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Home My WebLink AboutCOM 0676.000 2004-2006 •.'"+y~ William Takaba Harry Kim ~j',i,~~' nirec ~~r Algvor • Nancy E. Crawford nwa~j, o~.e«o~~ ~~I pj.Mli~ County of Hawaii Finance Department 25 Aupuni Stree[, Room 118 • Hilo, Hawaii 96720 (808)961-8234 • Fax (808)961-8248 February 3, 2006 - Stacy K. Higa, Chairman and Members of the Hawaii County Council Hawaii County Council _ 25 Aupuni Street Hilo, Hawaii 96720 RE: NONPROFIT ORGANIZATIONS In compliance with Chapter 2, Article 25 of the Hawaii County Code, I am submitting the applications from nonprofit organizations for your review and appropriation of funds for FY2006-07. Also enclosed is a list of the organizations with the name of their program and the amount they are requesting from the County. Should you have any questions, please feel free to call. William Takaba Director of Finance Enc. Applications for Nonprofit Grant Funds List of Nonprofit Grant Applicants LVote: Attached applications from nonprofit agencies are on file in the Clerk's Office. Cornm. No. Ref. Toy ~5E Re¢. Uate NONPROFIT GRANT APPLICANTS FOR FY2006-07 ORGANIZATION NAME PROGRAM NAME REQUESTED American Red Cross -Hawaii State Chapter Disaster Service $ 25,000.00 Adult Day Health/Life Skills The Arc of Kona (dba Kona Krafts) Trans ortation for Communit Access 27,000.00 The Bay Clinic, Inc. Violence Intervention Project with Youth Education Component 45,200.00 Big Island Substance Abuse Council East Hawaii Substance Abuse Program 50,000.00 Big Island Substance Abuse Council West HawaYi Substance Abuse Program 50,000.00 Brantley Center, Inc. Employment Rehabilitation 30,000.00 Bridge House, Inc. Vocational Skills Building Program 48,000.00 Child and Family Service Family Violence Continuum of Care Programs 10,000.00 Daughters of Hawat'i Hulihe'e Palace 160,000.00 East Hawaii Coalition for the Homeless Kihei Pua Emergency Shelter 45,000.00 East Hawaii Coalition for the Homeless Kihei Pua Transitional Housing Program 6,000.00 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers 65,000.00 Special Needs and Enhancement, Center Support, Friends of the Children's Justice Center of East Hawaii prevention/Education and Trainin Pro rams 20.000.00 Friends of the Children's Justice Center of West Hawaii Enhancement and Basic Needs Program 15,000.00 Goodwill Industries of Hawaii, Inc. Work Experience Program 29,500.00 Grassroots Community Development Group Kupukupu After-School Program 60,000.00 Habitat for Humanity Kona General Operating Support (as opposed to contruction) 25,000.00 Hawai I Centers for Independent Living Independent Living Services 15,000.00 Hawaii Island Adult Care, Inc. Hilo Adult Day Center 18,000.00 Hawaii Island HIV/AIDS Foundation Multi-Disciplinary HIV Case Management, Hilo 15,000.00 Hawaii Island HIV/AIDS Foundation Transmission Prevention for HIV+ Women in West Hawaii County 15,000.00 Hawaii's Volcano Circus Puna Performing Arts Festival 2006 30,000.00 Hui Okinawa Children's Cultural Day Camp 3,060.00 The Island of Hawaii YMCA Partners with Youth Services 60,000.00 Ka Hale O Na Keiki, Inc. Families-At-Risk Project 7,500.00 Kapi'olani Medical Center for Women & Children Kapio'lani Child Protection Center -West Hawaii 20,000.00 Title IV-B-West Hawaii Counselin & Su ortive Livin Pro~ect Kona Adult Day Center, Inc. Adult Day Care 30,000.00 Kona Literacy Council Kailua Learning Center 1,500.00 Ku'ikahi Mediation Center, Inc. Ku'ikahi Mediation Center 8,000.00 Laupahoehoe Train Museum Teaching, Tranportation and Technology 59,400.00 Mental Health Kokua Residential Rehabilitation Services 25,000.00 New Hope Christian Fellowship Under His Wings Street Ministry 10,000.00 Office for Social Ministry Care-A-Van 30,000.00 Office for Social Ministry Hawaii Island Food Bank 35,000.00 Office for Social Ministry Mobile Care Health Project 20,000.00 The Salvation Army - Family Intervention Services Ho'okala Adolescent Diversion Program 32,000.00 The Salvation Army -Family Intervention Services Youth Service Center Program - Honokaa 32,000.00 The Salvation Army -Family Intervention Services Youth Service Center Program -Puna 38,000.00 Special Olympics Hawaii -East Hawaii Special Olympics Hawaii - Easl Hawaii 12,000.00 Special Olympics HawaYi -West Hawaii Special Olympics West Hawaii General Funding 10,000.00 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program 20,000.00 Turning Point for Families, Inc. North Hawaii and Puna Groups 30,000.00 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter 22,000.00 West Hawaii Mediation Center Mediation Services 10,000.00 YWCA of Hawaii Island Empowering Alternatives Program 60,000.00 YWCA of Hawaii Island Hamakua Youth Center 50,000.00 TOTAL $ 1,429,160.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Agency Name: American Red Cross, Hawaii State Chapter Program Name: Disaster Service Agency Director: Coralie Chun Matayoshi, Chief Executive Officer Phone No.: 808-739-8101 Contact Person: Youline K. Kalima, County Executive Director Phone No.: 808-935-8305 Mailing Address: American Red Cross Hawaii County 55 iJlulani St., Hilo Hawaii 96720 Facility/Site Address: Site One: Hilo 55 iJlulani St., Hilo Hawaii 96720 Site Two: Kona 74-5615 Luhia St., Kailua-Kona, HI. 96714 Fax No.: 808-969-3673 Email address: . kalima e,hawaii.rr.com Name of CPA: Detor & Williams Phone No.: 808-531-0002 Mailing Address: 700 Bishop Street, Suite 1040 Honolulu, HI 96813 Amount of request for County Funds: $25,000 Prior Year(s) Funding: 03-04 04-OS OS-06 $5,000 $2,500 $5,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 1 1. Agency Mission Statement: The American Red Cross is a humanitarian organization led by volunteers and guided by its Congressional Charter and the Fundamental Principles of the International Red Cross Movement. Our mission is to prevent and alleviate human suffering by helping people prevent, prepare for, and respond to emergencies, and to provide disaster relief to the people of Hawaii 24 hours a day, 7 days a week, 365 days a year. 2. Program Description: When disasters strike our islands, you can count on the Hawaii State Chapter of the American Red Cross to be there, on the scene, providing assistance to the victims. Whether it's a fire in Hilo or a flood on Kauai, our staff and volunteers are prepared to help 24 hours a day, 7 days a week, 365 days a year. If a flood keeps senior citizens from their needed medication, Red Cross volunteers will be there to make sure their medication is replaced and that their emergency medical needs are addressed until they can safety return home. If a house fire destroys the school supplies of a young child, the Red Cross will help the family purchase replacement items so that the child can feel secure again. Since 1917, the Hawaii State Chapter of the American Red Cross has provided food, shelter, clothing and crisis counseling to the people of Hawaii, to help victims get back on their feet after a tragedy. People throughout the islands depend on the Red Cross to be prepared for and respond to everyday disasters and major disasters like Hurricane Katrina. With the threat of avian flu, bio-terrorist attacks, major natural disaster, and no end in sight for the withdrawal of troops from Iraq, the American Red Cross is more relevant and necessary than ever before. And with global warming and changing weather patterns, it is not "if," but "when" a major disaster in Hawaii will occur. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 2 Big Island Disasters: the Big Island has had more than its share of disasters over the years, including devastating tsunami, lava flows, flooding, heavy rains, high surf, earthquakes, brush fires, air crashes, explosions and hazardous material incidents. Whatever the incident, the Red Cross has always been there, ready to help those in need. The Hawaii Red Cross provides compassionate aid to people in Hawaii who fall victim to natural and man-made disasters that occur every 2-3 days in Hawaii. The vast majority of them live in low to moderate income areas, and since over half of them do not own their homes and have no property insurance, they are truly destitute after a fire destroys their home. Statewide, we respond to an average of 140 disasters statewide, affecting over 3,300 individuals per year. On the Big Island, we provided 156 families with disaster relief in the past 3 years. A major portion of the disaster victims we serve have incomes below the Poverty Guidelines set by the U.S. Housing & Urban Development, Federal Refister, Volumes 66, 67, 68, 69. Based on family income levels and size, our records show that over half of the Big Island disaster victims we serve live below the poverty level. In FY03, 50% were below poverty level; in FY04, 73% were below poverty level; and in FY05, 39% were below poverty level. For sure, the majority of our Big Island disaster clients are the poorest of the poor, living in households ranging from 1 to 13 people. In 2003, 41.6% of our client families made less than $7,500; in 2004, 56.2% made less than $7,500 per year. According to the 2004 State of Hawaii Data Book, the bottom 16.7% of the families in Hawaii make less than $25,000. Our records for the past 3 fiscal years show that an average of 74% of our Big Island disaster clients are within that bottom category making less than $25,000 per year. In 2003, 66.6% were in this bottom category; 2004 was 80.2%; and 2005 was 52.8%. While 46.5% of Hawaii's population is low to moderate income, a study of the zip codes of our Big Island disaster clients shows that up to 75% of them live in low to moderate income areas as defined by the CRA Wiz program utilized by local financial institutions. Most Big Island disaster victims rent (not own) their apartment or home, and have no property insurance. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 3 These facts demonstrate that the Red Cross is truly a safety net for victims of "every day" disasters who have nowhere else to turn. The Red Cross not only offers food, clothing, and shelter to those who may have lost everything they own, but volunteer caseworkers provide crisis counseling and emotional support to help these victims get back on their feet. The Red Cross is the only organization mandated by Congress to respond to disasters and provide emergency communication to military families, and the only local nonprofit organization that meets the needs of disaster victims any time of the day, 365 days a year. Over the past 3 years, we have spent over $65,000 on immediate emergency needs for Big Island disaster victims (about $22,000 per year). Beyond the "every day" disasters that we respond to every 2-3 days, the Red Cross is preparing for and will respond to major disasters like Hurricane Katrina, that may affect the entire population of Hawaii, especially those with special needs like the elderly, frail, handicapped, and poor. According to the 2004 State of Hawaii Data Book, 15.7% of the Big Island population (about 22,000 people) is below poverty level, which is our overall target population since the entire population of the Big Island is at risk for a major disaster. State of Hawaii Data Book 2004, Table 13.19. When disasters occur, the American Red Cross will be there to support the County of Hawaii by providing families with relief assistance in time of need. The Hawaii State Chapter is requesting $25,000 from the County of Hawaii to help subsidize the financial aid we provide to Big Island disaster victims, most of whom were already living below the poverty level before disaster struck. This amount does not even begin to cover the staff and volunteer training, equipment, and support needed to respond to every day disasters, as well as educate and prepare Big Island residents for the next major disaster that is sure to come. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 4 3. Total Budget and Position Count Total Program $157,000 Total Program Position Count 1.5 Bud et Total Agency $313,989 Total Agency Position Count 9.5 Bud et 4. Program Objectives: Overall Goal: To provide 24/7 emergency disaster response and relief to those in need on the Big Island after a disaster (man-made or natural). Objectives: 1. Provide for the immediate emergency needs of Big Island disaster victims (food, clothing, shelter, crisis counseling) 2. Support first responders like firefighters, police, civil defense, and others with food, water, and counseling during brush fires and other challenging incidents that threaten lives and property 3. Increase awareness of disaster preparedness to Big Island residents 4. Train Big Island volunteers in Red Cross disaster skills such as disaster assessment, casework, health services, crisis counseling, shelter management and mass care to increase our capacity to respond to disasters on the Big Island. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 5 5. Program Highlights: In Fiscal Year 2005 (hily 1, 2004 -June 30, 2005), the American Red Cross Hawaii County has achieved the following. • Reached 445 with Disaster Preparedness Information through community presentations. • Trained 125 individuals this past year in disaster courses in the communities of Hilo, Pahoa, Volcano, Kamuela, Keaau, Kona, Kapaau, Kealakekua, Honomu, Holualoa, Pepeekeo, Mountain View, Papaaloa, Paauilo, Ookala. • Opened 2 shelters during the Waikoloa Brush fires at Hawaii Preparatory Academy and the Waikoloa Hilton. • Certified 17 more volunteers to be able to respond to National disasters (total is now 50). 6 Big Island volunteers were deployed to the Gulf Coast to help Hurricane Katrina and Rita victims. • Responded to 25 disasters helping 36 families recover from their losses and begin rebuilding their lives. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 6 6. Performance Measures: FY 2004-OS FY 2005-06 FY 2006-07 Actual * Bud et * Estimate ~ Disaster Res onses 27 30 35 Disaster Assistance Cases 36 40 40 Mass Shelters O ened 2 2 2 Numbers Reached through Disaster Presentations in Communities 445 1,000 1,000 Trained Individuals in Dis. Res onse 125 150 100 Disaster Drills conducted 5 3 3 Disaster Re istered Nurses recruited 10 5 5 Disaster Mental Health Counselors ' Recruited ~ 4 10 10 Communit Partners 0 1 1 * if applicable 7. Program Expenditures: FY 2004-2005 FY2005-2006 FY2006-2007 ~ Actual Bud et Estimate Salaries and Wa es 78,000 83,000 85,000 Professional Fees 75 0 0 O erations 72,000 64,000 66,000 E ui ment 6,400 3,000 3,100 Materials Su lies 12,000 7,000 7,200 Other # Total 168,475 157,000 161,300 * if applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 7 8. Program Funding Source -Identify all funding sources (specific to this program only) Revenue Source FY2004-2005 FY2005-2006 FY2006-2007 Actual Bud et Estimate Hawaii Count 2,530 2,530 25,000 HI. Island United Wa 46,000 23,000 23,000 Pro ram Fees 0 0 0 Pro ram Material Sales 0 0 0 Contributions 4,414 4,000 4,000 TOTAL 52,940 29,530 52,000 9. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? We will be working on increasing Red Cross visibility in the community in order to then increase private individual and corporate donations from Big Island residents and businesses. We will also be looking at possible fundraising opportunities on the Big Island such as special events, along with major donor cultivation. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 Page 8 I (we) have read and understood all of the eligibility requirements, grant conditions, award procedures and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135-2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a Listing of other funding sources and an\mounts obtained during the award period. Failure to submit a timely complete and accurate Year end report may impact the evaluation of _~our ~ro~ram's or a ency's future funding requests. ~ ~-~S L~ Signature of Board President/Chair Date 1~~~/0(~ Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006 - 2007 The Arc of Kona (dba Kona Krafts) Adult Dav Health/Life Skills Transportation for Community Access Agency Director: Gretchen Lawson Phone No. (808)323-2626 Contact Person: Jeani Navarro Phone No. (808) 323-2626 Mailing Address: PO Box 127 Kealakekua, Hawaii 96750 Facility/Site Address: 81-1065 Konawaena School Road Kealakekua, Hawaii 96750 Fax No.: (808) 323-9444 Email Address: jeani@arcofkona.org Name of Accountant/CPA: Ann N. Fukuhara, CPA MBA An Accountancy Corporation Phone No.: (808) 961-5532 Fax (808) 934-8589 Mailing Address: PO Box 6691 Hilo, Hawaii 96720 Amount of Request for County Funds: $27,000.00 Prior Year(s) Funding: 03-04 04-05 05-06 $17,000 $17,000 $17,000 Agency Mission Statement: The Arc of Kona is a private non-profit organization for person with disabilities, their advocates, and families. We believe that people with disabilities are as individual in their needs, abilities and gifts as any other cross section of society. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 The Arc of Kona (dba Kona Krafts) Adult Dav Health/Life Skills Transportation for Community Access Program Description: The Arc of Kona operates an Adult Day Health (ADH) standard classroom program, which is CARF certified (the Rehabilitation Accreditation Commission) and serves 15 participants on a daily basis. Due to the Olmstead legislation that arose from a lawsuit (Olmstead vs. North Carolina) ADH programs are now required to be partially administered in the community. The Arc of Kona is seeking to secure funding to support our Adult Day Health classroom program in the areas of community access and transportation for the benefit of our Life Skills training program. All of the Arc of Kona participants in the ADH program have been identified as DD/MR by the State of Hawaii and have cognitive limitations that prevent them from living truly independently without extensive Life Skills training and transportation supports. These individuals do not make good judgments and therefore need supports to insure their safety and help with activities of daily living especially regarding regular access to community services and activities. In turn, participants have skills that can be accessed to benefit the community when provided with community access and transportation. This population has several risk and protective factors that we consider when designing a Life Skills training for them. First, this population is at risk of abuse, both sexual and physical, and need to be taught the skills for saying "NO" and for reporting abuse. They are also at risk for chronic disease and many have a high incidence of diabetes and heart problems related to weight and diet. And lastly they are at risk for being homeless and/or unprepared to prove they can live independently both with daily living skills and finances to prevent homelessness. Protective factors we consider include training in social development, appropriate sexual behaviors, protection from abuse including family members as well as strangers and preparing individuals to find their own housing accommodations and live as independently as possible, with or without other agency supports. Without adequate transportation supports, this population has only classroom theory to draw upon and is ill prepared to assume the role of an independent adult. The community as a classroom is essential to strengthening the protective factors around this vulnerable population. Money projected to be received for 2006-2007 via the Department of Health barely covers staff salaries and leaves the Arc of Kona with a $34,000.00 deficit at the end of the fiscal year. Specifically, the $27,000.00 request would be spent to enhance service delivery by paying costs associated with transportation to and NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 from home and classroom, and into the community for life skills training and activities. The dollars would pay for 60% of the transportation costs and 20% staffing and payroll taxes and 20% supplies and materials for the Life Skills training for independent living. Total Budget and Position Count FY 2005-2006 Total Pro ram Bud et $227,740.00 Total Pro ram Position Count 6 Total A enc Bud et $2,611,427.00 Total A enc Position Count 100 Program Objectives: (ADH Classroom) 1) Provide a safe, healthy, and supportive environment for daily living skills in the ADH classroom setting 6 hours per day 260 days per year from July 1, 2006 to June 30, 2007. 2) Provide individualized life skills training programs that allow each participant to develop at his or her own pace in order to live as independently as possible. 3) Insure access to community events and resources that will be a learning laboratory for independent living and reinforce skills taught in the classroom setting at a minimum of three times a week throughout the program year (7/06- 6/07) 4) Provide needed classroom materials to assess, instruct and support life skills, specific health and safety areas relating to abuse, appropriate sexual behavior, hygiene, money management and household safety issues. 5) Provide needed supports for interacting with each other and the public appropriately within the community daily throughout the program year so as to support independent living skills required to function on a day to day basis. Proposal Program Highlights: (ADH Classroom) 1) 15 participants are receiving daily lessons on health and safety as they pertain to daily living and toward independent living including information on hygiene and appropriate sexual behavior). 2) 15 participants have been able to access the community as required by law for independent living skills taught in the community. 3) 3 participants are seeking affordable housing so they can live independently with minimal supports. 4) One participant secured housing and is living independently for the first time in her life (with agency supports for some types of assistance). 5) One participant lives independently, with minimal supports, secured a drivers license, and is successfully employed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 The Arc of Kona (dba Kona Krafts) Adult Dav Health/Life Skills Transportation for Community Access Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate 1.Provide a safe, secure classroom 260 days of 260 days 260 days environment witn sufficient staff ADH standard 5 days per 5 days per supervision, 5 days a week, 52 weeks a classroom year, for 12-15 DD/MR participants. Week for 52 week for 52 activities with a weeks weeks one staff to four participant ratio 2. Provide access to the community for 144 transports 144 144 hands- on life skills training experiences into community transports transports including food shopping, ordering and for activities eating, handling money, laundry, clothing provided sho in that promote pp' g, making and getting to hands on Life appointments and seeking and securing Skills housing 3Xper week for 52 weeks per year. ex erience 3. Provide on-going Life Skills 260 days of 260 days of 260 days of assessments for classroom training classroom instruction will instruction including appropriate sexual behavior, instruction for be completed recognizing and reporting abuse, health, Life Skills and by June 30, hygiene and safety issues, and seeking daily living 2006. Post and securing housing. activities with testing is pre and post done on an testing for on-going assessment of basis for skill base line skills set success. and acquired skills at the end of the ear. Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $87,523 $153,837 $169,221 Professional Fees O erations $55,495 $46,700 $49,035 E ui ment Other' Total $143,018 $200,537 $218,256 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 The Arc of Kona (dba Kona Krafts) Adult Day Health/Life Skills Transportation for Community Access Program Funding Sources: identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate County of Hawaii $17,000 $20,000 $27,000 United Way $40,867 $40,867 Medicaid Waiver $166,873 $175,217 Residential FeelPass Through SSI $41,039 Tenant Rent (30% of clients' share $15,467 For Section 8 HUD Federal Funds $23,284 (70% Section 8 share of rent) Fund Raisin /Donations $13,032 $12,000 Total $109,822 $227,740 $255,084 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Arc of Kona has developed a professional marketing plan and fund raising component to increase our unrestricted funds. Traditionally the Arc holds an annual bazaar each November, and a Blue Grass concert at the Aloha Theater each January featuring Tom Rozum and Laurie Lewis (Blue Grass artists from the mainland). We also have plans this year for a wine tasting/auction event as well as a "phantom fund raiser". These are scheduled for late spring and early fall respectively. We do not anticipate that this program will be self sustaining for another three years when we have perfected the art of raising larger funds than our events are able to generate. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 The Arc of Kona (dba Kona Krafts) Adult Day Health/Life Skills Transportation for Community Access I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shalt include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will impact the evaluation of your arogram's or agency's future funding requests. Signature of oard Chair Date ' t ~ 1~ ~~.~-~(~ro Sign re of President/ EO Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 The Bay Clinic, Inc.- Agency Name Violence Intervention Project with Youth Education Component- Program Name Agency Director: Executive Director Robert Cooper Phone No.: *(808)934-3206 Contact Person: Belinda Cole-Schwartz Phone No.: (808)934-3244 Mailing Address: 311 Kalanianaole Avenue Hilo, HI 96720 Facility/Site Address: Pahoa Family Health Center 3 Government Rd., Pahoa, HI 96778 * Ka'u Family Health Center, 95-5583 Mamalahoa Hwy Fax No.: (808)934-3238 Email Address: bcoleC~bayclinic.org Name of AccountanUCPA (include name of firm if applicable): John Carbanaro from John Carbanaro CPA's Phone No.: (808)242-5002 Mailing Address: 1885 Main Street, Wailuku, HI 96793 Amount of Request for County Funds: $45,200.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Prior Year(s) Funding: 03-04 04-05 05-06 $20,000.00 $18,000.00 $0 Agency Mission Statement: Community directed and committed to improving the health and well-being of all people. Our mission will be accomplished by: 1. Providing high-quality accessible healthcare in a patient centered environment, regardless of an individual's ability to pay. 2. Working with the community in preventive healthcare and education. 3. Ensuring our services are sensitive to the cultural diversity of our community. 4. Taking a holistic approach to the treatment of our patients. 5. Advocating for improved healthcare and living conditions wherever the need is evident. 6. Cooperating and collaborating wherever possible, with other medical providers and organizations to improve the delivery of healthcare in our community. 7. Forming a partnership with our patients in planning a healthy future for themselves and their families. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 The Bay Clinic, Inc. -Agency Name Violence Intervention Project with Youth Education Component- Program Name Program Description: The Violence Intervention Project provides domestic violence services to rural Ka'u and Puna, by offering psycho-educational groups to court ordered men who batter, community education and awareness presentations that promote community and family safety, as well as classroom presentations to youth (12-18 years) in the public, charter and private schools. **Although we did not apply for funding last year, VIP continued to provide services through volunteer leadership, and in-kind services. We expanded the VIP message to youth in the classroom where our health educator speaks out on relationship violence; specifically what are the symptoms, how you can avoid it and what you can do to manage potentially hamrful situations. Educators offer options for youth who need guidance and referral who are in abusive relationships. Total Budget and Position Count Total Pro ram Bud et $64,930.00 Total Pro ram Position Count 3 Total A enc Bud et $7,768,325. Total A enc Position Count 95 Program Objectives: 1) *Maintain existing services (men's groups) in Puna and Ka'u. 2) *Assist in building community awareness on domestic violence and its effect on our community. 3) *Expand youth classroom presentations to include culturally relevant materials. 4) *Extend our community outreach on domestic violence education and referral with the creation of a local video and a Public Service Announcement to be aired on television. 5) *Assist in the establishment of women's and childrens services in Puna and Ka'u. Program Highlights: NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 1) VIP is the only program offering direct services to perpetrators of domestic violence in the isolated rural Puna and Ka'u districts. VIP Puna/Ka'u currently has 71 men attending class. VIP holds 48 mens groups in Puna every Tuesday evening, and 48 men's groups in Ka'u held every Thursday evening. Few of these men have access to legal transportation to Hilo or Kailua, many even have difficulty getting to Pahoa and Naalehu to fulfill their court mandated service plan. Failure to comply results in more court dates and re-sentencing to group education, a never ending cycle. Access to services in rural areas is critical to the safety of families and well-being of our community. 2) VIP extension is through the Bay Clinic health educators, who speak directly to youth on relationship violence and provide local referral. Our health educator speaks to youth age 12-18 in public, charter, and private schools as well as special need agencies, i.e. Interim home, BISAC, Baby safe. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 The Bay Clinic, Inc. -Agency Name Violence Intervention Program with Youth Education Component -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Men registered and interviewed to 71 75 85 attend VIP male group sessions in Puna and Ka'u district Men Com letin Pro ram, Pahoa 39 39 50 Men Com letin Pro ram, Ka'u 7 7 18 Intakes Pahoa 48 50 56 Intakes Ka'u 23 25 29 Youth attending class session on 2,125 2,125 2,130 relationship violence, located in Hilo, Puna and Ka'u districts *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es Professional Fees $18,000.00 $40,000.00 $47,200.00 O erations $18,000.00 $18,000.00 $18,000.00 E ui ment 0 0 $300.00 Other" $3,465.00 $6,930.00 $7,930.00 Total $39,465.00 $64,930.00 $73,430.00 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Program Expenditures -Narrative Professional Fees: FY 2004-OS Actual FY 2005-06 Bud et FY 2006-07 Estimate One lead group facilitator One group facilitator One group @ $18,000.00 per yeaz $18,000 per year one co- facilitator$20,000, one co- facilitator $12,000.00 and facilitator $14,OOOand one one .25 FTE health educator .25 FTE health educator $10,000.00 $13,200 with living increases O erations FY 2004-OS FY 2005-06 FY 2006-07 Fiscal Management, Office Fiscal Management, Office Fiscal Management, Office Space, Two sites, Phone, Space, Two sites, Phone, Space, Two sites, Phone, Pa er, Posta a Pa er, Posta a Pa er, Posta e E ui ment FY 2004-OS FY 2005-06 FY 2006-07 Two DVD/Video recorder at each site Other FY 2004-OS FY 2005-06 FY 2006-07 Mileage one facilitator Mileage one facilitator and Mileage one facilitator and 9,000 miles per year @ .385 one co-facilitator $18,000 one co-facilitator $18,000 -$3,465 miles per year @ .385 miles per year @ .385 =$6,930 =$6,930Milea e Documented media component 60 sec PSA + 20 minute video $1,000 The Bay Clinic, Inc. -Agency Name Violence Intervention Project with Youth Education Component -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii 0 0 $45,200.00 Pro ram Fees $5,265.00 $5,680.00 $6,290.00 In-Kind Services -Phone, Desk, $18,000.00 $18,000.00 $18,000.00 Liability Insurance, paper, postage, fiscal mana ement Total $23,265.00 $23,680.00 $69,490.00 `If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? We are actively pursuing grant opportunities. Currently we are writing to The Awareness Foundation and Kaiser Permanente Cares for Communities. We solicit donations from past donors for health education, clients and the community. Last year the program continued without county funding with the help of Lonnie Large, group facilitator, who has been doing group sessions for over 15 years. The Bay Clinic continued to offer its in-kind services providing fiscal accounting, a site, phone and office assistance. Although a "volunteer arrangement " is our last resort in continuing this program for rural Puna and Ka'u, we are dedicated to provide services for those who have no opportunity to attend in Hilo. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 The Bay Clinic, Inc. -Agency Name Violence Intervention Project with Youth Education Component -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate vear-end report will impact the evaluation of vour proaram's or agency's future funding requests. f~~~ G~ Sign t eura of Board PresidenUChair Date (~30 -~Ob ignature of Executive Dir for Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Agency Director: Dr. Stephen C. Zuniga Phone No.: 969-9994 Contact Person: Richard Teanio Phone No.: 935-4927 Mailing Address: 234 Waianuenue Avenue Suite 104, Hilo, HI 96720 Facility/Site Address: 297 Waianuenue Avenue Hilo, HI 96720 Fax No.: 969-7570 Email Address: LikekeT@bisac.com Name of Accountant/CPA (include name of firm if applicable): John Carbonaro, Carbonaro CPA's & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 03-04 04-05 05-06 $27,000 $27,000 $30,000 Agency Mission Statement: The Big Island Substance Abuse Council strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to the healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Program Description: The Big Island Substance Abuse Council's East Hawaii programs provide comprehensive substance abuse treatment services to adults and adolescents through research-based methods and best-practices designed for the area's target population. This population is primarily families to include, adolescents, parents and whole families who are experiencing substance abuse or dependency and require the structure of an institution such as BISAC to begin the process of recovery. BISAC recognizes the significant impact of crystal methamphetamine on this population and has designed programs to intervene in the addictive process and build on an individual's or family's strengths to abstain from the use of drugs and alcohol and increase protective factors and relapse prevention skills to maintain their rehabilitation. The East Hawaii BISAC programs provide outpatient treatment and therapeutic living services to adults and outpatient services (in both outpatient setting and in nineteen (19) school based programs island wide) to adolescents, giving special emphasis to pregnant women, HIV users, and those with co-occurring disorders. Several of the East Hawaii therapeutic living programs are designed to meet specific needs of the target population and include home-like settings for a variety of specialties including; mothers with children ages 0-5, fathers with children ages 5-12, women who are transitioning out of the Department of Corrections, single women, and single men. BISAC has also placed a strong emphasis on providing services to persons abusing or addicted to the drug Crystal Methamphetamine or, "Ice". The ice epidemic in East Hawaii is truly evident and requires immediate access to treatment services when the opportunity arises. BISAC is requesting funds to subsidize the Outpatient Treatment services to the Adolescents and Adults who present themselves at BISAC and require the immediate and intensive care necessary to recover from addiction. Total Budget and Position Count Total Pro ram Bud et 2,905,052 Total Pro ram Position Count 50 Total A enc Bud et 4,446,226 Total A enc Position Count 72 Program Objectives: 1) Provide immediate access to assessment and treatment services to individuals who are diagnosed with any substance related disorders. 2) Increase the availability of extended outpatient and therapeutic living program treatment services to addicted adults and adolescents who have no other funding availability for treatment services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 3) Decrease the number of days between when an individual requests treatment intervention services and the date that those services are delivered, by funding treatment-on-demand services while alternative reimbursement is identified. 4) Achieve understanding of disease concept of addiction and co-occurring disorders. 5) Identify potential for continued drug/alcohol and relapse risk with development of specific coping skills to reduce that risk within the first 30 days of treatment. 6) Demonstrate the severity of personal substance abuse issues through the completion of a written autobiography within the first 30 days of treatment. 7) Identify clean and sober social support networks and actively participate to identify and link with support systems in preparation for discharge. S) Identification of individualized protective factors that will significantly reduce risk factors, and has implemented a minimum of six within the first 90 days of treatment. 9) Complete 80% of identified treatment goals and has developed a transition plan to prepare for discharge within the first 90 days of treatment. Program Highlights: Was able to admit 1,340 adults and adolescents into all levels of outpatient substance abuse treatment and Therapeutic Living services. Follow-up data collected on adult and adolescent consumers who responded to the 6 month post-treatment survey disclosed the following: 63% of the adult consumers admitted into the outpatient and/or therapeutic living program services completed treatment Adolescents completed program objectives below adults (58%); however, 70% of the adolescent consumers admitted into outpatient services were able to remain abstinent 6 months post-treatment and had reduced their frequency of use of drugs and/or alcohol 74% of the adult consumers in outpatient treatment had no new treatment episodes Approximately 89% of the adult consumers reported having stable living arrangements 6 months post-treatment 100% of the adult therapeutic living program consumers reported no emergency room or hospital admissions post-treatment and fared better than adults admitted into the outpatient services by approximately 18% 67% of the consumers in the adult therapeutic living program services reported no new arrests post-treatment 77% of the adult consumers admitted into the therapeutic living programs had no significant psychological distress within 30 days post-treatment 100% of the adolescent consumers reported improved grades or attendance at the 6 month post-treatment follow-up 84% of the adolescents reported having no new juvenile arrest post-treatment 74% of the adolescent consumers reporting having improved social relationships NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Substance Abuse Treatment Units 26,144 29,338 29,522 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 1,706,239 1,976,194 2,035,480 Professional Fees 23,274 32,409 33,381 O erations 779,057 857,686 899,247 E ui ment 4,323 41,938 43,196 Other" "a" 30,786 Total 2,543,679 2,908,227 3,011,304 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count 27,000 30,000 50,000 State of Hawaii 1,079,935 1,595,140 1,642,995 Federal 959,470 852,179 877,744 HIUW 33,300 17,500 18,025 Trainin Fees 10,780 12,000 12,360 Donations/Fundraisin 7,012 4,500 4,635 Private Insurance 272,889 277,000 285,310 Client Fees 123,204 116,733 120,235 Total 2,513,590 2,905,052 3,011,304 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Big Island Substance Abuse Council continues efforts to diversify funding sources and expand services where appropriate throughout the State and Island of Hawaii. BISAC's adolescent treatment services grew by 3% last year and billing to 3rd party payors increased by 1 % to account for 11 % of BISAC's budget. Administrative fees increased by 2% and account for 8% of the revenue reported from July 1, 2004 through June 30, 2005. A conservative fiscal philosophy coupled with a team of skilled and dedicated staff members has enabled BISAC to expand and retain a positive, prominent presence in the community. BISAC's sound fiscal policies are incorporated into decisions related to program expansion or to enter market niches that would expand the behavioral health continuum. Business decisions include enrolling consumers in a Quest plan when eligible and appropriately utilizing benefits to cover treatment services. Administrative staff is scheduled to participate in meetings with HMSA and other substance abuse treatment providers to evaluate ways on increasing community awareness of insurance benefits and working with physicians to appropriately identify and refer consumers who may need treatment services that would be covered by HMSA insurance. BISAC plans to explore available funding that supports capacity building and sustainability efforts, and reduces our reliance on State and County funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Big Island Substance Abuse Council East Hawaii Substance Abuse Program I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end resort will impact the evaluation of vour program's or agency's future funding requests. ~ Signature of Boarcy resident/Chair Dafe Patricia Engelhard ~~l ~ O /7 2~oL Signature Executiv D~ ector' ate Dr. Stephen C. Zuniga UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Agency Director: Dr. Stephen C. Zuniga Phone No.: 969-9994 Contact Person: Marilyn McIntosh Phone No.: 322-3100 Mailing Address: 234 Waianuenue Avenue Ste 104, Hilo, HI 96720 Facility/Site Address: 81-947 Halekii Street, Kealakekua, Hawaii 96750 Fax No.: 969-7570 Email Address: Marilynm@bisac.com Name of Accountant/CPA (include name of firm if applicable): John Carbonaro, Carbonaro CPA's & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 03-04 04-05 05-06 $27,000 $27,000 $30,000 Agency Mission Statement: The Big Island Substance Abuse Council strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to the healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Program Description: The Big Island Substance Abuse Council's West Hawaii programs provide comprehensive substance abuse treatment services to adults and adolescents through research-based methods and best-practices designed for the area's target population. This population is primarily youth and young adults who are experiencing substance abuse or dependency and require the structure of an institution such as BISAC to begin the process of recovery. BISAC recognizes the significant impact of crystal methamphetamine on this population and has designed programs to intervene in the addictive process and build on an individual's strengths to abstain from the use of drugs and alcohol and increase protective factors and relapse prevention skills to maintain their rehabilitation. The West Hawaii BISAC programs provide outpatient treatment and therapeutic living services to adults and outpatient services (in both outpatient setting and in nineteen (19) school based programs island wide) to adolescents, giving special emphasis to pregnant women, HIV users, and those with co-occurring disorders. BISAC has also placed a strong emphasis on providing services to persons abusing or addicted to the drug Crystal Methamphetamine or, "Ice". The ice epidemic in West Hawaii is truly evident and requires immediate access to treatment services when the opportunity arises. BISAC is requesting funds to subsidize all Adolescents and Adults services that require the immediate and intensive care necessary to recover from addiction. Total Budget and Position Count Total Pro ram Bud et 1,536,675 Total Pro ram Position Count 22 Total A enc Bud et 4,446,226 Total A enc Position Count 72 Program Objectives: 1) Provide immediate access to assessment and treatment services to individuals who are diagnosed with any substance related disorders. 2) Increase the availability of extended outpatient and therapeutic living program treatment services to addicted adults and adolescents who have no other funding availability for treatment services. 3) Decrease the number of days between when an individual requests treatment intervention services and the date that those services are delivered, by funding treatment-on-demand services while alternative reimbursement is identified. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 4) Achieve understanding of disease concept of addiction and co-occurring disorders. 5) Identify potential for continued drug/alcohol and relapse risk with development of specific coping skills to reduce that risk within the first 30 days of treatment. 6) Demonstrate the severity of personal substance abuse issues through the completion of a written autobiography within the first 30 days of treatment. 7) Identify clean and sober social support networks and actively participate to identify and link with support systems in preparation for discharge. 8) Identification of individualized protective factors that will significantly reduce risk factors, and has implemented a minimum of six within the first 90 days of treatment. 9) Complete 80% of identified treatment goals and has developed a transition plan to prepare for discharge within the first 90 days of treatment. Program Highlights: Was able to admit 629 adults and adolescents into all levels of outpatient substance abuse treatment and Therapeutic Living services. Follow-up data collected on adult and adolescent consumers who responded to the 6 month post-treatment survey disclosed the following: 63% of the adult consumers admitted into the outpatient and/or therapeutic living program services completed treatment Adolescents completed program objectives below adults (58°Jo); however, 70% of the adolescent consumers admitted into outpatient services were able to remain abstinent 6 months post-treatment and had reduced their frequency of use of drugs and/or alcohol 74% of the adult consumers in outpatient treatment had no new treatment episodes Approximately 89% of the adult consumers reported having stable living arrangements 6 months post-treatment 100% of the adult therapeutic living program consumers reported no emergency room or hospital admissions post-treatment and fared better than adults admitted into the outpatient services by approximately 18% 67% of the consumers in the adult therapeutic living program services reported no new arrests post-treatment 77% of the adult consumers admitted into the therapeutic living programs had no significant psychological distress within 30 days post-treatment 100% of the adolescent consumers reported improved grades or attendance at the 6 month post-treatment follow-up 84% of the adolescents reported having no new juvenile arrest post-treatment 74% of the adolescent consumers reporting having improved social relationships NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Pertormance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Substance Abuse Treatment Units 10,986 14,302 14,731 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 745,834 1,091,047 1,123,778 Professional Fees 22,493 14,829 15,274 O erations 373,951 418,486 450,139 E ui ment 11,567 12,313 12,682 Other" Total 1,153,845 1, 536,675 1,601, 874 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count 27,000 30,000 50,000 State of Hawaii 640,195 1,067,598 1,099,625 Federal 217,706 179,077 184,449 HIUW 8,585 17,500 18,025 Private Foundation 93,685 0 0 Donations/Fundraisin 2,525 3,000 3,090 Private Insurance 122,505 201,000 207,030 Client Fees 33,728 38,500 39,655 Total 1,145,929 1, 536,675 1,601,874 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Big Island Substance Abuse Council continues efforts to diversify funding sources and expand services where appropriate throughout the State and Island of Hawaii. BISAC's adolescent treatment services grew by 3% last year and billing to 3`d party payors increased by 1 % to account for 11 % of BISAC's budget. Administrative fees increased by 2% and account for 8% of the revenue reported from July 1, 2004 through June 30, 2005. A conservative fiscal philosophy coupled with a team of skilled and dedicated staff members has enabled BISAC to expand and retain a positive, prominent presence in the community. BISAC's sound fiscal policies are incorporated into decisions related to program expansion or to enter market niches that would expand the behavioral health continuum. Business decisions include enrolling consumers in a Quest plan when eligible and appropriately utilizing benefits to cover treatment services. Administrative staff is scheduled to participate in meetings with HMSA and other substance abuse treatment providers to evaluate ways on increasing community awareness of insurance benefits and working with physicians to appropriately identify and refer consumers who may need treatment services that would be covered by HMSA insurance. BISAC plans to explore available funding that supports capacity building and sustainability efforts, and reduces our reliance on State and County funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Big Island Substance Abuse Council West Hawaii Substance Abuse Program I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will impact the evaluation of your program's or agency's future funding requests. ~ / _ ~ ClC ~li/ei Yj ~w~ ~~C'~I~CC'~ / 1P e3/ Signature of Board PresidentlChair D t Patricia Engelhard ~ ~ !7 oZOeG Signatur of Ex u ~ e Director Dat Dr. Stephen C. Zuniga UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Brantley Center, Inc.-Agency Name Employment Rehabilitation- Program Name Agency Director: Cami Post Phone No.: 775-7245 Contact Person: Cami Post Phone No.: 775-7245 Mailing Address: P.O. Box 1407, Honokaa, HI 96727 Facility/Site Address: 45-370 Ohelo Rd., Honokaa, HI 96727 Fax No.: 775-0211 Email Address: bcenter2@verizon.net Name of Accountant/CPA (include name of firm if applicable): Jennifer L. Gossert, CPA Phone No.: (808) 969-3115 Mailing Address: 688 Kinoole St., Suite 201, Hilo, HI 96720 Amount of Request for County Funds: $ 30,000 Prior Year(s) Funding: 03-04 04-05 05-06 $21,000 $21,000 $ 23,000 Agency Mission Statement: To provide quality services in addressing community needs for vocational training and independent living skills training to people with mental, emotional, and/or physical disabilities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Brantley Center, Inc. -Agency Name Employment Rehabilitation -Program Name Program Description: The Employment Rehabilitation Program provides participants with a variety of services that develop and support the accomplishment of goals leading to meaningful competitive employment. These services include: vocational evaluations, work adjustment training, occupational skills training, job-readiness classes, competitive employment placement services, and follow-up services while on-the-job. Participants receive quality vocational training and at the same time are paid for the work they perform. Program staff work closely with the community to provide community-based vocational training, and at the same time provide the public with an additional work force. Also included in this program are work transitional services for high school students. The Center's staff work with high school counselors to transition students with disabilities from a school environment to a work environment. Total Budget and Position Count Total Program Budget 221,540 Total Program Position Count 5.1 Total Agency Budget 427,066 Total Agency Position Count 9.0 Program Objectives: 1) Provide vocational evaluations to 30 consumers. 2) Provide individualized employment planning services to 20 consumers. 3) Provide work adjustment training to 26 consumers. 4) Provide vocational skills training to 26 consumers. 5) Provide specialized job-readiness classes to 20 consumers. 6) Provide competitive job placement and follow-up services to 12 consumers. 7) Provide work transition services to 14 high school students with disabilities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Brantley Center, Inc. -Agency Name Employment Rehabilitation -Program Name Program Highlights: 1) Provided vocational evaluations to 18 consumers. 2) Provided individualized employment planning services to 12 consumers. 3) Provided work adjustment training to 16 consumers. 4) Provided vocational skills training to 18 consumers 5) Provided specialized job-readiness classes to 13 consumers 6) Placed 9 consumers in competitive employment. 7), Provided work transition services to 8 high school students with disabilities. Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Number of consumers who 25 30 30 receive employment rehabilitation services. Number of consumers with 15 20 20 improved scores on the Vocational Evaluation and Training Report Number of consumers who 14 20 20 increased their productivity percentages. Number of consumers who 9 18 18 successfully completed the job- readiness class. Number of consumers placed in 7 10 10 competitive employment for a minimum of 90 days. Number of students who received 8 15 15 work transition services. 'If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Brantley Center, Inc. -Agency Name Employment Rehabilitation -Program Name Program Expenditures: FY 2004-05 FY 2005-05 FY 2006-07 Actual * Budget * Estimate Salaries and Wages 74,302 128,475 132,329 Professional Fees 14,000 14,000 14,000 Operations 65,725 69,914 72,711 Equipment (Yard) 2,500 Other" 154,027 212,389 221,540 * if appiicable Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004- FY 2005- FY 2006-07 05 Actual " 06 Budget Estimate County Mass Transit 8,400 8,400 8,400 State of Hawaii 30,000 30,000 30,000 Hawaii Island United Way 18,000 26,000 26,000 County of Hawaii Nonprofit Grant 0 23,000 30,000 Sales & Services 97,627 106,666 120,000 Other (fundraising & special events) 18,323 7,140 Total 154,027 212,389 221,540 'If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Brantley Center, Inc. -Agency Name Employment Rehabilitation -Program Name Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Last fiscal year sixty-three percent of the total cost to provide employment rehabilitation services was funded by the Center's private funds generated by services made available to the public. Brantley Center, Inc. continues to expand these services working toward decreasing dependency on government funds. However, it is essential that State and County funding are available to assist the Center in reducing people with disabilities financial dependence on welfare or Supplemental Security Income. The training and supports provided by the Employment Rehabilitation Program have enabled people with disabilities to obtain employment and become financial self-sufficient. For fiscal year 2006-2007 Brantley Center, Inc. plans to expand our Diversified Agricultural Program by developing a plant nursery. This will provide participants with additional training opportunities and at the same time increase program revenue. The Administrator has submitted a proposal to the HLP Hamakua Community Foundation for financial assistance. The Center's Board of Directors and Administrator plan to increase large donor contributions through special invitations to the Center to show case our program services. NONPROFI'T' GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Brantley Center, Inc. -Agency Name Employment Rehabilitation -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal near. