HomeMy WebLinkAboutCOM 0066.002 2022-2024 ,I diq
Mitchell D.Roth , . .,i;�� �1* Deanna S. Sako
Mayor • n r • D{rector
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`°`_"" f WU',TY �'1 Diati' ``Nakagawa
Deputy Director
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County of Hawai ><
Finance Department
25 Aupuni Street,Suite 2103 • Hilo,Hawai`i 96720
(808)961-8234 • Fax(808)961-8569
February 28, 2023
Heather Kimball, Council Chair and
Members of the Hawai`i County Council
Hawai`i County Council
25 Aupuni Street
Hilo, Hawai`i 96720
Re: Nonprofit Grant Applications
This is to transmit the application for VASH Hawaii Island.
This organization submitted their online application in a timely manner, however the
comprehensive profit and loss statement combined two fiscal years within one statement and the
two-year requirement was inadvertently reviewed as a submission documenting only one year's
financials. Upon further review, it was deemed that the financial requirements have been met.
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 the Nonprofit Grant application for
VASH Hawai`i Island for your review and apporpriation of funds for the FY 2023-24 nonprofit
grant program.
Should you have any questions, please feel free to call Lisa Tada at 961-8489.
6-- A
Deanna S. Sako
Director of Finance
Enc. Vash Hawai`i Island Application for Nonprofit Grant Funds
Revised list of Nonprofit Grant Applicants /�
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Hawaii County is an Equal Opportunity Employer and Provider
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FY 2023-24 Application Form
HAWA 11
FY 2023-24 Application Form
The purpose of the County of Hawaii Nonprofit Grants-in-Aid(Waiwai Grants)is to support qualified nonprofit organizations
to carry out work that improves the quality of life on Hawaii Island.
This grant is coordinated by the Hawaii County Council, in partnership with the Department of Finance.
A total of no less than$2.5 million is available on an annual basis through this grant program.
Applications will be accepted and can be modified/corrected until submitted to the County of Hawaii. Deadline for
submission is 11:59 PM HST on January 31,2023.What you submit electronically is what the County of Hawaii will receive.
Applicants have full responsibility to ensure all documents are complete and accurate prior to submittal. Errors, missing
documents and/or other areas of noncompliance will result in the immediate disqualification of your application. We urge
you to review your submission with extreme care. To resolve any technical problems you might encounter,we encourage
you to begin the application process as soon as you can.
For questions regarding documents required to be submitted with your application,contact: Lisa Tada, Budget Specialist,at
(808)961-8489.
For questions regarding the preparation and submission of the application or concerning the overall grant process, contact:
Council Services,at(808)961-8255.
VASH Hawaii Island-VAP=Visitor Assistant Program
Organization/Contact Information.
Organization/Contact information��^�!
Organization Name(As it appears on IRS Forms)* •
VASH Hawaii Island
Organization Director
Title* Suffix
Executive Director •
First Name* Last Name*
Rachelle Hennings
Contact Person
This person will be the primary point of contact for all communication related to this grant proposal and award. •
Title* Suffix •
Executive Director
First Name* Last Name* •
Rachelle Hennings
Phone Number* Email Address*
,(808)756-0392 admin@vashbigisland.org
Organization Mailing Address*
Street Address
• PO Box 669
Address Line 2 •
•
City State/Province/Region
Kailia-Kona HI
Postal/Zip Code Country
96745 USA . ,
VASH Hawaii Island-VAP=Visitor Assistant Program
Program 1r formation
1.Program Name*
VAP=Visitor Assistant Program
2.Number of years the program you are applying for has been in operation.*
20
3.Do you currently have or anticipate having any other coeitracts/agreements with the County of Hawaii during the fiscal year of this grant cycle
for the program you are applying for?*
.: Yes No
4.Have you previously applied for and received a County Nonprofit Grant Award?*
O Yes S No
5.Select all areas of Hawai9 Island where the program will be administered,delivered,and implemented.*
t'Al Puna Hamakua a North Kona
Ni South Hilo ><. North Kohala `'; South Kona
a North Hilo • South Kohala Ka.0
6.Identify the age group of the target audience(s)the program will serve.*
•
{i Infancy(0-3) itg Play Age.(3-5) ?:' School Age(6-11)
Ni Adolescence(12-17) : Young.Adulthood(18-39) r: Middle Adulthood(40-59)
60+
Kupuna P (60+)
7.Identify the primary services or activities to be provided.
*
} Educational concerns &'E.i Culture and the arts
Needs of the poor 0 Victims of Health or Social Crises
CI Youth Aged
0 Victims of Crimes s Physical/Emotional Disabilities
Public health and welfare of the people and the environment
In years past,applicants were asked to provide the County with an amount needed to advance their program or service. The County receives
more than 200 applications for grants-in-aid each year,resulting in nearly every applicant getting a"slice"of what they requested and some not
being able to advance on their proposal. We recognize this grant is a small piece of your larger operation.So,please identify a realistic amount •
that accurately reflects your need to administer your program or service. Be thoughtful in what you need as the County will make a yes/no
determination on the amount you are applying for.
•
• 8.Identify the amount of funds you are applying for.Must be equivalent or less than your estimated expenditures.*
O $2,500 0 $5,000 0 $7,500 0 $10,000
res $15,000 :< $20,000 $25,000 $30,000
• $35,000 0 $40,000 `r $45,000 0 $50,000
VASH Hawaii Island-VAP=Visitor Assistant Program
Tracking CHANGE & Ripple Effect
Does your program advance any of the following?
CHANGE Framework Sections; Please select indicators from only ONE sector of the CHANGE framework that best applies to the program you
are requesting funds for(Community&Economy,Health&Wellness,Arts&Culture,Natural Environment,Government&Civics or Education).
Do not select indicators from more than one sector.
