � o ��-sir�r"�n„r;� r^�)�i fy1, -'tri Vaj 0 ,I ,. 1 ;'�r}i l��a-i IIiI } j{ I� i uriot C �)p) icatiJ�Il�i� J-{ �L� 20Lj 'I `�� i`Vi; , of 4 381vvali Island r-s prog 1 ! f�jam-- Sexual Assault Support Services (SASS) Ia Pdor 14ea P-iv ;r 1 oY ¢'7®a?n4 ',i Rjottprcuuit Gr n`t Prograim Fuinds. Fy 18-19 F16,'091 21 ,8-17 17,1125 2.Agency hilission Stakeirrierit' The YWCA of Hawaii Island (YWCA)is dedicated to eliminating racism, empowering women,and promoting peace, justice,freedom and dignity for all. The YWCA,first organized in Hilo in 1919, has offered valuable programs and activities for the benefit of women, children, and their families. The YWCA was established as a 501(c)(3)non profit organization in 1965,and has been a partner agency of the Hawaii Island United Way(HIUW)since 1979, The YWCA belongs to a national organization consisting of over 300 YWCA Associations across the United States with.2.6 million members. Employing 48 full-and part-time staff,the YWCA offers a variety of services to people of all ages,from newborns to senior citizens throughout the island of Hawaii. Current programs include: Healthy Families Hawaii,a child abuse and neglect prevention program; Developmental Preschool, a nationally accredited(NAEYC)preschool serving 2-5 years olds; Sexual Assault Support Services,a program operating a 2417 rape crisis line and providing therapy to victims of sexual violence and their families and Sex Assault Nurse Examiners Program (SANE),a program to provide specially trained nurses to provide medical assessments and sex assault forensic,examinations of victims of crime. Program Description: The SASS program provides services for the healing of sexual violence. Sexual violence is an equal opportunity crime that crosses the boundaries of age, race, religion and gender equally. Sexual violence is pervasive on our island. In FY 2018-19 we opened 184 new sex assault cases; in FY 2019-2020,we opened 177 new cases and this year,even amidst COVID shelter in place directives,we have opened 64 cases in the first 6 months of the FY. More than 80%of our victims are female, over 55%are below the age of 17 and over 96% knew their offender. As an under-reported crime,we expect that we are serving about 35%of the survivors that were victimized during the course of the year. The SASS program has a three prong approach to providing services to victims. The SASS program mains a 24(7 crisis line to provide services to victims who call in for emotional support and information. It also serves as the conduit for professional and partner agencies to start care coordination for victims who disclose and are requesting services. We provide face-to-face services to victims who would like to police report, get a TRO,go through a forensic interview at the Children's Justice Center, and a medical forensic examination with a nurse examiner. After initial contact with the victims, there is outreach by staff to check in and see how the program might support them. The SASS program also supplies therapeutic services to victims and their families, currently at no cost to the victim and/or their family. The program also provides prevention education and awareness activities to schools, community events and groups who ask for information. In December 2020,the YWCA was informed that our master contract would be reduced by 30%due to Statewide cutbacks which will result in a reduction of crisis availability. The program will no longer be able to maintain the 2417 crisis line and respond to call-outs after hours. To keep the crisis program intact and victim centered,the program is asking the County of Hawaii to support us in keeping the crisis services available 24(7. 