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate vear-end resort will impact the evaluation of vour program's or agency's future funding requests. l~ v G Signature of Board Presid Chair Date l ~ C.ivru UI WSJ D~ Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 BRIDGE HOUSE, Inc.-Agency Name Vocational Skills Building Program- Program Name Agency Director: Mark Schuster, M.A. Phone No.: 808-322-3305 Contact Person: Mark Schuster Phone No.: 808-322-3305 Mailing Address: P.O. Box 2489 Kailua-Kona, HI 96745 Facility/Site Address: 78-6687-A Mamalahoa Hwy. Holualoa, HI 96725 Fax No.: 808-322-0809 Email Address: mark_bridgehouse@earthlink.net Name of Accountant/CPA (include name of firm if applicable): Brenda Smith, Smart Solutions Phone No.: 808-960-5041 Mailing Address: P.O. Box 1164 Captain Cook, HI 96704 Amount of Request for County Funds: $48,000.00 Prior Year(s) Funding: 03-04 04-05 OS-O6 $17,000.00 $18,000.00 $0.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Agency Mission Statement: The Bridge House mission is to assist adults who are in early recovery from drug and alcohol addiction to develop successful living skills through residential and vocational experiences in a safe, structured and supportive environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Bridge House, Inc. -Agency Name Vocational Skills Building Program- Program Name Program Description: The Vocational Skills Building Program is a specialized component of Bridge House that provides assessment, referral and linkages, and training to program residents, that will enable graduating residents to secure and maintain successful employment upon discharge. Funding of the full amount requested would allow us to create ahalf-time position of "Program Manager", who would be responsible for overseeing and expanding the current program, including the development of the currently idle growing grounds of approximately five acres. Funds would also be utilized to obtain supplies and plant stock that would enable Bridge House to begin to develop our'on-site' growing grounds, thus enabling us to provide more vocational opportunities within the confines of our property. This should also lead to increased agency self-sufficiency, as what is eventually produced may be sold in the open market. Bridge House has already been the recipient of in-kind support from several community resources (e.g. UofH Agricultural Extension Program; Agro Resources, Inc.) who have expressed a strong commitment to continuing to provide us ongoing support to bring this part of the vocational program to fruition. Also, we have already received $2,000.00 in donations to help initiate this phase of the program. Total Budget and Position Count Total Pro ram Bud et 67,180.00 Total Pro ram Position Count 1.5 Total A enc Bud et $312,020.00 Total A enc Position Count 5 Program Objectives: 1) All incoming residents to complete an "initial vocational/employment evaluation". 2) A vocational plan is developed that identifies areas of need, e.g. skills building/training, enhancement of atttitude and behavior, continuing education, job coaching, resume preparation, mock interviews, job hunting, etc. 3) All residents must contribute a minimum of 15 hours per week, in the manner of a practicum, of some form of labor back to the Bridge House 'ohana. This allows for on-site staff evaluation of attitude, commitment, and assessment of job readiness. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 4) At approximately 90 days of program participation, staff and resident complete apre-employment evaluation that assesses willingness to participate, punctuality, ability to establish and meet goals, and other items related to employment readiness. 5) Between 100-130 days of residency, individuals are encouraged and assisted to begin a job search for appropriate employment. Staff transports residents to and from resource centers (e.g. WorkForce Development) and job interviews, assists in the completion of employment applications, assists in resume preparation, and provides equipment such as computer, fax machine and copy machine to facilitate the job search process. 6} Upon securing a job, fridge House staff will provide the resident transportation to and from the worksite. Program Highlights: 1) Bridge House did not apply for a grant during Fiscal Year 2005-2006. However, we were a recipient of a grant during FY 200405, and highlights for that period will follow. 2) At the time of their admission, over 90% of the 48 admitted residents were deemed "unemployable". 3) 21 individuals successfully completed the program (i.e. obtained "clinical discharge"). 4) Three months post-discharge, over 60% of graduates remained employed in full-tme positions. 5) Six months post-discharge, 50% of graduates remain employed in full-time positions. 6) All 21 graduates had also obtained clean and sober housing, prior to discharge. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Bridge House, Inc. -Agency Name Vocational Skills Building Program -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate 65% of admits will obtain a clinical 44% 46% 50% dischar e. 50% of clinical discharges will be 50% 62% 70% employed, in school, or in a job- training program at 6 months post- dischar e. *If applicable program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 1,042.00 1,042.00 38,880.00 Professional Fees 1,199.00 1,199.00 1,800.00 O erations 12,903.00 12,903.00 16,500.00 E ui ment 2,856.00 2,856.00 10,000.00 Other* Tbtal 18,000.00 18,000.00 67,180.00 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Bridge House, Inc. -Agency Name Vocational Skills Building Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Hawaii Island United Wa 13,000.00 16,000.00 16,992.00 Donations 2,000.00 Total 18,992.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining Bridge House is anticipating submitting applications for additional grants, particularly through the U.S. Department of Agriculture, which is currently offering grants aimed at developing and enhancing agricultural resources. These grants would allow for the development of on-site agricultural opportunities (Bridge House is situated on property that includes approximately 5 acres of prime growing grounds available for use). This would enable Bridge House to offer on- site vocational training, and possible employment to qualified graduating residents. Additionally, whatever is grown (food crops, landscape plants) would be sold at market. With appropriate funding, the Vocational Skills Building Program could become self-sustaining within two years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 _ Bridge House, Inc. -Agency Name Vocational Skills Building Program -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will impact the evaluation of your program's or aaencv'~s future funding requests. Signature of Board President/Chair D e 2~ Signature of Executive Director D e UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Child and Family Service ~ 0 P Family Violence Continuum of Care Programs Agency Director: Patti Bates, Interim President and CEO Phone No.: 681-3500 Contact Person: Heidemarie Koop Phone No.: 323-2664 Danielle Spain 935-2186 Mailing Address: Child and Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 Facility/Site Address: West Hawaii: 81-6587 Mamalahoa Hwy, Kealakekua 96750 East Hawaii: 460 Kilauea Avenue, Hilo, HI 96720 Fax No.: 808 323-2999 West Hawaii 808 961-2073 East Hawaii Email Address: Abates a(~.cfs-hawaii.org Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPA's, inc. Phone No.: 524-2255 Mailing Address: American Savings Bank Tower, 1001 Bishop Street, Suite 1700, Honolulu, Hawaii 96813-3696 Amount of Request for County Funds: $ 5,000.00 Community Information and Health Education -West Hawaii $ 5,000.00 Domestic Abuse Shelter -East Hawaii $10.000.00 Total Prior Year(s) Funding: 03-04 04-05 05-06 $5,000 $0 $9,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Child and Family Service Family Violence Continuum of Care Programs Agency Mission Statement Since 1899, Child and Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". Child and Family Service offers an integrated and comprehensive human service and behavioral health care delivery system throughout the State of Hawaii. It provides a large array of clinical and non-clinical services that address serious social problems impacting our community. Child and Family Service is known in the community for its willingness to work with hard to engage individuals and families facing a multitude of difficult problems. As community populations present with increasingly complex problems and situations, CFS will be at the forefront of developing the skills, knowledge, and service models to address these needs. Program Description Funds are requested to support two programs of Child and Family Service that address the family violence continuum of care. These two programs are Community Information and Health Education in West Hawaii and the Domestic Abuse Shelter (DAS) in East Hawaii. These programs educate and serve individuals in the communities of East and West Hawaii, addressing the issues of domestic violence and/or sexual abuse. Funding is being requested to provide extensive training for the staff members of these two programs. Child and Family Service has provided Community Information and Health Education since 1994 and has developed a program that has been widely respected in the West Hawaii community. This program provides services, such as educational presentations and referral information to individuals regarding family planning and issues related to sexual violence, domestic violence and safety. Services are provided through direct and indirect contact with individuals, groups and training of paraprofessionals in the community. Direct service includes direct contact with the targeted population/consumer. Indirect service targets relaying information and education to the general public through exhibits such as bulletin board announcements, flyers, public service announcements via radio stations and local cable television broadcasts, and heath fair presentationsfbooths. In addition, indirect services are also conducted through trainings of other paraprofessionals in the community, who in turn provide direct services to consumers. The program has become unique to the community in West Hawaii since the psycho-educational approach to the general and hard-to- reach population relies on information education without regard for ethnicity, gender, sexual preference, religious, socioeconomic circumstance and physical conditional. The Community Information and Health Education program is funded through the Department of Health and even though funding received does not fully support NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Child and Family Service Family Violence Continuum of Care Programs the operation of the program, CFS remains committed to providing quality services to the community. Educational efforts include engaging hard-to-reach populations to include but not limited to adolescents, the homeless, disabled, uninsured or underinsured women, men, substance abusers and the general population. During the presentations, which are conducted in groups or on a one to one basis, the Health Educator also provides information on community resources the individual or family can access, including counseling services and medical referrals. The Domestic Abuse Shelter in East Hawaii is open to victims of domestic violence and their children on a 24-hour basis. Shelter and supportive services are provided to the residents of the shelter to help them break the cycle of violence and to make positive changes in their lives through education, counseling and support. CFS has operated the Domestic Abuse Shelter in East Hawaii since 1995 and unfortunately, the Department of Human Services does not cover the full cost of running this program. At CFS, we have a "no turn away" policy for our Shelter services. Turning away someone can endanger the life of an individual and{or their children, so we always make room for more. Therefore, services are still offered though resources are limited. Both programs will utilize funding by offering their employees in-depth training that focuses on domestic violence and sexual abuse. This expertise is greatly needed in the education of the community in understanding the role and cycle of sexual violence. Total Budget and Position Count Total Pro ram Bud et 253,436 Total Pro ram Position Count 15 Total A enc Bud et 5,116,355 Total A enc Position Count 84 Program Objectives Objectives for the Community Information and Health Education specify that: 1) 80°I° of all participants of a presentation will show an increased knowledge of the information presented regarding sexual violence awareness through pre and post tests. 2) 90% of people participating in the program presentations will complete and indicate a high level of satisfaction of the presentations based on the information provided regarding sexual violence. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Child and Family Service Family Violence Continuum of Care Programs Objectives for the Domestic Abuse Shelter specify that: 1) 80% of clients will show an increase in self-esteem. 2) 75% of clients will have an increase in knowledge of community resources. 3) 80% of clients will have obtained increased knowledge and understanding of domestic violence and its effect on themselves and their children. 4) 80% of clients in the shelter for at least 4 weeks will identify at least 3 skills to cope with verbal abuse and 3 skills to cope with physical abuse and understanding of the cycle of violence. 5) 90°I° of clients in the shelter for four weeks will have completed a personalized safety plan by discharge. (i) 60% of single adults and families will move from the shelter to anon- abusive home environment. 7) 80% of clients will feel supported regarding domestic violence. 8) 80% of returned client satisfaction surveys will show services to be satisfactory. Program Highlights Community Information and Health Education -West Hawaii (FY 2005) Child and Family Service in West Hawaii has provided Family Planning services consistently since 1994 and has developed a program that has been widely respected in the West Hawaii community. Services are offered to a hard-to- reach population, youth and families in schools, to clients of other agencies or organizational programs and to families. Over the past three years, indirect contact services have significantly increased and information and education are reaching more and more people. Furthermore, program outcomes have exceeded expectations for direct and indirect contacts for 11 years. In Fiscal Year 2005, the program provided the following: • 590 Direct Client Services • 8,028 In-Direct Client Services (201 % over projected goal) NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Child and Family Service Family Violence Continuum of Care Programs The program also achieved 100% for the following goal: • Participants demonstrated increased knowledge after the presentation based on pre- and post tests Domestic Abuse Shelter -East Hawaii (FY 2006) In Fiscal Year 2005, CFS provided safety to 76 adults and 91 children. During this period, our DHS contract requirement was to provide 3647 nights of safety (bed days). Instead, CFS provided 5104 nights of safety, or 140% of the contract requirement. In addition, the program served 344 individuals accessing the crisis hotline for crisis intervention services and provided 54 adults and 43 children with individual, group, dyad and/or family therapy. The program also achieved 100% of its outcomes for the following goals: Adult participants complete a personalized safety plan Participants have increased knowledge of community resources Returned client satisfaction surveys show that services are satisfactory Performance Measures FY 2004-05 FY 2005-08 FY 2006-07 Actual Bud et * Estimate Community Information and Health Education # of EducationlOutreach Activities 590 1,000 1,000 # of In-Direct Contact 8,028 4,000 4,000 Domestic Abuse Shelter # of hotline calls received from 869 750 750 ublic # of persons who were provided 167 225 225 shelter # of psycho-education hours 278.5 260 260 provided to families residing at the shelter 'If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Child and Family Service Family Violence Continuum of Care Programs Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Salaries and Wa es Not a plicable 0 Professional Fees Not a licable 0 O erations Not ap licable $4,500.00 E uipment Not ap licable $4,500.00 Other' Not a licable 0 $10,000 Total Not applicable $9,000.00 $10,000 If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only} Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Department of Health (Community $24,500.00 $24,500.00 $24,500.00 Information and Health Education Department of Human Services $253,436.00 $253,436.00 $253,436.00 Domestic Abuse Shelter Total $277,936.00 $277,936.00 $277,936.00 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Child and Family Service strives to achieve sustainability for all its programs. Yet, Child and Family Service is also committed to support critical services in the community despite their budgetary limitations. Child and Family Service is active in writing grants for supplemental funding to keep its critical programs operating. Providing high quality training for employees is critical in offering consistent effective interventions and services in the community of Hawaii. The goal is to implement a "train the trainer" model; train the trainer who can then train other employees in West and East Hawaii. This training will benefit the greater community since Child and Family Service will be able to share their knowledge and skill with other professionals in the community. Additionally, program employees will be offered opportunities to attend statewide and local training. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Child and Family Service Family Violence Continuum of Care Programs Attachment for Expenditure Other The West and East Hawaii teams are looking at two training opportunities on the mainland. These training sessions focus primarily on domestic violence and sexual abuse treatment. The National Coalition Against Domestic Violence is offering their 12'h National Conference on Domestic Violence in Atlanta, Georgia. "Organizing for Collective Power' is the focus in working with advocates and allies to end domestic violence. Workshops include addressing issues for women, men and children. The objective of the conference is to build leadership in communities to end the violence in people's life through the provision of community-based, non-violent alternatives. The San Diego Conference focuses on multi-disciplinary best-practice efforts to prevent, if possible, or otherwise to investigate, treat, and prosecute child and family maltreatment. The objective of the San Diego Conference is to develop and enhance professional skills and knowledge in the prevention, recognition, assessment and treatment of all forms of maltreatment including those related to family violence and substance abuse as well as to enhance investigative and legal skills. Issues concerning support for families, prevention, leadership, policy making and translating the latest research into action are also addressed. Taught by nationally recognized leaders in the field of child maltreatment, these seminars offer hands-on, skills-based training grounded in the latest empirical research. Additionally, program employees will be offered opportunities to attend statewide and local training. Child and Family Service is actively participating in the private, not-for-profit organization of the Hawaii State Coalition Against Domestic Violence (HSCADV) which provides education and training on family violence to the community. The next step for Child and Family Service is to participate actively in statewide and local training. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Child and Family Service Family Violence Continuum of Care Programs I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. ins Signature of Board President/Chair Date Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 Daughters of Hawaii- Agency Name Hulihe'e Palace- Program Name Agency Director: pavid Scott Phone No.: 595-6291 Contact Person: Same Phone No.: Same Mailing Address: Daughters of Hawaii 2913 Pali Hwy, Honolulu, HI 96817 Facility/Site Address: Hulihe'e Palace 75-5718 Ali'i Dr., Kailua-Kona, HI 96740 Fax No.: 595-4395 Email Address: davidscott49Qnetzero.com Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPA's Inc. Phone No.: 524-2255 Mailing Address: American Savings Bank Tower, 1001 Bishop St. Ste 1700, Honolulu, HI 96813-3696 Amount of Request for County Funds: $160,000 Prior Year(s) Funding: 03-04 04-05 05-06 $ $ $190,000 from State and private funds Agency Mission Statement: Preservation of the spirit and memory of old Hawaii and perpetuation of Hawaiian place sites and language. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Daughters of Hawaii - A ency Name Hulihe'e Palace- Program Name Program Description: Hulihe'e Palace was built on the shore of Kailua Bay in 1838 as the personal residence of Governor John Adams Kuakini. Long used by members of the royal family, it was acquired and restored by King Kalakaua in 1885. Following his death it continued to be a favorite retreat for royal family members. In 1925 Hulihe'e was purchased by the Territory of Hawaii and leased to the Daughters of Hawaii to be operated and maintained as a museum. Today the museum houses a collection of ancient Hawaiian artifacts and personal memorabilia of 19th century Hawaiian royalty. Most of the present furnishings were in the palace during the monarchy. Open Daily--Admission. Total Budget and Position Count Total Program Budget See Exhibit A Total Program Position Count See Exhibit A Total Agency Budget See Exhibit B Total Agency Position Count See Exhibit C Program Objectives: 1) Restoration and renovation of Hulihe'e Palace, a national historic building which is on the Register of National Historic Sites. Program Highlights: 1) The Hulihe'e Palace Museum houses a collection of ancient Hawaiian artifacts and personal memorabilia of 19th century Hawaiian royalty. Most of the present furnishings were in the palace during the monarchy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Daughters of Hawaii -Agency Name Hulihe'e Palace -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate See Exhibit B *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es See Exhibit A Professional Fees O erations E ui ment Other" Total If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Daughters of Hawaii -Agency Name Hulihe'e Palace -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate State Grant $50,000 Put in a State Grant $160,000 request for State Grant Private Funds $140,000 Hilo County Put in a $160, 000 request for Hilo County Grant Total $190,000 $160,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? This is a one-time program to restore and renovate the Hulihe'e Palace in Kailua- Kona, Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Daughters of Hawaii - A enc Name Hulihe'e Palace -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will impact the evaluation of vour program's or agency's future funding requests. ~ ~ 3i acb ~ Sig ature of Board Pres"d nUChair ate ~C~ ~ l)ll~~ ~~a.. d r Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Applicant: Daughters of Hawaii EXHIBIT Hulihe'e Palace 26 August 2005 David Scott Daughters of Hawaii Queen Emma Summer Palace 2913 Pali Highway Honolulu HI 96817 Subject: Hulihe'e Palace Condition Observations-August 2005 Deaz David: This is an update of the condition analysis I did earlier this yeaz, with additional observations made about the building since. I have also attached an updated cost estimate for doing the work. General The last time the building underwent repairs and repainting was in 1995, nine years ago. Prior to that, the previous major renovation was in 1979 - a span of 16 years. Given the environment at the site and the nature of its building materials, the building has always started to look like it needed some repairs after about ten years. In particulaz, painting and some minor wood repairs should be expected after this period. That being said, there are several current conditions that require special attention and description. Exterior I . A portion of the cast iron downspout on the Ka'u side is cracked and needs to be replaced. Some of that downspout was replaced in 1995, but more has since deteriorated. The downspout on the Kohala side should also be looked at. 2. There is a crack in the plaster at about the second floor level near the Ka'u downspout that is probably allowing water to wick into the wall and may be responsible for some of the interior cornice plaster damage. That isn't the only reason for the interior plaster problem, but is likely to be one of them. 3. The structure of the Ka'u entry roof has pulled slightly away from the building on the makai side. There is virtually no counterflashing of the wall to roof connection and it is highly likely water is infiltrating the wall at this location. This may be an important cause of the Kuakini Room plaster deterioration. The roof should be removed and replaced, new lead counterflashing installed and any hidden damage to the roof structure repaired. Applicant: Daughters of Hawaii page2 EXHIBIT ~ Hulihe'e Palace 26 August 2005 4. The wood pilaster on the makai side of the Ka'u entry is completely deteriorated. The mauka pilaster is deteriorated at the top but may be able to be patched rather than replaced. 5. Open both post bases at the Ka'u entry and treat the post bases with epoxy impregnator to harden and preserve them from future deterioration. 6. The base trim azound the Kau side post of the mauka entry is split at the corner and needs to be reattached. There may also be damage to the bottom of the post itself, because of the way the paint is acting at the joint. This post should be patched or replaced. 7. Various hairline cracks exist in the exterior plaster. Many of them would be disguised by another paint job on the exterior, which would be the simplest way to deal with this. However, it is recommended that certain areas, such as the one around and to the left of the basement door be replastered with salt-tolerant plaster. This will reduce the frequency of the plaster exhibiting cracking and salt bleed-through. 8. Some touch-up painting has been done of the plaster where it was cracked, but the entire exterior should be repainted, as the touch up painting is not satisfactory. Exterior Doors and Windows 1. The Ka'u door has deflected slightly and it is now very difficult to operate. This is partially due to slight opening of the joints. This door may need to be repaired to eliminate the slight sag and some work maybe needed on the threshold. The knobs and spindle on that door also need to be replaced. 2. At least one hinge pin is loose. Miscellaneous Other Exterior Problems Most of the list below is just a checklist of problems or issues that must be addressed. 1. Vents to the underside of the second floor makai lanai are rusting. I suggest that we get these replaced by laser cut Corian vents that would match the design of the existing vents. These would be dimensionally stable, and if attached with stainless steel screws, would last indefinitely. 2. A few lanai boards are rotting at the ends and need replacement. 3. The bottom trim of the lattice at the base of the lanai has fallen off and needs to be replaced. 4. All shutters definitely need repainting and a few need to have their joints tightened. This should happen soon, to reduce the chance that shutters will need to be replaced. 5. shutter hinge pins continue to pull out. All loose pins should be reset. I suggest that the pin detail be changed so they are less likely to pull out in the future. Hulihe'e Palace Observations Mason Architects, Inc. Applicant: Daughters of Hawaii EXHIBIT ~G}i') Hulihe`e Palace page 3 26 August 2005 Interior Minor interior plaster and paint touch up is required. There aze several areas where more signiScant work should be undertaken. 1. The ceiling cornice molding in the Kuakini Room is now pretty deteriorated. It is likely that most of it on the Ka'u side will have to be redone. The picture molding is a little more famished in that area and also could be refinished. 2. Several of the sash guides are faz enough out that the windows don't track well, resulting in the windows sitting crooked in the jambs or getting stuck. Some of this was taken care on the in the 1990s work, but many more window tracks could modified to make the windows work better. 3. The Kawananakoa Room is in the greatest need of help, primarily because the furnishings, which are such an important part of the room, are in such poor condition the room looks shabby. It is recommended that a conservator be retained to do the following: o Provide a general cleaning to all furnishings o Repair the lauhala mat o Reupholster, with accurate (custom) reproductions of fabric, the Queen Liliuokalani chair, two other chairs, and to recane a fourth chair. o Restore the French table so the wood veneer is not buckling. o Other restoration items as may be suggested by a conservator. Other Work or Reseazch There has been some wncem expressed by the Daughters of Hawaii that the former well site may be causing some of the rising damp problems in the building. As a result, it is recommended that two monitoring wells be installed on the grounds to verify mound water levels in relation to grade and the floor level of the basement. Please call me if you have questions about the above. Sincerely, Glenn Mason Hulihe'e Palace Observations Mason Architects, Inc. Applicant: Daughters of Hawaii EXHIBIT /F- ~ Hulihe'e Palace T~ 1~~1aid ~ ~ S ~.lr~y 26 October 2005 Leilani Maguire, Regent Daughters of Hawaii 2913 Pali Highway Honolulu, Hawaii 96817 Subject: Hulihe'e Palace -Renovations Deaz Leilani: The initial phase of work for the needed repairs to Hulihe'e Palace should include the following professional services. A. Conduct investigations of second floor lanai. This will include removal of a portion of the flooring at the second floor at the Ka'u end to verify embedment and/or attachment of the floor joists to the masonry wall. Temporary repairs will be done as part of our work, with final repairs being made during the construction. B: Produce a construction set of drawings covering the following items. These aze some of the items identified in the breakdown of work sent to you eazlier this yeaz. They are those whose repair will reduce further damage from accelerating or deal with items of structural concern. We do not believe that any more work can be accomplished for the $40,000 budget allocated for this phase of work. 1. Replace two pilasters at the Ka'u entry roof 2. Replace roofing and flashing at Ka'u roof 3. Replace deteriorated post at mauka entry 4. Replace damaged lanai flooring 5. Replace cracked cast iron downspout 6. Repair the Ka'u door so it operates. Replace the deteriorated hazdwaze on that door. 7. Minor repairs to the shutters. 8. Painting of all the above items. C. Provide copies of drawings and services for permit processing. D. Answer questions and issue clarifications doting bidding. E. Review the work during construction to maintain compliance with the construction documents. F. It is anticipated that at least two trips to the site will be required during the project. One will occur during the investigation phase and another during construction. Applicant: Daughters of Hawaii EXHIBIT Hulihe'e Palace I have attached a copy of a fee proposal breakdown for your review and record. I,et me know if you need anything further. Sincerely, Glenn Mason, AIA President cc. David Scott, Executive Director Applicant: Daughters of Hawaii EXHIBIT Hulihe'e Palace POSITION PAPER AS JUSTIFICATION FOR RENOVATION WORK FOR HULIHE'E PALACE IN KAILUA-KONA, HAWAII 1. The following is justification for the immediacy of the project: the highlights. Other work is outlined in this renovation request; this position paper merely outlines the points supporting the reason the renovation work must start immediately. 2. Dampness from water coming out from the ground and sea water spraying on the building has caused problems which must be remedied immediately. 3. Water has seeped into the walls, causing the plaster to crack on the Ka'u side of the building. Part of the ceiling is falling as well as cracks in the plaster on the wall. 4. Water has also seeped into the foundation on the lower lanai of the Ka'u side and one of the posts of the lanai is damaged from the water and possibly termites. This is causing the post to come away from the wall and causing the lanai roof to pull down. This in tum is causing some damage on the upper lanai of the Ka'u side. These conditions can be hazardous and must be remedied immediately. 5. Wells must be placed in the ground to alleviate seepage of water from the ground into the building. 6. As this is a historic building and open to the public, we would like all renovation work to be done at the same time to preserve unity and harmony in the look of the building. 7. Hulihe`e Palace serves as a museum in the Kailua-Kona area to educate the school children, the community and the tourists about Hawaii's royalty and heritage. It is important to maintain this building, both for it's educational and cultural purposes and for it's contribution to the economy of the state as a community and tourist attraction. Applicant: Daughters of Hawaii EXHIBIT A- Hulihe'e Palace Project Hulihe'e Palace Repairs .~..m..,r r, was General Quantity Unit Cost Total Architect/Engineer Fees (note 2) 1 $28,000.00 $28,000.00 Monitoring Wells each 2 $8,000.00 $16,000.00 General Conditions months 6 $2,000.00 $12,000.00 Supervision months 6 $2,000.00 $12,000.00 Scaffolding months 3 $5,000.00 $15,000.00 Demolition and disposal lump sum 1 $2,000.00 $2 000.00 X5,000.00 Division Sic- CarDrnfry Replace pilaster Ka'u side each 2 $I 900.00 $3 80D.00 Replace lanai flooring sf 80 $20.00 $1,600.00 Replace mauka post, base each 1 $1,950.00 $1 950.00 Retabricate, install lanai vents 4 _ $600.00 $2,400.00 Repair lattice If 10 $20.00 $200.00 Repair Ka'u Door refinish each 1 $2,100.00 $2 100.00 Repairs to shutters Is 1 $6,000.00 $6 000.00 $18,050.00 Division Seven- Thermal and Moisture Protection New C.I. downspout linear feet 20 $25.00 $500.00 Replace roofing at Ka'u roof sf 130 $25.00 $3,250.00 New lead flashing at Ka'u roof Is $2 000.00 Repair gutters & metal flashg If 150 $22.00 $3 300.00 $9,050.00 Division Eight- Doors and Windows _ New lock for Ka'u Door quantity 1 $450.00 $450.00 $0.00 X50.00 DWisbn Nine- Finishes Plaster Repairs Is 1 $40,000.00 $40,000.00 Poltice for salt mitigation, int. Sq Ft 20 $100.00 $2,OOD.00 Painting ~ Partial Interior Sq Ft 1900 $2.00 $3,800.00 Paint exterior shutters Sq Ft 468 $5.00 $2,340.00 Patch koa stair tread, interior Is 1 $800.00 $800.00 Paint Sand Finish Areas Sq Ft 1,850 $2.50 $4,625.00 Paint other exterior surfaces Sg Ft 5,400 $2.50 $13,500.00 567,065.00 DWizirn TweWe • Furnishings Restore Kawanakoa Rm Furn. Lump sum 1 $50,000.00 $50 000.00 Conservator Lump sum 1 $10000.00 $10000.00 $60,D00.00 Division Fiftern-Mechanical Replace basement fan I $3 500.00 $3 500.00 ;3,500.00 Dir{sirn Sistern- Electrical Replace lanai lights Quantity 6 $400.00 $2 400.00 $0.00 ;2,400.00 Subtotal $245,515.00 Insurance, bontling, etc $21,000.00 Job Conditions (note l) $49,103.OD Contingency 10% $29,461.80 TOTAL $345,079.80 Note 1: Job conditions markup is 20go This is based on the very tight construction market in Kona Note 2: Architect /Engineer fees include salt content analysis of existing plaster and mortar. 12/20/05 1 /~~~i (Gt'~ ' 7a1,. ~h hrs o{ l~t~'•^'~Yti+~, 1 ~-'-r i ~-'.e 7~J p c4 ~ o n io 'c v m° 3 m m w w O % w ° ~ m vvo~O3333333=~G1rr~+m OnCfmD~ ~ E ~cmm;;;;gc~ooomao~ p Mw,c 3mm»mmmm,mc~~mmsm^°~<° om m'~mmmm~~,>>>oo n3n mom°-m ~cSSmmm'ammwwa Qwo3Fzwm ~~°~.m3333~y^°'. »'c 3.mo ~ m m _y m micro > > > > ~ ~rD(n O^•wc n_ o J'"d d z--•-• yN 3 ° di~sy >;~$~mmmn yVl° yH. 3 ommmluldulma°>>>°_'p m'c ma mmmQ° ~~morcm~7 m'm' m wmmm>:~J~ayww wpm % w p m ~ m m m TI N~ O O A w A N m Om O V 'O a m C CI l7 ~ ry o ww 0>(RW$ m^ m ° Ci rri33oooweeo ° < .'OA~w ~p1 ~ a'M a ~c c c w 3 w m mm m my ro~ O O ~?~aw mco~ m V d d d k V D N N A y w j C1 6 A~ m d 3 a~~ O c ~ m w ~~?mc w .~G1 ~ n n ~ moo' °'NV w ~p O w m m O m O C ~ S w N ymi G N ~ O C w 0 ~ ~ -1 y N;~ O o Q. 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O O w O? O m [A O _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ J -I O i 1 N p m A D w 1 F A + m m Z m m x O O m N C C O C C N C I + .J-i H t ~ -x----- OiD I O --------------------------------a-a--A a-a- + om n S + x n p ~ ~ Z ~ ~ x n (mi t m In Z m m "Z t X 1 G/ x 1 + a o a o + _ d _____A _T__ D _p _ T__x_____ N + + m m t Z n 9 Z a + O O + m A N m S1 x D ~ D + A -1 O A ~ + a ~ N _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ i _ _ _ _ _y _ . _ A ~ x '-n'm O N + -1 x m Q + m x O £ m nol * * a m.. _ __-_t__' N sDnJ I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 _ _ _ _ _ _ _ _ _ _ rn _ _ + + O m a + m T + _ D O O O O + A .U + m m 3 3 Z~m t x C~3 m cn 3~v + A a x moo O O + 9y< N * m am z Accomplishments from fiscal year 2004-2005 for the Daughters of Hawaii. • Held annual Day at Queen Emma, community based cultural festival. • Held monthly concerts on the grounds of Hulihe'e Palace for the public • Hosted over 100,000 visitors to Hulihe'e Palace • Hosted over 30,000 visitors to Queen Emma Summer Palace • Hosted classical music concert at Hulihe'e Palace -The Music of King Kalakaua • Hosting Hula Halau practice four times a week on the grounds of Hulihe"e • Once a week host Lauhala weavers at Hulihe'e Palace • Once a week host a quilters group at Hulihe'e and Queen Emma Summer Palace • Evening of Elegance event with the Kona Chamber of Commerce at Hulihe'e • Day at Hulihe"e community based cultural event • Community based cultural classes held five nights a week in Emmalani Hale at Queen Emma Summer Palace • Monthly educational lecture series sponsored by Daughters of Hawaii at Queen Emma Summer Palace East Hawaii Coalition for the Homeless- Agency Name Kihei Pua Emergency Shelter- Program Name Agency Director: Steve Bader Phone No.: 969-4848 Contact Person: Steve Bader Phone No.: 969-4848 Mailing Address: 142 Kinoole Street Suite C Hilo, Hawaii 96720 FacilitylSite Address: 115 Kapiolani Street Hilo, Hawaii 96720 Fax No.: 969-4850 Email Address: ehchofficel~aol.com Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPA & Management Group Phone No.: 242-5002 Mailing Address: 1885 Main Street Suite 408 Wailuku, Hawaii 96793 Amount of Request for County Funds: $45,000 Prior Year(s) Funding: 03-04 04-05 05-06 $37,500 $38,000 $40,000 Agency Mission Statement: "Creating opprtunities that enhance the quality of life for homeless families and individuals." EHCH is comitted to reducing homelessness in the community by integrating shelter and support services in a caring and directed manner so participants are able to become self-sufficient and obtain permanent housing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Emergency Shelter- Program Name Program Description: Kihei Pua is a 24 hour emergency shelter that serves families and individuals. The program provides participants opportunities to become self sufficient and prepares them to secure and maintain permanent housing. The shelter can house 52 persons a night. Services include case management, 24 hour food pantry, classes that address issues such as personal responsibility, parenting and financial stability. Walk-in services (showers, emergency food, blankets) and phone and mail access are also provided. Hale OPuna, anon-shelter extension of the program is located in Pahoa and provides food, advocacy and referral services, as well as being a location for other agencies to access the homeless and at-risk population in the area. Total Budget and Position Count Total Pro ram Bud et 462,000 Total Pro ram Position Count 12 Total A enc Bud et 698,600 Total A enc Position Count 14 Program Objectives: 1) Develop individualized service plans for all clients within 3 days of entrance into program. 2) Provide effective case management, referrals and classes for afl participants. 3) Prepare participants to obtain and maintain permanent housing. 4) Ensure that 75% of those serves meet 75% of their goals within 6 weeks. Program Highlights: 1) Provided shelter and non-shelter services to 2,790 people. 2) Helped 77% of shelter participants secure permanent housing. 3) Participated in Continuum of Care planning efforts to address homelessness island wide. 4) Worked with faith community to provide meals, financial support and special activities for program participants throughout the year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Emergency Shelter -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate # Undu licated Served Shelter 290 500 550 # Unduplicated Served (Non 2,500 2,500 2,500 Shelter # Meal Packa es Provided 100,000 120,000 130,000 # Non-Food Services Provided 7,470 7,500 8,000 # Entered Permanent Housin 223 375 425 # Entered Transitional Housin 35 45 50 # Enrolled in Education/Trainin 20 30 40 # Obtained Em to ment 54 60 65 # Receivin Mental Health Treat. 39 40 45 # Receiving Substance Abuse 41 45 50 Treat. *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 221,609.00 300,000.00 309,000.00 Professional Fees 4,025.00 4,000.00 4,000.00 O erations 4,000.00 5,000.00 6,000.00 E ui ment 802.72 2,000.00 3,000.00 Other" 134,416.00 115,890.00 140,000.00 Total 364,852.72 426,890.00 462,000.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 East Hawaii Coalition for the Homeless Kihei Pua Emergency Shelter Other"`Expenses Year 04-05 Year 04-06 Year 06-07 Air Fare 557.00 850.00 1,500.00 Insurance 32,917.00 30,500.00 32,500.00 Lease/Rental Space 16,225.00 16,225.00 17,000.00 Postage/Freight 471.00 1,000.00 2,000.00 Publication/Printing 449.00 1,000.00 2,000.00 Repair/Maintenance 1,000.00 1,000.00 3,000.00 Supplies 1,500.00 2,000.00 3,000.00 Telecommunication 9,368.00 7,416.00 9,000.00 Utilities 18,040.00 20,000.00 25,000.00 Miscell/Tax/Dues 41,789.00 15,490.00 16, 000.00 Direct Services 12,100.00 20,409.00 29,000.00 Total Other 134,416.00 115,890.00 140,000.00 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Emergency Shelter -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate State of Hawaii 225,545.20 210,000.00 240,000.00 Coun of Hawaii 38,000.00 40,000.00 45,000.00 Hawaii Island United Wa 25,949.25 17,500.00 17,500.00 Client Fees 21,992.00 21,000.00 21,000.00 Other/Donations 65,186.66 126,000.00 126,000.00 Emer enc Shelter Grant Federal 62,732.00 50,100.00 50,100.00 Total 439,405.11 464,600.00 499,600.00 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self~ustaining? Fundraising: EHCH launched its first Donor Campaign in 2004-05 generated more than $20,000. This number respresents nearly 1/3 of the $65,000 raised that year. The organization is currently on pace to raise more $125,000 for 2005- 06. State Assistance: EHCH will be seeking additional monies from the state for much needed repairs and maintenance of facilities. Program Self Sufficiency: The high cost of providing services and the increasing demand for emergency and transitional housing makes it challenging for our programs to become entirely self-sufficient. EHCH will continue to look for ways to diversify its income so it does not become over reliant on government funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Emergency Shelter -Program Name I {we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofd Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public acxording to Chapter 92F, Hawaii Revised Statutes. 1f awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a yearend report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate vear~end report will imwct the evaluation of vour program's or agsncv's future funding reguests. Signa of Board President/ air Date Signature of Executive Director Date I~NSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Pace S East Hawaii Coalition for the Homeless- Agency Name Kihei Pua Transitional Housing program- Program Name Agency Director: Steve Bader Phone No.: 969-4848 Contact Person: Steve Bader Phone No.: 969-4848 Mailing Address: 142 Kinoole Street Suite C Hilo, Hawaii 96720 Facility/Site Address: 115 Kapiolani Street Hilo, Hawaii 96720 Fax No.: 969-4850 Email Address: ehchoffice1@aol.com Name of Accountant/CPA (include name of firm if applicable: Carbonaro CPA & Management Group Phone No.: 242-5002 Mailing Address: 1885 Main Street Suite 408 Wailuku, Hawaii 96793 Amount of Request for County Funds: $6,000 Prior Year(s) Funding: 03-04 04-05 05-06 $2,500 $3,000 $4,000 Agency Mission Statement: "Creating opprtunities that enhance the quality of life for homeless families and individuals." EHCH is comitted to reducing homelessness in the community by integrating shelter and support services in a caring and directed manner so participants are able to become self-sufficient and obtain permanent housing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Transitional Housing Program- Program Name Program Description: Kihei Pua Transitional Housing Program provides 21 scattered site housing opportunities for families and single men and women. Participants can receive services for a maximum of two years with the goal of securing and maintaining permanent housing. The program is designed for participants who are personally and financially stable and need more time obtaining permanent housing due to their circumstances (i.e. large family, disability, completing education or training, etc.) Total Budget and Position Count Total Pro ram Bud et 199,000 Total Pro ram Position Count 2 Total A enc Bud et 698,600 Total A enc Position Count 14 Program Objectives: 1) Prepare clients to secure and maintain permanent housing. 2) Ensure that 75% of those serves meet 75% of their goals before exiting the program. 3) Help participants to become productive members of the community who will maintain positive and healthy lifestyles. Program Highlights: 1) Increased number of participants by 10% over previous year. 2) Number of participants finding employment increased by 20% over previous year. 3) Successfully accomodated 200% increase in Pack Islander families seeking transitional housing in our program. 4) Worked with faith community to provide meals, financial support and special activities for program participants throughout the year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Transitional Housing Program -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate # Total Served 93 120 150 # New Families Served 18 20 25 # New Sin les Served 15 20 25 # Meal Packa es Provided 2,100 2,500 2,500 # Life Skills Classes Provided 56 56 56 # Enrolled in Educationlrrainin 5 20 25 # Transitioned Off Public 5 10 15 Assistance # Obtained Em to ment 15 20 25 # Receiving Substance Abuse 13 15 15 Treatment # Secured Permanent Housin 13 25 40 # Retained Permanent Housing for 22 30 40 6 Months After Leavin Pr ram *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et" Estimate Salaries and Wa es 72,639.00 82,745.00 85,600.00 Professional Fees 1,725.00 2,000.00 2,000.00 O erations 1,500.00 2,000.00 3,000.00 E ui ment 300.00 1,000.00 2,000.00 Other' 193,748.00 133,965.00 144,000.00 Total 269,912.00 221,710.00 236,600.00 ' If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 East Hawaii Coalition for the Homeless Kihei Pua Transitional Shelter Other"'Expenses Year 04-05 Year 05-06 Year 06-07 Air Fare 239.00 300.00 1,000.00 Insurance 14,108.00 15,000.00 16,000.00 Lease/Rental Space 94,477.00 58,175.00 60,000.00 Postage/Freight 202.00 200.00 500.00 PublicatioMPrinting 193.00 500.00 500.00 Repair/Maintenance 5,725.00 6,100.00 7,000.00 Supplies 535.00 1,000.00 1, 500.00 Telecommunication 4,016.00 4,000.00 4,500.00 Utilities 49,200.00 30,690.00 33,000.00 Miscell/Tax/Dues 20,053.00 8,000.00 8,000.00 Direct Services 5,000.00 10,000.00 12,000.00 Total Other 193,748.00 133,965.00 144,000.00 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Transitional Housing Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et' Estimate State of Hawaii 81,225.00 90,000.00 103,000.00 Coun of Hawaii 3,000.00 4,000.00 6,000.00 Hawaii Island United Wa 4,993.75 5,000.00 5,000.00 Client Fees 39,217.16 41,000.00 41,000.00 Other/Donations 27,937.14 44,000.00 44,000.00 Total 156,373.05 184,000.00 199,000.00 "If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Fundraising: EHCH launched its first Donor Campaign in 2004-05 generated more than $20,000. This number respresents nearly 1/3 of the $65,000 raised that year. The organization is currently on pace to raise more $125,000 for 2005- 06. State Assistance: EHCH will be seeking additional monies from the state for much needed repairs and maintenance of facilities. Program Self Sufficiency: The high cost of providing services and the increasing demand for emergency and transitional housing makes it challenging for our programs to become entirely self-sufficient. EHCH will continue to look for ways to diversify its income so it does not become over reliant on government funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 East Hawaii Coalition for the Homeless -Agency Name Kihei Pua Transitional Housing -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awaMed a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a fisting of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate vwr-end report will imuact the evaluation of vour nroaram's or aaencv's future fundlna requests. v 3 o TA ~ Z,o rYl Signet a of Board Presiden Chair Date t - 3u-- a~ ~2'~- ~i~ Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFCf GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Agency Director: Stone Wolfsong (Acting) Phone No.: 334-4116 Contact Person: Huellyn Whitford Phone No.: 334-4110 Mailing Address: 75-127 Lunapule Road, Suite 11 Kailua-Kona, HI 96740 FacilitylSite Address: Na'alehu and Hawi Fax No.: 808-334-4141 Email Address: kids@fsswh.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs & Management Group Phone No.: 242-5002 Mailing Address: 1885 Main Street, Suite 408 Wailuku HI 96793 Amount of Request for County Funds: $65,000 Prior Year(s) Funding: 03-04 04-05 05-06 $48,000 $49,500 $51,000 Agency Mission Statement: To Support Families and Communities in Providing Love and Care for our Children NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Program Description: Family Support Services of West Hawaii (FSSWH) is seeking funds for the continuation of the Ka'u and North Kohala Family Centers, opened in the mid- 90's as vital walk-in centers providing free access to over 500 people annually for a wide range of family support services and other community resources. As remote, rural areas of the Big Island, areas which generally lack access to support services, both Ka'u and North Kohala face challenges in accessing child care, health care, employment, housing, substance abuse, financial, counseling, and educational resources. FSSWH staff are available Monday through Friday to work with families as a whole, guiding people through the process of finding solutions to multiple problems and linking the families to any other available private and public services. Our purpose is to help families prevent crises, define problems, identify strengths, and be responsible for determining their own solutions. These Family Centers are the only places in their Districts that all residents can go to get the help and support they need in a familiar setting. Our Family Center Coordinators respond to family needs but also proactively create positive family events. For example, the Ka'u Family Center has partnered with the Hawaii County Department of Parks & Recreation to provide an annual Easter Egg Hunt. This event is for the community to come together, celebrate and cultivate social networks. The Ka'u Family Center is also one of the few sites located in South Hawaii that works with referrals from Hawaii Intake Services to help them meet their community service requirements; in 2005, these people performed 459 hours of community service through the centers. The centers also work with homeless families to help minimize the downward spiral that homelessness may bring in areas that lack most social service networks. The centers allow dozens of non-profit organizations and community groups to use the facilities, they provide office and meeting space for important Healthy Start, Early Head Start, and youth after-school and summer programs, have facilitated community-wide inter-organizational partnerships, and have been intimately involved in community based anti-drug efforts and initiatives. For example, in North Kohala, our Family Center Coordinator was one of the founding members of the Community Response to Ice (CRI) group and implementing of FSSWH's substance abuse prevention program, Kohala's Project Venture, while in Ka'u the Family Center facilitates the Ka'u Partnership of health, human services, and educational providers. Total Budget and Position Count Total Program Budget $99,100 Total Program Position Count t FTE (two 5 FTE positions) Total A enc Bud et $3,600,000 Total A enc Position Count 75 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Program Objectives: 1) Provide personalized support services to individuals who need access to financial, housing, educational, health, and psychological resources 2) Through partnerships and community needs assessments, strengthen the capacity of existing social service resources to help families 3) Provide facilities for use by community organizations and social services 4) Advocate for needed additional resources to rural Hawaii communities 5) Improve parenting skills 6) Decrease isolation in rural communities Program Highlights in Past Year: 1) Provided facilities to other service providers for 1127 service hours, a 290% increase over the previous year. 2) Provided information and referral to 515 people to meet their needs at our centers. 3) Provided office and technological support to 217 people in our communities. The centers have computers available to the public for Internet research on a wide variety of heath and human services issues. 4) Sponsored two community-wide events for family strengthening, one at each site. 5) Volunteers performed 459 hours of community service at the Family Centers, involving the community in their operations and in the support of families while also serving as a site to complete community service as mandated by the courts. 6) Facilitated the Kau Partnership, an inter-agency and community partnership that meets monthly. Members include Bay Clinic, Reach Out and Read, Friends of Kahuku Park, Naalehu Main Street, Queen Liliuokalani Children's Center, Public Health, Hana Hou Restaurant and Ocean View Community Association. Projects within the community have included a community health fair promoting healthy lifestyles. 