• Community&Economy Sector
Your program works to build a diverse and growing economy that allows people to earn incomes and build assets while also affording
opportunities for quality of life.
1.Community&Economy—Select all indicators that apply to your program.
Diversifies economy Build income,wealth,assets
Increases housing security/affordability f.3 Reduce or address the cost of living
Builds community network .0 Increases community safety
Increases community capacity to adapt and/or be self-sufficient
Health&Wellness Sector
Your program works to provide access to care that improves the quality of life on Hawaii Island and keeps'ohana safe and thriving.
1.Health&Wellness-Select all indicators that apply to your program.
• Addresses physician shortages Reduces healthcare costs
increases access to nutrition Provides resources for kupuna care
Addresses childhood poverty Provides services for at-risk youth
Improves access to mental/behavioral health services
Arts&Culture Sector
Your program cultivates Hawaii's rich culture and arts,which enriches the social,economic,and physical elements of community.
1.Arts&Culture-Select all indicators that apply to your program.
Supports arts education for youth
Promotes Native Hawaiian Culture
Provides access and opportunities to participate and practice arts and culture
Supports economic opportunities in the arts
Natural Environment Sector
Your program works to protect and preserve our natural resources and to keep Hawari,Hawai'i.
1.Natural Environment-Select all indicators that apply to your program.
Builds resilience to climate change Promotes renewable resources
Y..11 Reduces dependency on fossil fuels Protects water resources
Promotes local food resources and security Protects reef and ocean health
Protects watersheds and important natural environments
. Government&Civics Sector
Your program works to position Hawal'i as a model for local and global civic responsibility and collaborative policy development.
1.Government&Civics-Select all indicators that apply to your program.
Builds community volunteerism ij Helps to develop community leaders
Increases voter participation Increases civic engagement
• Promotes government transparency Builds trust in government
Promotes community investment
Education Sector
Your program works to educate the next generation properly so we can hope to find solutions to our most persistent and disruptive challenges. •
•
1.Education-Select all indicators that apply to your programa
El Reduces truancy IO Increases earning potential
Increases high school graduation rate '; Increases literacy
Increases access to STEAM education Provides workforce development •
`'s Improves access to post-secondary education ;? Increases quality and access to early childhood education
• VASH Hawaii Island-VAP=Visitor Assistant Program
Program Details
Please keep in mind that character counts include punctuation and spaces. Note:organizations are required to have at least one year of
experience with the proposed service/activity OR can demonstrate sufficient expertise.
•
1.In 500 characters,share your organization's mission.Provide a brief narrative about your organization's experience,knowledge,and
capacity.The organization is required to have at least one year of experience with the proposed service/activity OR can demonstrate sufficient
expertise.* •
•
VASH has for 20 years executed a tripartite mission:aid travelers stricken by adversity(crime,medical emergency,loved one's death);relieve •
police and health workers of the need to exceed their mandate to help travelers(emergency lodging,clothing,food,transportation,medical
equipment loans,interpretation,emotional support);support the tourism industry by educating travelers on physical and health safety for their
wellbeing and to lessen tourism-related strains on the EMS systems. •
2.In 1,000 characters,briefly describe the program you are seeking grant funds for.* •
As a mature organization,VASH leverages modern technology and a robust volunteer program to operate remotely and virtually(no office
space),with a skeleton staff of four(only one of which is full-time)and only a small rental storage unit to meet logistical needs(supply and
rec6rd storage).Staff members actively cultivate partner relationships in relevant industries(law enforcement,hospital,hospice,airlines,
cruise lines,hotels,car rental agencies,etc.)to advance the mission and exponentially increase our impact in relation to our size and budget.
Though well established,we are not calcified;we are constantly seeking ways to lower costs,increase impact,and maximize efficiency.Grant •
funds are sought to directly enhance and expand mission goals and deliverables,not salaries or infrastructure requirements.The bottom line
is to Export Aloha!And turn a negative experience into a heartfelt,welcoming memory.
VASH Hawaii Island-VAP=Visitor Assistant Program
•
Program Objectives & Performance
The next set of questions will provide grant application reviewers a clear sense of what your proposal is designed to accomplish and what is
needed to get there. The examples below relate to a fictional feeding program. Please keep in mind that character counts include punctuation
and spaces.
1.In 500 characters,what is the community need the program intends to fulfill?Along with the narrative,pleaseinclude data and/or citations
documenting/measuring the need.* •
VASH unburdens our strained law enforcement and healthcare professionals,letting them focus on primary obligations a`nd preventing them
from working unpaid overtime and using personal funds to fill travelers'emergency needs—food,clothes,transport&lodging.In 2022 alone,
VASH served 657 victims of crime and emergency patients.VASH's work inherently supports tourism,thus our job market and the broader •
•
economy,&promotes repeat business by leaving travelers with a sense of aloha and'ohana •
2.In 500 characters,what is the program goal?Describe how your program advances the CHANGE category you picked and creates a Ripple
Effect of positive impact.What is the clear desired future state that correlates to the end of the one-year program period?*
Weekly feedback from police,hospitals&distressed tourists clearly captures our Ripple Effect:lifesaver,safety net&guardian angles."The •
impact on police&health workers'day can be profound-the difference between getting to the next patient or crime or having to handhold a
traveler facing adversity.VASH's work creates a positive impression for visitors,with many expressing awe over the existence of such a
program&their turn of attitude—from tragedy to recovery&a desire to return.
3.In 1,000 characters,list what resources are needed to carry out your program,effort,or initiative.What do you need in order to carry out the
activities at the frequency and scale needed to achieve the outputs?These are your INPUTS.Hint:this should look similar to the narrative
section of the detailed budget request and include all types of in-kind services and contributions.*
To carry out our program activities at the frequency&scale needed to achieve our outputs,we are asking$25,000 from the County of Hawai'i.