4. Total Budget& Position Count. otal Procrarn ,� p — - L— utal 2,737,245 NONPROFIT GRANT APPLICATION FY 2021-)022 F; 2 of a i i r r i I an F2021 -22 1 S I ar' r r T C Vl y_is it^" 'y VV' t3 f a I_;3};11`l l l Isjand i i J am etat «lal Assault Support Services (SASS) _._.. - ui 5ogy „'1 d'(g So. cces � ads sources or u `di ng-apIl?ecd W I�u9srogra6a) I FY21-22 II si F,Sement Cente --committed 252,407 cial Projects--committed 113,000 Act through the Prosecuting Attorney --pending '12,000 Private Contributions --pending 20,000 County of Hawaii--ask 30,000 j - I TOTAL: 397,497 Attach additional pages,if needed. rotpiain vvha� PlIans Vourr agency or prreogranci has to increase revenues"co sd9ppon-L-thils program: j Given the state of funding reductions, additional efforts in grant writing will take place. There are grant announcements that have been made for RFIs with the proposals coming out in the next 3 quarters. The YWCA will be actively applying for those grants. In addition,the YWCA is researching 3rd party billing for therapeutic services and requesting rent reductions for the buildings that SASS utilizes. The program was unable to do their signature Walk A Mile fundraiser for the program this year due to COVID so other fundraising activities are being considered. 7. Prro rariint Oibyr:.a:tilifes Using County Nonprofit Guam Program Funds: The primary objective is to keep the 2417 crisis line manned and the program is responding to victims of sexual assault when the victim is requesting services. This means keeping raving two advocates on call (one for each side of the island) every hour of the day and available to meet clients face-to-face. The funding would provide salaries, cell phone expenses and software maintenance and licensing to support the HIPAA compliant database the advocates use for documentation of services. E-sk'H�,811 T A NONPROFIT GRAFT APPLICATION FY 2021-2022 Page 3 of 8 1 'k y f' Pi 1fI.`j'T [Jac-or,,{i �" '_ . lj i ' p' 7 _ 1. ` IG ��'VY(;A of I'iawaJi IsIrind i ne: Sex:i jai Assau rlk Support Services (SASS) v i What are the measurable performance outcornes that would he achieved with this funding? PROGRAM PE;IiFCPRiVIAHCE OUTCOMES v I (i.e:How are youmeasuring what happensfor the Participants after they have participated in your urogram?Describe,be specific.) I The crisis line will remain open and active 2417 will full coverage on both sides of the island. 100%coverage No client will receive a telephone recording because the phone lines are not being manned. 0 clients missed SASS call out services will be available for our partner agencies 2417 100%call out availability Attach additional pages c7s necessary. I a -- I F�FY ctual* Tetal Budget Grant Rep Salary and Wages� `-�—_— - -v�-------------�_—_—....._.288,378 268,602 20,672_.. _ Professional Fees 19,996 25,096 3,600 Operations 51,281 59,289 2,728 Supplies 3,651 4,000 Equipment - -- — Other: Audit ----- -- 4,689 5,000 1 Other: Rent 33,640 42,489 Other: Insurance -- 5,875 7,030 Other: Telephone 17,100 18,600J300,000000,000 Other: Mileage, R8tM, Training, Utilities 26,482 24,443 TOTAL 451,092 454,549 — *If applicable ---- T tl A NONIPROFIT GRANT APPLICATION FY 2021- 2022 4 of 8 's 1 3 I !, ._:'1 r 3 ""_i iia�_�__.,.� 4•_` 4sy..._�.i 164 ii '��! t Fi � . �� JJ lj' w_ 1 ..JS�� _.,, s, �E , i� � u� �J ,, `a�_ aa.1�=�� ca�U.s. d�L2FJ�11._: Yi c.r 131t._I_[_. r •� ?g nu U [F .__.l'.[f ig [,i^u°:'' i 9' ..."t 1. �.r _ ..,',.,[t., � s'N fe_i..vC ° l e, r), w;4e di. u, pl!C., w rsfl ._ [b [rt-'s,s,jrt"!'t t 4' I,�'€ di";�I, tu._J i.i^tiV ��.:.P. lS._ �J_ I.�<;l',ji v{... S_F !.3.�� '''�_J..,'.d "�[��,�.._ � I_r��" ..! '..,y_ettz;i:l E•�,,,.t_� ;'�s_H7_�' y. :�$a�w=,i.; >1`S !i_.�"de Y,. .,r ,... F., .��w"Y��. ' 4 �1J r:"V " "al.}d .m::�.y ( ,Js. t U,` Y,_,._ N.,+;r g`J r t r3 + �Fpt�r r>'r 1 Js a'^ fctl Fvl L..� :�P.,l:.tx" .wi � .rn 4t P,.(� l 4�5 �A Jr,x« lvl,Q1� "i �.�1. 4 rl.F J':�u�x r.... �I i 71� ik: '�....P� �, i_ .v3u a ?.» CJb ° _6ftFl _z8'Ili,al.4€.. if' j 1, UrrrJ:tYlNf1 LO !YSddi_�t.ta(;. ult ='F..tiet '4..1r ..�C.., <r :r� Fi F-,r, �..! .,��.t,[:';.�l,..tE, ,V �_fi t •:: o Wt '�,. [_s`C 44.