7) Facilitated the Kohala Coalition Against Drugs (KCAD), a task force consisting of community members, schools, health centers, youth groups and faith-based groups. KCAD is done in collaboration with the North Hawaii Drug Free Coalition. The focus has been on substance abuse prevention and prevention activities. Activities include sign waving to support awareness of substance abuse in Kohala and unify the community, a kite making and flying day with over 150 children and adults participating and the Kohala Walk on Drugs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Education 10 10 10 Em to ment 10 10 10 Financial 20 20 10 Health 20 20 20 Parentin Information 25 25 25 Office Equi ment/use 155 155 155 Childcare 6 6 n/a Substance Abuse Su ort and Info 60 60 60 Food 40 40 50 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $45,839.00 $52,000.00 $55,000.00 Professional Fees 289.00 500.00 500.00 O erations 498.00 500.00 500.00 E ui ment 3,057.00 3,000.00 5,000.00 Other" 30,837.00 38,100.00 38,100.00 Total $80,520.00 $94,100.00 $99,100.00 If applicable # Please explain in detail on separate sheet Program Expenditures -Detail of "Other" FY 2004-OS FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Emplo ee Benefits $7,989.00 $9,000.00 $9,000.00 Pa roll Taxes 5,431.00 6,300.00 6,300.00 Su lies 1,939.00 5,000.00 5,000.00 Occu anc 14,942.00 16,500.00 16,500.00 Insurance 530.00 1,000.00 1000.00 Travel 6.00 300.00 300.00 Total Other $30,837.00 $38,100.00 $38,100.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Family Support Services of West Hawaii Kau and North Kohala Family Centers Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii $49,500.00 $51,000.00 $65,000.00 Private Citizen Donations 31,020.00 43,100.00 34,100.00 Total $80,520.00 $94,100.00 $99,100.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Offering free support services to families in economically disadvantaged communities will always be a subsidized activity. Given the economic realities of these communities, it would not be prudent to charge a fee for these services; people simply wouldn't use them. Nevertheless, FSSWH has and wi{I continue to seek diverse revenue streams to support the centers. A $100,000 Grant-in-Aid awarded during the 2003 State Legislature was never released by the Governor. Currently, charitable donations from individuals throughout West Hawaii supplement the County's grant to cover the costs of operating the centers. In 2006, FSSWH is again submitting aGrant-in-Aid request to the legislature to expand the capacities of these centers. The agency also has hired agrant-writer to look for private philanthropic support for these centers; proposals are expected to be submitted within the next 4 months. In addition, FSSWH has agreed in principle to partner with Blueprint for Change in the expansion of Neighborhood Place family strengthening services (for low- and moderate-risk families reported to Child Welfare Services) by hosting these services at its family centers. While the exact funding amount is not yet determined, it is one way FSSWH is attempting to assure sustainability of these long-standing family centers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Family Support Services of West Hawaii Kau and North Kohala Family Centers I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate near-end report will impact the evaluation of vour program's or agency's future funding requests. Sig ature of Board PresidentlChair Date l•~~ •a~ Signature of Exe tive ' ector Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Friends of the Children's Justice Center of East Hawaii- Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs -Program Name Agency Director: Aileen Lum Phone No.: 935-8755 Contact Person: Jenny Tokuuke Phone No.: 935- 8755 Mailing Address: 1290 Kinoole Street Hilo, Hawaii 96720 Facility/Site Address: 1290 Kinoole Street Hilo, Hawaii 96720 Fax No.: 933-0968 Email Address: fcjceh@fcjc.org Name of Accountant/CPA (include name of firm if applicable): Jennifer Gossert, Jennifer Gossert CPA Phone No.: 969-3115 Mailing Address: 688 Kinoole Street, Hilo HI 96720 Amount of Request for County Funds: $20,000 Prior Year(s) Funding: 03-04 04-05 05-06 $13000 $13000 $15000 NONPROFiT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Agency Mission Statement: The mission of the Friends of the Chidlren's Justice Center of East Hawaii is to help sexually, physically, emotionally abused, and neglected children. We do this in partnership with the Chidlren's Justice Center of East Hawaii, by providing funds and reouces to support the needs of these children. The "Friends" offer hope, encouragement, and opportunity for victims of child abuse. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Friends of the Children's Justice Center of East Hawaii Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs -Program Name Program Description: The Friends of the Children's Justice Center of East Hawaii is a private nonprofit organization founded by concerned community members in 1990 whose primary goal was to protect and enhance the physical and psychological safety of abused or neglected children. The Friends are in a partnership with the Children's Justice Center (CJC), a State Judiciary Program. The CJC provides a safe, neutral homelike atmosphere where children can be interviewed about reports of abuse, particularly sexual abuse. This Children's Justice Program facilitates and coordinates the system's response to victims of child abuse to reduce their trauma through a multi- disciplinary team approach which involves police, social workers, prosecutors, guardians ad litem, medical professionals and advocates. The Friends support the CJC primarily by helping provide direct services and programs to child victims and their families which are not available through any other public or private source. The Friends facilitate services and accept referrals from state and private agencies working with child abuse victims such as Child Protective Services, Child and Family Services, Hawaii Behavioral Health, Catholic Charities, Parents Inc., etc. The Friends target children between the ages of 0-18, who are victims of maltreatment (sexual, physical, emotional, mental abuse or neglect) residing in East Hawaii. This includes North Hilo, South Hilo, Hamakua, Puna and parts of Ka'u. Our services are aimed at assisting children who are in temporary or permanent foster custody or who are living with the non-abusive parent with little means of financial support. The Special Needs and Enhnacement Program is designed to help child victims gain self-esteem and develop positive self-worth. This is accomplished by providing for needs that are not covered by any other public or private source. These children would otherwise "fall through the cracks" and not have the opportunity to gain a positive self-worth. Funds are used to provide basic essentials (i.e. clothing, diapers, toiletries), special needs (i.e. air/ground transportation, school supplies, correspondence course) and enhancement support (sports, music lessons, tutoring). The Friends also supply gifts to abused/neglected teens on Christmas because younger children are covered by other programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 The Center Support Program was developed to reduce trauma and ensure the safety and comfort of the children that come to the Center for interviews. The Friends maintain the Center's safe, child-friendly and homelike atmosphere by furnishing the center with toys, games, and snacks. This is often made possible by community donations and volunteerism. The Friends maintain the Center's appearance with repairs and refurbishing when it is needed. The Prevention and Education Program is designed to educate the community on child abuse issues. The program coordinates and carries out programs and services to the public promoting the awareness and prevention of child abuse. In the past the Friends have also coordinated and financially supported specially designed programs presented in the schools. The Training Program helps to sponsor the attendance of various professionals including social workers and police interviewers who talk with child victims and their families at seminars and conferences in order to enhance the quality of services that these victims receive. This prevents victims from being re- traumatized by the system's response to the reports of abuse. Total Budget and Position Count Total Program Budget 146,100 Total Program Position Count -1~ Total Agency Budget 146,100 Total Agency Position Count ~ ~ I Program Objectives: 1) Provide clothing, toiletries, bed/folding mattresses for children in emergency or relative foster placement. 2) Cover the costs of tutoring services, correspondence courses, summer school tuition to allow a child to graduate or progress on to the next grade level. 3) Pay for fees, equipment and supplies needed for the extracuricular activity (sports, music lessons, art, etc.) that a child is involved in. 4) Provide gifts for a special occasion such as Christmas when a child would otherwise not receive a gift. 5) Provide gas coupons to families on a limited budget so children may be able to attend treatment programs. 6) Pay for school fees, e.g. seniors cannot graduate without payment of fees at the start of a school year. 7) Cover costs, short-term, when gaps in funding for treatment occurs, for a child who needs ongoing therapy. 8) Provide formula and supplies for infants removed at birth from drug addicted mothers. 9) Give children a chance to participate in school functions by paying for excursion fees, prom dresses, senior pictures, etc. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 10) Assist police and social workers in keeping up to date of the latest investigative techniques, sensitivity training, forensics and knowledge of resources by helping to sponsor their attendance at trainings and seminars. 11) Provide privacy, comfort and safety for clients who come to the Center by maintaining its warm and low-key down in the environment. 12) Collaborate with community organizations to formulate and implement innovative prevention programs targeting schools. 13) Participate with the East Hawaii Coalition for child abuse Prevention in prevention/education activities within the community to spread awareness on issues about child abuse to the general public. 14) Continue in bringing a Elementary School program to kids dealing with Child Abuse. Program Highlights: 1) Increased awareness of the general public by carrying out prevention/education events (ie booth at Wal-Mart and the Boy Scouts annual Makahiki Festival). 2) Participated in the first ever Family Fun Day event at the Hilo Shopping Center. 3) Worked with the Coalition on a proclamation signed by Mayor Harry Kim in April, Child Abuse Prevention month. 4) Brigthened the holidays of 350 teens by providing $25 Christmas gift cards to each child. 5) Filled 1,167 appropriate special needs and enhancement requests for abusedlneglected children to provide for needs that would otherwise have gone unmet. 6) Helped sponsor 5 professionals to attend trainings on Oahu and the mainland. 7) Participated and won third place in the Festival of Trees at the Hilo Shopping Center. 8) Distributed two newsletters to over 1,500 business and community members. 9) Received over 200 slippers from the Macys Slipper fund to distribute to our children in need. 10) Researched and found a new funding source for orthodontic needs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate *If applicable Program Expenditures I- FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Salaries and Wages 21,733 26,000 30,000 Professional Fees 2,725 5,000 4,000 O erations 4,252 4,400 4,600 Equipment 2,400 Other" 86,416 98,695 107,500 Total 117, 526 134, 095 146,100 If applicable ° Please explain in detail on separate sheef NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Donation 7,280 5,000 5,000 Charity Walk 3,000 Ironman _ 1,000 1,000 1,000 Count of Hawaii 13,000 15,000 20,000 Hawaii Island United Way 21,560 15,000 18,000 Geist Foundation 30,000 30,000 33,000 Teresa Hughes Foundation 30,000 30,000 _ 33,000 Fundraisin 17,262 25,600 29,600 Workshop Fees 258 200 200 Interest 359 275 100 Other 1,525 1,200 1,200 John Ross Foundation 5,000 5,000 Carry Over Funds 5,820 Total 125,244 134, 095 146,100 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The future funding of our organization will determine the amount of programs and services we can provide for abusedlneglected children. We will continuously try to seek and write grant proposals and with the help of our Fundraising Committee we will find new ways to raise money. The Board of Directors also communicate to sustain different sources of funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate vear-end report will impact the evaluation of vour program's or agency's future funding requests. /l3//o G Signature of B and President/Chair Date ~ 1~31It~ Sig ature of Executive-0i~ecteF Date Program/Volunteer Coordinator UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 Friends of the Children's Justice Center of East HI, Inc. Special Needs and Enhancment, Center SupportlEducation, and Training Programs Breakdown of Other Costs -page 3 Nonprofit Grant Application: FY 2004-05 FY 2005-05 FY 2006-07 Center support 3804 3800 4000 Special needs/enhancements 72414 78050 81000 Facilities 1690 4000 4000 Education/prevention 4563 7500 12000 Training 3945 5345 6500 Total 86416 98695 107500 FRIENDS of the Children's Justice Center of West Hawaii- Agency Name Enhancement and Basic Needs Program- Program Name Agency Director: Alice Daniel Phone No.: 331-2425 Contact Person: Alice Daniel Phone No.: 331-2425 Mailing Address: 77-6403 Nalani Street, Kailua-Kona, HI 96740 Facility/Site Address: 77403 Nalani Street, Kailua-Kona, HI 96740 Fax No.: 331-2425 Email Address: fcjcwh@hawaii.rr.com Name of Accountant/CPA (include name of firm if alpplicable)• Alice Daniel (Supervised by im Ashcraft of Hawaii Community Fedral Credit Union manager and Denise Hill, former Phone No.: 331-2425 CPA) Mailing AddreSS: 77-6403 Nalani Street, Kailua-Kona, HI 96740 Amount of Request for County Funds: $15000.00 Prior Year(s) Funding: 03-04 04-05 05-06 $13000.00 $13000.00 $15000.00 Agency Mission Statement: To provide assistance to children who have been traumatized by sexual assault, physical abuse or neglect or who are witnesses to violent crime; to promote prevention of child abuse; and to support the Children's Justice Center of West Hawaii. NONPROFIT GRANT APPLICATION FYSCAL YEAR 2006-07 Page 1 FRIENDS of the Children's Justice Center of West Hawaii - Agency Name Enhancement and Basic Needs Program- Program Name Program Description: The FRIENDS of the Children's Justice Center of West Hawaii (FCJC-WH) was formed in 1989 as the Friends of the Children's Advocacy Center of West Hawaii to provide support to child victims of abuse, neglect and sexual assault. The name changed to the FRIENDS of the Children's Justice Center in 2001. The program for which we seek funds from the County of Hawaii is our "enhancement and basic needs" program which provides funds for activities, services and items that the child would otherwise go without. Requests for funding are submitted by a professional person working with the child, such as the social worker, therapist or counselor. To be eligible, a child must be a victim of a documented case of abuse or neglect or witness to violent crime. The requests have ranged from $5.00 food coupons used when children are transported to court by social workers to attending Winners' Camp on Oahu. Our goal is to "help a victim become a child again." The FCJC-WH is able to help with basic needs and provide emergency assistance in situations where no governmental or other private agency can meet the need as quickly. The "enhancement and basic needs" program is the only program of our agency. It is not a "program" in the traditional sense in that we are merely funding participation of our clients in other programs or supplying basic needs such as clothing and school supplies. Typical requests received are for participation in athletic, music, dance, karate, summer school programs and the Winners' Camp program on Oahu. The FCJC-WH also assists the Children's Justice Center by helping to provide a warm, child-friendly atmosphere for the children and their siblings when they are brought to the Center for their forensic interviews. The Friends also support the training programs provided for professionals by the CJC. In 2006-2007, FCJC-WH will continue to develop follow-up activities in West Hawaii for the teens returning from Winners' Camp on Oahu. The goal is to reinforce the positive lessons and skills they have learned at camp. The majority of teens supported by the FRIENDS to attend the Camp are from foster homes and are in need of on-going support. The program is coordinated by a half-time staff person, a 12-member board of directors, and approximately 30 volunteers who help with special projects. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Total Budget and Position Count Total Program Budget 116,101.00 Total Program Position Count 1/2 Total A ency Bud et 137,656.00 Total A enc Position Count 1/2 Program Objectives: 1) Assist ten or more teens to attend Winners' Camp by June 30, 2007 2) Give holiday gift stockings to 100 teenage youth by the end of December 2006. 3) Give 35 FRIEND boxes to children entering a foster home for the first time, or being suddenly transferred to a new foster home, by June 30, 2007 4) Assist in planning and carrying out two follow up activities for Winners' Camp graduates by June 30, 2007 5) Provide funding for 600 children through enhancement/basic needs requests by June 30, 2007. 6) Support one or more training projects coordinated by the Children's Justice Center of West Hawaii to build and sustain interdisciplinary teams for State and County staff who work with cases of child abuse and neglect in West Hawaii by June 30, 2007. Program Highlights: 1) Twenty-three teens were sent to Winners' Camp during the County fiscal year 2004-2005; (22 individuals attended during the calendar year 2005; several attended Winners' Camp sponsored events more than once -one attended as a camp staff person three times and another attended once as a camper and a second time as a camp staff person. Eight individuals attended a "graduates only" camp in December 2005. Seven of the eight had attended earlier in the year 2005 and the eighth attended camp several years earlier). 2) One-hundred twenty-eight Christmas gift stockings were distributed to teens in December 2004. 3) Thirty-four FRIEND boxes were distributed during the County fiscal year 2004-2005 to children entering foster care for the first time. 4) Two Winners' Camp follow up activities were sponsored during the County FY year 2004-2005 and three during the calendar year 2005. In addition seven planning meetings were held with teens, staff and volunteers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 5) Three hundred ninety-six separate requests were approved during the County fiscal year 2004-2005 assisting 692 children. 6) Two training sessions for professionals serving abused children were supported during the fiscal year 2004-2005. 7) Seven children were assisted with non-cosmetic dental services not covered by insurance. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 FRIENDS of the Children's Justice Center of West Hawaii - Agency Name Enhancement and Basic Needs Program -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Children benefitting from Children's 222 400 225 Justice Center-WH interviews Needs re nests 692 600 600 Holida ift bas 128 130 120 FRIEND Boxes 34 60 35 Winners' Cam attendees 23 20 20 Dental Care 7 3 3 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Salaries and Wa es Professional Fees 0.00 0.00 0.00 O erations 0.00 0.00 0,00 E ui ment 0.00 0.00 0.00 Other" 13,000.00 15,000.00 15,000.00 Total 13,000.00 15,000.00 15,000.00 If applicable u Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 FRIENDS of the Children's Justice Center of West Hawaii Program Expenditures * Other ITEM FY 2004-05 FY 2004-OS FY 2006-07 Actual Budget Budget Athletic $ 907.82 $ 500.00 $ 600.00 Center Support $ 135.00 $ 300.00 $ 200.00 Christmas Bags, Teens $ 197.44 $ - $ 200.00 Clothing $ 542.71 $ 600.00 $ 600.00 Dental $ 1,133.54 $ 3,000.00 $ 1,500.00 Education $ 154.95 $ 800.00 $ 500.00 Emergency $ 296.60 $ 1,500.00 $ 1,500.00 Food Coupons $ 863.12 $ 600.00 $ 800.00 FRIEND Boxes $ 125.00 $ 500.00 $ 200.00 Medical $ - $ 200.00 $ - Miscellaneous $ - $ 100.00 $ 100.00 Performing Arts $ 85.00 $ 500.00 $ 500.00 School SuppliesNearbook $ 208.60 $ 800.00 $ 800.00 School Break Programs $ 420.00 $ - $ 500.00 Special Events $ - $ 800.00 $ - SummerCamp/Fun $ 340.00 $ 1,000.00 $ 1,000.00 Summer School $ 886.00 $ - $ 1,000.00 Therapy $ - $ 200.00 $ - Travel $ 2,628.09 $ 600.00 $ 1,000.00 Winners' Camp $ 4,076.13 $ 3,000.00 $ 4,000.00 TOTALS: $ 13,000.00 $ 15,000.00 $ 15,000.00 FRIENDS of the Children's Justice Center of West Hawaii - Agency Name Enhancement and Basic Needs Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program onlyl Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et • Estimate Count of Hawaii 14,782.65 13,000.00 15,000.00 Private Foundations 51,289.31 47,002.00 57,001.00 Fundraisin 15,492.14 21,700.00 18,150.00 Donations 26,095.06 6,000.00 16,000.00 Interest 876.30 1,100.00 1, 000.00 Total $108,535.46 $88,802.00 $117,151.00 "If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The FRIENDS of the Children's Justice Center of West Hawaii"s "Enhancement and Basic Needs" program is essentially self-sustaining at the present time. No County of Hawaii funds are used for administrative or staff expenses. Should the County of Hawaii reduce the grant to the FRIENDS, less money would be available to help the children eligible for our services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 FRIENDS of the Children's Justice Center of West Hawaii - Agency Name Enhancement and Basic Needs -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate vear-end report will impact the evaluation of your program's or agency's future funding requests. / Signature of Board P esident/Chair Da e Signature of ~xea~tive~irector ate Program Coordinator UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Goodwill Industries Of Hawaii, Inc.- A ency Name Work Experience Program- Program Name Agency Director: Laura Robertson Phone No.: 808-836-0313 Contact Person: Kathleen Nielsen Phone No.: 808-961-0307 Mailing Address: 500 Kalanianaole Ave, Hilo, HI 96720 Facility/Site Address: 500 Kalanianaole Ave, Hilo, HI 96720 Fax No.: 808-969-3861 Email Address: knielsenC~3higoowill.org Name of AccountanUCPA (include name of firm if applicable): Catha Combs, Wikoff Combs and Co., LLC Phone No.: 808-791-1420 Mailing Address: 1001 Bishop Street, Suite 2760, Honolulu, Hi 96813 Amount of Request for County Funds: $29,500 Prior Year(s) Funding: 03-04 04-05 05-06 $17,000 $10,000 $10,000 Agency Mission Statement: Our mission statement is: Goodwill Industries of Hawaii, Inc. helps people with employment barriers to reach their full potential and become self- sufficient. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program- Program Name Goodwill Industries of Hawaii (GIH) has been in business in the State of Hawaii since 1959 providing vocational training and employment services to persons with barriers to employment, including: ¦ Individuals with disabilities; ¦ Youth who have disabilities or are economically disadvantaged; • Disabled veterans; • Asian and Pacific Islander immigrants; • Older individuals and dislocated workers; and Adults who are economically disadvantaged, including Welfare-To-Work TANFlTAONF and Food Stamp recipients. With 47 years of experience operating vocational training programs as well as teaching life skills, Goodwill has developed an expertise in bringing about success to the people we serve. Goodwill Industries of Hawaii in Hilo has been serving our community since 1998. We envision a world where all individuals with disabilities and other barriers will have the opportunity to participate in a full range of life's experiences, including employment. We provide services to empower individuals to be productive and independent, based on their abilities and interests. From July 2004 to June 2005, GIH successfully provided services to over 6,650 people statewide, and placed more than 1,050 people into gainful employment. The East Hawaii branch of Goodwill Industries provided services to 1,149 individuals and placed 176 people into employment in 2004-2005. Over the past five years, Goodwill has successfully provided training and employment services to more than 21,500 people with barriers to employment, and placed more than 4,700 people into employment. These numbers reflect that Goodwill has the necessary skills and experience to perform the proposed services. Last year Pacific Business News ranked GIH as the #1 Permanent Placement Firm in the State, for the fourth consecutive year. It is our belief that work is a basic right that will assist people to attain other life goals. Moreover, we believe in each individual's right to self-determination, to make their own decisions regarding life choices as a means of promoting independence and self- sufficiency. In previous years, GIH has provided a menu of services to train, place and support individuals with barriers into gainful employment and assist them to overcome their barriers to both employment and job retention. Additionally, Goodwill is committed to providing services to help individuals after they have obtained employment to acquire skills and resources to advance, and improve NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 their economic self-sufficiency through training in basic literacy, computer literacy, GED, ESL, and Earned Income Tax Credit filing. Participants also receive follow-up supports and transitional services once they are employed. GIH will coordinate these services with the appropriate agencies and identified networks of support, to better serve the participant on along-term basis. Examples of agencies and partners with whom we coordinate services include the Department of Health, Division of Vocational Rehabilitation, Workforce Development Department, Department of Human Services, YWCA, Hawaii Literacy, Department of Education, Legal Aid Society, East Hawaii Coalition for the Homeless, Chamber of Commerce, Goodwill Industries International, employers in identified industries with job opportunities corresponding to participants' career goals, and others. When possible natural supports will be developed to enhance the individual experience in the workplace. Collaboration between employer, family, friends, and the program staff will be emphasized to increase the probability of success. Program Description: Funding is requested for a work experience program to provide wage subsidy for individuals with disabilities and other barriers to employment .The program format will allow work training opportunities for individuals that do not have work experience or who need additional supports or training to succeed in their employment goals. The training programs available are Janitorial and/or Textile/Wares processing positions. The Work Experience program will follow guidelines as set forth by the Department of Labor. Goodwill Industries has a subminimum wage certificate that requires the following: • a standard be set for each work station • community wage survey be conducted annually, and • each paticipant's productivity is measured every six months. Each participant will become familiar with and choose the program that is right for them. When the work experience path has been chosen, the participant will be trained on how to perform the essential job functions needed for the position(s). The benefits of developing these work skills extend beyond the work environment. Through this program participants learn what it is like to earn a paycheck, while being provided valuable work experience and enhancing skills in a real work setting. We recognize the intrinsic value of work and understand the profound effects that meaningful, tangible employment brings to our trainees' lives. More than bringing financial self-sufficiency, work taps the spirit of the individual, provides equal opportunity, and demands commitment and dedication, values that provide the foundation for the community. In 2004-2005, the Work Experience Program served 20 participants that were enrolled in a Goodwill training program. The format allowed work-training opportunities for individuals to choose a position in our Janitorial program or NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 TextilelWares Processing program. The Work Experience Program followed guidelines as set forth by the Department of Labor. A standard was set for each workstation, a community wage survey was conducted, and each participant's productivity was measured every six months. Participants developed problem solving skills, motivational skills, an attitude for success, and increase their self- confidence in the workplace. In addition to the population served in the past year, Goodwill Industries of Hawaii proposes to begin serving high school special education students who will be transitioning out of school within the next 2 years. Work is a logical next step for high school graduates that are not continuing their education. Practical work experience provided by Goodwill Industries of Hawaii will assist these students in transitioning from high school into the workforce. This year Goodwill Industries of Hawaii is requesting an increase in funding to enable expanded services to high school students and other persons with employment barriers. The funding will also permit purchase of assistive devices for persons with disabilities in the program. Proposed equipment purchases include: tables with height adjustment to be used for people in wheelchairs, aprons with pockets to carry tools easily, back supports to assist when lifting, bins with springboard bottoms to raise product toward the person loading or unloading, rubber mats to ease leg fatigue when standing, adaptive chairs and low clothing racks that can be reached easily from a wheelchair. These devices will strengthen the program and increase the comfort, productivity, and success of participants. The training period for each participant will be increased to 5 hours per week for a minimum of 3 months and maximum of 12 months. Additional time will allow participants to strengthen their work abilities and gain the necessary self-confidence to allow them to succeed in the work environment. The increase in the proposed funding will allow us to serve participants that have transportation barriers. East Hawaii communities have challenging transportation needs due to the limited number of transportation resources in the Hilo area. People living in less populous areas, outside of Hilo, have difficulty finding reliable, affordable transportation. Goodwill Industries of Hawaii proposes to assist participants in meeting their transportation needs through existing transportation resources, such as the Mass Transit Shared Ride Program and using the Goodwill van to transport participants to and from the program when necessary. Total Budget and Position Count Total Pro ram Bud et $29,500 Total Pro ram Position Count 2 Total A enc Bud et $2,252,000 Total A enc Position Count 65 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Program Objectives: 1) Enroll 18 participants in the Work Experience Program. 2) Instruct proper work techniques for each workstation to be assigned, by review of the workstation development form during the first week of training. 3) Develop motivational skills and attitudes for success, self-confidence and problem solving skills throughout the training period. 4) Conduct time measurement study for participant during the first 2 weeks of entry into the program. 5) Review outcomes with the participant upon completion of the time study. 6) Continue to instruct and reinforce correct work procedures. 7) Track work hours, daily or as scheduled to work. 8) Pay each participant semi-monthly, according to hours worked. 9) Conduct time study for each participant every six months. 10) Update wages according to productivity level. The emphasis of this program is giving the participants the confidence and tools to maximize their abilities. Our philosophy is to provide an environment for people to believe they can succeed, achieve goals, develop skills and change the barriers they face every day. At Goodwill we believe in the power of work. We create hope, jobs and futures. Through our program, clients learn specific vocational skills and work environment behaviors. Individuals choose the work that matches their abilities and interests and earn wages based on productivity. Clients in the custodial services program perform a variety of cleaning duties in restrooms and offices. Clients in the retail program sort, inspect, hang, and price merchandise. Goodwill supervisors provide appropriate guidance during training that emphasizes safety, quality control, production, proper work behavior, and attendance. Program Highlights: i) Enrolled 20 participants in the Work Experience Program as of January, 2006. 2) In a random audit of program participants we found an average 19% increase in productivity for participants since their entry into the program. 3) Instructed participants in proper work techniques for each workstation. 4) Developed motivational skills and attitudes for success, self-confidence and problem solving skills for each participant. 5) Conducted time measurement study for each participant within 2 weeks from date of entry into program. 6) Reviewed outcome of time study with each participant upon completion of study. 7) Instructed and reinforced correct work procedures with each participant. 8) Tracked work hours, daily or as scheduled to work. 9) Paid participants on asemi-monthly basis, according to hours worked. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 10) Conducted time study of each participant every six months. 11) Updated wages according to productivity level. 12) Developed workstation for textile processing to accommodate each participant. 13) Placed two individuals in long-term competitive employment. Through participation in the work experience program, two participants have gained valuable job skills and have transitioned to competitive permanent employment. In the work experience program they learned how to take direction, follow through on their work and how to work as a team. As they progressed in the program they demonstrated strong work ethic, attention to detail and positive attitude. One trainee transitioned to work with the aid of a vocational counselor from one of our other programs. He has been placed and is learning his new job. As a person with a disability with little work experience it would have been difficult for him to find competitive employment. Through the work experience program he was able to gain valuable job skills and find competitive employment. The other trainee made a successful transition from her program and is a crucial member of her new team. She takes great pride in her work. She is working at hours that fit her schedule and provide her with discretionary income and an opportunity to budget for items she could not afford without work. All of the participants in the Work Experience Program look forward to receiving a paycheck. Earning a paycheck provides them with opportunities to budget, save and make decisions on where and how to spend their money. The power of work allows participants to gain self-esteem and develop the following qualities that are important for job retention: • Confidence Initiative Willingness to learn Desire to work • Cooperation • Attendance • Communication skills Team play Flexibility Honesty Respect for coworkers, workplace, and equipment NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 _ Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Work Ex erience Pro ram $10,000 $17,000 $29,500 Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete afollow-up survey used to evaluate the satisfaction and effectiveness of services. Upon program exit, each participant, employer and referring counselor will be asked to complete a satisfaction survey. Parties are asked to respond to questions in several areas including the quality of services received, the service outcomes, level of satisfaction regarding the program, and suggestions for changes. Satisfaction surveys are compiled and analyzed on an annual basis. The results are shared with funding sources and Goodwill's Board of Directors. Recommendations for needed changes are analyzed. Plans for improvements are then developed and implemented as a result of this feedback. For the most recent year 2004-5, the Work Experience Program participants that were also enrolled in the Home & Community Based Services Program indicated a participant and advocate satisfaction rate of 96% in the categories of "Very Good" to "Excellent". Participant's comments included: (I) like learning to do things for myself !likes working in textiles and janitorial and receiving a paycheck. Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $8,885 $16,000 $25,500 Professional Fees O erations E ui ment $3,000 Other (Payroll $1,115 $1,000 $1,000 Processin Char es " Total $10,000 $17,000 $29,500 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Coun of Hawaii Non-Profit Grant $ 10,000 $ 17,000 $ 29,500 Goodwill Industries of Hawaii 238 3,000 3,000 State of Hawaii 368,210 362,000 390,000 Total 378,448 382,000 422,500 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Work Experience Training Program is a component of a much larger service provided to persons with disabilities, through the State of Hawaii. The money provided by the county allows trainees to earn money while gaining valuable work experience in a structured learning environment. As they gain the necessary experience they transition out of the program. While this funding pays the direct salary, it does not cover overhead, supervision, and case management. We leverage the County funding to provide afull-range of services for the trainees. Although we do not have alternative funding for the program at this time, we are looking Into expanding the program for trainees who possibly qualify for Federal funds and using the County grant for trainees who have no other sources of funding. County grant serves as funding of last resort for our trainees, who have no other options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will imaact the evaluation of your proaram's or a enc 's future funding requests. ~13~~~ ignat a of Board President/Chair Date Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Grassroots Community Development Group- Agency Name Kupukupu After-School Program- Program Name Agency Director: Trina Nahm-Mijo Phone No.: °)~-k-~-5,5 Contact Person: same Phone No.: 966-7154 Mailing Address: P.O. Box 1772, Kea'au, HI 96749 Facility/Site Address: 15-0565 Kea'au-Pahoa Highway, Bdng. G Kea'au, HI 96749 Fax No.: 974-7757 Email Address: nahmmijo@hawaii.edu Name of AccountantlCPA {include name of firm if applicable): Peralto and Co. CPA Inc. Phone No.: 961-3462 Mailing Address: 180 Kinoole St., Ste. 302, Hilo, HI 96720 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 03-04 04-05 05-06 $0 $ $0 $ $0 Agency Mission Statement: To strengthen our communities through the cooperative development of programs and services for all of Puna. To provide a quality After-School Program for area youth, family strengthening, health and wellness, cultural diversity and economic development activites. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Grassroots Community Development Group - A ency Name Kupukupu After-School Program- Program Name Program Description: This free after-school program was first started through a HI Island Meth Initiative grant in 2004 in response to the documented ice epidemic on the Big Island. The target population are 6~', 7~h, and 8~h graders from Kea'au Middle School. Besides drug refusal skills, the program also teaches pro-social and communication skills through the LifeSkills curriculum and mentoring through physical activities, tutoring, cooking and nutrition, agriculture, and arts and crafts. Special workshops are also offered in expressive activities like music, video, and circus arts. It rapidly expanded and now serves approximately 45 youth from Monday through Friday from 1-5 p.m. The program also employs 3 Youth Leaders of high school age who are being mentored to develop leadership and job Skills. Total Budget and Position Count Total Program Budget 66,000 Total Program Position Count 4 part- time Total Agency Budget 73,000 Total Agency Position Count 4 part- time Program Objectives: 1) Prevent drug use and other anti-social behaviors in Kea'au area youth; 2) Increase academic performance of Kea'au Middle School youth; 3) Provide skill development in physical, social, communication, LifeSkiNs; 4) Provide family strengthening and community bonding activities; 5) Provide Youth Leadership opportunities through paid mentorships Program Highlights: 1) At the end of academic year 2004-2005, participants in the Kupukupu After-School program measured a 10-15% improvement in an Emotional Intelligence Survey administered at the Center; 2) Participants performed newly learned circus arts skills--juggling, acro- balance, stilt-walking at an end-of-the semester event for families; NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 . About 60 people attended. 3) Participants created an original anti-drug video which they composed, sang, and filmed which will be shared with other students, faculty, staff at Kea'au Middle School as well as other public drug awareness activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Grassroots Community Development Group -Agency Name Kupukupu After-School Program -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Youth attendin After-School Pro 25-30 30-40 35-50 Hi h School Youth Leaders Em I. 2 3 4 Famil Stren thenin Activities 5 8 10 Jobs created for Adults 4 5 6 Job Develo ment Placements 1 2 3 College Students learning 20 30 40 community engagement through Service Learnin Communit Meetin s Held 4/wk. 5/wk. 6/wk. Adults meetin at the Center 30/wk. 40/wk. 50(wk. *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 17,791.93 50,000 60,000 Professional Fees 3,900.00 1,000 2,000 O erations 24,591.62 10,000 11,000 E ui ment 10,909.53 1,000 Other` Total 57,193.08 62,000 73,000 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 .Grassroots Community Development Group -Agency Name Kupukupu After-School Program -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate HI Island Meth Initiative Grant 50,000 50,000 0 Kuki'o Grant 5,000 5,000 Healin Our Island Grant 1,000 2,000 Donations 3,159 4,000 4,000 Other Grants 6,000 Fundraisin 2,000 3,000 Count of Hawaii 60,000 Total 59,159 64,000 73,000 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? This program plans to increase revenues through the following activities: 1) Grant writing to foundations, government, and other entities; 2) Becoming a HI Island United Way recipient; 3) Fundraising events; The goal is to be self-sustaining in two years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 - ~ Grassroots Community Development Group -Agency Name Kupukupu After-School Program -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofd Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-gnd report will imaact the evaluation of vour proaram'a or aoencv's futun: fundingreauests. Signature of Boa d Presi ent/ hair Da e ~-at_~ ~ ~ ~ ~v i n ture of Da e ~ammuni Ct>or-d~n~ UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Habitat for Humanity Kona- Agency Name General Operating Support (as opposed to construction) - Program Name Agency Director: David Kish, Board President Phone No.: 327-1199 Contact Person: JoAnn Farnsworth, Consultant to the Board Phone No.: 329-0806 Mailing Address: Box 4619 Kailua Kona, HI 96725 Facility/Site Address: N/A Fax No.: 1-808-930-0849 Email Address: habitatkona@hialoha.net Name of Accountant/CPA Alex Smith, CPA Phone No.: 877-257-6484 Mailing Address: 1403 Frank Street, Honolulu Hi 96816 Amount of Request for County Funds: $25,000 Prior Year(s) Funding: 03-04 04-05 05-06 $N/A $ N/A $ N/A Agency Mission Statement: Vision: The vision of Habitat for Humanity Kona is that all residents of West Hawaii will have safe, decent and affordable housing through home ownership. Mission: To empower families, build community and hope through home ownership for partner families. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Habitat for Humanity Kona -Agency Name General Operating Support- Program Name Program Description: Affiliate Background Habitat for Humanity Kona, Inc. (HFHK) is a nonprofit housing ministry affiliated with Habitat for Humanity International (HFHI). We seek to "Build houses and Build hope" by eliminating poverty through homeownership. Habitat for Humanity International is blessed with a global base of volunteers, supporters and sponsors. With their help, this year we reached an important milestone by building our 200,OOOth house worldwide. It took 25 years to build the first 100,000 Habitat houses. Through the good will of our committed community, corporate and individual supporters, the next 100,000 were built in just five years. Every 24 minutes, someone in the world is walking through the doorway of their new Habitat home. We do this by working in respectful partnership with homeowner families, providing a hand up and not a hand out. And by working through and with local organizations, we offer sustainable, pragmatic, and culturally appropriate solutions to poverty housing. Habitat for Humanity is awell-tested, well- developed program that is successful around the globe, with affiliates in over 70 countries. Habitat for Humanity Kona has just begun and was granted affiliation with HFHI in 2002. HFHK is a volunteer effort with the only paid staff being a part time Operations Manager/Volunteer Coordinator. Our goal in this coming year is to raise the funds to hire a full time Executive Director to come on board in 2006. Building projects are undertaken by hundreds of local community volunteers who are provided leadership from our Board of Directors comprised of 12 members. How Habitat Works Habitat families are at risk for a number of poor outcomes. The housing situation in West Hawaii puts families at grave risk. The "affordable housing" that is being built, or being discussed by the County, is for homes costing minimally $250,000 with a monthly mortgage of $1,576.00 with 20°lo down. This is impossible for the Habitat target family who grosses between $1,666.00 and $2,666.00 a month. These families are forced to rent, but the average rent for a two bedroom apartment is running $1,000-$1,200 a month, homes are even more. These families are being forced to rent substandard units, live in over crowded conditions or face homelessness. Family members also can turn to illegal methods of support to make ends meet. On the other hand, a Habitat mortgage is designed so that no family is paying more than 21 % of their monthly income on their housing, 30% with utilities, taxes NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 and insurance. Habitat builds homes for families earning befinreen 40-60% of the median income for the County on a no-interest, no-profit basis and requiring 1 down payment. The family support component of the Habitat program, which extends over the length of the mortgage, provides assistance with budgeting, house repair and maintenance, guidance through the rough times a family might encounter such as illness or job loss and links to community social services organizations and faith based groups. This allows for the family to stay debt free and use the remainder of their income for reliable transportation, quality food, adequate health care, education and recreation. The most important partner is the Habitat partner family. Partner families are required to perform 300 hours of "sweat equity" on their or another family home. In addition, their mortgage payments go into the Habitat for Humanity Fund which is used as a revolving fund to finance the home build for another family. Community Impact Perhaps one of the most far reaching outcomes that an active Habitat affiliate can bring to a community is the opportunity for people from ail walks of life to work together, side by side, on a project where divisions of race, ethnicity, wealth or religious affiliation are bridged. Building a Habitat home is the epitome of building social capital. People from all walks of life volunteer; working side by side with each other on an uplifting task in which everyone is equal and all have a role to play. Building Habitat homes will give the Kona community an opportunity to work together in a way that hasn't happened since we built the playground at Higashihara Park in the late 1990s. In our first build over 25 people volunteered on the actual build and at least 25 more worked behind the scenes to find the funds, fix the lunches, provide the supplies and prepare and review mortgage and financial documents. To quote Robert Putman in his book Bowling Alone homeownership builds a stronger community, "homeowners are substantially more likely to be involved in community affairs than renters...mobility undermines civic engagement and community based social capital." The target population for Habitat is a low income family in need of a simple, decent home. Within that population Habitat of Kona has determined two subgroups to receive the highest priority for our assistance; 1) Families with young children who are at risk of homelessness or losing their children to Child Welfare as a result of unsafe housing conditions, and 2) Seniors living in substandard or unsafe homes. Family Outcomes Habitat affiliates have seen first-hand how home ownership impacts families, children, and communities. Dr. Donald Haurin of Ohio State University in a recent research paper highlighting the research on the benefits of homeownership found in a controlled study (i.e. controlling for other variables such as education, income, wealth etc) that children of homeowners have, NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 ? math scores that are 9% higher, ? reading scores that are 7% higher, ? a reduction in children's behavior problems by 3%, and ? that the longer one owns- the greater the effect. Other academic studies show: ? children of owners have a lower probability of dropping out of school, ? a lower probability of having a baby before 18, ? they achieve a higher level of education 10 years after leaving the parental home, and ? they are more likely to become homeowners. In summary, families have a chance to experience stability, build equity wealth, and have something tangible to pass on to their children. Children are healthier and safer. They do better in school, have higher self-esteem, and feel more hopeful about their future. Communities are improved, as homeowners tend to be more active in their communities than renters, and pay into the tax base. By providing a hand up, not a handout, Habitat maintains the dignity and pride of our homeowner families. In addition to building the very real concrete protective factor of financial independence, the Habitat family traditionally experiences a dramatic shift in self esteem, a shift that is passed on to the children in that family as well. Families that could never imagine themselves as home owners now have an asset that allows them to live in a safe, supportive neighborhood and is an asset (after the mortgage is paid) that can be inherited by their children, used to finance children's college education or sold to provide security for their retirement. Around the country Habitat affiliates see evidence of the success of the program in the less than 1 % default rate on Habitat for Humanity mortgages, far less than the foreclosure rate for commercial banks who are dealing with higher income earners. Total Budget and Position Count Fiscal Year 2007 Total Program Budget FY07$64,940 Total Program Position Count 1 Total A enc Bud et FY07$369,980 Total A enc Position Count 3 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Program Objectives: To date our affiliate has only been able to build homes for families with access to their own land; we have built one new home and completed three renovations and are starting our second and third houses this January However; we have spent this past year setting the stage for our long term plans. We have been meeting with State and County officials as well as the Department of Hawaiian Homes to discuss partnerships where land and infrastructure is donated to our affiliate in exchange for our building homes for families under 60% of the median income for our County. After many meetings it appears that these partnerships will come to fruition; a State owned development where we would build 16 multiple unit town houses, a partnership with UniDev Corporation in Waikoloa for potentially 36 units and a project with Department of Hawaiian Homes in 2006 for 6 houses and in 2007 for an additional 10. The March 2006 DHHL project will require little financing however the state and county projects and 2007 DHHL project will require approximately $4,000,000. Construction on these projects will not start until 2007 which leaves 2006 for us to develop the financing. It will be critical in the coming year for us to have staffing to develop both the financial and in kind resources for these projects that is why we are seeking funding for an Executive Director position who has had previous experience with Habitat fund development officer and developing the financing for large builds. In addition we have been accepted as a VISTA site. Our VISTA volunteer is a fund development position. Work Plan for Year One Goals & Objectives Goal 1: To develop a financial plan that details the financing of both the State Kealakehe Partnership, County of Hawaii UniDev project in Waikoloa and the Laiopua Partnership with Department of Hawaiian Homes (DHHL)and Menehune Development. Obj 1: Working with Building Committee develop cost estimates for the State, County and DHHL builds. Obj. 2: As goals 2, 3 and 4 are developed reliable revenue projections can be developed for public, corporate, private and fund raising campaigns and put into the plan. Goal 2: Public sources of funding for the above projects will have been researched and their appropriateness determined and grants written, including but not limited to; HUD, HOME, CDBG, USDA. Obj 1: Attend all public information sessions and training sessions as they occur Obj 2: Develop a timeline for submission of proposals Obj 3: Develop template information for grants such as affiliate statistics, affordable housing needs assessment, and program description. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Obj. 4: Write proposals as appropriate. Goal 3: A private donor base will be deve?oped and the data base established. Obj 1: Review and update existing private donor base and input into HabiTrak Obj 2: Research additional sources of private donors from other data bases; Chamber of Commerce, other non profits, Board of Realtors etc. Obj 3: Conduct annual "Friends" direct mail campaign Goa14: Corporate partnerships will be developed for in kind contributions and donations of building materials, including but not limited to; HPM, Home Depot, Loews, Trojan Lumber Obj 1: Research all corporate donations to date and develop a corporate donor base Obj 2: Develop the pitch to corporate donors and target list Obj 3: Begin to contact targets Goal 5: All real estate brokers will be contacted to develop the "1 % of closings" campaign. Obj 1: Identify all real estate brokers serving West Hawaii Obj 2: Work with the Board of Directors to develop the campaign and strategy for approach Obj 3: Provide support to the Board as they "make the ask" with appointments, materials and follow up requests. Goal 6: A signature event will be developed and hosted Obj 1: work with the special events volunteers to review past events and their success Obj 2: working with the special events volunteers determine a "signature event" Obj 3: provide support for the volunteer management of that event Obj 4: document the planning and staging of the event for future duplication. Program Highlights: 1) To date HFH-K has rehabbed one home, a family violence shelter, Bridge House transitional living facility and has completed its first four bedroom home for a partner family. There are currently four active partner families that have been approved by the Family Selection Committee. All four families have access to family held land and have children living at home. One family applicant is a grandmother whose six grandchildren have been removed by Child Protective Services from their parents' home. In order for her to obtain custody of the children she is being required to add on four additional bedrooms to her current home, this would technically be a renovation. The funds are in place for these projects and we anticipate them to be built out in spring and summer of 2006. 2) In addition, we will be beginning a six house collaboration with Menehune Development of Department of Hawaiian Homes Land in Waimea in March of 2006. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Habitat for Humanity Kona -Agency Name General Operating Support -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Outcome 1: A financial plan will be Completed in place that details the financing of both the State Kealakehe Partnership, County UniDev project and the Laiopua Partnership with Department of Hawaiian Homes. Outcome 2: Public sources of Completed funding for the above projects will have been researched and their appropriateness determined and grants written as appropriate, including but not limited to; HUD, HOME, CDBG, USDA. Outcome 3: A private donor base Completed and data base will be established established Outcome 4: Corporate partnerships Completed will be developed for in kind contributions and donations of building materials, including but not limited to; HPM, Home Depot, Loews, Trojan Lumber Outcome 5: All real estate brokers Completed will be contacted to develop the "1 of closin s" cam ai n. Outcome 6: A signature fundraising Completed event will be determined and hosted *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Program Expenditures See attached detail of the FY 2006 and FY 2007 budgets for operations and construction. Habitat for Humanity Kona is requesting $25,000 funding for an Executive Director position. This will cover approximately half of the salary and wages for the position. The position is expensed out half/ltalf between the operations budget (which is detailed in this chart) and the construction budget. FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 8,178.85 11,700 31,700 Professional Fees 10,440.00 27,500 12,000 Operations 12,292.46 11,150 14,900 E ui ment Other" Total 30,911.31 52,690 64,940 If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page S Habitat for Humanity Kona -Agency Name General Operating Support -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Habitat for Humanity Kona is requesting $25,000 in funding for an Executive Director position. This will cover approximately half of the salary and wages for the osition. Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Private Contributions(ourgoa/s is 5,000 5,000 0 that all private funds are used for construction and go into the Fund for Humani Special Events(ditto for special 1,000 1,000 0 event funds Hawaii Island United Wa 5,500 6,000 HFHK Revolvin Fund Office of Hawaiian Affairs 6,000 Coun of Hawaii 25,000 State Su ort Or anization Grants 20,000 16,000 0 Case Grants 4,500 5,000 5,000 Co orate S onsorshi s CDBG N/A N/A Foundation rants 20,000 25,000 Total 30,500 52,500 67,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self~ustaining? The current fiscal year 2006, has revenues available for operations of $52,500 this does not include the cost of construction. This operating budget only allows for a part time operations/volunteer coordinator, contract bookkeeper and strategic planning consultant. It is the policy of the Board that minimally 90% of the funds raised in the community are used for home construction. We seek grant funds to support our general operations. It is clear that in order to be able to accomplish our goals of building over 60 homes for low income families in the next three years we have to increase our staffing capacity at the professional Ievel.The funds from the County will enable us to hire an Executive Director with previous Habitat experience who will be capable of developing the funding streams necessary to finance the building of homes. The proposed work plan details the steps we will take in the coming year to develop revenue streams. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 9 Habitat for Humanity Kona -Agency Name General Operating -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. ! (we) understand that information supplied herein shat! be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, 1 (we) understand and will comply with the requirement to submit a yearend report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate yearend report will imaact the evaluation of your prooram's or aaencv's future fundin~l requests. {J 1 (ld'W'~W v~ I~~ I !o D 6 Signature of Board PresidenUChair Date ~ ~6 ~O 6 Si ature o v cecutive Director Date Gx}i nc( UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 10 Habitat for Humanity Kona Project Budget FY 2006, FY 2007 FY 2006 Budget Operations Constrvdion Total Operations Construction Total Revenue 2 houses 4 houses Case Grants $ 5,000 $ 40,000 $ 45,000 $ 5,000 $ 40,000 $ 45,000 Coryorete Sponsorships $ 20,000 $ 20,000 $ 20,000 20,000 Hawaii Island United Way $ 5,500 $ - $ 5,500 $ 6,000 $ 5,000 $ 11,000 County of Hawaii $ 25,000 $ - $ 25,000 CDBG $ 40,000 $ 40,000 Foundation Grants $ 20,000 $ - $ 20,000 $ 25,000 $ 25,000 $ 50,000 Unrestrided Contributions $ 5,000 $ 30,000 $ 35,000 $ - $ 35,000 $ 35,000 Special Events $ 1,000 $ 9,000 $ 10,000 $ - $ 14,000 $ 74,000 State Support Organization $ 16,000 $ - $ 16,000 $ - $ - $ - Office of Hawaiian Affairs $ 6,000 $ 54,000 $ 60,000 HFHK Revolving Fund $ 15,000 15,000 $ 20,000 $ 20,000 Loans as needed; USDA,RAC $ 50,000 $ ~ 50,000 Total Revenue E 52,500 E 114,000 E 766,500 E 67,000 E 303,000 E 370,000 Expenses _ _ Personnel Operations Manager $ 7,800 $ 7,800 $ 15,600 $ 7,800 $ 7,800 $ 15,600 Volunteer Coordinator $ 3,900 $ 3,900 $ 7,800 $ 3,900 $ 3,900 $ 7,800 Construdion Manager $ 40,000 $ 40,000 Executive Diredor $ 20,000 $ 20,000 $ 40,000 Personnel subtotal $ 11,700 $ 11,700 $ 23,400 $ 31,700 $ 71,700 $ 103,400 Taxes & Benefds $ 2,340 $ 2,340 $ 4,680 $ 6,340 $ 14,340 $ 20,680 Total Wages S 74,040 E 74,040 E 28,080 E 38,040 E 86,040 E 124,080 Professional fees ConsuBant $ 24,000 $ 24,000 $ - - Bookkeeping $ 2,000 $ 2,000 $ 4,000 $ 4,000 $ 2,000 $ 6,000 Auditor $ 1,500 $ 1,500 $ 2,000 $ 2,000 Constrodion Supervisor $ 10,000 $ 10,000 _ $ 20,000 $ 20,000 VISTA volunteer stipend $ 6,000 $ 6,000 Total Professional Fees E 27,500 E 10,000 E 37,500 E 12,000 E 20,000 E 32.000 Advertisement $ 1,000 $ 7,000 E 1,000 $ 1,000 Automobile Expense $ 200 $ 200 $ 200 $ 200 Contrad Labor $ 5,000 $ 5,000 $ 10,000 $ 10,000 Cost of Construdion__ _ $ 70,000 $ 70,000 $ 160,000 $ 160,000 Cost of Land $ 23,000 $ 23,000 $ 25,000 $ 25,000 Dues & Memberships $ 3,500 $ 3,500 $ 3,500 $ 3,500 Insurance $ 1,250 $ 1,250 $ 2,500 $ 2,000 $ 2,000 $ 4,000 Licenses and Permits $ 500 $ 500 $ 1,000 $ 1,000 Otfwe E~enses 8 Supplies S 2,000 $ 2,000 b 4,000 $ 4,000 Professional Development $ 1,000 $ 1,000 $ 1,000 $ 1,000 Program E~rense $ 1,000 $ 1,000 $ 1,000 $ 1,000 Telephone $ 500 $ 500 $ 1,000 $ 1,000 Internet $ 200 $ 200 $ 200 $ 200 Travel $ 1,500 $ 1,500 $ 2,000 $ 2,000 Total Operating $ 11,150 $ 100,750 $ 111,900 $ 14,900 $ 199,000 $ 213,900 Total FY 2006 E 52,690 E 721,790 E 177,460 E 64,940 E 305,040 S 369,980 JYF: Habitat:Grants/County 12/21/05 Habitat for Humanity Kona Project Budget FY 2006, FY 2007 .5fte/$15.00=15,600 .5fte1$15.00=15,600 for limos. salaries * 20°k JYF: Habitat:Grants/County 12/21/05 Hawaii Centers for Independent Living -Hawaii- Agency Name Independent Living Services- Program Name Agency Director: Patricia Lockwood Phone No.: 808- 522-5400 Contact Person: Lyman Graciano Phone No.: 935- 3777 Mailing Address: 400 Hualani St Suite 16D Hilo, HI FacilitylSite Address: Same as above Fax No.: 961-6737 Email Address: patl@pacificil.org Name of AccountantlCPA (include name of firm if applicable): Nathan Holmes Phone No.: 522-5400 Mailing Address: 414 Kuwili St. Honolulu, Hawaii 96817 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 03-04 04-05 05-06 $15.000 $15,000 $15,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Agency Mission Statement: Hawaii Centers for Independent Living, mission is this, "Building access independence and choice with people with disabilities.Hawaii Centers For Independent Living The Hawaii Centers for Independent Living (HCIL) is anon-profit organization operated by and for people with disabilities to ensure their rights to live independently and fully integrated in the community of their choice, outside of institutional care settings. As anon-profit, statewide resource, HCIL serves people of any age with any type of disability. HCIL was founded on the historical constitutional beliefs of civil rights and the empowerment of people with disabilities to have equal access, opportunities, and choices in life, no matter how severe their disability. To accomplish this, HCIL actively seeks systems change and promotes self- advocacy. Headquartered in Honolulu, we also have offices on the islands of Hawaii, Maui and Kauai and currently oversee Centers for Independent Living in Guam. The Philosophy That Guides HCIL Is Three-Fold: 1. HCIL's objective is to present information on a wide array of options, from full independence to other forms of community-based living, from which individuals with disabilities can make their own personal choices. 2. The needs of people with disabilities can be met effectively by comprehensive programs encompassing personal care, housing, transportation, work, recreation the list is almost endless. This is what drives HCIL's response to consumer requests. 3. Those who know best the needs of people with disabilities, and how to meet those needs, are people with disabilities themselves. It is the strong belief in this peer relationship that distinguishes HCIL and its services. Following is a description of the programs and services provided by HCIL-Hawaii. Core /Independent Living Program HCIL helps people with disabilities to develop greater problem-solving and self- management skills so they achieve their life-long aspirations. People with disabilities establish their own service goals for maximum "choices" in living. The staff at HCIL facilitates the development and implementation of these goals. Many of our staff members are also living with a disability and so they are in a unique position to provide experiential expertise because they have similar challenges and issues in their daily lives. Housing, transportation, employment, personal care, assistive technology, mobility, accessibility, financial resources, recreation, self-advocacy and interpersonal relationships are all addressed by NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 our Independent Living Specialists. The vast majority of those we serve, increase their personal choices and experience improved quality of life. Elderly Blind Services (EBS) Skills training in daily living activities, orientation and mobility, and use of visual aids are provided to people who are over the age of 55 years and legally blind. Lessons are individualized and taught in the person's home. Peer support activities, diagnostic consultation, referral to the Ho'opono Low Vision Clinic, and general resource linkages are also available. The purpose of this program is to enable the person to maintain their independence in the community. Outreach Making services accessible to people who are traditionally under-served, is the primary purpose of outreach. HCIL services can be delivered in the person's home or neighborhood because our outreach workers live and work in the communities they serve, resulting in greater access for more people of ethnic minority cultures. Person to person contacts can be made with an interpreter for those who prefer to communicate in another language including American Sign Language. Youth Leadership Program This unique program was established by HCIL in 2002 to help build Hawaii's next generation of leaders with disabilities. Our Youth Program is designed to support and encourage youth with disabilities to strive to increase self-sufficiency and to develop their personal strengths to achieve their goals. The Youth Program uses a variety of funding sources including Hawaii Island United Way and federal and private grants to offer youth with disabilities new experiences that promote the development of leadership skills. Community Rehabilitation Program The Interwork Institute at San Diego State University contracts with HCIL to implement the Hawaii Professional Education for Rehabilitation Centers. Areas of needed staff development are identified within community rehabilitation program agencies and training is delivered through in-service and college class opportunities. A local steering committee was convened to carry out participatory activities. Members include consumers, Commission on Persons with Disabilities, Department of Health, Department of Human Services, Easter Seals Society, Goodwill Industries of Hawaii, and Winners at Work. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-1Y7 Page 3 Hawaii Centers for Independent Living -Hawaii -Agency Name Independent Living Services- Program Name Program Description: The concept of independent living is being able to make choices in life that will enhance dignity and self-respect. People with disabilities want equal privleges as well as responsibilities which are available to everyone. Ignorance and discriminatory practices in society cause a combination of low education, vocation, income and social opportunities for people with disabilities. The Hawaii Centers for Independent Living -Hawaii believes that those who best know the needs of people with disabilities and how to meet those needs are people with disabilities themselves. The practice of "consumer-control" forms the foundation for staff resources and service delivery. Staff works with people with disabilities to determine, establish, and achieve independent living goals. which result in increased access, independence and choice. Total Budget and Position Count Total Pro ram Bud et 336,680 Total Pro ram Position Count 9 Total Agency Budget 1 646 724 Total Agency Position Count 33 Program Objectives: 1) Provide landlord /tenant rights training, as well as, instruction on how to complete a housing application, how to locate housing and how to maintain their housing situation. The outcomes are reduced homelessness and increased independence for persons with disabilities. As a component of this goal HCIL- Hawaii will coordinate services with other Hawaii Island Homeless and Housing agencies to insure there is no duplication of services. Hawaii Centers for Independent Living is a member of the new statewide affordable housing coalition, Housing Hawaii. Timeline: 7/1/06 - 6/30/07 2) Provide consumer training on how to interview, hire and fire an attendent. Develop a list of chore !personal assistance referrals for consumers to work with if they choose to do so. This increases the persons ability to stay in their own home in the community, as well as increasing their control of their lives while decreasing dependency on family and friends. Timeline: 7/1/06 - 6!30/07 3) Provide one--on-one independent living skills training to assist consumers in carrying out their every day living activities such as housekeeping, shopping, laundry, cooking, etc. This will increase their ability to develop or maintain their independence and be part of the community.Timeline: 7/1106 - 6130!07 NONPROFIT GRANT APPLICATION FISCAL YEAR 2~6-07 Page 4 4) Teach consumers about their rights and responsibilities as they work with different state and federal program. Teach consumers about what their options are and how to advocate for themselves. Support will be given to the consumer as they learn this process as needed. The ultimate outcome will be persons being empowered to be responsible for their actions and obtain the services they need in the community. Timeline: 7/1/06 - 6/30/07. 5) Provide one-on-one training with consumers to teach consumers about how to prioritize their needs, and determine an action plan to get those needs met. Persons with disabilities will serve as the peer mentors.. This will increase both the persons ability for self determination and encourage their full participation in the community. Timeline: 7/1/06 - 6/30/07 6) Provide consumer with information on their Social Security entitlements and how going to work will effect their housing and other benefits.This will provide the person with the information they need to become employed in the community while transitioning to less dependence on federal and state assistance programs. Timeline: 7/1/06 - 6/30/07 7) Provide consumers with housing referrals to acquire a place to live. This will increase their independence and decrease the threat of homelessness. Timeline: 7/1/06 - 6/30/07 8) Provide consumers with information and referral services to increase their access to resources in the community. This will increase their independence. Timeline: 711/06 - 6/30/07 9) Provide consumer with transportatin options in the community. This will increase their access to services in the community. The Center will work in coordination with other community agencies to insure there is no duplication of services Timeline: 7/1/06 - 6130/07 10) Work with consumers on educating them regarding the types, availability and funding sources for medical equipment and assistive technology in the community. The outcome being the consumer being able to gain access to the equipment they need. Timeline: 7/1/06 - 6/30/07 Program Highlights: 1) Hawaii Centers for Independent Living -Hawaii provided information on independent living services to approximately 400 seniors at the Senior Health Fair. 2) Hawaii Centers for Independent Living -Hawai continues to work with DRH (Disability Rights Hawaii) a local grassroots advocacy group to improve access in Hawaii county for people with disabilities. 3) Hawaii Centers for Independent Living - Hawaiparticipates in the PICIL (Partnership in Community Independent Living) advisory committee. This project assists people with disabilities to meet their self-determined goals. 4) Hawaii Centers for Independent Living -Hawai continues to work on disability-related issues in Hawaii county with the Mayor's Committee on People with Disabilities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 5) Hawaii Centers for Independent Living - Hawaireceived a grant from Hawaii Island United Way to form a Youth Empowerment Group for young adults with disabilities. 6) CIL-Hawaii provided technical assistance to Haola, Inc., University of Hawaii of Hilo Library Staff, and Hospice of Hilo. CIL- Hawaii has initiated the outreach staff working from their homes in different districts of Hawaii County. CIL-Hawaii has a staff person in the North & South Kona districts, Kau District, North & South Kohala District and Puna District. The Hilo office will assist with the North & South Hilo District and Hamakua District. Performance Measures: This year the Hawaii Centers for Independent Living -Hawaii provided services to 345 individuals with various types of disabilties. Sixty consumers completed their programs. Sixty per cent of the persons who completed their program met their goals. Fifteen percent dropped out of the program. The remainder of the individuals in the program either moved out of our servicee area or died. One hundred and thirty three of these individuals were over the age of 65. Persons served had cognitive, emotional, physical, hearing, vision and other types of disabilities such as diabetes. Sixty six percent of those served had more than one type of disability. Hawaii Centers for Independent Living -Hawaii counts goals set and met in terms of the following topics: self advocacy/self-empowerment, communication, mobility/transportation, community services, educational, vocational, self-care, informationa access, and personal resource management. A total of 1072 goals were set and a total of 820 goals were met (77%) In the section below I have listed the goals set and goals met by individuals to whom we provided services this year. I have then listed the anticipated number of goals which will be set for next year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Hawaii Centers for Independent Living- Hawaii -Agency Name Independent Living Services -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Goal description goal set goals met 2006 goals set self advocac 320 206 300 communication 7 7 8 trans ortation/mobilit 20 14 20 communit services 348 280 350 educational 7 6 7 vocational 6 2 6 self care 283 239 280 information access/technolo 7 6 8 ersonal resource mans ement 74 62 70 Total 1072 820 1049 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 10437.56 10960 10960 Professional Fees 669.41 650 650 O erations 2800.99 2800 2800 E ui ment 1092.04 1090 1090 Other" 0 0 0 Total 15000.00 15000.00 15000.00 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Hawaii Centers for Independent Living- Hawaii -Agency Name Independent Living Services -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii 15,000 15000 15,000 State of Hawaii 114,238 115,000 115,000 Federal Funds 156,417' 157,000 157,000 United Wa donations 15,000 15,000 15,000 Donations 34025 5000 5000 Total 321,180 307,000 307,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? At this point in time Hawaii Centers for Independent Living is working to develop feel for service programs which will supplement our office budgets throughout the state. At this point in time we have just received word that we will have a 1 decrease in our federal budget. This may also impact one of our state budgets since the state just lost 1 % of that budget. We are having a strategic planning meeting in April with board, staff, and community partners to discuss this as well as other matters. At this time the Chair of the board of directors and two other board members represent the County of Hawaii on our nine person board of directors; NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 Hawaii Centers for Independent Living -Hawaii -Agency Name Independent Living Program -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 pf the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate vear-end report will impact the evaluation of your oroaram's or apencv's``,,f'uture funding requests. 1.:~ .N 1/31/06 Signature of Board President/Chair Date 1/31/06 Signature of Executive Director Date NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 9 UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FLSCAL YEAR 2006-07 Page 10 Hawaii Island Adult Care, Inc. -Agency Name Hilo Adult Day Center -Program Name Agency Director: Carolyn Cabreira Phone No.: 961-3747 Contact Person: Carolyn Cabreira Phone No.: 961-3747 Mailing Address: 34 Rainbow Drive Hilo, HI 96720 FacilitylSite Address: same as above Fax No.: 961-3740 Email Address: adltcare@gte.net Name of Accountant/CPA (include name of firm if applicable): Jennifer L. Gossert, CPA Phone No.: 969-3115 Mailing Address: 688 Kinoole St., Suite 201, Hilo, HI 96720 Amount of Request for County Funds: $18,000.00 Prior Year(s) Funding: 03-04 04-05 05-06 $15,500.00 $15,500.00 $18,000.00 Agency Mission Statement: To advocate for the rights of frail elderly and disabled adults, and to assist them and their caregivers in maintaining their independence and dignity as active members in the life of the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 _ Hawaii Island Adult Care, Inc. -Agency Name Hilo Adult Day Center- Program Name Program Description: Hilo Adult Day Center provides a safe, socially active, quality adult day program for frail elders and mentally/physically challenged adults needing supervised daytime care. Total Budget and Position Count Total Pro ram Bud et 1,149,300.00 Total Pro ram Position Count 21 Total A enc Bud et 934,398.00 Total A enc Position Count 35 Program Objectives: 1) Provide a safe, caring daytime environment for frail elders and mentally/physically challenged adults including those with Alzheimer's disease; all of whom can no longer take full care of themselves, many are under doctor's orders for supervised care. 2) Provide interaction/socialization with others, hands-on activities, singing, arts/crafts, games, bingo, excursions, entertainment and more. These individuals are generally inactive at home, having old-age depression; the day center is geared to give them enjoyment of life, something to look forward every day. 3) Provide the opportunity for elders to continue living in their own homes as long as possible and deter pre-mature institionalization into long term care facilities. 4) Provide respite for caregivers and deter "caregiver burnout". 5) Allow working families to continue their employment while attending to their frail loved ones in the evenings and weekends. 6) Provide adult day care to all individuals needing supervised daytime care, regardless of their ability to pay by utilizing federal, state, county and private foundation tuition-assistance funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Program Highlights: 1) Provided day care services to 139 individuals having varied physical or mental limitations. June 2005 ended with 88 enrolled. 2) Enrolled new participants, 50; discharged, 50; attending full year 60. Five clients passed away while attendees of the center and still living at home; (this is the ultimate goal for our clients, to move on from this life while still living at home). 3) Maintained professional level of client services with the state of Hawaii, Department of Human Services(DHS), Adult Day Services program and Nursing Home without Walls (NHWW). The day center was re-licensed in January 2004 for two years. The DHS Purchase of Services application (RFP) for the Adult Day Services was submitted January 2005 and approved in May 2005 for an additional six years ($120,148.00/annually from July, 2005 to June, 2011) to provide adult day center services for 20 poverty level -Medicaid eligible (DHS) clients per month. 4) Continued working with numerous other agencies including the Interdisciplinary Team (IDT) organized by the State Department of Health (NHWW, DHS, Services for Seniors, Kokua Nurses, CareResouces, other agencies servicing seniors) to provide client specific care. 5) Continued writing and receiving private foundation grant support for tuition/fee assistance, received adequate support for everyone needing to attend the center who could not afford full costs. 6) Continued the Caregiver Support group twice a month, providing both for counseling and training sessions for community caregivers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Hawaii Island Adult Care, Inc. -Agency Name Hilo Adult Day Center -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Avera a month) attendance 89 92 92 All fi ures are totals for the ear: 139 140 141 Participants enjoyment of life, 135 136 137 maintain or improve personal h iene/self-care Participants continue to live in own 117 118 119 homes in care homes Families/caregivers able to continue 75 76 77 em to ment Families/caregivers receiving 102 105 105 res ite Participants continue to attend after 96 97 97 6 months Partici ants continuin after 1 ear 77 78 78 Partici ants continuin after 2 ears 58 59 59 Partici ants continuin after 5 ears 23 23 23 Medicaid monies saved on $763,200.00 763,200.00 763,200.00 participants attending day care (10 persons (10 persons) (10 persons) versus those living in long term care were institutions (based on clients discharged discharged into long term care into long Burin the ear term care *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 485,739.00 555,541.00 573,000.00 Professional Fees 12,473.00 21,500.00 15,000.00 O erations 147,880.00 173,107.00 176,000.00 E ui ment 6,373.00 2,400.00 2,500.00 Other" 145,235.00 167,250.00 167,898.00 Total 797,700.00 919,798.00 934,398.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Hawaii Island Adult Care, Inc. -Agency Name Hilo Adult Day Center -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et Estimate Tuition/Fees 396,240.00 486,800.00 504,000.00 State - DHS and Nursing Home 124,752.00 150,148.00 154,148.00 without Walls Federal -Nursing Home without 32,198.00 30,000.00 35,000.00 Walls and Ku una Care Count of Hawaii 15,500.00 18,000.00 18,000.00 Hawaii Island United Wa 16,500.00 20,750.00 20,750.00 Ma Tem leton Ho er Fund 69,625.00 75,000.00 75,000.00 Mclnerny/ Gwenfread Allen/HHA 46,059.00 73,500.00 60,000.00 Charity Walk/Friends of Hawaii Charities/other rants Donations 13,303.00 12,350.00 14,000.00 USDA Lunch reimbursement 31,200.00 32,000.00 32,000.00 ro ram PIN rant mana ement 5,000.00 5,000.00 5,000.00 Fundraising/interest/vending 5,801.00 16,250.00 16,500.00 machines/misc. sales Total 756,178.00 919,798.00 934,398.00 'If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Fees and rates were raised this year (21 % after no increases in 4 years) for pay raises (none in three years and increased costs. A golf fundraiser will be held in April, which should be come an annual event. This adult day center program can only become self-sustaining if the federal and/or state government would recognize the importance of adult day care and living at home versus long term institutionalized care, and recognize the large tax savings noted above. Only then govt. program allowing cost share for adult day care for those above poverty level could to be put in place. At that point we would not need to request funds for this gap group who cannot afford full costs. Some individuals are purchasing long term care insurance which will pay for these individuals in the future but only those who can afford to purchase this additional insurance will benefit. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Hawaii Island Adult Care, Inc. -Agency Name Hilo Adult Day Center -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will impact the evaluation of vour program's or aaency's future funding requests. Sign ture of Board Pr ise d ne t/Chair Date Signature of ecutive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Hawaii Island HIV/AIDS Foundation -Agency Name Multi-Disciplinary HIV Case Management, Hilo -Program Name Agency Director: Georgie Kennedy Phone No.: 331-8177 Contact Person: Georgie Kennedy Phone No.: 331-8177 Mailing Address: 75-240 Nani Kailua Dr. #5, Kailua-Kona, HI 96740 Facility/Site Address: 16-204 Melekahiwa PI. #1, Kea~au, HI 96749 Fax No.: 808-331-0762 or 808-982-8802 Email Address: georgie@hihaf.org Name of Accountant/CPA (include name of firm if applicable): James D. Jennings, CPA, Inc. Phone No.: 808-942-8813 Mailing Address: 1600 Kapiolani Blvd., Suite 730 Honolulu, HI 96814 Amount of Request for County funds: $15,000.00 Prior Year Funding: 03-04 04-05 05-06 $10,000.00 $10,000.00 $10,000.00 Agency Mission Statement: The Hawaii Island HIV/AIDS Foundation is anon-profit organization dedicated to assisting those affected by HIV/AIDS to maximize their quality of life, and to ending the spread of HIV. We also utilize the lessons learned in the HIV epidemic to care and advocate for others in the fight against related diseases. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Our vision is to build a healthier, stronger, and more sustainable community that supports all its members with a focus on HIV issues. The Hawaii Island HIV/AIDS Foundation, or HIHAF, was formally established on September 15, 2003, as a unification of the Big Island AIDS Project in Hilo and the West Hawaii AIDS Foundation in Kona. (Notice of Merger is attached.) Both organizations were established as IRS-designated 501(c)(3) tax-exempt non- profit organizations to provide care services for People Living With HIV/AIDS (PLWHA), and to provide HIV prevention and education of the residents of Hawaii County. Because most of the clients served at the Kea'au office live in the Hilo area, we refer to the Kea'au office as "HIV Foundation -Hilo". Required Checklist Forms are attached at the end of the proposal. HIHAF has been providing services to people at risk for, infected with, and affected by HIV/AIDS, since 1986. Our Foundation is an efficient and effective system to provide a comprehensive continuum of prevention, care, and support services with regard to HIV/AIDS for the entire Big Island. As reported by the Hawaii State Department of Health, Hawaii County has a higher rate of AIDS cases than the State overall, with a reporting rate of 10.5 per 100,000 population in the years from July of 2000 through June of 2005. (The state overall has 9.1 cases per 100,000 population for that time period.) A total of 13% of all AIDS cases reported in the state since the beginning of the epidemic come from the Island of Hawaii. Only Oahu has a higher percentage. The number of people with HIV/AIDS climbs steadily upward every year of the epidemic. Presently, the HIV Foundation -Hilo provides multi-disciplinary team HIV case management, advocacy, information and referral, food pantry, client financial assistance and other support services for more than 100 PLWHA and affected persons in East Hawaii. Over the course of the year December, 2004 through November, 2005, a total of 135 clients have been cared for in Hilo. Case Managers support client independence and self-determination by providing a range of supportive services. These include knowledge and assistance in accessing a variety of public and private benefit programs, medical and nursing services, housing, food, emergency financial assistance, transportation, employment counseling, and other forms of assistance as appropriate to help and support a client's retention and active participation in primary medical care. The services received by each client are monitored regularly to determine the effectiveness of the service plan, identify emergent needs, and measure the outcome(s) of service delivery. The HIV Foundation -Hilo proposes to continue its provision of high quality multi- disciplinary team HIV case management and primary prevention services, including anonymous HIV-antibody testing and counseling services, for at least NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 one hundred (110) Persons Living With HIV/AIDS during FY 2006-2007. During the last fiscal year, HIV testing and counseling was limited because the State of Hawaii Department of Health did not have testing reagent available for more than 4 months. Although we would expect this to severely curtail our ability to meet the HIV testing and counseling goals, we actually exceeded those goals, testing 67 people even though we projected to test only 65. We are still experiencing cuts in the State of Hawaii Department of Health funding allocated to HIV/AIDS case management services on all islands. This is reflected in our Program Expenditures and Program Funding Sources tables. We will do our very best, as ever, to continue to provide the highest quality of services to our clients, regardless of the decreases in funding available to us. Program Description: HIHAF is an organization that serves the "unseen, unheard" members of our community. Because HIV/AIDS still, after twenty-five years, carries a major stigma in our society, the people who are infected, affected, and at risk tend to hide their challenges concerning this disease. One of our major roles is to support our clients in the emotional, physical, social and economic aspects of their lives. Our Foundation is best described through stories of how we support the people we serve. One young man has been doing his best to stop using "ice' -finding out he's infected with HIV has been very hard for him. But he's staying clean, so far ...with the help of HIHAF. There's the young woman trying to free herself from an abusive partner. She relocated to a safer place, living on her own, with help from her HIHAF case manager. Another woman living on the East Side of the island found she was infected when her husband died of AIDS. At that time, she and her children were living in a challenging area that was unsafe, did not support healthy life choices, and did not allow her confidentiality for her situation. In order for her to change her lifestyle and sustain her new behaviors, she needed a strong support structure. Because we are now one organization serving the whole island, we have been able to provide truly comprehensive care for this family. We were able to assist in the move from one island location to another and to find a place to live. The woman also received our help with continuation of medical care, connection to social services, replacing furniture, and enrollment in job training, a truly multi- disciplinary approach to care. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 We arranged for this family, which includes one grand-baby, to have a miraculous Christmas, complete with holiday meal. The relationship between the two offices of the foundation has greatly strengthened our ability to provide the highest quality care in situations like this one. A multidisciplinary team composed of two full-time (2.0 FTE) case managers, one half-time (0.5 FTE) housing specialist and one half-time (0.5 FTE) client services facilitator provide the direct care services for PLWHA residing in East Hawaii. (The housing specialist also serves the Kona side clients.) The monthly average active caseload for the East Side office of the agency this year is ninety-eight (98) clients. Thirty-six percent (36%) of the HIV Foundation - Hilo's clients are homeless, multiply diagnosed, drug misusers and/or mentally ill. Eighty-two percent (82%) fall into two or more special population categories as defined by the federal Ryan White CARE Act Title II. Case management schedules are flexible to ensure service availability during the agency's regular days and hours of operation, 8:00 AM - 4:00 PM Monday through Friday. The Client Service Facilitator is responsible only for the delivery of support services including food bank, food deliveries, transportation volunteers and clerical services. The Executive Director provides program administrative oversight and program supervision for care staff, quarterly reports to all funders, job counseling, staff training and crisis intervention. Volunteers assist clients with computer searches, distributing food, clerical assistance, and helping clients shop at the food pantry. Each written service plan is developed cooperatively by the case manager with the client. The service plan identifies client needs; defines specific goals and objectives that address identified needs; and lists the action steps required to accomplish the client's stated goals and objectives. The service plan is developed and implemented within two weeks following intake of a new client and then updated quarterly or more often if needed until the client is discharged. Between service plan updates, clients are contacted at least once per month, to monitor their health status and identify new emergent needs. Acute clients in need of more frequent contact receive telephone calls, and/or office or home visits three-to-four times per week. One hundred ten (110) service plans will be developed or revised during the FY2006-2007 grant period. Primary HIV prevention is based upon a culturally appropriate harm reduction methodology. Case managers either provide such interventions themselves or make referrals to the HIV Foundation - Hilo's prevention department. Case managers also offer anonymous HIV-antibody counseling and testing for family members and significant others. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Evaluation: Quantitative evaluation measures for multi-disciplinary team case management services include the collection, tabulation and entry of service data into a computer tracking system provided by the State of Hawaii (The Reggie System). Data routinely tracked include: number of clients, types of service provided, and the number of services provided by service category. Planning estimations for service delivery during the FY2006-2007 currently project that a total of twenty- six (26) separate case management services will be individually provided for 90 to 110 clients living with HIV/AIDS. Services include, but are not limited to, intake, assessment, treatment advocacy, benefits counseling, volunteer referrals, hospital and home visits, medical liaison, crisis intervention, emergency financial assistance, housing assistance, home care and transportation. Quantitative Analysis: Data collection consists of counting the number of written service plans that are developed or revised each quarter. Computer reports indicating number and kinds of services delivered by each case manager are generated on a monthly basis. If projections are met or exceeded, service delivery is considered successful. The service component is also considered successful if ninety percent (90%) of clients have a medical care provider and adhere to their treatment routine. Qualitative Analysis: A client satisfaction survey is mailed to all clients annually. Completed surveys are returned anonymously and tallied survey results are distributed to the HIV Foundation's Board of Directors, staff, clients and state and federal granting organizations. Total Budget and Position Count Total Pro ram Bud et $364,811 Total Pro ram Position Count 3 Total A enc Bud et *$1,250,000 Total A enc Position Count 19 * Total Agency Budget now reflects combined Kona and Hilo budgets. Program Objectives: 1) Objective One: By June 30, 2007, and within twenty-five (25) days following a determination of need, identify and secure appropriate financial resources to pay health insurance premiums for no less than ninety percent (90%) of all PLWHA whose access to high quality primary care, ancillary health care and specialty medical care would otherwise be in jeopardy. 2) Objective Two: By June 30, 2007 and within twenty-five days following a determination of need, assist no less than ninety percent (90%) of all eligible PLWHA who request or demonstrate a need for substance misuse treatment, mental health counseling, oral health care, HIV-related NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 medication, food andJor transportation assistance to obtain such goods and services through appropriate referrals and practical support. 3) Objective Three: By June 30, 2007 and within twenty-five days following a determination of need, forestall homelessness by providing financial support and/or housing relocation assistance for no less than ninety percent (90%) of all eligible PLW HA requesting or demonstrating a need for emergency shelter, or either short-term or long-term shelter or housing assistance. 4) Objective Four: By June 30, 2007 offer HIV preventive education and/or anonymous HIV-antibody counseling and testing services to seventy-five (75) at-risk individuals. In addition, the HIV Foundation -Hilo shall provide the types and levels of case management related supportive services for its consumers, listed below. Benefits assessment/counseling Client family counseling Progressive case notes Crisis intervention Health care assessment/counseling Field /office visits Medical treatment referrals Home visits Housing assessments Intakelassessments Legal document assistance Financial benefits Funeral/estate coordination Generic assistance/counseling Housing assistance Health care benefits Legal advocacy assistance Client monitoring/assessment Nutritional assessment/counseling Risk assessment/counseling Mental health assessment/counseling Service coordination Mental health counseling referrals Transport activities Substance abuse assessment Substance abuse treatment referrals (as available) Total number of service categories: 26 Timeline: Service plans are developed within two weeks of the initial intake session and reviewed quarterly. Service delivery will be on-going during FY 2006-2007. The services listed above represent baseline service projections. Client-centered Outcome(s): One hundred ten (110) clients and their families will access critical services including medical, financial, social, care givers, legal, nutritional, etc. through the HIV Foundation - Hilo's case management and volunteer team. At least ninety percent (90%) of clients will secure a primary care physician and remain in medical treatment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Hawaii Island HIV/AIDS Foundation - AgerlCy Name Multi-Disciplinary HIV Case Management, Hilo -Program Name Program Highlights: Highlights of service accomplishments during FY 2005-2006 include: 1. To date during FY 2005-2006, medical case management services included one hundred thirty-five (135) clients receiving of medical assessment, patient education, treatment advice, nutrition, medical liaison, dental liaison. In addition, clients received $37,908.33 in financial assistance for medical and dental care services through the Ryan White CARE Act funds, among others. 2. Over the past nine years, eight (8) HIV positive families have birthed nine children. All but one are over the age of three, and not one of these is HIV positive. The youngest child is 9 months old. The HIV Foundation -Hilo is extremely proud of this fact and immensely happy for the parents. 3. As of December 2005, all except three clients are receiving the highest quality primary medical care; those three are accessing the best available medical care through public health clinics. Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Number of types of case 23 23 26 mana ement services rovided Number of clients receiving case 98 100 110 mana ement services Risk Behavior Assessment, 250 250 250 Counselin and Education HIV Counselin and Testin 65 65** 150 *If applicable During 2005, the State of Hawaii Department of Health was unable to obtain testing reagent, so for more than 4 months HIHAF did not have daily HIV testing and counseling available at our offices. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Hawaii Island HIV/AIDS Foundation - Agency Name Multi-Disciplinary HIV Case Management, Hilo -Program Name Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $189,823 $163,538 $140,181 Professional Fees $2,500 $3,000 $3,500 O erations services $125,008 $125,008 $221,135 E ui ment 0 0 0 Other* 0 0 0 Total $317,331.00 $291,546.00 $364,816.00 *Please explain in detail on separate sheet Program Funding Sources Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii 10000.00 10000.00 15000.00 De artment of Health, Title II 192808.00 170808.00 201,000.00 AIDS Communit Care Team 74635.00 52230.00 63,000.00 Medicaid Waiver 13293.00 13293.00 11000.00 United Wa 5000.00 8000.00 5000.00 Housing -Special Projects of 6000.00 6000.00 8800.00 National Si nificance Private Foundations 10000.00 20000.00 20000 Donations/Fundraisin 5595.00 11215.00 48000.00 Total $317,331 $291,546 $371,800 'If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Unfortunately, the HIV/AIDS epidemic shows no sign of ending, and indeed continues to grow. Often, there is a misrepresentation of facts about the epidemic in the media. The fact is, there are still people becoming infected, NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 regardless of the rate at which that happens. And each newly infected individual presents with a myriad of challenges to be met and overcome. Because the epidemic continues to grow, we do not see a specific point at which our program might become self-sustaining. We have received level or decreasing funding from our main revenue source, the State of Hawaii Department of Health, for the last 9 years. During this time, the number of people we are caring for has more than doubled, and may well double again over the next 9 years. In addition, our clients live longer now because of the availability of new drug treatments. This is wonderful in that it allows those who are infected to continue as productive members of society. But it also raises additional challenges for us as an agency to continue to support their productivity. We are the only HIV/AIDS services organization in Hawaii County providing these vital care and prevention services. We are currently working to develop an affiliated for-profit business, whose profits would help sustain our foundation. But this will happen at some point in the future. For now, we are very grateful that we have this support from the County, and we want to thank you for this opportunity to apply to you for funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 9 Hawaii Island HIV/AIDS Foundation - Agency Name Multi-Disciplinary HIV Case Management, Hilo -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate year-end report will impact the evaluation of your proaram's or agency's future funding requests. y ature of Board President/Cha'r Date Il / O Signature c f Executi a Director Dat UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 10 Hawaii Island HIV/AIDS Foundation - Ag@I1Cy Name Transmission Prevention for HIV+ Women in West Hawaii County - Program Name Agency Director: Georgie Kennedy Phone No.: 331-8177 Contact Person: Georgie Kennedy Phone No.: 331-8177 Mailing Address: 75-240 Nani Kailua Dr., # 5, Kailua-Kona, HI 96740 Facility/Site Address: 75-240 Nani Kailua Dr., # 5, Kailua-Kona, HI 96740 Fax No.: 331-0762 Email Address: georgie@hihaf.org Name of Accountant/CPA (include name of firm if applicable): James D. Jennings, CPA, Inc. Phone No.: 808-942-8813 Mailing Address: 1600 Kapiolani Blvd., Suite 730 Honolulu, HI 96814 Amount of Request for County funds: $15,000.00 Prior Year Funding: 02-03 03-04 04-05 $15,000.00 $15,000.00 $15,000.00 Agency Mission Statement: The Hawaii Island HIV/AIDS Foundation is anon-profit organization dedicated to assisting those affected by HIV/AIDS to maximize their quality of life, and to ending the spread of HIV. We also utilize the lessons learned in the NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page 1 HIV epidemic to care and advocate for others in the fight against related diseases. Our vision is to build a healthier, stronger, and more sustainable community that supports all its members with a focus on HIV issues. The Hawaii Island HIV/AIDS Foundation, or HIHAF, was formally established on September 15, 2003, as a unification of the Big Island AIDS Project in Hilo and the West Hawaii AIDS Foundation in Kona. (Notice of Merger is attached with all Required Checklist Forms at the end of the proposal.) Both organizations were established as IRS-designated 501(c)(3) tax-exempt non-profit organizations to provide care services for People Living With HIV/AIDS (PLWHA), and to provide HIV prevention and education of the residents of Hawaii County. HIHAF has been providing services to people at risk for, infected with, and affected by HIVlAIDS, since 1986. Our Foundation is an efficient and effective system to provide a comprehensive continuum of prevention, care, and support services with regard to HIV/AIDS for the entire Big Island. We refer to the Kona office as "HIV Foundation -Kona". As reported by the Hawaii State Department of Health, Hawaii County has a higher rate of AIDS cases than the State overall, with a reporting rate of 10.5 per 100,000 population in the years from July of 2000 through June of 2005. (The state overall has 9.1 cases per 100,000 population for that time period.) A total of 13% of all AIDS cases reported in the state since the beginning of the epidemic come from the Island of Hawaii. Only Oahu has a higher percentage. The number of people with HIV/AIDS climbs steadily upward every year of the epidemic. Additionally, the proportion of cases diagnosed in women has been increasing over time. According to the State of Hawaii Department of Health, for the first twenty-one years of the epidemic women represented 7.5% of all cases reported in the state. But for the five years from 2000 through 2004, a total of 12% of newly reported AIDS cases in the state were women. This is a distressing increase in infection among women. Our foundation has a strong focus on prevention programming, because this is still a preventable disease. We are still experiencing cuts in the State of Hawaii Department of Health funding allocated to HIV/AIDS prevention services on all islands. This is reflected in our Program Expenditures and Program Funding Sources tables. We always do our very best, as ever, to continue to provide the highest quality of services to our clients, regardless of the decreases in funding available to us. NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page 2 Program Description: The Hawaii Island HIV/AIDS Foundation -Kona is proposing to continue funding for the HIV transmission prevention programs for all HIV+ women in West Hawaii County, including individual and group protocols and counseling and testing of women at risk. This program is designed to STOP HIV at the source, that is with individuals who can transmit the disease to others. This program also provides early treatment for newly diagnosed HIV positive women, maintenance of stable health and well being for all HIV+ women in West Hawaii County, long term planning for health maintenance, and transmission prevention interactions. A new addition to women's prevention services this year is the SISTA Project, "Sisters Informing Sisters about Topics on AIDS". This program is aimed at local women at high risk for infection and transmission of HIV, and is an in-depth behavioral change program. Our Women's Outreach Worker leads a social skills training intervention, aimed at reducing HIV sexual risk behavior among minority women who are at highest risk for HIV and other sexually transmitted diseases. This includes women who experience poverty, drug addiction, violence and sexual abuse. The project consists of five once-a-week two-hour sessions, and includes a sixth, "booster" session a month after the women graduate at the fifth session. Currently, most of the women participating are from Alternatives to Violence -Turning Point for Families. We include the SISTA Project in this application because it will be instrumental in helping us reach women who may already be HIV positive to get them tested and into care services, as well as providing the type of behavior change training that has been accepted by the U.S. Centers for Disease Control and Prevention as the most effective. Total Budget and Position Count Total Pro ram Bud et $87,250 Total Pro ram Position Count 3.5 ~ Total Agency Budget *$1,250,000 Total Agency Position Count 19 * Total Agency Budget now reflects combined Kona and Hilo budgets. NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page 3 Hawaii Island HIV/AIDS Foundation - Agency Name Transmission Prevention for HIV+ Women in West Hawaii county -Program Name Program Objectives: 1) Review each HIV+ woman's transmission prevention service plan in first month of program, and/or initiate new transmission prevention plan for newly infected women. (Estimated 20 women, 1-2 hours per client.) 