Our total monetary budget for this fiscal year is$173,301.
Below is the breakdown of how the county monies will be spent: •
PAYROLL$19,270:A portion of the West HI Program Director's salary of$9,635&East HI Program Director's$9,635.
OPERATIONS$4,917:Mileage to transport&meet with visitors$2,136;training&education(primary police&hospital in-services)$1,113;
cell phones$720;volunteer recruitment,training,retention$600;online survey service$348
SUPPLIES$813:Brochures$500&office supplies(ink,paper,etc.)$325 •
NON COUNTY FUNDS:In-kind services direct to the visitor$40,000&TV/Radio crime prevention PSA's$19,200
HTA$130,000:Balance of payroll$75,849;balance of operations$53,326;balance of supplies$825 •
•
VASH CONTRIBUTION(donations/fundraising)$18,301
Total cash budget:$173,301.Total in-kind budget:$59,200
4.In 1,000 characters,list the MAJOR ACTIVITIES to be completed.To achieve the indicators you listed,what would you need to do?These
action statements begin with a verb and normally includes a timeline.For example:design and collect materials for STEM kits by month 4.*
Mo 1:Grow ability to loan medical equipment to injured travelers by building relationships w/healthcare supply outlets.Mo 2:Grow ability to
provide emergency transportation in public transportation deserts(Waimea&Kona hospital regions)through corporate accounts w/small taxi
services.Mo 4:Improve aid to medically disembarked ship travelers by rebuilding relations w/cruise lines&port authorities that were derailed
by COVID-driven changes.Mo 5:Build relationships in Waimea&Kealakekua BnB communities to expand lodging options near hospitals for
families of injured travelers.Month 6:Improve aid to foreign travelers by initiating partnerships w/key Oahu-based consular officers overseeing
citizen services on our island.Mo 7:Build a volunteer team in Waimea&Kealakekua to service the transportation needs of hospitalized
travelers.Mo 9:Help reduce tourism-related strain on our EMS system by leveraging rental car&airline contacts to distribute ocean&driving
safety info.
5.in 1,000 characters,list the outputs to be completed.What are the quantifiable results of those activities that you would need to obtain in
order to achieve the indicators you listed?These are OUTPUTS.Each output begins with a number and directly correlates to a specific activity.
For example:delivering 100 STEM kits for students in grades K-8 by month 9.*
Our planned initiatives(as described in 4B above)are expected to translate to a 10%growth in the number of distressed travelers we assist in
the fiscal year 2023-2024,even if the number of visitors to the island is static.In the calendar year 2022,VASH helped 657 people-265
victims of crime,381 medical emergencies(including 21 deaths of loved ones),and 11 miscellaneous.In the 2023-2024 fiscal year,we
anticipate helping 723 visitors-292 crime related,419 medical emergencies,and 12 miscellaneous.
6.In 1,000 characters,list the MEASUREABLE OUTCOMES to the public and your program participants based on your program's actions.How
will you know when you are closer to your goal?What evidence would indicate this?These indicators are your measurable outcomes.Each
statement should have a percentage.For example,rather than saying"we will conduct 10 community meetings"you could say"we will ensure
50%more of the target population will be better informed about XXX through pre/post surveys by month six.*
According to DBEDT 2021,73.8%of Big Island visitors are repeat visitors spending an average of$1,578 each.The 657 people we served in
2022 spent approximately$1,0367,746 in revenue on the island.We conservatively estimate that 20%of the people we assist(due to our
direct services)will return to the island again.This will bring at least$207,349 in future revenue to Hawaii Island.
In addition,VASH provided 297 hours of service to victims of crime.Using conservative figures of$50/hour in law enforcement pay saved the
County of Hawaii Police Dept.$14,850.VASH also provided 466 hours of service to visitors with medical emergencies.Again,conservative
figures of$75/hour in overall healthcare worker costs translate to saving our community hospitals$34,950.in 2023-2024 we anticipate both
•
the hours and value will increase by 10%for both crime and medical emergencies. •
VASH Hawaii Island-VAP=Visitor Assistant Program
Program Budget
1.Complete the program budgetwhich clearly identifies how your organization will utilize the grant funds being sought .
PROGRAM INCOME
CASH Anticipated* Committed* TotalP,oppywu|nnomp
GA $o5�onzN $�8� $���unoO
� m�^v� �n�n �e,�e, -~~ �
|
ApplicantOrganization $ 18�o1z0 $o�o $ 18�o1Im
� .
I
Other Funding Sources(list):
�
HTA $ $ 130.000z0 $ 130,00000
TOTAL $43,301.00 $ 130,000I0 $ 173,30 1.00
1
-------'___'--- ---_-_' __- ,''-__'---^'-' _--'--_'_----_`_- ' _'_----_----- -'---�-'-'--_'-
IN-KIND CONTRIBUTION Anticipatedmmwm Committedvomw TotalP,vnoenumn�mo
Direct Victim Assistance $40,000.00 $0.00 $40,000.00
List type of contribution
.
TV/Radio crime prevention PSAs $0.00 * 1802u.0o $ 19,020.00
List typo of contribution
TOTAL
$40,000.00 $ 19,020.00 $59,020.00
INCOME TOTAL $0m.nO1lm $ 149,020z0 $onu,32 z0 .
PROPOSED PROGRAM EXPENSES .
Expense Description Waiwai GrantOthermpv,m�^ Total Expenses Previous Year Council Awar
" •
Request* Actual Expenses
A.Salary and Wages $ 19,270.00 $ 110,280.00 $ 129,550.00 $ $
B.Professional Fees $0.00 $ 10.985.00 $ 10,985.00 $ $
C.Operations $4,917.00 $26,211.00 $31,128.00 $ $
D.Supplies $813.00 $825.00 $ 1,6nO.0O $ $
E.Equipmen $0.00 $0.00 $0.00 $ $
F.Othe (list): .