�..k il,U t. .. u_i s •s 3;._ r'oeu,as: r,SLf, _ ,r 7 c ?Pro:}r,:.ttk M 4- .cii_r7 i !, ? ,r..rei+st_.aJ#a,:'Ef I vifil rest>Riin ,neo5'_ir'r'1 le .I rest Jer el`7G3 wtct ruirig-o-blo ild'iVic"Ual ri5 horiefftst. . .Jt) .s_.,'`'sr h7 __. 4eJ 1S.S, i eA'T._ ,.[ �"t.,...mak S i i �U_ � ���,"lf -� ���' - v - --- - ^ - �I - �— ���— — - - - - - -- VV{�\ i !����� �]�� �� KJ��Q� ���XUB| ASSaWlt ��Qpnnr Services (SASS) �� ����) } kme\ have read and understood aUofthe e|i8ibi|kyrequipement� grant cond�iun� avxardprocedure� and records, reporting, and fiscal accountability requirements as mandated in Article 25, Sections 2- 135-2-142.1, HavvailCounty Code, relating toAppropriation afFunds ioNonpro�tOrganizations. | /mae\ agree ioaUowtheCounty (the Legislative Audito� the QepartrnentofFinance, designated {bund| representative, orexpendin&/ovemiQhLagency) fuU, free, and unrestricted access and authority 10examine and inspect any fad|ity, equiprnen� pnoperb� arrecords pertinent tnthe gran� contract, or progrannfor vvhichfunds vvenuused. | /vvel hereby certify that information supplied herein, including all supporting documents, is correct and that | /vve\ have the authority and ability tofully administer the program(s) pursuant to |avv. | (we) understand that information supplied herein shall be made public according to Chapter 92F, Havvai'iRevised Statutes. | (m/e) understand thaTapplications vvi|inot berevievvedbyCounty personnel receiving our County Nonprofit Grant subnnitta|, and that wehave full respondbi|itytoensure that all docurnen1sare connp|ctrand accurate prior tusubmittal. | (we) understand that all documents requiring a current signature must be the ORIGINAL, SIGNED document. Unsigned documents vvi|| be disqualified. Faxed or copied documents vviU not lie accepted asoriginal documents. |faxvardedagrant from the County ofHavvai'i, | (vvc) understand and vvi|| comply vviththe requirenoent toenroll vvith ' and beconnp|ian1prior toreceiving paymenUs\. To register, 90 toht��� `�h����`��y complete the easy step-by-step process, and pay the annual registration fee online using credit card, awarded.if awarded a grant from the County of Hawai'i, ! (we) understand and will comply with the requirement to submit a vear-end report to the County Council within 60 days after June 30 of the contractugl year for which the grant was The mapmr� using 8�e temmp|aWeproyi�ed, shaUU �mcUudem� explanation of the pmb8iobe�e���s de��wedfmmmmthe m*x������of the gra�L (�mcuF�n" on s��ci�c, mmeasurabKe outsmmmes)/ aoommpUeteaccounting ofmKUem�em����mes�����o�e� �yCmvnt�of Ham�K`| grant��md/�and aUKstimg of otherYunding sources and �mm�:om�� r4c�aiw�� �wTh�g��� awy�r� ��r���. ' ' �UlF » i I 4 r I' i G Iji J7�,�� Ellird ha a Ia 7Jt@t.P (', V . c a i.... o_ U'l..J Irp4�Int ,�,4�.'t,v�:,� E � � ,�5�g. Cf),;;,}yl_u #fig. 1�I expi +vi ir���Jry,7t''i uL;� ,4�.�... � i ✓'iii .,... J�..w��.tas?'C�a .,3�1"i"•�C9 S-i�'.v;AA ".thy, d k, ' £tl R €tettCi, xSl CII; l< ,,1; l l r( Alal G °,wt n 'r r h E i7 tE;1Ce rG` �L L,J ML GI a._t,',j't,U .,.�i �c d. ;�:u-LL„ �L94t9,._,ail— M ice! 1., ?M -i!k �:Yl ! C' I a+;.@ ,[l, _g° �Pr 0. ,L.='tid.?G.9g'.t , f ..�.u,.. � /; "«�'t !.�Y'�( .a1_ri ,tba? oll @'AffM .�i�" 7.n�a, f t � fi � j, If 'rr" e.r U .£:4_..,...�...<; +ft„� 61 iJ , . ,: ,�.a.�.., s� ,J �J ' "i810 ' _a a J."El .. ^?��,1j_ _�,..w.;t'i �( ':.t,t c sr( .k''� i�� � .� .tbw= [v �.�t_ �a E": , t U lN� G 3 +�.i 00s Ca Pv$-t`�.`N. C,-T QOTI alb e Y Vvc'/�, oi-�;�Iav,&:IN �-Iji- Lielxlua1 As-swilt Sivoporr Servicas (SASS) 'o ---------- 12. CXJI U VA r P,�f S�A F PRDG.',�6UO, �,DERFORNIVUMCE NTEASURES Applicam CouncH Proposed Pvojec�ed Resvks Projected Result A P,LE 660 PflUGRAM EXPENMTURES FV'21-22 Cound (G�vant Request Awa rd Salary and Wages Professional Fees Operations Supplies Equipment Other: Other: Other: Other: AL Addftiona� Cound d�racidves regav4j—", c. 'h;G'IS GRANT APPLICATION FY 20'1G- I PURE e