2) Refer women to appropriate providers if needed, i.e. mental health providers, substance abuse providers, etc. within the first month. These providers can deal with some of the behaviors which place these women at risk of transmitting this disease. These professional counseling sessions are paid for by other funding sources. 3) Initiate transmission prevention protocol (estimated 20 clients, 1 hour each) in the first session, then quarterly, as needed when problems arise. 4) Document progress and adherence to transmission prevention protocol with input from client each quarter (20). 5) Monthly support group for HIV+ women dealing with self-esteem, negotiation, sexual issues, transmission prevention. 6) Referral by participants of other women who may be at risk of contracting or transmitting HIV to others. Referral to result in HIV counseling and testing by prevention outreach staff and screening for possible referral for participation in the SISTA project. Program Highlights: 1) Achieved a review of care prevention service plans for twelve (14) women (meeting goal) during first half of funding year 2006-2006. 2) Referred women to specialized care for health and/or prevention issues during first half of the funding year. 3) Reviewed and updated health plans for all participants quarterly. 4) Initiated in-depth transmission protocols with all participants, and met with each participant on a one-to-one basis quarterly. 5) More than seventy-five (75%) percent of participants have reported 100% compliance with prevention protocols by second session (i.e., use of condoms or other protection during all sexual encounters.) 6) Fifty (50%) percent of participants have reported compliance 90% of the time to date, with the goal of 100% compliance by the end of the year. 7) Ninety-two (92%) percent of participants (13 of the 14) are documented to have benefited from the program by maintenance of good health, increased self-esteem, and ability to interact with sexual partners in a safe manner, thereby decreasing the probability of sexual transmission. 8) As of month seven (January 2005), zero transmission of HIV by any participants in the program. No hospitalizations, stable health, and maintenance of employment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page 4 9) A total of 13 women of unknown HIV infection status have participated in the SISTA Project training sessions. Performance Measures: In addition to the numbers listed below, the savings to the community of eliminating just one new case of HIV is between $22,000 and $33,000 annually. This is the cost of medical care, support, housing, and disability benefits for a single individual who is affected by this disease. Additionally, the only people who can transmit this disease are those who are infected with it. By working at the source we can STOP this disease, and do it in a humane and loving manner, which benefits both the individual and the community. During the past twelve months, the State of Hawaii Department of Health was unable to obtain the necessary reagent to provide HIV testing for more than 4 months. As a result, the numbers of people who were HIV tested and counseled were quite reduced this year. This reduction is reflected in the "2005-06" budget column. For purposes of this chart, the individual transmission prevention session count includes all counseling sessions, for both males and females. FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Individual transmission prevention 252 150** 400* session assessment session Health/prevention plan review 36 42 60 uarterl Quarterly individual transmission 36 42 60 revention sessions 1 hr. each Review and documentation of 36 42 60 ro ram uarterl SISTA Pro~ect artici ation 0 13 50-60 *If applicable During 2005, the State of Hawaii Department of Health was unable to obtain testing reagent, so for more than 4 months HIHAF did not have daily HIV testing and counseling available at our offices. * Numbers include the new Sista project. NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page 5 Hawaii Island HIV/AIDS Foundation - AgellCy Name Transmission Prevention for HIV+ Women in West Hawaii County - PrOQram Name Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 20,000 20,000 50,000 Professional Fees 0 0 0 O erations 15,192 15,192 27,000 E ui ment 0 0 0 Other* Program 4,000 4,000 10,000 Ex enses Total 39,192 39,192 87,000** *Other: Program expenses include costs for HIV testing kits, literature, condoms, incentives, and other miscellaneous items specific to prevention programs. **Includes new SISTA program. Program Funding Sources Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate State of Hawaii Prevention, 33% 15,192 12,500 35,000 Women onl 1/2 for Kona Hawaii Island United Wa 0 0 6,500 Fundraisin 4,308 9,692 5,000 Count of Hawai'I 15,000 15,000 15,000 Mac 's 0 2,000 3,750 CDC Com lementa Prevention** 4,692 0 0 Life Foundation/CDC SISTA 22,000 Total 39,192 39,192 87,250 *If applicable One time grant, non-renewable. Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Unfortunately, the HIV/AIDS epidemic shows no sign of ending, and indeed continues to grow. Often, there is a misrepresentation of facts about the epidemic in the media. The fact is, there are still people becoming infected, regardless of the rate at which that happens. And each newly infected individual NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page 6 presents with a myriad of challenges to be met and overcome. Because the epidemic continues to grow, we do not see a specific point at which our program for prevention might become self-sustaining. The more people who become infected, the greater the possibility of new cases of the disease. We have received level or decreasing funding from our main revenue source, the State of Hawaii Department of Health, for the last 9 years. During this time, the number of people we are testing and counseling and are caring for has more than doubled, and may well double again over the next 9 years. In addition, our clients live longer now because of the availability of new drug treatments. This is wonderful in that it allows those who are infected to continue as productive members of society. But it also raises additional challenges for us as an agency to continue to support them in their productivity. We are the only HIV(AIDS services organization in Hawaii County providing these vital care and prevention services. We are currently working to develop an affiliated for-profit business, whose profits would help sustain our foundation. But this will happen at some unknown and perhaps distant point in the future. For now, we are very grateful that we have this support from the County, and we want to thank you for this opportunity to apply to you for funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page 7 Hawaii Island HIV/AIDS Foundation - Agency Name Transmission Prevention for HIV+ Women in West Hawaii County - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will impact the evaluation of your program's or agency's future funding requests. ~ . ~ ~ ~ ~ C~ 'gnature of Board Presi_ t1t;FiAir Dat ~ ~ Signature of xecuti Director D t i ~ UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-06 Page H Hawaii's Volcano Circus- Agency Name Puna Performing Arts Festival 2006- Program Name Agency Director: Graham Ellis Phone No.: 965-8756 Contact Person: Graham Ellis Phone No.: 9655-8756 Mailing Address: RR2 Box 4524, Pahoa, Hi 96778 Facility/Site Address: "Bellyacres" 12-7105 Kamoamoa Homestead Road, Seaview Estate, Pahoa, Hi 96778 Fax No.: 965-8756 Email Address: info~hvcircus.org Name of Accountant/CPA (include name of firm if applicable): Lon Smith - H & R Block Phone No.: 959-1715 Mailing Address: 2100 Kanoelehua BBA, Hilo 96720 Amount of Request for County Funds: $30,000 Prior Year(s) Funding: 03-04 0 5 05-06 $0 $0 $15,000 Agency Mission Statement: To provide quality culture and arts enrichment programs in Hawaii with the mission of promoting the healthy development of children and communities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 PA OP ~ Hawaii's Volcano Circus -Agency Name Puna Performing Arts Festival 2006- Program Name Program Description: In 2002, 2004 and 2005 HVC led a collaboration of Puna organizations in three annual Performance Arts Festivals that have proved extremely successful. Between August -November 2006 HVC will be the lead organization in the third collaboration involving 5 Community Associations, 4 Schools and other arts groups. The leadership team will organize 70 two hour performance arts workshops in Hawaiian Paradise Park, Pahoa town, Nanawale, Kapoho, Kehena and Leilani involving over 250 youth and adults. These free public classes will be held after school and at weekends. They will blend traditions from China, Hawaii, Africa, Europe and North America in the arts of music, dance, drama and circus. Professional performing arts experts will be hired to teach the classes and produce the shows. Community volunteers will be recruited to assist with classes and the production of two large scale performances scheduled for late November or early December 2006. The shows that culminate the Festival will be widely advertised, using local media, magazines and posters. The 90 minute `Spectacle' production written by our locally hired director will include theater quality stage, sound and lighting in celebration of the largest arts project of its kind in the Puna District and probably the Big Island. Total Budget and Position Count Total Program Budget 74,422 Total Program Position Count 32 part time Total Agency Budget 240,000 Total Agency Position Count 32 part time Program Objectives: A. To raise an awareness to the rich cultural backgrounds of the people of Hawaii and to preserve and practice the ethnic performance arts of the Puna District. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Pnan 2 B. To improve the quality of the tourist's visit by providing entertaining and educational attractions; with a greater visitor experience interacting in local cultural events that demonstrate the islands cultural diversity. C. To support the education and development of performance arts skills in Puna D. To enhance the employment of local artists. E. To build social networks between individuals, community organizations and schools. F. To build the organizational capacity and infrastructure in community groups for the establishment of ongoing year round cultural activity programs for community members Program Highlights: 1. Over 300 children and adults from 11 community groups participate fully. 2. HVC will expand it's collaborations to include more community groups 3. Recruitment of program volunteers will lead to greater participation of parents and adults in community events 4. Each collaborating group is committed to participation in this annual event and each year the networking and relationships that make a community are developed and grow stronger 5. Organizational capacity building potential is developed for more youth activities relating from staff training, infrastructure acquisitions, equipment and facility improvements. 6. A first class full length DVD will be produced and distributed to Big Island Schools and libraries. 7. Original music scores by local musicians will involve new relationships between community artists. 8. Participation from students from many different schools 9. Ages of participants ranges from 4 years old to 74 years old. 10. Students from isolated rural subdivisions have and opportunity to participate in training workshops and in a major arts performance. 11. Local businesses are increasing their support for this local based event. 12. News articles about this event are being written for major publications. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 PA OP Hawaii's Volcano Circus -Agency Name Puna Performing Arts Festival 2006 -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate # of youth and adults participating in 235 300 300 rformin arts worksho s # of erformance arts worksho s 70 70 70 # of high school students trained 15 15 15 and involved in backsta a skills # of undergraduate students 6 6 6 involved in backsta a trainin # of adult volunteers helping with 43 40 40 costumes, ro sand sets # of audience members 1,200 1,750 1, 800 # of local artists and instructors 28 30 30 hired for ro ram *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 32,336 38,124 36,000 Professional Fees 5,230 6,000 6,500 O rations 12,954 15,550 16,200 E ui ment 7,852 8,000 10 500 Publicit and Printin 4,567 4,500 5,000 Total 62,939 72,174 74,200 ` If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 PROP d Hawaii's Volcano Circus -Agency Name Puna Performing Arts Festival 2006 -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual " Bud et' Estimate Hawaii Community Foundation 0 16,000 10,000 Mo' Bettah t ether r ram National Endowment For the Arts 25,000 20,000 20,000 Villa a Green Socie 15,000 2,000 5,000 Hawaii County 0 15,000 30,000 Non root Grant Hawaii County 0 10,000 0 Tourist Enrichment Hawaii County 0 2,000 2,000 Research and Develo ment Local Businesses 1,430 2,000 2,000 Ticket Sales 4,235 5,140 5,200 Friends of Hawaii 5,000 0 0 Concession Sales 2,274 0 0 New Moon Fund 5,000 0 0 Private donation 5,000 0 0 Total 62,939 72,140 74,200 "If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? We intend to focus on increasing local business support this year and to increase the price of tickets and possibly add more shows. Our goal is to be 50% self- sustaining by 2010. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 PROP Hawaii's Volcano Circus -Agency Name Puna Performing Arts Festival 2006 -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; awarcl procedures; and records, reporting and fiscal acxountability requirements as mandated in ArtiGe 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate vear-end report will impact the evaluation of vour program's or aaencv's future funding requests. 1 Signature of Board PresidenUChair Date I ~ .1.~t ~ a l- 1,~:;-- Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 PROP ~f HUI OKINAWA CHILDREN'S CULTURAL DAY CAMP Agency Director: Carolyn Oki, President Phone No.: 935-3518 Contact Person: Ruby Maekawa, Camp Phone No.: 959-4855 Director Mailing Address: P. O. Box 1793 Hilo, HI 96721-1793 Facility/Site Address: Honpa Hongwanji, Hilo Betsuin, YBA Hall 398 Kilauea Avenue Hilo, HI 96720 Fax No.: 935-0338 E-mail Address: rmaekawa(a~interaac.net Name of Accountant/CPA: Alben S. Namihira Phone No.: 961-3443 Mailing Address: 191 Hualalai St. Hilo, HI 96720 Amount of Request for County Funds: $3,060* Prior Year(s) Funding: 03-04 04-OS OS-06 $ None $ None $3,000 Agency Mission Statement: To promote, preserve, and perpetuate the Okinawan culture at a local, state, national, and international level. Also, to promote educational, charitable, and benevolent causes and to render service to the local, state, national, and international community. *See page 1-A for details NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-2007 Page 1 HUI OKINAWA CHILDREN'S CULTURAL DAY CAMP Attachment I: Explanation of Funding Request of $3,060* A. Resource persons from Oahu, Maui, and/or Kauai (Certi£cated Instructors) Airfare for 3 round trips @$200 each $600 Per Diem @$120/day, 8 days 960 Instructor's Fees, 25 hours @$20/hr. 500 $2,060 B. 50% of "In-Kind" Donations including Okinawan 1,000 Craft, Games, Food Items and/or Costumes. Total $3,060 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-2007 Page I-A HUI OKINAWA CHILDREN'S CULTURAL DAY CAMP Program Description: The Children's Cultural Day Camp, a week long Okinawan cultural learning experience, has been held in Hilo for the past four summers. June 12 to ]6, 2006, will be the fifth year that this program, sponsored by Hui Okinawa, Hawaii United Okinawa Association, and supported by the State Foundation of Culture and Arts (SFCA) will provide an opportunity for forty eight youngsters, ages 8 to 13, to learn Okinawan Culture and Arts. Classes in Okinawan songs and dances, language and history, karate and taiko, crafts, games, and cooking are designed to provide a fun learning experience for the participants. Plantation Days activities such as shooting marbles, playing Hanafuda and racing on Carnation milk cans are also part of their learning experiences. In the summer of 2005, Children's Cultural Day Camps were held in the Kona and Kohala communities. The SFCA has supported the Hilo, North Kohala, and Kona programs by covering costs of flying in artists from Oahu and Maui to train our staff, and to provide professional instruction in dance, drumming, and pottery. Instructors of this caliber are not available in our communities. SFCA funding will not be available to the Hilo group this summer. Instead, we will have the Hawaii County Non-Profit Grant to help us carry out our mission. It is the purpose of our organization to preserve, promote and perpetuate the Okinawan culture. The Children's Cultural Day Camp provides a vital avenue to introduce and instill an appreciation of these cultural lessons. Noteworthy, is that enrollment of students is not limited by ethnicity. Total Budget and Position Count Total Pro ram Bud et $32,170 Total Pro ram Position Count 5 Total A enc Bud et $55,000 Total A enc Position Count 7 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-2007 Page 2-A HUI OKINAWA CHILDREN'S CULTURAL DAY CAMP Program Objectives: 1. Introduce Okinawan Culture and Arts to children, ages 8 to 13, to promote an appreciation for these arts. 2. Introduce "Plantation Days" values and activities which may otherwise be lost. 3. Build an intergenerational fellowship between the children, the youth leaders, and the adult volunteers, some of them in their seventies and eighties. Program Highlights: 1. Areas of study include Uchinaguchi (Okinawan Language), History and Story Telling, Eisa Dancing, Drumming, Okinawan Cooking, Singing, Karate, Craft progects, Plantation Games, Pottery and Writing. The 80 staffers are volunteers from the community with the exception of one or two sensei's from Oahu or Maui. This translates into over 2000 "person"- hours of voluntary service. 2. Program evaluation, by the children of the 2005 Camp, indicated that 85% of the students rated all the activities as "good or excellent". Favorite activities included Okinawan cooking, Taiko, Bamboo Squirt Gun fighting, Hanafuda challenge, and Ice cream making. 3. 100% of the children polled indicated that they have gained knowledge and/or skills of Okinawan culture/ Plantation Day activities. 4. Student participation grew from 38 in 2004 to 48 in 2005. We also had a "Waiting List" in both years. 28% of the children have attended two or more sessions. 5. A few children have gone on to further their cultural skills by joining the Hui Okinawa Kobudo Taiko group. Some of the children have shared their newly learned skills as participants in the Honpa Hongwan ji Keirokai program and Hui Okinawa's Bonen Kai program. 6. Several graduating students from the Cultural Day Camp Program have returned as youth leaders. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-2007 Page 2-B HUI OKINAWA CHILDREN'S CULTURAL DAY CAMP Performance Measures: FY 2004-2005 FY 2005-2006 FY 2006-2007 Actual* Bud et* Estimate Cam ro'ects and activities $30,938 $31,430 $32,170 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual* Bud et* Estimate Salaries and Wa es None None None Professional Fees $200 $500 $600 O erations $30,738 $30,930 $31,570 E ui ment None None None Other None None None Total $30 938 $31,430 $32,170 * If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-2007 Page 3 HUI OKINAWA CHILDREN'S CULTURAL DAY CAMP Program Funding Sources: Identify all funding sources (specific to this program only) REVENUE SOURCE FY 2004-OS FY 2005-2006 FY 2006-07 Actual* Bud et* Estimate Cam Fees $2,690 $2,630 $3,310 Scholarshi 60 - - T-Shirts, Reimbursed 493 500 500 Cam Photos, Reimbursed 277 300 300 Cash Donations 535 - - In-Kind Goods 1,838 2,000 2,000 In-Kind Services 22,950 23,000 23,000 Grant 2,040 3,000 3,060 Total $30,883 $31,430 $32,170 Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program be become self- sustainiug? Our plans are to raise Camp Fees and Fundraising for the 2008-2009 Fiscal Year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-2007 Page 4 HUI OHINAWA CHILDREN'S CULTURAL DAY CAMP 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 - Z-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (wej understand and will comply with the requirement tv submit a year-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete. and accurate vear-end report will impact the evaluation of vour program's or aaencv's future funding reauests. ~-3~-Ora Signature Board President/Chair Date ~-u-~ ~ - ! - 3 ~ - ~ 6 Signature f Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Pape 5 The Island of YMCA- Agency Name Partners with Youth Services- Program Name Agency Director: B. Dannals CEO Phone No.: 9~~ -~yJ~ Contact Person: Claudia Boucher Phone No.: y,36 .~zi Mailing Address: P.O. Box 7067, Kamuela Hawaii 96743 Facility/Site Address: Hilo-300 West Lanikaula, Kona-74-5605 Pawai Place, and Waimea-65-1266 Mamalahoa Hwy, Kamuela, HI Fax No.: 808-887-1861 Email Address: ymca-cwb@hawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Taketa, Iwata, Hara & Associates LLP Phone No.: 808-935-5404 Mailing Address: 101 Aupuni Suite 139, Hilo, Hawaii Amount of Request for County Funds: $E0,000.00 Prior Year(s) Funding: 03-04 04-05 05-06 $50,000.00 $55,000 $0 Agency Mission Statement: Aloha Ke Akua - "God is Love". The mission of the Island of Hawaii YMCA is: To bring God's Love to children, adults and families of all races and faiths by putting Christian principles into practices through programs that build healthy spirit, mind and body for all. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Island of Hawaii YMCA -Agency Name Partners with Youth Services- Program Name Program Description: YMCA Partners with Youth Services to provide an aray of safe, developmentally appropriate activities that are based on the proven research of asset building. The program assists youth in developing assests in the following areas: support, empowerment, boundaries and expectations, constructive use of time, commitment to learning, positive values, social competencies and positive identity. Increasing developmental assets in youth increases resistance to negative high-risk behaviors such as using drugs and alcohol and violence. Youth with more assets exhibit more positive behaviors such as success in school, demonstrating leadership qualitites, and valuing diversity. Assets increase a youth's ability to face challenges and difficult situations. • Program activities are offered throughout the year, including intercessions and vacation periods when latch-key children are especially vulnerable to at-risk behaviors. The YMCA's vans increase quality by providing transportation services island-wide. YMCA Partners with Youth Services provides over 4,000 children. The Island of Hawaii is an islandwide association comprised of four operating units: Waiakea Settlement YMCA, Kona Family YMCA Waimea Family YMCA and the Neighborhood Place of Puna. Youth services are offered at each YMCA branch, with coordination and collaboration between programs to support youth in different communities participating together. To ensure quality programing, The Island of Hawaii YMCA has an association- wide Program Committee made up of community volunteers and staff. The responsibility of this committee is to provide both staff and board the necessary training and support to implement and evaluate the program. Program outcomes will be determined by participant surveys, parent surveys, and/or staff observations. YMCA Partners with Youth Services provides direct positive impact to the youth and families of Hawaii County by providing accessible, affordable opportunities. The county grant allows the YMCA to offer free programs (Wrestling CIub,Tahitian, basketball, martial arts) and assists in keeping program fees low so that more children can have access. The grant subsidizes YMCA programs in the community such as teen dances, martial arts and youth activities. As the evidence of how substance abuse and other factors contributing to family conflicts increase, it is more critical than ever to have our youth engaged in safe positive activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Total Budget and Position Count Total Pro ram Bud et $784,787 Total Pro ram Position Count 65 Total A enc Bud et $2,840,904 Total A enc Position Count 150 Program Objectives: 1) Increase decision-making 2) Increase sense of empowerment 3) Increase commitment to earning 4) Increase constructive use of time 5) Develop personal skills,talents and abilities 6) Increase self -esteem 7) Increase understanding of different cultures 8) Increase sense of positive values Program Highlights: 1) Aquatic programs in Waiakea Settlement YMCA at Hilo Bay (partnership with the Na Holumoku Yacht Club), and Waimea and Kona at the Kawaihae Aquatics Center with youth sailing, water safety and canoeing. 2) Continued Parnership with Hawaii Arts and Sciences Academy in Pahoa with a learning service program refurbishing donated sailing crafts for the youth sailing program in exhange for sailing lessons. 3) The Waiakea Settlement YMCA expanded its Youth Sports programs (wrestling, girls volleyball, to include Basketball. 4) Increase youth participation in the annual freedive tournament in Kona. 5) Waiakea Settlement YMCA youth music program paticipants (ukulele & piano) shared their talents with convalesent homes, and senior programs. 6) Kona Family YMCA to initate an afterschool program activity for middle school that combines sports and arts called Hoop Art. 7) Health and Fitness classes offered at Waimea Elementary for 3-6 graders. 8) Waimea Youth Center offered monthly dances for the youth with games and activities. 9) Waiakea Settlement YMCA started a dance program offering Hip Hop, Tahitian and Hula classes. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Island of Hawaii YMCA -Agency Name Partners with Youth Services -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Total Partici ants -Youth Services 3800 N/A 4000 Pro ram Participants will: Identif and achieve personal oats 83% 85% Learn to make better decisions 80% 85% Develop sportsmanship & the 85% 85% concept of fair pla Learn how to cooperate with others 82% 85% Enhance their problem solvin skills 80% 85% Assume and understand the 80% 85% i res onsibilities *If applicable Program Expenditures ~ FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $32,081 $37,017 Professional Fees $1,895 $2,186 Operations $17,509 $20,203 E ui ment $515 $594 Othertt Total $52,000 N/A $60,000 " If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Island of Hawaii YMCA -Agency Name Partners with Youth Services -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate County of Hawaii $52,000 $60,000 Hawaii Island United Wa $71,600 $56,000 Donations Fundraisin $215,287 $497,930 Total $338,887 NIA $613,930 `If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Individual youth programs such as Hip Hop that caters to a specialized group of youth would be able to become self-sustaining as the program fees charged will cover the costs of staffing supplies etc...The YMCA is trying to appeal to larger groups of youth by affording them the opportunity to participate in activities that promote the core YMCA values Respect, Responsibility, Caring and Honesty. We strive to get them into safe and positive environments. For these such activities (basketball, wrestling etc...) the YMCA does not charge a fee. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 The Island of Hawaii YMCA -Agency Name Partners with Youth Services -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. ~•ySignature of Board Preside Chair Da et Signature of x ,utive Director D to UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Ka Hale O Na Keiki, Inc.- Agency Name Families-At-Risk Project- Program Name Agency Director: Kathy Oshiro Phone No.: 775-9870 Contact Person: same Phone No.: 775-9473 Mailing Address: 45-3663 Honokaa-Waipio Rd Honokaa, HI 96727 FacilitylSite Address: same Fax No.: 775-9870 Email Address: gso~kona.net Name of Accountant/CPA (include name of firm if applicable): Hoolaea Andrade, Accountant, Andrade Accounting Services, LLC Phone No.: 775-1319 Mailing Address: 46-1068 Kinimaka Street Honokaa, HI 96727 Amount of Request for County Funds: $7500 Prior Year(s) Funding: 03-04 04-05 05-06 $2000.00 $2500.00 $3000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 200lr07 Page 1 Agency Mission Statement: At Ka Hale O Na Keiki it is our mission to help children develop a lifelong love of learning through a program that encourages freedon, individualism, and creativity. Our carefully prepared environment provides children with an opportunity to explore their surroundings, challenge their thoughts, and enjoy and love the people and world around them. Through a positive interaciton among the children's developmental characteristics, their school, practices, family, and community, children will be ready to have successful teaming experiences that will last throughout their lifetime. Above all, our children come first. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Ka Hale O Na Keiki, Inc. -Agency Name Families-At-Risk Project- Program Name Program Description: Ka Hale 0 Na Keiki is not "just another preschool", but a community organization that serves and meets multiple needs for the people of the entire area. While under our trained, caring, and gentle care, children at risk learn self confidence, initiative, self-worth, and independent thinking. Our teachers, all trained in Early Childhood Education, understand child development and excite our children about teaming, as well as provide them, and their families, with basic health and nutritional information and referrals. We promote positive social behavior and conflict resolution, as well as actively engage parents in their children's education. Our Families-At-Risk Project allows our school to remain open between 2:30 and 5:30 pm, daily, year round (including Summers and holidays), providing a safe, stimulating, and caring environment for children, ages 24 months to 6 years. This frees young parents to work at their jobs, allows the unemployed to seek work, and pursue training and educational opportunities, particularly working parents transitioning from welfare assistance. We serve the working poor. These families are likely to be cut off from the mainstream community because of poverty, racism, lack of education, unemployment, andlor the inability to timely access community and human services. They are therefore at risk of being unable to take care of their basic needs and those of their nuclear family. ft is imperative that we remain open at least 10 hours a day, and operate year round; otherwise, working parents would have no where to send their young children for quality care and education while gone from home. Most preschools are not open more than eight hours per day because a second qualified teaching staff is required; and, such a service is just not economically feasible. However, with literally NO OTHER full-time preschool available in our isolated area, parents would have no where to place their child, except perhaps, in front of a neighbor's TV, if our Families-At-Risk Project was not available. And, obviously, our Families-At-Risk Project benefits our parents, as well as our children. Our low-income parents, leaving welfare rolls and entering the workforce, become more economically self-sufficient because they have been given access to reliable, quality care for their children. Our school's positive stimulation of children's brains during these critical first years lays the foundation for the child's future ability to Team, develop language skills, and interact with others. Drug abuse is our worst nightmare here on the Hamakua Coast. We are the anti-drug. Numerous studies have shown that participation in a quality EGE program can actually prevent illegal drug usage in the future, because we teach these children, at a very early age, how to appropriately handle conflict resolution, and we give them good self esteem, If NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 we are to break the cyGe of drug abuse in our community, we must begin taking preventalive action now, and intervene at the preschool-age level. Our community, our island, our state also benefit, as it is estimated that for every $1 invested in high-quality programs the public will save $7 in costs like remedial education, welfare, and incarceration. Children who attend high-quality Early Childhood Education programs are more successful in later life and more productive than their peers who did not attend. Studies are showing that children with access to quality programs demonstrate higher I.Q.'s, high school graduation rates, and success than their peers. Private funds are a key to our success, but we also need additional public support in order to help these young children and their families towards a successful, productive future. We need the County's continuing financial support until financial stability is realized. We are so very grateful to the financial support we have received in the past from our County. And, we understand and acknowledge the scarcity of County funds, and sympathize with the Council's difficult budgetary task. We truly believe that the Countys continuing investment now in the Families-At-Risk Project will save the County ten-fold in future rehabilitation costs. Total Budget and Position Count Total Pro ram Bud et 40,425.00 Totat Pro ram Position Count 5 Total A ency Bud et 218,000.00 Total A enc Position Count 8 Program Objectives: 1) Make care and educational services available between the hours of 2:30 and 5:30 pm daily, to accommodate at-risk families and their children 2) Provide high quality care and educational services to children of at-risk families of the under-serviced Hamakua Coast 3) Provide monthly scholarshipltuition assistance to at-risk families. 4) Pursue other funding sources for the Families-At-Risk Project, to insure that the Project, and the school, will prevail. 5) Maintain a developmentally appropriate (earning environment among alt students, ensuring progress in social, emotional, cognitive, language, and physical development. 6) Recognize the need for and provide referral services for children of at-risk families who may need treatment for known or suspected health, psychological or developmental problems. 7) Increase the parenting skills, and understanding of the educational and developmental needs of children of the at-risk parents we serve. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Program Highlights: 1) Remained open for the at-risk families until 5:30 pm daily, including during holiday breaks and Summer. 2) Provided a developmentally appropriate, hightluality childcare and educational facility to the working poor of the Hamakua Coast. 3) Provided four jobs in our local community, in order to operate the Families-At-Risk Project. 4) Offered scholarship/tuition assistance to eighteen families using the Families-At-Risk Project, an increase by two from 2003-2004. 5) Succeeded in keeping our budget for the Project low and within reason, while being able to increase our services. 6) Referred two children, and their families, to special services counseling, to meet their special needs, as identified by our teaching staff. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Ka Hale O Na Keiki, Inc. -Agency Name Families-At-Risk Project -Program Name Performance Measures: P`f 2004-05 fl( 2005.06 FY 2006-07 Actual * Bud et' Estimate Total Enrollment 31 36 37 Students Enrolled 2:30 - 5:30 18 26 27 Families-At-Risk Pro~ect Families receiving financial 18 23 24 assistance from Ka Hale 0 Na Keiki For the 2:30 - 5:30 pm, Families-At- Risk Pro ed 'If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual ` Bud et " Estimate Salaries and Wa es 13,750.00 18,000.00 28,750.00 Professional Fees 775.00 900.00 775.00 O erations 6,500.00 7,500.00 7,800.00 E ui ment 2,425.00 2,100.00 3,100.00 Other" Total 23,450.00 28,500.00 40,425.00 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Ka Hale O Na Keiki, Inc. -Agency Name Families-At-Risk Project -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Payment from families for afternoon 10,000.00 13,000.00 13,500.00 ro ram Donations/Fundraisers 3,110.00 500.00 1,925.00 Count of Hawaii Grant 2,500.00 3,000.00 7,500.00 Youn Bros. Grant 1,000.00 1,000.00 1,000.00 Friends of Hawaii Charities 00.00 1,500.00 1 500.00 Hard Foundation 00.00 1,000.00 1,500.00 Day Program payment from 6,840.00 8,500.00 00.00 families, portion allocated to Families-At-Risk Pro~ect State of Hawaii Poverty ECE 00.00 00.00 10,000.00 Pro ram Wilcox Foundation 00.00 00.00 1000.00 Mclnern Foundation 00.00 00.00 1000.00 Frear Trust 00.00 00.00 1500.00 Total 23,450.00 28,500.00 40,425.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Ninety percent of our parents pay little, or nothing additional per month for their child's tuition, as we keep our monthly rates law enough so State Supplement payments cover the monthly tuition fees. When charging our families even $50 per month more could mean taking food off these families' tables, we simply must look for other avenues of revenue, other than simply increasing monthly tuition rates. The state average cost, per child, for a child to attend a quality ECE program is $8000 per year. Yet, we strive to keep our annual budget affordable, with our average cost, per child, being budgeted at only about $5800 per year, and even less in the past. And, this budget of ours includes sending our teachers back to NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 college for further training and education, to make them better teachers and caregivers. We have applied for Nationa{ Accreditation this year, not only to insure that we are providing the best quality care and education to our children, but also so our parents can receive higher State Supplement payments, as the reimbursement rates are higher for Accredited schools. But, the accreditation process has proven costly to our school, as, for example, we are needing to renovate our playground to bring it up to National safety standards. Our past budgets have taken funds away from our Day Program in order to help support the Families-At- Risk afternoon program, putting our entire operation at risk. This practice simply cannot continue. We are doing everything possible to obtain outside funds to support this critical Families-At-Risk Project, including the anticipation of the receipt of State funding, directly to our school, and other preschools serving poverty families, beginning, hopefully, in July, 2006. We pursued funding from the Kosasa Foundation. However, that foundation only supports Oahu agencies (a popular notion, where, once again, the needs of rural communities are forgottenfignored). We have applied for funding for next fiscal year from the Wilcox Foundation, the Mclnerny Foundation, and the Frear Eleemosynary Trust, and are optimistic that these foundations will provide much-needed funds to help our entire program, incuding our Families-At-Risk Project. Our family and community volunteers work tirelessly to provide costly services for free. Our highly trained and educated teaching staff continues to work for poverty wages, and our school director took a pay cut last year when anticipated funding did not materialize. With optimism, and with our State government's continued interest in providing funds for Early Childhood Education, we hope to be financially solvent and without need for continued County funds within the next three to five years. Our program is one that we were told "could not be done", as our isolated community could not provide the qual~ed teaching staff to run such a program, and that our community did not have the economic base to afford such a program. But, the need was there, and we did it. We just need the County's continued support for a few more years; that's all we ask. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 _ Ka Hale O Na Keiki, inc. -Agency Name Families-At-Risk Project -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating;o Appropriation of Funds to Nonprofit Organizations. 1 (we} hereby certify that information supplied herein inGuding all supporting documents is correct and that I {we) have the authority and ability to fully administer the programs} pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. ff awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within t30 davs after June 30 of the fiscal veer. Ttee report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate veer-end report will impact the evaluation of your proaram's or aaencv's future fundlna requests. i ' natu ~ of Board PresidentlChair Date Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 PaOe °J Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center-West Hawaii Title IV-B-West HI Counseling & Supportive Living Project Agency Director: Martha B. Smith - KMCWC Chief Operating Officer Dr. Steven Choy - KCPC Program Director Phone No.: 1-888-535-7790 Contact Person: Steven J. Choy, Ph.D. Phone No.: 1-888-535-7790 Mailing Address: Hawaii Pacific Health Research Institute Attn. Allison Lopes 55 Merchant Street - 26th Floor Honolulu, HI 96813 Facility/Site Address: 74-5599 Luhia Street - #E7 Kailua-Kona, HI 96740 Fax No.: 329-8628 (Kona) 1-888-535-8820 (Honolulu) Email Address: stevenc(cD.kapiolani.org Name of Accountant/CPA (include name of firm if applicable) Ernst & Young, LLP Phone No: (808) 531-2037 Mailing Address: 2400 Pauahi Tower 1001 Bishop Street Honolulu, Hawaii 96813-3429 Amount of Request for County funds: $20,000 Prior Year Funding: 03-04 04-05 05-06 $16,000 $16,000 $20,000 Agency Mission Statement: The mission of the Kapi'olani Child Protection Center is to protect children and strengthen families. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center-West Hawaii Title IV-B-West HI Counseling & Supportive Living Project Program Description: The Title IV-B Counseling and Supportive Living Project provides assessment, counseling, service linkage and coordination, educational and supportive services to assist West Hawaii families at risk of child abuse and neglect. This program is part of the Kapi'olani Child Protection Center - a Statewide Center whose mission is to protect children and strengthen families. Priority for services is given to families at risk due to substance abuse (85% of referrals). Special priority is given to families who have or are in the process of adopting or otherwise providing a permanent home for children who have been harmed. Services are provided by KCPC-WH staff and by staff of other organizations through subcontracts with KCPC. The array of services includes, crisis intervention, individual, couple and family counseling, anger management counseling and classes, substance abuse counseling, parenting and life skills education, assistance with supportive living and other adjunct supportive services as needed by family members. The program is funded through a Federal Grant and requires matching funds from the State and from the provider. Total Budget and Position Count Total Pro ram Bud et $380,000 Total Pro ram Position Count 7 Total A enc Bud et $1,616,288* Total A enc Position Count 21* *Statewide Services Program Objectives: 1) Improve child safety by reducing child abuse/neglect risk factors 2) Improve child safety by increasing child protective factors Program Highlights: During FY2005 the following performance measures were obtained: 1) Provided services to 149 families, 309 adults and 360 children. 2) Provided services to 13 permanency families 3) Completed all services -81.8% of individuals served. 4) Reduced CA/N risks - 67.7% of caregivers who completed services. 5) Increased Protective Factors - 64.5% of caregivers who completed services. 6) Had no new CPS report during services -100% of families served. 7) Had no new CPS report within 6 months after case closure - 100% of families who completed services. 8) Had no new CPS report within 1 year after case closure - 100% of families who completed services NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Kapi'olani Medical Center For Women & Children Kapi`olani Child Protection Center-West Hawaii Title IV-B-West HI Counseling & Supportive Living Project Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Families completing service plan that have no new report of child abuse or neglect 98.9% NA** NA durin ro ram services. Individuals Com letin Service Plan 63.5% 80% 80% Caregivers completing service plan who have 70.3% 95% 95% develo ed a radical Child Safet Plan. Caregivers completing Service Plan whose Child Safety Protective Factors have 75.3% NA NA increased Caregivers completing Service Plan whose 73.3% NA NA Child Safet Risk Fac[ors have decreased. Families completing Service Plan who have no new confirmed report of child abuse or 96.4% 90% 90% ne lect at 6-month follow-u Families completing Service Plan who have no new confirmed report of child abuse or 98.8% 95% 95% ne lect at 1 ear follow-u Permanent families without placement 100% NA NA disru tion durin the service eriod *If applicable "Discontinued by DHS-CWS as outcome indicators for contract period NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Kapi~olani Medical Center For Women & Children Kapi'olani Child Protection Center-West Hawaii Title IV-B-West HI Counseling & Supportive Living Project Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Salaries and Wa es $259,258 $267,798 $267,798 Professional Fees 22,768 $22,162 $22,162 O erations 80,668 $80,040 $86,040 E ui ment 0 $10,000 $4000 Other* Total $362,694 $380,000 $380,000 *Please explain in detail on separate sheet Program Funding Sources Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Title IV-B Federal Grant $380,000 $360,000 $360,000 HIUW $10,000 $10,000 $10,000 Charit Walk $5,000 0 $5,000 HI County Grant $16,000 $20,000 $20,000 Total $411,000 $390,000 $395,000 'If applicable Explain what plan, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to be self- sustaining? KCPC-West Hawaii will continue to seek donations and grants to provide the necessary matching funds to obtain the federal grant to continue to provide these very vital services for West Hawaii residents. The County grant has provided some of the matching funds that allow our program to obtain the federal funds. Without the matching funds, we will be unable to obtain the federal funds that are the major support for the program's services. KCPC-WH will need to continue to obtain matching funds and will need to continue to seek grants and donations to support this program. The IVB program can't be fully self-sustaining due to the requirements of matching funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center-West Hawaii Title IV-B-West HI Counseling & Supportive Living Project I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of al! expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate year-end report may impact the evaluation of your program's or agency's future funding requests. Martha B. Smith Date KMCWC Chief Operating Officer Steven J. Choy, Ph.D. Date KCPC Director UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 KONA ADULT DAY GARS, ING. Adult Day Care Agency Director: Rowena L. Tiqui Phone No.: 322-7977 Contact Person: Rowena L. Tiqui Phone No.: 322-7977 Mailing Address: P O Box 1360 Kealakekua HI 96750 Facility/Site Address: 81-989 Halekii Street Kealakekua HI 96750 Fax No.: 322-0614 Email Address: kadcrowena@hawaii.rr.com Name of Accour~tant/CPA (include name of firm if applicable): Ronald G. Hawks. CPA Phone No.: 328-0592 Mailing Address: P O Box 1420 Kailua Kona HI 96745-1420 Amount of Request for County Funds: $30,000.00 'Note: KADC has been operating on a bare bones budget for a number of years. We have used a lot of our savings for building repairs and improvements to offset lace of revenue. Savings are low. Wont' be able to continue much longer. Received $15,000 every year since 1999 to 2005. Prior Year(s) Funding: 413-04 ft4-tt5 05-406 $15,000 $15,000 $15,000 Agency Mission Statement: "Our mission is to provide health, social and recreational programs and activities that enable impaired adults to experience feeling of being, friendship, acceptance, accomplishment and independence in a caring and secure environment." NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 KQNA ADl1LT DAY CENTER, [NC.. Adult Day Care Program Description: Adult day care is viewed as a promising long-term care option because it provides regular and reliable respite to informal caregivers, while it fosters their continued participation in the workforce. Persons eligible for Kona Adult Day Center services are those adults 18 years and older, but particularly those 60 years and older, having either a physical or a cognitive disability, requiring supportive care. These are persons with Alzheimer's disease, dementia or Parkinson's disease, multiple sGerosis and those who are socially isolated. Day care provides a less restrictive setting and amore cost effective program than other types of care, such as home nursing or institutionalization. Total Budget and Position Count Total Pro ram Bud et 158,314.8f3 Total Pro ram Position Count 7 Total Agency Budget 143,299.2(1 Total Agency Position Count 7 Program Objectives: 1) Program Goals for Individuals a. Avoid premature or inappropriate institutionalization. b. The client will be able to associate with a place and a group corresponding with his/her own sense of identity. c. The client's maximum level of independence will be assessed through the individual program planning. d. Mentally and physically impaired aduts will be maintained at their highest level of functioning, thus preventing or delaying further deterioration. e. Health monitoring as well as protective and supportive care for the frail and disabled adults will be included in care planning and services. f. The caregivers' knowledge of, and access to elderly services available in the community. g. Socializing, peer interaction and continued relationship with the community ~a'il! be ensured. h. Isolation and prejudice often associated with frail and disabled adults will be reduced. 2) Program Goals for Families and Other Caregivers a. Families and other caregivers will be assured that elders dependent upon them are being cared for appropriately during the day. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 b. Families that desire to keep elderly members in the home will be given relief for full-time care of an impaired adult. c. Family members will be enabled to continue productive careers instead of being hanebound with an elderly, disabled spouse, parent or other family member. 3) Program Goals for the Community a. The medical community and other resources state wide will be provided a liaison in the geriatrics, especially Alzheimer's disease and other related disorders. Program Highlights: 1) Maintained of participants at home for a minimum of 6 months with adult caze services. 2) Maintained or improved socialization/infraction skills of participants. 3) Maintained or improved hygienelself--care of participants. 4) Surveyed caregivers, who responded, expressed satisfaction with Kona Adult Day Care. 5) Had intergenera6onal interaction activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 KQNA AQULT QAY CENTER, fNC. Adult Day Care Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Clients Served 38 45 54 `If a~7171iCah~iE Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 147,223.27 164,640.00 197,000.00 Professional Fees 37,073.84 3,756.00 7,800.00 O erations 70,776.17 76,614.00 77,854.00 E ui ment .00 .00 5,000.00 Other" 45,422.72 56,604.00 60,000.00 Total 300,496.00 301,614.00 347,654.00 If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 KONA ADULT DAY CARE, INC. Adult Day Care Program Expenditures Other FY 2004-05 FY 2005-06 FY 2006-07 Actual'" Bud et* Estimate Benefit 29,877.34 38,064.00 40,000.00 Pa roll Taxes 15,545.38 18,540.00 20,000.00 45,422.72 56,604.00 60,000.00 KONA ADULT DAY CENTER, [NC. Adult Day Care Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate DHS POS Pro ram 27,625.96 30,000.00 30,000.00 DHS NHWW 55,711.00 55,200.00 60,000.00 HCOA-Service for Seniors 1,434.66 2,040.00 3,000.00 Teresa Hu hes Trust 14.00 .00 .00 Coun of Hawaii 15,000.00 15,000.00 30,000.00 Mae Tem leton Ho er 15,843.00 25,200.00 25,500.00 Hawaii Island United Wa 15,000.00 15,000.00 15,000.00 Theodore Vierra 250.00 .00 .00 Other Grants 6,000.00 16,000.00 16,000.00 Tuition 75,461.34 78,000.00 80,000.00 Tuition Ad'ustment -32.78 .00 .00 Trans ortation Fees 5,348.75 7,200.00 7,500.00 Bathin Fees 9,480.00 14,400.00 14,400.00 Feedin Fees 420.00 420.00 500.00 Adult Food Pro ram 9,396.06 9,480.00 10,000.00 Intake Fees 270.00 480.00 600.00 Fundraisin Donations 6,762.86 7,000.00 7,000.00 Fundraisin S ecial Events 1,650.00 1,704.00 2,000.00 Fundraisin Sales 13,786.80 16,000.00 16,000.00 Membershi 5,095.00 5,000.00 5000.00 Administration Fees 1,190.00 1,000.00 1,250.00 Interest Income 967.36 960.00 960.00 Unrealized Gain 158.10 .00 .00 Total 266,832.11 300,084.00 324,710.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Plans are to incx+ease client census to maximum of 60 clients, which means tuition will increase. Staffing will also increase. Rates will also increase. ! antidpa~ to become self-sustaining by 2008-239 with ~ntinued support from the community. NONPROFTI' GRANT APPLICATION FI5CAL YEAR 2006-07 Page 5 KONA ADULT DAY CENTER, INC. Adult Day Care I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofd Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. M awarded a grant from the County of Hawaii, l (we) understand and will comply with the requirement to submit a y~r-end report to the L.eeislative auditor within ti0 days after June 30 of the ii~.al year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure bo submR a timely, comolebs, and accurate veer-end resort will impact tire evaluation of your oroaram's or anencv's future fundirrsr requests. ~o.~,V.4~Z.q..