In-Kind $0.00 $59,020.00 $59,020.00 $ $
•
TOTAL $25,000.00 $207,321.00 $232,321.00
\VASH Hawaii Island VAP Visitor AssistantProgram
' .
.
. .
/
Forms to Review and Sign
When uploading your file,please be sure that all fields are complete and that it is the correct and final document.
8.Please review and upload a signed copy of the_Certificate of Understanding*
VASH Certificate of Understanding.pdf 2.43MB
9.Please review and upload a signed copy of the County of Hawaii Disclosure Form*
VASH COH Disclosure Form and exclamation.pdf 503.85KB
VASH Hawaii Island-VAP=Visitor Assistant Program
Required Organizational Documents
Each document section will allow for only one file to be uploaded.Please combine all documents for each section into one file for that
document type(ex.two years financials must be scanned into one file for upload). When uploading your file,please be sure that it is the
correct and final document.
10.Upload your Proof of Authorization(Bylaws,Resolution,etc.)for binding signature.Must be authorized by Board to sign contracts.*
VASH ByLaws 2023.pdf 9.45MB
VASH Corporate Resolution 2018.pdf 762.98KB
11.Upload copies of your Annual Financial Statements for the two most recent years.You are required to provide Financial Statements
(Comprehensive Profit&Loss Statement or better required;Audited Statements if available)from the two most recent years.They must reflect
financial operations within the past three-year period(1/1/2020—12/31/2022).Name,title,address,and signature of preparer must appear on
•
statement.If not prepared by a licensed CPA,must be signed by the Executive Director or authorized member of your organization(title must
be indicated,with explanation to certify accuracy.)A waiver may be granted to provide(a minimum of)one year's information if organization's .•
date of incorporation is after January 1,2021.*
VASH Detailed Profit and Loss 2020-2021.pdf 3.75MB
12.Upload a copy of pages 1 and 2 of your IRS Form 990.If you filed electronic(e-Postcard)version(990N)provide receipt of filing.Must be for
a period within the past 24 months(1/1/2021—12/31/2022).*
VASFI 2021 Form 990_first two pages.pdf 3.23MB
13.Upload a copy of your organization's IRS letter of determination verifying agency's IRS 501(c)(3)tax exempt status.*
VASH Tax Exempt Letter.pdf 825.84KB
14.Upload a copy of your Articles of Incorporation.This must have a signature of the Executive Director or highest-ranking member of the
organization(title must be indicated,with explanation to certify validity).This signature may be from the initial documents of incorporation or
by the current Executive in charge if these are not available.* •
VASH Articles of Incorporation.pdf 1.32MB
• VASH Articles of Amendment to Change Corporate Name.pdf 374.96KB
15.Upload a copy of your organization's By-laws.This must have a signature of the Executive Director or highest-ranking member of the
organization(title must be indicated,with explanation to certify validity).This signature may be from the initial documents of bylaw adoption or
by the current Executive in charge if these are not available.*
VASH ByLaws 2023.pdf 9.45MB
16.Upload a copy of your organization's nepotism clauses(either contained in By-laws or organization policies).*
• VASH Anti-Nepotism Policy.pdf 1.27MB
•
•
17.Upload a copy of your organization's conflict of interest clauses(either contained in By-laws or organization policies).*
VASH Conflicts of Interest Policy.pdf 4.12MB
VASH Hawaii Island-VAP a:Visitor Assistant Program
•
Acknowledgment
18.Do you give the County permission to share information contained in your application with other County Departments and with
philanthropic groups,with the goal of increasing possible funding opportunities for your organization?*
Yes No
VASH Hawaii Island-VAP=Visitor Assistant Program
•
Agency Name: VASH Hawaii Island
Program Name: VAP = Visitor Asistant Program
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 )hereby
I (we) 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 signed by authorized
personnel. Unsigned documents will be disqualified.
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 http1/vendtprs.ehawaii.goy,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 Hawai'i, 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.
NONPROFIT GRANT APPLICATION FY 2023-2024 Page 1 of 2
Agency Name: VASH Hawaii (sand
Program Name:VAP = Visitor Assistance 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
($2,000,000 general aggregate and$1,000,000 each occurrence)must be provided to the County of
Hawaii Finance Department,which specifically and explicitly indicates that the County of Hawai'i 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 http://www.hawaiticounty.gov/fn-nonprofit-grant-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 June 30,2024 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.
January 18, 202,
Signature of Authorized Person
Date
VASH Hawaii Island President
Title/Position of Authorized Person
0.„„a,
NONPROFIT GRANT APPLICATION Pi'2023-2024
Page 2 of 2
County of Ilawail Nonprofit Grant Application FY 2023-24
Agency Name: VASH Hawaii Island
Program Name• : VAP v- Visitor Assistant Program
COUNTY OF HAWAII DISCLOSURE FORM
Please disclose any conflids or potential conflicts of interest that any board member,officer,director,
or administrator of your organization may have with the County of Hawaii or that any County of
Hawaiii employee listed below may have with your organization. Only those listed below need to
beclisdosed.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):
El Member or members of the Council
Ei Staff appointed by a member of the Council
ID The Mayor
gi M., p1: e, -The Managing Director .tro.. L.oleo..,) -:p 't..e-c SAAMO
0 The Director of Finance
0 The Corporation Counsel,the Assistant Corporation.Counsel,or a Deputy Corporation
Counsel
Conflict of Interest is defined es: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 ail mitigation measures to avoid,in fact or appearance,any conflicts or
potential conflicts of interest:
aLtiA,17
LI aLlk 0 4
\fijc
If no conflicts exist,check here.