®-vim. ~.n1 a. ~ . a OO !p Signature of Board President/Chair Date ` yY- `~-C Signature of Exec ive Die o Date UNSIGNED PROPOSALS VYILL NOT BE ACCEPTED[ NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Kona Literacy Council- q~ency Name KAILUA LEARNING CENTEF~~ Program Name Agency Director: loan Budnick Phone No.: 329- 1180 Contact Person: Brenda Natina Phone No.: 329- 1180 Mailing Address: Kailua Learning Center 75-5766 Kuakini Hwy Ste. 106A Kailua Kona, HI 96740 Facility/Site Address: Same Fax No.: Same Email Address: konalitQmsn.com Name of AccountanUCPA (include name of firm if applicable): None Phone No.: None Mailing Address: None Amount of Request for County Funds: $1,500 Prior Year(s) Funding: 03-04 04-05 05-06 $1,500 $1,000 $1,500 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 The Kona Literacy Council's volunteer tutors help any adult increase their basic reading, writing and communication skills to enable the learners to become better family members, workers, community members and lifelong learners. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Kona Literacy Council -Agency Name Kailua Learning Center- Program Name Program Description: The Kona Literacy Council's trained volunteer tutors provide free, one-to-one, small group, and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing, computation skills and computer literacy. Special programs designed to meet the specific needs of the learners are offered, such as: English as a Second Language, preparation for passing the GED or Competency Based High School Diploma, Citizenship preparation, keyboarding and computer literacy. All tutoring is at no cost to the student. All of the 559 students, who have had lessons at the Kailua Learning Center since it opened in September 1992, have made remarkable progress in their basic skills; some have gained their High School Equivalency Diploma, passed the Citizenship exam, and have gotten better jobs. Reading improves the adults' self-esteem, thereby improving their lives and becoming better family members, workers and community members. Total Budget and Position Count Total Pro ram Bud et $6,500 Total Pro ram Position Count 9 Total A enc Bud et $6,500 Total A enc Position Count 9 Program Objectives: 1) Continue to provide free one-to-one, small group and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing, computation and computer literacy skills. 2) Register, schedual, match learner with tutor, and prepare programs for 15 new students for the year. 3) Continue recruiting and training new tutors. 4) Continue networking with community agencies to provide free literacy assistance to their clients, i.e. Department of Human Services, Department of Labor & Industrial Relations, Kona Community School for Adults, various Vocational Rehabilitation Programs, Bridgehouse, Alternatiaves to Violence, court ordered participants, Family Support Services of West Hawaii, Head Start, Hawaii Community College and the public libraries. 5) Offer pre-employment skills, help in filling out application forms, resume writing and interview skills to enable our learners to get and hold jobs. 6) Improve family literacy services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 7) Help foreign born learners with their communication skills and assist them in passing their citizenship test. 8) Empower adults to become contributing members of our community by ensuring that everyone increases their literacy skills and becomes lifelong learners. 9) Publish a quarterly newsletter. 10) Hold general membership and public meetings quarterly. 11) Continue writing grants, pursuing fund raising functions, and seeking donations to keep open the doors of the Kailua Learning Center. . Program Highlights: 1) Tutored 9 basic literacy students. (includes reading, math & computer literacy) 2) Tutored 12 English as a Second Language students. 3) left the program and attained employment: 4 students. 4) Retained employment: 3 student. 5) Passed the citizenship test: 1 student. 6) Entered other educational programs: 2 student. 7) Increased involvement with children's education: 3 student 8) Met goals: 8 students. 9) Utilized 8 volunteer tutors. 10) Tutored 519 hours of actual tutoring. 11) Contributed aproximately 500 hours by volunteers in other areas. 12) Trained 2 new tutors. NONPROFIT GRANT AAPI.iCATIgN FISCAL YEAR 2Qg6~,7 P~e4 Kona Literacy Council -Agency Name Kailua Learning Center -Program Name Performance Measures: FY 2004-05 FY 2005-08 FY 2006-07 Actual * Bud et * Estimate Tutored Basic Literac Students 9 15 12 Tutored ESL Students 12 15 15 Trained new tutors 2 4 4 Published News letter 3 3 3 Total Tutorin hours 519 400 550 Total non-tutorin hours 500 700 550 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 0 0 0 Professional Fees 0 100 100 O erations 5,439 5,000 5,600 E ui ment 0 1,000 400 Other' KSura acF 400 400 400 Total _ 5,839 6,500 6,500 If applicable v Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Kona Literacy Council -Agency Name Kailua Learning Center -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Coun Grant 1,000 1,500 1,500 Membershi Dues 40 50 50 Wal-Mart 250 1,200 1,250 Donations 2,100 1,450 2,500 Fundraisin 0 500 500 Federal Campai n 673 800 700 Youn Brothers not forKLC 0 1,000 0 Total 4,063 6,500 6,500 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self~ustaining? The Kona Literacy Council plans to participate in more fundraising and grant proposal writing. Since we do not charge our clients for our literacy services, we will have to continue to rely on the generosity of our community supporters. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Kona Literacy Council -Agency Name Kailua Learning Center -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and,will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report sfia11 include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listiing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate year-end resort will imaact the evaluation of your aros~rem's or a~ency's future fundins~ requests. ~P2~ S' ature of Board President/6:i~r to Signature of Director Date 1 UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Ku'ikahi Mediation Center, Inc- Agency Name Ku'ikahi Mediation Center- Program Name Agency Director: Libby Pulelehua Oshiyama, Ed. D. Phone No.: 935-7844 Contact Person: Libby Pulelehua Oshiyama, Ed. D. Phone No.: 935-7844 Mailing Address: 614 Kilauea Ave. Ste 5A, Hilo, Hawaii 96720 Facility/Site Address: 614 Kilauea Ave. Ste 5A Hilo, Hawaii 96720 Fax No.: 961-9727 Email Address: kuikahi_mediation@verizon.net Name of Accountant/CPA (include name of firm if applicable): Taketa, Iwata, Hara & Associates, L.L.C. Phone No.: 935-5404 Mailing Address: 101 Aupuni Suite 139, Hilo, Hawaii 96720 Amount of Request for County Funds: $8,000 Prior Year(s) Funding: 03-04 04-05 05-06 $5,000 $4,000 $5,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 To provide a safe environment, an impartial process, and skilled trained personnel for the delivery of affordable dispute prevention and resolution services to the East Hawaii community on anon-profit basis. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Ku~ikahi Mediation Center, Inc. -Agency Name Ku~ikahi Mediation Center- Program Name Program Description: The Ku'ikahi Mediation Center (KMC) provides quality mediation services to individual and organizations in the East Hawaii community. KMC utilizes professionally trained community volunteers and handles disputes involving neighbor/neighbor, family (including intergenerational and divorce issues), work place, community, Special Education, and civil rights. Recipients of these services include: community meetings needing facilitation, referrals from the Prosecuting Attorney's Office, local attorneys, and the County Police Department. The Center has increased its services to individuals and families involved in neighborhood restraining orders, assisting as many as 200 county residents in peacefully resolving disputes. The successful resolution of these cases reduces the number of calls requiring a police response. The center provides training in mediation, and education of the community in the process through its contacts with the public and various organizations. This education is being expanded to corporations, condominium boards, and the department of education via mediations, and the opportunity for training. Total Budget and Position Count Total Program Budget Total Program Position Count 2 $77,360.00 Total A enc Bud et $77,360.00 Total A enc Position Count 2 Program Objectives: 1) Provide a safe environment for quality mediation and facilitation services to 800 individuals in Program year 2006-7. 2) Increase active mediator pool from 33 to 50 mediators. 3) Provide a refresher training for all existing mediators. 4) Provide advanced training for mediators in Divorce and Co-parenting, and in Training Trainers for Work Place Mediations. 5) Ensure that at least 85% of clients served in Program Year 2006-7. 6) Hire an Executive Director with the qualifications to develp and manage mediator training programs, and further develop data acquisitionlanalysis . 7) Develop the funds to hire one part time .5FTE Training Coordinator. 8) Obtain funds to develop a Mediation Training Program for Middle School Students. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Program Highlights: 1) For Program year 2005: Providing services fo 280 plus cases, which is an increase of the previous year, with more than 730 clients served. 2) Mediator pool has been rejuvenated, and mediator participation is at a remarkable 85%, volunteering 750 mediation hours. 3) Facilitation of large group meetings, a 10% increase in the number of Domestic mediations including, family arguments, divorce settlements, and co-parenting planning. 4) Eight mediators trained to do Special Education Mediations with parents and the DOE, 29 mediators trained in basic mediation. 5) Development of a Board of Directors composed of community members who are directly overseeing and improving administrative procedures and accountability, and are developing various ways to raise more money for the center. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Ku'ikahi Mediation Center, Inc. - A ency Name Ku~ikahi Mediation Center -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Number of Cases o ened 300 350 395 Number of mediators 45 33 50 Number of cases received from 07 10 12 rosecutin attorne office Percents a of satisfied clients 85% 88% 90% Number of cases from Hawaii 0 5 10 Condominium Commission Number of domestic case self- 30 50 referrals *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $63,180 Professional Fees 3,200 O erations 10,980 E ui ment 00 Other" Total $77,360.00 ` If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 200G-07 Page 5 Ku'ikahi Mediation Center, Inc. -Agency Name Ki'ikahi Mediation Center -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii 4000 5000 8000 Judicia ,State of Hawaii 50,424 51,851 54,360 Pro ram Service Fees 6000 6000 8000 Justice Foundation 2000 2000 6000 Donations 500 600 1000 Total $63,524 $64,451 $77,360 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The agency intends to increase the number of cases opened by at least 12.5%. The majority of these are expected to be in the area of divorce settlements, and co-parenting planing, which can be contributor for reduction in domestic violence. This and other increases in the number of cases opened requires that we move the Case Coordinator up to .75 fte, from .5 fte. There should be an increase of fees that will be realized by the agency, however, 52.86% of our clients are below the $20,625 level. This means that we are unable to collect the money necessary to cover the cost of staff time. We will also need to increase the number of mediators who are advance-trained in domestic/divorce mediation. The cost of this training will require more staff time and a staff member who has training credentials. We intend to set up a fundraising mechanisim via, membership in a Support Group for Community Justice., this should help us increase our income. We will be seeking funds to enable the development of a Mediation Training for Middle Schools program, and a .5fte time Training Coord. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Ku'ikahi Mediation Center Inc. -Agency Name Ku'ikahi Mediation Center -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, 1 (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate vear-end report will impact the evaluation of your program's or agencv's future funding requests. w - l,? Jrnnn. 3~ LOo~ a. Signa r of Board President/ air Date r stt~'~i ZOO ~o Si a of Executiv irector ate UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Laupahoehoe Train Museum- Agency Name Teaching, Tranportation and Technology- Program Name Agency Director: Lisa Barton Phone No.: 962-6300 Contact Person: Lisa Barton Phone No.: 936-9532 Mailing Address: P. O. Box 358 Laupahoehoe,H196764 Facility/Site Address: 36-2377 Mamalahoa Highway Laupahoehoe,H196764 Fax No.: 962-6957 Email Address: laupahoehoetrainmuseum@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Natalie Iwasa, CPA, Inc. Phone No.: (808) 395-3233 Mailing Address: 975 Kaluanui Rd. Honolulu, HI 96825 Amount of Request for County Funds: $59,400.00 $44,400 is for labor and $15,000 is for operational costs. Labor: The labor is for 125 hours/month for docents, 60 hours/month for a curator/marketer, 30 hours/month for bookkeeping and 30 hours/month for maintenance. Operations: Budget includes $5,000 for advertising, $6,000 for displays (to include TV, DVD and computer), and $4,000 for printing and postage. The $59,400 is a decrease from our original 2005-06 funding request of $75,000. Prior Year(s) Funding: 03-04 04-05 OS-O6 $ 0.00 $ 0.00 $35,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Agency Mission Statement: The purpose of the Laupahoehoe Train Museum (LTM) is to preserve, promote, and protect the historic, cultural, educational, social, civic and economic interests of the North Hilo and Hamakua districts, while highlighting the history of railroads on the island of Hawaii. The mission is to preserve Hawaii Island's railroad history for posterity and prosperity. The museum has worked towards three main goals in our eight years of operation to; 1) Create a quality museum; restoring house, yard and track to the era before the 1946 Tsunami. 2) Educate museum visitors on the historic, scenic, and cultural interests along the HamakualHilo Heritage Coast, 3) Assist in the development of projects, at the museum and throughout the community, that enhance the area. We are working towards sustainability of the museum by completion of objectives set at the establishment of the museum; providing jobs to stimulate the community's economic development; promoting the museum with enhanced interior and exterior displays; and developing a more comprehensive marketing strategy to attract visitors. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Laupahoehoe Train Museum -Agency Name Teaching, Tranportation and Technology- Program Name Program Description: The goal of this program is to make the best use of our facility as an educational resource using technology to increase displays in our limited space. The program will enhance museum programs, develop a business plan, maintain seven day a week operation and help transition key volunteer positions to paid staff. To enhance museum displays, we will include Japanese translation and add TV, DVD, and computer displays in the museum where more information can be stored and shown while making efficient use of museum space. We will also expand the museum's displays to tie together the rich history of the plantations, railroads and cultures that created these histories. Our goal is to provide a quality museum experience. To attract more visitors, we will develop a marketing and business plan to provide transportation of Hilo cruise ship visitors to the museum and other points of interest along the Hilo-Hamakua Coast. As new displays and programs are offered and new visitors attracted, we will see improved revenues, which improves our sustainability. Volunteers have been critical in creating and running the museum, however, our program goals and objectives can only be accomplished with the help of paid staff. To achieve the goals to hire local residents and maintain daily museum hours with limited funding, requires a mix of volunteer and paid staff. Balancing this mix is key where staff researches and creates displays, then volunteers and staff shares new information with visitors at the museum and during outreach programs. Total Budget and Position Count Total Pro ram Bud et 196,000 Total Pro ram Position Count 4 Total A enc Bud et 240,000 Total A enc Position Count 16 Program Objectives: 1) Create business and marketing plan to transport Hilo Cruise Ship visitors to Laupahoehoe Train Museum and other points of interest along the Hamakua Coast. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 2) Enhance museum displays to include Japanese translation, N, DVD, and computer displays. 3) Enhance museum displays focusing on island railroads, plantation days and cultural developments in island history. 4) Expand outreach programs to increased visitor count and sustainability. 5) Market the museum to increase visitor numbers, through brochure distribution, additional marketing venues and continued outreach. 6) Maintain hours of operation through paid staff. 7) Maintain grounds, gardens and buildings. 8) Maintain bookkeeping system using generally accepted accounting practices. 9) Transition key volunteer position to paid local staff. Program Highlights: 1) Eight years of operation 2) Museum Tours and Out reach -Veteran's Celebration at Hakalau, Festival of Trees, Education Partners at Prince Kuhio Plaza 3) Train Room -converted carport for additional, interactive displays. 4) Laupahoehoe Point Walking Trail -Partnered with County who budgeted $100,000 for emergency access road assessment and development. 5) Ookala Community Forest -trails and signage begun 2005, UH-Hilo and Hawaii Community College research area. Established in 1999. 6) Keiki car seats -Partner with Department of Health(DOH), Highway Safety grant provides car seat inspection stations and training for the Island of Hawaii. 7) Completed three year State Incentive Grant to reduce substance abuse in our community. 8) Interpretive sign created for Laupahoehoe Point overlook, scheduled for 2006 installation-partner with State of Hawaii. 9) Matson Ka Ipu Aina Grant for Ookala's Kaohaoha Gulch Clean-up. 10) Volunteer and paid staff maintained daily hours of operation to have the museum open everyday except for major Holidays 11) Paid staff research located information for displays to tie plantations and tsunami to railroads. 12) New Brochures created; first ones since our opening. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Laupahoehoe Train Museum -Agency Name Teaching, Tranportation and Technology -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate increase visitor count b 20% 6,000 7,000 8,400 increase school and community 30 40 50 tours b 25% create business/marketin Ian 0 0 1 ex and number of dis la s 0 2 2 increase aid staff FTE 0 .5 2.5 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 0 12,000 86,400 Professional Fees 0 0 0 O erations 23,700 52,600 49,600 E ui ment 0 0 5,000 Other" 75,0000 55,000 55,000 Total 98,700 119,600 196,000 ' If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Laupahoehoe Train Museum -Agency Name Teaching, Tranportation and Technology -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-05 FY 2006-07 Actual * Bud et * Estimate Admissionsldonations 14,500 19,000 20,000 Membershi dues 2,800 3,200 3,600 Sales net 6,400 7,400 8,000 Grants IMLS -federal 0 0 50,000 Docent in-kind 36,000 36,000 36,000 Museum mana ement in-kind 39,000 19,000 19,000 Count a ro riation 0 35,000 59,400 Total 98,700 119,600 196,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? A three year program grant through the Institute for Museum and Library Services has been applied for in the amount of $150,000.00. These are operational funds that would help to sustain the museum, while we build toward self sustainability. These funds are to be used to increase public awareness and educational programming. With grant assistance to increase visitor awareness and extend our outreach programs we project visitor count to be near 10,000 by 2010 and therefore be self-sustainable with a full paid staff. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Laupahoehoe Train Museum -Agency Name Teaching, Tranportation and Technology -Program Name I (we) have read and understood ail of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate vear-end report will impact the evaluation of your program's or aQencv's future funding requests. ~ ~ n Si na a of B and President/Chair Date j~3i~C+(v Signature f ;~"-~r+~-~,~~z Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Reference to Page 5 Program Expenditures Explanation: In regard to the column marked "Other" $75,000.00 is for in-kind volunteer time for FY 2004-2005. While in FY 2005-2006 and FY 2006-2007 our in-kind volunteer hours is $55,000.00. For FY 2004-2005 our docent volunteer time is $37,000.00 and $38,000.00 for volunteer managerial time. For FY 2005-2006 and 2006-2007 our docent volunteer time is $37,000.00 and management time was reduced to $18,000.00 because part time payment to management staff. Paying key staff positions has been very important to the museum in terms of maintaining museum hours, researching information for new displays, display creation and bookkeeping. Mental Health Kokua Residential Rehabilitation Services Agency Director: Joanne Lundstrom Phone No.: 737-2523 Contact Person: Gary Michell Phone No.: 331-1468 Mailing Address: 1221 Kapiolani Blvd., Ste 345, Honolulu, HI 96814 Facility/Site Address: 75-5752 & 75-5750 Alanoe Pl., Kailua-Kona, HI 96740 ] 40 Wainaku Avenue, Hilo, HI 96720 139 Amau Road, Hilo, HI 96720 Fax No.: 331-1468 Email Address: konamhkCn).mentalhealthkokua.org Name of Accountant/CPA (include name of firm if applicable): Summer B. Such, CPA Phone No.: (808) 737-2523 ext 1107 Mailing Address: Mental Health Kokua 1221 Kapiolani Ave, Suite 345 Honolulu, Hawaii 96814 Amount of Request for County funds: $25,000 Prior Year Funding: 03-04 04-05 05-06 $15,000 $15,000 $20,000 Agency Mission Statement: We believe that all citizens should have an opportunity to live and participate in and contribute to their communities. Through specially designed services, Mental Health Kokua helps those in Hawaii who are in mental distress, emotional crisis or recovering from serious mental illness achieve their optimum level of recovery and ability to function in the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Mental Health Kokua Residential Rehabilitation Services Program Description: Funding is requested for our transitional residential services, including PATCH (Psychosocial and Transitional Community Housing) Place in Hilo, Hale Alanoe and Kealahou in Kailua-Kona, and the recently acquired home in upper Kauamana section of Hilo, called Hale Amau. The acquisition of Hale Amau allows for a needed expansion of transitional housing for people in recovery from mental illness, in Hawaii County. Mental Health Kokua will offer 18 beds in Hilo, and 12 beds in Kailua-Kona, for a total of 30 beds to address the need for more transitional housing for this population. Mental Health Kokua staff provide 24-hour supervision and rehabilitation services with the goal to enable clients to move on to more independent housing. While in placement, clients are assisted in acquiring personal and social survival skills necessary for sustained community living. Staff provides training and support in daily living skills and medication management while facilitating social, educational and recreational activities in the community. Clients are also assisted in making connections to community resources including mental health centers, vocational training programs, and community housing agencies, as well as assistance with long-term community placement. These projects provide cost effective, humane, community based alternatives to institutional care and/or homelessness. Transitional bed day costs for FY 2005 are estimated at $94. Comparative bed day costs in a psychiatric hospital are estimated at $600 to $800 a day. Total Budget and Position Count Total Pro ram Bud et 1,029,789 Total Pro ram Position Count 20 Total Agency Budget 7,995,916 Total Agency Position Count 180 Program Objectives: 1) Provide residential and social rehabilitation services to 75 unduplicated persons with serious mental illness. 2) Show completion of identified treatment plan goals upon discharge by at least 80% of clients served. 3) Reduce consumer psychiatric hospitalization by at least 90% 4) Ensure 100% compliance of Commission on Accreditation of Rehabilitation Facilities (CARE) and other monitoring recommendations. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Mental Health Kokua Residential Rehabilitation Services 5) Show evidence of satisfaction with services received at 95% of consumers served 6) Show improvement in daily living skill scores upon discharge in at least 90% of consumers served. 7) Place at least 90% of consumers served in more independent living settings following planned discharge. Program Highlights: 1) Provided transitional residential rehabilitation services in FY 2005 to thirty- seven (37) unduplicated clients at PATCH Place and sixteen (16) unduplicated clients at Hale Alanoe. 2) Discharged 50% of clients served to more independent living in the community. All clients showed improvement in daily living skills. 3) Provided a total of 6,342 bed days and 12,684 meals in our transitional residential programs during FY 2005. 4) Purchased a five (5) bedroom home in the upper Kaumana area of Hilo in December 2005, allowing for expansion of the number of beds available in Hilo for transitional services from twelve (12) to eighteen (18). 5) Expanded the number of beds available for transitional residential services in Kona from six to twelve in November 2005. 6) Purchased the previously rented four-bedroom duplex Hale Alanoe facility in Kona. Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 ' Actual * Bud et* Estimate Number of unduplicated consumers 53 65 75 served Percentage of consumers served 50% 65% 75% who were discharged to more independent livin settin s Number of consumers served 5 4 3 re uirin hos italization Percentage of consumer satisfied 97% 95% 100% with services *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Mental Health Kokua Residential Rehabilitation Services Program Expenditures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et* Estimate Salaries and Wa es 485,475 635,099 708,175 Professional Fees 13,043 15,056 25,465 O erations 159,853 268,188 296,149 E ui ment Other# Total 658,371 918,343 1,029,789 If applicable #Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual Bud et* Estimate Count of Hawaii 15,000 20,000 25,000 Fees & Grants from Gov't A encies 459,429 632,776 700,118 United Wa 25,000 25,000 25,000 Pro ram Service Fee 84,280 111,211 122,877 CCS Fees 74,610 126,790 144,650 Donation/other 250 200 200 Total _ 658,569 _ 915,977 _1,0.17,845 'If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Mental Health Kokua Residential Rehabilitation Services Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Mental Health Kokua has demonstrated notable ability and success in obtaining funding from private sources such as trusts and foundations. We have been providing services to people with mental illness in Hawaii for over 30 years and have built strong relationships with many foundations and trusts. For example, in 2001 MHK started a capital campaign to raise $1.5 million to purchase properties on the Big Island and in Maui. This objective was achieved in 2003 through support from various foundations, trusts, individual donors, Board member donations, the County of Maui, and Housing and Community Development Corporation of Hawaii (HCDCH). Just this year, funding from the State of Hawaii and the U.S. Department of Housing and Urban Development (HUD) was granted to MHK for the acquisition of Hale Alanoe in Kona and another property in Hilo. We continue to explore ways for the agency to become fully self-sustaining. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Mental Health Kokua Residential Rehabilitation Services I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate vear-end report may impact the evaluation of your program's or aaency's future funding requests. Signature of Board President/Chair Date man / ignature of Executive Dir ~tor D e f~ UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Lti~^~/ New Hope Christian Fellowship- Agency Name 9 Under His Wings Street Ministry- Program Name Agency Director: Joyce Higashi-tkeda Phone No.: Contact Person: s/a Phone No.: 969-3094 Mailing Address: 840 Kupulau Road Hilo, HI 96720 Facility/Site Address: 183 Keawe Street Hilo,Hl 96720 Fax No.: 959-5186 Email Address: New Hope@newhopehilo.org Name of AccountantlCPA (include name of firm if applicable): Pastor Steve Rice, Administrator Phone No.: 959-7700 Mailing Address: 840 Kupulau Road, Hilo, HI 96720 Amount of Request for County Funds: $10,000 approximately Prior Year(s) Funding: 03-04 04-05 Q5-06 $ None $None $ Agency Mission Statement: To extend Christian love and care to the homeless and less fortunate in Downtown Hilo by providing the necessities for daily living. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 New Hope Christian Fellowship -Agency Name Under His Wings Street Ministry- Program Name Program Description: Ministering to the homeless and less fortuante of Downtown Hilo by providing food, meals, toilitries, clothing, blankets, daily showers, etc. The entire program is staffed by volunteers. Total Budget and Position Count Total Pro ram Budget $1,500 er mo. Total Program Position Count 0 Total A enc Bud et $1,500 r mo. Total A enc Position Count Program Objectives: 1) Providing food and meals to the homeless in Downtown Hifo. 2) Providing a place to shower and get clean clothing. Providing bags of food, daily breakfasts. Providing blankets and other necessities. Offering a safe place to relax, fellowship and receive encouragement. Program Highlights: 1) Daify Meals, showers, etc. 2) Thanksgiving Luncheon at Wailoa State Park 3) Christmas Luncheon at Under His Wings 4) Christmas gifts for the homeless children 5) NONPROFTf GRANT APPLICATION FI$CAL YEAR 2006-07 Page 2 New Hobe Christian Fellowship -Agency Name Under His Wings Street Ministry -Program Name performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate n!a *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 0 0 Professional Fees 0 0 O rations $15,120 0 E ui ment 0 0 Other" $3,000 0 Total $18,120 0 " If applicable " Pease explain in detail on separate SAeet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 New Hope Christian Fellowship -Agency Name Under His Wings Street Ministry -Program Name Program Funding Sources: Identify ali funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et' Estimate see attached Total *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self~ustaining? see attached NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 NEW HOPE CHRISTIAN FELLOWSHIP'S UNDER HIS WINGS STREET MINISTRY Funding for this ministry comes directly from the following sources: 1. Our church supports this ministry by providing $625.00 per month to cover the rent of their facilities at 183 Keawe Street, Hilo, Hawaii. 2. The volu?rteers have fundraising events, held within our church, to cover their other expenses. 3. They are also supported by other donations and monetary gifts. Future Program Support Same as above. This program is already self-sustaining. New Hope Ghristian Fellowship -Agency Name Under His Wings Street Ministry -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we}hereby certify that information supplied herein inGuding all supporting documents is correct and that I (we} have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that inforration supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. ff awarded a grant from the County of Hawaii, l (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failtlre fA submit a timely. complete, and accurate veer-end report will imuact the evaluation of vour aropram's or apencv's future funding requests. ~~~o~ Signatu of Bo d PresidentlChair Date ~ /-025- a~ Signature of Ex cu ive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Roman Catholic Church in the State of Hawaii, ~r Office for Social Ministry Care-A-Van Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Grandee Menino, Program Administrator Phone No.: 808-935-3050 X 113 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: carolrign@aol.com, bcachola@rcchawaii.org, Name of AccountantlCPA Nancy Kay Lee, BBA, MBA -Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Choo, Osada & Lee, CPAs, Inc. -Auditor Phone Number: (808) 734-1921 Mailing Address: 3536 Harding Ave., Room 605, Honolulu, HI 96816 Amount of Request for County Funds: $30,000 Prior Year(s) Funding: 03-04 04-05 05-06 $29,000 $29,000 $30,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is amulti-faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care-A-Van Program Description: Care-A-Von (CAV) is a mobile, homeless outreach program serving The unsheltered homeless of Hawaii County; it is the only such program on the island. Operating since 1991, CAV has engaged with over 1 3,000 homeless individuals. The ultimate goal of CAV is to help the unsheltered homeless progress towards healthier, more stable living conditions and ultimately move out of homelessness, and into permanent housing. We believe that in order to achieve this goal, we must establish a trusting relationship and rapport with each individual so that they are more receptive to addressing internal barriers. Outreach and engagement takes unique people To deal with multiple complex factors aT persons experiencing homelessness face. Our mobility allows staff to outreach and engage with the homeless where they are, whether they are on remote beaches, the woods, lava-covered areas (lava tubes) where they live in Tents and under Tarps, or in town. We currently utilize nine (9) program cars, with seven (7) of them having 4-wheel drive capabilities. We've begun to see an increase of homeless in the Town-areas as well as in the outlying rural areas of The island. According to a 2005 Homeless-Point-in-time Count (raw data), homelessness is on a rise. Hawaii County is in a unique situation with larger geographical areas To cover compared To other Counties in Hawaii. Rental costs are still out of reach for most households living on fixed incomes. Without their rent being supplemented in some government form, housing options for most are slim. Another component of CAV is the representative payee program. Payees manage The finances of The seriously mentally ill (SMI) and the mentally ill homeless who are unable To do so Themselves. Two payees serve 101 participants, island-wide. We plan to hire a part-time employee To assist additional persons with serious mental illnesses. Care-A-Van also facilitates empowerment groups as a creative avenue To engage the chronic homeless To participate in activities in a safe, healthy, and clean environment. These activities encourage and promote participation in meaningful activities on a regular basis; involves consumers in groups to enhance self-confidence and stimulate appropriate interpersonal interaction; facilitate an open dialogue about establishing and maintaining relationships intimacy; provide and promote opportunities to practice using their social skills; share information about systems and community resources; and promote awareness of resources available in our community. CAV also anticipate the grand opening of a "one-stop" service center for the homeless in West Hawaii. CAV is working closely with the County of Hawaii, Office of Housing and Community Development Office to manage the "Friendly Place." Stanford Carr, a major developer in Hawaii, has committed To a donation to The County, with a layout similar to a modest 3 bedroom~2 bath HPM kit home with modifications. This facility will house lockers, showers, bathrooms, mailing services, meeting/interview rooms and other supportive services such as mail, community bulletin boards, employment boards opportunities, feeding programs, and specialized services coordinated with existing resources in the community. We are currently engaging with The community to bring Their services To The "Friendly Place" for the homeless To receive all in a single location. This project was anticipated to open January 2006 as published in the County of Hawaii 2005 Annual Report. We have recently learned that iT has been delayed due to the availability of the Developei s sub- contractor for electrician work. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care-A-Van Office for Social Ministry, Care-A-Van program, continues to work strongly with the community, especially The STaTe and County Housing offices. An example of This is the selection of Care-A-Van's Program Administrator to represent the State of Hawaii as a "State Trainer" to learn how to expedite access to Social Security Administration (SSAJ Disability Benefits for people who are homeless in a "Train the Trainer" workshop in Alexandria, Virginia in December 2005. Only four persons represented Hawaii. One of Them is our own administrator, Brandee Menino. The State Interagency Council on Homelessness was awarded a federal grunt for technical assistance in implementing this initiative. Despite the benefits to individuals and communities, many homeless adults, particularly those who are chronically homeless and have mental illnesses or other disabilities, do not receive SSA disability benefits. Estimates are that two-thirds of people who are chronically homeless have one or more serious health or behavioral health problems. Many likely would be eligible for SSA benefits; however, only 1 1 percent of The homeless population is estimated To receive 551. The work does not stop here. Promising Practices indicate that Case managers need to focus on initial applications, become an applicant's representative, avoid the need for consultative examinations, work closely with health care providers, reach out To medical records departments, establish ongoing communication with SSA and DDS and create a comprehensive summary report to illustrate the story of each disabled applicant. Consultative examinations only provide a "snap shot" of the individual, especially if that is not their physician. Care-A-Van commit To incorporate promising practices, ensure adequate staffing, provide staff training, collaborate with other key stakeholders, and collect and report outcomes on this initiative. The State and local governments may recoup money spent on general assistance and medical benefits when individuals receive SSI and Medicaid. Total Budget and Position Count Total Pro ram Bud et 1,674,773 Total Pro ram Position Count 23 Total A enc Bud et 3,316,269 Total A enc Position Count 41 Program Objectives: For FY-06-07: 1. Increase residential stability by 80%; 2. Decrease homeless recidivism rates by 80%; 3. Decrease hospitalizations and visits to the emergency room by homeless individuals by ! 0%; 4. Increase client skills financial assets 50% of the time; 5. Prevent 25% of "at-risk" households from becoming homeless; 6. Improve access To health care services; 7. Encourage family social relationships; 8. Strengthen access To community services NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care-A-Van Program Highlights for FY 2004-05: 1. Served 1,204 unduplicated homeless person in Hawaii County, including; • 326 unduplicated families with children (423 individuals in families) & • 455 unduplicated single persons • 897 people were new program participants 2. Cultivated 81 Landlords into assisting individuals and families experiencing homelessness move into their private rental units. These landlords were offered support and services Through Care-A-Van's "Tenant Solutions" to act as intermediary between the landlord and tenant. Tenants are prepared prior to moving into a rental unit through a "tenant-education" class. "Tenant-ready" graduates learn about their rights and responsibilities as tenants, landlord's rights and responsibilities, expectations of tenants, being good tenants, neighbors and timely rental payments emphasized. 3. Awarded $50,000 through the State's Housing and Community Development Corporation of Hawaii (HCDCH) office to assist individuals and families with financial assistance To prevent homelessness, including rental deposits, rent assistance, utility costs, transportation, including major car repair, and temporary shelter. This grant actually began September 2005. 4. Awarded $91,000 from The Hawaii Community Foundation, Meth Initiative to increase The number of Certified Substance Abuse Counselors (CSAC) in Hawaii County. Initial grant funds for scholarships were actually received in September 2005. Offering these scholarships to existing community providers developed an open relationship with scholarship recipients including the Psychiatric Unit staff at the Hilo Medical Center (HMC). Care-A-Van Outreach Workers and HMC's Nurses and Psychiatric Aides meet weekly at the substance abuse courses facilitated by Elizabeth Bush, APRN, CSAC. This opportunity allows us To build stronger networks as providers AND as "classmates," taking that same journey to become skilled Certified Substance Abuse Counselors. 5. In our first year of implementing the Kukui Program, fourteen (14) households moved into private rental units and received rental subsidies. These participants were assessed as meeting HUD's (U.S. Department of Housing and Urban Development) definition of homeless and disabled. Tenants paid only 30% of their total adjusted monthly income. 6. Care-A-Van's staff nearly doubled by September 2005 due To an increase of TANF funds (from $178,000 to $500,000) to help TANF-eligible families' transition from the sTreets~shelTer to permanent supportive housing. This assistance allowed us to financially assist families with their rental deposits, rental costs, and utility deposits. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care-A-Van Performance Measures: FY 2004-OS FY 2005-06 FY 2006-07 Actual * Budget * Estimate Number of persons placed in emergency or 77 179 125 transitional housing Number of persons placed in permanent housing 235 319 300 Number of persons placed into drug treatment or 17 55 55 alcohol Treatment Number of persons provided or referred for 2,903 1,590 1,590 medical or dental services (duplicated) Number of persons who participated in long-term 1,228 806 800 case management services Number of persons accessing mental health 747 618 600 services *If applicable Residentiol Stability: • 94% of program participants have remained in housing for at least 6 months; • 90% of program participants have remained in housing for at IeasT one year; and • 87% of program participants have maintained their housing for at IeasT two years. Increased Skills~lncome: • Of those who reported no income, 100% of program participants were referred to apply for mainstream entitlement programs (DHS, TANF, SSA, Veteran benefits, etc.) for which They were eligible for. More than half of the program participants increased Their income. Self-Determination: • 60% of those who received case management services participated in budget counseling and a tenant-readiness workshop. Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 521,814 869,541 1,045,113 Professional Fees 0 0 0 O erations 253,586 484,422 326,364 E ui ment 2,668 7,004 8,500 Other(rent/deposit 45,912 345,877 208,766 subsidies " Total 823,980 1,706,844 1,588,743 IT applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Program Expenditures These funds came from HCDCH, TANF and Shelter Plus Care Funding -Grants to CAV Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care-A-Van Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Adult Mental Health-Rep Pa ee 82,402 100,800 119,040 Adult Mental Health-Outreach 145,757 155,621 155,621 HCDCH 431,458 600,000 1,000,000 TANF 44,217 588,591 Federal Shelter Plus 30,130 125,832 125,832 Count of Hawaii 29,000 30,000 30,000 H I UW 16,820 10,000 10,000 Hawaii Hotel Industry 5,000 5,000 5,000 Donations 1,903 Insurance Proceeds 8,000 CDBG Grant 106,000 HI Community Foundation- Meth Grant - 91,000 Su erNOFA - 90,000 Adult Mental Health-ICM - 53,250 Total 900,687 1,706,844 1,588,743 'If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? OSM plans to apply for additional financial support through aT least two additional sources. OSM intends to submit a 2006 SuperNOFA application Through HUD's the Continuum of Care process. The intent of these additional monies will be dedicated for operational and personnel support for West Hawaii's Drop-In Cenier, the "Friendly Place:' OSM also plans to explore additional monies from the Department of Health, AduIT Mental Health Division (AMHD) To expand "ICM" (intensive case management) services for homeless persons with serious mental illnesses. These services are unit rate reimbursable from AMHD. AMHD can then seek Medicaid reimbursement for The ICM services Care- A-Van provided. OSM also plans to ask for an increase in our budget from HCDCH for Homeless Outreach services. Governor Linda Lingle has included an increase of $20 million for homeless outreach services in her State Budget. If supported through legislation we anticipate an increase in our program budget from HCDCH. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 ROMAy,C„9THOLI~ CHt~CH IfJ THE STATE OF HAWAII l ICe Or OClai MInIStrV Care a Van I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported 4y County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate Year-end report will impact the evaluation of your program's or aaencv's future funding requests. °l ~i 0 ~ 2ot7 L Signature of Board President/Chair Date GARY TREASURER Signature of Executive Djre for Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT CRANT APPLICATION FISCAL YEAR 2006-07 Page'I ~ i Roman Catholic Church in the State of Hawaii Office for Social Ministry Hawaii Island Food Bank Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: 140 B. Holomua Street, Hilo, HI 96720 79-1016 Honalo Street, Kealakekua, Hi 96750 Fax No.: (808) 935-3794 Email Address: carolrignC~aol.com Name of Accountant Nancy Lee, BBA, MBA Phone Number: (S08) 935-3050 Mailing Address: 140 B Holomua Street, Hilo, HI 96720 Name of Independent Audit Firm: Choo, Osada, & Lee, CPAs, Inc. Phone Number: 808-7341921 Mailing Address: 3536 Harding Avenue -Suite 605, Honolulu, HI 96816 Amount of Request for County Funds: $35,000 Prior Year(s) Funding: 03-04 04-05 05-06 $32,500 $32,500 $35,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is amulti-faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges ofever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. W e Ilve out this misslon using afour-sided approach to service that incorporates direct services, advocacy, justice education and community development. All programs of the Office for Social Ministry serve the entire community regardless of religious beliefs, age sex, ethnicity or ability. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Roman Catholic Church in the State of Hawaii Office for Social Ministry Hawaii Island Food Bank Program Description: The Hawaii Island Food Bank is a network of people working together to fight hunger and build community. As a member of the national America's Second Harvest Food Bank network, HIFB began serving the Big Island community in 1990. The Food Bank distributes over 1.7 million pounds of food every year to over 98 non-profit agencies which assist hungry people throughout the island of Hawaii. These agencies provided over The HIFB has several projects besides its basic food distribution. The Senior Brown Bag Program provides weekly food packages to low-income housing projects throughout the island. In collaboration with the Kauai Food Bank we also participate with the USDA sponsored Senior Fresh Produce program, distributing well over 200,000 pounds of locally grown fresh produce weekly. The Hawaii Island Food Bank (HIFB) serves the entire County of Hawaii through athree-fold mission through which we work to: 1) Prevent the waste of all edible food in Hawaii County; 2) Feed the hungry with this tood; and 3) Educate the community about hunger and what can be done to eliminate hunger. The HIFB is a clearinghouse for food and non-food items that retailers, wholesalers and farmers would normally discard (reasons for discarding food: surplus product, discontinued product, near pull date product, ripped labeling, off-grade produce), and for food donated by the community through food drives. On a daily basis, HIFB staff members drive to donor sites to pick up these items. All goods are then taken back to the warehouses, one in East Hawaii and one in West Hawaii, where HIFB staff and volunteers weigh the incoming poundage and then salvage usable product. Once items are salvaged, they are stocked on the warehouse shelves for distribution to nonprofit member agencies. This past year, over 1.7 million pounds were distributed via our network of approved, nonprofit member agency network. These agencies distribute goods directly to the public either by serving meals, providing food boxes, or providing snacks to adults and children in day programs. Agencies include hot meal programs, after school programs, food pantries, child and adult day programs, programs that serve the chronically ill, homeless and abuse shelters, and substance abuse recovery programs. Equally important to the food bank's mission of feeding the hungry is to create awareness in the community about hunger and food insecurity. Throughout the year the food bank participates in community forums and gives presentations to civic groups, schools, businesses and other interested parties about hunger on the island and steps we all can take to help make a difference in the life of someone hungry. A special emphasis is our work with school children empowering them to plan and participate in projects which promote community security. The HIFB in conjunction with the Mayor's Office coordinated Hunger Awareness initiatives in June 2005, a national initiative by US Mayors. Brochures, i.e. "How to Hold a Food Drive,' poverty data and other statistical information are distributed at the forums and presentations. Forging partnerships through collaborations and building on community strengths, we believe, will move us closer to eliminating hunger on the Big Island Total Budget and Position Count Total Program Bud et 588,916 Total Pro ram Position Count 6 Total A enc Bud et 3,316,269 Total enc Position Count 41 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Roman Catholic Church in the State of Hawaii Office for Social Ministry Hawaii Island Food Bank Program Objectives for FY06-07: 1) The focus is simple: Get more food to more people and emphasize nutrition whenever possible and distribute this food island wide. Our first objective is to raise at least 1.5 million pounds of food from food retailers, wholesalers and community food drives. 2) To expand pantry services in the Oceanveiw and Puna area where there are higher incidences of poverty. HIFB is the only source of emergency food supplies in Oceanview where we provide food for the people there on a weekly basis. 3) To explore the legality, technology, and cost of developing a centralized data base system that all food bank member agencies will be hooked into. This will allow us to move into an "ordering system" which will cut down staff costs as well as minimize the "perception" that there is abuse among recipients that go from pantry to pantry. 4) To offer member agencies training sessions on helping repeat consumers to look at budgeting and decision making. 5) To explore further the "mobile pantry on wheels' which work well in other parts of the country? 6). To provide a minimum of 12 educational presentations to schools, businesses, civic groups and clubs, and to participate in community fairs or forums where informational booths will be set up for the public. At least one presentation or community booth per month will take place. Program Highlights for FY05-06: 1) Received and salvaged over 1.87 million pounds of goods from Big Island donor companies and the Hawaii Foodbank as well as organizations that held food drives. 2) Distributed over 1.7 million pounds of goods throughout Hawaii County via our island wide network of nonprofit member agencies and via the food bank's own Senior Brown Bag Program. This food served 95,990 individual requests for food (duplicated count, individuals are counted more than once if they visit the pantry more than once a year) through our food pantries. 3) Our member agency meal programs served meals and snacks to 49,816 individuals. 4). 1861 residential consumers were provided food (HIV, Domestic Violence, etc.) 52,988 pounds of food were delivered to low income senior housing complexes at no cost to them. 5) Presentations, warehouse tours, and forums were presented throughout the year in 18 cases. Information about the HIFB and how it works was presented to interested groups and the public at community forums. 6) This past year, the HIFB participated in aUSDA-funded program as a partner of the Kauai Food Bank. The grant titled, "Subsidizing Low-Income Seniors on the Islands of Kauai and Hawaii to Enhance Domestic Consumption of Locally Grown Produce," provided funds for the food banks to purchase fresh produce from local farmers. As such, it was a nutrition program as well as an economic development program. The program ran for 13 weeks (June 30, 2005 -September 30, 2005) providing over $200,000 worth of produce (241,210 pounds) to 1,556 low-income seniors. The Kauai Food Bank is once again submitting an application to the USDA for the same program and partnership and a funding decision will be made by February or March. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Roman Catholic Church in the State of Hawaii Office for Social Ministry Hawaii Island Food Bank Performance Measures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate 1. Pounds of grocery items rescued, over 1,840,000 1,800,000 1,800,000 salvaged, and stocked, island wide pounds pounds pounds incomin ounds e . 2. Pounds of grocery items distributed over 1,500,000 1,500,000 1,700,000 throw hout Hawaii Count ounds ounds ounds 3. Number of presentations to be given to 15 12 12 ublic re ardin wa s to hel fi ht hun er. resentations resentations resentations *If applicable Program Expenditures FY 2004-05 Actual * FY 2005-06 Budget * FY 2006.07 Estimate Salaries and Wa es 328,457.26 342,674.00 266,282 Professional Fees O erations 310,143.89 264,930 266,334 E ui ment Other* 52,480.77 56,300 56,300 Total 691,081.92 663,904 588,916 *P/ease explain in detail on separate sheet Program Funding Sources Revenue Source FY 2004-OS FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii 32,500.00 32,500 35,000 State of Hawaii-Hawaii Food Bank 14,490.00 14,490 14,490 Sr. Produce Pro ram 13,088.00 11,779 0 Hawaii Communit Foundation 20,000.00 15,000 15,000 Hawaii Island United Wa 11,000.00 15,000 15,000 Other Grants 22,500.00 80,000 50,000 Donations 64,692.40 108,685 92,976 Federal Cam ai n 20,658.66 18,500 18,500 Pro ram Service Fees 114,070.94 120,100 100,100 S ecial Events fundraisin 264,780.35 237,000 237,000 Interest Income 436.87 750 750 Other Revenue 8,867.06 10,100 10,100 s Total 587,084.28 663,904 588,916 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Roman Catholic Church in the State of Hawaii Office for Social Ministry Hawaii Island Food Bank Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? We have contracted with Solid Concepts, Inc. (Sanae Tokomura) to do a community assessment and strategic planning process with our staff, advisory board members and key community stakeholders. The purpose for this initiative is two fold: 1. To become better aware and informed about how the food bank is perceived in the community; and 2. To develop a major donor based constituency which will allow the HIFB to raise more money will less "manini" events that take so much time and resources. The completed report is due on in mid February. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 ROM THOLIC CH RCH IN THE STATE OF HAWAII ice for Social Ministry Hawaii Island Food Bank I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. f (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 laai. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement tosubmit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate Vear-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair Date GARY L. $ECOR TREASURER i.t t , CAE ~ C~-~^--- i E Signature of Executive i ector Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page G Roman Catholic Church in the State of Hawaii ~ Office for Social Ministry Mobile Care Health Project Agency Director: Carol R. Ignacio, Executive Director Phone No.: (808) 935-3050, x105 Contact Person: Kaye Lundburg, Program Director Phone No.: (808) 987-8904 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: Carolrign@aol.com, mikela@aloha.net Name of Accountant: Nancy Kay Lee, BBA, MBA Phone Number: (808) 935-3050 Mailing Address: 140 B Holomua St., Hilo, HI 96720 Name of Independent Auditor: Choo, Osada & Lee, CPAs, Inc. Phone Number: 808-734-1921 Mailing Address: 3536 Harding Ave. Suite 605 Honolulu, Hawaii 96816 Amount of Request for County funds: $20,000 Prior Year Funding: 03-04 04-05 05-06 $20,000 $20,000 $20,000 Agency Mission Statement: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. Program Description: Funds are being requested for continuing support of the Mobile Care Health Project (hereinafter MCHP). The MCHP is a joint partnership between the Office for Social Ministry (hereinafter OSM), St. Francis Community Health Services and the community of the Big Island. The project provides primary dental care in NONPROFIT GRANT APPLICATION FISCAL YEAR. 2006-07 Page 1 Roman Catholic Church in the State of Hawaii Office for Social Ministry Mobile Care Health Project the rural areas of West and North Hawaii and in Kona and Honokaa. Services are delivered to the low-income uninsured and underinsured people through two (2) Winnebago vans that are fully equipped for dental services. Each of the two Winnebago vans is aself-contained, fully equipped dental office including digital x-ray units and secure web-based Electronic Medical Record Systems. Additional services include oral health education in schools and at community health fairs and oral health assessments in long-term care facilities. The project partners with many different agencies to achieve the goals and objectives of meeting the dental needs of the Big Island rural poor. Currently, the MCHP has established outreach sites at the following five (5) locations: West Hawaii: Ocean View, Honaunau, Kailua-Kona North Hawaii: Honokaa, Kapa'au With the opening of the Keaau Family Health Center Dental Clinic in March 2003, the Mobile Care Health Project suspended services in East Hawaii. The Keaau Family Health Center Dental Clinic is now established and providing dental services for the target underserved population in East Hawaii. Mobile Care continues to advocate for the target population and provides dental services for East Hawaii patients at scheduled clinic sites. The Mobile Care Health Project focuses its efforts in North Hawaii and West Hawaii providing direct services in scheduled clinics and working collaboratively with Hawaii Healthcare Systems Corporation (HHSC) and community health centers to expand dental services. Under a Memorandum of Agreement between the Hamakua Health Center and the Mobile Care Health Project dental services are provided to the underserved population in Hamakua and North Hawaii in clinics 2 days each week. Mobile Care provides dental services at sites in Kailua, Honaunau, and Oceanview 3 days per week. West Hawaii Community Health Center (WHCHC) opened in Kona in January 2005 with medical services. Federal funding was secured in May 2005. Mobile~Care Program Director and the WHCHC Executive Director have met to draft a Memorandum of Agreement to provide for the expanded dental services during the first phase of development. A contract between Hawaii Hospital Systems Corporation and St. Francis Healthcare System enables Mobile Care to provide dental assessments for the long-term care patients in Honokaa, Kapa'au and Pahala. Total Budget and Position Count - FY 2006-07 Total Program 461,726 Total Program Position Count 4 Bud et Total A enc Bud et 3,316,269 Total A enc Position Count 41 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Roman Catholic Church in the State of Hawaii Office for Social Ministry Mobile Care Health Project Program Objectives - FY 2006-07: Goal I: To provide quality dental care and health education through the Mobile Care Health Project in at least 2,000 patient visits in FY 2006- 07 on the island of Hawaii who are unable to access dental care. Obiectives: 1. Provide primary dental services in an average of 20 clinic days per month. 2. Provide an estimated 85 Dental Assessments annually for long-term care patients in Hawaii Health Systems Corporation facilities in Honoka'a, Kapa'au and Pahala. 3. Provide Dental Education, Screenings, and Fluoride Treatments in 4 Community Health Fairs annually. 4. Provide Oral Health Education in 4 Hawaii Island schools. Goal II: To continue to work on long-term solutions, which will establish sustainable dental capacity on the island of Hawaii through fixed clinics at community health centers and to support neighboring islands initiatives to develop oral health access for the underserved. Obiectives: 1. Pursue funding opportunities through the federal government collaborating with Bay Clinic, Hamakua Health Center, West Hawaii Community Health Center and Hui Malama Ola Na Oiwi. 2. Actively participate as a member of the Hawaii Island Dental Task Force by educating legislators and policy makers about the critical needs of the underserved population and disparities in dental access on the neighbor islands. 3. Present and actively advocate for creative solutions to address the critical need through collaborative efforts with other neighboring island providers and community groups. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Roman Catholic Church in the State of Hawaii Office for Social Ministry Mobile Care Health Project Program Highlights - FY 2004-05: 1) Provided direct dental visits in 1651 patient encounters. 2) Averaged 20 clinic days per month. 3) Provided a total of 4135 units of care including extractions and restorations. 4) Provided a value of $119.933 in uncompensated dental services. 5) Provided dental assessments, fluoride treatments and oral health education for 280 children and adults in community health fairs, long-term care facilities and island schools. 6) Participates as a member of the Hawaii Island Oral Health Task Force and the Tri-County (Hawaii, Maui, and Kauai) Oral Health Task Force to address the oral health needs of Hawaii County as stated in the Hawaii Island Oral Health Strategic Plan and to pursue collaborative funding. Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate # of people accessin services 1651 2000 2000 Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 171,619 181,141 191,259 Professional 106,240 100,000 120,000 Fees dentists O erations 142,632 122,859 150,467 E ui ment Other' Total 420,981 404,000 461,726 *P/ease explain in detail on separate sheet (see page 6) NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Roman Catholic Church in the State of Hawaii Office for Social Ministry Mobile Care Health Project Program Funding Sources Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate State Grant in Aid 13,000 100,000 100,000 Count of Hawaii 20,000 20,000 20,000 HDS 16,667 25,000 50,000 H I UW 10,000 10,000 10,000 HMSA 50,000 50,000 50,000 Thomas J Lon Foundation 10,000 20,000 20,000 Bank of Hawaii 10,000 10,000 Hawaii Communit Foundation 10,000 25,000 25,000 Hawaii Hotel Association 5,000 5,000 5,000 OHA Foundation 47,500 40,000 40,000 Various rants 4999 and less 2,000 10,000 20,000 Donations 40,497 23,000 40,726 Third Part /Client Pa ments 38,833 65,000 70,000 Health Fair Fees 1,000 1,000 1,000 Total 264,497 404,000 461,726 "If applicable Future Program Support The MCHP is a short-term project/solution. As an advocate for the underserved, we will continue to collaborate with local and state government, foundations, service providers and the community to ensure oral health access for the low- income population. The long-term solution for expanded dental access includes stationary dental clinics within the array of services of Federally Qualified Health Centers (FQHC). Bay Clinic (FQHC) opened the first dental clinic on the island of Hawaii in Keaau in 2003). The MCHP currently collaborates with Hamakua Health Center (FQHC) in Honokaa and the West Hawaii Community Health Center (FQHC) in Kona to provide interim dental services. We anticipate these Community Health Centers will be providing dental services in North and West Hawaii by 2010. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 ROMAN.C0.THQLI,C~Fit~RCH I<J ZHErSIS Try F HAWAII MIIJJOTTTTb~IiICCeee TTCOOareJJOOHCC~IeaalltlVhllPro[ject I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate Year-end report may impact the evaluation of Your program's or agency's future funding requests. Signature of Board President~Chair Date GARY L. SECOR TREASURE ~ ~ Signature of Executive'Di ector Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR ?006-07 Page 6 The Salvation Army-Fami{y {ntervention Services Ho'okala Ado{escent Diversion Program Agency Director: Pauline Pavao Phone No,: 935411 Ext. 11 Contact Person: Michael Chung Phone No.: 959-5855 Ext. 28 Mailing Address: POB 5085, Hilo HI 96720 Facility/Site Address: 82-1123 Kinue Road Captain Cook Fax No.: 933-9810 Email Address: PaulinePavao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Carole Nagamine, Fiscal Coordinator Phone No,: 935-4411 Mailing Address: POB 5085, Hilo HI 96720 Donna Lum, Divisional Director of Finance Phone No.: (808) 988-2136 Mailing Address: POB 620, Honolulu, HI 96889-0620 Amount of Request for County Funds: $32,000 Prior Years} Funding: 03-04 04-05 05-06 $29,000 $29,000 $32,000 Agency Mission Statement: To provide skills for a healthy life, and instill purpose, hope, and vision to youth and their families. The Agency's goats are to provide youth a safe, caring, and nurturing environment, and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: We plan to continue utilizing the County Grant funding to help further develop and improve the services of our agency's Ho'okala adolescent diversion program in the West Hawaii district. Through this grant, we have been able to extent our services to NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 the outlying regions of West Hawaii, which include not only Kona, but areas of the North Kohala ,South Kohala, and Kau districts as well. Since 1993 to current, the Office of Youth Services (OYS) has been funding our agency to implement the Ho' okala services on the Big Island. This specfic funding from OYS primarily allows us to provide a 24-7, 365 days a year crisis response to assist the police with youngsters that have been arrested and are in their custody. "Ho okala" which means to pardon and forgive, helps to prevent these youth from getting inappropriately detained in the police lockup facilities. The funds from the County Grant has allowed us to incorporate additional prevention and early intervention activities to help develop and enharice our program in the West Hawaii region, so that we are now not only providing a 24-7 crisis service to the police, but are also helping to assure that these youngsters do not get further involved with juvenile justice system, and prevent them from other potentially problematic behaviors that place them at risk such as: teen pregnancy, drug usage, gang involvement and violence, family management problems, and school related problems. Our Case Management services allows us to develop early risk assessments and individualized service plans on all youths and their famines that enter our program. The goals are to help preserve the youngster within hislher family unit and to help motivate the family to engage in further services. We have provided informational and referral services to help link the youths and their families to other services/resources that may be available within our agency and/or in the community- Wdh our fallow-up services, we continue on-going contacts with youth and families, even after the youth has left our program, to assure that these youth do not require further police intervention. For youths and families that are either resistive or difFcult to reach do to their geographical locations, we employ a service strategy called targeted outreach. Social skill building and other relapse prevention activities may also be provided while a youth is in follow- up and/or outreach services. Finally, we have begun the process of recruiting and developing Emergency Foster homes and mentors, which we believe will further strengthen and support the services for these youngsters in the community. Through the support of the County Grant, we are clearly noticing positive changes with the youths and families that we have serviced. Total Budget and Position Count Total Pro ram Bud et 137,875 Total Pro ram Position Count 2.25 Total A enc Bud et 3,235,039 Total A enc Position Count 62 Program Objectives: 1) 80% of the youth who will come to the attention of the program will not require further police intervention. 2) 60% of the youth who will come to the attention of the program will decrease their anti-social behaviors. 3) 60 % of the youth who will come to the attention of the program will successfully fulfill all the program requirements. NONPROFTT GRANT APPLICATION . FISCAL YEAR 2006-07 Page 2 Program Highlights: 1) Throughout this past fiscal year, our program has worked with 102 youths from the West Hawaii District. 2) Our program staff attends the Monthly Hui Laulima Meetings at the Neighborhood place of Kona to improve collaborations services with other providers ip the West Hawaii community. 3) We have developed and are now implementing new Risk Focus Assessments and Relapse Prevention Instruments to help improve our case management services to our youth and families. 4) We have begun the recruitment process of possible emergency foster parents and even mentors to eventually support the program's efforts with the youths and families we are involved with. 5) We have provided 55 youngsters and their families provided outreach services, which has our program staff "going to" the youth's families to engage them in services. Many of these families were either resistive to stay involve with program, had transportation difficulties, and/or lived to far away from services to want to travel to Central Kona to receive it. 6) We continue partner with Parent Project Program in West Hawaii to help the families in this region. It is a collaborative program supported between our agency, the DOE, Family Support Services. The program is a 10-week parent skills training and support class that helps parent better deal with out of control and unruly youth. Through this process we have also been able to educate parents about laws of the juvenile system and other important issues regarding adolescents and teens. 7) Our program continues to utilize the Project IMPACT Program held at the Kealakehe Police Station. The Hawaii County Juvenile Aid Section provides alcohol and drug awareness education. The youths that we refer to this program are also required to participate in a community service project as part of their educational process. 8) We confinue utilizing andlor col{aborating with other agencies to support the youth and families we work with, which have included: ATV (Alternative to Violence) for youths anger management classes, BISAC (Big Island Substance Abuse Council) for youths with substance abuse issues, Family Support Services for different Outreach and Prevention services, Private Practitioners and Dept of Health for youth's with Mental Health issues, and Kapiolani Child Protection Team to provide diversion services for youth at-risk of being involved with CPS. Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Case Mana ement Services 80 75 75 Follow-U Services 80 75 75 Altemative Placement Services 36 30 30 Outreach Services 55 40 40 Social Skill Buildin Services 44 30 30 Referral and Information Services 66 50 50 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 *If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 96,809 103,198 105,045 Professional Fees O erations 38,066 34,677 32,830 E ui ment Other* Total 134,875 137,875 137,875 * if applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-0fi FY 2006-07 Actual * Bud et * Estimate Office of Youth Services 105,875 105,875 105,875 Coun of Hawaii 29,000 32,000 32,000 Total 134,875 137,875 137,875 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army-Family Intervention Services, while part of The Salvation Army, is required to seek its own funding for program services. As such, FIS relies primarily on funding from govemment at the federal, stale and county levels to continue our prevention and intervention programs to assist at-risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Very limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs- However, in view of the nature of our mission in developing healthy lifestyles for youths and their families, we do rely heavily on funding from all levels of government. As such, we do not anticipate being self-sufficient in providing prevention services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FLSCAL REAR 2006-07 Page 4 The Salvation Army-Family Intervention Services - A~@IICy Name? Ho'okala Adolescent Diversion Program - PI'Ogl'8I71 Name I (we) have read and unc)erstood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, .Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including al? supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal ye8r. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. ,Failure to submit a timely. complete. and accurate vear-end report will imaact the evaluation of Vour arogram's or agency's future funding requests. i't,~~,ry~ O / - 0 3 - 06 Signature of Divisional Cc(~ jI1StCUCt1011 Date Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 The Salvation Army Family Intervention Services Youth Service Center Program-Honakaa Agency Director: Pauline Pavao Phone No.: 935-4411 Contact Person: Raymond Dangaran Phone No.: 935-9777 ext.200 Mailing Address: P.O. Box 5085 Hilo, Ht 96720 Facility/Site Address: 1786 IGnoole St. Hilo, HI 96720 Fax No.: 933-9810 Email Address: pauline~avao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Name: Carole Nagamine(TSA-Elsa Donna Lum (SA-Divisional Director of Finance) Phone: (808) 935-4411/ (808) 988-2136 Mailing: P.O. Box 5085 Hilo, H196720/ P.O. Box 620 Honolulu, HI 96809 Amount of Request for County funds: $ 32,000 Prior Year Funding: 03-04 04-05 05-06 $o $o $o Agency Mission Statement: The Salvation Army-Family Intervention Services' (TSA-EIS) mission is to provide youth with skills for a healthy life, and instill purpose, hope, and vision to youth and their families. Our agency's goals are to provide youth with a safe, caring, and nurturing environment; and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Program Description: The Salvation Army Family Intervention Services-Youth Service Center Prevention Program provides a safe and nurturing environment along with access to opportunities, experiences, and services to support positive youth development. We utilize a prevention approach #o decrease the use and abuse of alcohol, tobacco, and other illicit drugs (ICE, ecstasy, and etc.), involvement in gangs and violence, delinquent behaviors, early sexual behaviors, and to improve academic performance and school attendance. Currently in the Honokaa Community, the Youth Service Center Program (Ke Kama Pono) provides a Teenage Pregnancy Prevention and Family Strengthening (TPP/FS) Program, funded through the Department of Defense, This program is implemented both during and after School hours, for youth ages 7-19, and their families residing in the Honokaa Community. Referrals come from school personnel, other community agencies and services, and from the "word of mouth" community. The TPP/FS program utilizes a "best practice" curriculum called, "Making Choices", that wnsist of 12 sessions of skill building development in personal development, health and wellness, cultural diversity, gender equity, career exploration, and family relationships. We also provide Positive Alternative Activities that of consist of: Recreational, Educational, Cultural, and Youth Leadership Activities. Qther activities offered include Gender Specific Activities, Community Service and Learning Projects, and Excursions. Also, youth from TSA-FIS's Ke Kama Pono-Residential Program will provide support and assistance as "positive peer mentors" to the Youth Service Center. Youth wilt help during group sessions, assist with supervision of other youth, and participate in activities offered at the center. We believe that if youth are given an opportunity, recognition, and a positive influence, it wiN be more likely that they will make better choices to became positive citizens and future leaders of their communities. All services will be part of the Youth Service Center Program (Ke Kama Pono), currently funded by the Department of Defense, located at the Salvation Army facility in Honokaa. Program services will be conducted during school, after-school, and occasionally weekend hours. The proposed County funding will support the after school program and provide for 1-.70 FTE staff to implement prevention program activities during after school hours at the Youth Service Center. As more funding for prevention programs becomes available, we would like to duplicate programs and services, and replicate the positive successes and achievements we have shown in the Puna Youth Service Center. Total Budget and Position Count Total Pro ram Bud et 157 000 Total Pro ram Position Count 2.80 Total A ency Bud et 3,235,039 Total A ency Position Count 62 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Program Objectives: 1) Of the 45 youth targeted to participate in the Youth Service Center Program, at least 80% will register for Prevention Services (Making Choices, Project Family, Positive Alternative Activities) and maintain participation with the program to completion or for 6 months beyond the registration date. 2) Of the 45 youth partiapating in the Youth Service Center activities throughout the year, at least 80% will complete the Making Choices Curriculum and demonstrate an increase in knowledge and developmental skills for the first 6 months, or to the completion of the program. Program Highlights: 1) In the Honokaa Community, are currently providing a Teenage Pregnancy Prevention and Family Strengthening Program, funding by the Department of Defense, under the "Healthy lifestyles in Our Community' contract. The program includes in-school presentations/group sessions and after school group sessions at the Youth Center in the Honokaa Community. We utilize an evidence-based curriculum (Making Choices) that consists of skill building activities in personal development, decision-making, sexuality, STDlSTI, and other related topics. 2) We also offer positive alternative activities (Recreational, Educational, and Leadership Activities) at the Youth Center during after school hours. 3) We are collaborating with the Honokaa School Complex to provide program activities on campus, and also with Community resources and agencies discussing the gaps of services and the needs of the youth and families to further provide a comprehensive prevention program. Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Completion of "Making Choices" 45 Pro ram Participates in Positive Altemative 45 Activities Participates in Project Family- 45 Famil Oa s Follow up and Monitoring 45 *If applicable Note: This is a first time proposing county funds for the Honokaa Program. Hence, no numbers are reported for the FY 2004-05 and FY 2005-06. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Salaries and Wa es 89,100 118,471 Professional Fees O erations 35,900 38,529 E ui ment Other* Total 125,000 157,000 *Please explain in detail on separate sheet Program Funding Sources Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate De artment of Defense 125,000 125,000 Count of Hawaii 0 32,000 Total 125,000 157,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army-Family Intervention Services, while part of The Salvation Army, is required to seek its own funding for program services. As such, FIS relies primarily on funding from govemment at the federal, state and county levels to continue our prevention and intervention programs to assist at-risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Very limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs. However, in view of the nature of our mission in developing healthy lifestyles for youths and their families, we do rely heavily on funding from all levels of govemment. As such, we do not anticipate being self-sufficient in providing prevention services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 The Salvation Army-Family Intervention Services - Ac,~ency Name Honokaa Youth Service Center - PfOgf8f1'1 N8f11@ I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting aid fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. 1 (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and wi{I comply with the requirement to submit ayear-end report to the i.egislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate vear-end report will impact the evaluation of your program's or aaencv's future fundincf requests. o/-v3-o~ Signature of Divisional Go man r . Date ~ignec~~y Instruction ~1~ ~ ~~o ~ Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFTT GRANT APPLICATION FISCAL REAR 2006-07 Page 5 The Salvation Army Family Intervention Services Youth Service Center Program-PUNA Agency Director: Pauline Pavao Phone No.: 935-4411 Contact Person: Raymond Dangaran Phone No.: 935-9777 ext.200 Mailing Address: P,O. Box 5085 Hito, HI 96720 Facility/Site Address: 1786 IGnoole St. Hilo, HI 96720 Fax No.: 933-9810 Email Address: pauline~avao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Name: Carole Nagamine(7SA-FIS)/ Donna Lum (Divisional Director of Finance) Phone: (808) 935-4411/ (808} 988-2136 Malting: P.Q. Box 5085 Hilo, HI 96720! P.O. Box 620 Honolulu, H196809 Amount of Request for County funds: $ 38,000 Prior Year Funding: 03-04 04-05 05-06 $ 35,000 $ 35,000 $ 38,000 Agency Mission Statement: The Salvation Army-Family Intervention Services' (TSA-FIS) mission is to provide youth with skills for a healthy life, and instill purpose, hope, and vision to youth and their families. Our agency's goals are to provide youth with a safe, caring, and nurturing environment; and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: The Salvation Army Family Intervention Services-Youth Service Center Program provides a safe and nurturing environment along with access to opportunities, experiences, and services to support positive youth development. We utilize a prevention approach to decrease the use and abuse of alcohol, tobacco, and other illicit drags (ICE, ecstacy, and etc.), involvement in gangs and viotence, delinquent behaviors, early sexual behaviors, and to improve academic performance and school NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-OT Page 1 attendance. Phis will be accomplished by implementing Community-Based Outreach Services and Case Management Services to youth ages 7-18 years old and their families, residing in the Puna districts. Community-Based Outreach services consist of: ? leadership Development Program -The L.E.AD. Team (teaming Experience in Assisting and Directing) is a 10-session curriculum that provides development of leadership skills and training in areas of personal and social skills, teamwork, decision making, goal setting, and action planning to cAnduct community service and learning projects. ? Project Family Activities-Provide parent support and family strengthening activities to promote family cohesion and positive relationships within diverse family structures. "Family Days" includes family excursions, community service and teaming projects, and recreational gatherings. ? Positive Alternative Activities-Recreational, Educational and Youth Leadership Activities during after school program. Case Management Services consist of. ? Intake and Assessment, Crisis Intervention, Individual Service Planning, Linkage to Community Resources, Follow-up and Monitoring Services. Other Program Activities consist of: A Community Service and teaming Projects ? Community Activity Involvement (Resource Fairs, Special Events) ? Community Collaborations (Neighborhood Place of Puna, Weed and Seed, and with other agencies and services) AA services will be part of the Pahoa Youth Service Center Program, currently funded by the Office of Youth Services. All program services wit! be provided at Keaau and Pahoa School Districts and at the Nanawale Community Center. The proposed County funding would support and provide for 1-.50 FTE staff to implement prevention program activities to the Puna communities. Total Budget and Position Count Total Pro ram Bud et 213,000 Total Pr ram Position Count 2.25 Total Agenc Bud et 3,235,039 Total A enc Position Count 62 Program Objectives: 1) Of the 100 youth participating in Youth Service Center Program, 60% will wit! register for Outreach Services and maintain participation with the program registered for to completion or for 6 months beyond the registration date. 2) Of the 20 youth particpating in the Youth Service Center Program, 68°~ will be ident~ed for Gase Management Services, wiN receive or be referred to an appropriate service based on an assessment, and will complete an individual service plan, and demonstrate improvement based on service plan to completion or for 6 months beyond the date of intervention. NONPROFIT' GRANT APPLICATION FLSCAL XF.AR 2006-07 Page 2 Program Highlights: 1) Durin~ the past year 2004-2005, we provided in-school services for 62 youth in the 3 ~`n grade classes at Keaau Elementary School and for 24 youth in the 6'n- 7'n grade classes at the Keaau Middle School. The in-school services provided youth with skill-building development in areas such as; personal development, social development, decision-making, problem solving, teamwork, drug awareness, anger management, responsibility, and respect. We measured the in-school program by providing pre-and post-test, teacher evaluations, and staff evaluations. Results have shown positive progress and feedback about the in- school program. 2) We also provided the L.E.A.D. (Learning Experience in Assisting and Directing) Team Program for 35 youth from the Pahoa High and Intermediate Schools and the Nanawale Community Center. The L.E.A.D. Team provides youth with leadership skills and other fife skill building activities that will empower youth to become future leaders within their community. The basic components of the program consist of Skill Building Development, Community Service Learning, Peer/Youth Mentoring, and Leadership/Facilitation Training. Throughout the year, youth participated in skill building activities, organized and implemented Community Service Projects (Clean-ups, Sign Waving), assisted with supervision of other youth activities (Youth Dance at Pahoa Gymnasium, and Educational/Cultural Excursions (Volcano National Park, Makalii, and Ganoe Paddling) and facilitated/co-facilitated the L.EA.D. Team Curriculum to other youth in the program. 3) This past summer, we provided a Water Awareness Program for 25 youth from Keaau and Pahoa Communities. This program consisted of water safety/rescue skills, first aid/CPR training, cultural arts and crafts, recreational activities, and canoe paddling. We collaborated with Palekana Kai, Kamehameha Canoe Club, and the American Red Cross. 4) Throughout the year, we have collaborated with the Nanawale Community Association to provide various youth and family activities at the Nanawale Community Center. Also, we collaborated with the Boys and Girls Club. of the Big Island to target youth and families and provide positive activities. 5) Other collaborations inGuded the Kamehameha Canoe Club and the Volcano National Park to provide youth with a cultural experience in learning about Hawaiian history, belief and customs. We have also beers involved with community building and collaboration by attending monthly meetings at the Neighborhood Place of Puna to network with other agencies, and plan for community activities. Also involved with the Weed and Seed Planning Committee to assist with youth and family activities for the Puna Communities. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Budget * Estimate Com letion of L.E.A.D. Team 79 60 60 Partici ates in Pos. Alter. Activities 121 60 60 Partici ates in Case M t. Services 25 20 20 Partici ates in Pro'ect Famil 73 60 60 Follow u and Monitorin 75 60 60 *If applicable Pro ram Ex enditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et' Estimate Salaries and Wa es 104,774 106,828 110,033 Professional Fees O erations 55,226 56,172 52,967 E ui ment Other* 50,000 50,000 50,000 Total 210,000 213,000 213,000 *Please explain in detail on separate sheet *Sub-Contract with Boys and Girls Club-Big Island to provide Positive Alternative Activities at the Pahoa Youth Service Center. Pro ram Fundin Sources Revenue Source FY 2004-05 FY 2005-06 FY 2006-0T Actual * Bud et * Estimate Count of Hawaii 35,000 38,000 38,000 Office Of Youth Services 175,000 175,000 175 000 Total 210,000 213,000 213,000 'If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army-Family Intervention Services, while part of The Salvation Army, is required to seek its own funding for program services. As such, FIS relies primarily on funding from government at the federal, state and county levels to continue our prevention and intervention programs to assist at-risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Very limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs. However, in view of the nature of our mission in developing healthy lifestyles for youths and their families, we do rely heavily on funding from all levels of government. As such, we do not anticipate being self-sufficient in providing prevention services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 the Salvation Army-Family Intervention Services - Agency Name Pahoa Youth Service center -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accpuntability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to faw. 1 (we) understand that information supplied herein shall be made public according t0 Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 ~ the fiscal vear. The report shall include ~n explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained durir?g the award period. Failure to submit a timelx, complete, and accurate vear-end report will imaact the evaluation of vour proaram's or aaencv's future fundina requests. p~_ ~ 3 -aG Signature of Divisional Commander ~ Date Signed by instruction aa~~ ~~1~~~ Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEbt NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Special Olympics Hawaii- Agency Name Special Olympics Hawaii-East Hawaii- Program Name Agency Director: Nancy Bottelo Phone No.: (808) 943-8808 Ext:22 Contact Person: Glenn Hirara Phone No.: (808) 966- 8629 Mailing Address: P.O. Box 7265 Hilo, Hawaii 96720 Facility/Site Address: 15-2712 Moi Street Pahoa ,Hawaii 96778 Fax No.: (808) 965-9026 Emait Address: gshirata@hotmail.com Name of Accountant/CPA (include name of firm if applicable): Akamine, Oyadomari & Kosaki Phone No.: (808) 941-0500 Mailing Address: 1440 Kapiolani Blvd. Suite 900 Honolulu, Hawaii 96814 Amount of Request for County Funds: $12,000 Prior Year(s) Funding: 03-04 04-05 05-06 $5,000 $5,500 $12,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 The Mission of Special Olympics is to provide year round sports training and athletic competition in a variety of Olympic-type sports for children and aduts with intellectual disabilities, giving them continuing opprotunities to develop physical fdness, demostrate courage, experience joy and participate in the sharing the gifts ,skills and friendship with their families, other Special Olympics athletes and the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Special Olympics Hawaii -Agency Name Special Olympics Hawaii- East Hawaii- Program Name Program Description: Timothy Shriver, Chairman of the Special Olympics Incorporation Board of Directors, stated at the 2003 World Games in Dublin Ireland, "Somewhere near and somewhere very far away, there is a boy or girl, a woman or a man, sitting silently in lonely despair, longing for human contact and simple affirmation, longing for the joy we feel here tonight" People who are isolated from Irfe experience by a disability have little chance for the development growth and acquisition of important skills that they will need to gain employment,maintain relationships and function disability the necessary skills to achieve that independence. We believe that all people regardless of their disability deserve tto lead full, active lives, enriched with social and recreational opportunities that most of us take for granted. Unfortunatey, appropriate physical education programs in the public schools and social service programs that realistically address the special needs of this population are virtualy non-existent. Special Olympics East Hawaii fulfills that need and provides the necessary skills for people to continue good health throughout their lives within our community. Special Olympics East Hawaii Unified Sports Program is vital program where these special needs individuals interact with their non-handicapped peers on a weekly basis. Unified Sports is a program that combines equal numbers of athletes with intellectual disabilities and special partners without disabilities. All participants are of similar age and athletic ability. This program dramaticalty increases inGusion of our athletes into the community by helping break down barriers that have historically kept people with and without disabilities apart. Special Olympics East Hawaii now has a softball team and several bowling teams that participant in the Unified Sports Program. They all train and compete together here in East Hawaii and they travel to Maui and Oahu for regional and state competitions. The benefits that all the athletes receive from their participation in Special Olympics include: improved physical fitness and motor skills, greater seff- confidence, amore postitive self-image, friendships, and increased famity support. Special Olympics athletes carry these benefits with them into their daily lives at home, in the classroom, on the job, and in the community. Families who participate become stronger as they team a greater appreciation for their child's talents. We have found that our strongest supporters and best volunteers are the family members of our Special Olympics athletes. We provide a "safe haven" for families where they know that their child is accepted for who they are and for what they can do. Community volunteers find out what good friends the athletes can be. Everyone teams more about the capabilities of people with intellectual disabilties. NONPROFTI' GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 The need for Special Olympics East Hawaii program to continue hereon this island is extremely high. Special training is provided for our athletes and the coaching staff throughout the year. The training is essential due to the unique services that we provide. These services are not available anywhere else but with our program. We not only touch the lives of our Special Olympics athletes, but also their families and the hundreds of volunteers from our community. Our founder, Eunice Kennedy Shriver, believes sports training and competition opportunities should be available for all who qualify rather than all who could afford to participate. Therefore, our program is free of cost to all our athletes, special partners, and coactres. We receive no money from the Kennedy Foundation or the Federal Government. All of the money raised for the East Hawaii program stays here to support our program. Due to the aspect of our program, a volunteer committee under the leadership of our Area Director must raise all the funds needed for this unique program. Those funds will pay for all aspects of the Special Olympics program, which includes, equipment, un'rforms, transportation cysts, training of the coaching staff, family activities and trainings, our Athlete Leadership Program (ALPS). In the ALPS program athletes are trained to become coaches, public speakers, members of the Board of Directors, officials, and technology experts using PowerPoint. In 2006 our athletes will be trained in Public Speaking. Special Olympics East Hawaii believes that the community must hear from the people that this program was developed for and that is our athletes. They are the Voice of our program. In February 2007 we will have three athletes representing our program at the Athlete Congress. Athletes come together to vote on issues concerning our Special Olympics program. The results will be shared with our CEO/President and Board of Directors. Special Olympics East Hawaii's largest expense for 2006 is transportation. It is an essential part of our program that Special Olympics athletes are provided an opportunity to interact and compete against people of similar athletic ability. Unfortunately our area program is too small to be able to provide quality competition, therefore our athletes must travel to other islands to achieve that goal. The state competitions that are held on Oahu 3 times per year provide many activities that our athletes never have a chance to experience. They include;dances, Opening and Closing Ceremonies, entertainment and games, and being exposed to a Healthy Athlete Village. This village provides a free dental screening, vision screening and hearing screening for our athletes. As you know, these services are sometimes not available to individuals with disabilities due to financial difficulty or lack of professionals who are trained to treat people with disabilities. Special Olympics East Hawaii wishes to continue to provide these fantastic opportunities to all the athletes that are currently involved and be able to reach out to new special needs individuals throughout our communities. In order to do this, we will need funds to maintain our services and to Outreach to athletes and volunteers, training for coaches and athletes, pay for bowling fees, and provide transporation for athletes to get to practices and competitions. Special Olympics Hawaii-East Hawaii Area is asking for $12,000.00 from the County of Hawaii to help fund Special Olympics East Hawaii program activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Psge 4 Totaf Budget and Position Count Total Program Budget $92,600.00 Total Program Position Count 1 Total A enc Bud et $1,827,202.00 Total A nc Position Count 18 Program Objectives: 1) Provide quality training and competition for 190 athletes and special partners within our program by June 2007. 2) Develop a Powerlifting Program . To provide additional choice to our athletes for physical fdness. 3) Provide training and necessary equipment including travel and housing for our 3 Athlete Congress representatives and 1 Athlete mentor for the Athlete Congress in August 2007. 4) Increase the total number of athletes being provided services by Special East Hawaii by an overall 10% by June 2007. Seeking Outreach to establish a Special Olympic East Hawaii Delegation in Keaau Area. 5) Continue with our 2 family activities for 75 family members that will be conducted by our family committee by June 2007. 6) Provide transportation to 120 athletes, coaches, special partners 3 times per year so they may travel to state competitions to compete with their peers to be completed by June 2007. Program Highlights: 1) Achieved goal of 4 Basketball Teams, thereby improving several more athletes health through better cardiovascular activities. 2) Provided in Oct. 2006 Area Bowling Tournament for the Unified Bowling Program. Which provided our athletes another opportunity to interact with their non-handicapped peers within the community 3) Provided special events for our family members throughout the year. Family Picnic & Dinner /Dance. 4) Continued to develop ttie Area Management Team which helps to coordinate all activities for the Special Olympics East Hawaii Program. 5) Continued to develop the Area Fundraising Team which helps to seek new fundraising idea and implement fundraising activities for the Special Olympics East Hawaii Program. 6) Continued to provide community activities to beautify our community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 7) Conducted a very successful athletic training program for 153 Special Olympics athletes. 8) Conducted 3 major athletic competitions (April Area Track & Field and Troy Barboza Torch Run with the County of Hawaii Police Dept. /October Two day Area Individual Bowling & Unified Bowling Tournament / November Weinberg Area Basketball Toumament) 9) Provided additional training for our Games Management Team who coordinates all competRons for East Hawaii. 10) Continued our 3 year Program Development program highlighting program goals, fundraising goals and objectives for Special Olympics East Hawaii Program. 11) Provided a specialized training for our Area Director in the Fundraising Area. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Special Olympics Hawaii -Agency Name Special Olympics Hawaii -East Hawaii -Program Name Performance Measures: FY 2004-05 FY 2005-06 F'Y 2006-07 Actual * Bud t * Estimate Athletes Numbers 139 140 150 Unified Partner Numbers 50 50 55 Volunteers 125 165 150 Famil Members 40 75 50 Mana ement Team 10 20 15 *If applicable Program Expenditures FY 200405 F=1( 2005-06 FY 2006-07 Actual * Bud t * Estimate Salaries and W es 2,959.20 $2,986.00 $3,000.00 Professional Fees 0 $2650.00 0 O erations $58,269.84 $82,239.00 $87,900.00 E ui ment $2,022.49 $1,750.00 $1,700.00 Other` Total $63,251.53 $89,625.00 $92,600.00 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Special Olympics Hawaii -Agency Name Special Olympics Hawaii-East Hawaii -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Coun of Hawaii Grant $5,500 $12,000 $12,000 Foundations $6,550 $14,000 $11,000 Individuals Contributions $4,730.76 $5,000 $5,000 Co orate Contributions $4,739.00 $6,400 $6,000 S cial Events $19,577.85 $49,200 $50,000 HSO Co-O Monies $9,319.20 $2,925 $3,000 Interest income $4.85 $100.00 $10 Merchandise Sale-East Hawaii $581.50 $590 Men;handisin -Other Sales $15,950.50 $5,000 Unde Red Recei is $1,552.25 $0 Total $68,505.91 $89,625.00 $92,600.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self~sustaining? Our Plans for 2006 to increase revenues to support our programs: We are implementing a Fundraising Program for each Delegations . 1) 2006 School Delegation will be applying for DOE Grant for their Program. 2) Delegation will participate in the Area's Major Fundraiser: a) Cop on Top b) Fire Truck Pull c) Torch Run d) Tip a Cop e) Champange & Diamonds 3) Delegations will be able to do their own fund-raisers to raise money to pay for: a) Un'rforms b) Bowling Fees c) Equipment NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 4) 4 major fund-raisers will be implemented. a) See's Candies b) Blane's Bento c) Snack Packs d) Car Washes 5) Utilizing a strong Fundraising Team to seek other revenue sources to fund our programs and establishing an Endowment Fund. 6) Special Olympic East Hawaii has always had a very diversified Fundraising effort to meet our financial obligations. We will continue to generate revenues in that manner. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 9 Special Olympics Hawaii -Agency Name Special Olympics Hawaii-East Hawii -Program Name I (we) have read and understood all of the elgibility requirements; grant conditions; award procedures; and records, reporting and fiscal acxountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofd Organizations. 1 (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, l (we) understand and will comply wHh the requirement tc submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. The report shall include an explanation of the public benefits deriived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure tho submit a timely. complete. and accurate vear~nd report will impact the evaluation of your progrem's or agency's future funding requests. ~~4~ttcc ~~~~u i ~~~(,~~oU Signature Board P sidentlChair Date 1.~~~G~ Sig ature Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Psge 10 Special Olympics Hawaii-West Hawaii - A ency Name SOWH General Funding- Program Name Agency Director: Nancy Bottelo Phone No.: 943- 8808 x 22 Contact Person: Ted Spitaleri Phone No.: 322-9976 Mailing Address: P.O. Box 390358, Keauhou, Hawaii 96739 Facility/Site Address: 77-187 Mahiehie Street, Kailua Kons, HI 96740 Fax No.: 322-6698 Email Address: ted@tccomputer.net Name of Accountant/CPA (include name of firm if applicable): Akamine, Oyadomari, and Kosaki CPA's Inc. Phone No.: 808 941-0500 Mailing Address: 440 Kapiolani Blvd. Suite 900 Honolulu, HI 96814 Amount of Request for County Funds: $10,000 Prior Year(s) Funding: 03-04 04-05 05-06 $5,000.00 $5,500.00 $5,500.00 Agency Mission Statement: The mission of Special Olympics is to provide year-round sports training and athletic competition in a variety of Olympic-type sports for all children and adults with intellectual disabilities, giving them continuing opportunities to develop physical fitness, demonstrate courage, experience joy and participate in a NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 sharing of gifts, skills and friendships with their families, other Special Olympics athletes and the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Special Olympics Hawaii-West Hawaii -Agency Name SOWH General Funding -Program Name Program Description: Special Olympics West Hawaii will continue our Outreach program in the coming year as well as continue to provide services to the current athletes who are training and competing. For our Outreach program we have targeted school age individuals and have been making contacts within schools in order to be able to reach out to the disabled community to find and work with individuals with intellectual disabilities. We added a new school to our program this last year however we realize there are many more to reach. West Hawaii was able to increase our athlete participation by over 20%. Our goal for the next year is to continue to focus the outreach programs on the school age population. Our growth will continue to be slow and steady so that we may provide a quality program without stretching resources too far. This long term goal includes a new school in the Kohala region and one in Ka'u. Special Olympics provides the necessary physical activity that special needs children and adults are rarely provided. In addition to the physical benefits these new athletes will receive, they will be given a chance to socialize and make new friendships. Special Olympics West Hawaii provides so many opportunities for the special needs individuals in our community to become productive citizens of our community. We provide them the opportunity to live "normal" lives within the community in which they live. Special Olympics conducts local competitions and training, we provide Holiday parties, hold local dances and picnics, and travel together to neighbor islands for competitions where dances and banquets are held. We have many athletes who have never traveled away from Kona until joining Special Olympics. We provide these individuals with a much larger view upon the world. Special Olympics West Hawaii helps more than the Special Olympics athlete, we reach out to the families, teachers, care givers, and communities. In Special Olympics, we are all 'Ghana. We provide an opportunity for parents to share their experiences with other families that desperately need to find encouragement and hope for their disabled child. We provide an opportunity for the care givers and teachers to see their clients active and accepted by their peers, and maybe most importantly, we provide an opportunity for the community of West Hawaii to experience the unique gift of sharing time and experiences with another member of their community, that is usually forgotten through our Volunteer program. Our Athlete Leadership Program helps to train our Special Olympics athletes to become leaders within our organization. This is a project that Special Olympics West Hawaii believes in strongly. We have athletes speaking to the Kona community all the time. It is a wondertul way for the community to get to know our athletes and accept them for who they are! Very unique individuals! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 In order for Special Olympics West Hawaii to provide this much needed service to the families and their special needs children, there are many expensive needs to be covered. As you know, the cost of the equipment for these athletes to train and compete in their given sport can be quite costly. Additional needs include ground transportation to practices and competition, air transportation to State competitions, uniforms, meals and awards. There are also mandatory training's for coaches and volunteers to attend in order to receive certification to work with Special Olympics athletes. Special Olympics Hawaii has been an accredited program of Special Olympics Incorporated since 1968. The West Hawaii Area Director, who will make contact through the school systems, newspaper, radio, television, adult facilities, etc., will coordinate the Outreach Project along with the Outreach Chairperson. Total Budget and Position Count Total Pro ram Bud et $55,000.00 Total Pro ram Position Count 1 Total A enc Bud et $1,082,272.02 Total A enc Position Count 18 Program Objectives: • Increase school participation in Kona District by 1 school • Increase athlete count by 10% total in the West Hawaii program. • Continue Unified Sports programs to involve more family members and general public. • Establish stable and functioning Kona • Train new delegations on ways to maintain current and recruit new athletes, coaches, and volunteers. • Provide financial support for new delegations • Provide quility activities for families and siblings. • Increase Athlete Leadership by training more Global Messengers (athletes trained in public speaking). • Continue providing high quality training and competition to the intellectually disabled individuals in the West Hawaii region. • Provide Athlete an opportunity to be involved with planning and attending social events • Increase the fund raising opportunities for SOWH NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Program Highlights: 1) Increased number of certified coaches in our program by 2. 