January 18' 2023
Signature of Authorized Person(spedfy title) Date
This Form DOES NOT take the place of the requirement that your organization have a conflict of
interest clauseholicy within the organization's published rules. This form is to assist the County of
Hewer'to avoid potential conflicts of interest during this grant process.
verks1.4
VISITOR ALOHA SOCIETY OFAHAWAII ISLAND
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Ca4idi...4,71...41 4 tict,.K1dttt,,:
VASHHaWaii.org:
1/18/23
Lee Lord, Is the Managing Director under the Mayor and is aboard member of
VASH Hawaii Island.
Kindly note, Mr. Lord has nochain of command or supervisory authority with the
Council. He does not participate in any portions of the COH Nonprofit Grant
process.
Also, no VASH board member receives any financial compensation for being a
board member; it is strictly a volunteer position.
C" f.
Exe.utive Director Da
NONPROFIT GRANT APPLICANTS FOR FY 2023-24
Sort order matches separation sheet numbers(hard copies). Note that the disqualified applicants sort order are AFTER qualified applicants.
Numerical sort
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68 1 After-School All-Stars Hawaii Academic Enrichment 50,000.00
67 2 After-School All-Stars Hawaii Sports as a Hook 50,000.00
170 3 Alexander&Duke De Rego Foundation Water Safety&Ocean Awareness Education 35,000.00
33 4 Aloha Club of Hilo Hale Oluea Clubhouse 40,000.00
174 5 Aloha Ilio Rescue Aloha'ilio Rescue Spay Neuter Program 45,000.00
56 7 ALS Ohana of Hawaii Excellence in ALS Care-Equipment Loan Program 10,000.00
57 8 ALS Ohana of Hawaii Excellence in ALS Care-Professional Care Management 20,000.00
95 10 American National Red Cross Disaster Preparedness&Response in Hawaii County 35,000.00
179 13 Arts&Science Center Puna Rising Entrepreneur Hub 45,000.00
99 14 Arts&Sciences Center ASC Community Learning Program 40,000.00
152 15 Big Island Mediation,Inc.DBA West Hawaii Mediation Center Community Mediation 20,000.00
166 16 Big Island Mediation,Inc.DBA West Hawaii Mediation Center Peer Mediation 15,000.00
Big Island Invasive Species Committee Invasive Plant Eradication
168 17 Big Island Resource Conservation and Development Council Program 35,000.00
192 18 Big Island Resource Conservation and Development Council Nutrition Grown Farming Educational Program 20,000.00
Production of Organic Fertilizers from Recycled Organic Wastes on
184 19 Big Island Resource Conservation and Development Council Campus by Composting and Vermicomposting 30,000.00
18 20 Big Island Substance Abuse Council Community Outreach and Training 10,000.00
20 22 Big Island Substance Abuse Council East Hawaii Substance Abuse Treatment 50,000.00
21 23 Big Island Substance Abuse Council Hawaii Island Health&Wellness Multi-Disciplinary Treatment 50,000.00
22 24 Big Island Substance Abuse Council HIHWC Specialized Group,Couples,and Individual Therapy 50,000.00
38 25 Big Island Substance Abuse Council Intensive Case Management 50,000.00
24 26 Big Island Substance Abuse Council Ola Kino Program 35,000.00
26 27 Big Island Substance Abuse Council Pookela Vocational Training Program 45,000.00
27 28 Big Island Substance Abuse Council Provider Training 50,000.00
29 29 Big Island Substance Abuse Council Rural Wetness and Recovery 15,000.00
34 30 Big Island Substance Abuse Council Therapeutic Living(TLP)and Clean and Sober(CS)Housing 50,000.00
35 31 Big Island Substance Abuse Council West Hawaii Dual Diagnosis Treatment 50,000.00
37 32 Big Island Substance Abuse Council Youth Services 50,000.00
153 44 Boys to Men Mentoring Network of Hawaii Boys to Men Group Mentoring Program 50,000.00
212 46 Bridge House,Inc Vocational Skills Building Program 20,000.00
207 47 Bridge House,Inc. Clean&Sober Living Transitional Program 50,000.00
124 48 Center for Getting Things Started Farm to Family 50,000.00
162 49 Center for Getting Things Started FEAST Food Experiences for Agricutlure Science Training 40,000.00
139 51 Child and Family Service Alternatives to Violence 50,000.00
135 52 Child and Family Service Domestic Abuse Shelters 50,000.00
48 54 East Hawaii Cultural Council EHCC Lecture Series 5,000.00
93 55 East Hawaii Cultural Council Art Forward 5,000.00
203 56 East Hawai'i Cultural Council I HEART SUMMER(2024) 15,000.00
52 57 East Hawai'i Cultural Council Young At Art 20,000.00
14 58 Educators Of America Inc Building Cultural Bridges Program for the West Hawaii Complex 35,000.00
15 59 Educators of America Inc Mo'olelo Kailikea:The View from Kamakahonu 7,500.00
NONPROFIT GRANT APPLICANTS FOR FY 2023-24
74 60 Educators of America Inc Project Based Learning Support-Hawaii County 45,000.00
69 61 Family Support Services of West Hawaii Fatherhood Initiative20,000.00
32 62 Family Support Services of West Hawaii Healthy Keiki 20,000.00
167 63 Friends of Big Island Drug Court,Inc. Friends of Big Island Drug Court(FOBIDC) 20,000.00