2) Our program is almost completely coordinated by family members. This includes management team, coaches, and volunteers 3) Have family specific events and booths at competitions 4) Outreached to teachers at Teacher Institute Day. 5) Maintained and expanded relations with local adult center (Kona Krafts). 6) Contiue start working with AYSO VIP program 7) Extended the knowledge of what Special Olympics is all about through numerous press releases and other public education information 8) Trained and competed in 9 Special Olympics official sports. 9) Power lifting incresed from 3 to 7 athletes 10) Athletes who participate in bowling increased 11) With a staff addition we did more PR work 12) NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Special Olympics Hawaii-West Hawaii -Agency Name SOWH General Funding -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Community Service projects-Aid 7 8 8 Station State Com etitions on Oahu 3 3 3 Area/ Re Tonal Com etitions 8 8 8 Dele ations within school 2 3 3 Number of athletes within ro ram 42 50 52 Number of S ecial Partners 20 20 25 Number of Unified Softball Teams 1 1 1 Number of Unified Bowlin Teams 1 4 6 Number of Families actively 25 35 40 involved Number of Famil Events 6 8 8 'If applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 940.00 9600.00 9600.00 Professional Fees 0.00 0.00 0.00 O erations 13939.15 16000.00 17000.00 E ui ment 4958.87 6000.00 5500.00 Other" 23073.44 23400.00 24900.00 Total 51700.00 55000.00 57000.00 ` If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Special Olympics Hawaii-West Hawaii -Agency Name SOWH General Funding -Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii Non-Profit Grant 3000.00 5000.00 5000.00 Lar Mitchell Memorial Fund 2000.00 2000.00 2000.00 First Aide Stations 1500.00 1500.00 1500.00 Ironman Foundation 2000.00 1000.00 1000.00 Private Donations 2000.00 1739.40 2000.00 Merchandise Sales 1150.00 1227.57 1500.00 Fire Truck Pull 7000.00 00.00 7000.00 Co on To 15000.00 24000.00 25000.00 Silent Auction 500.00 00.00 1000.00 Cor orate Contributions 1900.00 3001.00 3500.00 Under ants Run 2000.00 2500.00 3000.00 Interest Income 49.00 40.39 40.00 SOHI Co-O Mone 2500.00 2500.00 2500.00 Total 40599.00 37507.96 52040.00 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Special Olympics West Hawaii is constantly increasing our database for fundraising purposes. Additional fundraising events involving individuals and corporations are in the planning stages to both increase revenues and awareness of the needs of our program. Due to the fact that it is our hope to grow our program so that more deserving individuals may benefit, becoming self-sustaining would be at least 5-10 years. It would be our hope that more corporate and individual contributions would help as well as additional fundraising/awareness events. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 7 Special Olympics Hawaii-West Hawaii -Agency Name SOWH General Funding -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. ~ ~ ~a~~o~ Signatur f Board resident/Chair Date ~ / ~ f~.~1 X.~i(T~--Y U ~ /'CJ~n Sig ature of xecutive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8 Turning Point for Families Inc. Hale Kahua Pa'a Transitional Housing Program Agency Director: Judy Segobia Phone No.: 808 935-8229 Contact Person: Judy Segobia Phone No.: 808 935-2735 Mailing Address: P.O. Box 612 Hilo, Hawaii 96720 Fax No.: (808) 935-8229 Email Address: admin2@ilhawaii.net CPA: Alex J Smith Phone No.: 877 257-6484 Mailing Address: 1403 Frank Street Honolulu, Hawaii 96816 Amount of Request for County Funds: $20,000.00 Prior Year(s) Funding: 03-04 04-05 05-06 $0 $0 $0 Agency Mission Statement: Turning Point for Families Inc. is a domestic violence agency that provides Shelter, Counseling, Education and Advocacy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Turning Point for Families, Inc. Hate Kahua Pa'a Transitional Housing Program Program Description: Perpetrators of domestic violence isolate their victims from family, friends, and community. These same perpetrators control the income, the household, and eliminate self-esteem, not only from their partners but their children as well. Victims of domestic violence have no idea how to manage funds and often time have never had access to funds, they lack social skills and are often times afraid of independence. 92% of the homeless women and children in the nation are homeless as a direct result of domestic violence (office on violence against women).Women that have become homeless and have assets as a result of the marriage (even if they have no access to the assets) are ineligible for transitional housing designated for the homeless. In addition, they are ineligible for financial assistance for the same reason. Because of contract restrictions victims of domestic violence are limited to a 90 days stay at and abuse shelter. Once victims have exhausted their 90 days they are left with two options, 1 they become homeless or 2 return to their perpetrator. Hale Kahua Pa'a (house on a stable foundation) is a 12-month transitional housing program designed to assist victims of domestic violence and their children rebuild their lives. The program goal is to assist victims and their children in gaining stability and independence while transitioning into aviolence- free lifestyle. Victims will transition from emergency shelters such West Hawaii Domestic Abuse Shelter, Hale Ohana (located in East Hawaii) and East Hawaii Coalition for the Homeless emergency shelter priority will be given in that order if the participant is eligible. The program will target victims with little or no resources or support system. Victims will receive support services to address the barriers to establishing income, housing, and independence. Each child will have an individual service plan that will address issues such as health, grades, after school activities, and tutoring. Total Budget and Position Count Total Pro ram Bud et $77,779.00 Total Pro ram Position Count 1.40 Total A enc Bud et 1748472.96 Total A enc Position Gount 39 Program Objectives: 1) Make available 12-months of affordable and safe transitional housing with extensions granted on a case by case basis. 2) Develop individualized safety plans with participant 3) Provide individual weekly case management meetings 4) Offer weekly life skill classes and support groups 5) Conduct individual safety planning for both adults and children within 7 days of intake. 6) Provide 6-months follow-up services NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Program Highlights: This is a new program and has no highlights from the previous year. However the program staff has worked hard to develop a comprehensive and well thought out program. They have developed a contract and all of the necessary documents to begin operation. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Short-term # of individuals rovided housin 0 0 14 # of service lans develo ed 0 0 14 # rovided case mana ement 0 0 14 # of safe lans develo ed 0 0 14 # of life skill classes 0 0 52 # of su ort rou s 0 0 52 Lon Term 1-12 months # secured income 0 0 6 # enrolled in education ro ram 0 0 3 # secured em to ment 0 0 3 # obtained ermanent housin 0 0 4 *If applicable This program is a long-term proyram. Some participants will transition quickly and others will require more than the 12-months offered. Program Expenditures FY 2004-OS FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es 0 $29,712.00 $29,712.00 Professional Fees 0 $4,487.00 $4,487.00 O erations 0 $42,030.00 $62,030.00 E ui ment 0 $1,550.00 $1,550.00 Other" 0 0 0 Total $77,779.00 $97,779.00 ` If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Turning Point for Families, Inc. Hale Kahua Pa'a Transitional Housing Program Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Office on Violence A ainst Women 0 $77,779.00 $77,779.00 Coun of Hawaii 0 0 $20,000.00 Pro ram Fees 0 0 0 Total $97,779.00 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Turning Point for Families, Inc. will seek funding for purchase of transitional housing units. In doing so it will eliminate much of the overhead costs associated with rent, deposits, etc. As anon-profit serving one of our most vulnerable population, who's income is non-existent or below the 30% median income it is difficult to generate revenue. However we will continue to look at new ideas and funding opportunities as they arise. Turning Point will seek support from Hawaii Community Development Corporation of Hawaii (HCDCH) homeless stipend program and the emergency Shelter Grant Program (ESG). Funding through these programs will not be available until fiscal year 2007-08. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Turning Point for Families Inc. Hale Kahua Pa'a Transitional Housing Program I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate vear-end report will imaact the evaluation of your arogram's or agencv's future funding requests. d ~ j.~L~ D~ Signature of Board PresidenUChair Date S' ture of iv Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Turning Point for Families, Inc. North Hawaii and Puna Groups Agency Director: Judy Segobia Phone No.: 808 935-8229 Contact Person: Judy Segobia Phone No.: 808 935-8229 Mailing Address: P.O. Box 612 Hilo, Hawaii 96720 Facility/Site Address: 1266 Kamehameha Ave. Suite AS Hilo, Hawaii 96720 Fax No.: 808 935-2573 Email Address: admin2@ilhawaii.net CPA: Alex J Smith Phone No.: 877 257-6484 Mailing Address: 1403 Frank Street Honolulu, Hawaii 96816 Amount of Request for County Funds: $30,000.00 Prior Year(s) Funding: 03-04 04-05 05-06 $8,000.00 $8,000.00 $30,000.00 Agency Mission Statement: To provide Shelter, Counseling, Education and Advocacy to promote a violence-free community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 Turning Point for Families, Inc. North Hawaii and Puna Groups Program Description: Turing Point for Families, Inc. (TPFFI) is seeking continued funding for the Kona/North Hawaii Alternatives to Violence Program (ATV); and the Puna AN groups. The ATV batterers groups are held in Waimea at Tutus House and in Keaau, in the district of Puna at the Ola'a Community Center. ATV is designed to assist batterers in changing their abusive behaviors, challenge their beliefs system, and taking personal responsibility for their abusive actions. Batterers learn to replace their abusive behaviors with positive behaviors. The benefits are: safety for family members, safety for neighbors, and community. In addition the program stops to the perpetuation of domestic violence, and provides an opportunity for abusers to become a positive role model, which results in a reduction for the need of societal interventions. The target population is the domestic violence batterers who reside in North Hawaii County and in the District of Puna who are being referred to ATV. These are batterers who lack or have no reliable transportation to travel to Kona or Hilo, and cannot afford childcare for the length of time it would take them to commute to Kailua-Kona or Hilo for their classes. The North Hawaii group encompasses the Honokaa, Waimea, Kohala, and Waikoloa areas. Group is held once a week at Tutu's House in Waimea on Monday evenings from 6pm to 8pm. The Puna groups encompass Pahoa, Keaau, Kurtis town, and Volcano. Groups are held for 2 hours from 6pm to 8pm at the Ola'a Community Center in Keaau. Psycho educational groups are used to deliver the information in a classroom style presentation. Interactive discussions are incorporated into the process with mandatory homework due for every class. Individual assessments are completed to test the participant's knowledge and understanding of the material during program participation. A pre/post testis administered prior to and at the completion of the program. Classroom participation is mandatory throughout the program. Sheltering the victim does not bring change to the behavior of the batterer. The program teaches participants, who are the abusers, to take accountability for their actions and abusive behavior. This is a justifiable expenditure of public funds, if the abuse continues, our children, families, and neighbors are at-risk of injury. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Total Budget and Position Count Total Pro ram Bud et 42,000.00 Total Pro ram Position Count 6.50 Total A enc Bud et 1,748,472.96 Total A enc Position Count 39 Program Objectives: The main objective for all ATV program's, is for participants to reduce or stop the use of physical violence towards their spouse and/or intimate partner. The objectives of the program are to: 1) 95% of participants in group will be violence free while in the program 2) 60% of participants who complete the 28 week program will reduce the frequency and severity of physical violence while in group. 3) 60% of participants who complete the program will have demonstrated an increased knowledge of power and control tactics. 4) 45% of participants who successfully complete group will remain violence free for 1 year after completion of group. Tracking participant's use of physical violence starts immediately. The methods used for tracking are as follows: • Self-reporting of violent acts and behavior is required and agreed to during enrollment into the ATV program. • Safety checks are conducted a minimum of once a month with the perpetrators victim prior to group so that the perpetrator (with the permission of the victim) can be confronted. (see attached form) • TPFFI staff collaborates and maintains contact with probation officers, sharing participant information in regards to violent incidences and other criminal activity. • TPFFI ATV staff attends court hearings on a weekly basis to report on non-compliance/compliance of program participation. Program Highlights: 1) On-site drug screening, assessments and treatment for all Turning Point for Families, Inc. participants 2) Securing site for the Puna groups 3) 25 Hours of Domestic Violence training for all staff. 4) Continued on-going training in the domestic violence field. 5) Turning Point for Families, Inc. enters into subsidiary agreement with Child and Family Services to strengthen services to victims of domestic violence NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Turning Point for Families, Inc. North Hawaii and Puna Groups Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et Estimate # of men served 82 991 164 # of Psycho-Educational Groups 52 974 156 for men who batter # rovided case mana ement 82 1,090 164 # of individuals com letin ro ram 65 172 130 *if applicable Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual Bud et" Estimate Salaries and Wa es $15,258.00 $266,478.56 $25,258.00 Professional Fees $1,500.00 $500.00 $1,500.00 O erations $25,722.00 $91,177.20 $35,722.00 E ui ment $0 $0 $0 Other* $0 $0 $0 Total $42,480.00 $358,155.76 $62,480.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Turning Point for Families, Inc. North Hawaii and Puna Groups Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-0ti FY 2006-07 Actual * Bud et * Estimate Coun of Hawaii $8,000.00 $40,885.00 $30.000.00 State of Hawaii $0 $581,341.00 $0 Federal $0 $104,377.00 $0 Private Foundations $0 $10,000.00 $0 Donations $0 $34,954.00 $0 Service/Pro ram Fees $34,480.00 $193,455.00 $54,000.00 Vendin $0 $0 $0 Fundraisin $0 $26,457.00 $0 Interest Income $0 $0 $0 *Other Income $0 $0 $0 Total $42,480.00 $958,574.00 $62,480.00 *If applicable Explain what plans, if any, your agency andlor program has to increase revenues to support this program. When do you anticipate your program to become selfsustaining? Turning Point for Families continually seeks funding to sustain all of the various programs that it provides to the residents of Hawaii County who accesses its services. We will seek an increase in funding from the Judiciary of Hawaii during the next RFP cycle. Human service programs by nature struggle to find consistent and reliable funding sources for the services that are so desperately needed by the members of our community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Turning Point for Families, Inc. North Hawaii and Puna Groups I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, 1 (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate vear-end report will impact the evaluation of your program's or agency's f~uture'funding requests. Signature of Board President/Chair Date Si ture of E ecutiv Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter Agency Director: Judy Segobia Phone No.: 808 935-8229 Contact Person: Judy Segobia Phone No.: 808 935-8229 Mailing Address: P.O. Box 612 Hilo, Hawaii 96720 Facility/Site Address: Confidential Location (safe housing) Fax No.: 808 935-2573 Email Address: admin2@ilhawaii.net CPA: Alex J Smith Phone No.: 877 257-6484 Mailing Address: P.O. Box 612 Hilo, Hawaii 96720 Amount of Request for County Funds: $22,000.00 Prior Year(s) Funding: 03-04 04-05 05-05 $21,000.00 $21,000.00 $22,000.00 1. Agency Mission Statement: To provide Shelter, Counseling, Education and Advocacy to promote a violence-free community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 _ Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter 2. Program Description: Turning Point for Families, Inc. (TPFFI), is seeking funds for the West Hawaii Domestic Abuse Shelter program. The West Hawaii shelter has been providing emergency shelter and services to victims of domestic violence and their children for more than a quarter of a century. We are the only battered women's shelter providing services to the districts of Kau, Captain Cook, Kealakekua, Kailua Kona, Waikoloa, Kohala, and Waimea. The West Hawaii shelter also provides services to victims fleeing their perpetrators on the East side of the Island. The main goal of the shelter is to provide 24-hour emergency shelter to battered adults and their children. Furthermore, the shelter provides a safe environment 365 days a year. In addition to Emergency shelter, the program provides the following: Emergency food pantry • Safe shelter for a maximum of 90 days 24 hours crisis hotline (information, referral, screening, and intake for the shelter) Peer counseling and support groups Advocacy Case Management Individualized safety planning Assistance with completing and filing of Temporary Restraining Orders Links to other TPPFI programs such as Alternatives to Violence, Youth Services, and the Children's Programs Shelter Transportation Childcare during shelter group's or individual counseling Children's program 3. Total Budget and Position Count Total Program Budget 368,155.00 Total Pro ram Position Count 11 Total Agency Budget 1 748 472.96 Total A enc Position Count 39 4. Program Objectives: Key Objectives for the program are as follows: 1. Provide 24 hour emergency shelter services for battered adults and their children. 2. Provide case management services, individual counseling, and group counseling to the victims of domestic violence to assist them in working 3. towards self-sufficiency and enable them to transition into aviolence-free life style. 4. Provide a 24-hour crisis hotline to assist persons with a domestic violence crisis, providing information, crisis counse?ing, and appropriate referrals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter Residents at the shelter are adults and children who have become homeless as a result of fleeing domestic violence. In addition the victims and their children do not have another safe place and/or confidential place to receive specialized support services. During the fiscal year 2004-2005 the shelter provided a total of 6246 bed nights, an increase of 2705 bed night's from the previous year. Outcome Indicator Initial outcomes 24-hour access to emergency shelter Number of domestic violence victims and crisis counseling for battered adults provided intake and assessment. and their children. Increased knowledge of the legal system, Education on the legal system and number of residents filing Temporary options available to protect them and Restraining Orders. (Documentation in their children. client files). Intermediate Outcomes Short-term and long-term goal setting for Service plans developed. Goals being adult victims and their children. achieved. (Documentation in client files) Case Management, individual and group 2. Clear understanding of the dynamics of counseling sessions. domestic violence and the impact on their children. (Client evaluations) Long-Term Outcomes Transition into a violence free and Percentage of clients who report violence healthy lifestyle. free transition. (Follow-up documentation in client file) Children understand that domestic violence is a choice. Children can articulate verbally that domestic violence is not ok. (Observation during children's groups and documented in client file 5. Program Highlights: Successfully provided shelter services to 159 adults and 195 children who were victims of domestic violence in need of emergency shelter and services. Successful completion of the ADA renovations. Through the support of community members, businesses, and the USDA the wheel chair ramp has been completed. Renovations to the shelter have been an ongoing process however the ramp has been a challenge to complete. With the growth in West Hawaii it was difficult to find contractors to even give an estimate of the cost associated with the completion. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter However, in true shelter fashion, the staff was not going to give up until the ramp was completed. Utilizing favors, family resources, and volunteers the job was completed. The ramp was inspected by the USDA and passed with flying colors. • The Fairmont Orchid, who has adopted the West Hawaii Shelter, sponsored its annual Mothers Day Brunch. Both residents and staff of the shelter were invited to partake in the meal. • The Central Union Church provided a wonderful dinner at the shelter the Saturday prior to Mothers Day. They served dinner to all of the residents and the staff on duty that day. 6. Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate 1. # of bed ni hts 6246 4068 4068 2. # of group service sessions (hours) 841 416 416 3. # of rou service reci Tents 407 200 200 4. # of individual session hours 2047.75 1500 1500 5. # of adults receiving individual service hours 159 100 100 6. # of children receiving individual sessions 187 130 130 7. # of outreach hours 173.11 234 234 8. # of follow-up hours 172.84 234 234 9. # of hotline crisis calls 121 210 210 10. # of referrals 477 465 465 11. # of van tri s b staff for clients 185 260 260 'if applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter 7. Program Expenditures FY 2004-OS FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $266,478.00 $333,047.00 $266,478.00 Professional Fees $13,553.00 $4,300.00 $500.00 O erations $78,124.00 $174,472.00 $101,177.00 E ui ment 0 $4,700.00 $0 Other" 0 $0 $0 Total $358,155.00 $517,519.00 $368,155.00 ` If applicable "Please explain in detail on separate sheet 8. Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii $21,000.00 $22,000.00 $22.000.00 State of Hawaii $95,424.00 $166,904.00 $95,424.00 Federal $177,509.00 $114,909.00 $177,509.00 Private Foundations $0 $40,125.00 $0 Donations $14,000.00 $131,287.00 $14,000.00 Service/Pro ram Fees $10,000.00 $10,000.00 $10,000.00 Vendin $0 $0 $0 Fundraisin $7,000.00 $29,086.00 $10,000,00 Interest Income $3,000.00 $0 $0 *Other Income HIUW $30,000.00 $30,000.00 $30,000.00 Total $357,933.00 $513,311.00 $368,155.00 `If applicable 9. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? It is difficult to say when the emergency shelter will become self-sustaining, those who access the program have no income or receive income that is below the 30% median. However, Turning Point for Families has become a subsidiary of Child and Family Services, Child and Family Services has a longstanding reputation in the State of Hawaii and is the first social service agency to provide services to families who are at- risk. They provide a wide array of programs to our communities state-wide. As we embark on this relationship we will keep funder's, such as the County Human Service Program, abreast of the changes and resources available to TPFFI. Please be assured that every effort to become sell-sustaining will be made. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 Turning Point for Families, Inc. West Hawaii Domestic Abuse Shelter I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, 1(we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely complete and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair Date S~ nature of xecutive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 West Hawaii Mediation Center Mediation Services Agency Director: Deborah Chai phone No.: 885.5525 Contact Person: Deborah Chai Phone No.: 885-5525 Mailing Address: PO Box 7020, Kamuela, HI 96743 FacilitylSite Address: 65-1279 Kawaihae Rd., Ste. 217, Kamuela, H196743 Fax No,: 887-0525 Email Address: westhimed001(~hawaii.rr.com Name of AccountantlCPA: John Carbonaro Carbonaro CPA's Phone No.: 808-242-5002 Mailing Address: 1885 Main Street, Suite 408, Wailuku, HI 98793 Amount of Request for County Funds: $1D,000.00 Prior Year(s) Funding: 03-04 OiN~ 05-06 ssooo.oo saooo.oo X5000.00 Agency Mission Statement: West Hawaii Mediation Center exists to improve the way people deal with conflict by providing mediation, facilitation, conflict resolution education and training services. Program Description: The funds are requested to support West Hawaii Mediation Center (WHMC} which serves the districts of Hamakua, North & South Kohala, North 8 South Kona, and Ka'u. WHMC provides community-based mediation services for both self-referred and court/legal system referred clients. These servloss are provided in an accessible and affordable manner to ensure any and all disputes in West Hawaii can be resolved in a safe, fair and appropriate way without the expense (time and money) of litigation. WHMC utilizes trained community volunteers to deliver this vital service to their fellow community members. Total Budget and Position Count Total P ram Bud t 90,000 Total Pr ram Position Court 1.25 Total A enc Bud et 120,000 Total A nc Position Count 1.7' NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 1 West Hawaii Mediation Center Mediation Services Program Objectives: 1) Provide information and referrel services to individuals who need services instead of, or in addition to, the mediation services offered et WHMC. 2) Recruit, train and retain high quality volunteer community mediators. 3) Provide mediation services in an affordable and accessible manner for disputes arising both in and out of the courNegal system. 4) Offer mediation services for a wide array of dispute issues including neighbor-neighbor, divorce (property division, finances, parenting plans), landlord-tenant, consumer- merohaM, real estate, small dafms, condominium, dvil rights, spedal education, vidim- offender, and communfty issues. 5) Provide adequate case management services to adequately serve all referred cases. B} Provide community outreach and education around constructive conflid resolution practices. Program Highlights: 1) Delivered 1,665 hours of case intake services. 2) Served 248 cases (83% courUlegal system refereed; 37°~ self-refereed) with 619 dients Served. 3) Utilized 41 volunteer mediators in 133 mediation sessions for a total of 423.7 hours of mediation. 4) Reached full agreement in 52% of cases mediated. 5) Achieved a 89% service satisfaction rating by respondents (post-mediation satisfaction survey). 6} Achieved a 95% rating by respondents indicating that they would recommend mediation to others in the future. 7) Provided 45% of total services to low income dients (annual income under $20,625}. Performance Measures: Flt 2004-05 FY 2006-06 FY 2005-06 Actual• Bud et' Estimate" Case Mana ement Hours 1865 1885 1665 Mediation Cases Served 248 250 260 Mediation Sessions Conducted 123 150 156 A regiments reached in mediation 52% 80% 70% Clients' satisfied with service 89°,6 90% 90% Client's willing to recommend service to 95% 95% 95% others Skills enhancement trainings offered for 7 8 8 volunteers Afforciable service to low income (°kof 45% 45% 45% clients considered low income Community Awareness and Education 5 8 8 Sessions `If applicable NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 West Hawaii Mediation Center Mediation Services Program Expenditures: FY 2004-05 FY 2005-06 FY 2006-07 Actual" Bud eY Estimate Salaries and Wa es 85,547.88 55,190.00 81,000.00 Professional Fees 272.50 O ralions 20,497.31 22,300.00 28,000.00 E ui ent 2,500.00 1,000.00 OtheP Total 88,559.87 79,990.00 90,000 "Please explain in detail on separate sheet Program Funding Sources: Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual " Bud et' Estimate Count of Hawaii 4,000.00 5,000.00 10,000.00 State of Hawaii 45,000.00 47,822.00 47,622.00 Private Foundations 3,000.00 1,000.00 2,000.00 Donations 14,110.00 13,000.00 13,000.00 Fundreisin 5,692.14 5,000.00 8,500.00 Service/P ram Fees 8,887.50 4,500.00 8,000.00 Client Private fees 5,170.00 4,000.00 8,000.00 Total 88,839.84 80,122.00 91,122.00 "If applicable Future Program Support: As our services are offered at no cost to those unable to affoni it, it is difficuh to rely on service fees to help support our program. This year, however, we saw a 30% increase in our caseload, and an increase in monies received from these services. We are looking at increasing our facilitation services, and are currently in the process of providing a 15 hour comprehensive facilitation training in January 2008 in order to staff ourselves accordingly. The fees for these services will provide revenue to the mediation center. Many of our programs are gran! funded, so we will continue to look and request for funding from various grants sources. This year we will be requesting funding from Hawaii Island United Way, which is the first time we have utilized this resource. We are also in the process of researching a major fundraising event to raise money as well as awareness of our Center and its services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 West Hawaii Mediation Center Mediation Services I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. H awarded a grant from the County of Hawaii, 1(we) understand and will comply wkh the requirement to submit a yearend report to the Legislative auditor within 60 davs aRer June 30 of the fiscal veer. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all ezpendhures supported by County of Hawaii grant funds, and a listing of other funding sources and amourits obtained during the award period. Failure to submit a timely. complete. and a~rrurate vear~nd report will impact the evaluation of vour program's or aaencv's future funding requests. Q/ r ~ a® 6~ Si ature of Boa PresidenUChair ate ~6 Signature of ExecuO a Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 YWCA of Hawaii Island- Agency Name Empowering Alternatives Program- Program Name Agency Director: Cynthia Albers Phone No.: 935-7141, ext 102 Contact Person: Lorraine Davis Phone No.: 935-7141, ext 103 Mailing Address: 145 Ululani Street, Hilo, HI 96720 Facility/Site Address: East Hawaii - 197 Kinoole Street, Hilo, HI 96720 West Hawaii - 75-5759 Kuakini Hwy., Kailua-Kona, HI 96740 Fax No.: 935-5150 Email Address: Cynthia Albers - calbers@ywcahawaiiisland.org; Lorraine Davis - Idavis@ywcahawaiiisland.org Name of Accountant/CPA (include name of firm if applicable): Tekata, Iwata, Hara and Associates Phone No.: 935-5404 Mailing Address: 101 Aupuni Street, Hilo, Hawaii 96720 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 03-04 04-05 05-06 $50,000 $46,000 $50,000 Agency Mission Statement: The YWCA is a women's membership movement nourished by its roots in the Christian faith and sustained by the richness of many beliefs and values. Strengthened by diversity, the YWCA draws together members who strive to create opportunities for women's growth, leadership and power in order to attain a common vision: peace, justice, freedom and dignity for all people. The YWCA will thrust its collective power toward the elimination of racism wherever it exists and by any means necessary. NONPROFTT GRANT APPLICATION FISCAL YEAR 200(x07 Page 1 YWCA of Hawaii Island -Agency Name Empowering Alternatives Program- Program Name Program Description: The Program's mission is to work to reduce the incidence of sexual assault on the Big Island and to reduce disability to those who have been victimized. The YWCA Empowering Alternatives (formerly known as the SAVE Program) operates a rape crisis center for the island of Hawaii. Skilled and supportive Crisis Workers provide phone support to callers on the 24-hour Sexual Assault Crisis Line, or offer face-to-face help in East and West Hawaii to sex assault victims who report the crime to the police. Crisis Workers function as team members with police investigators and sex assault forensic examiners (SAFE) in the Hawaii County Protocol for forensic examination of sex assault victims. A full-time masters-prepared Therapist is employed in Hilo and a 3/4-time masters-prepared Therapist is employed in Kailua-Kona to provide psychotherapy, case management and legal system advocacy by appointment or walk-in. Community professionals, the general public, and school-aged groups are helped to become aware of sexual assault suvivor needs, available services and prevention strategies through the Empowering Alternatives Program's community prevention education activities. The YWCA of Hawaii Island is now in our third decade of helping sex assault survivors, who are women and men, girls and boys. Primary funding of the program is through the State of Hawaii, Department of Health through a subcontract with the Kapi'olani Women's and Children Medical Center, Sex Assault Treatment Center (SATC). As a result, quality assurance, program and fiscal monitoring of services are maintained at state and industry established standards. If the County of Hawaii decides favorably for continued funding of the Empowering Alternatives Program, it can do so with the knowledge that professional standards are practiced in both service delivery and expenditure of funds. Total Budget and Position Count Total Pro ram Bud et 446,588 Total Pro ram Position Count 15 Total A enc Bud et 3,840,000 Total A enc Position Count 112 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 2 YWCA of Hawaii Island -Agency Name Empowering Alternatives Program- Program Name Program Objectives: 1) Continue to operate the 24-hour Crisis Hotline intercepting calls from person seeking support, information and referral that may lead to face-to-face support in Objective #2 below. 2) Provide an Empowering Alternatives Crisis Worker to support each sexual assault victim undergoing medical-legal examination in the period July 1, 2006 through June 30, 2007. 3) Deliver professional counseling and/or case management services to 100 sexual assault survivors. 4) Attend and participate in monthly case tracking and interagency team coordinator meetings of the East and West Hawaii Children's Justice Centers throughout the fiscal year. 5) Provide sexual assault awareness and prevention education to 500 school-aged students. 6) Provide education to 25 professionals about the needs of adult/child survivors of sexual assualt and methods to detect and report sexual child abuse or abuse of dependent adults. Program Highlights: 1) Three University of Hawaii, Hilo nursing students began their practicum for their senior community health seminar in January 2006 through the YWCA Empowering Alternatives Program. 2) Members of the Empowering Alternatives staff and YWCA administrators participated in the Children's Justice Center Interagency Advisory Committee meetings, the Big Island Coalition Against Physical and Sexual Assault meetings, the Hawaii Coalition Against Sexual Assault meetings. These committees or coalitions inGude the involvement by staff from the following agencies: The Hawaii County Police Department, Child Welfare Services, Office of the Prosecuting Attomey, OPA's Victim Assistance Counselor, Family Court, Juvenile Probation Officers, the Deputy Attomey General, Public Health Nurses, CAMH Division of the Department of Health, Department of Human Services, Department of Education and statewide service providers. These meetings foster consistent care thoughout the County and State for sexual assault services and working together as agencies to provide the best practices care for sexual assault survivors. 3) In April 2005, the program changed its name to Empowering Alternatives Program (EAp) to provide a more positive perception of our program and to remove "victim" and negative connotation from our program title. 4) In July 2005, the West Hawaii office was moved and is co-located with the YWCA Teen Court. This move has provided a reduction in expenses and provides the staff increased interagency support. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 3 YWCA of Hawaii Island -Agency Name Empowering Alternatives Program- Program Name 5) The West Hawaii Empowering Altematives Therapist position was vacated in April and other staff were on medical leaves. This resulted in the Gosure of the West Hawaii Alternatives office for approximately 2.5 months. During this time, services were not diminished due to the redirection of crisis calls and face-to-face interviews to the East Hawaii Empowering Altematives staff. The East Hawaii Therapist continued therapeutic services with the majority of Gients and provided referral for others. Fully staffed offices were re-opened on July 1, 2005. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 YWCA of Hawaii Island -Agency Name Empowering Alternatives Program -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Fully trained personnel are Phone line Phone line Phone line available to assess and respond to available 24 available 24 available 24 callers on the Sexual Assault hours/day, 365 hours/day, 365 hours/day, Crisis phone line. days/year daystyear 365 days/year served 377 estimated 350 estimated 350 callers calls calls Crisis counseling, legal systems 152 crisis 150 crisis 150 crisis advocacy, information and referral outreach outreach outreach are provided to each sex assault contacts contacts contacts victim undergoing medical-legal examination in East Hawaii and West Hawaii Survivors of sexual assault receive 173 suvivors 100 survivors 100 survivors psychotherapy services and intensive clinical case management from Empowering Alternatives masters level practitioners in East Hawaii and West Hawaii Preschool and school aged 412 students 500 students 500 students students receive sexual assault revention and awareness trainin Professional receive training in 34 professionals 25 25 awareness of needs of adult and professionals professionals child sexual assault survivors, how to detect and report child sexual abuse or sexual abuse of de endent adults `If applicable Pro ram Ex enditures FY 2004-05 FY 2005-08 FY 2006-07 Actual ` Bud * Estimate Salaries and Wa es 169,318.81 222,848.00 285,624.00 Professional Fees 0 3200.00 0 O erations 69,009.26 75,791.00 92,276.00 E ui ment 0 0 0 Othe 0 0 0 Total 238,328.07 301,839.00 357,900.00 * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 YWCA of Hawaii Island -Agency Name Empowering Alternatives -Program Name Program Funding Sources: Identify all funding sources (specrfc to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual ' Bud et ` Estimate Coun of Hawaii 46 000.00 50 000.00 60,000.00 State of Hawaii DoH-KWCMC 166,964.00 166,964.00 "*266,964.00 Federal Fundin -VAWA, VOCA 20,018.27 34,700.00 28,688.00 State of Hawaii DoH - fCWCMC 0.00 31,938.00 0.00 Rain Da Hawaii Island United Wa 5,684.00 0.00 0.00 Donations 1, 500.00 1,500.00 1,500.00 Total 240,166.27 285,102.00 357,152.00 In FY2006-07, request for funds from State of Hawaii DoH-KWCMC is increased by $100,000. Note: $2500 in restricted funds from previous years augments FY2005-06 budget. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustainingT The agency has co-located the West Hawaii office with the YWCA Teen Court to reduce expenses. Plans to co-locate the East Hawaii office with another YWCA program are being evaluated. State funding for sexual assault will be shifted from the Department of Health to the Attomey General's office beginning July 1, 2006. The Attomey General has submitted to the legislature a budget requesting an additional $1 million in funds be appropriated for statewide sexual assault core services. As a service provider, the YWCA has been supporting the efforts of our contractor (SATC) and the Attoney General's office in this endeavor through letter writing and information gathering in hopes that this increased appropriations for base-line services will fund the core Empowering Alternatives program and auxilliary funding will enhance or expand our services. As a result, we anticipate $100,000 increase to core funding from the State, which will lead to less reliance on Hawaii County for funding for core services. Other funding sources are being sought as well as evaluating the possibility of program service fees through third party billing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 YWCA of Hawaii Island -Agency Name Empowering Alternatives Program -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in ArtiGe 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein inGuding all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. ff awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 days after June 30 of the fiscal vear. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete. and accurate vear-end report will impact the evaluation of o r ro ram's or a enc 's future fundin re nests. Si na of Board President/Chair Date Si ure of F~cecutive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Pale 7 YWCA of Hawaii Island- Agency Name Hamakua Youth Center- Program Name Agency Director. Cynthia Albers Phone No.: 935-7141 Contact Person: Cynthia Albers Phone No.: 935-7141 Mailing Address: 145 Ululani St., Hilo, Hawaii 96720 Facility/Site Address: 45-3396 Mamane St. Honoka'a, Hawaii 96727 Fax No.: 935-5150 Email Address: calbers@ywcahawaiiisland.org Name of AccountanUCPA (include name of firm if applicable): Taketa, Iwata, Hara and Associates Phone No.: 935-5404 Mailing Address: 101 Aupuni St., Hilo, Hawaii 96720 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 03-04 0405 05-06 $5,500 $6,000 $10,000 Agency Mission Statement: 'The YWCA of Hawaii Island is a women's membership movement nurtured by its roots in the Christian faith and sustained by the richness of many beliefs and values. Strengthened by diversity, the Association draws together members who strive to cxeate opportunity for women's growth, leadership, and power in order to attain a common vision- Peace, justice, freedom and dignity for all people. The YWCA will thrust its collective power toward the elimination of racism wherever it exists and by any means necessary.' NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Paa;e 1 YWCA of Hawaii Island -Agency Name Hamakua Youth Center- Program Name Program Description: The YWCA Hamakua Youth Center has served the Honoka'a community since 1996 offering an array of programs and activities for youth, inGuding substance abuse prevention education, alternative activities and summer youth leadership camp. In response to a direct call from the citizens of the Hamakua community, our energies and resources are currently directed to one primary activity; the After-School Drop-In Center. The YWCA Hamakua Youth Center, located at 45-3396 Mamane Street in Honoka'a, is directly across the street from Honoka'a Middle and High Schools, making it readily accessible to students. The 900 square foot facility includes a social area, pool table, homework area and boasts a computer lab with 6 intemet connected workstations and several printers. During FY 2005-07, the non- renewal of a contract under ADAD prompted a program evaluation to learn how we would continue to respond to community needs. A brief closure in December 2005 elicited an outcry from the community: That being that the YWCA Hamakua Youth Center is vital and serves an important and otherwise unmet need. A citizen's advisory committee has re-activated to work in partnership with the YWCA to ensure the stability and continuance of the After-School Drop-In Center. The group is made up of independent citizens, representatives from agencies, businesses and civic groups, as well as several youth delegates, to assure that the youth perspectives guide direction and decisions. Total Budget and Position Count Total Pro ram Bud et $81,000 Total Pro ram Position Count 1.4 FTE Total A enc Bud et $3 840,000 Total A enc Position Count 112 . Program Objectives: The primary purpose of the YWCA Hamakua Youth Center is to reduce the risk factors and increase the protective factors influencing the behaviors of and outcomes for youth in Hamakua. The objectives are to: 1. Increase social bonding of youth with peers and adults 2. Reduce reckless or risky behaviors 3. Promote participation in activities that foster healthy choices 4. Delay the age of initiation to alcohol, tobacco and other drugs 5. Encourage parents to be more actively involved with youth 6. Build stronger community partnerships NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Pale Z _ YWCA of Hawaii Island -Agency Name Hamakua Youth Center- Program Name Program Objectives: (continued) Objectives #1-5 shall be measured by use of data from records of attendance and participation in YWCA Hamakua Youth Center programs and through a survey process to assess youth participants' behaviors and attitudes. Objective #6 will be measured by the number partnerships and the number of successful collaborative activities achieved by the groups. Targets established to measure success are stated in the table titled "Performance Measures". Program Highlights: 1) In 2005, the YWCA Hamakua Youth Center continued to provide the After- School Drop-In center with structured and unstructured activities for youth at no cost. Daily operations took place every day after school, during school breaks and in the summer months. Over 150 individual students have benefited as of 12/30/05. 2) After-school operation hours were expanded from 5:00 closure to 6:30 pm in December in direct response to requests by youth for longer hours. The center welcomes both genders who enjoy use of computers with Internet access, playing pool, listening to music, arts and crafts, or taking part in discussions on current events or topics relative to youth. The center provided literature geared to young adults with information on variety of subjects related to youth, such as dating, substance abuse, relationships, personal safety, higher education, and the like. The daily sign-in requires time-in and time-out notation by youth to assist staff in accountability of those in attendance. 3) Over 80°h of those attending are boys, prompting more activities that appeal to girls to be developed and presented. The CHOICES program for girls was provided to all 28 eighth grade girls from Honoka'a School during a 10 week session in Fall 2005. The goals of the program include providing anon-competitive teaming environment for girls devoid of the distractions generally associated with a mixed gender setting. Focus areas are computer skills, career planning /development and exploration of gender roles and the real or perceived limitations relative to gender. CHOICES will be presented in Spring semester of 2006 to 7"' or 9"' grade girls. Additionally, special events will be presented periodically to provide social and educational experiences that are distinctly female focused. CHOICES is supported through funding by the Hawaii Island United Way. NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Pale 3 YWCA of Hawaii Island -Agency Name Hamakua Youth Center -Program Name Program Highlights: (continued) 4) "Follow the Eyes of Youth° is the title of the traveling exhibit that was the culmination of this year's Photography Program. All 8"' grade boys from Honoka'a School took part in an 8 week course in both Darkroom and Digital photography. The students finished and framed their work which was presented as part of the traveling exhibit during July-September. The photography classes are instructed by two individuals who tailor the schedule to that of Honoka'a School, and was supported through funding from the Mclnerny Foundation and the Hawaii Tourism Authority, Product Enrichment Program. 5) Partnerships with other organizations and individuals who provide services to youth is being developed. Co-location at existing facility by the coordinator of the North Hawaii Coalition for Drug Free Hawaii is being evaluated and will potentially be implemented in February 2005. Other collaborative options are developing with Goodwill Industries, the Girls Academy and the Salvation Army. Strong support from the Power of Choice, Hamakua is evidenced by the mobilization of the Advisory Committee to the YWCA Hamakua Youth Center. Benefits of these relationships include enhanced networking and support among professionals who serve youth, and the building of a reputation so that youth know the YWCA Hamakua Youth Center as the place to go where caring adults can be counted on to help. 6) Unprecedented concern and response from the community following the brief closure in early December prompted a series of fortunate outcomes. These incude: The Power of Choice making a $1500 donation to support the center; County Council appropriation of $10,000 in emergency funding to reopen and reinvigorate the center; and introductions to many individuals with drive and commitment to foster our youth, two of whom were subsequently hired to staff the program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 4 YWCA of Hawaii Island -Agency Name Hamakua Youth Center -Program Name Performance Measures: FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Dail attendance b oath n/a 35 35 Total number of youth served n/a 120 170 annual) as of 12/30/05 Total number of waivers on file n/a 149 165 signed by parents Of youth as of 12/30/05 artici ants Total number of youth in 48 45 n/a Photo rah r ram Total number students in Project 123 n/a n/a Alert ADAD Surveys collected from youth with Na n/a 80 self-report on responsible vs. reckless or irres onsible behaviors surveys reporting an Increased Na n/a 80°~ or improved social bonding of youth with ears and adults °k surveys reporting no or reduced n/a n/a 70% reckless or risk behaviors surveys reporting no use of n/a n/a 50% alcohol, tobacco and other dru s surveys reporting limited use of Na n/a 25% alcohol, tobacco and other dru s Total number of partners and Na Na 12 su otters Total number of parents participants Na Na 20 (in special events, as partners, su otters or volunteer Total number of partner projects or Na Na 10 activities resented •ff applicable NONPROFTT GRANT APPLICATION FISCAL YEAR 2006-07 Page 5 YWCA of Hawaii Island -Agency Name Hamakua Youth Center -Program Name Program Expenditures FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Salaries and Wa es $63,702 30,500 46,437 Professional Fees 6944 6,128 8 663 0 rations 23,251 24,000 25,000 E ui ment 0 500 900 Other" 0 0 0 Total $93, 897 $61,128 $81, 000 ' If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2004-05 FY 2005-06 FY 2006-07 Actual * Bud et * Estimate Count of Hawaii 6,000 10,000 $50,000 Co of HI/HI Tourism Authori 3,866 1,134 0 Federal Funds, ADAD 75,000 0 0 Prosecuting Attorney, Emergency 0 10,000 0 Funds, Count of Hawaii Private Foundations 11,125 11,500 26,000 Hawaii Island United Wa 831 20,822 0 Donations 911 500 500 Pro ram Service Fee 0 50 0 Fundraising 0 0 1000 Cost Sharing, Occupancy 0 1400 3500 YWCA Support 0 3000 0 Total $97,733 **$58,406 $81,000 **Note: In FY 2005-06 we will expend $3,710 McInemy Foundation funds received and recognized in FY 200405. *If applicable '2005-06 Private Foundation Revenue Power of Choice $1,500 Kukio Foundation $5,000 Rotary of North Hawaii $5,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 6 YWCA of Hawaii Island -Agency Name Hamakua Youth Center -Program Name Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The YWCA Hamakua Youth Center is experiencing a radical shift in operations due to the loss of ADAD funding in 2005-06, resulting in the substantial increase in amount requested from Hawaii County. The YWCA is working cooperatively with a concerned and invested community to assure the continuance of the Youth Center, which is identified as a vital service by both youth and adults in the area. The Advisory Committee has begun the work of identifying potential funding sources for the YWCA Hamakua Youth Center for FY 2006-07 and beyond. The YWCA is encouraged by the community support and the promise to assure that youth have a safe place to gather. We anticipate that foundation funding will be secured in subsequent years such that the amount of funding requested from Hawaii County shall be reduced. Additionally, partnerships or co-location are informative stages, that will allow a sharing of certain operational expenses, thereby reducing total budget needed to operate the YWCA Hamakua Youth Center. A factor affecting the number of youth using the center is that it is free and assures that no child is turned away due to an inability to pay fees. Costs continue to rise in critical areas such as rent, insurance and competitive wages to assure quality staff, making a predictor of when the program will become self-sustaining a moving target. An investment of collateral, both human and financial,will likely be needed for some time in order to assure that opportunities that guide youth safely into adulthood are available. NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Pale 7 YWCA of Hawaii Island -Agency Name Hamakua Youth Center -Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that f (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. ff awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit ayear-end report to the Legislative auditor within 60 davs after June 30 of the fiscal veer. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures.supported by County of 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 ear~nd re rt will im act the evaluation of our ro ram's or a enc ' future fundin re uests. I -~S-O6 Si a of Board Presiderrt/Chair Date ature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2006-07 Page 8