54 65 Friends of the Children's Justice Center of East Hawaii,Inc. Special Needs,Enhancement,Support,Education&Training 15,000.00
11 66 Friends of the Palace Theater Annual Musical 15,000.00
16 67 Friends of the Palace Theater Hawaii International Film Festival 20,000.00
25 68 Friends of the Palace Theater Hawaiian Roots Festival of Talent 15,000.00
17 69 Friends of the Palace Theater Youth Theater Program 10,000.00
83 70 Full Life Renissance of Inclusion 15,000.00
161 72 Going Home Hawaii Hawar i Island Going Home Consortium 50,000.00
182 73 Going Home Hawaii Reentry and Recovery Housing 40,000.00
78 74 Goodwill Industries of Hawaii,Inc. Career Services 35,000.00
79 75 Goodwill Industries of Hawaii,Inc. Ho'olana Education and Arts Program 50,000.00 ,
81 76 Goodwill Industries of Hawaii,Inc. Ola I Ka Hana Youth Program 30,000.00
123 77 Grassroots Community Development Group La'au'Ohana'Eha 7,500.00
204 78 Grassroots Community Development Group Media Literacy 5,000.00
The Farmers'Market at Hamakua Harvest:Growing Economic
104 80 Hamakua Harvest,INC. Recovery and Community Resilience 30,000.00
198 81 Hamakua Institute Hawai'i Island Agriculture Partnership' 50,000.00
200 82 Hamakua Youth Foundation,Inc. Hamakua Youth Center 40,000.00
206 83 Hawaii Aquatics Foundation Elementary School Aquatic Safety Education Program 25,000.00
65 85 Hawaii Environmental Restoration Keau'ohana Native Rainforest Restoration 35,000.00
The Hawai'i Food System Leaders Internship:A Career Connected
195 86 Hawaii Institute of Pacific Agriculture Learning Pilot at Kohala High School 40,000.00
218 93 Hawaii Rise Foundation Kokua Keiki Sports Scholarship 50,000.00
12 94 Hawaii Rise Foundation Together We Can 50,000.00
96 95 Hawaii Society of Obstetricians and Gynecologists Hawaii County OB/GYN Resident Program 2023-2024 50,000.00
147 97 Hawai'i's Volcano Circus LTD Hiccup Circus 20,000.00
202 98 Hawai'i's Volcano Circus LTD Out On A Limb-Community Agriculture and Food Rescue Program 20,000.00
6 100 Heart Ranch Youth Mentorship Program 35,000.00
102 101 Hilo Community Players 46th Annual Shakespeare in the Park Festival 20,000.00
171 102 Hilo Community Players Annual Musical Theatre Program 30,000.00
180 103 Hilo Community Players Artist in Residence Program 20,000.00
132 104 Hilo Community Players Dinner with Divas 5,000.00
112 105 Hilo Community Players Disney in the Park 7,500.00
77 106 Hilo Community Players Kid-Shakesl 7,500.00
138 107 Hilo Community Players LBGTQIA+Outreach Through Theatre 5,000.00
145 108 Hilo Community Players Na Mea Hawai'i Theatre 7,500.00
158 109 Hilo Community Players Rising Stars 10,000.00
208 110 Holualoa Foundation for Arts&Culture dba Donkey Mill Art Center Exhibition Program 30,000.00
199 111 Holualoa Foundation for Arts&Culture dba Donkey Mill Art Center Youth Education&Mentorship Program 30,000.00
106 112 Honokaa Hongwanji Mission Katsu Goto Memorial Committee 45,000.00
80 113 Ho'ola Na Pua Continuum of Services for At-Risk Youth&Victims of Trafficking 25,000.00
NONPROFIT GRANT APPLICANTS FOR FY 2023-24
181 114 Hospice of Hilo Community Bereavement&Grief Support Counseling Program 20,000.00
164 115 Hospice of Kona,Inc Maluihi Grief Services 15,000.00
144 116 Hospice of Kona,Inc Nakamaru Hale,hospice residential care 40,000.00
211 117 Hui Aloha Kiholo Hoa Aina Program 25,000.00
121 118 Hui Pono Holoholona Low Cost Spay/Neuter Clinics 35,000.00
191 119 Humanity Hale Abuse Prevention&Diversity Training Program 50,000.00
186 120 Humanity Hale Art Therapy Program 50,000.00
185 121 Humanity Hale Hawaiian Arts Program 50,000.00
188 122 Humanity Hale Individual&Group Therapy Program 50,000.00
190 123 Humanity Hale Life Skills Program 50,000.00
193 124 Humanity Hale Permanent Supportive Housing Program 50,000.00
10 126 Innovations Public Charter School Foundation Na Kalai Ola-Life Navigators-Wellness Program 10,000.00
19 127 Island of Hawaii YMCA Aquatics-Sailing Program 15,000.00
2 128 Island of Hawaii YMCA Family Visitation Program 50,000.00
4 129 Island of Hawaii YMCA New Horizons Youth Program 25,000.00
126 130 Japanese Cultural Center of Kona Office Modernization 45,000.00
178 131 Junior Achievement of Hawaii,Inc. Future Proofing Hawaii Island's Keiki 30,000.00
84 132 Kahilu Theatre Foundation 2023-24 Kahilu Performing Arts,Education and Exhibits 50,000.00
-47 133 Kamuela Philharmonic Orchestra Society Community Concerts 20,000.00
46 134 Kamuela Philharmonic Orchestra Society Music Education Program 7,500.00
40 135 Keaukaha One Youth Development Hoola Hou-Hawaiian Warriorship Program 50,000.00
49 136 Keaukaha One Youth Development Hui Kui Hao-Welder's Hui 50,000.00
lomakualani Voyaging Canoe(formerly known as Hokualakai
50 137 Keaukaha One Youth Development Restoration Project) 50,000.00
53 138 Keaukaha One Youth Development Ka Uapo—UH-Hllo Kinesiology Collaboration Project 50,000.00
41 139 Keaukaha One Youth Development Na Anela Kai(formerly known as Junior Lifeguarding Program) 50,000.00
31 140 Keaukaha One Youth Development Paahana Vaa(formerly known as Youth Paddling Program) 50,000.00
30 141 Keaukaha One Youth Development RISE 21st Century After School Program 50,000.00
55 142 Keaukaha One Youth Development Temple Children Collaboration Project 50,000.00
42 143 Keaukaha One Youth Development VEX IQ Robotics Program 50,000.00
165 144 Koa Community Clinic,Inc dba Koa Community Health Foundation Perinatal Support Program 20,000.00
13 145 Kohala Animal Relocation and Education Service Veterinary Care and Spay/Neuter for Family Companion Pets 45,000.00
36 148 Kona Dance and Performing Arts,Inc. Youth After School and Weekend Program 15,000.00
156 151 Kuikahi Mediation Center Inc Community Mediation&Facilitation Services 15,000.00
157 152 Kuikahi Mediation Center Inc Conflict Prevention&Resolution Education 15,000.00
183 153 La'i'opua 2020 Board and Stone In Every Home 25,000.00
9 157 Little Big Tots Foundation Ike Loa 10,000.00
Adolescent Substance Abuse and Mental Health Treatment
70 158 Lokahi Treatment Centers Programs 35,000.00
66 159 Lokahi Treatment Centers Adult Substance Abuse and Mental Health Treatment Program 50,000.00
137 160 Lokahi Treatment Centers Anger Management Treatment Programs 30,000.00
Domestic Violence Offender Treatment Intervention(DVOTI)
115 161 Lokahi Treatment Centers Programs 30,000.00
197 162 Lokahi Treatment Centers Health and Fitness Recovery Program 15,000.00
148 163 Maika'i Health Corporation Maika'i Health Public Housing Project 50,000.00
NONPROFIT GRANT APPLICANTS FOR FY 2023-24
140 164 Maika'i Health Corporation Pilina Care at Home 50,000.00
214 165 MALA'AI The Culinary Garden of Waimea Middle School 25,000.00
217 166 MALA'AI The Hawaii Island School Garden Network 25,000.00
116 167 Malama 0 Puna Food Security Program 30,000.00
118 168 Malama 0 Puna Hawaii Tracker-Volcano Education Campaign 45,000.00
28 180 PETFIX Spay and Neuter Spay and Neuter Clinics 40,000.00
154 182 Project Vision Hawaii Mobile Showers 40,000.00
160 183 Project Vision Hawaii Street Medicine 45,000.00
130 184 Puna Canoe Club 'Alelauloa 50,000.00
131 185 Puna Canoe Club Nauliohiloone 50,000.00
169 188 Services for Seniors Inc. Services for Seniors 50,000.00
71 192 Special OlympicsSpecial Olympics East Hawaii 30,000.00
39 193 SPECIAL OLYMPICS HAWAII SPECIAL OLYMPICS WEST HAWAII-GENERAL FUND 15,000.00
A Multidisciplinary Team Approach to Holistic Legal Advocacy for
177 195 The Children's Law Project of Hawaii Children in Foster Care 20,000.00
173 196 The Children's Law Project of Hawai'i Project Permanence:Guardianships and Adoptions for At-Risk Kids 7,500.00
113 197 The Food Basket Inc. DA BOX Community Supported Agriculture 50,000.00
209 198 The Food Basket Inc. DA BUX Double Up Food Bucks 50,000.00
59 199 The Food Basket Inc. Emergency Food Program 50,000.00
58 200 The Food Basket,Inc. Keiki Backpack Program 50,000.00
60 201 The Food Basket,Inc. Senior Brown Bags Program 50,000.00
The Salvation Army,a California Corporation: DBA:The Salvation
88 203 Army Family Intervention Services Independent Living Skills Program-East Hawaii 10,000.00
The Salvation Army,a California Corporation: DBA:The Salvation
87 204 Army Family Intervention Services Puna Prevention and Outreach Programs 20,000.00
The Salvation Army,a California corporation; DBA: The Salvation
86 205 Army Family Intervention Services Project TLP Hilo 10,000.00
The Salvation Army,a California corporation;DBA: The Salvation
89 206 Army Family Intervention Services Cultural Based Program 10,000.00
8 207 Three Ring Ranch Inc Paws Across Water Hawaii 35,000.00
7 208 Three Ring Ranch Inc. Afterschool mentors,Pre-vets,Interns&Externs 10,000.00
109 209 VASH Hawaii Island VAP=Visitor Assistant Program 25,000.00
128 210 Vibrant Hawaii 'OAKA:'Opio Alliance for Kuleana Advancement 50,000.00
127 211 Vibrant Hawai'i Vibrant Hawai'i Streams 50,000.00
120 212 Volcano Art Center Cultural Connections Initiative 25,000.00
98 213 VOLUNTEER LEGAL SERVICES HAWAII Hawaii County Pop Up Clinics 5,000.00
Total 5,007,500.00
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205 6 Aloha Performing Arts Company Theatre Education Program dba Aloha Theatre 10,000.00
73 9 American Lung Association Vape Free Hawaii Island 50,000.00
176 11 Arc of Hilo 2023 King Kamehameha's Awesome Athletes Canoe Race 5,000.00
111 12 Arc of Hilo Career Exploration Program 25,000.00
23 21 Big Island Substance Abuse Council Community Outreach and Training 50,000.00
76 33 Boy Scouts of America,Aloha Council Hawaii Island Scouting Program 50,000.00
Academic Tutoring and Homework Support for Income-Challenged
103 34 Boys&Girls Club of the Big Island Youth 50,000.00
Building Income-Challenged Youth to Become Leaders on Hawaii
125 35 Boys&Girls Club of the Big Island Island 50,000.00
NONPROFIT GRANT APPLICANTS FOR FY 2023-24
Child Care and Youth Development Services for Hawaii Island
1 151 36 Boys&Girls Club of the Big Island Families 50,000.00
97 37 Boys&Girls Club of the Big Island Daily Meal Support for Income-Challenged Youth and Families 50,000.00
Daily Transport Services of Critical Needs Resources for Income-
101 38 Boys&Girls Club of the Big Island Challenged Youth,Kupuna,and Families 50,000.00
Healthy Lifestyles and Sports Programming for Income-Challenged
150 39 Boys&Girls Club of the Big Island Youth 50,000.00
122 40 Boys&Girls Club of the Big Island Mentoring for At-Risk Youth on Hawaii Island 50,000.00
SociaUEmotional Learning&Development for Hawaii Island Income-
119 41 Boys&Girls Club of the Big Island Challenged Youth 50,000.00
Wellness and Mental Health for Income-Challenged Youth and
143 42 Boys&Girls Club of the Big Island Families 50,000.00
107 43 Boys&Girls Club of the Big Island Youth and Community:Workforce Development Program 50,000.00
82 45 Brantley Center Inc Job Skills Development 50,000.00
5 50 Changemakers Community Economic Development Corporation RaisingChange Fund Development Network 30,000.00
201 53 ClimbHl ClimbHl Bridge 20,000.00
172 64 Friends of Hawaii Technology Academy Furniture,Fixtures,Equipment 50,000.00
1 71 Girl Scouts of Hawaii Hawaii Island Girl Scout Leadership Experience 20,000.00
105 79 Habitat for Humanity Hawaii Island Inc. Together We Build 35,000.00
Hawai'i Diaper Bank(a fiscally sponsored program of Hawaii
91 84 Hawaii Children's Action Network Children's Action Network) 50,000.00
94 87 Hawaii Island Adult Care,Inc. Hilo Adult Day Center 40,000.00
Hawaii Island HIV/AIDS Foundation dba Kumukahi Health+
194 88 Wellness Transgender/Non-Binary Support Services 50,000.00
146 89 Hawaii Island Home for Recovery,Inc.HIHR HIHR Kitchen and Pantry Outreach Programs 30,000.00
136 90 Hawaii Island Home for Recovery,Inc.HIHR HIHR Permanent Supportive Housing Program 30,000.00
142 91 Hawaii Island Home for Recovery,Inc.HIHR HIHR Transitional Shelter Housing Program 30,000.00
117 92 Hawaii Keiki Museum Support for ADA accommodations and outreach programs 50,000.00
213 96 HAWAII SWIM SHOW LLC HAWAII SWIM SHOW 50,000.00
44 99 Healthy Mothers Healthy Babies Coalition of Hawaii Mana Mama 50,000.00
210 125 Infinite Reach Hanai'Ai Hawaii 35,000.00
196 146 Kona Aloha Singers,Inc(KAS) Risers and Rehearsal Microphones for Directors 10,000.00
9 P
75 147 Kona Association for Retarted Citizens DBA/The Arc of Kona Health and Wellness for All Abilities 15,000.00
72 149 Kona Task Force on Feeding the Hungry Kona Task Force on Feeding the Hungry 10,000.00
155 150 KUA 0 Kanaueue West Hawaii Community Kitchen 45,000.00
133 154 Laupahoehoe Train Museum 'Aina-based Education for Youth and Community 15,000.00
134 155 Laupahoehoe Train Museum Honeybee Education Program Professional Development 10,000.00
85 156 Legal Aid Society of Hawaii Civil Legal Services for Rural Residents of Hawaii Island 10,000.00
189 169 Mental Health Kokua Residential Rehabilitation 50,000.00
100 170 Neighborhood Place of Puna Parenting 911 40,000.00
215 171 North Kohala Community Resource Center Building Capacity in North Kohala 30,000.00
92 172 Nostalgia Music Consortium,Inc. Nostalgia Jazz Lab 50,000.00
114 173 0 Kau Kakou Ka'u Coffee Trail Run 10,000.00
108 174 0 Ka'u Kakou Naalehu Resilience Hub 40,000.00
63 175 '0 Ka'u Kakou Family Fun Fest 10,000.00
62 176 '0 Ka'u Kakou Ka'u Sanitation 10,000.00
64 177 '0 Ka'u Kakou Keiki Fishing Tournament 10,000.00
61 178 '0 Ka'u Kakou Veterans Day Celebration 2,500.00
175 179 Ocean View Skatepark Association Ocean View Skatepark Association 30,000.00
NONPROFIT GRANT APPLICANTS FOR FY 2023-24
216 181 Pohaku Pelemaka Protect and Preserve Ka'akepa 20,000.00
3 186 Rainbow Tribal culture church of the mother earth Church of the mother earth Unified HI VIBE TRIBE 50,000.00
187 187 Re-use Hawaii Hawaii Island Expansion 50,000.00
110 189 Society for Kona's Education&Art Root&Rise Hawaii:Nature&Art as Therapy(NAT) 10,000.00
43 190 Society for Kona's Education&Art(SKEA) SKEA Art Camps 5,000.00
51 191 Society for Kona's Education&Art(SKEA) SKEA Workshops&Classes 5,000.00
90 194 Teach For America Teach For America Hawaii—Hawai'i Island Programming 50,000.00
141 202 The Housing and Land Enterprise of Hawaii County Development and Marketing 35,000.00
Ulu La au Waimea Nature Park Removal of Invasive and Dangerous
149 214 Waimea Outdoor Circle Trees 35,000.00
West Hawaii Community Health Center(dba Hawaii Island
159 215 Community Health Center) East Hawaii School-Based Health Centers 50,000.00
West Hawaii Community Health Center(dba)Hawaii Island
163 216 Community Health Center Outreach to Vulnerable Populations 45,000.00
45 217 YWCA Hawaii Island Developmental Preschool Developmental Preschool 50,000.00
129 218 YWCA of Hawaii Island Sexual Assault Support Services(SASS) 30,000.00
Total 2,142,500.00